TITLE GOES HERE - World Health Summit

Actual and Predicted Figures forObesity for a Number of CountriesKlim McPherson Oxford UniversityWorld Health Summit, October 2012

NHF Work throughout the World

Methods• It all started with the Tacking Obesities report forForesight team in 2007.

Ability• What are the distributions of obesity, amongwhom, are they likely to develop over the next fortyyears (by age, gender, ethnicity)• What are the likely health consequences ofextrapolated obesity trends and• By how much can these consequences beattenuated with what we currently know and mightcome to know (policy effectiveness – testingscenarios)

Micro-Simulation• Computer model of a specified population (1993-2050)• Simulations for over 60 countries at present• Population accurately reflects age profiles, birth, deathand health statistics and makes future projections• Model specifically targets relationship betweenindividuals’ evolving risk factors and disease incidence(several million individuals)• Risk factor distributions determined by predictions &specified health interventions• Model can simulate and compare the impact and cost ofvarious public health interventions

Micro Simulationrisk_distribution.exeC ++ development 2006-2010health_simulations.exeC ++ development 2006-2010

Micro-Simulation

PrevalenceUKMalesFemales100100908026%31%36%41%44%908026%30%33%37%41%707060504044%41%38%35%32%60504033%32%31%29%28%3030201030% 28% 26% 25% 24%201041%38% 36% 34%31%02010 2020 2030 2040 2050BMI ≤24.9 kg/ m² BMI 25-29.9kg/m² BMI ≥30kg/m²02010 2020 2030 2040 2050BMI ≤24.9 kg/ m² BMI 25-29.9kg/m² BMI ≥30kg/m²

PrevalenceUSAMalesFemales1001009090807035%45%55%62%68%807036%41%46%50%54%6060504030201039%26%34%21%28%23%18%17% 15% 14%504030201028%36%28%31%26%24%22%28% 26% 24%02010 2020 2030 2040 205002010 2020 2030 2040 2050BMI ≤24.9 kg/m² BMI 25-29.9kg/m² BMI ≥30kg/m²BMI ≤24.9 kg/m² BMI 25-29.9kg/m² BMI ≥30kg/m²

Prevalence (%)Latin AmericaBMI ≥25kg/m² among malesBMI ≥25kg/m² among females10010090908080Argentina7070BoliviaBrazil6060ChileColombia5050Costa RicaCuba4040Mexico3030NicaraguaPanama2020PeruUruguay101002010 2020 2030 2040 205002010 2020 2030 2040 2050

Prevalence (%)BMI≥25 kg/m² among malesEastern Europe100100BMI≥25 kg/m² among females90908080Bulgaria7070CroatiaCzech Republic6060EstoniaHungary50405040LatviaLithuaniaPoland3030RomaniaRussia2020SerbiaSlovenia101002010 2020 2030 2040 205002010 2020 2030 2040 2050

Aggregated predictions/extrapolationssupported by crude data. But detailedexamination possibly gives a differentpicture. cf Health Survey for England1990-20108 consecutive years used to predict future trends:1995 - 2002 in red1999 – 2006 in blue2003 – 2010 in greenExtrapolated through to 2030, four age groups,both sexes

Proportion of population (%)Proportion of population (%)% Obese by year, three data periodsMales age 65+ Females10090BMI>30 : trend obtained using data for years 1995−2002BMI>30 : trend obtained using data for years 1999−2006BMI>30 : trend obtained using data for years 2003−201010090BMI>30 : trend obtained using data for years 1995−2002BMI>30 : trend obtained using data for years 1999−2006BMI>30 : trend obtained using data for years 2003−201080807070606050504040303020201010001995 2000 2005 2010 2015 2020 2025 2030Year1995 2000 2005 2010 2015 2020 2025 2030Year

Proportion of population (%)Proportion of population (%)% Obese by year, three data periodsMales age 45-64 Females10090BMI>30 : trend obtained using data for years 1995−2002BMI>30 : trend obtained using data for years 1999−2006BMI>30 : trend obtained using data for years 2003−201010090BMI>30 : trend obtained using data for years 1995−2002BMI>30 : trend obtained using data for years 1999−2006BMI>30 : trend obtained using data for years 2003−201080807070606050504040303020100201001995 2000 2005 2010 2015 2020 2025 2030Year1995 2000 2005 2010 2015 2020 2025 2030Year

Proportion of population (%)Proportion of population (%)% Obese by year, three data periodsMales age 30-44 Females10090BMI>30 : trend obtained using data for years 1995−2002BMI>30 : trend obtained using data for years 1999−2006BMI>30 : trend obtained using data for years 2003−201010090BMI>30 : trend obtained using data for years 1995−2002BMI>30 : trend obtained using data for years 1999−2006BMI>30 : trend obtained using data for years 2003−201080807070606050504040303020201010001995 2000 2005 2010 2015 2020 2025 2030Year1995 2000 2005 2010 2015 2020 2025 2030Year

