Reduce Obesity Prevalence Research Articles

Lung cancer and obesity: A contentious relationship (Review).

The global obesity epidemic, attributed to sedentary lifestyles, unhealthy diets, genetics and environmental factors, has led to over 1.9 billion adults being classified as overweight and 650 million living with obesity. Despite advancements in early detection and treatment, lung cancer prognosis remains poor due to late diagnoses and limited therapies. The obesity paradox challenges conventional thinking by suggesting that individuals with obesity and certain diseases, including cancer, may have an improved prognosis compared with their counterparts of a normal weight. This observation has prompted investigations to understand protective mechanisms, including potentially favorable adipokine secretion and metabolic reserves that contribute to tolerating cancer treatments. However, understanding the association between obesity and lung cancer is complex. While smoking is the primary risk factor of lung cancer, obesity may independently impact lung cancer risk, particularly in non‑smokers. Adipose tissue dysfunction, including low‑grade chronic inflammation, and hormonal changes contribute to lung cancer development and progression. Obesity‑related factors may also influence treatment responses and survival outcomes in patients with lung cancer. The impact of obesity on treatment modalities such as chemotherapy, radiotherapy and surgery is still under investigation. Challenges in managing patients with obesity and cancer include increased surgical complexity, higher rates of postoperative complications and limited treatment options due to comorbidities. Targeted interventions aimed at reducing obesity prevalence and promoting healthy lifestyles are crucial for lung cancer prevention. The impact of obesity on lung cancer is multifaceted and requires further research to elucidate the underlying mechanisms and develop personalized interventions for prevention and treatment.

Trends and Patterns in Obesity-Related Deaths in the US (2010-2020): A Comprehensive Analysis Using Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Data.

Obesity is a significant public health issue in the United States, contributing to a range of chronic conditions and premature mortality. This study analyzes patterns in obesity-related deaths from 2010 to 2020 using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) databaseto identify trends and demographic disparities. A retrospective analysis was conducted using the CDC WONDER Database, focusing on mortality data associated with specific International Classification of Diseases, Tenth Revision (ICD-10) codes for obesity (E66.0, E66.1, E66.2, E66.8, and E66.9). Data were extracted for the period from January 1, 2010, to December 31, 2020. Mortality rates per 100,000 population were calculated and analyzed across different demographic groups, including age, gender, and race/ethnicity. The analysis revealed an overall increase in obesity-related mortality rates, rising from 1.8 per 100,000 in 2010 to 3.1 per 100,000 in 2020. Age-specific mortality rates showed a significant increase in older age groups, with the highest rates observed in individuals aged 55-64 years (6.4 per 100,000) and 65-74 years (7.2 per 100,000). Gender disparities were evident, with higher mortality rates in males (3.4 per 100,000) compared to females (2.8 per 100,000) by the end of the study period. Racial disparities were also noted, with Black or African American individuals experiencing the highest mortality rates (4.3 per 100,000). The study highlights a concerning upward trend in obesity-related mortality in the United States over the past decade, with notable disparities based on age, gender, and race. These findings underscore the need for targeted public health interventions and policies aimed at reducing obesity prevalence and its associated mortality. Further research should explore the underlying causes and contributing factors to these trends to develop effective strategies for obesity management and prevention. Among the notable strengths of this study include the observation that it leveraged a comprehensive and decade-long countrywide database with detailed and up-to-date ICD-10 codes and demographic data to offer in-depth insights into obesity-related disparities and mortality trends in the United States. Nevertheless, the findings of this study have been limited by its increased focus on the United States' data, depending only on mortality records devoid of consideration of morbidity, alongside the lack of detailed data on lifestyle factors and comorbid conditions.

