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Abstract

Several country-specific and global projections of the future obesity prevalence have been conducted. However, these projections are obtained by extrapolating past prevalence of obesity or distributions of body weight. More accurate would be to base estimates on the most recent measures of weight change. Using measures of overweight and obesity incidence from a national, longitudinal study, we estimated the future obesity prevalence in Australian adults. Participants were adults aged ≥25 years in 2000 participating in the Australian Diabetes, Obesity, and Lifestyle (AusDiab) study (baseline 2000, follow-up 2005). In this population, approximately one-fifth of those with normal weight or overweight progressed to a higher weight category within 5 years. Between 2000 and 2025, the adult prevalence of normal weight was estimated to decrease from 40.6 to 28.1% and the prevalence of obesity to increase from 20.5 to 33.9%. By the time, those people aged 25-29 in 2000 reach 60-64 years, 22.1% will be normal weight, and 42.4% will be obese. On average, normal-weight females aged 25-29 years in 2000 will live another 56.2 years: 26.6 years with normal weight, 15.6 years with overweight, and 14.0 years with obesity. Normal-weight males aged 25-29 years in 2000 will live another 51.5 years: 21.6 years with normal weight, 21.1 years with overweight, and 8.8 years with obesity. If the rates of weight gain observed in the first 5 years of this decade are maintained, our findings suggest that normal-weight adults will constitute less than a third of the population by 2025, and the obesity prevalence will have increased by 65%.

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... Although the incidence rate (IR) of joint arthroplasty varies by country [17,23,24,26], a consistent historical increase in the incidence of joint arthroplasty has been reported worldwide [7-12, 20, 23-26]. Many reasons have been reported or postulated to explain this increase in joint arthroplasties, including aging of the general population [17], the increase in obesity worldwide [27], an increase in osteoarthritis prevalence [17], benefits in patients' quality of life and function, supplier-induced demands, expansion of surgical indications, and patient-driven behavior [16]. ...
... However, we believe this is not a disqualifying limitation of our study as we assume these to be constant in the projected years, which we believe results in conservative projection estimates. We recognize that the future demands of joint arthroplasties in Australians also might increase if the proportion of patients who become obese should increase [27], if life expectancies increase, or if the prevalence of osteoarthritis continues to increase in the aging population [17]. We could not account for these factors in our analysis owing to data availability and modeling constraints. ...
... The population of Australia is expected to increase by 41% between 2013 and 2036 (from 23.1 to 34.4 million) [3], which is substantially higher than the 13% expected for the United Sates [8], 10% for the United Kingdom [22], or 11% for Sweden during a comparable period (2013-2030) [20]. In addition to the expected increase in population, the projected increase in the numbers of procedures could be attributed to factors which have been postulated by others [16,17,27], including the changes in patient characteristics, expansion of surgical indications, willingness to undergo surgery, and less concern regarding complications from these procedures, which have much success and increasing survivability. Our estimates that the incidence of TKAs is expected to increase less than the incidence of THAs are contrary to estimates in other studies [9,20,21,25], which reported the largest expected growth to be in the incidence or volume of TKAs. ...
Article
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Background The incidence of joint arthroplasty is increasing worldwide. International estimates of future demand for joint arthroplasty have used models that propose either an exponential future increase, despite obvious system constraints, or static increases, which do not account for past trends. Country-specific projection estimates that address limitations of past projections are necessary. In Australia, a high-income country with the 7th highest incidence of TKA and 15th highest incidence of THA of the Organization for Economic Cooperation and Development (OECD) countries, the volume of TKAs and THAs increased 198% between 1994 and 2014. Questions/purposeTo determine the projected incidence and volume of primary TKAs and THAs from 2014 to 2046 in the Australian population older than 40 years. Methods Australian State and Territory Health Department data were used to identify TKAs and THAs performed between 1994 and 1995 and 2013 and 2014. The Australian Bureau of Statistics was the source of the population estimates for the same periods and population-projected estimates until 2046. The incidence rate (IR), 95% CI, and prediction interval (PI) of TKAs and THAs per 100,000 Australian citizens older than 40 years were calculated. Future IRs were estimated using a logistic model, and volume was calculated from projected IR and population. The logistic growth model assumes the existence of an upper limit of the TKA and THA incidences and a growth rate directly related to this incidence. At the beginning, when the observed incidence is much lower than the asymptote, the increase is exponential, but it decreases as it approaches the upper limit. ResultsA 66% increase in the IR of primary THAs between 2013 and 2046 is projected for Australia (2013: IR = 307 per 100,000, [95% CI, 262-329 per 100,000] compared with 2046: IR= 510 per 100,000, [95% PI, 98-567 per 100,000]), which translates to a 219% increase in the volume during this period. For TKAs the IR is expected to increase by 26% by 2046 (IR = 575 per 100,000; 95% PI, 402-717 per 100,000) compared with 2013 (IR = 437 per 100,000; 95% CI, 397-479 per 100,000) and the volume to increase by 142%. ConclusionA large increase in the volume of arthroplasties is expected using a conservative projection model that accounts for past surgical trends and future population changes in Australia. These findings have international implications, as they show that using country- specific, conservative projection approaches, a substantial increase in the number of these procedures is expected. This increase in joint arthroplasty volume will require appropriate workforce planning, resource allocation, and budget planning so that demand can be met. Level of EvidenceLevel II, economic and decision analysis.
... 11 To understand the implications for population health, some countries have constructed models to project body mass index (BMI) and obesity trends over time. 12,13 Microsimulation modelling is particularly useful for studying BMI trends, as it can simultaneously account for population dynamics such as aging, migration, and mortality. As well, the longitudinal framework of such models allows BMI to evolve over the life course of simulated individuals, to interact with factors such as physical activity, and to contribute to the risk of multiple diseases. ...
... These projected increases are comparable to those of the Foresight microsimulation model, which has been used for the United Kingdom (UK), the United States, and other countries, 10,12,43 and to statistical projections (non-microsimulation) for Australia. 13 A greater increase in the prevalence of obesity among men than women was also noted for Russia and Poland by the Foresight researchers. 44,45 However, the increase in the prevalence of overweight/ obesity projected by POHEM-BMI is not as steep as the Foresight models, which predict levels as high as 72% for the UK population by 2035, 9 and 80% for the Irish population by 2030. ...
... 44,45 However, the increase in the prevalence of overweight/ obesity projected by POHEM-BMI is not as steep as the Foresight models, which predict levels as high as 72% for the UK population by 2035, 9 and 80% for the Irish population by 2030. 46 Similar results were reported by Walls et al. 13 and in Figure 4 for women. For both sexes, average self-reported BMI is projected to rise by more than one BMI unit between 2001 and 2030. ...
Article
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Background: The increasing prevalence of overweight and obesity has necessitated the development of body mass index (BMI) projection models such as the POpulation HEalth Model (POHEM). This study describes the POHEM-BMI model, a microsimulation tool that can be used to support evidence-based health policy making for obesity reduction. Methods: The National Population Health Survey, the Canadian Community Health Survey (CCHS), and the Canadian Health Measures Survey (CHMS) were used to develop and validate a predictive model of BMI for adults and childhood BMI history. Models were incorporated into POHEM and used to transition BMI over time in a fully dynamic simulated Canadian population. Results: POHEM-BMI projections of self-reported and measured adult BMI and childhood BMI history agreed well with CCHS and CHMS validation estimates. Among men and women, average BMI is projected to increase by more than one BMI unit between 2001 and 2030. Projections of self-reported BMI show that 59% of the adult population will be overweight or obese by 2030; projections of measured BMI show that the percentage will be 66%. Interpretation: Using empirically developed BMI prediction models for adults and childhood BMI history integrated into the POHEM framework, validated projections of BMI for the Canadian population can be produced. Projections of BMI trends could have important applications in tracking the prevalence of related diseases and in planning and comparing intervention strategies.
... 11 To understand the implications for population health, some countries have constructed models to project body mass index (BMI) and obesity trends over time. 12,13 Microsimulation modelling is particularly useful for studying BMI trends, as it can simultaneously account for population dynamics such as aging, migration, and mortality. As well, the longitudinal framework of such models allows BMI to evolve over the life course of simulated individuals, to interact with factors such as physical activity, and to contribute to the risk of multiple diseases. ...
... These projected increases are comparable to those of the Foresight microsimulation model, which has been used for the United Kingdom (UK), the United States, and other countries, 10,12,43 and to statistical projections (non-microsimulation) for Australia. 13 A greater increase in the prevalence of obesity among men than women was also noted for Russia and Poland by the Foresight researchers. 44,45 However, the increase in the prevalence of overweight/ obesity projected by POHEM-BMI is not as steep as the Foresight models, which predict levels as high as 72% for the UK population by 2035, 9 and 80% for the Irish population by 2030. ...
... 44,45 However, the increase in the prevalence of overweight/ obesity projected by POHEM-BMI is not as steep as the Foresight models, which predict levels as high as 72% for the UK population by 2035, 9 and 80% for the Irish population by 2030. 46 Similar results were reported by Walls et al. 13 and in Figure 4 for women. For both sexes, average self-reported BMI is projected to rise by more than one BMI unit between 2001 and 2030. ...
Article
Full-text available
Background: The increasing prevalence of overweight and obesity has necessitated the development of body mass index (BMI) projection models such as the POpulation HEalth Model (POHEM). This study describes the POHEM-BMI model, a microsimulation tool that can be used to support evidence-based health policy making for obesity reduction. Data and methods: The National Population Health Survey, the Canadian Community Health Survey (CCHS), and the Canadian Health Measures Survey (CHMS) were used to develop and validate a predictive model of BMI for adults and childhood BMI history. Models were incorporated into POHEM and used to transition BMI over time in a fully dynamic simulated Canadian population. Results: POHEM-BMI projections of self-reported and measured adult BMI and childhood BMI history agree well with CCHS and CHMS validation estimates. Among men and women, average BMI is projected to increase by more than one BMI unit between 2001 and 2030. Projections of self-reported BMI show that 59% of the adult population will be overweight or obese by 2030; projections of measured BMI show that the percentage will be 66%. Interpretation: Using empirically developed BMI prediction models for adults and childhood BMI history integrated into the POHEM framework, validated projections of BMI for the Canadian population can be produced. Projections of BMI trends could have important applications in tracking the prevalence of related diseases, and in planning and comparing intervention strategies.
... Obesity represents a significant global health burden, with the World Health Organisation highlighting the importance of weight gain prevention in adults of healthy weight, particularly among women of reproductive age [1]. In any given 5-year period, 20% of women of reproductive age have sufficient weight gain to progress them into a higher body mass index (BMI) category [2,3]. Furthermore, the rate of weight gain is highest (approximately 700 g per year) among women of normal BMI [4,5]. ...
... 1 This number excludes four women who were randomised in error prior to trial registration. 2 Termination of pregnancy (TOP) 3 Three hundred and twelve infants with non-missing data included in raw data analysis, one infant with missing data had outcomes imputed and was therefore included in the imputed analysis. 4 Stillbirths excluded from infant outcomes analysis but included for analysis of maternal antenatal outcomes only. ...
... Notes: 1 This number excludes four women who were randomised in error prior to trial registration. 2 Termination of pregnancy (TOP) 3 Three hundred and twelve infants with non-missing data included in raw data analysis, one infant with missing data had outcomes imputed and was therefore included in the imputed analysis. 4 Stillbirths excluded from infant outcomes analysis but included for analysis of maternal antenatal outcomes only. ...
Article
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There are well-recognised associations between excessive gestational weight gain (GWG) and adverse pregnancy outcomes, including an increased risk of pre-eclampsia, gestational diabetes and caesarean birth. The aim of the OPTIMISE randomised trial was to evaluate the effect of dietary and exercise advice among pregnant women of normal body mass index (BMI), on pregnancy and birth outcomes. The trial was conducted in Adelaide, South Australia. Pregnant women with a body mass index in the healthy weight range (18.5–24.9 kg/m2) were enrolled in a randomised controlled trial of a dietary and lifestyle intervention versus standard antenatal care. The dietitian-led dietary and lifestyle intervention over the course of pregnancy was based on the Australian Guide to Healthy Eating. Baseline characteristics of women in the two treatment groups were similar. There was no statistically significant difference in the proportion of infants with birth weight above 4.0 kg between the Lifestyle Advice and Standard Care groups (24/316 (7.59%) Lifestyle Advice versus 26/313 (8.31%) Standard Care; adjusted risk ratio (aRR) 0.91; 95% confidence interval (CI) 0.54 to 1.55; p = 0.732). Despite improvements in maternal diet quality, no significant differences between the treatment groups were observed for total GWG, or other pregnancy and birth outcomes.
... A recent study revealed that almost 26% of Australian adults aged 15 years and over were obese in 2019 [5]. Besides, it is predicted that the obesity rate in Australia might increase by 65% within 2025 [6]. The high and growing trends of overweight and obesity is a serious public health concern in Australia since it is associated with chronic diseases [7], disability [8], and poor self-rated physical and mental health outcomes [9]. ...
