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Hou X, Anderson I, Burton-Mckenzie EJ. The value of lost output and cost of illness of noncommunicable diseases in the Pacific. HEALTH POLICY OPEN 2022. [DOI: 10.1016/j.hpopen.2022.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Three Growth Spurts in Global Physical Activity Policies between 2000 and 2019: A Policy Document Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073819. [PMID: 35409498 PMCID: PMC8997640 DOI: 10.3390/ijerph19073819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/28/2022]
Abstract
Non-communicable diseases (NCDs) contribute significantly to global mortality and are of particular concern in growing urban populations of low- and-middle income countries (LMICs). Physical inactivity is a key NCD determinant and requires urgent addressing. Laudable global and regional efforts to promote physical activity are being made, but the links between physical activity (PA), NCD reduction, and integrated intersectoral approaches to reducing obesogenic environments are not consistently made. This study applied a document analysis approach to global PA and NCD policies to better understand the current global policy environment and how this may facilitate integrated PA promotion. A total of 34 global policies related to PA, from different sectors, were analyzed. PA policy in mitigation of NCDs has evolved exponentially, with a progression towards addressing structural determinants alongside individual behavior change. The global PA agenda is primarily driven by the World Health Organization. Intersectoral collaboration is importantly regarded, but the contributions of other sectors, outside of health, education, transport, and urban planning, are less clear. Improving PA among key sub-populations-women, girls, and adolescents-requires greater policy consideration. It is imperative for PA-relevant sectors at all levels to recognize the links with NCDs and work towards integrated policy and practice in mitigation of the rising NCD pandemic.
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Essman M, Stoltze FM, Carpentier FD, Swart EC, Taillie LS. Examining the news media reaction to a national sugary beverage tax in South Africa: a quantitative content analysis. BMC Public Health 2021; 21:454. [PMID: 33676468 PMCID: PMC7937301 DOI: 10.1186/s12889-021-10460-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/17/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND South Africa was the first sub-Saharan African country to implement a sugar-sweetened beverage (SSB) tax called the Health Promotion Levy (HPL) in April 2018. Given news media can increase public awareness and sway opinions, this study analyzed how the media represented the HPL, including expressions of support or challenge, topics associated with the levy, and stakeholder views of the HPL. METHODS We performed a quantitative content analysis of online South African news articles related to the HPL published between January 1, 2017 and June 30, 2019. We coded the presence or absence of mentions related to health and economic effects of the HPL and HPL support or opposition. Prevalence of these mentions, overall and by source (industry, government, academics, other), were analyzed with Pearson χ2 and post-hoc Fisher exact tests. RESULTS Across all articles, 81% mentioned health, and 65% mentioned economics topics. 54% of articles expressed support, 26% opposition, and 20% a balanced view of the HPL. All sources except industry expressed majority support for the HPL. Health reasons were the most common justifications for support, and economic harms were the most common justifications for opposition. Statements that sugar intake is not related to obesity, the HPL will not reduce SSB intake, and the HPL will cause industry or economic harm were all disproportionately high in industry sources (92, 80, and 81% vs 25% prevalence in total sample) (p < 0.001). Statements that sugar intake is related to obesity and non-communicable diseases were disproportionately high in both government (46 and 54% vs 31% prevalence in total sample) (p < 0.001) and academics (33 and 38% vs 25% prevalence in total sample) (p < 0.05). Statements that the HPL will improve health and the HPL will reduce health care costs were disproportionately high in government (47% vs 31% prevalence in total sample) (p < 0.001) and academics (44% vs 25% prevalence in total sample) (p < 0.05), respectively. CONCLUSIONS Industry expressed no support for the HPL, whereas academics, government, and other sources mainly expressed support. Future studies would be improved by linking news media exposure to SSB intake data to better understand the effects news media may have on individual behavior change.