Predictors of body image perceptions among healthcare providers in Terengganu, Malaysia

ObjectivesThe study's aim was to find predictors of body image perception scores among health care providers (HCPs) in Terengganu, Malaysia. MethodsA cross-sectional study among 201 health care providers (HCPs) was conducted from January to March 2023. This study participants were drawn from a pool of HCPs with a BMI of 25 kg/m2 or higher. Body image perceptions were scored using the Malay version of the Body Self-Image Questionnaire-Short Form. Multiple linear regression was used to determine the predictors of body image perception scores. ResultsAge and longer work hours correlate with higher body satisfaction among HCPs, while higher BMI lowers satisfaction. Nurses typically experience more height dissatisfaction. Higher income is associated with better self-ratings in looks, health, and fitness, but higher education correlates with poorer self-ratings. Married HCPs report lower attractiveness, health, fitness, and self-esteem but are more satisfied with their height. ConclusionThis situational analysis identifies predictors, such as sociodemographic factors and occupational aspects, that can aid in customising interventions to address specific body image concerns among HCPs, with the goal of reducing obesity prevalence among them.

Impact of mitigating obesity, smoking, and physical inactivity on type 2 diabetes mellitus burden in Oman: insights from mathematical modeling

IntroductionTo estimate the impact of reducing obesity, smoking, and physical inactivity (PIA) prevalence, and of introducing physical activity (PA) as an explicit intervention, on the prevalence, incidence, and mortality of...

Estimated reduction in obesity prevalence and costs of a 20% and 30% ad valorem excise tax to sugar-sweetened beverages in Brazil: A modeling study.

The consumption of sugar-sweetened beverages (SSBs) is associated with obesity, metabolic diseases, and incremental healthcare costs. Given their health consequences, the World Health Organization (WHO) recommended that countries implement taxes on SSB. Over the last 10 years, obesity prevalence has almost doubled in Brazil, yet, in 2016, the Brazilian government cut the existing federal SSB taxes to their current 4%. Since 2022, a bill to impose a 20% tax on SSB has been under discussion in the Brazilian Senate. To simulate the potential impact of increasing taxes on SSB in Brazil, we aimed to estimate the price-elasticity of SSB and the potential impact of a new 20% or 30% excise SSB tax on consumption, obesity prevalence, and cost savings. Using household purchases data from the Brazilian Household Budget Survey (POF) from 2017/2018, we estimated constant elasticity regressions. We used a log-log specification by income level for all beverage categories: (1) sugar-sweetened beverages; (2) alcoholic beverages; (3) unsweetened beverages; and (4) low-calorie or artificially sweetened beverages. We estimated the adult nationwide baseline intake for each beverage category using 24-h dietary recall data collected in 2017/2018. Taking group one as the taxed beverages, we applied the price and cross-price elasticities to the baseline intake data, we obtained changes in caloric intake. The caloric reduction was introduced into an individual dynamic model to estimate changes in weight and obesity prevalence. No benefits on cost savings were modeled during the first 3 years of intervention to account for the time lag in obesity cases to reduce costs. We multiplied the reduction in obesity cases during 7 years by the obesity costs per capita to predict the costs savings attributable to the sweetened beverage tax. SSB price elasticities were higher among the lowest tertile of income (-1.24) than in the highest income tertile (-1.13), and cross-price elasticities suggest SSB were weakly substituted by milk, water, and 100% fruit juices. We estimated a caloric change of -17.3 kcal/day/person under a 20% excise tax and -25.9 kcal/day/person under a 30% tax. Ten years after implementation, a 20% tax is expected to reduce obesity prevalence by 6.7%; 9.1% for a 30% tax. These reductions translate into a -2.8 million and -3.8 million obesity cases for a 20% and 30% tax, respectively, and a reduction of $US 13.3 billion and $US 17.9 billion in obesity costs over 10 years for a 20% and 30% tax, respectively. Study limitations include using a quantile distribution method to adjust self-reported baseline weight and height, which could be insufficient to correct for reporting bias; also, weight, height, and physical activity were assumed to be steady over time. Adding a 20% to 30% excise tax on top of Brazil's current federal tax could help to reduce the consumption of ultra-processed beverages, empty calories, and body weight while avoiding large health-related costs. Given the recent cuts to SSB taxes in Brazil, a program to revise and implement excise taxes could prove beneficial for the Brazilian population.

Predicting the prevalence of type 2 diabetes in Brazil: a modeling study.

