Methods for the economic evaluation of obesity prevention dietary interventions in children: A systematic review and critical appraisal of the evidence

Sundus Mahdi*, Colette Marr, Nicola J. Buckland, Jim Chilcott

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Objectives: We aim to describe and provide a discussion of methods used to conduct economic evaluations of dietary interventions in children and adolescents, including long-term modelling, and to make recommendations to assist health economists in the design and reporting of such evaluations. Methods: A systematic review was conducted in 11 bibliographic databases and the grey literature with searches undertaken between January 2000 and December 2021. A study was included if it (1) was an economic evaluation or modelling study of an obesity-prevention dietary intervention and (2) targeted 2- to 18-year-olds. Results: Twenty-six studies met the inclusion criteria. Twelve studies conducted an economic evaluation alongside a clinical trial, and 14 studies modelled long-term health and cost outcomes. Four overarching methodological challenges were identified: modelling long-term impact of interventions, measuring and valuing health outcomes, cost inclusions and equity considerations. Conclusions: Variability in methods used to predict, measure and value long-term benefits in adulthood from short-term clinical outcomes in childhood was evident across studies. Key recommendations to improve the design and analysis of future economic evaluations include the consideration of weight regain and diminishing intervention effects within future projections; exploration of wider intervention benefits not restricted to quality-of-life outcomes; and inclusion of parental or caregiver opportunity costs.

Original languageEnglish
Article numbere13457
Number of pages22
JournalObesity reviews
Issue number9
Early online date27 Apr 2022
Publication statusPublished - Sept 2022

Bibliographical note

© 2022 The Authors.Obesity Reviewspublished by John Wiley & Sons Ltd on behalf of World Obesity Federation.

Funding Information:
We thank Professor Tracey Young (School of Health and Related Research, University of Sheffield) for reviewing a draft of the manuscript and providing feedback. This work was supported by the Wellcome Trust Doctoral Training Centre in Public Health Economics and Decision Science [108903/B/15/Z] and the University of Sheffield. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.


  • childhood obesity prevention
  • diet
  • economic evaluation
  • systematic review

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