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Affiliation(s)
- Michael Essman
- Gillings School of Global Public Health, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Fernanda Mediano Stoltze
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Elizabeth C Swart
- Faculty of Community and Health Sciences, University of the Western Cape, Robert Sobukwe Rd, Bellville, Cape Town, South Africa
| | - Lindsey Smith Taillie
- Gillings School of Global Public Health, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Baugh Littlejohns L, Wilson A. Strengthening complex systems for chronic disease prevention: a systematic review. BMC Public Health 2019; 19:729. [PMID: 31185993 PMCID: PMC6558784 DOI: 10.1186/s12889-019-7021-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 05/21/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND While frameworks exist for strengthening health care systems and public health systems, there are no practical frameworks to describe, assess and strengthen systems for chronic disease prevention (CDP) using complex systems approaches. METHODS A systematic and integrative review of peer reviewed literature was conducted to answer the following questions: How can systems for CDP be defined? What are key attributes of effective systems? How are complex systems approaches discussed? Search terms were identified and the Medline, SCOPUS, and Global Health databases were searched December 2017 and January 2018. Reference lists and selected journals were hand searched. A working definition for a system for CDP was developed to provide a guideline for inclusion. Key exclusion criteria were literature did not address the research questions or working definition; was published in a language other than English and before 2000; focused on specific chronic diseases and/or risk factors and not CDP broadly; concentrated on the health care sector and clinical services and/or health status and surveillance data; and described evaluations of setting specific actions such as policies, programs, interventions, approaches, projects, laws, or regulations. Selected literature (n = 141) was coded in terms of the extent to which the research questions and the working definition of systems for CDP were addressed. Data was then analysed and synthesized to determine key themes. RESULTS A revised definition of systems for CDP and seven attributes of effective systems for CDP are reported (collaborative capacity, health equity paradigm, leadership and governance, resources, implementation of desired actions, information and complex systems paradigm). A framework was developed to provide a foundation for describing, assessing and strengthening systems for CDP. CONCLUSIONS The results of this literature review provide a strong foundation for a framework to help strengthen systems for CDP. The framework consolidates not only well-established attributes of effective CDP but also highlights theoretical and practical insights from complex systems perspectives.
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Affiliation(s)
- Lori Baugh Littlejohns
- Menzies Centre for Health Policy, The Australian Prevention Partnership Centre, D17 Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
| | - Andrew Wilson
- Menzies Centre for Health Policy, The Australian Prevention Partnership Centre, D17 Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
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Jaichuen N, Phulkerd S, Certthkrikul N, Sacks G, Tangcharoensathien V. Corporate political activity of major food companies in Thailand: an assessment and policy recommendations. Global Health 2018; 14:115. [PMID: 30466492 PMCID: PMC6249932 DOI: 10.1186/s12992-018-0432-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 11/04/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The food industry can influence individual and population level food consumption behaviours, shape public preferences and interfere with government policy on obesity prevention and NCDs. This paper identifies the Corporate Political Activity (CPA) of major food companies in Thailand which relate to obesity and NCDs. METHODS Using the INFORMAS framework to classify CPA, we reviewed publicly available information by 12 food companies between August 2011 and July 2016 in order to identify, analyse and classify the CPA contents. Semi-structured interviews with 17 key stakeholders who are experts in this field supplemented evidence from the document review. Data analysis applied a thematic approach. RESULTS Food industry in Thailand applied a variety of CPA strategies and practices. The two most common strategies were constituency building and information and messaging. CONCLUSION The diverse range of CPA strategies which influence government policy and public opinion can undermine efforts to prevent obesity and diet-related NCDs. We recommend systematic monitoring of their CPA, strengthening mechanisms to hold the food industry accountable for their role in protecting and promoting the nutrition and health of the population, introducing mandatory registration of lobbyists, mandatory disclosure of political donations, and stronger oversight of conflicts of interest among the government actors.
