ObjectiveTo estimate the impact of the UK government’s sugar reduction programme on child and adult obesity, adult disease burden, and healthcare costs.DesignModelling study.SettingSimulated scenario based on National Diet and Nutrition Survey waves 5 and 6, England.Participants1508 survey respondents were used to model weight change among the population of England aged 4-80 years.Main outcome measuresCalorie change, weight change, and body mass index change were estimated for children and adults. Impact on non-communicable disease incidence, quality adjusted life years, and healthcare costs were estimated for adults. Changes to disease burden were modelled with the PRIMEtime-CE Model, based on the 2014 population in England aged 18-80.ResultsIf the sugar reduction programme was achieved in its entirety and resulted in the planned sugar reduction, then the calorie reduction was estimated to be 25 kcal/day (1 kcal=4.18 kJ=0.00418 MJ) for 4-10 year olds (95% confidence interval 23 to 26), 25 kcal/day (24 to 28) for 11-18 year olds, and 19 kcal/day (17 to 20) for adults. The reduction in obesity could represent 5.5% of the baseline obese population of 4-10 year olds, 2.2% of obese 11-18 year olds, and 5.5% of obese 19-80 year olds. A modelled 51 729 quality adjusted life years (95% uncertainty interval 45 768 to 57 242) were saved over 10 years, including 154 550 (132 623 to 174 604) cases of diabetes and relating to a net healthcare saving of £285.8m (€332.5m, $373.5m; £249.7m to £319.8m).ConclusionsThe UK government’s sugar reduction programme could reduce the burden of obesity and obesity related disease, provided that reductions in sugar levels and portion sizes do not prompt unanticipated changes in eating patterns or product formulation.
Aims: We used data from a recent systematic review to investigate weight regain after behavioural weight management programmes (BWMPs, sometimes referred to as lifestyle modification programmes) and its impact on quality-of-life and costeffectiveness.Materials and Methods: Trial registries, databases and forward-citation searching (latest search December 2019) were used to identify randomized trials of BWMPs in adults with overweight/obesity reporting outcomes at ≥12 months, and after programme end. Two independent reviewers screened records. One reviewer extracted data and a second checked them. The differences between intervention and control groups were synthesized using mixed-effect, meta-regression and time-to-event
Background Considered a “best buy” intervention to cope with the obesity burden, a tax on sugar-sweetened beverage (SSB) has been adopted in more than 40 countries. In Vietnam, a tax on SSBs has been proposed several times (most recently in 2017). This study aimed to estimate the health impacts of different SSB tax plans currently under discussion to provide an evidence base to inform decision-making about a SSB tax policy in Vietnam. Method Five tax scenarios were modelled, representing three levels of price increase: 5%, 11% and 19-20%. Scenarios of the highest price increase were assessed across three different tax designs: ad valorem, volume-based specific tax & sugar based specific tax. In each case we modelled SSB consumption in each tax scenario; how this reduction in consumption translates to a reduction in total energy intake and how this relationship in turn translates to an average change in body weight and obesity status among adults by applying the calorie-to weight conversion factor. Changes in diabetes type 2 diabetes burden were then calculated based on the change in average body mass index of the modelled cohort. A Monte Carlo simulation approach was applied on the conversion factor of weight change and diabetes risk reduction for the sensitivity analysis. Results While the impact of a 5% price increase arising from a tax was relatively small, increasing SSB’s price up to 20% appeared likely to impact substantially on national overweight and obesity rates. The greatest reduction in rates was observed for the population who were categorised as being overweight and obesity grade 1. The decline in overweight and obesity prevalence rates was slightly higher for women than men. Differences were evident across the three tax designs considered with a specific tax based on sugar density achieving greatest effects .
ObjectivesRates of overweight and obesity vary across England, but local rates have not been estimated for over 10 years. We aimed to produce new small area estimates of body mass index (BMI) by age and sex for each lower tier and unitary local authority in England, to provide up-to-date and more detailed estimates for the use of policy-makers and academics working in non-communicable disease risk and health inequalities.DesignWe used generalised linear modelling to estimate the relationship between BMI with social/demographic markers in a cross-sectional survey, then used this model to impute a BMI for each adult in locally-representative populations. These groups were then disaggregated by 5-year age group, sex and local authority group.SettingThe Health Survey for England 2018 (cross-sectional BMI data for England) and Census microdata 2011 (locally representative).ParticipantsA total of 6174 complete cases aged 16 and over were included.Outcome measuresModelled group-level BMI as mean and SD of log-BMI. Extensive internal validation was performed, against the original data and external validation against the National Diet and Nutrition Survey and Active Lives Survey and previous small area estimates.ResultsIn 94% of age–sex are groups, mean BMI was in the overweight or obese ranges. Older and more deprived areas had the highest overweight and obesity rates, which were particularly in coastal areas, the West Midlands, Yorkshire and the Humber. Validation showed close concordance with previous estimates by local area and demographic groups.ConclusionThis work updated previous estimates of the distribution of BMI in England and contributes considerable additional detail to our understanding of the local epidemiology of overweight and obesity. Raised BMI now affects the vast majority of demographic groups by age, sex and area in England, regardless of geography or deprivation.
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