... Earlier studies conducted in Australia focused on overweight and obesity trends that covered only specific dimensions. For example, prediction of higher BMI trends [6,18,19], costs of obesity [20], prevalence and factors of child obesity [21,22], and modelling for obesity prevention [23,24] are the most prominent. However, some cross-sectional studies executed outside of Australia determined the risk indicators of obesity [25][26][27][28]. ...
Article
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The prevalence of overweight and obesity is rising dramatically worldwide, including in Australia. Therefore, the necessity of identifying the risk factors of overweight and obesity is pivotal. The main objective of this study is to investigate the influence of neighbourhood socio-economic circumstances and place of residence on obesity amongst Australian adults. This study has used nationally representative panel data on 183,183 person-year observations from 26,032 unique Australian adults from the Household, Income, and Labour Dynamics in Australia (HILDA). Random-effects logistic regression technique was employed to examine the relationships. The prevalence of overweight and obesity has been found at approximately 34% and 24%, respectively. The most striking result to emerge from the analyses is that adults living in the most socio-economic disadvantaged area were 2.04 times (AOR: 2.04, 95% CI: 1.57–2.65) and adults from regional cities of Australia were 1.71 times (AOR: 1.71, 95% CI: 1.34–2.19) more prone to be obese compared to their healthy counterparts. The prevalence of overweight and obesity is very high among Australian adults, especially those living in disadvantaged neighbourhoods and the regional cities. Unhealthy levels of BMI have costly impacts on the individual, the economy, and the health care system. Therefore, this study emphasises effective weight control strategies that can potentially tackle the obesity epidemic in Australia.
... The results of the age-period-cohort modeling identified substantial cohort effects illustrating a change in rates in successive age groups in successive time periods; this is often associated with a change in exposure affecting an entire birth cohort. The prevalence of key colorectal cancer risk factors has shifted in recent decades in Australia and in other high-income countries (36,37). Overweight and obesity prevalence has increased in Australia, and this increase is projected to continue to 2025 (37,38). ...
... The prevalence of key colorectal cancer risk factors has shifted in recent decades in Australia and in other high-income countries (36,37). Overweight and obesity prevalence has increased in Australia, and this increase is projected to continue to 2025 (37,38). Childhood obesity has also increased over 2.5-fold from 1985 to 2012 (39). ...
Article
Background: Colorectal cancer is the third most commonly diagnosed cancer in Australia. Emerging evidence from several countries suggests increasing incidence in people aged <50 years. Methods: We assessed colon and rectal cancer incidence trends in people aged 20+ in Australia from 1982 to 2014. We used data on 375,008 incident cases (248,162 colon and 126,846 rectal). We quantified the annual percentage change (APC) in rates by age group using Joinpoint regression. Results: For people aged <50 years, colon cancer rates increased from the mid-2000s, with the increase in APCs ranging from 1.7% to 9.3% per annum (depending on specific age group); rectal cancer rates increased from the early 1990s, with APCs ranging from 0.9% to 7.1% per annum. For people aged 50 to 69 years, colon and rectal cancer rates decreased from the mid-1990s, with the decrease in APCs in specific age groups ranging from 0.8% to 4.8% per annum (except for colon cancer in those ages 65 to 69 years, where similar rate decreases were observed from 2007). An overall reduction in older persons (>70 years) was estimated at 1.9% to 4.9% per annum for colon cancer from 2010 onward and 1.1% to 1.8% per annum in rectal cancer from the early 2000s onward. Conclusions: Colon and rectal cancer incidence has increased in people aged <50 years in Australia over the last two decades. However, colon and rectal cancer rates decreased in people aged 50+, likely due to and organized bowel cancer screening. Impact: Further research is needed to examine the cause of the increase and to quantify the impact of future trends on the cost-effectiveness of population-based screening for those <50 years.
... Obesity and eating disorders are significant public health concerns that are associated with a range of adverse physical and psychological outcomes. In Australia, more than 60% of adults and 25% of children and adolescents are overweight or obese [1,2], with an additional 16% presenting with disordered eating behaviours or eating disorders [3]. The rate of both eating disorders [4] and obesity [2] is increasing in the Australian population, and recent evidence indicates that the rate of comorbid obesity and eating disorder behaviours has increased more rapidly than either disorder alone [5]. ...
... In Australia, more than 60% of adults and 25% of children and adolescents are overweight or obese [1,2], with an additional 16% presenting with disordered eating behaviours or eating disorders [3]. The rate of both eating disorders [4] and obesity [2] is increasing in the Australian population, and recent evidence indicates that the rate of comorbid obesity and eating disorder behaviours has increased more rapidly than either disorder alone [5]. Individuals with comorbid obesity and eating disorders face the added difficulty of receiving care for both the medical complications associated with obesity and the psychosocial impairments associated with eating disorders [5]. ...
Article
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Objective Most weight loss research focuses on weight as the primary outcome, often to the exclusion of other physiological or psychological measures. This study aims to provide a holistic evaluation of the effects from weight loss interventions for individuals with obesity by examining the physiological, psychological and eating disorders outcomes from these interventions. Methods Databases Medline, PsycInfo and Cochrane Library (2011–2016) were searched for randomised controlled trials and systematic reviews of obesity treatments (dietary, exercise, behavioural, psychological, pharmacological or surgical). Data extracted included study features, risk of bias, study outcomes, and an assessment of treatment impacts on physical, psychological or eating disorder outcomes. ResultsFrom 3628 novel records, 134 studies met all inclusion criteria and were evaluated in this review. Lifestyle interventions had the strongest evidence base as a first-line approach, with escalation to pharmacotherapy and bariatric surgery in more severe or complicated cases. Quality of life was the most common psychological outcome measure, and improved in all cases where it was assessed, across all intervention types. Behavioural, psychological and lifestyle interventions for weight loss led to improvements in cognitive restraint, control over eating and binge eating, while bariatric surgery led to improvements in eating behaviour and body image that were not sustained over the long-term. DiscussionNumerous treatment strategies have been trialled to assist people to lose weight and many of these are effective over the short-term. Quality of life, and to a lesser degree depression, anxiety and psychosocial function, often improve alongside weight loss. Weight loss is also associated with improvements in eating disorder psychopathology and related measures, although overall, eating disorder outcomes are rarely assessed. Further research and between-sector collaboration is required to address the significant overlap in risk factors, diagnoses and treatment outcomes between obesity and eating disorders.
... The Obesity Society, Australia anticipates the adult population prevalence of normal healthy weight will decrease from 40.6% to 22.9% over the period from 2001 and 2025. Obesity in Australia will increase from 20.5% to 33.9% [1]. Bariatric surgeries are the best available means to achieve durable and meaningful weight loss. ...
... She had undergone a stomach partitioning gastrojejunostomy 20 years prior which made access with endoscopy difficult (Figure 1). 1 2, 3 4 Open Access Case Relevant other medical history included morbid obesity (BMI 62.5 kg/m2), atrial fibrillation, insulindependent diabetes mellitus, and obstructive sleep apnoea and iron deficiency anaemia. She was a nonsmoker and was not on any regular non-steroidal anti-inflammatory drugs (NSAIDs) or regular proton pump inhibitors. ...
Article
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We report an unusual case of a 76-year-old woman with a necrotic perforated excluded gastric pouch who had stomach partitioning gastrojejunostomy 20 years earlier for morbid obesity. The necrotic mucosa of the excluded gastric pouch was seen on gastroscopy with retrograde cannulation from the pylorus. Laparotomy revealed a distended excluded stomach with full-thickness ischaemia of the posterior wall with perforation into the lesser sac. Partial gastrectomy with Roux-en-Y gastrojejunostomy was performed. We strongly suggest early surgical exploration for these patients when they are hemodynamically unstable or do not have a precise diagnosis despite imaging to prevent potentially life-threatening gastric pouch necrosis. We advocate for avoiding risk factors like alcohol, nicotine, and nonsteroidal anti-inflammatory drugs (NSAIDs) and implement preoperative Helicobacter pylori testing and its eradication to reduce the incidence of perforation in the excluded pouch.
... 5 There is a prediction that future obesity prevalence in Australia will increase beyond 65% by 2025. 6 This rapid progression of obesity in the community has serious implications for health, productivity, and quality of life. At the national level, it imposes a tremendous economic burden on the health system. ...
... 8 Previous studies focusing on the prevalence of overweight and obesity in Australia have examined a particular dimension. For instance, projections of overweight and obesity trends, 6,7,9 prevalence and associated factors for child obesity, 10,11 factors influencing the probability of being obese, 12 socioeconomic disparities in obesity, 13 costs of obesity, 14 modeling of obesity prevention, 15,16 and the association between place and weight 17,18 are the most prominent. Some studies [19][20][21][22] conducted in other countries have attempted to identify the risk factors of obesity based on cross-sectional data. ...
Article
Purpose This study aims to investigate the impact of disadvantaged neighborhoods and lifestyle factors on obesity among Australian adults. Design Quantitative, longitudinal research design. Setting Cohort. Sample Data for this study came from a cohort of 10 734 adults (21 468 observations) who participated in the Household, Income and Labour Dynamics in Australia survey. The participants were interviewed at baseline in 2013 and were followed up in 2017. Measures Generalized Estimating Equation model with logistic link function was employed to examine within-person changes in obesity due to disadvantaged neighborhoods and lifestyle factors at 2-time points over a 4-year follow-up period. Results Adults living in the most disadvantaged area were 1.22 (odds ratio [OR]: 1.22, 95% CI: 1.08-1.38) and 1.30 (OR: 1.30, 95% CI: 1.20-1.42) times, respectively, more prone to be overweight and obese compared with peers living at least disadvantaged area. Study results also revealed that adults who consume fruits regularly and perform high levels of physical activity were 6% (OR: 0.94, 95% CI: 0.91-0.98) and 12% (OR: 0.88, 95% CI: 0.85-0.92) less likely to be obese, respectively, compared to their counterparts. Current alcohol drinkers were 1.07 (OR: 1.07, 95% CI: 1.01-1.13) times more likely to be obese compared to peers not consuming alcohol. Highly psychologically distressed adults were 1.08 times (OR: 1.08, 95% CI: 1.02-1.13) more likely to be obese than their peers. Conclusion This study contributes to the literature regarding disadvantaged neighborhoods and lifestyle factors, which have an influence on adult obesity rates and thus help health decision-makers to formulate effective obesity prevention strategies.
... However projections of future overweight and obesity prevalence in Australia have estimated an increase. We modelled the impact of an estimated 72% of the Australian adult population being overweight or obese in 2025 (Walls et al., 2012). The model draws on Australian data on employment status, health related absenteeism from work and disruption to household and leisure activities 1 for persons exposed and not exposed to the risk factor of interest to predict the economic burden and healthcare costs attributable to these two risk factors. ...
... Initial consumption rates are determined by the recent dietary survey NNPAS data. Projections of per capita consumption rates were based on increases in the prevalence of overweight and obese to 72% in 2025 (Walls et al 2012). The consumption rates of this cohort and the nonoverweight cohort were determined from the calibrated average consumption rates (with a 10year smoothing window to eliminate significant noise in the data) and the observation that the overweight cohort is about 30% in 1985 (ABS, 2013b). ...
Article
(For full text of 'author-accepted manuscript manuscript' go to http://www.seonacandy.com/publications-1/ and scroll down to 'Peer-reviewed papers'.) While historically Australia has been a major exporter of food commodities and is generally considered to be “food secure”, our inter-disciplinary modelling of Australia’s food system and contemporary diet demonstrates that Australia is likely to become a net importer of key nutritious foods such as nuts and dairy if it continues along its current policy path. Furthermore, this occurs in the context of accelerating international debt, complete dependence on imported oil and declines in Gross Domestic Product per capita. Coupled with no reduction in greenhouse gas emissions, and increasing water deficits around many capital cities, these factors indicate increasing threats to Australia’s food security. These strategic challenges arise from past and current policy choices and trends, including continued consumption of an unhealthy diet. Their effects are modelled for the coming decades using an innovative scenario simulation based on comprehensive accounts of physical processes in Australia’s economy simulated in the Australian Stocks and Flows Framework. Our analysis further employed health and economic cost modelling based on burden of disease data, conservatively demonstrating that productivity and health costs of unhealthy diets would be at least three billion Australian dollars for the 2025 Australian population if we were to continue on this trajectory.
... By 2025, it is estimated that 36.9% of the Australian population aged 65 years and over will be obese [1]. Similar rates have been proposed for the US, with France and other European nations not far behind at 17.9-30% [2]. ...
... HRQoL encompasses physical and mental domains, each constituting numerous sub-domains such as physical function, social functioning, mental health, and self-perceived health [16]. Within our study, we have chosen to examine well-being from two methodological standpoints: (1) HRQoL, which measures quality of life by comparing an individual's self-rated health status against communityderived standards, and (2) life satisfaction, whereby the individual's quality of life is assessed against his/her own chosen criteria and requires a cognitive, judgemental process. Although there is considerable overlap between the concepts of QoL and life satisfaction [17], these constructs have been measured separately in many studies. ...