We adopted a modeling approach to predict the likely future prevalence of type 2 diabetes, taking into account demographic changes and trends in obesity and smoking in Brazil. We then used the model to estimate the likely future impact of different policy scenarios, such as policies to reduce obesity. The IMPACT TYPE 2 DIABETES model uses a Markov approach to integrate population, obesity, and smoking trends to estimate future type 2 diabetes prevalence. We developed a model for the Brazilian population from 2006 to 2036. Data on the Brazilian population in relation to sex and age were collected from the Brazilian Institute of Geography and Statistics, and data on the prevalence of type 2 diabetes, obesity, and smoking were collected from the Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey (VIGITEL). The observed prevalence of type 2 diabetes among Brazilians aged over 25 years was 10.8% (5.2-14.3%) in 2006, increasing to 13.7% (6.9-18.4%) in 2020. Between 2006 and 2020, the observed prevalence in men increased from 11.0 to 19.1% and women from 10.6 to 21.3%. The model forecasts a dramatic rise in prevalence by 2036 (27.0% overall, 17.1% in men and 35.9% in women). However, if obesity prevalence declines by 1% per year from 2020 to 2036 (Scenario 1), the prevalence of diabetes decreases from 26.3 to 23.7, which represents approximately a 10.0% drop in 16 years. If obesity declined by 5% per year in 16 years as an optimistic target (Scenario 2), the prevalence of diabetes decreased from 26.3 to 21.2, representing a 19.4% drop in diabetes prevalence. The model predicts an increase in the prevalence of type 2 diabetes in Brazil. Even with ambitious targets to reduce obesity prevalence, type 2 diabetes in Brazil will continue to have a large impact on Brazilian public health.

Benefits managers’ attitudes toward obesity treatment coverage

Despite the existence of effective treatments, obesity continues to present a severe public health crisis. Limited access to treatments works against efforts to reduce obesity prevalence. A major barrier to treatment access is a lack of insurance coverage. This study focused on an important population of stakeholders: benefits managers. The purpose of this study was to explore the relationships between attitudes about insurance coverage of obesity treatments and obesity stigma. Benefits managers have the ability to advocate for insurance coverage of medical interventions. We assessed whether attitudes toward covering obesity benefits for employees could be modified by receiving targeted information or were associated with particular factors. We recruited participants from Dun & Bradstreet’s employer database using emails. Participants were randomized to one of three conditions that provided written information about: (1) prevalence of obesity (control), (2) prevalence + financial implications of obesity, and (3) prevalence + physiology of obesity. Questionnaires were self-administered online. The response rate was 4.8%, with 404 participants meeting eligibility criteria. While attitudes toward coverage of obesity interventions did not differ significantly based on condition (p > 0.05), gender, history of previous obesity treatment, and an individual’s likelihood to attribute obesity to biological and environmental factors showed significant associations with supporting coverage of obesity treatment (p < 0.05). Findings suggest that understanding obesity as a condition caused by biological factors as opposed to personal responsibility and behavior is associated with greater support for coverage of all its treatments.

Effect of calorie labelling in the out-of-home food sector on adult obesity prevalence, cardiovascular mortality, and social inequalities in England: a modelling study

England implemented a menu calorie labelling policy in large, out-of-home food businesses in 2022. We aimed to model the likely policy impact on population-level obesity and cardiovascular disease mortality, as well as the socioeconomic equity of estimated effects, in the adult population in England. For this modelling analysis, we built a comparative assessment model using two scenarios: the current implementation scenario refers to actual deployment only in large (≥250 employees), out-of-home food businesses, whereas the full implementation scenario refers to deployment in every out-of-home food business. We compared each scenario with a counterfactual: the scenario in which no intervention is implemented (ie, baseline). For both scenarios, we modelled the impact of the policy through assumed changes in energy intake due to either consumer response or product reformulation by retailers. We used data from the Office for National Statistics and the National Diet and Nutrition Survey 2009-19, and modelled the effect over 20 years (ie, 2022-41) to capture the long-term impact of the policy and provided mid-period results after 10 years. We used the Monte Carlo approach (2500 iterations) to estimate the uncertainty of model parameters. For each scenario, the model generated the change in obesity prevalence and the total number of deaths prevented or postponed. The current implementation scenario was estimated to reduce obesity prevalence by 0·31 percentage points (absolute; 95% uncertainty interval [UI] 0·10-0·35), which would prevent or postpone 730 cardiovascular disease deaths (UI 430-1300) of the 830 000 deaths (UI 600 000-1 200 000) expected over 20 years. However, the health benefits would be increased if calorie labelling was implemented in all out-of-home food businesses (2·65 percentage points reduction in obesity prevalence [UI 1·97-3·24] and 9200 cardiovascular disease deaths prevented or postponed [UI 5500-16 000]). Results were similar in the most and the least deprived socioeconomic groups. This study offers the first modelled estimation of the impact of the menu calorie labelling regulation on the adult population in England, although we did not include a cost-effectiveness analysis. Calorie labelling might result in a reduction in obesity prevalence and cardiovascular disease mortality without widening health inequalities. However, our results emphasise the need for the government to be more ambitious by applying this policy to all out-of-home food businesses to maximise impact. European Research Council.

