1
|
Giannichi B, Nilson E, Ferrari G, Rezende LFM. The projected economic burden of non-communicable diseases attributable to overweight in Brazil by 2030. Public Health 2024; 230:216-222. [PMID: 38579649 DOI: 10.1016/j.puhe.2024.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/01/2024] [Accepted: 02/29/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVES The prevalence of overweight increases the risk of several non-communicable diseases (NCDs) and, consequently, the costs of health care systems. In this study, we aimed to project the economic burden of NCDs attributable to overweight in Brazil between 2021 and 2030. METHODS A cohort simulation of adults (17-117 years) using multistate lifetable modeling was used to estimate the costs of NCDs attributable to overweight in Brazil. The projections of direct health care costs (outpatient and inpatient expenses in the Unified Health System) and indirect costs (years of productive life lost) considered different trajectories of the prevalence of overweight between 2021 and 2030. RESULTS In 2019, the prevalence of overweight was 55.4% in the adult Brazilian population. We estimate that around 1.8 billion international dollars (Int$) would be spent on the direct health care cost of NCDs between 2021 and 2030, through the continued increase in overweight prevalence observed between 2006 and 2020. The indirect costs over the same time would be approximately 20.1 billion Int$. We estimate that halving the annual increase in body mass index slope from the beginning of 2021 until 2030 would save 20.2 million Int$ direct and indirect costs by 2030. In the scenario of keeping the prevalence of overweight observed in 2019 constant until 2030, the savings would be 40.8 million Int$. Finally, in the scenario of a 6.7% reduction in the prevalence of overweight observed in 2019 (to be achieved gradually until 2030), 74.1 million Int$ would be saved. CONCLUSIONS These results highlight the high economic burden of overweight in the Brazilian adult population.
Collapse
Affiliation(s)
- B Giannichi
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - E Nilson
- Center for Epidemiological Research in Nutrition and Public Health, University of São Paulo, São Paulo, Brazil; Food, Nutrition and Culture Program, Fundação Oswaldo Cruz, Brasília, Brazil; Facultad de Ciencias de la Salud, Universidad Autonoma de Chile, Santiago, Chile
| | - G Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Chile; Facultad de Ciencias de la Salud, Universidad Autonoma de Chile, Santiago, Chile
| | - L F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil; Facultad de Ciencias de la Salud, Universidad Autonoma de Chile, Santiago, Chile.
| |
Collapse
|
2
|
Nagi MA, Ahmed H, Rezq MAA, Sangroongruangsri S, Chaikledkaew U, Almalki Z, Thavorncharoensap M. Economic costs of obesity: a systematic review. Int J Obes (Lond) 2024; 48:33-43. [PMID: 37884664 DOI: 10.1038/s41366-023-01398-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Obesity is a growing public health problem leading to substantial economic impact. This study aimed to summarize the economic impact of obesity and to critically analyze the methods used in the cost-of-illness (COI) studies on obesity. METHODS We conducted systematic search in PubMed and Scopus from September 1, 2016, to July 22, 2022. Original COI studies estimating the economic cost of obesity and/or overweight in at least one country, published in English were included. To facilitate the comparison of estimates across countries, we converted the cost estimates of different years to 2022 purchasing power parity (PPP) values using each country's consumer price index (CPI) and PPP conversion rate. RESULTS Nineteen studies were included. All studies employed a prevalence-based approach using Population Attributable Fraction (PAF) methodology. About half of the included studies (53%) were conducted in high-income countries while the others (47%) were conducted in middle-income countries. The economic burden of obesity ranged between PPP 15 million in Brazil to PPP 126 billion in the USA, in the year 2022. Direct medical costs accounted for 0.7% to 17.8% of the health system expenditure. Furthermore, the total costs of obesity ranged from 0.05% to 2.42% of the country's gross domestic product (GDP). Of the seven studies that estimated both direct and indirect costs, indirect costs accounted for the largest portion of five studies. Nevertheless, a variety in methodology across studies was identified. The number of co-morbidities included in the analysis varied across studies. CONCLUSIONS Although there was a variety of methodologies across studies, consistent evidence indicated that the economic burden of obesity was substantial. Obesity prevention and control should be a public health priority, especially among countries with high prevalence of obesity.
