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Reid AL, Porter KJ, Kirkpatrick BM, Brock DJP, Altizer CJ, Zoellner JM. Student and caregiver acceptability of a school-based intervention to improve sugar-sweetened beverage behaviors: a mixed methods study. HEALTH EDUCATION RESEARCH 2024; 39:339-350. [PMID: 38517985 PMCID: PMC11258806 DOI: 10.1093/her/cyae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/17/2024] [Accepted: 02/21/2024] [Indexed: 03/24/2024]
Abstract
Kids SIPsmartER is a 6-month behavioral and health literacy intervention effective at reducing sugar-sweetened beverage (SSB) intake among middle school students and their caregivers in the rural Appalachian region. This exploratory mixed methods study utilized a convergent parallel design to assess participant acceptability of a school-based curriculum for students and a text messaging program for caregivers. Acceptability was assessed using surveys (873 students and 453 caregivers), five focus groups (34 students) and telephone interviews (22 caregivers). Quantitative data were analyzed descriptively, and qualitative data were content coded. On a 5-point scale, average quantitative survey acceptability ratings ranged from 2.7 to 3.3 among three student-rated questions and 4.1 to 4.2 among four caregiver-rated questions. Qualitative focus group findings suggested that students preferred curricular activities that were hands-on and involved social interaction, while caregiver interview results showed high acceptability of the text messaging program's design, including usability, content messages and personalization. Students and caregivers reported similar program benefits: increased knowledge of SSBs and health risks, increased awareness of SSB behaviors and support to make beverage behavior changes. Results from this study can be used to understand Kids SIPsmartER's effectiveness data, communicate the intervention's acceptability with stakeholders and plan for future implementation studies.
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Affiliation(s)
- Annie L Reid
- Department of Public Health Sciences, School of Medicine, University of Virginia, 16 E. Main St., Christiansburg, VA 24073, USA
| | - Kathleen J Porter
- Department of Public Health Sciences, School of Medicine, University of Virginia, 16 E. Main St., Christiansburg, VA 24073, USA
| | - Brittany M Kirkpatrick
- Department of Public Health Sciences, School of Medicine, University of Virginia, 16 E. Main St., Christiansburg, VA 24073, USA
| | - Donna-Jean P Brock
- Department of Public Health Sciences, School of Medicine, University of Virginia, 16 E. Main St., Christiansburg, VA 24073, USA
| | | | - Jamie M Zoellner
- Department of Public Health Sciences, School of Medicine, University of Virginia, 16 E. Main St., Christiansburg, VA 24073, USA
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Waugh A, Thille P, Roger K, Bombak A, Mann K, Riediger N. "Coke's not a food": A critical discourse analysis of sugar-sweetened beverage tax acceptability by white residents from an upper-middle class neighborhood in Winnipeg Manitoba. Heliyon 2024; 10:e30089. [PMID: 38707291 PMCID: PMC11066379 DOI: 10.1016/j.heliyon.2024.e30089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 05/07/2024] Open
Abstract
Increasing concerns about the health impacts of sugar consumption has led to the proposition of a sugar-sweetened beverage (SSB) tax in Canada. However, competing concerns related to stigma and equity remain and have not been explored in a Canadian context. As part of a broader study examining the perspectives of various populations on SSB tax acceptability, we examined how residents of an upper-middle class neighborhood conceptualize SSB tax acceptability, and we explored the discourses that inform their discussion. We conducted and analyzed qualitative, semi-structured interviews with residents of an upper-middle class neighborhood in Winnipeg, Manitoba, Canada. Recruitment criteria were residence, adults, and English speaking. Critical discourse analysis methodology was used, and healthism (health moralism) and tax psychology informed the analysis. Eighteen participants volunteered: 15 females and 3 males; all self-identified as white, and all spoke about (grand)parenting. Healthist discourse was utilized in supportive discussion of SSB taxation. With the mobilization of healthism, ideal citizens and parents were described as "health conscious" and those who might be likely to reduce SSB intake because of taxation. Healthism also contributed to their identification of beverages targeted by a tax, versus those they deemed as having redeeming nutritional qualities. Limits to SSB tax support were expressed as fairness concerns, with a focus on the procedural justice of the tax. Participants supported SSB taxation and the discourses they employed suggested support for the tax was perceived as contributing to their construction of the kind of ideal, health-valuing citizens they hoped to embody. However, participants were also concerned about the fairness of implementation, although this did not outweigh the prioritization of good health.
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Affiliation(s)
- Anne Waugh
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
| | - Patricia Thille
- Department of Physical Therapy, University of Manitoba, Winnipeg, Manitoba, R3E 0T6, Canada
| | - Kerstin Roger
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
| | - Andrea Bombak
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, E3B 5A3, Canada
| | - Kelsey Mann
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
| | - Natalie Riediger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, R3T 2N2, Canada
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Riediger ND, Neufeld T, Tait M, Turnbull L, Mann K, Waugh A, Bombak A. An examination of sugar-sweetened beverage tax regulations in six jurisdictions: Applying a social justice perspective to beverage taxation and exemptions. Glob Public Health 2024; 19:2394806. [PMID: 39183469 DOI: 10.1080/17441692.2024.2394806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/14/2024] [Indexed: 08/27/2024]
Abstract
Taxes, legislation and politics are social determinants of health, which can impact health through multiple pathways. The purpose of this study was to review regulations regarding sugar-sweetened beverage (SSB) taxation and describe taxation/exemption of various beverage categories. We reviewed SSB taxation regulations from Mexico, the United Kingdom, Berkeley, Philadelphia, San Francisco and South Africa. Supplementary government documents and academic publications were also reviewed to further discern beverage taxation/exemption and zero-rating. There were a number of beverage types that fell clearly into typically taxed or exempt/zero-rated categories across all six jurisdictions (e.g. pop/soda as taxed and water as zero-rated). Exemptions and ambiguities within the six regulations can generally be grouped as a lack of clarity regarding the meaning and use of milk; the meaning of 'medical purposes' and 'supplemental'; the point at which a beverage is prepared; the form of concentrate (i.e. liquid/frozen/powder) or medium used (e.g. water, coffee); and location of preparation or business size of retailer. SSB tax regulations are complex, unclear, vary across jurisdiction and leave several beverage types with added sugar exempt from taxation or at risk of a legal challenge. Lastly, tax exemptions generally reflect and perpetuate existing sociopolitical dynamics within the food system.
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Affiliation(s)
- Natalie D Riediger
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada
| | - Tamara Neufeld
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Myra Tait
- Independent Scholar, Coleman, Canada
| | - Lorna Turnbull
- Faculty of Law, University of Manitoba, Winnipeg, Canada
| | - Kelsey Mann
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada
| | - Anne Waugh
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Canada
| | - Andrea Bombak
- Department of Sociology, University of New Brunswick, Fredericton, Canada
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Purohit BM, Dawar A, Bansal K, Nilima, Malhotra S, Mathur VP, Duggal R. Sugar-sweetened beverage consumption and socioeconomic status: A systematic review and meta-analysis. Nutr Health 2023; 29:465-477. [PMID: 36384341 DOI: 10.1177/02601060221139588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sugar-sweetened beverages (SSB) are an independent risk factor for obesity and other non-communicable diseases. Socioeconomic status (SES) is one of the key drivers for the purchase and consumption of SSBs among children and adults; however, there is a lack of strong evidence. This study aims to determine the association between SES and consumption patterns of SSBs across populations. RESULTS The review was conducted according to PRISMA guidelines. PubMed, MEDLINE, Scopus, EMBASE, LILACS, Web of Science, Cochrane, and CINHAL databases were searched for relevant articles until 2022. Participants included children, adolescents, and adults who consumed different SSBs and were assessed based on their SES. The random-effects model was used to obtain the pooled odds ratio (OR). Twenty-one studies (152,070 participants) met the inclusion criteria. The risk of bias was assessed using the Newcastle-Ottawa tool, with the majority of the studies indicating medium to high quality. Eight ORs from four studies (34,454 participants) were considered for meta-analysis. Results showed those belonging to high SES had 48% lower odds of consuming the SSBs (OR 0.52; 95% CI: 0.42-0.61; p = 0.017). The overall quality of evidence was ascertained using GRADE criteria, illustrating a moderate certainty of evidence between SSB consumption and SES. CONCLUSION Meta-analysis suggests that SES influences the consumption pattern of SSBs, with high SES having lower odds of SSB consumption.
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Affiliation(s)
- Bharathi M Purohit
- Division of Public Health Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Anika Dawar
- Division of Periodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Kalpana Bansal
- Division of Pedodontics and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nilima
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Sumit Malhotra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay P Mathur
- Division of Paediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Duggal
- Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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AlTamimi JZ, Alshwaiyat NM, Alkhalidy H, AlKehayez NM, Alagal RI, Alsaikan RA, Alsemari MA, BinMowyna MN, AlFaris NA. Sugar-Sweetened Beverages Consumption in a Multi-Ethnic Population of Young Men and Association with Sociodemographic Characteristics and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4861. [PMID: 36981770 PMCID: PMC10049135 DOI: 10.3390/ijerph20064861] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Sugar-sweetened beverages are frequently consumed among adults and are linked with the incidence of obesity. We aimed to determine rates of weekly and daily sugar-sweetened beverage intake in a multi-ethnic population of young men and their association with sociodemographic characteristics and obesity. This cross-sectional study included 3600 young men who lived in Riyadh, KSA. Participants' sociodemographic characteristics and frequency of sugar-sweetened beverage consumption were gathered through personal interviews. The outcome variables in this study are based on the weekly and daily consumption of sugar-sweetened beverages. Weight and height were measured following standard protocols. The rates of weekly and daily sugar-sweetened beverage intake by participants were 93.6% and 40.8%, respectively. Nationality was a predictor of weekly and daily consumption of sugar-sweetened beverages. The highest rates of weekly (99.5%) and daily (63.9%) consumption were observed in subjects from the Philippines and Yemen, respectively, while Bangladeshi subjects had the lowest rates of weekly (76.9%) and daily (6.9%) consumption. Obesity was another predictor of sugar-sweetened beverage consumption. Obese participants had a significantly higher odds ratio of weekly sugar-sweetened beverage consumption than non-obese subjects (OR = 4.53, p = 0.037). In conclusion, sugar-sweetened beverage consumption was relatively high and our results support an association between the consumption of sugar-sweetened beverages and certain sociodemographic variables and obesity.
