Towards a novel model for studying the nutritional stage dynamics of the Colombian population by age and socioeconomic status

Abstract

Low-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.

A systematic review of system dynamics and agent‐based obesity models: Evaluating obesity as part of the global syndemic

“…Another large group of models (n = 8) focused on dynamics of population and individual transitions between weight and other health states , all but one using system dynamics modeling.…”

“…Meisel et al modeled the accumulation and transference of people between the normal weight, overweight, and obesity categories focusing on the urban Colombian population, and tested several interventions for increasing transference to more healthy categories. Frerichs et al focused on the BMI‐category dynamics in US adults and children, while expanding the model to include and explore peer versus adult influence on obesity and testing combinations of prevention and treatment interventions for children and adults.…”

“…simulated obesity interventions that targeted highly connected individuals in models focused on US children, US adult women, and English adults, respectively; only one study28 found an effect compared with other strategies, specifically that targeting most popular individuals in the network resulted in greater weight loss than random targeting of individuals with obesity. In a model focused on US youth, Beheshti, Jalalpour, and Glass 24 compared random targeting to two networkbased targeting strategies, targeting based on high risk (ie, high BMI), and targeting of youth in obesogenic environments, and found that the network-based strategies outperformed the other targeting strategies in terms of nutrition or physical activity intervention effectiveness.Another large group of models (n = 8) focused on dynamics of population and individual transitions between weight and other health states,[32][33][34][35][36][37][38][39][40][41][42] all but one using system dynamics modeling.Meisel et al33,35 modeled the accumulation and transference of people between the normal weight, overweight, and obesity categories focusing on the urban Colombian population, and tested several interventions for increasing transference to more healthy categories.Frerichs et al 32 focused on the BMI-category dynamics in US adults and children, while expanding the model to include and explore peer versus adult influence on obesity and testing combinations of prevention and treatment interventions for children and adults. Chen et al 36 also expanded a model simulating transitions between normal weight, overweight, and obesity categories in the US population to include related transitions between income and employment categories, and tested interventions that varied transitions between the income and employment categories for effectiveness in controlling population obesity.…”

A System Dynamics Simulation Applied to Healthcare: A Systematic Review

“…Many diseases and conditions, such as type 2 diabetes mellitus, coronary heart disease, cancer, hypertension, and musculoskeletal disorders, are associated with obesity [ 46 ]. The included papers investigate obesity among children [ 47 , 48 , 49 , 50 ], women of reproductive age [ 51 ], individuals in low-income urban areas [ 52 ], and lower-socioeconomic status (SES) groups [ 53 , 54 ]. The objectives of the selected papers can be categorized into two main groups: (a) reducing obesity (reactive responses) and (b) presenting interventions for obesity prevention (proactive responses).…”

Nutrition status in adult Chilean population: economic, ethnic and sex inequalities in a post-transitional country

“…Differences in malnutrition prevalence by sex and SES have been also shown in other countries of the region. Results of a novel modelling of nutrition stages dynamics in Colombian population showed that the burden of excess weight is likely higher in those with lower SES (53) . Additionally, Hernandez et al (54) found that food insecure women had a greater percentage of obesity and overweight compared with food secure women, while among men the proportion of obesity and overweight was similar between food secure and food insecure participants.…”