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Affiliation(s)
- Nongnuch Jaichuen
- International Health Policy Program (IHPP), Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000 Thailand
| | - Sirinya Phulkerd
- Institute for Population and Social Research Mahidol University Salaya, Nakhon Pathom, 73170 Thailand
| | - Nisachol Certthkrikul
- International Health Policy Program (IHPP), Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000 Thailand
| | - Gary Sacks
- Deakin University, Geelong, Australia, Global Obesity Centre, 221 Burwood Highway, Burwood, VIC 3125 Australia
| | - Viroj Tangcharoensathien
- International Health Policy Program (IHPP), Ministry of Public Health, Tiwanon Road, Nonthaburi, 11000 Thailand
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Newton A, Lloyd-Williams F, Bromley H, Capewell S. Food for thought? Potential conflicts of interest in academic experts advising government and charities on dietary policies. BMC Public Health 2016; 16:735. [PMID: 27495802 PMCID: PMC4975877 DOI: 10.1186/s12889-016-3393-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 07/27/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND A conflict of interest (CoI) can occur between public duty and private interest, in which a public official's private-capacity interest could improperly influence the performance of their official duties and responsibilities. The most tangible and commonly considered CoI are financial. However, CoI can also arise due to other types of influence including interpersonal relationships, career progression, or ideology. CoI thus exist in academia, business, government and non-governmental organisations. However, public knowledge of CoI is currently limited due to a lack of information. The mechanisms of managing potential conflicts of interest also remain unclear due to a lack of guidelines. We therefore examined the independence of academic experts and how well potential CoI are identified and addressed in four government and non-governmental organisations in the UK responsible for the development of food policy. METHODS Policy analysis. We developed an analytical framework to explore CoI in high-level UK food policy advice, using four case studies. Two government policy-making bodies: Department of Health 'Obesity Review Group' (ORG), 'Scientific Advisory Committee on Nutrition' (SACN) and two charities: 'Action on Sugar' (AoS), & 'Heart of Mersey' (HoM). Information was obtained from publicly available sources and declarations. We developed a five point ordinal scale based upon the ideology of the Nolan Principles of Public Life. Group members were individually categorised on the ordinal ConScale from "0", (complete independence from the food and drink industry) to "4", (employed by the food and drink industry or a representative organisation). RESULTS CoI involving various industries have long been evident in policy making, academia and clinical practice. Suggested approaches for managing CoI could be categorised as "deny", "describe", or "diminish". Declared CoI were common in the ORG and SACN. 4 out of 28 ORG members were direct industry employees. In SACN 11 out of 17 members declared industry advisory roles or industry research funding. The two charities appeared to have equally strong academic expertise but fewer conflicts. No HoM members declared CoI. 5 out of 21 AoS members declared links with industry, mainly pharmaceutical companies. We were unable to obtain information on conflicts for some individuals. CONCLUSIONS Conflicts of interest are unavoidable but potentially manageable. Government organisations responsible for policy development and implementation must institutionalize an approach to identify (disclose) and manage (mitigate or eliminate) perceived and actual CoI to improve public confidence in government decision-making relevant to food policy.
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Affiliation(s)
- Alex Newton
- Department of Public Health and Policy, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Ffion Lloyd-Williams
- Department of Public Health and Policy, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK.
| | - Helen Bromley
- Department of Public Health and Policy, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Simon Capewell
- Department of Public Health and Policy, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK
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Elliott-Green A, Hyseni L, Lloyd-Williams F, Bromley H, Capewell S. Sugar-sweetened beverages coverage in the British media: an analysis of public health advocacy versus pro-industry messaging. BMJ Open 2016; 6:e011295. [PMID: 27436666 PMCID: PMC4964256 DOI: 10.1136/bmjopen-2016-011295] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To assess the extent of media-based public health advocacy versus pro-industry messaging regarding sugar-sweetened beverages (SSBs). DESIGN We conducted a systematic analysis to identify and examine all articles regarding SSBs published in all mainstream British print newspapers and their online news websites from 1 January 2014 to 31 December 2014. We initially conducted a brief literature search to develop appropriate search terms and categorisations for grouping and analysing the articles. Articles were then coded according to the publishing newspaper, article type, topic, prominence and slant (pro-SSB or anti-SSB). A contextual analysis was undertaken to examine key messages in the articles. RESULTS We identified 374 articles published during 2014. The majority of articles (81%) suggested that SSBs are unhealthy. Messaging from experts, campaign groups and health organisations was fairly consistent about the detrimental effects of SSB on health. However, relatively few articles assessed any approaches or solutions to potentially combat the problems associated with SSBs. Only one-quarter (24%) suggested any policy change. Meanwhile, articles concerning the food industry produced consistent messages emphasising consumer choice and individual responsibility for making choices regarding SSB consumption, and promoting and advertising their products. The food industry thus often managed to avoid association with the negative press that their products were receiving. CONCLUSIONS SSBs were frequently published in mainstream British print newspapers and their online news websites during 2014. Public health media advocacy was prominent throughout, with a growing consensus that sugary drinks are bad for people's health. However, the challenge for public health will be to mobilise supportive public opinion to help implement effective regulatory policies. Only then will our population's excess consumption of SSBs come under control.
