scholarly journals Better transport accessibility, better health: a health economic impact assessment study for Melbourne, Australia

Author(s):  
Vicki Brown ◽  
Alison Barr ◽  
Jan Scheurer ◽  
Anne Magnus ◽  
Belen Zapata-Diomedi ◽  
...  

Abstract Background Physical inactivity is a global public health problem, partly due to urbanization and increased use of passive modes of transport such as private motor vehicles. Improving accessibility to public transport could be an effective policy for Governments to promote equity and efficiency within transportation systems, increase population levels of physical activity and reduce the negative externalities of motor vehicle use. Quantitative estimates of the health impacts of improvements to public transport accessibility may be useful for resource allocation and priority-setting, however few studies have been published to inform this decision-making. This paper aims to estimate the physical activity, obesity, injury, health and healthcare cost-saving outcomes of scenario-based improvements to public transport accessibility in Melbourne, Australia. Methods Baseline and two hypothetical future scenario estimates of improved public transport accessibility for Melbourne, Australia, were derived using a spatial planning and decision tool designed to simulate accessibility performance (the Spatial Network Analysis for Multimodal Urban Transport Systems (SNAMUTS)). Public transport related physical activity was quantified by strata of age group and sex from Melbourne travel survey data (VISTA survey) and used with the SNAMUTS Composite Index to estimate input data for health impact modelling for the Melbourne population aged 20–74 years. A proportional multi-state, multiple cohort lifetable Markov model quantified the potential health gains and healthcare cost-savings from estimated changes in physical activity, body weight and injuries related to walking to access/egress public transport under two scenarios: (S1) public transport accessibility under current policy directions, and (S2) multi-directional, high-frequency network improvements. Results Multi-directional, high-frequency improvements to the public transport network (S2) resulted in significantly greater health and economic gains than current policy directions (S1) in relation to physical activity (mean 6.4 more MET minutes/week), body weight (mean 0.05 kg differential), health-adjusted life years gained (absolute difference of 4878 HALYs gained) and healthcare cost-savings (absolute difference of AUD43M), as compared to business as usual under both scenarios (n = 2,832,241 adults, over the lifecourse). Conclusions Based on our conservative analyses, improving accessibility to public transport will improve population health by facilitating physical activity and lead to healthcare cost savings compared with business-as-usual. These wider health benefits should be better considered in transport planning and policy decisions.

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 649 ◽  
Author(s):  
Anita Lal ◽  
Anna Peeters ◽  
Vicki Brown ◽  
Phuong Nguyen ◽  
Huong Ngoc Quynh Tran ◽  
...  

Over one third of Australians’ daily energy intake is from discretionary foods and drinks. While many health promotion efforts seek to limit discretionary food intake, the population health impact of reductions in the consumption of different types of discretionary foods (e.g., sugar-sweetened beverages (SSBs), confectionery, sweet biscuits) has not been quantified. This study estimated the potential reductions in body weight, obesity-related disease incidence, and healthcare cost savings associated with consumption of one less serving per week of different discretionary foods. Reductions in the different types of discretionary food were modelled individually to estimate the impact on energy consumption and population body weight by 5-year age and sex groups. It was assumed that one serving of discretionary food each week was replaced with either a serving of fruit or popcorn, and a serving (375 mL) of SSBs was replaced with coffee, tea, or milk. Proportional multi-state multiple-cohort Markov modelling estimated likely resultant health adjusted life years (HALYs) gained and healthcare costs saved over the lifetime of the 2010 Australian population. A reduction of one serving of SSBs (375 mL) had the greatest potential impact in terms of weight reduction, particularly in ages 19–24 years (mean 0.31 kg, 95% UI: 0.23 kg to 0.37 kg) and overall healthcare cost savings of AUD 793.4 million (95% UI: 589.1 M to 976.1 M). A decrease of one serving of sweet biscuits had the second largest potential impact on weight change overall, with healthcare cost savings of $640.7 M (95% CI: $402.6 M to $885.8 M) and the largest potential weight reduction amongst those aged 75 years and over (mean 0.21 kg, 95% UI: 0.14 kg to 0.27 kg). The results demonstrate that small reductions in discretionary food consumption are likely to have substantial health benefits at the population level. Moreover, the study highlights that policy responses to improve population diets may need to be tailored to target different types of foods for different population groups.