Article
Full-text available
Objectives: While obesity has been linked with lower quality of life in the general adult population, the prospective effects of present obesity on future quality of life amongst the elderly is unclear. This article investigates the cross-sectional and longitudinal relationships between obesity and aspects of quality of life in community-dwelling older Australians. Method: A 2-year longitudinal sample of community dwellers aged 70-90 years at baseline, derived from the Sydney Memory and Ageing Study (MAS), was chosen for the study. Of the 1037 participants in the original MAS sample, a baseline (Wave 1) sample of 926 and a 2-year follow-up (Wave 2) sample of 751 subjects were retained for these analyses. Adiposity was measured using body mass index (BMI) and waist circumference (WC). Quality of life was measured using the Assessment of Quality of Life (6 dimensions) questionnaire (AQoL-6D) as well as the Satisfaction with Life Scale (SWLS). Linear regression and analysis of covariance (ANCOVA) were used to examine linear and non-linear relationships between BMI and WC and measures of health-related quality of life (HRQoL) and satisfaction with life, adjusting for age, sex, education, asthma, osteoporosis, depression, hearing and visual impairment, mild cognitive impairment, physical activity, and general health. Where a non-linear relationship was found, established BMI or WC categories were used in ANCOVA. Results: Greater adiposity was associated with lower HRQoL but not life satisfaction. Regression modelling in cross-sectional analyses showed that higher BMI and greater WC were associated with lower scores for independent living, relationships, and pain (i.e. worse pain) on the AQoL-6D. In planned contrasts within a series of univariate analyses, obese participants scored lower in independent living and relationships, compared to normal weight and overweight participants. Longitudinal analyses found that higher baseline BMI and WC were associated with lower independent living scores at Wave 2. Conclusions: Obesity is associated with and predicts lower quality of life in elderly adults aged 70-90 years, and the areas most affected are independent living, social relationships, and the experience of pain.
... Maintaining optimal body weight is crucial in supporting good health, but there are large proportions of the population who fail to maintain their body weight within a healthy range [1]. The prevalence of obesity and obesity-related metabolic diseases such as type 2 diabetes mellitus, cardiovascular disease and hypertension continues to rise in Australia and globally in adults [2,3]. These conditions are top public health priorities [4] as they are common causes of disability and mortality [5,6], and impose significant burdens on the healthcare system. ...
Article
Full-text available
Purpose The global prevalence of overweight remains high; effective strategies that consider patterns of body weight changes to identify periods when adults are susceptible to weight gain are warranted. This systematic review aimed to investigate body weight patterns, and how they were associated with dietary intake and/or dietary behaviours (Prospero CRD42020161977). Methods Systematic literature search was conducted in the Medline, Embase, and CINAHL databases until November 2020. Observational studies in adults (18 years and over) that reported at least two measurements of weight and dietary intake in a year were included. Risk of bias was conducted using the Evidence Analysis Library by the Academy of Nutrition and Dietetics tool. This review included 16 unique studies after title, abstract, and full-text screening, and findings were narratively synthesised. Results Of the six studies conducted in the farming populations, five were conducted in countries with two seasons (dry vs. rainy seasons) and all studies observed higher body weight during the dry season (up to 3.1 kg difference between seasons). The remaining study was conducted in a sub-tropical country and did not observe temporal weight patterns. Higher dietary intake was also reported during the dry season in the tropical countries. In non-farming populations (n = 10), temporal patterns were also seen, where higher body weight and adiposity was observed during colder seasons (autumn and winter). However, the opposite was found in a study conducted in Iran, where higher weight was seen in summer. Concurrent with higher body weight, higher energy, fat, carbohydrate and soda consumption, and lower fiber and vegetable intake were observed. Conclusion Temporal weight and dietary patterns exist, and they were country- and context-specific; these patterns were also related to factors such as activity levels, seasons and occupation. Future interventions should consider temporal patterns in the design and delivery of timely and tailored dietary interventions to promote optimal body weight. PROSPERO Registration PROSPERO Registration: CRD42020161977.
... morbid obesity) or BMI z-scores. [14][15][16] Children with morbid obesity require tertiary treatment; hence, monitoring of changes are important for estimating future health-care costs as well as determining if obesity prevention programmes are effective in attenuating obesity rates. The purpose of this study is to use national data to examine temporal changes in BMI z-scores and the prevalence obesity and morbid obesity in children aged 7-15 years from 1985 to 2014. ...
Article
Aim Children with obesity have a greater risk of adverse social and physical health outcomes. We examined temporal changes in body mass index (BMI) z‐scores and the prevalence obesity and morbid obesity in children from 1985 to 2014. Methods Secondary data analysis of BMI data for children aged 7–15 years from five cross‐sectional Australian datasets. Changes in age‐ and gender‐adjusted BMI (BMI z‐scores) and nutritional status were categorised using the International Obesity Task Force cut‐off points. Results The percentage of children who were obese tripled between 1985 and 1995 from 1.6 to 4.7%, before plateauing between 1995 and 2014. The percentage of morbidly obese children was <1% in 1985 and 1995, increasing to 2% between 1995 and 2007, with no further increase between 2007 and 2014. The proportion of obese children classified as morbidly obese was 12% in 1985–1995, 24% in 2007–2012 and 28% in 2014. Between 1985 and 2012, the mean BMI z‐score increased in children categorised as obese from 1.94 (standard deviation 0.15) to 2.03 (0.22), and then plateaued. For morbidly obese children, the mean BMI z‐score was 2.4 (0.13) and remained similar over the study period. Conclusions Our findings suggest that the relative fatness of children with morbid obesity, as measured by BMI z‐score, has remained stable. The proportion of obese and morbidly obese children has also plateaued between 2007 and 2014. However, the prevalence of obesity remains high, and more dedicated resources are required to treat children with obesity to reduce the short‐ and long‐term health impact.
... 11,12 It has been estimated that women of reproductive age gain approximately 700 g of weight per year, 11 and in any given 5-year period, 20% of women will gain sufficient weight to progress into a higher BMI category. 13 This, in turn, contributes to an increase in interpregnancy BMI and an increased risk of adverse pregnancy outcomes and perpetuates longer-term risks of obesity and its health consequences. 14 The effect of a change in interpregnancy BMI on birth outcomes in a subsequent pregnancy has been investigated in a number of observational studies. ...
Article
Context: Many international clinical guidelines recommend that overweight and obese women lose weight prior to pregnancy to reduce the risk of adverse pregnancy outcomes. Women who have recently given birth and plan future pregnancies are an important target population for preconception weight-loss interventions. Objective: A systematic review to evaluate postpartum dietary and/or physical activity interventions to promote weight loss and improve health in a subsequent pregnancy was conducted. Data sources: Five databases-the Cochrane Central Register of Controlled Trials, MEDLINE (through PubMed), Embase, the Australian New Zealand Clinical Trials Registry, and the International Clinical Trials Registry-were searched using the following terms: preconception, pregnancy, postpartum, pregnancy outcomes, body mass index, weight gain, weight loss, weight change, postpartum weight retention, dietary or lifestyle intervention, and randomiz(s)ed controlled trial. The date of last search was November 2017. Data extraction: Data were extracted from each identified study using a standard form. The primary outcomes were weight loss at the completion of the intervention and at follow-up assessments. Secondary endpoints included maternal and infant outcomes in a subsequent pregnancy. Data analysis: Mean differences (MDs) were calculated for continuous data and risk ratios for dichotomous data, both with 95%CIs. Results: A total of 235 abstracts (193 after duplicates were excluded) were identified, from which 37 manuscripts were selected for full-text review. In total, 27 trials were identified for inclusion. Outcome data were available for approximately 75% of participants (n = 3485). A combined dietary and physical activity intervention provided post partum produced greater postpartum weight loss (MD, -2.49 kg; 95%CI, -3.34 to -1.63 kg [random-effects model]; 12 studies, 1156 women), which was maintained at 12 months post partum (MD, -2.41 kg; 95%CI, -3.89 to -0.93 kg [random-effects model]; 4 studies, 405 women), compared with no intervention. No studies reported maternal or infant health outcomes in a subsequent pregnancy. Conclusions: Providing a postpartum intervention is associated with weight loss after birth, but effects on maternal and infant health in a subsequent pregnancy are uncertain.
... Globally, an estimated 41 million children aged under five are overweight or obese [4]. In Australia, 20% of children aged 2-4 years are overweight or obese [5], with predictions that this could reach 33% by 2025 [6]. One in three children living in lower socioeconomic areas (33%) are overweight or obese compared with those living in higher socioeconomic areas (19%), while levels are comparable across urban (26%) or regional (27%) areas [7]. ...
Article
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The ‘early years’ is a crucial period for the prevention of childhood obesity. Health services are well placed to deliver preventive programs to families, however, they usually rely on voluntary attendance, which is challenging given low parental engagement. This study explored factors influencing engagement in the Infant Program: a group-based obesity prevention program facilitated by maternal and child health nurses within first-time parent groups. Six 1.5 h sessions were delivered at three-month intervals when the infants were 3⁻18 months. A multi-site qualitative exploratory approach was used, and program service providers and parents were interviewed. Numerous interrelated factors were identified, linked to two themes: the transition to parenthood, and program processes. Personal factors enabling engagement included parents’ heightened need for knowledge, affirmation and social connections. Adjusting to the baby’s routine and increased parental self-efficacy were associated with diminished engagement. Organisational factors that challenged embedding program delivery into routine practice included aspects of program promotion, referral and scheduling and workforce resources. Program factors encompassed program content, format, resources and facilitators, with the program being described as meeting parental expectations, although some messages were perceived as difficult to implement. The study findings provide insight into potential strategies to address modifiable barriers to parental engagement in early-year interventions.
... 8 These problems are projected to escalate given the increased longevity and growing epidemic of diabetes and obesity both in Australia and worldwide. Highlighting this concerning trend is the fact that by 2025, the number of Australian adults (25+ years) who are obese is projected to exceed 6 million, 9 and almost 5 million Australians will be aged 65+ years. 10 In 2014, a total of 22 218 people died from kidneyrelated diseases. ...
... Almost 40% of older adults living in western countries are obese 1,2 . An obese older individual has similar life expectancy to a non-obese counterpart, but has health care costs around $US40,000 higher owing to their increased risk for cardiometabolic disorders (e.g. ...
Article
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Objectives: To determine whether associations of calf muscle density with physical function are independent of other determinants of functional decline in overweight and obese older adults. Methods: This was a secondary analysis of a cross-sectional study of 85 community-dwelling overweight and obese adults (mean±SD age 62.8±7.9 years; BMI 32.3±6.1 kg/m2; 58% women). Peripheral quantitative computed tomography assessed mid-calf muscle density (66% tibial length) and dual-energy X-ray absorptiometry determined visceral fat area. Fasting glucose, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and C-reactive protein (CRP) were analysed. Physical function assessments included hand grip and knee extension strength, balance path length (computerised posturography), stair climb test, Short Physical Performance Battery (SPPB) and self-reported falls efficacy (Modified Falls Efficacy Scale; M-FES). Results: Visceral fat area, not muscle density, was independently associated with CRP and fasting glucose (B=0.025; 95% CI 0.009-0.042 and B=0.009; 0.001-0.017, respectively). Nevertheless, higher muscle density was independently associated with lower path length and stair climb time, and higher SPPB and M-FES scores (all P⟨0.05). Visceral fat area, fasting glucose and CRP did not mediate these associations. Conclusions: Higher calf muscle density predicts better physical function in overweight and obese older adults independent of insulin resistance, visceral adiposity or inflammation.
... Although the US has the highest proportion (about 35% of its population), in Australia the change in the percentage of obese people has been the highest, an increase of 8% in the last 15 years 145 . If overweight and obesity rates are combined, by 2024 it is forecast that 72% of Australians will be in this category 146 . In addition, mental health conditions such as anxiety, depression and substance-use disorders are on the rise, with 45% of the Australian adult population expected to experience one of these disorders in their lifetime 147 . ...
Technical Report
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Surfing the Digital Tsunami uses scenarios to explore how digital innovation might transform Australian business and the economy, and impact the role of government. The report is based on a scenario development process conducted by CSIRO | Data61 in partnership with the Department of Industry, Innovation and Science (DIIS). Scenarios are hypothetical stories about the future that are informed by evidence relating to important trends or drivers of change. Scenarios do not predict the future but rather highlight critical issues and plausible chains of events, and their outcomes. The report is presented in two parts: 1 Scenarios report – describing four preliminary scenarios exploring the decade ahead for Australian business and the economy 2 Technical report – providing important background literature and methodology that underpin the scenarios. This material is summarised in the scenarios report. Four preliminary scenarios are presented in this report. These scenarios were based on analysis of relevant trends and emerging digital innovations impacting on business, and were developed in collaboration with a cross section of federal government policy makers through an interactive workshop. The exercise explored changes and events that could show up to transform the business sector broadly rather than analysing impacts on specific industries. These scenarios are preliminary because they aim to open further dialogue about the role of government in a complex and rapidly digitalising economic environment. Continuing dialogue will shed more light on what could happen over the coming decade, including how digital disruption might uniquely impact different industries and businesses of varying sizes (SME vs large companies). Our aim is to see these scenarios and their implications evolve and help guide future policymaking. Underpinning this aim is the assumption that technological futures are not inevitable, but shaped by people. People bring values and aspirations, world views and agendas that can influence the direction and impact of technological change.