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Affiliation(s)
- Jozaa Z. AlTamimi
- Department of Physical Sports Sciences, College of Education, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (J.Z.A.); (N.M.A.)
| | - Naseem M. Alshwaiyat
- School of Nutrition and Dietetics, Faculty of Health Sciences, Gong Badak Campus, Universiti Sultan Zainal Abidin, Kuala Nerus 21300, Terengganu, Malaysia;
| | - Hana Alkhalidy
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Nora M. AlKehayez
- Department of Physical Sports Sciences, College of Education, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (J.Z.A.); (N.M.A.)
| | - Reham I. Alagal
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (R.I.A.); (R.A.A.)
| | - Reem A. Alsaikan
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (R.I.A.); (R.A.A.)
| | - Malak A. Alsemari
- Department of Medical Imaging—MRI, King Abdullah bin Abdulaziz University Hospital (KAAUH), Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia;
| | - Mona N. BinMowyna
- College of Science and Humanities, Shaqra University, Shaqra 11911, Saudi Arabia;
| | - Nora A. AlFaris
- Department of Physical Sports Sciences, College of Education, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (J.Z.A.); (N.M.A.)
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Regional Differences in Added Sweetener Knowledge, Consumption and Body Mass Index in People with HIV in the United States. AIDS Behav 2023; 27:816-822. [PMID: 36094637 DOI: 10.1007/s10461-022-03814-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 11/01/2022]
Abstract
This analysis of U.S.-based survey data reports regional differences (Northeast, Midwest, South, and West) in sweetener knowledge, consumption, and body mass index (BMI) among 877 people with HIV (PLWH; median age 54 years). BMI was lowest in the West and highest in the Midwest. Respondents in the West reported greater sweetener knowledge than in the Northeast, Midwest, and South. Respondents from the West reported lower sweetener consumption than the Midwest and South. Regional differences in BMI, sweetener knowledge, and consumption were demonstrated. Findings support consideration of regional differences when providing nutrition education.
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Lee SH, Park S, Blanck HM. Consumption of Added Sugars by States and Factors Associated with Added Sugars Intake among US Adults in 50 States and the District of Columbia-2010 and 2015. Nutrients 2023; 15:nu15020357. [PMID: 36678228 PMCID: PMC9863459 DOI: 10.3390/nu15020357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/29/2022] [Accepted: 01/08/2023] [Indexed: 01/13/2023] Open
Abstract
Purpose: The high intake of added sugars from foods or beverages increases the risk of obesity, hypertension, dyslipidemia, and cardiovascular disease. Because state-level data are lacking, we estimated dietary intake of added sugars by state and factors associated with intake among US adults. Design: Nationally representative, cross-sectional, in-person, household survey. Setting: 50 states and DC. Sample: 52,279 US adults from pooled data from 2010 and 2015 National Health Interview Surveys. Measures: Estimated total added sugars intake (tsp/day) using the National Cancer Institute’s scoring algorithm that converts responses from the Dietary Survey Questionnaire screener to estimated total added sugars intake (tsp/day). Analysis: Mean dietary-added sugars intake estimates and standard error were calculated for adults’ characteristics and by state for all 50 states and the District of Columbia. Differences by adult’s characteristics were assessed by pairwise t-tests (p < 0.05). All analyses accounted for complex survey design and sampling weights. Results: Overall, US adults consumed 17.0 tsp of added sugars/day (range: 14.8 tsp/day in Alaska to 1.2 tsp/day in Kentucky). Added sugars intake varied by states and sociodemographic characteristics. Conclusion: Findings may inform efforts to reduce added sugars intake to lower the high burden of chronic disease.
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Leal JSV, Fogal AS, Meireles AL, Cardoso LDO, Machado ÍE, de Menezes MC. Health economic impacts associated with the consumption of sugar-sweetened beverages in Brazil. Front Nutr 2022; 9:1088051. [PMID: 36601075 PMCID: PMC9806132 DOI: 10.3389/fnut.2022.1088051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction The consumption of sugar-sweetened beverages (SSBs) is among the main risk factors for non-communicable diseases (NCDs). This study aimed to estimate the financial costs of hospitalizations and procedures of high and medium complexity for NCDs attributable to the consumption of SSBs in the Brazilian Unified Health System (SUS) in 2019. Methods This ecological study used data from the Global Burden of Disease (GBD) 2019 and the Department of Informatics of the Unified Health System (DATASUS). The attributable costs were estimated from the population-attributable fraction (PAF) and the costs in the treatment of chronic diseases [type 2 diabetes mellitus and ischemic heart disease (IHD)], stratified by sex, age group, level of complexity of treatment, and federative units. Results In 2019, in Brazil, US$ 14,116,240.55 were the costs of hospitalizations and procedures of high and medium complexity in the treatment of NCDs attributable to the consumption of SSBs. These values were higher in males (US$ 8,469,265.14) and the southeast and southern regions, mainly in the state of São Paulo. However, when evaluating these results at a rate per 10,000 inhabitants, it was observed that the states of Paraná, Tocantins, and Roraima had higher costs per 10,000 inhabitants. Regarding the age groups, higher costs were observed in the older age groups. Conclusion This study revealed the high financial impact of the NCDs treatment attributed to the consumption of SSBs in Brazil and the variability among Brazilian macro-regions. The results demonstrate the urgency and need for the expansion of policies to reduce the consumption of SSBs in Brazil with strategies that consider regional particularities.
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Affiliation(s)
- Joice Silva Vieira Leal
- Graduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Aline Siqueira Fogal
- Graduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Adriana Lúcia Meireles
- Graduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil,Department of Clinical and Social Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Letícia de Oliveira Cardoso
- Department of Epidemiology, Oswaldo Cruz Foundation, National School of Public Health Sérgio Arouca (ENSP), Quantitative Methods in Health, Rio de Janeiro, Brazil
| | - Ísis Eloah Machado
- Graduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil,Department of Family Medicine, Mental and Collective Health, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Mariana Carvalho de Menezes
- Graduate Program in Health and Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil,Department of Clinical and Social Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil,*Correspondence: Mariana Carvalho de Menezes,
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AlFaris NA, Alshwaiyat NM, Alkhalidy H, AlTamimi JZ, Alagal RI, Alsaikan RA, Alsemari MA, BinMowyna MN, AlKehayez NM. Sugar-sweetened beverages consumption in a multi-ethnic population of middle-aged men and association with sociodemographic variables and obesity. Front Nutr 2022; 9:987048. [PMID: 36110403 PMCID: PMC9468762 DOI: 10.3389/fnut.2022.987048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adults frequently consume sugar-sweetened beverages. These products are linked to negative health effects such as obesity. Our study was carried out to assess rates of weekly and daily sugar-sweetened beverages consumption in a multi-ethnic population of middle-aged men and association with sociodemographic variables and obesity. Methods A sum of 1,800 middle-aged men (36–59 years) living in Riyadh, KSA, participated in this cross-sectional study. Sociodemographic variables and the frequency of sugar-sweetened beverages consumption were gathered from participants using face to face interviews. Weekly and daily consumption of sugar-sweetened beverages were the two binary outcome variables applied in this research. Weight and height were measured following standard procedures. Results In this study, 93.8 and 32.6% of participants consumed sugar-sweetened beverages weekly and daily, respectively. The weekly and daily sugar-sweetened beverages consumption was predicted by nationality. Subjects from Pakistan (99.3%) and Yemen (60.0%) reported the greatest rates of weekly and daily consumption, respectively, while Bangladeshi and Sudanese subjects reported the lowest rates of weekly (87%) and daily (2.9%) consumption, respectively. Another factor that predicted weekly sugar-sweetened beverages consumption was obesity. Obese subjects had a significantly greater odds ratio of weekly sugar-sweetened beverages intake than non-obese individuals (OR = 3.80, P = 0.003). Conclusion Consumption of sugar-sweetened beverages is common among middle-aged men who live in KSA. Results show connecting sugar-sweetened beverages intake with specific sociodemographic variables and obesity.
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Affiliation(s)
- Nora A. AlFaris
- Department of Physical Sports Sciences, College of Education, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Naseem M. Alshwaiyat
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
| | - Hana Alkhalidy
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Jozaa Z. AlTamimi
- Department of Physical Sports Sciences, College of Education, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reham I. Alagal
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reem A. Alsaikan
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Malak A. Alsemari
- Department of Medical Imaging – MRI, King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mona N. BinMowyna
- College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Nora M. AlKehayez
- Department of Physical Sports Sciences, College of Education, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- *Correspondence: Nora M. AlKehayez
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Linde JA, Horning Dehmer ML, Lee J, Friend S, Flattum C, Arcan C, Fulkerson JA. Associations of parent dietary role modeling with children's diet quality in a rural setting: Baseline data from the NU-HOME study. Appetite 2022; 174:106007. [PMID: 35331787 DOI: 10.1016/j.appet.2022.106007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/25/2022] [Accepted: 03/16/2022] [Indexed: 11/02/2022]
Abstract
These analyses examined associations of parent dietary role modeling with diet quality among school-age children in a rural community. Past research has found protective associations between parent role modeling and children's dietary intake; however, there is a gap in understanding these associations for families in rural communities. Baseline data (2017 -2018) were drawn from the New Ulm at Home (NU-HOME) randomized controlled trial, conducted in the United States. The trial recruited 114 children (7-10 years old) and parents. Parents self-reported dietary intake [fruit and vegetable (FV), sugar-sweetened beverage (SSB), fast food (FF)] and frequency of sitting and eating with their child. Children reported parent role modeling of healthful eating (FV and salad at the evening meal; FV as snacks). Two 24-h dietary recalls assessed child diet quality indicators [Healthy Eating Index-2015 (HEI-2015) total scores, FV intake, SSB intake]. General linear models (GLM) and logistic regression analyzed associations of child diet quality (HEI score, FV intake, SSB intake) with parent dietary intake, parent sitting and eating the evening meal with their child, and child perceptions of parent role modeling healthful eating, adjusted for highest level of education in the home. Higher child HEI-2015 scores were positively associated with more frequent parent role modeling of fruit intake at meals, and inversely associated with more frequent parent role modeling of fruit as a snack; no significant associations of child FV intake with parent role modeling were observed. Higher child SSB intake was positively associated with parent FF intake. In this rural community, parents play significant roles in shaping children's dietary quality and intake, though more work needs to be done to address optimal intervention strategies to promote parent role modeling of healthful eating.
