Abstract

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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 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.

Keywords

Health projections, obesity, overweight, physical activity, POHEM, population surveillance

Findings

In both the developed and the developing world, obesity has increased, with global prevalence more than doubling since 1980 to 13%. This dramatic change has popularly been labelled the “obesity epidemic.” [Full Text]

Authors

Deirdre Hennessy (deirdre.hennessy@canada.ca), Rochelle Garner, William M. Flanagan and Claude Nadeau are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario. Ron Wall is with the Science Integration Division at the Public Health Agency of Canada, Ottawa, Ontario

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What is already known on this subject?

  • The global prevalence of obesity has more than doubled since 1980.
  • Obesity is an important risk factor for several diseases, including diabetes, osteoarthritis, cardiovascular disease, kidney disease, and certain cancers.
  • As a consequence, obesity surveillance has become an international priority.
  • To understand implications for population health, some countries have constructed models to project body mass index (BMI) and obesity trends over time.

What does this study add?

  • The POpulation HEalth Model (POHEM) is a microsimulation tool developed at Statistics Canada; POHEM-BMI projects trends in body mass index.
  • POHEM-BMI projections of self-reported and measured BMI agree well with survey estimates, especially for the percentage obese.
  • By 2030, approximately 59% of Canadian adults will be overweight/obese according to POHEM projections of self-reported BMI; according to POHEM projections of measured BMI, 66% of adults will be overweight/obese.

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