... Worldwide, at least 2.8 million people die each year as a result of being overweight or obese, and an estimated 35.8 million (2.3%) global DALYs (Disability Adjusted Life Years) are affected by excess weight or obesity. Shockingly, the number of people globally with a body mass index (BMI) greater than 30 has risen from 105 million in 1975 to 641 million in 2014, and this upward trend is predicted to continue over the coming decades (Walls et al. 2012, The journal.ie 2017Daily Record 2016;Kelland 2016). An epidemic of overweight-and obesity-related diseases, such as diabetes and cardiovascular disease (CVD), is prevalent in many Asian countries. ...
Article
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There is evidence that rapid weight gain during the first year of life is associated with being overweight later in life. Therefore, overweight tendencies need to be detected at an appropriate age, and suitable strategies need to be implemented for weight management to achieve optimal long-term health. The objective of this study was to investigate comparisons in BMI status and associated categories in male and female students over ten years in two phases, including 2008-2013 and 2009-2014. Weight and height data were collected to obtain BMI (Body Mass Index) over ten years in two phases. The first phase occurred from 2008 to 2013, and the second phase occurred from 2009 to 2014 in a population of 10846 school children (Males: 6970, 64.3%, and females: 3875, 35.7%) in Macau. Their ages ranged from 6 years old in 2008 to 11 years old in 2013. The same age range was observed in the second phase, i.e., 2009-2014. Statistical analyses included descriptive statistics, such as the mean, standard deviation, t-tests to determine gender differences (year-wise) and a Chi square test for independence to determine the relationship between BMI (Underweight, Standard, Overweight and Obese) and age groups. In the first phase (2008-2013), the findings indicated a higher BMI level among the male students than the female students across all age groups (2008 t = 5.24, 2009 t = 88.25, 2010 t = 11.32, 2011 t = 17.45, 2012 t = 19.70 and 2013 t = 19.92). In the second phase (2009-2014), a higher BMI level was found among the male students than the female students across all age groups (2009 t = 2.68, 2010 t = 2.886, 2011 t = 3.076, 2013 t = 4.228, and 2014 t = 2.405). The results of the two phases combined (2008 to 2014 and 2009 to 2014) revealed that male students in 2008 had a higher BMI level than their counterparts in 2009 in the two age categories (8 years t = 3.025 and 11 years t = 3.377). Female students in the second phase (2009-2014) showed a higher BMI level than their male counterparts (9 years, t = 3.151). The results indicate the need to have focused strategies and structured interventions for male students at the critical age range of 8 to 9 years old. The results of this study also imply the need for the delivery of suitable school intervention activities at the appropriate time. Specifically, the prevention of weight gain should start early in life to encourage the development of healthier behaviours and habits throughout childhood and later ages.
... In the last twenty years, the prevalence of obesity has increased significantly, and in Australia is expected to reach 75% of the population by 2025 (Walls et al., 2012;Welfare, 2020). Increased adiposity is associated with an increased risk of many diseases, including hypertension, cardiovascular disease, diabetes type II, and some cancers (Boles et al., 2017;Calle and Kaaks, 2004;Hubert et al., 1983). ...
Article
Kisspeptin is vital for the regulation of both fertility and metabolism. Kisspeptin receptor (Kiss1r) knockout (KO) mice exhibit increased adiposity and reduced energy expenditure in adulthood. Kiss1r mRNA is expressed in brown adipose tissue (BAT) and Kiss1r KO mice exhibit reduced Ucp1 mRNA in BAT and impaired thermogenesis. We hypothesised that mice with diminished kisspeptin signalling would exhibit reduced core body temperature (Tc) and altered dynamics of circadian and ultradian rhythms of Tc. Tc was recorded every 15-min over 14-days in gonadectomised wild-type (WT), Kiss1r KO, and also Kiss1-Cre (95% reduction in Kiss1 transcription) mice. Female Kiss1r KOs had higher adiposity and lower Ucp1 mRNA in BAT than WTs. No change was detected in Kiss1-Cre mice. Mean Tc during the dark phase was lower in female Kiss1r KOs versus WTs, but not Kiss1-Cre mice. Female Kiss1r KOs had a lower mesor and amplitude of the circadian rhythm of Tc than did WTs. In WT mice, there were more episodic ultradian events (EUEs) of Tc during the dark phase than the light phase, but this measure was similar between dark and light phases in Kiss1r KO and Kiss1-Cre mice. The amplitude of EUEs was higher in the dark phase in female Kiss1r KO and male Kiss1-Cre mice. Given the lack of clear metabolic phenotype in Kiss1-Cre mice, 5% of Kiss1 transcription may be sufficient for proper metabolic control, as was shown for fertility. Moreover, the observed alterations in Tc suggest that kisspeptin has a role in circadian and ultradian rhythm-driven pathways.
... The increase in incidence is likely due to better detection practices [52], with some contribution from overdiagnosis [30]. Although the drivers for the increasing burden of thyroid cancer are not completely explained, obesity was found to be a risk factor in a previous study [53], and the prevalence has increased in Australia [54]. An increasing use of diagnostic imaging that eventually leads to increased exposure to radiation could be another contributor [55]. ...
Article
Background: Comparative evidence on the burden, trend, and risk factors of cancer is limited. Using data from the Global Burden of Disease (GBD) study, we aimed to assess cancer burden - incidence, prevalence, mortality, disability-adjusted life years (DALYs) - and attributable risk factors for Australia between 1990 and 2015, and to compare them with those of 34 members of the Organisation for Economic Co-operation and Development (OECD). Methods: The general GBD cancer estimation methods were used with data input from vital registration systems and cancer registries. A comparative risk assessment approach was used to estimate the population-attributable fractions due to risk factors. Results: In 2015 there were 198,880 (95% uncertainty interval [UI]: 183,908-217,365) estimated incident cancer cases and 47,562 (95% UI: 46,061-49,004) cancer deaths in Australia. Twenty-nine percent (95% UI: 28.2-29.8) of total deaths and 17.0% (95% UI: 15.0-19.1) of DALYs were caused by cancer in Australia in 2015. Cancers of the trachea, bronchus and lung, colon and rectum, and prostate were the most common causes of cancer deaths. Thirty-six percent (95% UI: 33.1-37.9) of all cancer deaths were attributable to behavioral risks. The age-standardized cancer incidence rate (ASIR) increased between 1990 and 2015, while the age-standardized cancer death rate (ASDR) decreased over the same period. In 2015, compared to 34 other OECD countries Australia ranked first (highest) and 24th based on ASIR and ASDR, respectively. Conclusion: The incidence of cancer has increased over 25 years, and behavioral risks are responsible for a large proportion of cancer deaths. Scaling up of prevention (using strategies targeting cancer risk factors), early detection, and treatment of cancer is required to effectively address this growing health challenge.
... In Australia, for example, 63 percent of adults and 25 percent of children are overweight or obese [1]. If current trends continue, over two-thirds of Australians would be overweight or obese by 2025 [2]. The epidemic of lifestyle-related diseases is harming the well-being of those directly affected and has been placing a burden on the public health sector. ...
Article
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Diet-related chronic diseases are a major health problem faced by developed and developing countries. Although individuals’ dietary patterns are often associated with varied psychological and socioeconomic factors, built environment factors can be important determinants of food choices. Whilst there is some evidence to suggest a link between access to food and food consumption, it remains unclear how a wider range of built environment factors influence residents’ food choices. A deeper understanding of these relationships could reveal under-researched aspects of a healthy built environment. This paper explores how residents in inner Sydney neighborhoods access food and investigates how characteristics of the built environment influence their food choices. Eighteen participants, representing a range of ethnic backgrounds and levels of income, were selected for in-depth interviews. Several urban barriers to healthy food consumption were identified through analysis. Distance, land use and urban form, in particular, shape the food choices of individuals in different ways. These findings have implications for urban planning and policy making for healthy cities.
... For example, in the USA the proportion of women with pre-pregnancy obesity increased from 13.0% in 1993-1994 to 22.0% in 2002-2003, an increase of 69.3%. 2 Similarly, there has been an increasing trend of maternal obesity, particularly severe obesity, in Australia, where maternal obesity is already an endemic problem. 3,4 Maternal pre-pregnancy obesity is one of the most common modifiable risk factors associated with the higher maternal and perinatal adverse outcomes. It is an important cause of maternal morbidities such as pre-eclampsia, gestational diabetes mellitus (GDM) and increased risk of caesarean section deliveries. ...
Article
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Objective: Maternal obesity, usually associated with the adverse birth outcomes, has been a serious public health concern. Studies examining its effect on the physical and cognitive development of children have only recently emerged and the findings are inconsistent. This review aimed to systematically examine the role of maternal obesity on children's physical and cognitive development using the available evidence. Methods: The CINAHL, EMBASE, PSYCINFO, PUBMED and SCOPUS databases were searched. Studies addressing children's (⩽12 years) physical and cognitive development as outcome and maternal pre-pregnancy body mass index as an exposure were included. Data were extracted and evaluated for quality by two independent reviewers. Results: A total of 17 articles were eligible for this systematic review; 10 of them were birth cohorts from the USA. Nine of the 14 studies supported an adverse association between maternal pre-pregnancy obesity and childhood cognitive development. A few studies also demonstrated a negative association between the maternal obesity and gross motor function in children (5 of 10), but not with fine motor function (none out of five studies). Whether the observed negative association between the maternal obesity and children's cognitive and gross motor abilities is casual or due to residual confounding effects is unclear. The current evidence is based on a limited number of studies with heterogeneous measurement scales and obesity definition. Conclusions: From the available evidence, it seems that exposure to maternal pre-pregnancy obesity in the intrauterine environment has a detrimental effect on children's cognitive development. However, evidence of the association between the maternal obesity and physical development of children is too scarce to offer a conclusion. More research work is required to delineate the intrauterine effect of the maternal obesity from the residual confounding effects.
... Little international evidence is available on projected population mean BMI to provide comparison with these results, but published projections of obesity prevalence in Australia, 56 Strengths of this study include the large sample size obtained from nationally representative surveys conducted over an 18-year time period. Results were consistent using both the HAPC additive cohort effects model and the age-period interaction model, and across a range of sensitivity analyses, strengthening the reliability of the findings. ...
Article
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Objective: To estimate the effects of age, period and birth cohort on observed trends, and to provide short‐ to medium‐term projections of population BMI in New Zealand. Methods: Data were obtained from New Zealand national health surveys covering the period 1997 to 2015 (n=76,294 individuals). A Hierarchical Age‐Period‐Cohort (HAPC) model and an Age‐Period model with interaction terms were specified for population groups defined by ethnicity and sex. Observed trends were extrapolated to estimate group‐specific BMI projections for the period 2015–2038; these were weighted by projected population sizes to calculate population‐wide BMI projections. Results: Population mean BMI increased from 26.4 kg/m² (95%CI 26.2–26.5) in 1997 to 28.3 kg/m² (95%CI 28.2–28.5) in 2015. Both models identified substantial, approximately linear, period trends behind this increase, with no significant cohort effects. Mean BMI was projected to reach 30.6 kg/m² (95%CI 29.4–31.7; HAPC model) to 30.8 kg/m² (95%CI 30.2–31.4; Age‐Period model) by 2038. Conclusions: BMI continues to increase in New Zealand. On current trends, population mean BMI will exceed 30 kg/m² – the clinical cut‐off for obesity – by the early 2030s. Implications for public health: Unless prevented by comprehensive public health policy changes, increasing population obesity is likely to result in unfavourable economic and health impacts.
... According to projections, based on current rates of weight gain, the prevalence of obesity will increase to 34% by 2025 in Australia. 1 Many obese individuals are in need for lower limb joint arthroplasty due to the higher likelihood of developing osteoarthritis. 2 Operating on individuals with a higher body mass index (BMI) is challenging to the surgeons because of the complexity of the procedure, increased risk of perioperative complications, and issues with patient recovery in the long term. ...
Article
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Purpose: To investigate the association between body mass index (BMI) and perioperative complications until hospital discharge, following primary total knee arthroplasty (TKA). Methods: This retrospective study reviewed 1665 cases of elective primary unilateral TKA performed between 2006 and 2010, from a prospective secure electronic database. Types of complications, length of operating time, and duration of hospital stay were analyzed in both adjusted (for known confounders) and unadjusted analyses. A further matched analysis was also performed. Results: In terms of overall complications, there was no statistically significant difference between the BMI categories. When individual obesity category was considered, obese 2 had the lowest odds of developing complications, both with unadjusted (odds ratio (OR): 0.61, 95% confidence interval (CI) 0.41-0.91, p < 0.015) and adjusted regression analysis (OR: 0.65, 95% CI: 0.43-0.99, p = 0.044). Compared to normal weight category, obese class 3 (≥40 kg/m2) individuals were at 66% (OR: 0.34, 95% CI: 0.21-0.55) lower (unadjusted) odds of developing cardiac complications (overall p < 0.001). With the matched analysis, compared to normal weight category, obese class 3 (≥40 kg/m2) individuals were at a 60% (OR: 0.40, 95% CI: 0.23-0.68) lower (unadjusted) odds of developing cardiac complications (overall p = 0.004). Obese 3 patients had significantly higher operating time compared with other groups ( p < 0.001). Conclusion: This study did not find a significant association between BMI and increased overall in-hospital medical or surgical complications following primary TKA. Obesity significantly increased the length of operating time.