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Affiliation(s)
- Jennifer A Linde
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis MN, 55454, USA.
| | | | - Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis MN, 55455, USA
| | - Sarah Friend
- School of Nursing, University of Minnesota, Minneapolis MN, 55455, USA
| | - Colleen Flattum
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis MN, 55454, USA
| | - Chrisa Arcan
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond VA, 23284, USA
| | - Jayne A Fulkerson
- School of Nursing, University of Minnesota, Minneapolis MN, 55455, USA
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Andreyeva T. Large State Variation in Sugar-Sweetened Beverage Purchases: What We Learn from the Beverage Industry Data. Curr Dev Nutr 2021; 5:nzab128. [PMID: 34934896 PMCID: PMC8676708 DOI: 10.1093/cdn/nzab128] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/04/2021] [Accepted: 10/15/2021] [Indexed: 11/24/2022] Open
Abstract
Negative health consequences of excessive sugar-sweetened beverage (SSB) consumption have prompted recommendations for SSB taxation to improve diet and health. Over 40 countries and 8 local US jurisdictions have implemented SSB taxes to date. There is considerable interest in state SSB taxes in the USA, but state-level data on SSB consumption levels is lacking. This article uses proprietary data from the Beverage Marketing Corporation on beverage sales across all US retail channels to estimate state-level per capita SSB purchases in 2021. There is considerable variation in per capita SSB purchases across states, from an estimated annual 23.5 gallons (89.1 L) in Hawaii to 51.8 gallons (196.1 L) in Missouri. Current average levels of SSB purchases at 13 ounces (0.38 L) daily leave little to no room for added sugars from all other sources. Policymakers in states with extra-high SSB purchases, especially in the Midwest, should consider effective evidence-based policies, including fiscal approaches, to increase awareness about SSB risks, encourage healthier beverage choices, and improve population diet.
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Affiliation(s)
- Tatiana Andreyeva
- Department of Agricultural and Resource Economics, Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT, USA
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Norman-Burgdolf H, DeWitt E, Cardarelli KM, Gillespie R, Slone S, Gustafson A. Sugar-sweetened beverage consumption among adults in rural Appalachia. Prev Med Rep 2021; 24:101642. [PMID: 34976693 PMCID: PMC8684001 DOI: 10.1016/j.pmedr.2021.101642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/05/2021] [Accepted: 11/13/2021] [Indexed: 12/14/2022] Open
Abstract
Sugar-sweetened beverage (SSB) consumption is decreasing nationally, yet intakes remain high in certain sub-populations as new varieties of SSBs are introduced. This study aims to expand on SSB intake patterns among adults living in Appalachia to develop policy, systems, and environmental (PSE) interventions to reduce consumption. Baseline cohort surveys were conducted to examine beverage consumption patterns of adults in one rural Appalachian county in Kentucky using a validated BEVQ-15 instrument. Ages were collapsed into three generational groups - Millennials (22-38 years), Generation X (39-54 years), and Boomers/Silents (≥55 years). Over half (n = 81; 54%) of the sample (n = 150) were Boomers/Silents. Age was a significant predictor of SSB consumption, with Millennials drinking more daily calories of SSB compared to older adults (329.2 kcal v 157.0 kcal v 134.6 kcal, p = 0.05); a significant amount of those calories coming from non-soda SSBs. Millennials were twice as likely to drink sweetened fruit juice drinks (p = 0.0002) and energy drinks (p = 0.01) daily and consumed six times more daily calories from sweetened fruit juice drinks than the other groups (73.5 kcal v 11.1 kcal v 8.0 kcal, p < 0.01). To our knowledge, this is the first study to show beverage choices and consumption patterns in Appalachian adults vary by age and non-soda SSBs are significant sources of added sugar. These findings inform PSE interventions for reducing SSB consumption, such as tailored marketing approaches and technology-based strategies, within a unique setting, and offer insight for nutrition educators and public health professionals working within rural, remote communities.
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Affiliation(s)
| | - Emily DeWitt
- Family and Consumer Sciences Extension, University of Kentucky, Lexington, KY, USA
| | - Kathryn M. Cardarelli
- Department of Health, Behavior, & Society, University of Kentucky, Lexington, KY, USA
| | - Rachel Gillespie
- Family and Consumer Sciences Extension, University of Kentucky, Lexington, KY, USA
| | - Stacey Slone
- Department of Statistics, University of Kentucky, Lexington, KY, USA
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY, USA
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Bekelman TA, Dabelea D, Ganiban JM, Law A, Reilly AM, Althoff KN, Mueller N, Camargo CA, Duarte CS, Dunlop AL, Elliott AJ, Ferrara A, Gold DR, Hertz-Picciotto I, Hartert T, Hipwell AE, Huddleston K, Johnson CC, Karagas MR, Karr CJ, Hershey GKK, Leve L, Mahabir S, McEvoy CT, Neiderhiser J, Oken E, Rundle A, Sathyanarayana S, Turley C, Tylavsky FA, Watson SE, Wright R, Zhang M, Zoratti E. Regional and sociodemographic differences in average BMI among US children in the ECHO program. Obesity (Silver Spring) 2021; 29:2089-2099. [PMID: 34467678 PMCID: PMC9088705 DOI: 10.1002/oby.23235] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of this study was to describe the association of individual-level characteristics (sex, race/ethnicity, birth weight, maternal education) with child BMI within each US Census region and variation in child BMI by region. METHODS This study used pooled data from 25 prospective cohort studies. Region of residence (Northeast, Midwest, South, West) was based on residential zip codes. Age- and sex-specific BMI z scores were the outcome. RESULTS The final sample included 14,313 children with 85,428 BMI measurements, 49% female and 51% non-Hispanic White. Males had a lower average BMI z score compared with females in the Midwest (β = -0.12, 95% CI: -0.19 to -0.05) and West (β = -0.12, 95% CI: -0.20 to -0.04). Compared with non-Hispanic White children, BMI z score was generally higher among children who were Hispanic and Black but not across all regions. Compared with the Northeast, average BMI z score was significantly higher in the Midwest (β = 0.09, 95% CI: 0.05 to 0.14) and lower in the South (β = -0.12, 95% CI: -0.16 to -0.08) and West (β = -0.14, 95% CI: -0.19 to -0.09) after adjustment for age, sex, race/ethnicity, and birth weight. CONCLUSIONS Region of residence was associated with child BMI z scores, even after adjustment for sociodemographic characteristics. Understanding regional influences can inform targeted efforts to mitigate BMI-related disparities among children.
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Affiliation(s)
- Traci A. Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jody M. Ganiban
- Department of Psychological and Behavioral Sciences, The George Washington University, Washington, DC, USA
| | - Andrew Law
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alexandra McGovern Reilly
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Keri N. Althoff
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Noel Mueller
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Cristiane S. Duarte
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University, New York, New York, USA
| | - Anne L. Dunlop
- Woodruff Health Sciences Center, School of Medicine and Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, South Dakota, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Diane R. Gold
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, Davis, California, USA
| | - Tina Hartert
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kathi Huddleston
- College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | | | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Catherine J. Karr
- Department of Environmental and Occupational Health Sciences, Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | | | - Leslie Leve
- Prevention Science Institute, University of Oregon, Eugene, Oregon, USA
| | | | - Cindy T. McEvoy
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - Jenae Neiderhiser
- Department of Psychology, Penn State University, Pennsylvania, Pennsylvania, USA
| | - Emily Oken
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Andrew Rundle
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Sheela Sathyanarayana
- University of Washington/Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Christine Turley
- University of South Carolina, Columbia, South Carolina, USA
- Atrium Health Levine Children’s, Charlotte, North Carolina, USA
| | - Frances A. Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Sara E. Watson
- Department of Pediatrics, University of Louisville, Louisville, Kentucky, USA
| | - Rosalind Wright
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mingyu Zhang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Bombak AE, Colotti TE, Raji D, Riediger ND. Exploring attitudes toward taxation of sugar-sweetened beverages in rural Michigan. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:36. [PMID: 34344480 PMCID: PMC8329609 DOI: 10.1186/s41043-021-00259-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND While policies to address "obesity" have existed for decades, they have commonly focused on behavioral interventions. More recently, the taxation of sugar-sweetened beverages is gaining traction globally. This study sought to explore individuals' attitudes and beliefs about sugar-sweetened beverages being taxed in a rural Michigan setting. METHODS This qualitative study was conducted using critical policy analysis. Data were collected in 25 semi-structured, audio-recorded interviews with adult Michiganders. Following data collection, transcripts were coded into themes using NVivo software. RESULTS Four themes emerged in participants' perspectives regarding sugar-sweetened beverages being taxed: resistance, unfamiliarity, tax effects, and need for education. While some participants were unfamiliar with sugar-sweetened beverage taxes, many viewed taxation as a "slippery slope" of government intervention, which invoked feelings of mistrust. In addition, participants predicted a sugar-sweetened beverage tax would be ineffective at reducing intake, particularly among regular consumers, who were frequently perceived as mostly low income and/or of higher weight. CONCLUSIONS Further research is needed to explore perceptions of sugar-sweetened beverage taxes in different geographic areas in the USA to examine how perceptions vary. Policymakers should be aware of the potential implications of this health policy with respect to government trust and stigma towards lower income and higher-weight individuals.
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Affiliation(s)
- Andrea E. Bombak
- Department of Sociology, University of New Brunswick, Tilley Hall, Room 9, Fredericton, NB E3B 5A3 Canada
- School of Health Sciences, Community Health Division, Central Michigan University, 1280 E Campus Dr, Mt Pleasant, MI 48859 USA
| | - Taylor E. Colotti
- School of Health Sciences, Community Health Division, Central Michigan University, 1280 E Campus Dr, Mt Pleasant, MI 48859 USA
| | - Dolapo Raji
- School of Health Sciences, Community Health Division, Central Michigan University, 1280 E Campus Dr, Mt Pleasant, MI 48859 USA
| | - Natalie D. Riediger
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, 407 Human Ecology Building, Winnipeg, MB R3T 2N2 Canada
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB Canada
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Chevinsky JR, Lee SH, Blanck HM, Park S. Prevalence of Self-Reported Intake of Sugar-Sweetened Beverages Among US Adults in 50 States and the District of Columbia, 2010 and 2015. Prev Chronic Dis 2021; 18:E35. [PMID: 33856977 PMCID: PMC8051857 DOI: 10.5888/pcd18.200434] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Frequent intake of sugar-sweetened beverages (SSBs) is associated with adverse health outcomes, including obesity, type 2 diabetes, and cardiovascular disease. We used combined data from the 2010 and 2015 National Health Interview Survey to examine the prevalence of SSB intake among US adults in all 50 states and the District of Columbia. Approximately two-thirds of adults reported consuming SSBs at least daily, including more than 7 in 10 adults in Hawaii, Arkansas, Wyoming, South Dakota, Connecticut, and South Carolina, with significant differences in sociodemographic characteristics. Efforts to decrease SSB consumption could consider the sociodemographic and geographic differences in SSB intake when designing equitable interventions.
