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Original research
Using a system dynamics model to study the obesity transition by socioeconomic status in Colombia at the country, regional and department levels
  1. Jose D Meisel1,
  2. Angie M Ramirez1,
  3. Valentina Esguerra2,
  4. Felipe Montes2,
  5. Ivana Stankov3,
  6. Olga L. Sarmiento4,
  7. Juan A Valdivia5,6
  1. 1Facultad de Ingeniería, Universidad de Ibague, Ibagué, Tolima, Colombia
  2. 2Department of Industrial Engineering, Social and Health Complexity Center, Universidad de los Andes, Bogota, Colombia
  3. 3Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
  4. 4Department of Public Health, School of Medicine, Universidad de los Andes, Bogota, Colombia
  5. 5Departamento de Física, Facultad de Ciencias, Universidad de Chile, Santiago de Chile, Chile
  6. 6Centro para el Desarrollo de la Nanociencia y la Nanotecnología, CEDENNA, Santiago de Chile, Chile
  1. Correspondence to Dr Jose D Meisel; jd.meisel28{at}uniandes.edu.co

Abstract

Objective We study the obesity transition by socioeconomic status (SES), gender and age within the Colombian urban population at the country, regional and department levels.

Design The study is informed by cross-sectional data from the 2005 and 2010 ENSIN survey. We used these data to develop a system dynamics model that simulates the dynamics of obesity by body mass index (BMI) categories, gender and SES at the country, regional and department levels from 2005 to 2030.

Participants The sample size of the 2005 ENSIN comprised 8515 children younger than 5 years, 32 009 children and adolescents aged 5–17 years and 48 056 adults aged 18–64 years. In 2010, the corresponding numbers were 11 368, 32 524 and 64 425, respectively.

Primary and secondary outcome measure The obesity prevalence ratio and prevalence rates for each BMI category.

Results The results show, at the country level, transitions from overweight to obesity were projected to increase sharply among lower SES adults, particularly among women, suggesting that these groups will undergo an obesity transition by 2030. The model projections also indicate that the regions of Colombia are in different stages of the obesity transition. In the case of women, five out of the six regions were expected to undergo an obesity transition by SES over time. For men, only one region was expected to undergo an obesity transition. However, at the department level, trends in the burden of obesity varied.

Conclusions We evidence that the Colombian population could be experiencing an obesity transition where the increase in the GDP could be related to shifts in the burden of obesity from higher to lower SES, especially in women. These patterns support the need for policy planning that considers SES and gender, at the national and subnational levels, as important determinants of overweight and obesity among adults in Colombia.

  • epidemiology
  • public health
  • statistics & research methods
  • nutrition & dietetics
http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Twitter @jdmeisel

  • Contributors All authors had substantial contributions in the article. Particularly, JDM and OLS designed the study. JDM and VE did the analysis and interpretation of data. JDM, AMR, OLS, FM, IS and JAV led the writing of the report. OLS, JAV, FM, IS and AMR contributed in the analysis and interpretation of data. JDM and JAV developed the mathematical model fully described in the supplementary appendix. OLS, IS, AMR, VE and FM reviewed the mathematical model, and JDM implemented the model under the direction of JAV. Finally, all authors drafted sections of the report, provided critical review of the draft and approved the final version of the manuscript.

  • Funding This work was supported by project #19–528-ESP of the joint grant of Research Offices at the Universidad de Los Andes and the Universidad de Ibagué. FM was funded by NIH FIC D43TW010540 and by FAPA grant PR.3.2017.4527 of Universidad de los Andes. OLS received funding from the Administrative Department of Science, Technology and Innovation (Colciencias grant number726-2016) and Vicerrectoria de Investigaciones from Universidad de los Andes. JAV would like to thank Fondecyt grant 1 190 703 and the support of Centro para el Desarrollo de la Nanociencias y la Nanotecnología (CEDENNA).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval All the protocols were reviewed and approved by the Profamilia Institutional Review Board on Research Involving Human Subjects.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All data used in this study are within the paper and its supplementary files.

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