Abstract
The global prevalence of obesity is rising rapidly, highlighting the importance of understanding risk factors related to the condition. Childhood obesity, which has itself become increasingly prevalent, is an important predictor of adulthood obesity. Studies suggest that the protein content consumed in infanthood is an important predictor of weight gain in childhood, which may contribute to higher body mass index (BMI). For instance, there is evidence that a lower protein infant formula (lpIF) for infants of overweight or obese mothers can offer advantages over currently-used infant formulas with regard to preventing excessive weight gain. The current study used health economic modelling to predict the long-term clinical and economic outcomes in Mexico associated with lpIF compared to a currently-used formula. A discrete event simulation was constructed to extrapolate the outcomes of trials on the use of formula in infanthood to changes in lifetime BMI, the health outcomes due to the changes in BMI and the healthcare system costs, productivity and quality of life impact associated with these outcomes. The model predicts that individuals who receive lpIF in infancy go on to have lower BMI levels throughout their lives, are less likely to be obese or develop obesity-related disease, live longer, incur fewer health system costs and have improved productivity. Simulation-based economic modelling suggests that the benefits seen in the short term, with the use of lpIF over a currently-used formula, could translate into considerable health and economic benefits in the long term. Modelling over such long timeframes is inevitably subject to uncertainty. Further research should be undertaken to improve the certainty of the model.
Highlights
The global prevalence of obesity has doubled in the last 30 years, with World HealthOrganization (WHO) estimates at approximately 10% in men and 14% in women [1]
(6+ years after school) and the rest are unskilled. *** Maternal smoking status is based on the percentage of female smokers in Mexico between the ages of 18 to 29. **** Standard deviation calculated from the lower protein infant formula trial. ***** The standard error is calculated based on the assumption that this variable is normally distributed with 95% of the area within 1.96 standard deviations of the mean
The model predicts that individuals who receive lower protein infant formula (lpIF) in infancy have lower body mass index (BMI) levels throughout their lives (Table 3)
Summary
The global prevalence of obesity has doubled in the last 30 years, with World Health. The differences in the content of breast milk and formula raised the possibility that re-adjusting the content of infant formula might help prevent rapid weight gain and obesity in infancy This has been demonstrated in a trial in Chile, in which infants whose mothers were overweight and who were predominantly formula-fed by three months were randomised either to lower protein infant formula (lpIF), low caloric density and probiotics included or to a currently-used formula [13]. A survey of infant feeding practices in Mexico between 1999 and 2006 suggested trends largely towards lower rates of breast feeding, especially among vulnerable groups, such as indigenous people [21] These findings suggest that preferential use of the lpIF over other formulas where mothers have stopped breastfeeding may confer significant benefits to their children, in Mexico and other settings. The current study used health economic modelling to investigate
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