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Affiliation(s)
- Jennifer R Chevinsky
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.,National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS: S-107-5, Atlanta, GA 30341.
| | - Seung Hee Lee
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Heidi M Blanck
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Lee SH, Zhang L, Rubin DL, Park S. Associations of Health Literacy and Menu-Labeling Usage With Sugar-Sweetened Beverage Intake Among Adults in Mississippi, 2016. Am J Health Promot 2020; 34:923-928. [PMID: 32436417 PMCID: PMC9006158 DOI: 10.1177/0890117120927302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Examine association of health literacy (HL) and menu-labeling (ML) usage with sugar-sweetened beverage (SSB) intake among adults in Mississippi. DESIGN Quantitative, cross-sectional study. SETTING 2016 Mississippi Behavioral Risk Factor Surveillance System data. PARTICIPANTS Adults living in Mississippi (n = 4549). MEASURES Outcome variable was SSB intake (regular soda, fruit drinks, sweet tea, and sports/energy drinks). Exposure variables were 3 HL questions (find information, understand oral information, and understand written information) and ML usage among adults who eat at fast-food/chain restaurants (user, nonuser, and do not notice ML). ANALYSIS Multinomial logistic regressions were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for SSB intake ≥1 time/d (reference: 0 times/d) associated with HL and ML. RESULTS In Mississippi, 46.8% of adults consumed SSB ≥1 time/d, and 26.9% consumed ≥2 times/d. The odds of consuming SSBs ≥1 time/d were higher among adults with lower HL (aOR = 1.7; 95% CI = 1.3-2.2) than those with higher HL. Among adults who ate at fast-food/chain restaurants, the odds of consuming SSBs ≥1 time/d were higher among nonusers of ML (aOR = 2.3; 95% CI = 1.7-3.1) and adults who did not notice ML (aOR = 1.8; 95% CI = 1.3-2.6) than ML users. CONCLUSION Adults with lower HL and adults who do not use or notice ML consumed more SSBs in Mississippi. Understanding why lower HL and no ML usage are linked to SSB intake could guide the design of interventions to reduce SSB intake in this population.
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Affiliation(s)
- Seung Hee Lee
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA, USA
| | - Lei Zhang
- Office of Health Data & Research, Mississippi State Department of Health, Jackson, MS, USA
| | - Donald L Rubin
- Department of Communication Studies, Franklin College of Arts and Sciences, University of Georgia, Athens, GA, USA
| | - Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA, USA
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Lord J, Roberson S, Odoi A. Investigation of geographic disparities of pre-diabetes and diabetes in Florida. BMC Public Health 2020; 20:1226. [PMID: 32787830 PMCID: PMC7425001 DOI: 10.1186/s12889-020-09311-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 07/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Diabetes is a leading cause of death and disability in the United States, and its precursor, pre-diabetes, is estimated to occur in one-third of American adults. Understanding the geographic disparities in the distribution of these conditions and identifying high-prevalence areas is critical to guiding control and prevention programs. Therefore, the objective of this study was to investigate clusters of pre-diabetes and diabetes risk in Florida and identify significant predictors of the conditions. METHODS Data from the 2013 Behavioral Risk Factor Surveillance System were obtained from the Florida Department of Health. Spatial scan statistics were used to identify and locate significant high-prevalence local clusters. The county prevalence proportions of pre-diabetes and diabetes and the identified significant clusters were displayed in maps. Logistic regression was used to identify significant predictors of the two conditions for individuals living within and outside high-prevalence clusters. RESULTS The study included a total of 34,186 respondents. The overall prevalence of pre-diabetes and diabetes were 8.2 and 11.5%, respectively. Three significant (p < 0.05) local, high-prevalence spatial clusters were detected for pre-diabetes, while five were detected for diabetes. The counties within the high-prevalence clusters had prevalence ratios ranging from 1.29 to 1.85. There were differences in the predictors of the conditions based on whether respondents lived within or outside high-prevalence clusters. Predictors of both pre-diabetes and diabetes regardless of region or place of residence were obesity/overweight, hypertension, and hypercholesterolemia. Income and physical activity level were significant predictors of diabetes but not pre-diabetes. Arthritis, sex, and marital status were significant predictors of diabetes only among residents of high-prevalence clusters, while educational attainment and smoking were significant predictors of diabetes only among residents of non-cluster counties. CONCLUSIONS Geographic disparities of pre-diabetes and diabetes exist in Florida. Information from this study is useful for guiding resource allocation and targeting of intervention programs focusing on identified modifiable predictors of pre-diabetes and diabetes so as to reduce health disparities and improve the health of all Floridians.
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Affiliation(s)
- Jennifer Lord
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, USA
| | - Shamarial Roberson
- Bureau of Chronic Disease Prevention, Division of Community Health Promotion, Florida Department of Health, Tallahassee, FL, USA
| | - Agricola Odoi
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, USA.
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Hut S. Determinants of Dietary Choice in the US: Evidence from Consumer Migration. JOURNAL OF HEALTH ECONOMICS 2020; 72:102327. [PMID: 32442802 DOI: 10.1016/j.jhealeco.2020.102327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 06/11/2023]
Abstract
I study the evolution of the quality of grocery purchases among migrants to learn how changes in the environment affect dietary choice. Using detailed household level panel data on food purchases I find that healthfulness of grocery purchases is very persistent in the short-run. Three to four decades after moving, however, households have closed about half of the gap in healthfulness between the origin and destination area. The results suggest that dietary habits are highly persistent, but may eventually shift in the face of different local environments.
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Affiliation(s)
- Stefan Hut
- Brown University, Department of Economics, Brown University Population Studies and Training Center, United States
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Abstract
PURPOSE OF REVIEW This review is an assessment of the state of the science on nutrition disparities and their contribution to disparities in cardiovascular health. RECENT FINDINGS Nutrition disparities remain pervasive by race/ethnicity, sex/gender, socioeconomic status, and geography. They are rooted in differences in social, cultural, and environmental determinants of health, behavioral and lifestyle factors, and the impact of policy interventions. Systematic differences in diet quality, dietary patterns, and nutrient intakes contribute to cardiovascular disparities and are mediated by microbiota, and CVD risk factors including high levels of blood pressure, low density lipoprotein cholesterol (LDL), and glucose; oxidative stress, pro-inflammatory cytokines, and endothelial dysfunction. Despite the progress made in nutrition research, important gaps persist that signal the need for more effective interventions at multiple levels to reduce cardiovascular disparities. Research opportunities include (1) exploring the gene-nutrient-environment interactions in the context of ancestral diversity; (2) investigating the causal link between diet and gut microbiota and impact of social determinants of health; (3) understanding resilience; (4) testing the effectiveness of multi-level interventions that address social and environmental determinants; and (4) supporting intervention research informed by validated implementation science frameworks.
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Affiliation(s)
- George A Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), 6705 Rockledge Drive, Suite 6070, Bethesda, MD, 20892, USA.
| | - Alison G M Brown
- Division of Cardiovascular Sciences, NHLBI, NIH, 6710 Rockledge Drive, Suite 10115, Bethesda, MD, 20892, USA
| | - Charlotte A Pratt
- Division of Cardiovascular Sciences, NHLBI, NIH, 6710 Rockledge Drive, Suite 10115, Bethesda, MD, 20892, USA
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Cohen DA, Bogart LM, Han B, Williamson S, Castro G. High consumption of energy-dense nutrient-poor foods among low-income groups in the Mississippi Delta and Alabama. Public Health Nutr 2020; 23:1067-1075. [PMID: 31566159 PMCID: PMC10200526 DOI: 10.1017/s1368980019002817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/28/2019] [Accepted: 05/31/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess the consumption of sugar-sweetened beverages (SSB) and other energy-dense nutrient-poor (EDNP) foods in two Southern low-income communities targeted by the Balance Calories Initiative, a campaign by the top-three American beverage companies intended to reduce the consumption of sugary beverages by 20 % over 10 years. DESIGN We conducted self-administered intercept surveys in front of food retail outlets between August and November 2016. We recruited adults with children <18 years living at home and adolescents aged 10-17 years with parental consent. SETTING Retail food outlets in Mississippi and Alabama, USA. PARTICIPANTS Adults (n 11 311) and adolescents (n 3460). RESULTS The percentage of high SSB consumers (≥4 servings/d) was 40·9 % among adult males, 32·3 % among adult females, 43·0 % among adolescent males and 34·4 % among adolescent females (male - female difference, P < 0·0001). In aggregate, respondents also reported consuming a mean of 3 servings of salty snacks, cookies and/or candy in the past 24 h, with adolescent males reporting 4 servings. CONCLUSIONS SSB should be a primary target of future interventions to improve dietary intake, but EDNP foods likely contribute as many daily kilojoules as SSB among this population. Future campaigns should aim to limit the consumption of all EDNP foods.
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Affiliation(s)
- Deborah A Cohen
- RAND Corporation, 1776 Main Street, Santa Monica, CA90407, USA
| | - Laura M Bogart
- RAND Corporation, 1776 Main Street, Santa Monica, CA90407, USA
| | - Bing Han
- RAND Corporation, 1776 Main Street, Santa Monica, CA90407, USA
| | | | - Gabriela Castro
- RAND Corporation, 1776 Main Street, Santa Monica, CA90407, USA
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Fontes AS, Pallottini AC, Vieira DADS, Fontanelli MDM, Marchioni DM, Cesar CLG, Alves MCGP, Goldbaum M, Fisberg RM. Demographic, socioeconomic and lifestyle factors associated with sugar-sweetened beverage intake: a population-based study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200003. [DOI: 10.1590/1980-549720200003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/30/2018] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT: Introduction: The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population. Objective: To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo. Methods: Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models. Results: The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages. Conclusion: Age group, sex, household per capita income, and body mass index status were associated with SSB intake.
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Kovalskys I, Rigotti A, Koletzko B, Fisberg M, Gómez G, Herrera-Cuenca M, Cortés Sanabria LY, Yépez García MC, Pareja RG, Zimberg IZ, Del Arco A, Zonis L, Previdelli AN, Guajardo V, Moreno LA, Fisberg R. Latin American consumption of major food groups: Results from the ELANS study. PLoS One 2019; 14:e0225101. [PMID: 31877144 PMCID: PMC6932811 DOI: 10.1371/journal.pone.0225101] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 10/29/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The Latin American (LA) region is still facing an ongoing epidemiological transition and shows a complex public health scenario regarding non-communicable diseases (NCDs). A healthy diet and consumption of specific food groups may decrease the risk of NCDs, however there is a lack of dietary intake data in LA countries. OBJECTIVE Provide updated data on the dietary intake of key science-based selected food groups related to NCDs risk in LA countries. DESIGN ELANS (Latin American Study of Nutrition and Health) is a multicenter cross-sectional study assessing food consumption from an urban sample between15 to 65 years old from 8 LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela). Two 24-HR were obtained from 9,218 individuals. The daily intake of 10 food groups related to NCDs risk (fruits; vegetables; legumes/beans; nuts and seeds; whole grains products; fish and seafood; yogurt; red meat; processed meats; sugar-sweetened beverages (ready-to-drink and homemade)) were assessed and compared to global recommendations. RESULTS Only 7.2% of the overall sample reached WHO's recommendation for fruits and vegetables consumption (400 grams per day). Regarding the dietary patterns related to a reduced risk of NCDs, among the overall sample legumes and fruits were the food groups with closer intake to the recommendation, although much lower than expected (13.1% and 11.5%, respectively). Less than 3.5% of the sample met the optimal consumption level of vegetables, nuts, whole grains, fish and yogurt. Largest country-dependent differences in average daily consumption were found for legumes, nuts, fish, and yogurt. Mean consumption of SSB showed large differences between countries. CONCLUSION Diet intake quality is deficient for nutrient-dense food groups, suggesting a higher risk for NCDs in the urban LA region in upcoming decades. These data provide relevant and up-to-date information to take urgent public health actions to improve consumption of critically foods in order to prevent NCDs.