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Boulton J, Hashem KM, Jenner KH, Lloyd-Williams F, Bromley H, Capewell S. How much sugar is hidden in drinks marketed to children? A survey of fruit juices, juice drinks and smoothies. BMJ Open 2016; 6:e010330. [PMID: 27009146 PMCID: PMC4809069 DOI: 10.1136/bmjopen-2015-010330] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To investigate the amount of sugars in fruit juices, juice drinks and smoothies (FJJDS) marketed to children. DESIGN We surveyed the sugars content (per 100 ml and standardised 200 ml portion) of all FJJDS sold by seven major UK supermarkets (supermarket own and branded products). Only products specifically marketed towards children were included. We excluded sports drinks, iced teas, sugar-sweetened carbonated drinks and cordials as being not specifically marketed towards children. RESULTS We identified 203 fruit juices (n=21), juice drinks (n=158) and smoothies (n=24) marketed to children. Sugars content ranged from 0 to 16 g/100 ml. The mean sugars content was 7.0 g/100 ml, but among the 100% fruit juice category, it was 10.7 g/100 ml. Smoothies (13.0 g/100 ml) contained the highest amounts of sugars and juice drinks (5.6 g/100 ml) contained the lowest amount. 117 of the 203 FJJDS surveyed would receive a Food Standards Agency 'red' colour-coded label for sugars per standardised 200 ml serving. Only 63 FJJDS would receive a 'green' colour-coded label. 85 products contained at least 19 g of sugars-a child's entire maximum daily amount of sugars. 57 products contained sugar (sucrose), 65 contained non-caloric sweeteners and five contained both. Seven products contained glucose-fructose syrup. CONCLUSIONS The sugars content in FJJDS marketed to children in the UK is unacceptably high. Manufacturers must stop adding unnecessary sugars and calories to their FJJDS.
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Affiliation(s)
- Jane Boulton
- School of Dentistry, University of Liverpool, Liverpool, UK
| | - Kawther M Hashem
- Wolfson Institute of Preventive Medicine, Queen Mary, University of London, London, UK
| | - Katharine H Jenner
- Wolfson Institute of Preventive Medicine, Queen Mary, University of London, London, UK
| | | | - Helen Bromley
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Simon Capewell
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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Kovács E, Hunsberger M, Reisch L, Gwozdz W, Eiben G, De Bourdeaudhuij I, Russo P, Veidebaum T, Hadjigeorgiou C, Sieri S, Moreno LA, Pigeot I, Ahrens W, Pohlabeln H, Molnár D. Adherence to combined lifestyle factors and their contribution to obesity in the IDEFICS study. Obes Rev 2015; 16 Suppl 2:138-50. [PMID: 26707023 DOI: 10.1111/obr.12349] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 09/25/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND The Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study investigated the aetiology of childhood obesity and developed a primary prevention programme. METHODS Pre-intervention adherence to key behaviours related to childhood obesity, namely water/sweetened drink, fruit/vegetable consumption, daily TV time, physical activity, family time and adequate sleep duration, was measured at baseline. Adherence to international recommendations was converted into a composite score ranging from 0 (none) to 6 (adhering to all). Data on adherence were available for 7,444 to 15,084 children aged 2-9.9 years, depending on the behaviour. By means of multi-level logistic regression models adjusted for age, sex and country, we calculated odds ratios (OR) and 95% confidence intervals (CI) to estimate the relationship between adherence to these recommendations and the risk of being overweight/obese. RESULTS Adherence ranged from 15.0% (physical activity) to 51.9% (TV time). As adherence increased, a lower chance of being overweight/obese was observed; adhering to only one key behaviour (score = 1) meant an OR = 0.81 (CI: 0.65-1.01) compared with non-adherence (score = 0), while adhering to more than half of the key behaviours (score ≥ 4) halved the chance for overweight/obesity (OR = 0.54, CI: 0.37-0.80). Adherence to physical activity, TV and sleep recommendations was the main driver reducing the chance of being overweight. Overweight/obese children were more likely not to adhere to at least one of the recommended behaviours (19.8%) than normal-weight/thin children (12.9%) CONCLUSION The selected key behaviours do not contribute equally to a reduced chance of being overweight. Future interventions may benefit most from moving more, reducing TV time and getting adequate sleep.
