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Cost-effective measures to prevent obesity: epidemiological basis and appropriate target groups

Published online by Cambridge University Press:  07 March 2007

Jacob C. Seidell ,
Astrid J. Nooyens  and
Tommy L. S. Visscher
Jacob C. Seidell*
Affiliation:
Department of Nutrition & Health, Vrije Universiteit, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands VU University Medical Center, Amsterdam, The Netherlands
Astrid J. Nooyens
Affiliation:
Department of Nutrition & Health, Vrije Universiteit, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
Tommy L. S. Visscher
Affiliation:
Department of Nutrition & Health, Vrije Universiteit, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
*
*Corresponding author: Professor Jacob C. Seidell, fax +31 20 4446940, email jaap.seidell@falw.vu.nl
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Abstract

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Cost-effective prevention strategies to prevent weight gain and the development of obesity should be based on appropriate knowledge of the determinants of weight gain. The body of evidence on the dietary determinants of weight gain is, however, fragmentary at best, partly because inappropriate research methods are used to study the determinants of obesity under normal circumstances. Evidence from studies using experimental diets have shortcomings because of their short duration and selection of highly-motivated subjects and because the outcomes can be easily influenced by the choice of foods to be used in the intervention. Of the observational studies, many have severe methodological shortcomings, e.g. ecological studies, cross-sectional surveys and classical cohort studies in which the baseline diet is linked to subsequent weight development over long periods of time. Longitudinal studies with repeated measurements in which changes in diet and physical activity are linked to changes in weight are probably the most informative, but these studies are relatively rare. There is a great interest in interventions that are effective and efficient for the prevention of obesity. Many countries and research funding agencies seem to show a strong tendency to develop interventions for children and adolescents exclusively. It can be easily shown, however, that intervention programmes are much more likely to be cost-effective in older adults than in children, which indicates that adults should not be neglected as target populations for obesity prevention. Obesity prevention should follow a life-course approach, as currently recommended for non-communicable diseases in general by the WHO.

Keywords

ObesityOverweightPreventionCost-effectivenessEpidemiology
Type
The Boyd Orr Lecture
Information
Proceedings of the Nutrition Society , Volume 64 , Issue 1 , February 2005 , pp. 1 - 5
Copyright
Copyright © The Nutrition Society 2005