... In the last decades, the prevalence of obesity has increased dramatically all over the world. 4,5 In accordance with this, the incidences of maternal obesity and obesity-related maternal, fetal, and neonatal complications have increased considerably. These complications include gestational diabetes, hypertensive pregnancy disorders, intrauterine fetal death, preterm birth, and related neonatal morbidities. ...
Article
Çelik HT, Korkmaz A, Özyüncü Ö, Yiğit Ş, Yurdakök M. Maternal adipose tissue, antenatal steroids, and Respiratory Distress syndrome: complex relations. Turk J Pediatr 2019; 61: 859-866. The incidences of maternal obesity and obesity-related maternal, fetal and neonatal complications have increased considerably. Obese people may have lower, normal or increased fat mass independent from their body mass index. We aimed to investigate the relationships between antenatal steroid therapy and maternal body fat ratio for the risk of Respiratory distress syndrome (RDS) in preterm infants. Pregnant women and their newborn infants between 24-34 weeks of gestation, who received a full course of antenatal steroid therapy were included in the study. Mother`s body weight, body mass ındex (BMI), and body compositions (muscle, fat, water) were calculated using the bioelectrical impedance method 5 days after giving birth. Neonatal characteristics and respiratory outcomes were noted. A total of 42 mothers and their single premature infants were included in the study. Nineteen (45.2%) infants developed RDS (Group 1) while 23 (54.8%) infants did not develop RDS (Group 2). The mean body fat mass (kg), fat ratio (%), truncal fat mass (kg), and truncal fat ratio (%) were statistically significantly higher in Group 1 than in Group 2. The incidence of RDS was significantly higher in the group of mothers with a body fat ratio > 30.0% (n=15/24, 62.5%) when compared with the group of mothers with a body fat ratio ≤ 30% (n=4/18, 22.2%) (p=0.013). Maternal adipose tissue plays an important role and should be taken into consideration especially in obese women, before giving antenatal steroids to achieve positive effects of the therapy in preterm infants.
... Overweight and obesity is a major public health issue facing the Australian population. Results from the 2017-18 National Health Survey showed that 67% of adults were overweight or obese, an increase of 11% since 1995 (Walls et al., 2012;Australian Bureau of Statistics, 2019). Of even greater concern are the rising rates of overweight and obesity amongst children, increasing from 21% in 1995 to 25% in 2017-18 (Australian National Preventive Health Agency, 2014; Australian Bureau of Statistics, 2018). ...
Article
Globally, 43 jurisdictions have implemented a tax on sugar-sweetened beverages (SSBs) for obesity prevention; however, there is significant political resistance to adopting such a policy in Australia. This paper applies Kingdon’s Multiple Streams Framework (MSF) to the case study of an SSB tax in Australia to identify barriers and enablers to policy adoption, and to inform future advocacy strategies in local and international contexts. A systematic search was conducted of scholarly literature, parliamentary documents and media articles relating to an SSB tax. Information retrieved was analysed and integrated under the ‘problem’, ‘policy’ or ‘political’ streams of the MSF. The findings reveal that Australia is a substantial way from having the conditions in place where a tax might be successfully implemented due to industry influence, fragmented advocacy efforts, political opposition to paternalistic policies, conflicting political agendas, and inadequate pressure for change from civil society. Opening a policy window will require a shift in political ownership of the obesity problem, or the coupling of an SSB tax to an alternative problem. The public health community also needs to agree that an SSB tax deserves greater priority, relative to alternative policies for addressing obesity, and to agree on the most effective tax design.
... 5-7 Concerningly, 42% of the Australian population is predicted to be obese in 2035. 8 Correlations between population obesity rates and hospital admissions of obese patients have been demonstrated, which presents ongoing risks for healthcare workers and requirements for obesity risk reduction initiatives by healthcare organisations. 1,[9][10][11] While recording and measuring obese patient healthcare requirements is important from a staff safety perspective, it is also important for public health information which may inform obesity-related education and targeted treatment campaigns. ...
Article
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Purpose: Identification and mitigation of obesity-related risks to staff and healthcare organisations can occur using patient obesity data; however, a 2017/18 audit of obesity data accuracy was assessed to be poor. This study investigates the results of an intervention to improve obesity data recording and coding accuracy at an Australian hospital. Background: Increasing population obesity rates result in increased organisational and financial risks to hospitals. Australian obesity prevalence has steadily increased since 1995, and 42% of the Australian population is predicted to be obese in 2035. To reduce risks to healthcare staff who care for obese patients, complete and accurate obesity recording is required. Methods: Following a previous audit of obesity recording and coding accuracy of patients admitted to hospital with Type II diabetes, a 12-month intervention was undertaken, comprising staff education, introduction of tape measures and obesity decision-making tools, recording of patient volunteered height, regular reinforcement of obesity recording requirements and enhanced clinical coding of obesity. A re-audit was subsequently conducted to determine if the intervention impacted obesity recording and coding at the previously audited site. Results: Improved recording of obesity-related measures and obesity data accuracy were observed, including increased patient BMI, impacted by increased patient height measurements and increased patient weight measurements. Obesity recording accuracy increased due to the intervention, including increased sensitivity, increased negative predictive values and reduced false negatives. Conclusion: The obesity recording intervention was successful; however, as hospitals increasingly use electronic health records, improvement opportunities should be considered such as compulsory recording of patient weight and height, embedded BMI calculators and "check boxes" for recording impacts of obesity conditions on treatment. Immediate improvement of obesity recording in manual patient files can be achieved in the meantime by implementing targets of 100% weight, height and BMI recording, introducing education programs and auditing compliance.
... The Australian Bureau of Statistics' (ABS) National Health Survey 2017-18 reveals that Australian obesity rates have increased dramatically, from 18.7% in 1995 to 31.3% in 2017- 18. 6 Alarmingly, the Australian obesity rate is predicted to reach 42% by the year 2035. 7 Significant increase in future risks to healthcare organisations and staff is supported by research that has demonstrated a strong correlation between population obesity rates and obese patients requiring hospital admission, 8 and the increased likelihood of obese patients requiring hospitalisation than non-obese patients. 9,10 Additionally, obesity contributes to increased risks of developing other chronic conditions, such as heart disease, diabetes, stroke, chronic kidney disease, cancers and mental health conditions, all of which may also require hospital admission. ...
Article
Full-text available
Purpose: Pressure on Australia's healthcare system is increasing annually due to corresponding increases in chronic diseases such as obesity and rapidly ageing population growth across Australia, resulting in requirements for increased funding. This study investigates the financial impact to hospitals due to inaccurate obese patient recording and coding. Background: Australian healthcare organisations receive Activity-Based Funding (ABF) which provides reimbursement of costs relating to the type of patient care delivered and the resources required for the patient treatment. Accurate healthcare data are essential to ensure accuracy of ABF and appropriate reimbursement of costs incurred by hospitals that manage obese patients. Managing obese patients results in operational funding requirements such as increased staffing and purchasing of equipment such as hoists, bariatric wheelchairs and bariatric beds, and hospitals must ensure that these clinical requirements are documented accurately in order to be reimbursed of these costs by way of ABF. Methods: This study identifies the financial implications of inaccurate obesity data within the Western Australian Country Health Service (WACHS) and examines factors that may affect obesity data recording accuracy. The study involves 85 cases of identified obesity data recording inaccuracy that were adjusted by entering corrected obesity codes, which then adjusted Diagnosis-related Groups, National Weighted Activity Units and Activity-Based Funding results. Results: The study demonstrated estimated annual lost funding opportunities of $2.23 million due to obesity coding inaccuracy. An annual average of 616 cases of obesity data inaccuracy was calculated with an average lost funding opportunity of $3625 per case. Conclusion: Improvements are required in the clinical recording and coding of patient obesity, such as mandatory recording of patient weight and height data and automated BMI calculations within electronic patient records. Enhanced obesity recording and coding accuracy will result in increased funding opportunities and reduced cost burdens that hospitals currently experience when required to fund obesity-related clinical and safety requirements within operational budgets.
... These trends were determined based on past food consumption data in the historical database in ASFF. Projected increases in consumption due to rising obesity(Walls et al., 2012) were not taken into consideration in the Average current Australian diet profile for the ASFF food types derived from the NNPAS ...
Article
Full-text available
As cities grow and climate change intensifies, challenges related to the sustainable supply of food to urban areas are increasing. This is a particular issue for Melbourne, Australia’s fastest growing city. Although food consumption accounts for a significant proportion of environmental impact, there is little or no data quantifying what it takes to feed a city to help city governments plan for the future. This paper presents the methodology and findings of an investigation into the environmental impact of feeding Greater Melbourne by quantifying its ‘foodprint’ – the land and water required, and food waste and greenhouse gas (GHG) emissions generated. It forms part of a larger project, Foodprint Melbourne, investigating the sustainability and resilience of Melbourne’s foodbowl. The foodprint was calculated for 2014 and 2050, using the Australian Stocks and Flows Framework (ASFF). It was found that it takes 758 gigalitres/yr of water and 16.3 million hectares/yr of land to feed Melbourne, with over 907,537 tonnes/yr of edible food waste and 4.1 million tonnes/yr of GHG emissions generated. With projected trends in consumption patterns, efficiencies of production methods, land degradation and climate change impacts, in 2050 1598 gigalitres/yr of water (111% increase) and 32.3 million hectares/yr (98% increase) will be required, with 7.4 million tonnes/yr of GHG emissions generated (80% increase).
... Genes may affect the amount of body fat that is stored, and where that fat is distributed. Genetics may also play a role in how efficiently body converts food into energy and how the body burns calories during exercise 6 . Family lifestyle: Obesity tends to run in families. ...
... As such, adults who are IR are at an even greater risk for sarcopenia as they age as they not only are less able to mount an anabolic response to protein feeding, but they are less able to blunt MPB in the fasted state. Indeed, studies in older prediabetic or diabetic individuals show that rates of muscle mass decline are greater than that seen in healthy, older adults (40) and that they have lower muscle mass, strength and function than age-matched controls (41). ...
Article
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The prevalence of pre-diabetes (PD) and type II diabetes (T2D) has risen dramatically in recent years affecting an estimated 422 million adults worldwide. The risk of T2D increases with age, with the sharpest rise in diagnosis occurring after age 40. With age, there is also a progressive decline in muscle mass starting after the age of 30. The decline in muscle mass and function due to aging is termed sarcopenia and immediately precedes the sharp rise in T2D. The purpose of the current review is to discuss the role of protein to attenuate declines in muscle mass and insulin sensitivity to prevent T2D and sarcopenia in aging adults. The current recommended dietary allowance for protein consumption is set at 0.8 g/kg/day and is based on dated studies on young healthy men and may not be sufficient for older adults. Protein consumption upwards of 1.0–1.5 g/kg/day in older adults is able to induce improvements in glycemic control and muscle mass. Obesity, particularly central or visceral obesity is a major risk factor in the development of PD and T2D. However, the tissue composition of weight loss in older adults includes both lean body mass and fat mass and therefore may have adverse metabolic consequences in older adults who are already at a high risk of lean body mass loss. High protein diets have the ability to increase weight loss while preserving lean body mass therefore inducing “high-quality weight loss,” which provides favorable metabolic changes in older adults. High protein diets also induce beneficial outcomes on glycemic markers due to satiety, lowered post-prandial glucose response, increased thermogenesis, and the ability to decrease rates of muscle protein breakdown (MPB). The consumption of dairy specific protein consumption has also been shown to improve insulin sensitivity by improving body composition, enhancing insulin release, accelerating fat oxidation, and stimulating rates of muscle protein synthesis (MPS) in older adults. Exercise, specifically resistance training, also works synergistically to attenuate the progression of PD and T2D by further stimulating rates of MPS thereby increasing muscle mass and inducing favorable changes in glycemic control independent of lean body mass increases.
... Obesity and EDs are significant public health problems characterised by substantial impairment in quality of life, high burden of disease more generally, and resistance to treatment [1,2]. Current trends suggest that eating and weight-related health issues are increasing and are likely to present public health challenges for the next few decades [3,4]. Given the adverse physical and mental health outcomes associated with these conditions [1,2,5]. ...
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Background: Understanding the knowledge and beliefs of key stakeholders is crucial in developing effective public health interventions. Knowledge and beliefs about obesity and eating disorders (EDs) have rarely been considered, despite increasing awareness of the need for integrated health promotion programs. We investigated key aspects of knowledge and beliefs about obesity and EDs among key stakeholders in Australia. Methods: Using a semi-structured question guide, eight focus groups and seven individual interviews were conducted with 62 participants including health professionals, personal trainers, teachers and consumer group representatives. An inductive thematic approach was used for data analysis. Results: The findings suggest that, relative to obesity, EDs are poorly understood among teachers, personal trainers, and certain health professionals. Areas of commonality and distinction between the two conditions were identified. Integrated health promotion efforts that focus on shared risk (e.g., low self-esteem, body dissatisfaction) and protective (e.g., healthy eating, regular exercise) factors were supported. Suggested target groups for such efforts included young children, adolescents and parents. Conclusions: The findings indicate areas where the EDs and obesity fields have common ground and can work together in developing integrated health promotion programs.
