The case for investment in nutritional interventions to prevent and reduce childhood and adolescent overweight and obesity in Peru: a modelling study.

IF 5.6 1区 医学 Q1 NUTRITION & DIETETICS
Maria Elena Ugaz, Christina L Meyer, Angela M Jackson-Morris, Daphne Wu, M Michelle Jimenez, Carlos Rojas-Davila, Carlos Orlando Zegarra Zamalloa, Elizabeth F Ludwig-Borycz, D'Arcy Williams, Jo Jewell
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引用次数: 0

Abstract

Background: Between 2006 and 2016 the prevalence of overweight and obesity among children and adolescents aged 5-19 years in Peru increased from 22.7 to 27.0%. This investment case quantifies the economic impacts of childhood and adolescent overweight and obesity in Peru. It identifies and quantifies the potential impact of a set of new or expanded interventions that can strengthen current national efforts to prevent and reduce child and adolescent overweight and obesity.

Methods: A deterministic Markov cohort model with a societal cost perspective estimated reductions in mortality and morbidity from implementing interventions to prevent and reduce child and adolescent overweight and obesity and the impact in savings in healthcare costs and gains in wages and productivity. Interventions identified through a review of published literature includes a school-based social marketing campaign, exclusive breastfeeding promotion and support, a healthy food and drink policy for school premises, and a 20% subsidy on fruits and vegetables for people living below the national poverty line. The return on investment (ROI) was calculated along with the estimated cost savings associated with the interventions. Analysis was conducted to test ROI sensitivity to changes in the key parameters and assumptions.

Results: Between 2025 and 2092, the expected combined direct and indirect healthcare costs attributable to child and adolescent overweight and obesity in Peru are 210.6 billion USD. The direct healthcare costs are 1.8 billion USD, and the indirect costs are 208.8 billion USD. Expected savings for all interventions combined is 13.9 billion USD with a per-person savings of 12,089.8 USD. The expected ROI of the four interventions combined is 39.3 USD (30-years), 64.6 USD (50-years), and 164.1 USD (66-years) per one USD invested.

Conclusions: The overweight and obesity epidemic among children and adolescents in Peru requires wide-ranging and expanded implementation of policies to achieve long-term reductions in prevalence. This study's findings show that the four priority interventions have high ROIs and can be used to guide policy to address the complex interplay of factors that contribute to the obesogenic environment.

投资营养干预措施以预防和减少秘鲁儿童和青少年超重和肥胖的案例:一项模型研究。
背景:2006 年至 2016 年间,秘鲁 5-19 岁儿童和青少年的超重和肥胖患病率从 22.7%增至 27.0%。本投资案例量化了秘鲁儿童和青少年超重和肥胖症的经济影响。它确定并量化了一系列新的或扩大的干预措施的潜在影响,这些干预措施可以加强当前国家预防和减少儿童和青少年超重和肥胖症的努力:方法:采用确定性马尔可夫队列模型,从社会成本的角度估算了通过实施干预措施预防和减少儿童和青少年超重和肥胖症而降低的死亡率和发病率,以及节约的医疗成本和提高的工资及生产力的影响。通过查阅已发表的文献,确定的干预措施包括以学校为基础的社会营销活动、纯母乳喂养推广和支持、校舍健康食品和饮料政策,以及为生活在国家贫困线以下的人群提供 20% 的水果和蔬菜补贴。在计算投资回报率(ROI)的同时,还估算了与干预措施相关的成本节约情况。对投资回报率对关键参数和假设变化的敏感性进行了分析测试:2025 年至 2092 年期间,预计秘鲁儿童和青少年超重和肥胖症造成的直接和间接医疗成本合计为 2,106 亿美元。直接医疗成本为 18 亿美元,间接成本为 2,088 亿美元。所有干预措施加在一起预计可节省 139 亿美元,人均节省 12089.8 美元。每投入 1 美元,四项干预措施的预期投资回报率分别为 39.3 美元(30 年)、64.6 美元(50 年)和 164.1 美元(66 年):结论:秘鲁儿童和青少年超重和肥胖症的流行需要广泛和扩大政策的实施范围,以实现长期降低流行率的目标。这项研究的结果表明,四项优先干预措施具有很高的投资回报率,可用于指导政策,以解决导致肥胖的各种因素之间复杂的相互作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
13.80
自引率
3.40%
发文量
138
审稿时长
4-8 weeks
期刊介绍: International Journal of Behavioral Nutrition and Physical Activity (IJBNPA) is an open access, peer-reviewed journal offering high quality articles, rapid publication and wide diffusion in the public domain. IJBNPA is devoted to furthering the understanding of the behavioral aspects of diet and physical activity and is unique in its inclusion of multiple levels of analysis, including populations, groups and individuals and its inclusion of epidemiology, and behavioral, theoretical and measurement research areas.
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