scholarly journals Sugar sweetened beverages attributable disease burden and the potential impact of policy interventions: a systematic review of epidemiological and decision models

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea Alcaraz ◽  
Andrés Pichon-Riviere ◽  
Alfredo Palacios ◽  
Ariel Bardach ◽  
Dario Javier Balan ◽  
...  

Abstract Background Around 184,000 deaths per year could be attributable to sugar-sweetened beverages (SSBs) consumption worldwide. Epidemiological and decision models are important tools to estimate disease burden. The purpose of this study was to identify models to assess the burden of diseases attributable to SSBs consumption or the potential impact of health interventions. Methods We carried out a systematic review and literature search up to August 2018. Pairs of reviewers independently selected, extracted, and assessed the quality of the included studies through an exhaustive description of each model’s features. Discrepancies were solved by consensus. The inclusion criteria were epidemiological or decision models evaluating SSBs health interventions or policies, and descriptive SSBs studies of decision models. Studies published before 2003, cost of illness studies and economic evaluations based on individual patient data were excluded. Results We identified a total of 2766 references. Out of the 40 included studies, 45% were models specifically developed to address SSBs, 82.5% were conducted in high-income countries and 57.5% considered a health system perspective. The most common model’s outcomes were obesity/overweight (82.5%), diabetes (72.5%), cardiovascular disease (60%), mortality (52.5%), direct medical costs (57.35%), and healthy years -DALYs/QALYs- (40%) attributable to SSBs. 67.5% of the studies modelled the effect of SSBs on the outcomes either entirely through BMI or through BMI plus diabetes independently. Models were usually populated with inputs from national surveys -such us obesity prevalence, SSBs consumption-; and vital statistics (67.5%). Only 55% reported results by gender and 40% included children; 30% presented results by income level, and 25% by selected vulnerable groups. Most of the models evaluated at least one policy intervention to reduce SSBs consumption (92.5%), taxes being the most frequent strategy (75%). Conclusions There is a wide range of modelling approaches of different complexity and information requirements to evaluate the burden of disease attributable to SSBs. Most of them take into account the impact on obesity, diabetes and cardiovascular disease, mortality, and economic impact. Incorporating these tools to different countries could result in useful information for decision makers and the general population to promote a deeper implementation of policies to reduce SSBs consumption. PROSPERO protocol number CRD42020121025.

2021 ◽  
Author(s):  
Andrea Alcaraz ◽  
Andres Pichon-Riviere ◽  
Alfredo Palacios ◽  
Ariel Bardach ◽  
Dario Balan ◽  
...  

Abstract Background Around 184 000 deaths per year could be attributable to sugar sweetened beverages (SSBs) consumption worldwide. Epidemiological and decision models are important tools to estimate disease burden. The purpose of this study was to identify models to assess the burden of diseases attributable to SSBs consumption or the potential impact of health interventions.Methods We carried out a systematic review and literature search up to August 2018. Pairs of reviewers independently selected, extracted, and assessed the quality of the included studies through an exhaustive description of each model features. Discrepancies were solved by consensus. The inclusion criteria were epidemiological or decision models evaluating SSBs health interventions or policies, and descriptive SSBs studies of decision models. We excluded studies published before 2003, cost of illness studies and economic evaluations based on individual patient data.Results We identified a total of 2766 references. Out of the 40 included studies, 45% were models specifically developed to address SSBs, 82.5% were conducted in high income countries and 57.5% considered a health system perspective. The most common model’s outcomes were obesity/overweight (82.5%), diabetes (72.5%), cardiovascular disease (60%), mortality (52.5%), direct medical costs (57.35%), and healthy years -DALYs/QALYs- (40%) attributable to SSBs. 67.5% of the studies modelled the effect of SSBs on the outcomes either wholly through BMI or through BMI plus diabetes independently. Models were usually populated with inputs from national surveys -like obesity prevalence, SSBs consumption-; and vital statistics (67.5%). Only 55% reported results by gender and 40% included children; 30% presented results by income level, and 25% in selected vulnerable groups. Most of the models evaluated at least one policy intervention to reduce SSBs consumption (92.5%), being taxes the most frequent (75%).Conclusions There is a wide range modelling approaches with different complexity and information requirements to evaluate the burden of disease attributable to SSB. The majority consider the impact on obesity, diabetes and cardiovascular disease, mortality, and economic impact. Incorporating these tools to different countries could generate useful information for decision makers and the general population to promote the deeper implementation of policies to diminish SSB consumption.


BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e014954 ◽  
Author(s):  
Jose Leal ◽  
Waqar Khurshid ◽  
Eva Pagano ◽  
Talitha Feenstra

IntroductionDiabetes is a major public health problem and prediabetes (intermediate hyperglycaemia) is associated with a high risk of developing diabetes. With evidence supporting the use of preventive interventions for prediabetes populations and the discovery of novel biomarkers stratifying the risk of progression, there is a need to evaluate their cost-effectiveness across jurisdictions. In diabetes and prediabetes, it is relevant to inform cost-effectiveness analysis using decision models due to their ability to forecast long-term health outcomes and costs beyond the time frame of clinical trials. To support good implementation and reimbursement decisions of interventions in these populations, models should be clinically credible, based on best available evidence, reproducible and validated against clinical data. Our aim is to identify recent studies on computer simulation models and model-based economic evaluations of populations of individuals with prediabetes, qualify them and discuss the knowledge gaps, challenges and opportunities that need to be addressed for future evaluations.Methods and analysisA systematic review will be conducted in MEDLINE, Embase, EconLit and National Health Service Economic Evaluation Database. We will extract peer-reviewed studies published between 2000 and 2016 that describe computer simulation models of the natural history of individuals with prediabetes and/or decision models to evaluate the impact of interventions, risk stratification and/or screening on these populations. Two reviewers will independently assess each study for inclusion. Data will be extracted using a predefined pro forma developed using best practice. Study quality will be assessed using a modelling checklist. A narrative synthesis of all studies will be presented, focussing on model structure, quality of models and input data, and validation status.Ethics and disseminationThis systematic review is exempt from ethics approval because the work is carried out on published documents. The findings of the review will be disseminated in a related peer-reviewed journal and presented at conferences.Reviewregistration numberCRD42016047228.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ariel Esteban Bardach ◽  
Andrea Olga Alcaraz ◽  
Agustín Ciapponi ◽  
Osvaldo Ulises Garay ◽  
Andrés Pichón Riviere ◽  
...  

Abstract Background Around 6% of total deaths are related to alcohol consumption worldwide. Mathematical models are important tools to estimate disease burden and to assess the cost-effectiveness of interventions to address this burden. Methods We carried out a systematic review on models, searching main health literature databases up to July 2017. Pairs of reviewers independently selected, extracted data and assessed the quality of the included studies. Discrepancies were resolved by consensus. We selected those models exploring: a) disease burden (main metrics being attributable deaths, disability-adjusted life years, quality-adjusted life years) or b) economic evaluations of health interventions or policies, based on models including the aforementioned outcomes. We grouped models into broad families according to their common central methodological approach. Results Out of 4295 reports identified, 63 met our inclusion criteria and were categorized in three main model families that were described in detail: 1) State transition -i.e Markov- models, 2) Life Table-based models and 3) Attributable fraction-based models. Most studies pertained to the latter one (n = 29, 48.3%). A few miscellaneous models could not be framed into these families. Conclusions Our findings can be useful for future researchers and decision makers planning to undertake alcohol-related disease burden or cost-effectiveness studies. We found several different families of models. Countries interested in adopting relevant public health measures may choose or adapt the one deemed most convenient, based on the availability of existing data at the local level, burden of work, and public health and economic outcomes of interest.


Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000943 ◽  
Author(s):  
Leopold Ndemnge Aminde ◽  
Linda J Cobiac ◽  
J Lennert Veerman

ObjectiveTo assess the potential impact of reduction in salt intake on the burden of cardiovascular disease (CVD) and premature mortality in Cameroon.MethodsUsing a multicohort proportional multistate life table model with Markov process, we modelled the impact of WHO’s recommended 30% relative reduction in population-wide sodium intake on the CVD burden for Cameroonian adults alive in 2016. Deterministic and probabilistic sensitivity analyses were conducted and used to quantify uncertainty.ResultsOver the lifetime, incidence is predicted to decrease by 5.2% (95% uncertainty interval (UI) 4.6 to 5.7) for ischaemic heart disease (IHD), 6.6% (95% UI 5.9 to 7.4) for haemorrhagic strokes, 4.8% (95% UI 4.2 to 5.4) for ischaemic strokes and 12.9% (95% UI 12.4 to 13.5) for hypertensive heart disease (HHD). Mortality over the lifetime is projected to reduce by 5.1% (95% UI 4.5 to 5.6) for IHD, by 6.9% (95% UI 6.1 to 7.7) for haemorrhagic stroke, by 4.5% (95% UI 4.0 to 5.1) for ischaemic stroke and by 13.3% (95% UI 12.9 to 13.7) for HHD. About 776 400 (95% UI 712 600 to 841 200) health-adjusted life years could be gained, and life expectancy might increase by 0.23 years and 0.20 years for men and women, respectively. A projected 16.8% change (reduction) between 2016 and 2030 in probability of premature mortality due to CVD would occur if population salt reduction recommended by WHO is attained.ConclusionAchieving the 30% reduction in sodium intake recommended by WHO could considerably decrease the burden of CVD. Targeting blood pressure via decreasing population salt intake could translate in significant reductions in premature CVD mortality in Cameroon by 2030.