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Affiliation(s)
- E Kovács
- Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary.,Institute for Medical Information Processing Biometrics and Epidemiology, German Centre for Vertigo and Balance Disorders, Ludwig Maximilian University, Munich, Germany
| | - M Hunsberger
- Section for Epidemiology and Social Medicine, University of Gothenburg, Gothenburg, Sweden
| | - L Reisch
- Department of Intercultural Communication and Management, Copenhagen Business School, Copenhagen, Denmark
| | - W Gwozdz
- Department of Intercultural Communication and Management, Copenhagen Business School, Copenhagen, Denmark
| | - G Eiben
- Section for Epidemiology and Social Medicine, University of Gothenburg, Gothenburg, Sweden
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - P Russo
- Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | - T Veidebaum
- National Institute for Health Development, Tallinn, Estonia
| | - C Hadjigeorgiou
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - S Sieri
- Department of Preventive and Predictive Medicine, Nutritional Epidemiology Unit, National Tumor Institute, Milan, Italy
| | - L A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
| | - I Pigeot
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany
| | - W Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany
| | - H Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - D Molnár
- Department of Paediatrics, Medical Faculty, University of Pécs, Pécs, Hungary
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Hendrie GA, Ullah S, Scott JA, Gray J, Berry N, Booth S, Carter P, Cobiac L, Coveney J. Past and projected trends of body mass index and weight status in South Australia: 2003 to 2019. Aust N Z J Public Health 2015; 39:536-43. [PMID: 26337728 DOI: 10.1111/1753-6405.12442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/01/2015] [Accepted: 05/01/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE Functional data analysis (FDA) is a forecasting approach that, to date, has not been applied to obesity, and that may provide more accurate forecasting analysis to manage uncertainty in public health. This paper uses FDA to provide projections of Body Mass Index (BMI), overweight and obesity in an Australian population through to 2019. METHODS Data from the South Australian Monitoring and Surveillance System (January 2003 to December 2012, n=51,618 adults) were collected via telephone interview survey. FDA was conducted in four steps: 1) age-gender specific BMIs for each year were smoothed using a weighted regression; 2) the functional principal components decomposition was applied to estimate the basis functions; 3) an exponential smoothing state space model was used for forecasting the coefficient series; and 4) forecast coefficients were combined with the basis function. RESULTS The forecast models suggest that between 2012 and 2019 average BMI will increase from 27.2 kg/m(2) to 28.0 kg/m(2) in males and 26.4 kg/m(2) to 27.6 kg/m(2) in females. The prevalence of obesity is forecast to increase by 6-7 percentage points by 2019 (to 28.7% in males and 29.2% in females). CONCLUSIONS Projections identify age-gender groups at greatest risk of obesity over time. The novel approach will be useful to facilitate more accurate planning and policy development.