Addressing the global obesity burden: a gender-responsive approach to changing food environments is needed.

Obesity is a leading cause of death and disability globally. There is a higher proportion of women living with obesity than men, with differences in prevalence rates between women and men particularly staggering in low- and middle-income countries. The food environments that most people live in have been defined as 'obesogenic', characterised by easy access to energy dense, highly palatable foods with poor nutritional value. There is an established need to intervene to change food environments to prevent obesity. However, minimal successes are evident with no country set to meet the WHO goal of reducing obesity prevalence to 2010 numbers by 2025. In this review, we provide a narrative around the sex (biological)- and gender (sociocultural)-related considerations for the relationship between nutrition, interactions with the food environment and obesity risk. We provide an argument that there are gendered responses to food environments that place women at a higher risk of obesity particularly in relation to food industry influences, due to gendered roles and responsibilities in relation to paid and unpaid labour, and due to specific food security threats. This review concludes with hypotheses for addressing the obesity burden in a gender-responsive manner, with a call for gender equity to be a key component of the development, implementation and monitoring of obesity prevention focused policies going forward.

Evaluating the Implementation of the Connect for Health Pediatric Weight Management Program

Adoption of primary care interventions to reduce childhood obesity is limited. Progress in reducing obesity prevalence and eliminating disparities can be achieved by implementing effective childhood obesity management interventions in primary care settings. To examine the extent to which implementation strategies supported the uptake of research evidence and implementation of the Connect for Health pediatric weight management program. This quality improvement study took place at 3 geographically and demographically diverse health care organizations with substantially high numbers of children living in low-income communities in Denver, Colorado; Boston, Massachusetts; and Greenville, South Carolina, from November 2019 to April 2022. Participants included pediatric primary care clinicians and staff and families with children aged 2 to 12 years with a body mass index (BMI) in the 85th percentile or higher. Pediatric weight management program with clinician-facing tools (ie, clinical decision support tools) and family-facing tools (ie, educational handouts, text messaging program, community resource guide) along with implementation strategies (ie, training and feedback, technical assistance, virtual learning community, aligning with hospital performance metrics) to support the uptake. Primary outcomes were constructs from the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework examined through parent, clinician, and leadership surveys and electronic health record data to understand the number of children screened and identified, use of the clinical decision support tools, program acceptability, fidelity to the intervention and implementation strategies, and program sustainability. The program screened and identified 18 333 children across 3 organizations (Denver Health, 8480 children [46.3%]; mean [SD] age, 7.97 [3.31] years; 3863 [45.5%] female; Massachusetts General Hospital (MGH), 6190 children [33.8%]; mean [SD] age, 7.49 [3.19] years; 2920 [47.2%] female; Prisma Health, 3663 children [20.0%]; mean [SD] age, 7.33 [3.15] years; 1692 [46.2%] female) as having an elevated BMI. The actionable flagging system was used for 8718 children (48%). The reach was equitable, with 7843 children (92.4%) from Denver Health, 4071 children (65.8%) from MGH, and 1720 children (47%) from Prisma Health being from racially and ethnically minoritized groups. The sites had high fidelity to the program and 6 implementation strategies, with 4 strategies (67%) used consistently at Denver Health, 6 (100%) at MGH, and 5 (83%) at Prisma Health. A high program acceptability was found across the 3 health care organizations; for example, the mean (SD) Acceptability of Intervention Measure score was 3.72 (0.84) at Denver Health, 3.82 (0.86) at MGH, and 4.28 (0.68) at Prisma Health. The implementation strategies were associated with 7091 (39%) uses of the clinical decision support tool. The mean (SD) program sustainability scores were 4.46 (1.61) at Denver Health, 5.63 (1.28) at MGH, and 5.54 (0.92) at Prisma Health. These findings suggest that by understanding what strategies enable the adoption of scalable and implementation-ready programs by other health care organizations, it is feasible to improve the screening, identification, and management of children with overweight or obesity and mitigate existing disparities.