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Affiliation(s)
- Irina Kovalskys
- Nutrition, Health and Wellbeing Area, International Life Science Institute (ILSI-Argentina), Buenos Aires, Argentina
- Pontifica Universidad Catolica Argentina Facultad de Medicina, Buenos Aires, Argentina
| | - Attilio Rigotti
- Departamento de Nutrición, Diabetes y Metabolismo, Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Berthold Koletzko
- Ludwig-Maximilians-Universität Munich, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany
| | - Mauro Fisberg
- Instituto Pensi, Fundação Jose Luiz Egydio Setubal, Hospital Infantil Sabara, São Paulo, Brazil
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | | | | | | | - Ioná Zalcman Zimberg
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ana Del Arco
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luciana Zonis
- Nutrition, Health and Wellbeing Area, International Life Science Institute (ILSI-Argentina), Buenos Aires, Argentina
| | | | - Viviana Guajardo
- Nutrition, Health and Wellbeing Area, International Life Science Institute (ILSI-Argentina), Buenos Aires, Argentina
| | - Luis A. Moreno
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), University of Zaragoza, Zaragoza, Spain
| | - Regina Fisberg
- Departmento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
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Overlapping spatial clusters of sugar-sweetened beverage intake and body mass index in Geneva state, Switzerland. Nutr Diabetes 2019; 9:35. [PMID: 31727876 PMCID: PMC6856345 DOI: 10.1038/s41387-019-0102-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 01/01/2023] Open
Abstract
Background Obesity and obesity-related diseases represent a major public health concern. Recently, studies have substantiated the role of sugar-sweetened beverages (SSBs) consumption in the development of these diseases. The fine identification of populations and areas in need for public health intervention remains challenging. This study investigates the existence of spatial clustering of SSB intake frequency (SSB-IF) and body mass index (BMI), and their potential spatial overlap in a population of adults of the state of Geneva using a fine-scale geospatial approach. Methods We used data on self-reported SSB-IF and measured BMI from residents aged between 20 and 74 years of the state of Geneva (Switzerland) that participated in the Bus Santé cross-sectional population-based study (n = 15,423). Getis-Ord Gi spatial indices were used to identify spatial clusters of SSB-IF and BMI in unadjusted models and models adjusted for individual covariates (education level, gender, age, nationality, and neighborhood-level median income). Results We identified a significant spatial clustering of BMI and SSB-IF. 13.2% (n = 2034) of the participants were within clusters of higher SSB-IF and 10.7% (n = 1651) were within clusters of lower SSB-IF. We identified overlapping clusters of SSB-IF and BMI in specific areas where 11.1% (n = 1719) of the participants resided. After adjustment, the identified clusters persisted and were only slightly attenuated indicating that additional neighborhood-level determinants influence the spatial distribution of SSB-IF and BMI. Conclusions Our fine-scale spatial approach allowed to identify specific populations and areas presenting higher SSB-IF and highlighted the existence of an overlap between populations and areas of higher SSB-IF associated with higher BMI. These findings could guide policymakers to develop locally tailored interventions such as targeted prevention campaigns and pave the way for precision public health delivery.
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Marriott BP, Hunt KJ, Malek AM, Newman JC. Trends in Intake of Energy and Total Sugar from Sugar-Sweetened Beverages in the United States among Children and Adults, NHANES 2003-2016. Nutrients 2019; 11:E2004. [PMID: 31450689 PMCID: PMC6770750 DOI: 10.3390/nu11092004] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 02/04/2023] Open
Abstract
Consumption of sugar-sweetened beverages (SSBs) increases total caloric intake, is linked to cardiometabolic outcomes as well as dental caries, and sugar in SSBs is associated with mortality and frailty among adults. We describe energy and total sugar intake trends among the United States (US) population from SSBs, soft drinks, other beverage groups, and the total diet based on the first 24-h recall data from the National Health and Nutrition Examination Survey (NHANES) cycles (2003-2004 through 2015-2016). SSBs included soft drinks, sports drinks, energy drinks, and fruit drinks, but excluded sports beverages with protein and sweetened teas/coffees. Among the total population (age ≥2 years: 57,026), energy intake from SSBs declined significantly from 183.9 ± 6.9 mean kcal/d (±SE) in 2003-2004 to 95.0 ± 3.5 in 2015-2016, while total sugar intake declined from 43.6 ± 1.7 mean g/d to 22.3 ± 0.8 (p-trend < 0.0001). Decreases were found for energy and total sugar intake, as well as percentage of energy and total sugar intake from SSBs, soft drinks, and all beverages for all age groups examined (≥2, 2-19, ≥20 years) (p-trend < 0.0001). From 2003 to 2016, energy and sugar intake from all beverages, SSBs, soft drinks, and the total diet decreased among the total population, children, and adults.
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Affiliation(s)
- Bernadette P Marriott
- Department of Medicine, Medical University of South Carolina, 114 Doughty Street, Charleston, SC 29425, USA.
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Kelly J Hunt
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC 29425, USA
| | - Angela M Malek
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC 29425, USA
| | - Jill C Newman
- Department of Medicine, Medical University of South Carolina, 114 Doughty Street, Charleston, SC 29425, USA
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25
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Riediger ND, Bombak AE. Sugar-sweetened beverages as the new tobacco: examining a proposed tax policy through a Canadian social justice lens. CMAJ 2019; 190:E327-E330. [PMID: 29555863 DOI: 10.1503/cmaj.170379] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Natalie D Riediger
- Department of Community Health Sciences (Riediger); Ongomiizwin Research (Riediger), Indigenous Institute of Health and Healing, Rady Faculty of Health Sciences; Department of Food and Human Nutritional Sciences (Riediger), Faculty of Agricultural & Food Sciences, University of Manitoba, Winnipeg, Man.; Division of Community Health (Bombak), School of Health Sciences, Central Michigan University, Mount Pleasant, Mich.
| | - Andrea E Bombak
- Department of Community Health Sciences (Riediger); Ongomiizwin Research (Riediger), Indigenous Institute of Health and Healing, Rady Faculty of Health Sciences; Department of Food and Human Nutritional Sciences (Riediger), Faculty of Agricultural & Food Sciences, University of Manitoba, Winnipeg, Man.; Division of Community Health (Bombak), School of Health Sciences, Central Michigan University, Mount Pleasant, Mich
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26
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Vadiveloo M, Perraud E, Parker HW, Juul F, Parekh N. Geographic Differences in the Dietary Quality of Food Purchases among Participants in the Nationally Representative Food Acquisition and Purchase Survey (FoodAPS). Nutrients 2019; 11:nu11061233. [PMID: 31151225 PMCID: PMC6627193 DOI: 10.3390/nu11061233] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/20/2019] [Accepted: 05/23/2019] [Indexed: 12/20/2022] Open
Abstract
Objective grocery transactions may reflect diet, but it is unclear whether the diet quality of grocery purchases mirrors geographic and racial/ethnic disparities in diet-related diseases. This cross-sectional analysis of 3961 households in the nationally representative Food Acquisition and Purchase Survey evaluated geographic and racial/ethnic disparities in grocery purchase quality. Respondents self-reported demographics and recorded purchases over 7 days; the Healthy Eating Index (HEI) 2015 assessed diet quality. Survey-weighted multivariable-adjusted regression determined whether there were geographic and racial/ethnic differences in HEI-15 scores. Respondents were, on average, 50.6 years, non-Hispanic white (NHW) (70.3%), female (70.2%), and had attended some college (57.8%). HEI-15 scores differed across geographic region (p < 0.05), with the highest scores in the West (57.0 ± 0.8) and lowest scores in the South (53.1 ± 0.8), and there was effect modification by race/ethnicity (p-interaction = 0.02). Regionally, there were diet disparities among NHW and non-Hispanic black (NHB) households; NHWs in the South had HEI-15 scores 3.2 points lower than NHWs in the West (p = 0.003). Southern NHB households had HEI-15 scores 8.1 points lower than Western NHB households (p = 0.013). Racial/ethnic disparities in total HEI-15 by region existed in the Midwest and South, where Hispanic households in the Midwest and South had significantly lower diet quality than NHW households. Heterogeneous disparities in the diet quality of grocery purchases by region and race/ethnicity necessitate tailored approaches to reduce diet-related disease.
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Affiliation(s)
- Maya Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| | - Elie Perraud
- AgroParis Tech., 75231 Paris, Ile-de-France, France.
| | - Haley W Parker
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| | - Filippa Juul
- College of Global Public Health, New York University, New York, NY 10012, USA.
| | - Niyati Parekh
- College of Global Public Health, New York University, New York, NY 10012, USA.
- New York University School of Medicine, New York, NY 10016, USA.
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Wykes TL, Bourassa KA, Slosser AE, McKibbin CL. Community Mental Health Providers' Beliefs About Addressing Weight Loss Among Youth Clients with Serious Emotional Disturbance and Overweight/Obesity: An Elicitation Study. Community Ment Health J 2018; 54:1136-1145. [PMID: 29427055 PMCID: PMC9911299 DOI: 10.1007/s10597-018-0242-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 01/27/2018] [Indexed: 01/24/2023]
Abstract
Youth with Serious Emotional Disturbance (SED) have high rates of overweight/obesity. Factors influencing mental health provider intentions to deliver weight-related advice are unclear. This study used qualitative methodology and Theory of Planned Behavior (TPB) constructs to examine these factors. Community mental health providers serving youth with SED were recruited via convenience sampling and an online provider list. Participants completed an open-ended TPB-based questionnaire online. Content analysis identified thematic beliefs. Twenty-one providers completed the questionnaire. Providers identified behavioral beliefs (e.g., client defensiveness), normative beliefs (e.g., medical professionals), and control beliefs (e.g., limited resources) that impact decisions to provide weight-related advice. Knowledge of factors that may influence providers' delivery of weight-related advice may lead to more effective healthy lifestyle programming for youth with SED.