References

Andersen, LB (2004) Relative risk of mortality in the physically inactive is underestimated because of real changes in exposure level during follow-up. American Journal of Epidemiology 160, 189–195.Google Scholar
Ball, K, Brown, W & Crawford, D (2002) Who does not gain weight? Prevalence and predictors of weight maintenance in young women. International Journal of Obesity and Related Metabolic Disorders 26, 1570–1578.CrossRefGoogle ScholarPubMed
Braam, LAJLM, Ocké, MC, Bueno, de & HB Seidell, JC (1998) Determinants of obesity-related under-reporting of energy intake. American Journal of Epidemiology 147, 1081–1086.Google Scholar
Bray, GA & Popkin, BM (1998) Dietary fat intake does affect obesity!. American Journal of Clinical Nutrition 68, 1157–1173.Google Scholar
Coakley, EH, Rimm, EB, Colditz, GA, Kawachi, I & Willett, WC (1998) Predictors of weight change in men, results from the health professionals follow-up study. International Journal of Obesity and Related Metabolic Disorders 22, 89–96.Google Scholar
Colditz, GA, Willett, WC, Rotnitzky, A & Manson, JE (1995) Weight gain as a risk factor for clinical diabetes mellitus in women. Annals of Internal Medicine 122, 481–486.Google Scholar
Colditz, GA, Willett, WC, Stampfer, MJ, London, SJ, Segal, MR & Speizer, FE (1990) Patterns of weight change and their relation to diet in a cohort of healthy women. American Journal of Clinical Nutrition 51, 1100–1105.Google Scholar
Drapeau, V, Despres, JP, Bouchard, C, Allard, L, Fournier, G, Leblanc, C & Tremblay, A (2004) Modifications in food-group consumption are related to long-term body-weight changes. American Journal of Clinical Nutrition 80, 29–37.Google Scholar
French, SA, Jeffery, RW, Forster, JL, McGovern, PG, Kelder, SH & Baxter, JE (1994) Predictors of weight change over two years among a population of working adults, the Healthy Worker Project. International Journal of Obesity and Related Metabolic Disorders 18, 145–154.Google Scholar
Gostynski, M, Gutzwiller, F, Kuulasmaa, K, Doring, A, Ferrario, M, Grafnetter, D & Pajak, A (2004) Analysis of the relationship between total cholesterol, age and body mass index among males and females in the WHO MONICA project. International Journal of Obesity and Related Metabolic Disorders 28, 1082–1090.Google Scholar
Heitmann, BL & Lissner, L (1995) Dietary underreporting by obese individuals – is it specific or non-specific. British Medical Journal 311, 986–989.CrossRefGoogle ScholarPubMed
Klesges, RC, Klesges, LM, Haddock, CK & Eck, LH (1992) A longitudinal analysis of the impact of dietary intake and physical activity on weight change in adults. American Journal of Clinical Nutrition 55, 818–822.Google Scholar
Kromhout, D, Bloemberg, B, Seidell, JC, Nissinen, A & Menotti, A (2001) Physical activity and dietary fiber determine population body fat levels. The Seven Countries Study. International Journal of Obesity and Related Metabolic Disorders 25, 301–306.Google Scholar
Ludwig, DS, Pereira, MA, Kroenke, CH, Hilner, JE, Van Horn, L, Slattery, ML, Jacobs, DR Jr (1999) Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. Journal of the American Medical Association 282, 1539–1546.Google Scholar
Mann, J (2004) Free sugars and human health, sufficient evidence for action. Lancet 363, 1068–1070.CrossRefGoogle ScholarPubMed
Parker, DR, Gonzalez, S, Derby, CA, Gans, KM, Lasater, TM & Carleton, RA (1997) Dietary factors in relation to weight change among men and women from two southeastern New England communities. International Journal of Obesity and Related Metabolic Disorders 21, 103–109.Google Scholar
Peters, ETJ, Seidell, JC, Menotti, A, Aravanis, C, Dontas, A, Fidanza, F, Karvonen, M, Nedeljkovic, S, Nissinen, A, Buzina, R, Bloemberg, B & Kromhout, D (1995) Changes in body weight in relation to mortality in 6,441 European middle-aged men, the Seven Countries Study. International Journal of Obesity and Related Metabolic Disorders 19, 862–868.Google Scholar
Newby, PK, Muller, D, Hallfrisch, J, Qiao, N, Andres, R & Tucker, KL (2003) Dietary patterns and changes in body mass index and waist circumference in adults. American Journal of Clinical Nutrition 77, 1417–1425.Google Scholar
Ravussin, E & Gautier, F (1999) Metabolic predictors of weight gain. International Journal of Obesity and Related Metabolic Disorders 23, 37–41 Suppl. 1.CrossRefGoogle ScholarPubMed
