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- PublicaciónSólo datosTowards a novel model for studying the nutritional stage dynamics of the Colombian population by age and socioeconomic status(PLoS ONE, 2018-02-08) Meisel, Jose D.; Sarmiento, Olga L.; Olaya, Camilo; Lemoine, Pablo D.; Valdivia, Juan A.; Zarama, RobertoLow-and middle-income countries (LMICs) are experiencing a nutritional transition in which the burden of obesity tends to shift towards the lower-socioeconomic status (SES) group. We propose a system dynamics (SD) model for assessing the nutritional stage dynamics of the Colombian urban population by age and SES projected to 2030. This SD model captures the ageing population according to body mass index (BMI) categories and SES. In this model, the transference rates (TRs) between BMI categories by age and SES are estimated using a heuristic based on data obtained from national surveys. The simulation results show that the Colombian population, particularly those aged 20 to 39 years with a lower SES, is moving towards the overweight and obese categories. The TRs for overweight and obese categories in the lower SES group (the mean TR from not overweight to overweight = 0.0215 (per year) and mean TR from overweight to obese = 0.0098 (per year)) are increasing more rapidly than the those in the middle (the mean TR from not overweight to overweight = 0.0162 (per year) and mean TR from overweight to obese = 0.0065 (per year)) and higher SES groups (the mean TR from not overweight to overweight = 0.0166 and mean TR from overweight to obese = 0.0054 (per year)). Additionally, from 2005 to 2010, individuals aged 20 to 39 years had the highest TRs towards the overweight and obese categories (from 0.026 to 0.036 per year and from 0.0064 to 0.012 per year, respectively). The TRs also indicated that children aged 0 to 14 years are moving from the obese to overweight and from the overweight to not overweight categories. These TRs show that the Colombian population is experiencing an SES-related nutritional transition that is affecting the lower SES population. The proposed model could be implemented to assess the nutritional transitions experienced in other LMICs.
- PublicaciónSólo datosUsing a system dynamics model to study the obesity transition by socioeconomic status in Colombia at the country, regional and department levels(BMJ Open, 2020-06-03) Meisel, Jose D.; Ramirez, Angie M.; Esguerra, Valentina; Montes, Felipe; Stankov, Ivana; Sarmiento, Olga L.; Valdivia, Juan A.Objective: We study the obesity transition by socioeconomic status (SES), gender and age within the Colombian urban population at the country, regional and department levels. Design: The study is informed by cross-sectional data from the 2005 and 2010 ENSIN survey. We used these data to develop a system dynamics model that simulates the dynamics of obesity by body mass index (BMI) categories, gender and SES at the country, regional and department levels from 2005 to 2030. Participants: The sample size of the 2005 ENSIN comprised 8515 children younger than 5 years, 32 009 children and adolescents aged 5–17 years and 48 056 adults aged 18–64 years. In 2010, the corresponding numbers were 11 368, 32 524 and 64 425, respectively. Primary and secondary outcome measure: The obesity prevalence ratio and prevalence rates for each BMI category. Results: The results show, at the country level, transitions from overweight to obesity were projected to increase sharply among lower SES adults, particularly among women, suggesting that these groups will undergo an obesity transition by 2030. The model projections also indicate that the regions of Colombia are in different stages of the obesity transition. In the case of women, five out of the six regions were expected to undergo an obesity transition by SES over time. For men, only one region was expected to undergo an obesity transition. However, at the department level, trends in the burden of obesity varied. Conclusions: We evidence that the Colombian population could be experiencing an obesity transition where the increase in the GDP could be related to shifts in the burden of obesity from higher to lower SES, especially in women. These patterns support the need for policy planning that considers SES and gender, at the national and subnational levels, as important determinants of overweight and obesity among adults in Colombia.