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Affiliation(s)
- Thomas L Wykes
- Department of Psychology, University of Wyoming, 1000 E. University Avenue, Laramie, WY, 82071, USA
| | - Katelynn A Bourassa
- Department of Psychology, University of Wyoming, 1000 E. University Avenue, Laramie, WY, 82071, USA
| | - Andrea E Slosser
- Department of Psychology, University of Wyoming, 1000 E. University Avenue, Laramie, WY, 82071, USA
| | - Christine L McKibbin
- Department of Psychology, University of Wyoming, 1000 E. University Avenue, Laramie, WY, 82071, USA.
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Di Onofrio V, Gallé F, Di Dio M, Belfiore P, Liguori G. Effects of nutrition motivational intervention in patients affected by type 2 diabetes mellitus: a longitudinal study in Naples, South Italy. BMC Public Health 2018; 18:1181. [PMID: 30333012 PMCID: PMC6192365 DOI: 10.1186/s12889-018-6101-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 10/05/2018] [Indexed: 01/04/2023] Open
Abstract
Background Type 2 diabetes (T2D) is associated with a prion diminished quality of life, especially due to the severe complications that it implicates. Changing dietary habits is an absolute priority, as well as implementing nutritional motivational programs. The aim of this study was to verify the effectiveness of a nutritional intervention in improving the health of patients affected by T2D. Methods A total of 69 patients participated in a nine-months motivational program focused on the principles of the Mediterranean diet, the classes of nutrients, the distribution of the meals during the day and the dietary choices. During regular meetings, the patients were requested to fill out a questionnaire about their dietary habits and behaviours. Clinical and metabolic parameters were also analysed. Results At the end of the intervention the number of people who declared that they ate five meals a day (p = 0.006) and preferred to have fruit for snack (p = 0.004) increased, while there was a reduction in the use of sweeteners and an elimination of the use of fructose (p = 0.05). The total daily consumption of kilocalories (kcal) had been reduced and the percentages of carbohydrates, proteins and lipids, after the intervention, follow the guidelines. In relation to this, a significant improvement (p < 0.05) was registered in systolic and diastolic pressure, BMI and waist circumference, as well as in glycaemic values (p = 0.018). Conclusions A nutritional motivational intervention may be useful in improving dietary habits and health status of patients with T2D. We hope that a similar intervention will be applied in Campania and in other Italian regions. Trial registration Registration number is ISRCTN11067689; date of registration: 10/09/2018. Retrospectively registered. Electronic supplementary material The online version of this article (10.1186/s12889-018-6101-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Valeria Di Onofrio
- Department of Sciences and Technologies, University of Naples "Parthenope", Business District, Block C4, 80143, Naples, Italy.
| | - Francesca Gallé
- Department of Movement and Wellbeing Sciences, University of Naples "Parthenope", Via Medina 40, 80133, Naples, Italy
| | - Mirella Di Dio
- Department of Movement and Wellbeing Sciences, University of Naples "Parthenope", Via Medina 40, 80133, Naples, Italy
| | - Patrizia Belfiore
- Department of Movement and Wellbeing Sciences, University of Naples "Parthenope", Via Medina 40, 80133, Naples, Italy
| | - Giorgio Liguori
- Department of Movement and Wellbeing Sciences, University of Naples "Parthenope", Via Medina 40, 80133, Naples, Italy
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Kornatowski BM, Comstock SS. Dietary diversity is inversely correlated with pre-pregnancy body mass index among women in a Michigan pregnancy cohort. PeerJ 2018; 6:e5526. [PMID: 30210942 PMCID: PMC6130235 DOI: 10.7717/peerj.5526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 08/05/2018] [Indexed: 01/05/2023] Open
Abstract
Background During pregnancy, healthy maternal body weight and a nutritionally complete diet provide a favorable environment for fetal development. Yet nearly two-thirds of women of reproductive age in the United States (US) are either overweight or obese. The objective of this research was to investigate the relationship between a measure of dietary diversity and body mass index (BMI) in a sample of women enrolled in a US pregnancy cohort. Methods Dietary data was obtained from one 24-hour dietary recall collected during the third trimester of pregnancy (n = 40). Pre-pregnancy BMI was calculated from pre-pregnancy weight and height self-reported by survey at the time of enrollment. Using the Minimum Dietary Diversity for Women (MDD-W) indicator developed by the Food and Agriculture Organization of the United Nations, dietary data was categorized and scored. Results Overall, 35% of participants did not achieve minimum dietary diversity (MDD-W ≥5). In addition, 45% of participants were obese, 35% were normal weight and 20% were overweight. Women with higher BMI had lower MDD-W scores than women with lower BMI (p < 0.05). The median MDD-W for both normal and overweight women was ≥5 indicating that normal and overweight pregnant women tended to consume a diet that was high in micronutrients. Conversely, the median MDD-W for obese women was below 5 meaning these women tended to consume a diet that was low in micronutrient density. The most commonly consumed food group was grain. In addition, 75% of all participants consumed sweetened drinks. Individuals with an MDD-W score ≥5, were more likely to have consumed dark green leafy vegetables, vitamin A-rich fruits or vegetables, other vegetables and other fruits than those with MDD-W scores <5. Discussion In this study, we show that a food group diversity indicator that has been shown to reflect adequacy of micronutrient intake in populations from less economically developed countries may also be informative in US populations. Furthermore, these results reflect the importance of encouraging all pregnant women with less varied diets to consume more fruits and vegetables.
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Affiliation(s)
- Breanna M Kornatowski
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States of America
| | - Sarah S Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States of America
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Xu F, Park S, Siegel KR. Factors Associated With Frequency of Sugar-Sweetened Beverage Consumption Among US Adults With Diabetes or Prediabetes. Am J Health Promot 2018; 32:1489-1497. [PMID: 29254359 PMCID: PMC10423497 DOI: 10.1177/0890117117746187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE This study assessed the associations between sociodemographic and behavioral characteristics and sugar-sweetened beverage (SSB) intake among US adults with diabetes or prediabetes. DESIGN Quantitative, cross-sectional study. SETTING The 2013 Behavioral Risk Factor Surveillance System. PARTICIPANTS A total of 13 268 adults with diabetes and 9330 adults with prediabetes (median response rate: 46.8%). MEASURES The outcome measure was SSB intake (0, >0 to <1, and ≥1 time/day). The exposure measures were sociodemographic and behavioral characteristics. ANALYSIS Both crude and age-adjusted prevalences were calculated. Multinomial logistic regressions were used to estimate the adjusted prevalence ratio (PR) for SSB intake by participants' characteristics. RESULTS In 2013, 22.0% adults with diabetes and 38.2% adults with prediabetes consumed SSBs ≥1 time/day. Among adults with diabetes, adjusted PR for consuming SSBs ≥1 time/day was significantly greater for those who had shorter duration of diabetes (≤5 years: PR = 1.47; 6-10 years: PR = 1.33 vs ≥11 years), less frequently self-checking blood sugar (≥0 to <1 time/day: PR = 1.69; ≥1 to <3 times/day: PR = 1.43 vs ≥3 times/day), and no self-management of diabetes course taken (PR = 1.25 vs yes). Among adults with prediabetes, testing blood sugar ≤3 years was not associated with consuming SSBs ≥1 time/day. CONCLUSION Daily SSB intake was associated with various characteristics among adults with diabetes or prediabetes. The findings can inform efforts to decrease SSB intake among high-risk populations.
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Affiliation(s)
- Fang Xu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sohyun Park
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karen R. Siegel
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Lundeen EA, Park S, Dooyema C, Blanck HM. Total Sugar-Sweetened Beverage Intake Among US Adults Was Lower When Measured Using a 1-Question Versus 4-Question Screener. Am J Health Promot 2018; 32:1431-1437. [PMID: 29121793 PMCID: PMC6298428 DOI: 10.1177/0890117117736957] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To compare the performance of a 1-question survey screener measuring total sugar-sweetened beverage (SSB) intake to a screener measuring SSB types separately using 4 questions. DESIGN Cross-sectional. SETTING Web-based 2014 SummerStyles survey. PARTICIPANTS A total of 4167 US adults (≥18 years). MEASURES Frequency of SSB intake measured using a 1-question screener was compared to frequency using a 4-question screener (regular soda, fruit drinks, sports/energy drinks, sweetened coffee/tea). SSB intake (number of time/day) was categorized as 0, >0 to <1, and ≥1 time/day; difference in mean intake was calculated between 4 questions versus 1. ANALYSIS Paired t tests were used, and agreement was evaluated using weighted κ and Lin's concordance correlation coefficient (CCC). RESULTS Mean SSB intake was 1.7 (95% confidence interval [CI]: 1.65-1.79) times/day using 4 questions and 0.6 (95% CI: 0.56-0.62) times/day using 1 question ( P < .001). Intake frequency based on 4 questions versus 1 was 16.0% versus 38.5% for 0 time/day, 15.6% versus 42.5% for >0 to <1 time/day, and 68.4% versus 18.9% for ≥1 time/day. There was fair agreement for the 3 SSB intake categories (κ: .27) and poor absolute agreement between the 2 continuous measures (Lin's CCC: 0.31). CONCLUSION Daily SSB intake was significantly lower using a 1-question screener versus a 4-question screener. Researchers should assess SSB types separately or consider that daily SSB intake is likely underestimated with 1 question.