... Worryingly, Australian obesity projections predict in 2035, 42% of the population will be obese and 35% will be overweight. 3 Increases in population obesity rates correlate with increases in patients with obesity requiring care, and future risks of patient handling injuries to nurses and other healthcare staff will be considerable. 4 A number of sources have also demonstrated that patients with obesity have an increased likelihood of requiring medical intervention than patients who are within healthy weight ranges. ...
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Kim McClean, Martyn Cross, Sue Reed School of Medical and Health Sciences, Edith Cowan University, Western Australia, 6027, AustraliaCorrespondence: Kim McCleanOccupational Safety and Health Department at Edith Cowan University, Western Australia, 6027, AustraliaTel +61 8 6304 5764Fax +61 8 6304 2626Email k.mcclean@ecu.edu.auAbstract: This literature review explores obesity risks to healthcare staff and organizations that manage and caring for obese (bariatric) patients. These risks are anticipated to increase due to Australian population obesity rate projections increasing from 31% in 2018 to 42% by the year 2035, which will result in increased hospital admissions of patients with obesity. Literature searches were conducted through the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, Scopus, and Web of Science. Thirty studies met the inclusion criteria and were tabulated and critiqued using appropriate appraisal techniques. High risk of injury to healthcare staff was identified relating to bariatric patient handling tasks. High liability and financial risks of organizations were also identified relating to workers’ compensation and common law claims by injured staff and medical negligence claims by patients with obesity. Availability of obesity data was identified within clinically captured information, which could be utilized to inform obesity risk management programs. Future research should focus on improving the use and quality of obesity data to better understand obesity risks to healthcare organizations and staff, including accurate identification of obese patient admissions, enhanced ability to measure bariatric patient handling hazards and related staff injuries and improved assessment of bariatric intervention effectiveness.Keywords: hospital, patient handling, injury, risk management, body mass index, patient
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More women than not are entering pregnancy either overweight or obese. This presents a significant health care burden with respect to maternal morbidities and offspring complications at birth and in later life. In recent years it has also become clear that maternal obesity is an even greater global health problem than anticipated, because the effects are not limited to the mother but are also programmed in the fetus, known as the ‘intergenerational cycle of obestiy’. Despite a large body of epidemiological evidence reporting outcomes of obese pregnancies, including offspring respiratory complications, much less is known about the molecular effects of maternal obesity on fetal lung development. This review focuses on the influence of altered substrate supply associated with the obesogenic intrauterine environment on fetal lung development. Understanding the molecular mechanisms contributing to altered fetal lung development will lead to improved respiratory outcomes for offspring at birth and in later life.
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The incidence of type 2 diabetes is increasing in Australia’s older adult population. Sarcopenia, the age-related decline in skeletal muscle mass, quality and function, may make a significant but under-appreciated contribution to increasing the risk of type 2 diabetes. As skeletal muscle is the largest insulin-sensitive tissue in the body, low muscle mass in sarcopenia likely results in reduced capacity for glucose disposal. Age-related declines in muscle quality, including increased mitochondrial dysfunction and fat infiltration, are also implicated in skeletal muscle inflammation and subsequent insulin resistance. Prospective studies have shown that low muscle mass and strength are associated with increased risk of incident type 2 diabetes. Prevalent type 2 diabetes also appears to exacer- bate progression of sarcopenia in older adults. Recently developed operational definitions and the inclusion of sarcopenia in the International classification of diseases, 10th revision, clinical modification, provide impetus for clinicians to diagnose and treat sarcopenia in older patients. Simple assessments to diagnose sarcopenia can potentially play a role in primary and secondary prevention of type 2 diabetes in older patients. Lifestyle modification programs for older adults with type 2 diabetes, particularly for those with sarcopenia, should incorporate progressive resistance training, along with adequate intakes of protein and vitamin D, which may improve both functional and metabolic health and prevent undesirable decreases in muscle mass associated with weight loss interventions. As some older adults with type 2 diabetes have a poor response to exercise, clinicians must ensure that lifestyle modification programs are appropriately prescribed, regularly monitored and modified if necessary. © 2016 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.
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Objective: Preoperative pain and function is viewed as an important predictor of total knee arthroplasty (TKA) outcomes. We examined whether variations in pain and function outcomes existed at 12 months between two centres in Sweden and Australia, and whether this was explained by variations in patient presentation for TKA. Methods: This was a retrospective analysis of prospectively collected data. Patients from one centre in Australia (SVH, N=516) and in Sweden (TGB, N=899) who underwent primary TKA between 2012 and 2013. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) was analysed pre- and 12 months' post TKA from which non-response to surgery was determined using the OMERACT-OARSI criteria. Multiple linear regression analysis was used to examine the relationship between change in pain and function and surgery centre, adjusting for preoperative patient characteristics and surgical technique. Results: Despite worse preoperative outcomes in all subscales of the WOMAC for the SVH cohort, there were no clinically meaningful differences in 12-month WOMAC subscales nor change in WOMAC subscales between SVH and TGB. Almost identical proportions of patients were considered OMERACT-OARSI responders, 85.7% (SVH) and 85.9% (TBG), however for the SVH cohort 25 (4.9%) were moderate and 417 (80.8%) were high responders, compared to the TGB cohort of which 225 (25%) were moderate and 547 (60.9%) were high responders. Conclusion: Despite differences in preoperative presentation between 2 countries, improvements in pain and function and the proportion of individual who responded to TKA surgery at 1 year were similar. Factors related to poor response to TKA surgery require further elucidation.
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The cost and comorbidity of obesity in hospitalized inpatients, is less known. A retrospective study of patients presenting to a large district hospital in Western Sydney (April 2016‐February 2017) using clinical, pathological as well as diagnostic coding data for obesity as per ICD‐10. Of 43 212 consecutive hospital presentations, 390 had an obesity‐coded diagnosis (Ob, 0.90%), of which 244 were gender and age‐matched to a non‐obesity coded cohort (NOb). Weight and BMI were higher in the Ob vs NOb group (126 ± 37 vs 82 ± 25 kg; BMI 46 ± 12 vs 29 ± 8 kg/m2, P < .001) with a medical record documentation rate of 62% for obesity among Ob. The Ob cohort had 2‐5× higher rates of cardiopulmonary and metabolic complications (P < .001), greater pharmacologic burden, length of stay (LOS, 225 vs 89 hours, P < .001) and stay in intensive care but no differences in the prevalence of mental disorders. Compared with BMI <35 kg/m2, inpatients with BMI >35 kg/m2 were 5× more likely to require intensive care (OR 5.08 [1.43‐27.3, 95% CI], P = .0047). The initiation of obesity‐specific interventions by clinical teams was very low. People with obesity who are admitted to hospital carry significant cost and complications, yet obesity is seldom recognized as a clinical entity or contributor.
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Obesity is an important consideration in neurosurgical practice. 28.3% of Australian adults are obese and it is estimated that over two-thirds of Australia’s population will be overweight or obese by 2025. This review of the effects of obesity on neurosurgical procedures demonstrated that, in patients undergoing spinal surgery, an increased BMI is a significant risk factor for surgical site infection, venous thromboembolism, major medical complications, prolonged length of surgery and increased financial cost. Although outcome scores and levels of patient satisfaction are generally lower after spinal surgery in obese patients, obesity is not a barrier to deriving benefit from surgery and, when the natural history of conservative management is taken into account, the long term benefits of surgery may be equivalent or even greater in obese patients than in non-obese patients. In cranial surgery, the impact of obesity on outcome and complication rates is generally lower. Specific exceptions are higher rates of distal catheter migration after shunt surgery and CSF leak after posterior fossa surgery. Minimally invasive approaches are showing promise in mitigating some of the adverse effects of obesity in patients undergoing spine surgery but further studies are needed to develop strategies to reduce obesity-related surgical complications.
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Background: INTERGROWTH-21st charts provide standards for infants born under optimal pregnancy conditions. However, their validity in a general obstetric population is unclear. We aimed to identify whether INTERGROWTH-21st charts, compared with gestation related optimal weight (GROW) charts customized on maternal height, weight, and parity, better identified the at-risk infant. Methods: We performed a retrospective cohort analysis of all term women who gave birth at a single tertiary obstetric center during the period 1994–2016. Routinely collected maternity data was used for analysis. The primary outcome was an Apgar score <7 at 5 min. Secondary outcomes included Apgar score <5 at 5 min, stillbirth or admission to the neonatal intensive care unit (NICU). Populations of newborns were identified as SGA by: (a) INTERGROWTH-21st <10th centile (SGAIG10th); (b) INTERGROWTH-21st z-score < −1 (SGAIGzscore); and (c) GROW customized charts <10th (SGAcust). The subgroups identified by only one chart were also specifically examined. Each SGA group was compared to infants appropriate for gestational age (AGA) on all charts (non-SGA). Results: Data for 71,487 births were available for analysis after exclusion of women with missing height or weight data. Only 3280 (4.6%) newborns were considered SGAIG10th, with 5878 (8.2%) SGAIGzscore and 7599 (10.6%) SGAcust. INTERGROWTH-21st identified only 110 additional infants (0.15%) that were not identified by customized charts; none of these experienced any adverse outcomes. Customized centiles identified a further 4429 (6.2%) SGA infants (SGAcust-only) that were not identified as SGAIG10th, and who did demonstrate an increased risk of Apgar score <7 (OR 1.33, 95%CI 1.08–3.28) and stillbirth (OR 2.47, 95%CI 1.41–4.44) compared to the non-SGA infant. Significantly more obese women had infants considered SGAcust (19.3%) than SGAIG10th (10.0%) or SGAIGzscore (9.9%). Conclusions: Amongst our general obstetric study population, the 10th centile of INTERGROWTH-21st identified only 4.6% of infants as SGA and was less likely to identify infants of obese women as SGA. Customized centiles identified almost all SGA-IG infants, including an additional group (SGAcust-only) at higher risk of stillbirth and adverse outcomes compared with non-SGA infants.
Article
Purpose: To establish the prevalence of obesity in an inpatient rehabilitation setting, examine its impact on hospital outcomes, and explore staff perceptions of caring for patients with obesity. Methods: A retrospective audit of inpatients admitted to a sub-acute rehabilitation hospital over 12 months. Hospital outcomes included length of stay (LOS), Functional Independence measure (FIM), and discharge destination. Linear regression models were used to determine whether obesity was associated with hospital outcomes. Staff working on rehabilitation wards were invited to complete a survey exploring their perceptions on caring for those who are obese. Results: Of 1280 episodes of care, 359 (28%) patients were classified as obese with a body mass index 30 kg/m⁻². Obesity was not associated with LOS or functional improvement after controlling for age, gender, and admission FIM. One hundred and twelve hospital staff (response rate 71%) completed the survey. Most rated their bariatric care knowledge as average (45%) or good (36%). The majority (60%) perceived that patients with obesity have longer LOS than those who are non-obese. Conclusion: One-third of patients admitted to inpatient subacute rehabilitation were classified as obese. Whilst obesity was not associated with poorer hospital outcomes, staff perceived that obesity negatively impacts on care requirements and LOS. • Implications for rehabilitation • A third of patients admitted to a public, inpatient rehabilitation setting may be classified as obese based on their body mass index. • Although staff perceived that obesity negatively impacts on length of stay and functional gains, there was no evidence that obesity was associated with poorer hospital outcomes. • Patients who are classified as obese were able to achieve comparable hospital outcomes including length of stay in the rehabilitation setting to those who are not obese.
Article
Objective: To forecast the prevalence and direct healthcare costs of osteoarthritis (OA) and rheumatoid arthritis (RA) in Australia to the year 2030. Methods: An epidemiological model of the Australian population was developed. Data on the national prevalence of OA and RA were obtained from the Australian Bureau of Statistics (ABS) 2014-2015 National Health Survey. Future prevalence was estimated using ABS population projections for 2020, 2025 and 2030. Available government data on direct healthcare expenditure for OA and RA were modelled to forecast costs (in AUD) for the years 2020, 2025 and 2030, from the perspective of the Australian public healthcare system. Results: The number of people with OA is expected to increase nationally from almost 2.2 million in 2015 to almost 3.1 million Australians in 2030. The number of people with RA is projected to increase from 422,309 in 2015 to 579,915 in 2030. Healthcare costs for OA were estimated to be over $2.1 billion in 2015; by the year 2030, these are forecast to exceed $2.9 billion ($970 for every person with the condition). Healthcare costs for RA were estimated to be over $550 million in 2015, including $273 million spent on biological disease-modifying anti-rheumatic drugs. Healthcare costs for RA are projected to rise to over $755 million by the year 2030. Conclusions: OA and RA are costly conditions that will impose an increasing healthcare burden at the population level. These projections provide tangible data that can be utilised to map future health service provision to expected need.