Collapse
Affiliation(s)
- Mouaddh Abdulmalik Nagi
- Doctor of Philosophy Program in Social, Economic and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen
| | - Hanan Ahmed
- Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen
- Master of Public Health, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Mustafa Ali Ali Rezq
- Master of Public Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Pharmacy, Sana'a University, Sana'a, Yemen
| | - Sermsiri Sangroongruangsri
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Usa Chaikledkaew
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Ziyad Almalki
- Prince Sattam Bin Abdulaziz University, Department of Clinical Pharmacy, Al-Kharj, Riyadh, Saudi Arabia
| | - Montarat Thavorncharoensap
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
3
|
Zhu T, Yang S, Mauro TM, Man MQ. Association of Epidermal Biophysical Properties with Obesity and Its Implications. Skin Pharmacol Physiol 2023; 36:165-173. [PMID: 37640014 DOI: 10.1159/000533587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/04/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Obesity is a condition defined by an excess amount of body fat, with body mass index (BMI) of 30 and higher. It is associated with a number of other medical conditions, including insulin resistance, diabetes mellitus, and cardiovascular diseases, as well as dyslipidemia, and it is also associated with several cutaneous disorders such as atopic dermatitis, psoriasis, intertriginous dermatitis, acanthosis nigricans and skin infections. SUMMARY Evidence suggests a link between obesity and epidermal dysfunction. Generally, individuals with obesity display higher transepidermal water loss rate and lower stratum corneum hydration levels, although no association of obesity with epidermal dysfunction has been documented. Results of skin surface pH are controversial. But study demonstrated a positive correlation of BMI with skin surface pH on both the forearm and the shin in males, suggesting that the changes in epidermal function vary with gender in individuals with obesity. KEY MESSAGES This review summarizes the association between obesity and epidermal function, and discusses possible underlying mechanisms. Individuals with obesity exhibit poor epidermal permeability barrier and lower stratum corneum hydration levels. Because of the pathogenic role of compromised epidermal function in inflammation, which is also linked to obesity, improvement in epidermal function could benefit individuals with obesity, particularly those with abnormalities in epidermal function.
Collapse
Affiliation(s)
- Tingting Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shuyun Yang
- Department of Dermatology, The People's Hospital of Baoshan, Baoshan, China
| | - Theodora M Mauro
- Department of Dermatology, Veterans Affairs Medical Center San Francisco, University of California San Francisco, San Francisco, California, USA
| | - Mao-Qiang Man
- Department of Dermatology, Veterans Affairs Medical Center San Francisco, University of California San Francisco, San Francisco, California, USA
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
4
|
Fuentes R, Nilson E, Rezende LFM, Christofaro DGD, Silva DR, Ferrero-Hernández P, Cristi-Montero C, Marques A, Farías-Valenzuela C, Ferrari G. Future burden of non-communicable diseases attributable to overweight in Chile: a multistate life table modeling study. BMC Public Health 2023; 23:1337. [PMID: 37438831 DOI: 10.1186/s12889-023-16255-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Previous studies have quantified the current burden of diseases attributable to overweight in Chile. However, no study has estimated the attributable burden of overweight in the future. Herein, we estimated the potential impact of different trajectories in the prevalence of overweight on the incidence and mortality from non-communicable diseases (NCDs) in Chilean adults from 2019 to 2030. METHODS A multistate life table modelling was used to estimate the business-as-usual (BAU: if the current rate of increase in BMI persist through the next 11 years; i.e., 0.4% per year from 2003 to 2017) and three counterfactual scenarios (1: the increase rate of overweight is reduced by half; 2: maintanance of the current prevalence of overweight; 3: the prevalence of overweight is reduced by 6.7%) over a 11-year simulation period for burden of NCDs attributable to overweight in Chilean adults aged 20 to 80 years. The model inputs included nationally representative data of body mass index, national official demographic records, NCDs from the Global Burden of Disease study in 2019, and relative risks from a published meta-analysis. RESULTS If the current trends of increase in overweight are maintained in Chile, approximately, 669 thousand cases and 117 thousand deaths from NCDs will occur from 2020 to 2030. In case the increase rate of overweight is reduced by half during this period, around 7 thousand cases and 1.4 thousand deaths from NCDs would be prevented, while achieving no increase in the prevalence of overweight would avert 10 thousand cases and 2 thousand deaths. In the optimistic scenario of reducing the prevalence of overweight by 6.7% until 2030, approximately 25 thousand cases and 5 thousand deaths from NCDs would be prevented. CONCLUSION We estimated that the number of NCDs cases and deaths that could be avoided by decreasing the prevalence of overweight in Chilean adults. Preventive programs aimed to reduce overweight may have a high impact on the future burden of NCDs in Chile.
Collapse
Affiliation(s)
- Rodrigo Fuentes
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile
| | - Eduardo Nilson
- Center for Epidemiological Research in Nutrition and Public Health, University of São Paulo, São Paulo, Brazil
- Oswaldo Cruz Foundation (Fiocruz/Brasilia), Brasília, Brazil
| | - Leandro F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Diego Giulliano Destro Christofaro
- Physical Education Department, Graduate Program in Movement Sciences, School of Technology and Sciences, São Paulo State University (Unesp), São Paulo, Brazil
| | - Danilo R Silva
- Department of Physical Education, Universidade Federal de Sergipe - UFS, São Cristóvão, Brazil
| | - Paloma Ferrero-Hernández
- Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Santiago, 8900000, Chile
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, 1499-002, Portugal
| | - Claudio Farías-Valenzuela
- Facultad de Ciencias Para El Cuidado de La Salud, Universidad San Sebastián, Lota 2465, Providencia, 7510157, Chile
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile.