Rissanen, AM, Heliövaara, M, Knekt, P, Reunanen, A & Aromaa, A (1991) Determinants of weight gain and overweight in adult Finns. European Journal of Clinical Nutrition 45, 419–430.Google Scholar
Saris, WHM, Astrup, A, Prentice, AM, Zunft, HJ, Formiguera, X, Verboeket-van, de, WP, Raben, A, Poppitt, SD, Seppelt, B, Johnston, S, Vasilaras & TH Keogh, GF (2000) Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids, the CARMEN study. International Journal of Obesity and Related Metabolic Disorders 24, 1310–1318.CrossRefGoogle ScholarPubMed
Schulz, M, Kroke, A, Liese, AD, Hoffmann, K, Bergmann, MM & Boeing, H (2002) Food groups as predictors for short-term weight changes in men and women of the EPIC-Potsdam cohort. Journal of Nutrition 132, 1335–1340.Google Scholar
Seidell, JC & Visscher, TLS (2000) Body weight and weight change and their health implications for the elderly. European Journal of Clinical Nutrition 54, S33–S39 Suppl. 3.CrossRefGoogle ScholarPubMed
Sherwood, NE, Jeffery, RW, French, SA, Hannan, PJ & Murray, DM (2000) Predictors of weight gain in the Pound of Prevention study. International Journal of Obesity and Related Metabolic Disorders 24, 395–403.Google Scholar
Silventoinen, K, Sans, S, Tolonen, H, Monterde, D, Kuulasmaa, K, Kesteloot, H & Tuomilehto, J (2004) Trends in obesity and energy supply in the WHO MONICA Project. International Journal of Obesity and Related Metabolic Disorders 28, 710–718.Google Scholar
Stamler, J & Dolewcek, TA (1997) Relation of food and nutrient intakes to body mass in the special intervention and usual care groups in the Multiple Risk Factor Intervention Trial. American Journal of Clinical Nutrition 65, Suppl. 366S–373S.Google Scholar
Swinburn, BA, Caterson, I, Seidell, JC & James, WPT (2004) Diet, nutrition and the prevention of excess weight gain and obesity. Public Health Nutrition 7, 123–146.Google Scholar
Togo, P, Osler, M, Sörensen, TIA & Heitman, BL (2001) Food intake patterns and body mass index in observational studies. International Journal of Obesity and Related Metabolic Disorders 25, 1741–1751.Google Scholar
Trentham-Dietz, A, Newcomb, PA, Egan, KM, Titus-Ernstoff, L, Baron, JA, Storer, BE, Stampfer, M & Willett, WC (2000) Weight change and risk of postmenopausal breast cancer. Cancer Causes and Control 11, 533–542.Google Scholar
Tuomilehto, J, Lindstrom, J, Eriksson, JG, Valle, TT, Hamalainen, H, Ilanne-Parikka, P, Keinanen-Kiukaanniemi, S, Laakso, M, Louheranta, A, Rastas, M, Salminen, V & Uusitupa, M (2001) Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine 344, 1343–1350.Google Scholar
van den, Hoogen, PCW, Seidell, JC, Menotti, A Kromhout, D (2000) Blood pressure and long-term coronary heart disease mortality in the Seven Countries Study, implications for clinical practice and public health. European Heart Journal 21, 1639–1642.Google Scholar
van Rossum, CT, Hoebee, B, Seidell, JC, Bouchard, C, van Baak, MA, de Groot, CP, Chagnon, M, de Graaf, C & Saris, WHM (2002) Genetic factors as predictors of weight gain in young adult Dutch men and women. International Journal of Obesity and Related Metabolic Disorders 26, 517–528.Google Scholar
Visscher, TLS, Kromhout, D & Seidell, JC (2002) Long-term and recent time trends in the prevalence of obesity among Dutch men and women. International Journal of Obesity and Related Metabolic Disorders 26, 1218–1224.Google Scholar
Visscher, TLS, Seidell, JC, Molarius, A, van der, Kuip, D, Hofman, A Witteman, JCM (2001) A comparison of body mass index, waist-hip ratio and waist circumference as predictors of all-cause mortality in the elderly: the Rotterdam study. International Journal of Obesity and Related Metabolic Disorders 25, 1730–1735.Google Scholar
Willett, WC (1998) Dietary fat and obesity: an unconvincing relation. American Journal of Clinical Nutrition 68, 1149–1150.Google Scholar
Willett, WC, Manson, JE, Stampfer, MJ, Colditz, GA, Rosner, B, Speizer, FE & Hennekens, CH (1995) Weight, weight change, and coronary heart disease in women. Risk within the ‘normal’ weight range. Journal of the American Medical Association 273, 461–465.Google Scholar
World Health Organization (2000) Obesity: Preventing and Managing the Global Epidemic. Report of a WHO consultation. WHO Technical Report Series no. Geneva:WHO.Google Scholar
World Health Organization (2003) Diet, Nutrition and the Prevention of Chronic Diseases. Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series no. Geneva:WHO.Google Scholar