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In southwestern Sydney the timing of introduction of formula and solids may be associated with risk of childhood overweight or obesity, and this may vary by age at breastfeeding cessation during first year. We included 346 infants from southwestern Sydney using the longitudinal study for Australian children (LSAC), who at baseline were singleton, full term, and normal weight births. The outcome risk of overweight or obesity was measured at every two-year interval of children aged 0 or 1 year at baseline until they reached age 10 or 11, defined by body mass index (BMI) ≥ 85th percentile, using the Centre for Disease Control and Prevention growth charts. Age at introduction to formula or solids was dichotomized at four months. We used mixed effects logistic regression for performing all analyses with and without adjusting for mother’s BMI, age during pregnancy, and social disadvantage index. Missing data were estimated using multivariate normal imputation having 25 imputations. The odds of overweight or obesity were significantly higher among infants introduced to formula or solids at ≤4 months compared to those introduced at >4 months in both unadjusted (odds ratio = 2.3262, p = 0.023) and adjusted (odds ratio = 1.9543, p = 0.0475) analyses. The odds of overweight or obesity when age at formula or solids introduction was held fixed at ≤4 months, increased significantly (odds ratio = 2.0856, p = 0.0215) for children stopping breastfeeding at age ≤4 months compared to >4 months. Thus, increasing the prevalence of breast-feeding without any formula or solids to 4–6 months in southwest Sydney should be a worthwhile public health measure.
Article
Aim: The present article aimed to evaluate the feasibility of implementing a very low calorie diet (VLCD) weight loss program into the pre-operative model of care for elective general surgery patients with obesity. Methods: A prospective, randomised control trial of adults with obesity awaiting elective general surgery was conducted at an outpatient clinic at a tertiary hospital. Patients were randomised to the intervention group, an 8-week VLCD program incorporating Optifast (Nestle Health, Germany) shakes, or to standard care (generic healthy eating information). Data were collected at baseline, week 8 and at 30 days post-surgery. The primary outcome of the study was feasibility, which was evaluated through demand, practicality, integration and acceptability measures. Results: Forty-six participants (M 17: F 29, mean age 51.6 (13.1) years) with a mean body mass index ≥ 30 kg/m2 (40.5 kg/m2 (5.9)) were recruited. Of participants who completed the study there was a higher mean weight loss in the intervention group compared to the control group (-6.5 vs +0.15 kg; P = <.001), with no excessive loss of muscle mass (MM), measured by bioelectrical impedance analysis. The reduction in waist circumference was greater for the intervention compared to control group (-6.11 vs +1.36 cm; P = .003). Quality of life increased significantly in the intervention group (P < .001). Conclusions: The pre-operative VLCD program produced clinically meaningful rapid weight loss pre-surgery and improved quality of life without an excessive loss of MM.
Chapter
Overweight/obesity tends to co-occur with disturbed sleep and disordered eating (e.g. binge-eating, night-eating), although the precise mechanism/s underpinning the relationships is unclear. However, overweight/obese people are more likely to eat late at night than normal-weight people, thus, late night-eating (or binge-eating, which often occurs at night) may at least partly explain the observed relationship between overweight/obesity and impaired sleep in affected individuals. For example, night-eating and binge-eating are related to impaired sleep (e.g. longer sleep onset latency) and weight gain in obese people, and clinically, obese people are at an increased risk of a binge eating disorder and/or night eating syndrome diagnosis. A similar profile of sleep deficits is evident in overweight/obese people, binge-eaters, and night-eaters, and impaired sleep (e.g. longer sleep onset latency, shorter sleep duration) is associated with overweight/obesity, night-eating, and binge-eating. Thus, it is possible that the sleep problems experienced by overweight/obese people are at least in part due to the indirect effects of late night-eating and/or binge-eating on sleep, although it is less clear exactly how this might occur. Several psychological and biological mechanisms are examined as potential explanations of the relationship between disordered eating, overweight/obesity, and impaired sleep, including an elevated nocturnal body temperature.
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The term “osteosarcopenic obesity” describes the presence of osteosarcopenia in obese older adults, and also highlights the important contribution of adipose tissue to processes which lead to skeletal muscle and bone losses during ageing. Obesity is associated with increased rates of falls and disability but is commonly perceived to protect against fractures in older adults. However, beneficial effects of obesity for bone health are likely attributable to increased absolute muscle mass and those with sarcopenia and/or osteopenia/osteoporosis may have significantly higher fracture risk. Few studies to date have explored whether the combination of osteopenia/osteoporosis, sarcopenia and obesity is associated with poorer musculoskeletal health than observed in the presence of only one or two of these conditions. While prospective cohort studies are required to determine the clinical value of osteosarcopenic obesity for disability, falls and fracture prediction, it is clear that health professionals need to consistently diagnose and treat poor bone and muscle health in obese older patients. The most effective interventions for reducing risk of disability, falls and fracture in osteosarcopenic obesity are likely to involve lifestyle modification. This may include caloric restriction to induce fat loss, but with the addition of progressive resistance training and weight-bearing impact exercises, as well as maintenance of adequate protein, vitamin D and calcium intakes, in order to minimize weight loss-associated declines in bone and muscle mass. Nevertheless, randomized controlled trials are required to identify effective treatment strategies for the prevention of disability, falls and fractures in osteosarcopenic obese older adults.
Article
Aims: The aim of this study was to examine factors including family history, medical history and comorbidities associated with the risk of colorectal cancer (CRC) in young (18-49 years) and middle-age (50-69 years) individuals. Methods: State records were used to identify individuals born in Western Australia between 1945 and 1996, and their first-degree relatives. Individuals in the cohort and their relatives were linked to State cancer registry, hospital and mortality data to identify diagnoses of CRC and other risk factors. The associations between CRC and identified risk factors were examined using multivariable logistic regression. Results: For both young and middle-aged patients, family history of CRC, and a history of smoking, inflammatory bowel disease, liver disease and non-CRC cancer were associated with a significant increase in odds of CRC. In middle-aged patients, having a colonoscopy in the previous 10 years was associated with a reduced odds of CRC regardless of the detection of polyps. However, in young patients only the absence of polyps as confirmed by colonoscopy was associated with a decreased risk of CRC (OR: 0.38, 95%CI: 0.26 - 0.54, p < 0.001). Conclusions: Many of the risk factors associated with CRC were similar in young and middle-aged persons, and should be used to identify high risk young patients for screening. The association between colonoscopy and polyps with CRC was modified by age, likely as the result of routine screening in middle-aged patients.
Article
The prevalence of women of child‐bearing age with obesity continues to rise at an alarming rate. This has significant implications for both the short‐term and long‐term health of mother and offspring. Given the paucity of evidence‐based literature in this field, the preconception management of women with obesity is highly variable both between institutions and around the world. This systematic review aims to evaluate studies that inform us about the role of preconception weight loss in the fertility and pregnancy outcomes of women with obesity. Current therapeutic interventions are discussed, with a specific focus on the suitability of weight loss interventions for women with obesity planning pregnancy. There are significant knowledge gaps in the current literature; these are discussed and areas for future research are explored.
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Background: Nutrition screening and assessment tools often include body mass index (BMI) as a component in identifying malnutrition risk. However, rising obesity levels will impact on the relevancy and applicability of BMI cut-off points which may require re-evaluation. This study aimed to explore the relationship between commonly applied BMI cut-offs and diagnosed malnutrition. Methods: Data (age, gender, BMI and Subjective Global Assessment (SGA) ratings) were analysed for 1152 inpatients aged ≥65 years across annual malnutrition audits (2011-2015). The receiver operation characteristic (ROC) curve analysed the optimal BMI cut-off for malnutrition and concurrent validity of commonly applied BMI cut-offs in nutritional screening and assessment tools. Results: Malnutrition prevalence was 36.0% (n = 372) using SGA criteria (not malnourished, moderate or severe malnutrition). Median age was 78.7 (IQR 72-85) years, median BMI 25.4 (IQR 21.8-29.7) kg/m2; 52.1% male and 51.2% overweight/obese. ROC analysis identified an optimal BMI cut-off of <26 kg/m2, 80.8% sensitivity and 61.5% specificity (AUC 0.802, 95% CI 0.773, 0.830; p < 0.0001). Commonly applied BMI cut-offs (between 18.5 and 23 kg/m2) failed to meet the alpha-priori requirement of 80% sensitivity and 60% specificity. However, BMI <23 kg/m2 had the highest agreement (κ = 0.458) with malnutrition diagnosed using the SGA. Conclusions: Both malnutrition and overweight/obesity are common in older inpatients. Continuing increases in the prevalence of overweight and obesity will impact on the sensitivity of BMI as a screening component for malnutrition risk. The current study suggests tools developed over a decade ago may need to be revisited in future.
Article
Introduction and Objective Imaging obese patients poses a number of challenges for diagnostic radiographers through positioning, radiation exposure, communication and care. Furthermore, the increasing prevalence of obesity in Australian society ensures these imaging challenges are more frequent however little is known about this area. This study aims to explore the attitudes and perceptions of diagnostic radiographers toward imaging obese patients through a mixed methods study. Methods Ethics approval was granted to interview and survey diagnostic radiographers about their attitudes and perceptions of imaging obese patients. Twelve diagnostic radiographers who are designated clinical educators (DR CEs) took part in a 30–45 min semi-structured interview as well as a 20 min computer-based Weight Implicit Association Test (Weight-IAT) and self-report questionnaire of explicit attitudes. An additional 25 experienced Diagnostic Radiographers who were associate supervisors completed the Weight-IAT/explicit questionnaire only. Results Thematic analysis of the interviews revealed that DR CEs adopted an image-focussed or patient-focussed approach to obese patients. Key themes with a negative bias included blame, tolerance and insecurity of skill. Positively associated key themes were empathy and experience in radiography. The sample overall showed a significant negative implicit weight bias (P = 0.016) as measured by the Weight-IAT and there was no evidence of negative explicit attitudes. Conclusion Australian diagnostic radiographers in this study exhibited significant negative implicit weight bias, with interview results highlighting attitudes of blame and frustration towards obese patients. DR CEs were more likely to be focussed on image acquisition rather than patient considerations, with fewer responses related to empathy and equity.
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Controlling obesity has become one of the highest priorities for public health practitioners in developed countries. In the absence of safe, effective and widely accessible high-risk approaches (e.g. drugs and surgery) attention has focussed on community-based approaches and social marketing campaigns as the most appropriate form of intervention. However there is limited evidence in support of substantial effectiveness of such interventions. To date there is little evidence that community-based interventions and social marketing campaigns specifically targeting obesity provide substantial or lasting benefit. Concerns have been raised about potential negative effects created by a focus of these interventions on body shape and size, and of the associated media targeting of obesity. A more appropriate strategy would be to enact high-level policy and legislative changes to alter the obesogenic environments in which we live by providing incentives for healthy eating and increased levels of physical activity. Research is also needed to improve treatments available for individuals already obese.
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In 2008, The Council of Australian Governments set a target to increase by 5% the proportion of Australian adults at a healthy body weight by 2017, over a 2009 baseline. Target setting is a critical component of public health policy for obesity prevention; however, there is currently no context within which to choose such targets. We analyzed the changes in current weight gain that would be required to meet Australian targets. By using transition-based multistate life tables to project obesity prevalence, we found that meeting national healthy weight targets by 2017 will require a 75% reduction in current 5-year weight gain. A reliable model of future body weight prevalence is critical to set, evaluate, and monitor national obesity targets.
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In Switzerland a rapid increase in the total overweight population (BMI > or = 25) from 30.3% to 37.3% and in the obese segment (BMI > or = 30) from 5.4% to 8.1% was observed between 1992 and 2007. The objective of this study is to produce a projection until 2022 for the development of adult overweight and obesity in Switzerland based on four National Health Surveys conducted between 1992 and 2007. Based on the projection, these prevalence rates may be expected to stabilize until 2022 at the 2007 level. These results were compared with future projections estimated for France, UK, US and Australia using the same model.
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The prevalence of obesity increased in the United States between 1976-1980 and 1988-1994 and again between 1988-1994 and 1999-2000. To examine trends in obesity from 1999 through 2008 and the current prevalence of obesity and overweight for 2007-2008. Analysis of height and weight measurements from 5555 adult men and women aged 20 years or older obtained in 2007-2008 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population. Data from the NHANES obtained in 2007-2008 were compared with results obtained from 1999 through 2006. Estimates of the prevalence of overweight and obesity in adults. Overweight was defined as a body mass index (BMI) of 25.0 to 29.9. Obesity was defined as a BMI of 30.0 or higher. In 2007-2008, the age-adjusted prevalence of obesity was 33.8% (95% confidence interval [CI], 31.6%-36.0%) overall, 32.2% (95% CI, 29.5%-35.0%) among men, and 35.5% (95% CI, 33.2%-37.7%) among women. The corresponding prevalence estimates for overweight and obesity combined (BMI > or = 25) were 68.0% (95% CI, 66.3%-69.8%), 72.3% (95% CI, 70.4%-74.1%), and 64.1% (95% CI, 61.3%-66.9%). Obesity prevalence varied by age group and by racial and ethnic group for both men and women. Over the 10-year period, obesity showed no significant trend among women (adjusted odds ratio [AOR] for 2007-2008 vs 1999-2000, 1.12 [95% CI, 0.89-1.32]). For men, there was a significant linear trend (AOR for 2007-2008 vs 1999-2000, 1.32 [95% CI, 1.12-1.58]); however, the 3 most recent data points did not differ significantly from each other. In 2007-2008, the prevalence of obesity was 32.2% among adult men and 35.5% among adult women. The increases in the prevalence of obesity previously observed do not appear to be continuing at the same rate over the past 10 years, particularly for women and possibly for men.
