Modeling the impact of calorie-reduction interventions on population prevalence and inequalities in childhood obesity in the Southampton Women's Survey
Modeling the impact of calorie-reduction interventions on population prevalence and inequalities in childhood obesity in the Southampton Women's Survey
Background: in the United Kingdom, rates of childhood obesity are high and inequalities in obesity have widened in recent years. Children with obesity face heightened risks of living with obesity as adults and suffering from associated morbidities. Addressing population prevalence and inequalities in childhood obesity is a key priority for public health policymakers in the United Kingdom and elsewhere. Where randomized controlled trials are not possible, potential policy actions can be simulated using causal modeling techniques.
Objectives: using data from the Southampton Women's Survey (SWS), a cohort with high quality dietary and lifestyle data, the potential impact of policy-relevant calorie-reduction interventions on population prevalence and inequalities of childhood obesity was investigated.
Methods: predicted probabilities of obesity (using UK90 cut-offs) at age 6–7 years were estimated from logistic marginal structural models adjusting for observed calorie consumption at age 3 years (using food diaries) and confounding. A series of policy-relevant intervention scenarios were modeled to simulate reductions in energy intake (differing in effectiveness, the targeting mechanisms, and level of uptake).
Results: at age 6–7 years, 8.3% of children were living with obesity, after accounting for observed energy intake and confounding. A universal intervention to lower median energy intake to the estimated average requirement (a 13% decrease), with an uptake of 75%, reduced obesity prevalence by 1% but relative and absolute inequalities remained broadly unchanged.
Conclusions: simulated interventions substantially reduced population prevalence of obesity, which may be useful in informing policymakers.
causal modeling, child and adolescent health, dietary interventions, health inequalities, obesity, Southampton Women's Survey
545-554
Russell, Simon J.
70fb8764-c6e0-49f2-a8fa-a6cf037340f9
Hope, Steven
a5d35d9a-53bf-4b5f-820c-94c137dbdf14
Croker, Helen
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Crozier, Sarah
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Packer, Jessica
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Inskip, Hazel
5fb4470a-9379-49b2-a533-9da8e61058b7
Viner, Russell M.
f3c28e2e-0950-4e7e-a368-39bb378b7f19
17 May 2021
Russell, Simon J.
70fb8764-c6e0-49f2-a8fa-a6cf037340f9
Hope, Steven
a5d35d9a-53bf-4b5f-820c-94c137dbdf14
Croker, Helen
8bcca9b8-d062-409b-9dea-2447c300d9fa
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Packer, Jessica
fb5370bd-1b3b-4a78-aae9-22ebd6b6d0cb
Inskip, Hazel
5fb4470a-9379-49b2-a533-9da8e61058b7
Viner, Russell M.
f3c28e2e-0950-4e7e-a368-39bb378b7f19
Russell, Simon J., Hope, Steven, Croker, Helen, Crozier, Sarah, Packer, Jessica, Inskip, Hazel and Viner, Russell M.
(2021)
Modeling the impact of calorie-reduction interventions on population prevalence and inequalities in childhood obesity in the Southampton Women's Survey.
Obesity Science and Practice, 7 (5), .
(doi:10.1002/osp4.520).
Abstract
Background: in the United Kingdom, rates of childhood obesity are high and inequalities in obesity have widened in recent years. Children with obesity face heightened risks of living with obesity as adults and suffering from associated morbidities. Addressing population prevalence and inequalities in childhood obesity is a key priority for public health policymakers in the United Kingdom and elsewhere. Where randomized controlled trials are not possible, potential policy actions can be simulated using causal modeling techniques.
Objectives: using data from the Southampton Women's Survey (SWS), a cohort with high quality dietary and lifestyle data, the potential impact of policy-relevant calorie-reduction interventions on population prevalence and inequalities of childhood obesity was investigated.
Methods: predicted probabilities of obesity (using UK90 cut-offs) at age 6–7 years were estimated from logistic marginal structural models adjusting for observed calorie consumption at age 3 years (using food diaries) and confounding. A series of policy-relevant intervention scenarios were modeled to simulate reductions in energy intake (differing in effectiveness, the targeting mechanisms, and level of uptake).
Results: at age 6–7 years, 8.3% of children were living with obesity, after accounting for observed energy intake and confounding. A universal intervention to lower median energy intake to the estimated average requirement (a 13% decrease), with an uptake of 75%, reduced obesity prevalence by 1% but relative and absolute inequalities remained broadly unchanged.
Conclusions: simulated interventions substantially reduced population prevalence of obesity, which may be useful in informing policymakers.
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Obesity Science Practice - 2021 - Russell - Modeling the impact of calorie‐reduction interventions on population
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Accepted/In Press date: 2 May 2021
e-pub ahead of print date: 6 May 2021
Published date: 17 May 2021
Additional Information:
Funding Information:
The authors are grateful to the participants in the Southampton Women's Survey (SWS) who have given their time to the study, and to the members of the SWS Study Group for all their work in collecting, processing, and managing the data. The authors would also like to thank colleagues and collaborators within the Obesity Policy Research Unit and the UCL Great Ormond Street Institute of Child Health. This report is independent research commissioned and funded by the National Institute for Health Research Policy Research Programme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health and Social Care or its arm's length bodies, and other Government Departments. The Southampton Women's Survey has been supported by the UK Medical Research Council, University of Southampton, Dunhill Medical Trust, British Heart Foundation, Food Standards Agency, British Lung Foundation, the NIHR Southampton Biomedical Research Centre, the European Union’s Seventh Framework Programme (FP7/2007‐2013), project EarlyNutrition (grant 289346), and European Union’s Horizon 2020 Research and Innovation Programme under grant agreement No 733206, 9.6 M€ (LifeCycle).
Publisher Copyright:
© 2021 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
causal modeling, child and adolescent health, dietary interventions, health inequalities, obesity, Southampton Women's Survey
Identifiers
Local EPrints ID: 453476
URI: http://eprints.soton.ac.uk/id/eprint/453476
ISSN: 2055-2238
PURE UUID: c6dfbd90-00ea-43d0-a525-275c9f781a2c
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Date deposited: 18 Jan 2022 17:37
Last modified: 18 Mar 2024 02:53
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Contributors
Author:
Simon J. Russell
Author:
Steven Hope
Author:
Helen Croker
Author:
Jessica Packer
Author:
Russell M. Viner
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