2021 ◽  
Author(s):  
Nithya Neelakantan ◽  
Su Hyun Park ◽  
Guo-Chong Chen ◽  
Rob M van Dam

Abstract Context The prevalence of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs) is increasing in Asia and several countries are adopting preventive policies to reduce consumption of sugar-sweetened beverages (SSBs). However, evidence on the relation between SSB consumption and cardiometabolic health in Asian populations has not been summarized. Objective In this systematic review, the associations between consumption of SSBs and cardiometabolic outcomes, including obesity, T2DM, and CVD, are examined in Asian populations. Data sources The PubMed, Scopus, and Web of Science databases, and gray literature were searched up to October, 2020 to identify relevant articles. Data extraction Two investigators independently extracted data from included studies. Data analysis When sufficient studies were available, a random-effects meta-analysis was used to calculate the pooled estimates (expressed as risk ratio [RR] and 95% confidence interval [CI]). Heterogeneity was tested and quantified using the Cochrane Q test and I2 statistic, respectively. Results Of the 17 studies included, 8 provided results about measures of adiposity (3 on weight change, 4 on body mass index (BMI), 2 on percent body fat, and 1 on abdominal obesity), 6 reported results about T2DM, and 3 reported on different CVD outcomes. High SSB consumption was significantly associated with greater weight gain and with a higher risk of selected CVD outcomes as compared with low consumption. In the meta-analysis, high SSB consumption was associated with greater T2DM risk before (RR, 1.51; 95%CI, 1.15–1.98 for highest vs lowest category; I2 = 76%) and after (RR, 1.38; 95%CI, 1.09–1.73; I2 = 56%) adjustment for BMI. Conclusions These findings suggest that high SSB consumption is directly associated with weight gain, risk of T2DM, and, possibly, selected CVD outcomes in Asian populations. Public health strategies to reduce SSB consumption in Asian countries are warranted. Systematic Review Registration PROSPERO registration no. CRD42019129456.Keywords: adiposity. cardiovascular disease, Asia, sugar-sweetened beverages, type 2 diabetes.


2021 ◽  
Author(s):  
Leonardo Pozza Santos ◽  
Denise Petrucci Gigante ◽  
Felipe Mendes Delpino ◽  
Ana Paula Maciel ◽  
Renata Moraes Bielemann

Abstract This study aimed to examine longitudinal associations between sugar-sweetened beverages (SSB) intake and type 2 diabetes, obesity, coronary heart disease and stroke in adults. We performed a systematic review and meta-analysis searching for articles in the Pubmed, Lilacs, Web of Science, Cochrane, Embase, and Scopus databases. After screening of titles and abstracts, 27 longitudinal studies were included for the narrative synthesis with all of them presenting medium or high methodological quality. None of the selected studies were from low-income countries and only three were conducted in middle-income countries. Type 2 diabetes was the most investigated disease – outcome in 15 out of 27 studies. Around 80% of the studies enrolled more than 10,000 individuals in the sample, and almost half of them followed the subjects for less than 10 years. A total of 1.5 million individuals were included in the pooled analyses, and results indicated that SSB intake increased the risk of type 2 diabetes (RR = 1.20; 95%C.I. 1.13 – 1.28), obesity (RR = 1.17; 95%C.I. 1.10 – 1.25), coronary heart disease (RR = 1.15; 95%C.I. 1.06 – 1.25), and stroke (RR = 1.10; 95%C.I. 1.01 – 1.19) in adults after adjustment for all potential confounders. Our systematic review and meta-analysis demonstrated that consumption of SSB intake appears to increase the risk non-communicable chronic disease, being the strongest evidence for type 2 diabetes. Actions are needed to be taken to reduce the SSB intake and its consequences worldwide.


Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 178 ◽  
Author(s):  
Wendy Van Lippevelde ◽  
Leentje Vervoort ◽  
Jolien Vangeel ◽  
Lien Goossens

Background: Reward sensitivity has been associated with adolescents’ intake of unhealthy snacks and sugar-sweetened beverages. However, so far, there are no studies published describing the impact of parenting practices on this relationship. The present study will, therefore, investigate whether food parenting practices can moderate the association between reward sensitivity and diet intakes. Method: A cross-sectional research study was conducted among 14- to 16-year old Flemish adolescents (n = 867, age 14.7 ± 0.8 y, 48.1% boys) and a subset of their parents (n = 131), collecting data on daily intakes, reward sensitivity, and food parenting practices. Linear regression was used to assess the moderation effect of parenting practices (both adolescent- and parent-reported) on the relationship between reward sensitivity, and diet using SPSS 25.0. Results: In the main analysis (adolescent-reported), no significant moderation effects were found for parenting practices on the relationship between reward sensitivity and diet. However, the sensitivity analysis (parent-reported) showed a moderation effect for health-reducing parenting practices on the association between reward sensitivity and unhealthy snack intake (β = 0.297, 95% CI = 0.062, 0.531, p = 0.01). Conclusion: Given the difference in the effect of parenting practices between the adolescent- and parent-reported data, our inconclusive findings warrant more research in larger adolescent-parent dyad samples.


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