Recommendations are based on low to moderate quality evidence or on consensus, but are well aligned with recommendations from international guidelines. The guideline working groups recommend that research efforts in relation to all aspects of management of LBP and LR be intensified.

Objectives To examine the outcomes of the Elderly Persons in the Risk Zone study, which was designed to evaluate whether it is possible to delay deterioration if a health‐promoting intervention is made when an older adult (≥80) is at risk of becoming frail and whether a multiprofessional group intervention is more effective in delaying deterioration than a single preventive home visit with regard to frailty, self‐rated health, and activities of daily living (ADLs) at 3‐month follow‐up. Design Randomized, three‐armed, single‐blind, controlled trial performed between November 2007 and May 2011. Setting Two urban districts of Gothenburg, Sweden. Participants Four hundred fifty‐nine community‐living adults aged 80 and older not dependent on the municipal home help service. Intervention A preventive home visit or four weekly multiprofessional senior group meetings with one follow‐up home visit. Measurements Change in frailty, self‐rated health, and ADLs between baseline and 3‐month follow‐up. Results Both interventions delayed deterioration of self‐rated health (odds ratio (OR) = 1.99, 95% confidence interval (CI) = 1.12–3.54). Senior meetings were the most beneficial intervention for postponing dependence in ADLs (OR = 1.95, 95% CI = 1.14–3.33). No effect on frailty could be demonstrated. Conclusion Health‐promoting interventions made when older adults are at risk of becoming frail can delay deterioration in self‐rated health and ADLs in the short term. A multiprofessional group intervention such as the senior meetings described seems to have a greater effect on delaying deterioration in ADLs than a single preventive home visit. Further research is needed to examine the outcome in the long term and in different contexts.

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Objective: To evaluate the socioeconomic impact of obesity by estimating the direct and indirect costs associated with obesity in Denmark, based on individual level data. Methods: Costs were assessed for different BMI groups, and the relative risks for change in direct and indirect costs per BMI point above 30 were estimated. A fourth analysis estimated the odds ratio for comorbidities per BMI point above 30. Individual data on income, social transfer payments, healthcare costs and diagnoses were retrieved from national registries. Results: One BMI point above 30 was associated with a 2% decrease in income, a 3% increase in social transfer payments, and a 4% increase in healthcare costs. In absolute numbers, income contributed to most of the total economic burden. One BMI point above 30 was also associated with increased comorbidity, which explains the increase in both direct and indirect costs. Conclusion: Obesity is associated with increased comorbidity, giving rise to an increase in both direct and indirect costs. Especially income is affected, which emphasizes the importance of including both measures when evaluating the total socioeconomic burden of obesity. Our findings draw attention to the potential for saving public resources and preventing loss of income by preventing obesity.

BackgroundIn the present study we analyze the relationship between body mass index (BMI) and waist circumference (WC) and future health care costs. On the basis of the relation between these anthropometric measures and mortality, we hypothesized that for all levels of BMI increased WC implies added future health care costs (Hypothesis 1) and for given levels of WC increased BMI entails reduced future health care costs (Hypothesis 2). We furthermore assessed whether a combination of the two measures predicts health care costs better than either individual measure.Research Methodology/Principal FindingsData were obtained from the Danish prospective cohort study Diet, Cancer and Health. The population includes 15,334 men and 16,506 women 50 to 64 years old recruited in 1996 to 1997. The relationship between future health care costs and BMI and WC in combination was analyzed by use of categorized and continuous analyses. The analysis confirms Hypothesis 1, reflecting that an increased level of abdominal fat for a given BMI gives higher health care costs. Hypothesis 2, that BMI had a protective effect for a given WC, was only confirmed in the continuous analysis and for a subgroup of women (BMI<30 kg/m2 and WC <88 cm). The relative magnitude of the estimates supports that the regressions including WC as an explanatory factor provide the best fit to the data.ConclusionThe study showed that WC for given levels of BMI predicts increased health costs, whereas BMI for given WC did not predict health costs except for a lower cost in non-obese women with normal WC. Combining WC and BMI does not give a better prediction of costs than WC alone.

There are no cost savings of bariatric surgery in the short run. Further real-world evidence over a longer period of time is needed to examine whether the higher health care costs will eventually be counterbalanced, making bariatric surgery a profitable intervention in a socio-economic perspective.

Our results indicate that smoking cessation programmes and a smoking ban in enclosed public places both in the short term and the long term are cost-effective strategies compared with the status quo.

Background: To examine the relationship between waist circumference and future health care costs across a broad range of waist circumference values based on individual level data. Method: A prospective cohort of 31,840 subjects aged 50–64 years at baseline had health status, lifestyle and socio-economic aspects assessed at entry. Individual data on health care consumption and associated costs were extracted from registers for the subsequent 7 years. Participants were stratified by presence of chronic disease at entry. Results: Increased waist circumference at baseline was associated with higher future health care costs. For increased and substantially increased waist circumference health care costs rise at a rate of 1.25% in women and 2.08% in men, per added centimetre above normal waistline. Thus, as an example, a woman with a waistline of 95 cm and without co-morbidities can be expected to incur an added future cost of approximately USD 397.– per annum compared to a woman in the normal waist circumference group, corresponding to 22% higher health care costs. Conclusions: Future health care costs are higher for persons who have an increased waist circumference, which suggests that there may be a potential for significant resource savings through prevention of abdominal obesity.