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Affiliation(s)
- Elizabeth A. Lundeen
- Epidemic Intelligence Service Officer at the time this work was conducted, Division of Nutrition, Physical Activity and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, Atlanta, GA 30341
| | - Sohyun Park
- DNPAO, NCCDPHP, CDC, Atlanta, GA. Tel: 770-488-5163, Fax: 770-488-6039,
| | - Carrie Dooyema
- DNPAO, NCCDPHP, CDC, Atlanta, GA. Tel: 770-488-5039, Fax: 770-488-6039,
| | - Heidi M. Blanck
- DNPAO, NCCDPHP, CDC, Atlanta, GA. Tel: 770-488-5638, Fax: 770-488-6039,
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Park S, Lundeen EA, Pan L, Blanck HM. Impact of Knowledge of Health Conditions on Sugar-Sweetened Beverage Intake Varies Among US Adults. Am J Health Promot 2018; 32:1402-1408. [PMID: 28664774 PMCID: PMC5575990 DOI: 10.1177/0890117117717381] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE This study examined associations between knowledge of sugar-sweetened beverage (SSB)-related health conditions and SSB intake among US adults. DESIGN Quantitative, cross-sectional study. SUBJECT The 2014 SummerStyles survey data for 4163 US adults (≥18 years) were used. MEASURES The outcome measure was frequency of SSB intake (regular soda, fruit drinks, sports or energy drinks, sweetened coffee/tea drinks). Exposure measures were knowledge of 6 SSB-related health conditions: weight gain, diabetes, cavities, high cholesterol, heart disease, and hypertension. ANALYSIS Six logistic regression models were used to estimate adjusted odds ratios (ORs) for consuming SSBs ≥2 times/d according to knowledge of SSB-related health conditions. RESULTS Overall, 37.8% of adults reported consuming SSBs ≥2 times/d. Although most adults identified that weight gain (80.2%), diabetes (73.6%), and cavities (71.8%) are related to drinking SSBs, fewer adults identified high cholesterol (24.1%), heart disease (31.5%), and hypertension (33.0%) as being related to drinking SSBs. Crude analyses indicated that lower SSB intake was significantly associated with knowledge of the associations between SSBs and weight gain, diabetes, cavities, and heart disease. However, after adjustment for covariates, only lack of knowledge of the association between heart disease and SSBs was significantly associated with consuming SSBs ≥2 times/d (OR = 1.29) than non-SSB consumers. CONCLUSIONS The finding that knowledge of SSB-related health conditions, in general, was not associated with high SSB intake suggests that knowledge on SSB-related health conditions alone may not be sufficient for adult behavior change.
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Affiliation(s)
- Sohyun Park
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth A. Lundeen
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Liping Pan
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Heidi M. Blanck
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Park S, Ayala GX, Sharkey JR, Blanck HM. Knowledge of Health Conditions Associated With Sugar-Sweetened Beverage Intake Is Low Among US Hispanic Adults. Am J Health Promot 2018; 33:39-47. [PMID: 29747519 DOI: 10.1177/0890117118774206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To examine associations between knowledge of health conditions and sugar-sweetened beverage (SSB) intake among Hispanic adults. DESIGN Quantitative, cross-sectional study. SETTING The 2015 Estilos survey data. PARTICIPANTS One thousand US Hispanic adults (≥18 years). MEASURES The outcome variable was frequency of SSB intake (regular soda, fruit drink, sports/energy drink, and sweetened coffee/tea drink). Exposure variables were knowledge of 6 SSB-related health conditions (weight gain, diabetes, dental caries, high cholesterol, heart disease, and hypertension). ANALYSIS Six multinomial logistic regression models were used to estimate adjusted odds ratios for consuming SSBs ≥3 times/day (high intake), in relation to knowledge of SSB-related health conditions. RESULTS Overall, 58% of Hispanic adults consumed SSBs ≥2 times/day and 36% consumed SSBs ≥3 times/day. Although most identified that weight gain (75%) and diabetes (76%) were related to drinking SSBs, only half identified this relation with dental caries (57%) and hypertension (41%). Even fewer identified high cholesterol (32%) and heart disease (32%) as related. In crude analyses, SSB intake was significantly associated with knowledge of the associations between SSBs and weight gain, dental caries, and heart disease; however, after adjusting for sociodemographics and acculturation, associations were no longer significant. CONCLUSIONS Although SSB intake was very high, knowledge of SSB-related health conditions was low and was not related to high SSB intake among US Hispanic adults. Education efforts alone may not be adequate for Hispanic adults to change their behaviors.
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Affiliation(s)
- Sohyun Park
- 1 Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Guadalupe X Ayala
- 2 College of Health and Human Services, SDSU and Institute for Behavioral and Community Health, San Diego, CA, USA
| | - Joseph R Sharkey
- 3 Health Promotion and Community Health Sciences and Program for Research and Outreach-Engagement on Nutrition and Health Disparities Solutions, Texas A&M University School of Public Health, College Station, TX, USA
| | - Heidi M Blanck
- 1 Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Park S, Onufrak S, Wilking C, Cradock A. Community-Based Policies and Support for Free Drinking Water Access in Outdoor Areas and Building Standards in U.S. Municipalities. Clin Nutr Res 2018; 7:91-101. [PMID: 29713617 PMCID: PMC5921334 DOI: 10.7762/cnr.2018.7.2.91] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/08/2018] [Accepted: 03/11/2018] [Indexed: 11/19/2022] Open
Abstract
We examined community-level characteristics associated with free drinking water access policies in U.S. municipalities using data from a nationally representative survey of city managers/officials from 2,029 local governments in 2014. Outcomes were 4 free drinking water access policies. Explanatory measures were population size, rural/urban status, census region, poverty prevalence, education, and racial/ethnic composition. We used multivariable logistic regression to test differences and presented only significant findings. Many (56.3%) local governments had at least one community plan with a written objective to provide free drinking water in outdoor areas; municipalities in the Northeast and South regions and municipalities with ≤ 50% of non-Hispanic whites were less likely and municipalities with larger population size were more likely to have a plan. About 59% had polices/budget provisions for free drinking water in parks/outdoor recreation areas; municipalities in the Northeast and South regions were less likely and municipalities with larger population size were more likely to have it. Only 9.3% provided development incentives for placing drinking fountains in outdoor, publicly accessible areas; municipalities with larger population size were more likely to have it. Only 7.7% had a municipal plumbing code with a drinking fountain standard that differed from the statewide plumbing code; municipalities with a lower proportion of non-Hispanic whites were more likely to have it. In conclusion, over half of municipalities had written plans or a provision for providing free drinking water in parks, but providing development incentives or having a local plumbing code provision were rare.
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Affiliation(s)
- Sohyun Park
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Stephen Onufrak
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | | | - Angie Cradock
- Prevention Research Center on Nutrition and Physical Activity, Harvard T.H. Chan School of Public Health, Landmark Center, Boston, MA 02115, USA
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Kearns CE, Lisha NE, Ling PM. Soda intake and tobacco use among young adult bar patrons: A cross-sectional study in seven cities. Prev Med Rep 2018; 10:195-199. [PMID: 29868367 PMCID: PMC5984229 DOI: 10.1016/j.pmedr.2018.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 02/13/2018] [Accepted: 03/14/2018] [Indexed: 01/10/2023] Open
Abstract
Young adults are among the greatest consumers of sugar sweetened beverages, and they also have high smoking rates. However, few studies address the relationship between these risk behaviors; this study examined the relationship between soda consumption and smoking among young adult bar patrons, a high-risk understudied population. A cross-sectional survey of young adult bar patrons (between January 2014 and October 2015) was conducted using randomized time location sampling (N = 8712) in Albuquerque, NM, Los Angeles, CA Nashville, TN, Oklahoma City, OK, San Diego, CA, San Francisco, CA, and Tucson, AZ. The survey found the prevalences of daily regular soda intake ranged from 32% in San Diego to 51% in Oklahoma City and current smoking ranged from 36% in Los Angeles, CA to 49% in Albuquerque, NM. In multinomial multivariate models with no soda consumption as the reference group and controlling for demographics and location, non-daily (OR = 1.24, 95% CI = 1.05, 1.47) and daily smokers (OR = 1.34, 95% CI = 1.08, 1.66) were both more likely to drink regular soda compared to not drinking any soda. No effects were found for diet soda consumption. These linked risks suggest that comprehensive health promotion efforts to decrease sugar sweetened beverage consumption and tobacco use, among other risky behaviors, may be effective in this population. Young adult (YA) bar patrons who smoke consume more regular soda than nonsmokers. Being a non-daily or a daily-smoker increased odds of drinking regular soda. Prevalence of smoking among YA bar patrons who were regular soda drinkers varied by region. YA bar patrons attending or graduated from college were less likely to drink soda.
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Affiliation(s)
- Cristin E Kearns
- Philip R. Lee Institute for Health Policy Studies and Division of Oral Epidemiology and Dental Public Health, Department of Preventive and Restorative Dental Sciences, University of California San Francisco, 3333 California St, Box 0936, San Francisco, CA 94143, USA
| | - Nadra E Lisha
- Center for Tobacco Control Research and Education and Division of General Internal Medicine, Department of Medicine, University of California San Francisco, Box 1390, San Francisco, CA 94143, USA
| | - Pamela M Ling
- Center for Tobacco Control Research and Education and Division of General Internal Medicine, Department of Medicine, University of California San Francisco, Box 1390, San Francisco, CA 94143, USA
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Secular trends in regional differences in nutritional biomarkers and self-reported dietary intakes among American adults: National Health and Nutrition Examination Survey (NHANES) 1988-1994 to 2009-2010. Public Health Nutr 2018; 21:927-939. [PMID: 29317006 DOI: 10.1017/s1368980017003743] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To understand the contribution of regional differentials in dietary exposures to regional gradients in health, we examined 20-year trends in the association of US census region of residence with nutritional biomarkers and dietary intakes of American adults. DESIGN Observational. SETTING The biomarker and 24 h dietary recall data were from the National Health and Nutrition Examination Surveys (NHANES) conducted during 1988-1994 and 1999-2010. The US census region was operationalized as Northeast, Midwest, South and West. Nutritional biomarker outcomes were serum folate, vitamins B6, B12, C, D and E, and carotenoids; dietary outcomes were intakes of nutrients, food groups and eating patterns. SUBJECTS US adults, n>8000-40 000 for biomarkers and >43 000 for dietary outcomes. RESULTS The interactions of survey time period and region were not significant for the examined biomarker and dietary outcomes, indicating similar secular trends among regions. The main effect of region was significant for all nutritional biomarkers except serum vitamin B6, most dietary micronutrients, food groups and eating patterns (P<0·001). The mean serum folate, vitamins B12, C and E, and all carotenoid (except lycopene) biomarker levels, and intakes of dietary fibre, vitamins A, E, C and B6, folate, K, Ca, Mg and Fe, fruits, vegetables and whole grains, were higher in the West and Northeast regions, relative to the South and Midwest regions. CONCLUSIONS Overall, the regional gradients in dietary exposure, expressed objectively as biomarkers or as self-reported nutrient and food group intakes, paralleled trajectories reported for health outcomes and were remarkably persistent over time.
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Franckle RL, Moran A, Hou T, Blue D, Greene J, Thorndike AN, Polacsek M, Rimm EB. Transactions at a Northeastern Supermarket Chain: Differences by Supplemental Nutrition Assistance Program Use. Am J Prev Med 2017; 53:e131-e138. [PMID: 28818413 PMCID: PMC5657566 DOI: 10.1016/j.amepre.2017.06.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 05/19/2017] [Accepted: 06/20/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although one in seven Americans receives Supplemental Nutrition Assistance Program (SNAP) benefits, little is known about how these benefits for food are spent because individual-level sales data are not publicly available. The purpose of this study is to compare transactions made with and without SNAP benefits at a large regional supermarket chain. METHODS Sales data were obtained from a large supermarket chain in the Northeastern U.S. for a period of 2 years (April 2012-April 2014). Multivariate multiple regression models were used to quantify relative differences in dollars spent on 31 predefined SNAP-eligible food categories. Analyses were completed in 2016. RESULTS Transactions with SNAP benefit use included higher spending on less healthful food categories, including sugar-sweetened beverages ($1.08), red meat ($1.55), and convenience foods ($1.34), and lower spending on more healthful food categories, such as fruits (-$1.51), vegetables (-$1.35), and poultry (-$1.25) compared to transactions without SNAP benefit use. CONCLUSIONS These findings provide objective data to compare purchases made with and without SNAP benefits. Next steps should be to test proposed SNAP modifications to determine whether they would have the intended effect of promoting healthier purchasing patterns among SNAP beneficiaries.
