An improved algorithm to harmonize child overweight and obesity prevalence rates

BACKGROUND: Prevalence rates of child overweight and obesity for a group of children vary depending on the BMI reference and cut-off used. Previously we developed an algorithm to convert prevalence rates based on one reference to those based on another. OBJECTIVE: To improve the algorithm by combining information on overweight and obesity prevalence. METHODS: The original algorithm assumed that prevalence according to two different cut-offs A and B differed by a constant amount dz $$dz$$ on the z-score scale. However the results showed that the z-score difference tended to be greater in the upper tail of the distribution and was better represented by b × dz $$b\times dz$$ , where b $$b$$ was a constant that varied by group. The improved algorithm uses paired prevalence rates of overweight and obesity to estimate b $$b$$ for each group. Prevalence based on cut-off A is then transformed to a z-score, adjusted up or down according to b × dz $$b\times dz$$ and back-transformed, and this predicts prevalence based on cut-off B. The algorithm's performance was tested on 228 groups of children aged 6-17 years from 20 countries. RESULTS: The revised algorithm performed much better than the original. The standard deviation (SD) of residuals, the difference between observed and predicted prevalence, was 0.8% (n = 2320 comparisons), while the SD of the difference between pairs of the original prevalence rates was 4.3%, meaning that the algorithm explained 96.7% of the baseline variance (88.2% with original algorithm). CONCLUSIONS: The improved algorithm appears to be effective at harmonizing prevalence rates of child overweight and obesity based on different references

Exploring an algorithm to harmonize International Obesity Task Force and World Health Organization child overweight and obesity prevalence rates

BACKGROUND: The International Obesity Task Force (IOTF) and World Health Organization (WHO) body mass index (BMI) cut-offs are widely used to assess child overweight, obesity and thinness prevalence, but the two references applied to the same children lead to different prevalence rates. OBJECTIVES: To develop an algorithm to harmonize prevalence rates based on the IOTF and WHO cut-offs, to make them comparable. METHODS: The cut-offs are defined as age-sex-specific BMI z-scores, for example, WHO +1 SD for overweight. To convert an age-sex-specific prevalence rate based on reference cut-off A to the corresponding prevalence based on reference cut-off B, first back-transform the z-score cut-offs z A and z B to age-sex-specific BMI cut-offs, then transform the BMIs to z-scores z B , A and z A , B using the opposite reference. These z-scores together define the distance between the two cut-offs as the z-score difference dz A , B = 1 2 z B - z A + z A , B - z B , A . Prevalence in the target group based on cut-off A is then transformed to a z-score, adjusted up or down according to dz A , B and back-transformed, and this predicts prevalence based on cut-off B. The algorithm's performance was tested on 74 groups of children from 14 European countries. RESULTS: The algorithm performed well. The standard deviation (SD) of the difference between pairs of prevalence rates was 6.6% (n = 604), while the residual SD, the difference between observed and predicted prevalence, was 2.3%, meaning that the algorithm explained 88% of the baseline variance. CONCLUSIONS: The algorithm goes some way to addressing the problem of harmonizing overweight and obesity prevalence rates for children aged 2-18

The impact of economic, political and social globalization on overweight and obesity in the 56 low and middle income countries

This is the final published version. It first appeared at http://www.sciencedirect.com/science/article/pii/S0277953615001744.Anecdotal and descriptive evidence has led to the claim that globalization plays a major role in inducing overweight and obesity in developing countries, but robust quantitative evidence is scarce. We undertook extensive econometric analyses of several datasets, using a series of new proxies for different dimensions of globalization potentially affecting overweight in up to 887,000 women aged 15e49 living in 56 countries between 1991 and 2009. After controlling for relevant individual and country level factors, globalization as a whole is substantially and significantly associated with an increase in the individual propensity to be overweight among women. Surprisingly, political and social globalization dominate the influence of the economic dimension. Hence, more consideration needs to be given to the forms of governance required to shape a more health-oriented globalization process.The authors were supported by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust (087636/Z/ 08/Z ESRC: ES/G007462/1), under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged

Do the outcomes of interventions for the treatment of obesity and overweight in children aged under ten years, delivered by a health care professional, vary by socio-demographic characteristics? A review of Cochrane reviews

To review the evidence from five Cochrane systematic reviews of interventions to treat overweight and obesity in children. Applying a social determinants of health perspective and focusing on interventions delivered by health care professionals, for children aged less than ten years, and the challenging phases of interventions including recruitment, adherence and follow-up. The analysis of the social determinants of health is based on the PROGRESS-Plus approach (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, age, disability and sexual orientation). The aims are to improve our understanding of the barriers to successful obesity treatment for children, delivered by health care professionals in a setting linked to the provision of health care services, and to identify the characteristics of these children and highlight knowledge gaps. Overarching question: what are the barriers to successful treatment delivered by health care professionals in a setting linked to the provision of health care services for children aged less than ten years, and do these barriers vary by socio-demographic characteristics? Sub-questions: a. What are the best practices management strategies for recruitment to obesity treatments for children aged less than ten years and do these strategies vary by socio-demographic characteristics? b. What are the best practice management strategies for adherence to obesity treatments for children aged less than ten years and do these strategies vary by socio-demographic characteristics? c. What are the best practice management strategies for follow-up in obesity treatment for children aged less than ten years and do these strategies vary by socio-demographic characteristics?This is a protocol for a systematic review