Changes in Obesity Prevalence Following Spinal Cord Injury: A Retrospective Review of Body Mass Index

Background: The prevalence of obesity is high in individuals with spinal cord injury (SCI) due to the alterations in body composition that occur as a direct result of injury. Body mass index (BMI) is used to classify body habitus. In 2009, an adjusted BMI classification, with lower thresholds for obesity, was recommended for individuals with SCI. Objective: Determine obesity prevalence before and after SCI to examine the trajectory of obesity development. Furthermore, we discuss the challenges of applying a modified BMI classification system in this population. Methods: We conducted a retrospective medical record review. Adults with traumatic SCI were selected. Height and body weight measurements were used to calculate BMI two years before injury through two years after injury. Results: Obesity prevalence is high in SCI participants. However, we report no significant difference in BMI between motor complete and incomplete injuries, or between tetraplegic or paraplegic injuries. We report a decrease in BMI from one year before injury to one- and two-years after injury for all groups. With moderate obesity before injury, the transition to a new BMI classification system creates a challenge in reducing obesity prevalence. Conclusion: Obesity prevalence encompassed nearly all participants by the second year following SCI. The adjusted BMI classification system dictates the high obesity prevalence in this population and is best used as a screening tool to track the risk of developing obesity. Exceptions should be considered when using the SCI-adjusted BMI classification system, and tissue composition analysis is preferred.

The Potential Effect of Sugar-Sweetened Beverages Tax on Obesity Prevalence in Tanzania.

Obesity and the associated non-communicable diseases contribute significantly to the disease burden in Tanzania. Obesity can be attributed to the consumption of Sugar Sweetened Beverages (SSB) due to their high sugar content that leads to high caloric intakes. This study estimates the effect of SSB tax on the prevalence of obesity. A mathematical model that compares the reference population which is unchanged and a counterfactual population in which tax intervention has been introduced is developed. Changes in price and consumption of SSBs, and subsequent changes in energy intake are applied to estimate the body mass change by age groups. The change in body mass by age groups is merged with the reference population to estimate changes in body mass index and obesity. Imposing a 20% SSB tax in Tanzania is estimated to reduce the average overall energy intake by 76.1 kJ per person per day. This change is associated with an overall reduction of prevalence of obesity by 6.6%; and by 12.9% and 5.2% in adult males and adult females, respectively. The number of obese people will potentially decrease by about 47,000 among adult males and about 85,000 among adult females from the current levels. The SSB tax is a potential strategy to complement efforts to reduce obesity prevalence in Tanzania. The revenue generated from the tax should be channelled towards public health promotion programs.

Abstract 13519: US Population Eligibility and Estimated Impact of Tirzepatide on Obesity Prevalence and Preventable Cardiovascular Disease Events in US Adults