2006 ◽  
Vol 76 (4) ◽  
pp. 208-215 ◽  
Author(s):  
Astrup

The epidemic of both obesity and type 2 diabetes is due to environmental factors, but the individuals developing the conditions possess a strong genetic predisposition. Observational surveys and intervention studies have shown that excess body fatness is the major environmental cause of type 2 diabetes, and that even a minor weight loss can prevent its development in high-risk subjects. Maintenance of a healthy body weight in susceptible individuals requires 45–60 minutes physical activity daily, a fat-reduced diet with plenty of fruit, vegetables, whole grain, and lean meat and dairy products, and moderate consumption of calorie containing beverages. The use of table values to predict the glycemic index of meals is of little – if any – value, and the role of a low-glycemic index diet for body weight control is controversial. The replacement of starchy carbohydrates with protein from lean meat and lean dairy products enhances satiety, and facilitate weight control. It is possible that dairy calcium also promotes weight loss, although the mechanism of action remains unclear. A weight loss of 5–10% can be induced in almost all obese patients providing treatment is offered by a professional team consisting of a physician and dieticians or nurses trained to focus on weight loss and maintenance. Whereas increasing daily physical activity and regular exercise does not significantly effect the rate of weight loss in the induction phase, it plays an important role in the weight maintenance phase due to an impact on daily energy expenditure and also to a direct enhancement of insulin sensitivity.


2020 ◽  
Author(s):  
Lu Ma ◽  
Liwang Gao ◽  
Joseph Tak-Fai Lau ◽  
Rahman Atif ◽  
Blair T. Johnson ◽  
...  

BACKGROUND This study primarily aimed to evaluate the associations between mental distress and COVID-19-related changes in behavioral outcomes, and potential modifiers (age, gender, and educational attainment) of such associations. OBJECTIVE The COVID -19 pandemic has led to elevated levels of mental distress attributed to prolonged lockdowns, business closures, and social isolation. Its impact on behavioral outcomes is however less known. This study is designed to primarily evaluate the associations between mental distress and COVID-19-related changes in drinking, smoking, physical activity and body weight, and potential modifiers of such associations including age, gender, and educational attainment. METHODS An online survey using anonymous network sampling was conducted in China during April-May, 2020 using a 74-item questionnaire distributed through social media. A national sample of 10,545 adults in 31 provinces provided data on socio-demographic characteristics, COVID-19-related mental distress, and changes in behavioral outcomes. Structural equation models were used for data analyses. RESULTS About 13% of adults reported experiencing at least one symptom of mental distress. After adjusting for age, education, gender, ethnicity, marital status, residence, and number of chronic conditions, greater mental distress was associated with increased smoking and alcohol consumption (among current smokers and drinkers) and with both increased and decreased physical activity. Underweight adults were more likely to lose body weight (≥1 kg) whereas overweight adults were more likely to gain weight by the same amount. The association between mental distress and change in physical activity was stronger in adults aged 40 and above and those with high education. Mental distress was significantly associated with an increase in smoking in males but not females. CONCLUSIONS Mental distress was associated with increased smoking in males but not females. These findings inform the design of tailored public health interventions aimed to mitigate long-term negative consequences of mental distress on outcomes.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rachel G. Curtis ◽  
Timothy Olds ◽  
François Fraysse ◽  
Dorothea Dumuid ◽  
Gilly A. Hendrie ◽  
...  

Abstract Background Almost one in three Australian adults are now obese, and the rate continues to rise. The causes of obesity are multifaceted and include environmental, cultural and lifestyle factors. Emerging evidence suggests there may be temporal patterns in weight gain related, for example, to season and major festivals such as Christmas, potentially due to changes in diet, daily activity patterns or both. The aim of this study is to track the annual rhythm in body weight, 24 h activity patterns, dietary patterns, and wellbeing in a cohort of Australian adults. In addition, through data linkage with a concurrent children’s cohort study, we aim to examine whether changes in children’s body mass index, activity and diet are related to those of their parents. Methods A community-based sample of 375 parents aged 18 to 65 years old, residing in or near Adelaide, Australia, and who have access to a Bluetooth-enabled mobile device or a computer and home internet, will be recruited. Across a full year, daily activities (minutes of moderate to vigorous physical activity, light physical activity, sedentary behaviour and sleep) will be measured using wrist-worn accelerometry (Fitbit Charge 3). Body weight will be measured daily using Fitbit wifi scales. Self-reported dietary intake (Dietary Questionnaire for Epidemiological Studies V3.2), and psychological wellbeing (WHOQOL-BREF and DASS-21) will be assessed eight times throughout the 12-month period. Annual patterns in weight will be examined using Lowess curves. Associations between changes in weight and changes in activity and diet compositions will be examined using repeated measures multi-level models. The associations between parent’s and children’s weight, activity and diet will be investigated using multi-level models. Discussion Temporal factors, such as day type (weekday or weekend day), cultural celebrations and season, may play a key role in weight gain. The aim is to identify critical opportunities for intervention to assist the prevention of weight gain. Family-based interventions may be an important intervention strategy. Trial registration Australia New Zealand Clinical Trials Registry, identifier ACTRN12619001430123. Prospectively registered on 16 October 2019.