| |
Collapse
|
5
|
Ferreira ALL, Freitas-Costa N, da Silva Rosa Freire S, Figueiredo ACC, Padilha M, Alves-Santos NH, Kac G. Association of pre-pregnancy maternal overweight/obesity and dietary intake during pregnancy with the concentrations of persistent organic pollutants in the human milk of women from Rio de Janeiro, Brazil. Environ Sci Pollut Res Int 2023; 30:44999-45014. [PMID: 36701066 DOI: 10.1007/s11356-023-25308-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Persistent organic pollutants (POPs) are toxic chemical compounds that can bioaccumulate, adhere to lipid matrices, and affect human health. This study aimed to investigate the association between maternal pre-pregnancy overweight/obesity and dietary intake during pregnancy and POP concentrations in the human milk of women from Rio de Janeiro, Brazil. One hundred and forty-seven women were followed from the third trimester of pregnancy until 119 days postpartum, and 77 human milk samples were analyzed between 2 and 119 days postpartum. POP concentrations were analyzed using gas chromatography-triple quadrupole mass spectrometry. Pregnancy dietary intake was estimated using a semi-quantitative food frequency questionnaire, and pre-pregnancy body mass index at baseline was classified as normal or overweight/obesity. Multiple logistic and linear regression models were performed to investigate the association between pre-pregnancy overweight/obesity, dietary intake during pregnancy, and POP concentrations in human milk. The models were adjusted for maternal age, maternal schooling, total cholesterol serum concentrations, and time postpartum. The analyses were corrected for multiple comparisons using the Benjamini-Hochberg test. Significant associations were observed between pre-pregnancy overweight/obesity and dichlorodiphenyldichloroethane (ppDDE), polychlorinated biphenyl (PCB)74, PCB138, PCB153, PCB170, PCB180, total PCBs, total 4PCBs, total 2 organochlorine pesticides (OCPs), and total POP concentrations. Higher daily lipid intake during pregnancy increased human milk hexachlorobenzene (HCB). This study showed that pre-pregnancy overweight/obesity and total lipid intake during pregnancy were associated with POP concentrations in the milk of women from Rio de Janeiro, Brazil. To promote adequate nutritional status since preconception and surveillance and control of POP in the environment could be essential to ensure binomial mother-infant health and biomonitoring studies and programs for these POPs should be stimulated.
Collapse
Affiliation(s)
- Ana Lorena Lima Ferreira
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Avenida Carlos Chagas Filho 373/CCS, Bloco J, 2º Andar, Sala 29, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Nathalia Freitas-Costa
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Avenida Carlos Chagas Filho 373/CCS, Bloco J, 2º Andar, Sala 29, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Samary da Silva Rosa Freire
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Avenida Carlos Chagas Filho 373/CCS, Bloco J, 2º Andar, Sala 29, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Amanda Caroline Cunha Figueiredo
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Avenida Carlos Chagas Filho 373/CCS, Bloco J, 2º Andar, Sala 29, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Marina Padilha
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Avenida Carlos Chagas Filho 373/CCS, Bloco J, 2º Andar, Sala 29, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Nadya Helena Alves-Santos
- Faculty of Collective Health, Institute for Health and Biological Studies, Federal University of South and Southeast of Pará, Rodovia BR-230 (Transamazônica), Loteamento Cidade Jardim, Avenida Dos Ipês, S/N.°-Cidade Jardim, Marabá, PA, 68500-000, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Avenida Carlos Chagas Filho 373/CCS, Bloco J, 2º Andar, Sala 29, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil.
| |
Collapse
|
6
|
Estivaleti JM, Guzman-Habinger J, Lobos J, Azeredo CM, Claro R, Ferrari G, Adami F, Rezende LFM. Time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030. Sci Rep 2022; 12:12699. [PMID: 35882969 PMCID: PMC9315079 DOI: 10.1038/s41598-022-16934-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/18/2022] [Indexed: 01/22/2023] Open
Abstract
We examined time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030 by sex, race/skin color, educational attainment, and state capitals. Self-reported body weight and height of 730,309 adults (≥ 18 years) from the Vigitel study were collected by telephone interview between 2006 and 2019. A multinomial logistic regression model was used to predict the prevalence of body mass index (BMI) categories as a function of time by 2030. The prevalence of obesity increased from 11.8% in 2006 to 20.3% in 2019. The projected prevalences by 2030 are estimated to be 68.1% for overweight, 29.6% for obesity, and 9.3% for obesity classes II and III. Women, black and other minority ethnicities, middle-aged adults, adults with ≤ 7 years of education, and in Northern and Midwestern capitals are estimated to have higher obesity prevalence by 2030. Our findings indicate a sustained increase in the obesity epidemic in all sociodemographic subgroups and across the country. Obesity may reach three out of 10 adults by 2030.
Collapse
Affiliation(s)
- José Matheus Estivaleti
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Juan Guzman-Habinger
- Facultad de Ciencias, Especialidad Medicina del Deporte Y La Actividad Física, Universidad Mayor, Santiago, Chile
| | | | | | - Rafael Claro
- Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG), Minas Gerais, Belo Horizonte, Brasil
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, El Deporte y la Salud, Santiago, Chile
| | - Fernando Adami
- Laboratório de Epidemiologia e Análise de Dados, Centro Universitário FMABC, Santo André, São Paulo, Brasil
| | - Leandro F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil.
| |
Collapse
|