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Affiliation(s)
- Rebecca L Franckle
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Alyssa Moran
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Tao Hou
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Dan Blue
- Hannaford Marketing, Hannaford Supermarkets, Scarborough, Maine
| | - Julie Greene
- Hannaford Healthy Living, Hannaford Supermarkets, Scarborough, Maine
| | - Anne N Thorndike
- General Medicine Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michele Polacsek
- School of Community and Population Health, University of New England, Portland, Maine
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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Tamura K, Duncan DT, Athens JK, Bragg MA, Rienti M, Aldstadt J, Scott MA, Elbel B. Geospatial clustering in sugar-sweetened beverage consumption among Boston youth. Int J Food Sci Nutr 2017; 68:719-725. [PMID: 28095725 PMCID: PMC10809269 DOI: 10.1080/09637486.2016.1276519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 12/18/2016] [Accepted: 12/19/2016] [Indexed: 01/26/2023]
Abstract
The objective was to detect geospatial clustering of sugar-sweetened beverage (SSB) intake in Boston adolescents (age = 16.3 ± 1.3 years [range: 13-19]; female = 56.1%; White = 10.4%, Black = 42.6%, Hispanics = 32.4%, and others = 14.6%) using spatial scan statistics. We used data on self-reported SSB intake from the 2008 Boston Youth Survey Geospatial Dataset (n = 1292). Two binary variables were created: consumption of SSB (never versus any) on (1) soda and (2) other sugary drinks (e.g., lemonade). A Bernoulli spatial scan statistic was used to identify geospatial clusters of soda and other sugary drinks in unadjusted models and models adjusted for age, gender, and race/ethnicity. There was no statistically significant clustering of soda consumption in the unadjusted model. In contrast, a cluster of non-soda SSB consumption emerged in the middle of Boston (relative risk = 1.20, p = .005), indicating that adolescents within the cluster had a 20% higher probability of reporting non-soda SSB intake than outside the cluster. The cluster was no longer significant in the adjusted model, suggesting spatial variation in non-soda SSB drink intake correlates with the geographic distribution of students by race/ethnicity, age, and gender.
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Affiliation(s)
- Kosuke Tamura
- Department of Population Health, School of Medicine, New York University, New York, NY
| | - Dustin T. Duncan
- Department of Population Health, School of Medicine, New York University, New York, NY
- College of Global Public Health, New York University, New York, NY
| | - Jessica K. Athens
- Department of Population Health, School of Medicine, New York University, New York, NY
| | - Marie A. Bragg
- Department of Population Health, School of Medicine, New York University, New York, NY
- College of Global Public Health, New York University, New York, NY
| | - Michael Rienti
- Department of Geography, University at Buffalo, State University of New York, Buffalo, NY
| | - Jared Aldstadt
- Department of Geography, University at Buffalo, State University of New York, Buffalo, NY
| | - Marc A. Scott
- College of Global Public Health, New York University, New York, NY
- PRIISM Applied Statistics Center, New York University, New York, NY
| | - Brian Elbel
- Department of Population Health, School of Medicine, New York University, New York, NY
- Wagner Graduate School of Public Service, New York University, New York, NY
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Piontak JR, Russell MA, Danese A, Copeland WE, Hoyle RH, Odgers CL. Violence exposure and adolescents' same-day obesogenic behaviors: New findings and a replication. Soc Sci Med 2017; 189:145-151. [PMID: 28768573 PMCID: PMC5907915 DOI: 10.1016/j.socscimed.2017.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 06/23/2017] [Accepted: 07/07/2017] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To test whether exposure to violence is associated with same-day increases in obesogenic behaviors among young adolescents, including unhealthy food and beverage consumption, poor quality sleep, and lack of physical activity. METHODS Young at-risk adolescents between 12 and 15 years of age were recruited via telephone screening from low-income neighborhoods. Adolescents and their parents completed in-person assessments, followed by Ecological Momentary Assessment (EMA) delivered to 151 adolescents' mobile phones three times a day for 30 days (4329 person days). Three obesogenic behaviors - unhealthy food consumption, poor sleep quality, and lack of physical activity - and violence exposure were assessed daily. Adolescents' body mass index (BMI) was assessed prior to the EMA and 18 months later. A replication was performed among 395 adolescents from a population-representative sample (with 5276 EMA person days). RESULTS On days that at-risk adolescents were exposed versus not exposed to violence, they were more likely to consume unhealthy foods and beverages (b = 0.12, p = 0.01), report feeling tired the next morning (OR = 1.58, p < 0.01), and to be active (OR = 1.61, p < 0.01). At-risk adolescents who reported higher consumption of soda and caffeinated beverages during the 30-day EMA were more likely to experience increases in BMI in later adolescence. Findings related to sleep and activity were supported in the population-based replication sample; however, no significant same-day associations were found between violence exposure and unhealthy dietary consumption. CONCLUSIONS This study provides evidence that exposure to violence is associated with same-day unhealthy dietary consumption among at-risk adolescents and next-day tiredness related to sleep quality among adolescents from both at-risk and normative populations. Findings also point to unhealthy soda consumption during early adolescence as an important predictor of weight gain among at-risk adolescents.
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Affiliation(s)
- Joy Rayanne Piontak
- Sanford School of Public Policy, Duke University, Box 90239, Durham, NC 27708-7401, USA; RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709, USA.
| | - Michael A Russell
- The Methodology Center, Penn State University, 431 Health and Human Development Building, University Park, PA 16802, USA.
| | - Andrea Danese
- MRC Social, Genetic, and Developmental Psychiatry (SGDP) Centre, Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London 16 De Crespigny Park, London SE5 8AF, United Kingdom.
| | - William E Copeland
- Center for Developmental Epidemiology, Duke University, 905 W. Main Street, Suite 22B Brightleaf Square, Durham, NC 27701, USA.
| | - Rick H Hoyle
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC 27708, USA.
| | - Candice L Odgers
- Sanford School of Public Policy, Duke University, Box 90239, Durham, NC 27708-7401, USA; Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC 27708, USA.
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Park S, Thompson FE, McGuire LC, Pan L, Galuska DA, Blanck HM. Sociodemographic and Behavioral Factors Associated with Added Sugars Intake among US Adults. J Acad Nutr Diet 2016; 116:1589-1598. [PMID: 27236642 PMCID: PMC5068358 DOI: 10.1016/j.jand.2016.04.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 04/19/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Reducing added sugars intake is one of the Healthy People 2020 objectives. High added sugars intake may be associated with adverse health consequences. OBJECTIVE This cross-sectional study identified sociodemographic and behavioral characteristics associated with added sugars intake among US adults (18 years and older) using the 2010 National Health Interview Survey data (n=24,967). METHODS The outcome variable was added sugars intake from foods and beverages using scoring algorithms to convert dietary screener frequency responses on nine items to estimates of individual dietary intake of added sugars in teaspoons per day. Added sugars intake was categorized into tertiles (lowest, middle, highest) stratified by sex. The explanatory variables were sociodemographic and behavioral characteristics. Multinomial logistic regression was used to estimate the adjusted odds ratios for the highest and middle tertile added sugars intake groups as compared with the lowest tertile group. RESULTS Estimated median added sugars intake was 17.6 tsp/d for men and 11.7 tsp/d for women. For men and women, those who had significantly greater odds for being in the highest tertile of added sugars intake (men: ≥22.0 tsp/d; women: ≥14.6 tsp/d) were younger, less educated, had lower income, were less physically active, were current smokers, and were former or current infrequent/light drinkers, whereas non-Hispanic other/multiracial and those living in the West had significantly lower odds for being in the highest tertile of added sugars intake. Different patterns were found by sex. Non-Hispanic black men had lower odds for being in the highest tertile of added sugars intake, whereas non-Hispanic black women had greater odds for being in the highest tertile. CONCLUSIONS One in three men consumed ≥22.0 tsp added sugars and one in three women consumed ≥14.6 tsp added sugars daily. Higher added sugars intake was associated with various sociodemographic and behavioral characteristics; this information can inform efforts to design programs and policies specific to high-intake populations.
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Park S, Xu F, Town M, Blanck HM. Prevalence of Sugar-Sweetened Beverage Intake Among Adults--23 States and the District of Columbia, 2013. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2016; 65:169-74. [PMID: 26914018 DOI: 10.15585/mmwr.mm6507a1] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The 2015-2020 Dietary Guidelines for Americans recommend that the daily intake of calories from added sugars not exceed 10% of total calories. Sugar-sweetened beverages (SSBs) are significant sources of added sugars in the diet of U.S. adults and account for approximately one third of added sugar consumption. Among adults, frequent (i.e., at least once a day) SSB intake is associated with adverse health consequences, including obesity, type 2 diabetes, and cardiovascular disease. According to the 2009-2010 National Health and Nutrition Examination Survey (NHANES), an in-person and phone follow-up survey, 50.6% of U.S. adults consumed at least one SSB on a given day. In addition, SSB intake varies by geographical regions: the prevalence of daily SSB intake was higher among U.S. adults living in the Northeast (68.4%) and South (66.7%) than among persons living in the Midwest (58.8%). In 2013, the Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey, revised the SSB two-item optional module to retain the first question on regular soda and expand the second question to include more types of SSBs than just fruit drinks. Using 2013 BRFSS data, self-reported SSB (i.e., regular soda, fruit drinks, sweet tea, and sports or energy drinks) intake among adults (aged ≥18 years) was assessed in 23 states and the District of Columbia (DC). The overall age-adjusted prevalence of SSB intake ≥1 time per day was 30.1% and ranged from 18.0% in Vermont to 47.5% in Mississippi. Overall, at least once daily SSB intake was most prevalent among adults aged 18-24 years (43.3%), men (34.1%), non-Hispanic blacks (blacks) (39.9%), unemployed adults (34.4%), and persons with less than a high school education (42.4%). States can use the data for program evaluation and monitoring trends, and information on disparities in SSB consumption could be used to create targeted intervention efforts to reduce SSB consumption.
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