Background: Tirzepatide, a novel GIP-GLP-1 receptor agonist therapy, has been shown to be beneficial for weight loss and reduction of cardiovascular disease (CVD) risk factors in adults with obesity in the SURMOUNT-1 trial. We estimated US population eligibility for tirzepatide and the impact on reduction of CVD events in US adults with obesity. Methods: We applied SURMOUNT-1 eligibility criteria (body mass index [BMI] &gt; 30 kg/m 2 or BMI &gt; 27 kg/m 2 with at least one risk factor or CVD, excluding diabetes) to US adults aged &gt; 18 years in the US National Health and Nutrition Examination Survey (NHANES) 2015-2018 to estimate the US eligible population using NHANES sample weighting. Tirzepatide 15 mg group weight changes in the SURMOUNT-1 trial were applied to estimate the population impact on weight and obesity, and in those aged 30 to 74 years without prior CVD, the estimated 10-year CVD risks utilizing the BMI-based Framingham CVD risk scores. The difference in the estimated risks with and without tirzepatide “treatment” multiplied by the eligible weighted population represented the estimated “preventable” CVD events. Results: We identified 4015 US adults weighted to an estimated population size of 93.4 million [M] (38% of the US adult population) who fit SURMOUNT-1 trial eligibility criteria, of which 51% were female and 89% were without prior CVD. Applying tirzepatide 15 mg SURMOUNT-1 treatment effects on weight loss resulted in an estimated 70.6% (65.9 M) and 56.7% (53.0 M) showing &gt; 15% and &gt; 20% weight reductions, respectively, translating to a 58.8% (55.0 M) reduction in obesity (BMI &gt; 30 kg/m 2 ) prevalence and 36.4% (34.0 M) increase in normal weight (BMI &lt;25 kg/m 2 ) prevalence among the eligible population. Among those without CVD, estimated 10-year CVD risks were 10.1% “before” and 7.8% “after” tirzepatide “treatment” reflecting a 2.3% absolute (and 23% relative) risk reduction (number needed to treat [NNT]=43) translating to an estimated 1.95 million preventable CVD events over 10 years. Conclusions: Tirzepatide treatment in eligible US adults may reduce obesity prevalence nearly 60% representing 55M adults and prevent up to 2M CVD events over 10 years, suggesting a dramatic impact on societal burden and healthcare costs in those with these conditions.

Governments policy measures to address obesity among adults: a scoping review of the global evidence

BackgroundObesity epidemic is one of the greatest challenges in public health in modern societies. This study aimed to address the main gap by reviewing the effectiveness of nutritional policy measures implemented globally by governments to reduce obesity prevalence among adults. MethodsWe developed a scoping review by searching Ovid Medline, PubMed, and Embase from May 5, to July 12, 2022 for papers published in English between Jan 1, 2002 and May 1, 2022. Eligible papers included adults older than 18 years and focused on obesity prevention strategies. No restrictions on study design or geographic location were applied. The search terms included “obesity”, “health policy”, “government regulation”, and “obesogenic environment”. Findings17 articles were eligible for this scoping review across seven countries (USA, UK, France, Mexico, Colombia, Chile, and India). The identified studies were observational, cross-sectional, and systematic reviews, with the majority published in the USA and the UK within the past 5 years. Policies were categorised into three groups: food and beverages taxes (n=6), food labelling (n=6) and national campaigns (n=5). Most policies showed a small magnitude change in obesity reduction metrics such as body-mass index (BMI) and weight outcome (n=10). Two studies found that food labelling did not significantly change weight status. Two other studies targeting national campaigns showed a reduction in risk for obesity and overweight. However, the sugar tax demonstrated promising results compared with all other policies when the tax levy tier was increased. Three studies reported that a higher tax increase was correlated with a greater decline in obesity prevalence when increasing the tax up to 20%. InterpretationOur findings inform recommendations for policy makers of how other countries have implemented and evaluated their food policies. It can also encourage food industries to reformulate their products and promote population health. The limited number of settings included in this study is a main limitation of the review. Further investigation of the tax equity is needed. FundingNone.

Longitudinal associations between family meal quality and quantity: Does one matter more for child, parent, and family health and well-being or are they synergistic?

It is unknown how family meal quantity (i.e., frequency) and quality (i.e., meal healthfulness and interpersonal quality) are associated with child, parent, and family health and well-being over time. This study aimed to examine longitudinal associations between family meal quantity and quality and child, parent, and family health and well-being and whether there was a synergistic effect between family meal quantity and quality. Children ages 5-9 and their parents from six racial/ethnic groups participated in this longitudinal cohort study. Regression models adjusted for socio-demographic characteristics examined family meal quantity, interpersonal quality, and nutritional quality at baseline and interactions between quantity and quality, in relation to changes in child, parent, and family health outcomes from baseline to 18-month follow-up. Higher family meal quantity predicted reduced obesity prevalence, improved diet quality and less food fussiness, food responsiveness, and conduct problems among children at follow-up. Higher family meal quality predicted improved diet quality, lower emotional problems, less food responsiveness, and fewer peer relationship problems among children, improved diet quality and reduced psychological distress for parents, and less family chaos at follow-up. One interaction between family meal quantity and quality was found for child peer relationship problems. Overall, family meal quantity and quality were independently important for child health and well-being and for some parent and family health outcomes. Clinicians working with families may want to emphasize the importance of both family meal quantity and quality, as these longitudinal findings suggest potential benefits for the entire family.

