Exploring ways to respond to rising obesity and diabetes in the Caribbean using a system dynamics model.
Exploring ways to respond to rising obesity and diabetes in the Caribbean using a system dynamics model.
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探索使用系统动力学模型来应对加勒比海中肥胖和糖尿病上升的方法。
DOI：
10.1371/journal.pgph.0000436
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发表时间：
2022
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糖尿病和肥胖症在加勒比地区造成了沉重且日益加重的疾病负担，而预防政策和干预措施却未能对此作出反应。这些情况是一个复杂的驱动因素和决定因素系统造成的，因此很难预测干预措施的影响。我们与利益相关者合作，开发了一个系统动力学模拟模型，以牙买加为测试案例，绘制加勒比地区糖尿病和肥胖症流行的驱动系统。该研究旨在利用该模型评估实现世卫组织全球行动计划设定的全球目标所需的身体活动和饮食摄入量的幅度变化，并测试减少糖尿病和肥胖负担的干预措施。该模型预测，牙买加成年人（20岁以上）的糖尿病将从2018年的12%上升到2030年的15.4%和2050年的20.9%。对于肥胖症，它预测患病率将从2018年的28.6%上升到2030年的32.1%和2050年的39.2%。实现世界卫生组织制定的全球目标所需的巨大变化是无法实现的。然而，人口层面的上游（包括减少含糖饮料和超加工食品的消费、增加水果和蔬菜摄入量以及增加中度至剧烈活动）和下游（针对高风险人群）的综合措施可以显着减轻该地区未来糖尿病和肥胖的负担。没有任何单一的干预措施能像综合干预措施那样降低这些疾病的发病率。因此，这一模式的研究结果有力地支持在各部门采取持续和协调的办法，以协同增效的方式最大限度地发挥干预措施的效益。
Diabetes and obesity present a high and increasing burden of disease in the Caribbean that have failed to respond to prevention policies and interventions. These conditions are the result of a complex system of drivers and determinants that can make it difficult to predict the impact of interventions. In partnership with stakeholders, we developed a system dynamics simulation model to map the system driving diabetes and obesity prevalence in the Caribbean using Jamaica as a test case. The study aims to use the model to assess the magnitude changes necessary in physical activity and dietary intake to achieve global targets set by the WHO Global Action plan and to test scenarios for interventions to reduce the burden of diabetes and obesity. Continuing current trends in diet, physical activity, and demographics, the model predicts diabetes in Jamaican adults (20+ years) to rise from 12% in 2018 to 15.4% in 2030 and 20.9% by 2050. For obesity, it predicts prevalence to rise from 28.6% in 2018 to 32.1% by 2030 and 39.2% by 2050. The magnitude change necessary to achieve the global targets set by the World Health Organization is so great as to be unachievable. However, a combination of measures both upstream (including reducing the consumption of sugar sweetened beverages and ultra processed foods, increasing fruit and vegetable intake, and increasing moderate-to-vigorous activity) at the population level, and downstream (targeting people at high risk and with diabetes) can significantly reduce the future burden of diabetes and obesity in the region. No single intervention reduces the prevalence of these conditions as much as a combination of interventions. Thus, the findings of this model strongly support adopting a sustained and coordinated approach across various sectors to synergistically maximise the benefits of interventions.