Author(s):  
Giovanni Castellini ◽  
Giulio D’Anna ◽  
Eleonora Rossi ◽  
Emanuele Cassioli ◽  
Fabio Voller ◽  
...  

Abstract Aim The study aimed to determine trends in the prevalence of underweight, overweight, obesity and their putative risk factors in different cohorts from a representative population of adolescents in Central Italy. Subject and methods After random sampling, five cohorts of adolescents attending public high schools – aged 14 to 18 years – were evaluated from 2005 to 2018 (n: 25,174). Collected information included self-reported body mass index (BMI), descriptors of family environment, eating behaviour, physical activity, screen use, bullying victimisation, sexual behaviour (age at first intercourse, number of partners) and perceived psychological distress. For these data, between-cohort prevalence differences were used to esteem prevalence variations across time. In the 2018 cohort, the association between these factors and body weight was evaluated through multinomial regressions with sex-specific crude relative risk ratios for different BMI categories. Results An increased prevalence of overweight was observed for both boys and girls. The study outlined a transition towards higher parental education and unemployment, reduced soft drinks consumption and higher psychological distress. Sex-specific changes were observed for physical and sexual activity, and a rising percentage of girls reported being bullied and distressing family relationships. Parental education and employment, together with physical activity, confirmed to be protective factors against pathological weight. The latter clustered with reduced soft drinks consumption, bullying victimisation, early sexual activity, worse family relationships and higher distress. Conclusion An increased prevalence of both overweight and underweight was observed across time. Economic factors associated with unemployment and changes in behavioural patterns may have contributed to this trend.


Author(s):  
Hubert Dobrowolski ◽  
Dariusz Włodarek

The outbreak of the COVID-19 pandemic caused a number of changes in social life around the world. In response to the growing number of infections, some countries have introduced restrictions that may have resulted in the change of the lifestyle. The aim of our study was to investigate the impact of the lockdown on body weight, physical activity and some eating habits of the society. The survey involving 183 people was conducted using a proprietary questionnaire. The mean age of the study participants was 33 ± 11 and mean height 169 ± 8 cm. An average increase in body weight was observed in 49.18% by 0.63 ± 3.7 kg which was the result of a decrease in physical activity and an increase in food consumption. We also observed a decrease in PAL from 1.64 ± 0.15 to 1.58 ± 0.13 and changes in the amount of food and individual groups of products consumption, including alcohol. Among the study participants who did not lose body mass, there was an average weight gain of 2.25 ± 2.5 kg. In conclusion, an increase of weight was shown in about half of the respondents in the study group which was associated with a decrease in physical activity and an increase in the consumption of total food and high energy density products.


2007 ◽  
Vol 97 (7) ◽  
pp. 995-998 ◽  
Author(s):  
E Lucenteforte ◽  
C Bosetti ◽  
R Talamini ◽  
M Montella ◽  
A Zucchetto ◽  
...  

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 930
Author(s):  
Odysseas Androutsos ◽  
Maria Perperidi ◽  
Christos Georgiou ◽  
Giorgos Chouliaras

Previous studies showed that the coronavirus disease 2019 (COVID-19) lockdown imposed changes in adults’ lifestyle behaviors; however, there is limited information regarding the effects on youth. The COV-EAT study aimed to report changes in children’s and adolescents’ lifestyle habits during the first COVID-19 lockdown and explore potential associations between changes of participants’ lifestyle behaviors and body weight. An online survey among 397 children/adolescents and their parents across 63 municipalities in Greece was conducted in April–May 2020. Parents self-reported changes of their children’s lifestyle habits and body weight, as well as sociodemographic data of their family. The present study shows that during the lockdown, children’s/adolescents’ sleep duration and screen time increased, while their physical activity decreased. Their consumption of fruits and fresh fruit juices, vegetables, dairy products, pasta, sweets, total snacks, and breakfast increased, while fast-food consumption decreased. Body weight increased in 35% of children/adolescents. A multiple regression analysis showed that the body weight increase was associated with increased consumption of breakfast, salty snacks, and total snacks and with decreased physical activity. The COV-EAT study revealed changes in children’s and adolescents’ lifestyle behaviors during the first COVID-19 lockdown in Greece. Effective strategies are needed to prevent excessive body weight gain in future COVID-19 lockdowns.


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