US Population Eligibility and Estimated Impact of Semaglutide Treatment on Obesity Prevalence and Cardiovascular Disease Events.

Semaglutide 2.4mg benefits weight loss and reduction of cardiovascular disease (CVD) risk factors in adults with obesity. We estimated the US population eligibility for semaglutide 2.4mg (based on the weight management indication) and the impact on obesity and CVD events. We applied STEP 1 trial eligibility criteria to US adults aged ≥ 18years in the US National Health and Nutrition Examination Survey (NHANES) 2015-2018 to estimate the US eligible population. Semaglutide weight changes in STEP 1 were applied to estimate the population impact on weight changes and obesity prevalence. We also estimated 10-year CVD risks utilizing the BMI-based Framingham CVD risk scores. The difference in estimated risks with and without semaglutide "treatment" multiplied by the eligible NHANES weighted population represented the estimated "preventable" CVD events. We identified 3999 US adults weighted to an estimated population size of 93.0 million [M] (38% of US adults) who fit STEP 1 eligibility criteria. Applying STEP 1 treatment effects on weight loss resulted in an estimated 69.1% (64.3M) and 50.5% (47.0M) showing ≥ 10% and ≥ 15% weight reductions, respectively, translating to a 46.1% (43.0M) reduction in obesity (BMI ≥ 30kg/m2) prevalence. Among those without CVD, estimated 10-year CVD risks were 10.15% "before" and 8.34% "after" semaglutide "treatment" reflecting a 1.81% absolute (and 17.8% relative) risk reduction translating to 1.50 million preventable CVD events over 10years. Semaglutide treatment in eligible US adults may substantially reduce obesity prevalence and CVD events, which may dramatically impact associated healthcare costs.

Have States Reduced Obesity by Legislating More Physical Activity in Elementary School?

To control childhood obesity, leading medical organizations have recommended increasing the time that children spend in physical education (PE) and other school-based physical activity (PA). Yet, it is unknown how many states have passed laws that codify these recommendations, and it is unknown what effect changing state laws has had on obesity or the time that children actually spent in PE and PA. We joined state laws to national samples of 13,920 children from two different cohorts of elementary students. One cohort attended kindergarten in 1998; the other attended kindergarten in 2010; both cohorts were followed from kindergarten through fifth grade. We estimated the effects of changes to state laws in a regression with state and year fixed effects. Twenty-four states and the District of Columbia increased the time that children were recommended or required to spend in PE or PA. These changes in state policies did not increase actual time spent in PE or recess, did not affect average body mass index (BMI) or BMI Z score, and did not affect the prevalence of overweight or obesity. Increasing the PE or PA time required or recommended by state laws has not slowed the obesity epidemic. Many schools have failed to comply with state laws. A back-of-the-envelope calculation suggests that, even with better compliance, the legislated changes in PE laws might not have changed energy balance enough to reduce obesity prevalence.

Associations between trajectories of obesity prevalence in English primary school children and the UK soft drinks industry levy: An interrupted time series analysis of surveillance data.