Proportion of population (%)Proportion of population (%)% Obese by year, three data periodsMales age 16-29 Females10090BMI>30 : trend obtained using data for years 1995−2002BMI>30 : trend obtained using data for years 1999−2006BMI>30 : trend obtained using data for years 2003−201010090BMI>30 : trend obtained using data for years 1995−2002BMI>30 : trend obtained using data for years 1999−2006BMI>30 : trend obtained using data for years 2003−201080807070606050504040303020201010001995 2000 2005 2010 2015 2020 2025 2030Year1995 2000 2005 2010 2015 2020 2025 2030Year

Number of cases per 100,000Disease prevalence in UK80007000600050004000HypertensionType 2 DiabetesCHD & Stroke3000200010007 CancersKneeOsteoarthritis02010 2020 2030 2040 2050

Number of cases per 100,000Cumulative incidence cases3000025000200001500010000CHD & StrokeHypertension7 CancersType 2 DiabetesKnee Osteoarthritis500002010 2020 2030 2040 2050

Interventions• The micro-simulation enables us to testvarious policy interventions• Here we have tested the impact of 1%and 5% decrease of the mean BMI acrossthe population• Outputs are for disease prevalence,incidence and healthcare costs

Number of cases per 100,0001000900800Prevalence cases avoided1% decrease in mean BMI10009008005% decrease in mean BMI70070060060050050040040030030020020010010002010 2020 2030 2040 2050Type 2 DiabetesHypertensionCHD & Stroke7 CancersKnee Osteoarthritis02010 2020 2030 2040 2050

Number of cases per 100, 0002500Cumulative incidence avoided1% decrease in mean BMI5% decrease in mean BMI250020002000150015001000100050050002010 2020 2030 2040 2050Type 2 DiabetesCHD & StrokeHypertension7 CancersKnee Osteoarthritis02010 2020 2030 2040 2050

Millions of €Economic burden in UK300002500020000920000900000880000150001000050000All males andfemales2010 2020 2030 2040 205015906 19791 22594 24800 26212Males 7758 10161 11796 13028 13818Females 8148 9628 10798 11771 12394860000840000820000800000Total cost 2010-2050Unchanged trend1%decrease5%decrease910746 892845 845233

Reports

Thank you!• Contact:klim.mcpherson@obs-gyn.ox.ac.uktim.marsh@heartforum.org.uk• Acknowledgements:Modelling group at the NHF

PrevalenceMalesBrazilFemales100100908015%24%33%41%45%908014% 15% 16% 18% 20%706040%706028%30%31%32%32%5047%504050%40302045%50%50%302058%55% 53%50% 48%10029%17%9%5%2010 2020 2030 2040 20501002010 2020 2030 2040 2050BMI ≤24.9kg/m² BMI 25-30kg/m² BMI ≥30kg/m²BMI ≤24.9kg/m² BMI 25-30kg/m² BMI ≥30kg/m²

PrevalenceMalesMexicoFemales10010090807027%35%43%49%54%90807037%43%49%53%57%6060504041%40%38%504037%36%3036%34%3036%35%34%2010032%25%19%15%12%2010 2020 2030 2040 20502010026%21%15%12%9%2010 2020 2030 2040 2050BMI ≤24.9 kg/ m² BMI 25-29.9kg/m² BMI ≥30kg/m²BMI ≤24.9 kg/ m² BMI 25-29.9kg/m² BMI ≥30kg/m²

Prevalence100MalesRussian Federation100Females908015% 20%24%29%34%908028% 28% 28% 28% 27%7060504036%39%40%42%42%7060504030% 29% 28% 27% 27%3030201048%42%35%29%24%201042% 43% 44% 45% 46%02010 2020 2030 2040 205002010 2020 2030 2040 2050BMI ≤24.9kg/m² BMI 25-30kg/m² BMI ≥30kg/m²BMI ≤24.9kg/m² BMI 25-30kg/m² BMI ≥30kg/m²

Proportion of population (%)% Obese by year, three data periodsMales age 16-29 Females10090BMI>30 : trend obtained using data for years 1995−2002BMI>30 : trend obtained using data for years 1999−2006BMI>30 : trend obtained using data for years 2003−2010807060504030201001995 2000 2005 2010 2015 2020 2025 2030Year

% Obese by year, three data periodsMales age 30-44 Females

% Obese by year, three data periodsMales age 45-64 Females

% Obese by year, three data periodsMales age 65+ Females

Proportion of population (%)10090BMI>30 : trend obtained using data for years 1995−2002BMI>30 : trend obtained using data for years 1999−2006BMI>30 : trend obtained using data for years 2003−2010807060504030201001995 2000 2005 2010 2015 2020 2025 2030Year