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Although increases in obesity over the past 30 years have adversely affected the health of the U.S. population, there have been concomitant improvements in health because of reductions in smoking. Having a better understanding of the joint effects of these trends on longevity and quality of life will facilitate more efficient targeting of health care resources. For each year from 2005 through 2020, we forecasted life expectancy and quality-adjusted life expectancy for a representative 18-year-old, assuming a continuation of past trends in smoking (based on data from the National Health Interview Survey for 1978 through 1979, 1990 through 1991, 1999 through 2001, and 2004 through 2006) and past trends in body-mass index (BMI) (based on data from the National Health and Nutrition Examination Survey for 1971 through 1975, 1988 through 1994, 1999 through 2002, and 2003 through 2006). The 2003 Medical Expenditure Panel Survey was used to examine the effects of smoking and BMI on health-related quality of life. The negative effects of increasing BMI overwhelmed the positive effects of declines in smoking in multiple scenarios. In the base case, increases in the remaining life expectancy of a typical 18-year-old are held back by 0.71 years or 0.91 quality-adjusted years between 2005 and 2020. If all U.S. adults became nonsmokers of normal weight by 2020, we forecast that the life expectancy of an 18-year-old would increase by 3.76 life-years or 5.16 quality-adjusted years. If past obesity trends continue unchecked, the negative effects on the health of the U.S. population will increasingly outweigh the positive effects gained from declining smoking rates. Failure to address continued increases in obesity could result in an erosion of the pattern of steady gains in health observed since early in the 20th century.
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This study aims to project the prevalence of adult obesity to 2012 by age groups and social class, by extrapolating the prevalence trends from 1993 to 2004. Repeated cross-sectional surveys were carried out of representative samples of the general population living in households in England conducted annually (1993 to 2004). Participants were classified as obese if their body mass index was over 30 kg/m(2). Projections of obesity prevalence by 2012 were based on three scenarios: extrapolation of linear trend in prevalence from 1993 to 2004; acceleration (or slowing down) in rate of change based on the best fitting curve (power or exponential); and extrapolation of linear trend based on the six most recent years (1999 to 2004). The prevalence of obesity increased significantly from 1993 to 2004 from 13.6% to 24.0% among men and from 16.9% to 24.4% among women. If obesity prevalence continues to increase at the same rate, it is projected that the prevalence of obesity in 2012 will be 32.1% (95% CI 30.4 to 34.8) in men and 31.0% (95% CI 29.0 to 33.1) in women. The projected 2012 prevalence for adults in manual social classes is higher (43%) than for adults in non-manual social classes (35%). If recent trends in adult obesity continue, about a third of all adults (almost 13 million individuals) would be obese by 2012. Of these, around 43% are from manual social classes, thereby adding to the public health burden of obesity-related illnesses. This highlights the need for public health action to halt or reverse current trends and narrow social class inequalities in health.
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To measure the prevalence of obesity in Australian adults and to examine the associations of obesity with socioeconomic and lifestyle factors. AusDiab, a cross-sectional study conducted between May 1999 and December 2000, involved participants from 42 randomly selected districts throughout Australia. Of 20,347 eligible people aged > or = 25 years who completed a household interview, 11,247 attended the physical examination at local survey sites (response rate, 55%). Overweight and obesity defined by body mass index (BMI; kg/m(2)) and waist circumference (cm); sociodemographic factors (including smoking, physical activity and television viewing time). The prevalence of overweight and obesity (BMI > or = 25.0 kg/m(2); waist circumference > 80.0 cm [women] or > or = 94.0 cm [men]) in both sexes was almost 60%, defined by either BMI or waist circumference. The prevalence of obesity was 2.5 times higher than in 1980. Using waist circumference, the prevalence of obesity was higher in women than men (34.1% v 26.8%; P < 0.01). Lower educational status, higher television viewing time and lower physical activity time were each strongly associated with obesity, with television viewing time showing a stronger relationship than physical activity time. The prevalence of obesity in Australia has more than doubled in the past 20 years. Strong positive associations between obesity and each of television viewing time and lower physical activity time confirm the influence of sedentary lifestyles on obesity, and underline the potential benefits of reducing sedentary behaviour, as well as increasing physical activity, to curb the obesity epidemic.
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To examine the trend in obesity prevalence using annual representative cross-sectional samples of the South Australian population, to project the increase of obesity using current trends, and to examine the increase in prevalence by generational assessment. Face-to-face interviews of representative population samples of people aged 18 years and over living in South Australia from 1991 to 1998 and again in 2001 and 2003. Information on height and weight was provided by participants, in order to calculate body mass index (BMI) as a measure of obesity. The proportion of respondents classified as obese according to their self-reported body mass index (BMI > or = 30 to <35) increased significantly from 8.7% in 1991 to 14.1% in 2003 (chi2 trend=79.4, p<0.001). Severe obesity (BMI > or = 35) increased significantly from 2.6% in 1991 to 5.3% in 2003 (chi2 trend=50.4, p<0.001). Current prevalence trends indicate that by 2013, the self-reported prevalence of obesity in South Australian adults will be 27.8%, with the prevalence in males being 26.4% and in females, 29.3%. Secular obesity trends indicate that younger birth cohorts had the greatest percentage increases. Obesity has increased significantly between 1991 and 2003, and is increasing fastest among younger adults. Multifactorial interventions at all levels of the population are required to prevent overweight and obesity and promote weight maintenance, weight loss and address the health burden of obesity.
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We evaluated trends in the incidence of overweight and obesity over the past 50 years. We evaluated trends in the incidence of overweight (25< or =body mass index [BMI] <30 kg/m2), obesity (BMI > or =30 kg/m2) and stage 2 obesity (BMI > or =35 kg/m2) from 1950 to 2000 in Framingham Study participants (n=6798, 54% women). Individuals aged 40-55 years who attended 2 examinations 8 years apart in each decade were eligible. The incidences of overweight, obesity, and stage 2 obesity increased across the decades in both sexes (P for trend <.001). For men, the incidence of overweight rose from 21.8% (95% confidence interval [CI], 17.6-26.5) in the 1950s to 35.2% (95% CI, 28.6-42.5) in the 1990s; of obesity from 5.8% (95% CI, 4.4-7.6) to 14.8% (95% CI, 12.2-17.9); and of stage 2 obesity from 0.2% (95% CI, 0.1-0.9) to 5.4% (95% CI, 4.0-7.2). For women, incidence rates of overweight increased from 15.0% (95% CI, 12.3-18.1) to 33.1% (95% CI, 29.0-37.4); of obesity from 3.9% (95% CI, 2.9-5.3) to 14% (95% CI, 11.6-16.7); and of stage 2 obesity from 1.7% (95% CI, 1.1-2.6) to 4.4% (95% CI, 3.2-6.0). Overall, incidence rates of overweight increased 2-fold and that of obesity more than 3-fold over 5 decades, findings that remained robust upon additional adjustment for baseline BMI in each decade. The incidence of overweight and obesity increased progressively over the last 5 decades, suggesting that the rising trend in prevalence is not a recent phenomenon.
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To determine secular trends in overweight/obesity among 7- to 15-year-olds for the periods 1985, 1997, and 2004. RESEARCH METHOD AND PROCEDURES: Data from representative surveys conducted in New South Wales, Australia, in 1985, 1997, and 2004 were analyzed. Height and weight were measured, and BMI categories were created using International Obesity Task Force definitions. Students were grouped as Grades 2 + 4 + 6 and 8 + 10. The prevalences of overweight/obesity for 1985, 1997, and 2004 were 10.9%, 20.6%, and 25.7% among the younger boys and 10.6%, 19.5%, and 26.1% among the older boys. The average annual rate of increase for 1985 to 1997 was 0.81% and for 1997 to 2004 was 0.73% among the younger boys and was 0.74% and 0.94% for the two periods among the older boys. The prevalences of overweight/obesity in 1985, 1997, and 2004 were 14.0%, 22.0%, and 24.8% among the younger girls and 8.3%, 17.9%, and 19.8% among the older girls, respectively. The average annual rates of increase for the two periods were 0.8% and 0.4% among the younger girls and 0.80% and 0.27% among the older girls. Change in the prevalence of overweight/obesity and socioeconomic status were not associated. Over the period 1985 to 1997, the prevalence of overweight and obesity increased significantly among the younger and older boys and the younger girls. The prevalence of overweight, but not obesity, increased among the older girls over this period. Over the period 1997 to 2004, the prevalence of overweight/obesity combined increased significantly among boys of both age groups but not among girls.
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The objective was to forecast BMI distribution in the U.S. population along with demographic changes based on past race-, sex-, and birth cohort-specific secular trends. We compiled data from 44,184 subjects from 4 National Health and Nutrition Examination Surveys (NHANES; 1971 to 2004). By race and sex, we fit regression models to create smoothed mean BMI curves by age for 1970 to 2010. Linking corresponding birth cohorts across age- and year-specific mean BMI projections, we estimated the trajectory of relative BMI throughout each cohort's lifetime. These projections were validated using actual cohorts in the Nurses' Health Study and Health Professionals Follow-up Study. Combined with U.S. census, we predicted BMI distributions in 2010 and examined the joint impact of the obesity epidemic and population aging. BMI secular trends in the past 3 decades differ significantly by birth cohort, sex, and race. If these trends continue, the prevalence of obesity is expected to reach 35%, 36%, 33%, and 55% in 2010 among white men, white women, black men, and black women, respectively, far from the Healthy People 2010 goal of 15%. Such forecasts translate into 9.3 million more obese adults 20 to 74 years of age than in 2000, 8.3 million of whom would be 50 years of age or older, and 8.5 million of whom would be white. The mean age among obese men and women is also expected to rise from 47 to 49 years among whites and from 43 to 44 years among blacks. As the baby boom generation approaches retirement age, the continuing obesity epidemic signals a likely expansion in the population with obesity-related comorbidities. A framework to combine BMI and demographic trends is essential in evaluating the burden and disparity associated with the epidemic in the aging U.S. population.
Article
To estimate the overall prevalence and absolute burden of overweight and obesity in the world and in various regions in 2005 and to project the global burden in 2030. Pooling analysis. We identified sex- and age-specific prevalence of overweight and obesity in representative population samples from 106 countries, which cover approximately 88% of the world population, using MEDLINE and other computerized databases, supplemented by a manual search of references from retrieved articles. Sex- and age-specific prevalence of overweight and obesity were applied to the 2005 population to estimate the numbers of overweight and obese individuals in each country, each world region and the entire world. In addition, the prevalence, with and without adjusting for secular trends, were applied to the 2030 population projections to forecast the number of overweight and obese individuals in 2030. Overall, 23.2% (95% confidence interval 22.8-23.5%) of the world's adult population in 2005 was overweight (24.0% in men (23.4-24.5%) and 22.4% in women (21.9-22.9%)), and 9.8% (9.6-10.0%) was obese (7.7% in men (7.4-7.9%) and 11.9% in women (11.6-12.2%)). The estimated total numbers of overweight and obese adults in 2005 were 937 million (922-951 million) and 396 million (388-405 million), respectively. By 2030, the respective number of overweight and obese adults was projected to be 1.35 billion and 573 million individuals without adjusting for secular trends. If recent secular trends continue unabated, the absolute numbers were projected to total 2.16 billion overweight and 1.12 billion obese individuals. Overweight and obesity are important clinical and public health burdens worldwide. National programs for the prevention and treatment of overweight, obesity and related comorbidities and mortalities should be a public health priority.
Trends in body mass index in urban Australian Adults
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Walls HL, Wolfe R, Haby MM et al. Trends in body mass index in urban Australian Adults, 1980–2000. Public Health Nutrition 2009;22:1–8.
Preventing and Managing the Global Epidemic World Health Organization: Geneva Increasing trends in incidence of overweight and obesity over 5 decades
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Tackling the Obesity epidemic: New Zealand 1977–2003
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Trends in body mass index in urban Australian Adults, 1980–2000
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A Portrait of Health: Key Results of the 2006/07 New Zealand Health Survey. Ministry of Health: Wellington
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Preventing and Managing the Global Epidemic. World Health Organization: Geneva
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National Health Survey: Summary of Results
Australian Bureau of Statistics. National Health Survey: Summary of Results. Australian Bureau of Statistics, Canberra, 2009.
Tackling the Obesity epidemic: New Zealand Ministry of Health: Wellington
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