Sugar-sweetened beverages (SSBs) are the primary source of dietary added sugars in children, with high consumption commonly observed in more deprived areas where obesity prevalence is also highest. Associations between SSB consumption and obesity in children have been widely reported. In March 2016, a two-tier soft drinks industry levy (SDIL) on drinks manufacturers to encourage reformulation of SSBs in the United Kingdom was announced and then implemented in April 2018. We examined trajectories in the prevalence of obesity at ages 4 to 5 years and 10 to 11 years, 19 months after the implementation of SDIL, overall and by sex and deprivation. Data were from the National Child Measurement Programme and included annual repeat cross-sectional measurement of over 1 million children in reception (4 to 5 years old) and year 6 (10 to 11 years old) in state-maintained English primary schools. Interrupted time series (ITS) analysis of monthly obesity prevalence data from September 2013 to November 2019 was used to estimate absolute and relative changes in obesity prevalence compared to a counterfactual (adjusted for temporal variations in obesity prevalence) estimated from the trend prior to SDIL announcement. Differences between observed and counterfactual estimates were examined in November 2019 by age (reception or year 6) and additionally by sex and deprivation quintile. In year 6 girls, there was an overall absolute reduction in obesity prevalence (defined as >95th centile on the UK90 growth charts) of 1.6 percentage points (PPs) (95% confidence interval (CI): 1.1, 2.1), with greatest reductions in the two most deprived quintiles (e.g., there was an absolute reduction of 2.4 PP (95% CI: 1.6, 3.2) in prevalence of obesity in the most deprived quintile). In year 6 boys, there was no change in obesity prevalence, except in the least deprived quintile where there was a 1.6-PP (95% CI: 0.7, 2.5) absolute increase. In reception children, relative to the counterfactual, there were no overall changes in obesity prevalence in boys (0.5 PP (95% CI: 1.0, -0.1)) or girls (0.2 PP (95% CI: 0.8, -0.3)). This study is limited by use of index of multiple deprivation of the school attended to assess individual socioeconomic disadvantage. ITS analyses are vulnerable to unidentified cointerventions and time-varying confounding, neither of which we can rule out. Our results suggest that the SDIL was associated with decreased prevalence of obesity in year 6 girls, with the greatest differences in those living in the most deprived areas. Additional strategies beyond SSB taxation will be needed to reduce obesity prevalence overall, and particularly in older boys and younger children. ISRCTN18042742.

Economic burden of excess weight among older adults in Singapore: a cross-sectional study

ObjectivesTo estimate the incremental per capita and aggregate direct and indirect costs of excess weight among older adults (aged 40–80) in Singapore.DesignSecondary data analysis of an existing cross-sectional surveySettingResidential districts...

Impact of sustained health policy and population-level interventions on reducing the prevalence of obesity in the Caribbean region: A qualitative study from The Bahamas.

BackgroundThe 2020 Global Nutrition Report highlights that despite improvements in select nutrition indicators, progress is too slow to meet the 2025 Global Nutrition Targets. While the Latin America and the Caribbean (LAC) region has achieved the greatest global reduction in undernutrition (stunting, underweight, and wasting) in the past decade, it also has the highest prevalence of people with overweight worldwide. Since the early 2000s, the region has mounted increasingly comprehensive and multi-sectoral policy interventions to address nutritional health outcomes. The Bahamas is one such LAC country that has used consistent policy responses to address evolving nutritional challenges in its population. After addressing the initial problems of undernutrition in the 1970s and 80s, however, overconsumption of unhealthy foods has led to a rising prevalence of obesity which The Bahamas has grappled with since the early 2000s.ObjectiveThis study develops a timeline of obesity-related health policy responses and explores the macrosocial factors and conditions which facilitated or constrained public health policy responses to obesity in The Bahamas over a 20-year period.MethodsThis multi-method case study was conducted between 2019 and 2021. A document review of health policies was combined with secondary analysis of a range of other documents and semi-structured interviews with key actors (policymakers, health workers, scholars, and members of the public). Data sources for secondary data analysis included policy documents, national survey data on obesity, national and regional newspaper websites, and the Digital Library of the Caribbean database. An adapted framework approach was used for the analysis of semi-structured interviews.ResultsBetween 2000 and 2019, a series of national policies and community-level interventions were enacted to address the prevalence of obesity. Building on previous interventions, obtaining multi-sectoral collaboration, and community buy-in for policy action contributed to reducing obesity prevalence from 49.2 to 43.7% between 2012 and 2019. There are, however, constraining factors, such as political and multi-sectoral challenges and gaps in legislative mandates and financing.ConclusionSustained multilevel interventions are effective in addressing the prevalence of obesity. To maintain progress, there is a need to implement gender-specific responses while ensuring accessibility, availability, and affordability of nutritious food for all.