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other·epidemiology, public health, endocrinology, nutrition, research methods·PMC10021196

Exploring ways to respond to rising obesity and diabetes in the Caribbean using a system dynamics model

PLOS Global Public Health · 10 authors, 7 centres

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TL;DR

A system dynamics model projected that diabetes and obesity prevalence in Jamaican adults will continue to rise under current trends, and achieving WHO global targets is deemed unachievable. A coordinated combination of upstream and downstream interventions is modeled to significantly reduce this future burden.

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This study used a system dynamics simulation model, calibrated to Jamaican data, to project future diabetes and obesity prevalence and assess intervention scenarios. Under current trends, the model predicts diabetes prevalence in Jamaican adults will rise from 12% in 2018 to 20.9% by 2050, and obesity from 28.6% to 39.2%. The study found that the magnitude of change needed in physical activity and diet to meet WHO global targets is considered unachievable. However, simulations showed that a combination of population-level measures (e.g., reducing sugar-sweetened beverage consumption) and targeted downstream interventions could significantly reduce the future burden, with the combination being more effective than any single intervention. Key limitations include model simplifications, reliance on projected trend data for key determinants, and the omission of other diabetes risk factors like hypertension and tobacco use.

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other

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epidemiology

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ORIGINAL PAPER

PMC10021196

Exploring ways to respond to rising obesity and diabetes in the Caribbean using a system dynamics model

PLOS Global Public Health

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ABSTRACT

Abstract 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.

CITATION EXPORT

Leonor Guariguata, Leandro Garcia, Natasha Sobers et al.. Exploring ways to respond to rising obesity and diabetes in the Caribbean using a system dynamics model. PLOS Global Public Health. (2022). https://doi.org/10.1371/journal.pgph.0000436

AUTHORS

10 · 7 CENTRES

Leonor Guariguata, Leandro Garcia, Natasha Sobers, Trevor S Ferguson, James Woodcock, T Alafia Samuels, Cornelia Guell, Nigel Unwin, Peter Rohloff, Peter Rohloff

1George Alleyne Chronic Disease Research Centre, University of the West Indies, Cave Hill, Barbados
2Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, United Kingdom
3Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
4MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
5Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
6European Centre for Environment and Human Health, University of Exeter Medical School, Cornwall, United Kingdom
7Brigham and Women’s Hospital, GUATEMALA