Abstract P291: Projected Heterogeneity in the Long-term Effects of Obesity Interventions Across the Life Course
Approximately 69% of U.S. adults are obese or overweight, with African Americans (AA) and Mexican Americans (MA) shouldering disproportionate burdens when compared to Caucasian Americans (CA). Despite the vast resources dedicated to testing obesity interventions, few studies have compared their effectiveness for obesity prevention across the life course or in multi-ethnic populations. We therefore leveraged race/ethnic- and sex-specific body mass index and population size estimates from the National Health and Nutrition Examination Survey (n=15,007; 2007-12; ages 18-80), mortality rates from the National Center for Health Statistics (2010), previously estimated net transition probabilities, and the Dynamic Modeling for Health Impact Assessment simulation tool to project the effects of two classes of obesity interventions by race/ethnicity (AA; CA; MA) and sex: interventions that proportionally decreased the prevalence of overweight and obesity at age 18, thereby modeling the cumulative effect of interventions throughout childhood and adolescence; and interventions that proportionally decreased the probability of transitioning to overweight or obesity in adults 18-80 years. At age 18, the prevalence of obesity ranged from 17-32%, with the lowest prevalence estimated for CA females and the highest estimated for AA females. Interventions achieving a 10% proportional decrease in the prevalence of overweight and obesity at age 18 were associated with modest decreases in the prevalence of obesity later in life, with the greatest benefits projected for MA males (e.g., an 8.8% proportional decrease in obesity at age 40) and the smallest benefits projected for AA females (e.g., a 5.5% proportional decrease in obesity at age 40). In comparison, projected effects of interventions achieving a 10% proportional decrease in the probability of transitioning to overweight and obesity in adults 18-80 years of age were smaller in magnitude, with the greatest benefits projected for CA females (e.g., a 6.2% proportional decrease in obesity at age 40) and the smallest benefits projected for MA males (e.g., a 2.8% proportional decrease in obesity at age 40). When both interventions were applied simultaneously, the largest effects were projected for CA males and females (e.g., a 12.5% proportional decrease in obesity at age 40). We conclude that both classes of interventions decrease the prevalence of obesity across the life course, but they are not equivalent and could potentially exacerbate longstanding disparities. Further work evaluating the race/ethnic- and sex-specific optimal age epochs at which to intervene is therefore warranted.
Author Disclosures: C.L. Avery: None. J.K. Schönbach: None. P.A. Palta: None. S.B. Wheeler: None. S.K. Lhachimi: None.
- © 2016 by American Heart Association, Inc.