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Affiliation(s)
| | - Shahid Ullah
- Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, South Australia
| | - Jane A Scott
- School of Public Health, Curtin University, Western Australia
| | - John Gray
- South Australian Health and Medical Research Institute
| | - Narelle Berry
- School of Nursing & Midwifery, Flinders University, South Australia
| | - Sue Booth
- School of Health Sciences, Flinders University, South Australia
| | - Patricia Carter
- Public Health and Clinical Systems, South Australian Department for Health and Ageing
| | - Lynne Cobiac
- CSIRO Food and Nutrition Flagship, South Australia
| | - John Coveney
- School of Health Sciences, Flinders University, South Australia
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Koutoukidis DA, Knobf MT, Lanceley A. Obesity, diet, physical activity, and health-related quality of life in endometrial cancer survivors. Nutr Rev 2015; 73:399-408. [PMID: 26011914 PMCID: PMC4477700 DOI: 10.1093/nutrit/nuu063] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Obesity, low-quality diet, and inactivity are all prevalent among survivors of endometrial cancer. The present review was conducted to assess whether these characteristics are associated with health-related quality of life (HRQoL). Electronic databases, conference abstracts, and reference lists were searched, and researchers were contacted for preliminary results of ongoing studies. The quality of the methodology and reporting was evaluated using appropriate checklists. Standardized mean differences were calculated, and data were synthesized narratively. Eight of the 4385 reports retrieved from the literature were included in the analysis. Four of the 8 studies were cross-sectional, 1 was retrospective, 1 was prospective, and 2 were randomized controlled trials. Obesity was negatively associated with overall HRQoL in 4 of 4 studies and with physical well-being in 6 of 6 studies, while it was positively associated with fatigue in 2 of 4 studies. Meeting the recommendations for being physically active, eating a diet high in fruit and vegetables, and abstaining from smoking were positively associated with overall HRQoL in 2 of 2 studies, with physical well-being in 2 of 3 studies, and with fatigue in 1 of 3 studies. Improvements in fatigue and physical well-being were evident after lifestyle interventions. The findings indicate a healthy lifestyle is positively associated with HRQoL in this population, but the number of studies is limited. Additional randomized controlled trials to test effective and practical interventions promoting a healthy lifestyle in survivors of endometrial cancer are warranted.
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Affiliation(s)
- Dimitrios A Koutoukidis
- D.A. Koutoukidis, A. Lanceley, and M.T. Knobf are with the Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK. M.T. Knobf is with the Acute Care/Health Systems Division, Yale University School of Nursing, New Haven, Connecticut, USA.
| | - M Tish Knobf
- D.A. Koutoukidis, A. Lanceley, and M.T. Knobf are with the Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK. M.T. Knobf is with the Acute Care/Health Systems Division, Yale University School of Nursing, New Haven, Connecticut, USA
| | - Anne Lanceley
- D.A. Koutoukidis, A. Lanceley, and M.T. Knobf are with the Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK. M.T. Knobf is with the Acute Care/Health Systems Division, Yale University School of Nursing, New Haven, Connecticut, USA
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Ananthapavan J, Sacks G, Moodie M, Carter R. Economics of obesity--learning from the past to contribute to a better future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:4007-25. [PMID: 24736685 PMCID: PMC4025046 DOI: 10.3390/ijerph110404007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 03/28/2014] [Accepted: 03/28/2014] [Indexed: 11/16/2022]
Abstract
The discipline of economics plays a varied role in informing the understanding of the problem of obesity and the impact of different interventions aimed at addressing it. This paper discusses the causes of the obesity epidemic from an economics perspective, and outlines various justifications for government intervention in this area. The paper then focuses on the potential contribution of health economics in supporting resource allocation decision making for obesity prevention/treatment. Although economic evaluations of single interventions provide useful information, evaluations undertaken as part of a priority setting exercise provide the greatest scope for influencing decision making. A review of several priority setting examples in obesity prevention/treatment indicates that policy (as compared with program-based) interventions, targeted at prevention (as compared with treatment) and focused “upstream” on the food environment, are likely to be the most cost-effective options for change. However, in order to further support decision makers, several methodological advances are required. These include the incorporation of intervention costs/benefits outside the health sector, the addressing of equity impacts, and the increased engagement of decision makers in the priority setting process.
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Affiliation(s)
- Jaithri Ananthapavan
- Deakin Health Economics, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
| | - Gary Sacks
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
| | - Marj Moodie
- Deakin Health Economics, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
| | - Rob Carter
- Deakin Health Economics, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
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