Poor choices: the limits of competitive markets in the provision of essential services to low-income consumers

A major study of the problems faced by the poor in the market for seven essential services in the UK - energy, food, housing, water, telecoms, transport, and financial services. Together these represent 60% of spending by the poorest 30% of households

Sydney principles for reducing the commercial promotion of foods and beverages to children

A set of seven principles (the &lsquo;Sydney Principles&rsquo;) was developed by an International Obesity Taskforce (IOTF) Working Group to guide action on changing food and beverage marketing practices that target children. The aim of the present communication is to present the Sydney Principles and report on feedback received from a global consultation (November 2006 to April 2007) on the Principles.The Principles state that actions to reduce marketing to children should: (i) support the rights of children; (ii) afford substantial protection to children; (iii) be statutory in nature; (iv) take a wide definition of commercial promotions; (v) guarantee commercial-free childhood settings; (vi) include cross-border media; and (vii) be evaluated, monitored and enforced.The draft principles were widely disseminated and 220 responses were received from professional and scientific associations, consumer bodies, industry bodies, health professionals and others. There was virtually universal agreement on the need to have a set of principles to guide action in this contentious area of marketing to children. Apart from industry opposition to the third principle calling for a statutory approach and several comments about the implementation challenges, there was strong support for each of the Sydney Principles. Feedback on two specific issues of contention related to the age range to which restrictions should apply (most nominating age 16 or 18 years) and the types of products to be included (31 % nominating all products, 24 % all food and beverages, and 45 % energy-dense, nutrient-poor foods and beverages).The Sydney Principles, which took a children&rsquo;s rights-based approach, should be used to benchmark action to reduce marketing to children. The age definition for a child and the types of products which should have marketing restrictions may better suit a risk-based approach at this stage. The Sydney Principles should guide the formation of an International Code on Food and Beverage Marketing to Children.<br /

Progress achieved in restricting the marketing of high-fat, sugary and salty food and beverage products to children

In May 2010, 192 Member States endorsed Resolution WHA63.14 to restrict the marketing of food and non-alcoholic beverage products high in saturated fats, trans fatty acids, free sugars and/or salt to children and adolescents globally. We examined the actions taken between 2010 and early 2016 – by civil society groups, the World Health Organization (WHO) and its regional offices, other United Nations (UN) organizations, philanthropic institutions and transnational industries – to help decrease the prevalence of obesity and diet-related noncommunicable diseases among young people. By providing relevant technical and policy guidance and tools to Member States, WHO and other UN organizations have helped protect young people from the marketing of branded food and beverage products that are high in fat, sugar and/or salt. The progress achieved by the other actors we investigated appears variable and generally less robust. We suggest that the progress being made towards the full implementation of Resolution WHA63.14 would be accelerated by further restrictions on the marketing of unhealthy food and beverage products and by investing in the promotion of nutrient-dense products. This should help young people meet government-recommended dietary targets. Any effective strategies and actions should align with the goal of WHO to reduce premature mortality from noncommunicable diseases by 25% by 2025 and the aim of the UN to ensure healthy lives for all by 2030

Policy options for obesity in Europe: a comparison of public health specialists with other stakeholders

Objective: To explore policy options that public health specialists (PHS) consider appropriate for combating obesity in Europe, and compare their preferences with those of other stakeholders (non-PHS). Design: Structured interviews using multicriteria mapping, a computer-based, decision-support tool. Setting: Nine European countries. Subjects: A total of 189 stakeholders. Twenty-seven interviewees were PHS and non-PHS included food, sports and health sectors. Measurements: A four-step approach was taken, i.e. selecting options, defining criteria, scoring options quantitatively and weighting the criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. Results: The PHS concur with other stakeholders interviewed, as all emphasised the importance of educational initiatives in combating obesity, followed by policies to improve community sports facilities, introduce mandatory food labelling and controlling food and drink advertising. Further analyses revealed several significant differences. The non-PHS from the private sector ranked institutional reforms favourably; the PHS from non-Mediterranean countries supported the option of medicines to prevent obesity; and those PHS from Mediterranean countries endorsed the use of activity monitoring devices such as pedometers. As far as appraisal criteria were concerned, PHS considered efficacy and the economic impact on the public sector to be the most important. Conclusion: There is clear consensus among PHS and other stakeholders concerning the need for a package of policy options, which suggests that European-wide implementation could be successful. However, it would be advisable to avoid more contentious policy options such as taxation until future changes in public opinion.New and Emerging Science and Technology (NEST) research programme (European Union)