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北京市儿童和青少年超重肥胖预防和治疗的投资回报:建模研究。

The Return on Investment for the Prevention and Treatment of Childhood and Adolescent Overweight and Obesity in Beijing: A Modeling Study.

机构信息

Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China.

Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing 100191, China.

出版信息

Nutrients. 2024 Sep 5;16(17):3006. doi: 10.3390/nu16173006.

Abstract

The increasing prevalence of child and adolescent overweight and obesity (CAOAO) in Beijing poses significant health and economic challenges. This study assesses the potential health and economic outcomes of implementing specific interventions to address CAOAO in Beijing. A deterministic Markov cohort model was used to estimate the impact of five interventions from 2025 to 2115: restrictions on unhealthy food marketing to children, mandatory front of package labeling (FOPL), family-based nutrition and exercise education, school-based nutritional health education, and nutritional counseling in primary healthcare. The model evaluated societal costs, healthcare savings, wages, and economic productivity in adulthood, calculating the return on investment (ROI) for each intervention and their combined effect. Without intervention, Beijing is projected to experience a loss of 13.4 million disability-adjusted life years (DALYs) due to CAOAO. The health and economic impact of childhood obesity in Beijing is projected to be CNY 14.6 trillion (USD 2.1 trillion), or a lifetime loss of CNY 6.8 million (USD 0.96 million) per affected child, exceeding the sum of Beijing's GDP from 2021 to 2023. Restrictions on unhealthy food marketing to children and nutrition counseling in primary healthcare are projected to yield the highest returns, with benefits accruing within one year of implementation. Owing to the substantial upfront costs, including personnel, materials, and training, school-based and family-based interventions require a longer time horizon to realize significant health and economic benefits. Effective management of CAOAO in Beijing demands a multifaceted approach. The combination of restrictions on unhealthy food marketing to children, mandatory front of package labeling, nutrition counseling in primary healthcare, school-based intervention, and family-based intervention presents the most substantial health and economic returns. This comprehensive strategy aligns with global best practices and addresses the unique challenges faced by Beijing in combating childhood obesity.

摘要

北京市儿童和青少年超重和肥胖(CAOAO)的患病率不断上升,给当地带来了重大的健康和经济挑战。本研究评估了实施特定干预措施来解决北京市 CAOAO 问题的潜在健康和经济效益。本研究使用确定性马尔可夫队列模型来评估从 2025 年到 2115 年实施以下五种干预措施的影响:限制向儿童推销不健康食品、强制实施食品标签前置、以家庭为基础的营养和运动教育、学校营养健康教育、初级保健中的营养咨询。该模型评估了社会成本、医疗保健储蓄、工资和成年后的经济生产力,并计算了每种干预措施及其综合效果的投资回报率(ROI)。如果不采取干预措施,预计北京市将因 CAOAO 而损失 1340 万残疾调整生命年(DALYs)。预计北京市儿童肥胖的健康和经济影响将达到 14.6 万亿元人民币(2.1 万亿美元),即每个受影响儿童的终生损失为 680 万元人民币(96 万美元),超过 2021 年至 2023 年北京的 GDP 总和。限制向儿童推销不健康食品和初级保健中的营养咨询预计将产生最高的回报,其收益将在实施后的一年内实现。由于人员、材料和培训等前期成本较高,基于学校和家庭的干预措施需要更长的时间才能实现显著的健康和经济效益。有效管理北京市的 CAOAO 需要采取多方面的方法。限制向儿童推销不健康食品、强制实施食品标签前置、初级保健中的营养咨询、学校干预和家庭干预相结合,将带来最大的健康和经济效益。这种综合策略符合全球最佳实践,并应对了北京市在应对儿童肥胖方面所面临的独特挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8ef/11396931/d0ea21d4acb0/nutrients-16-03006-g001.jpg

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