Modeling the impact of calorie-reduction interventions on population prevalence and inequalities in childhood obesity in the Southampton Women's Survey.

Simon J Russell,Hazel Inskip,Steven Hope,Helen Croker,Jessica Packer,Sarah Crozier,Russell M Viner

doi:10.1002/osp4.520

Simon J Russell, Hazel Inskip + Show 5 more

Open Access

https://doi.org/10.1002/osp4.520

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Abstract

BackgroundIn 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.ObjectivesUsing 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.MethodsPredicted 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).ResultsAt 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.ConclusionsSimulated interventions substantially reduced population prevalence of obesity, which may be useful in informing policymakers.

Highlights

In England, rates of childhood overweight and obesity remain high and, in 2019/2020, 23.0% of reception‐age school children (4– 5 years) were living with overweight or obesity.[1]
A simulation approach was applied, using the Southampton Women's Survey (SWS) cohort, to estimate the potential impacts of calorie reduction interventions on population prevalence and inequalities in childhood obesity. These analyses were carried out on younger age groups; prior work considered energy intake at age 7 years and impacts on obesity at age 11 years, whereas these analyses considered the mediator at age 3 years and the outcome at age 6–7 years
Calorie reduction interventions are a promising area for policy focus and may be helpful in tackling high rates of childhood obesity

Summary

Introduction

In England, rates of childhood overweight and obesity remain high and, in 2019/2020, 23.0% of reception‐age school children (4– 5 years) were living with overweight or obesity.[1] Children with obesity face heightened risks of living with obesity as adolescents and adults[2] and suffering from associated morbidities.[3] Socioeconomic disadvantage is a key determinant of childhood obesity,[4,5] and inequalities in obesity have widened in the United Kingdom in recent years.[1]. Addressing population prevalence and inequalities in childhood obesity is a key priority for public health policymakers in the United Kingdom and elsewhere and has been undertaken in various ways. Addressing population prevalence and inequalities in childhood obesity is a key priority for public health policymakers in the United Kingdom and elsewhere. Conclusions: Simulated interventions substantially reduced population prevalence of obesity, which may be useful in informing policymakers

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