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Iyer A, Hsu FC, Bonnecaze A, Skelton JA, Palakshappa D, Lewis KH. Association Between Child Sugary Drink Consumption and Serum Lipid Levels in Electronic Health Records. Clin Pediatr (Phila) 2024; 63:893-901. [PMID: 37735915 DOI: 10.1177/00099228231200405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Sugar-sweetened beverage (SSB) and fruit juice (FJ) consumption may promote lipid abnormalities in childhood. We examined the association between SSB/FJ intake and lipid levels using electronic health record data for 2816 adolescents. Multivariable logistic regression models treated clinical cutpoints for abnormal lipid levels (triglycerides [TG], high-density lipoprotein (HDL), low-density lipoprotein [LDL], and total cholesterol) as dependent variables. In models not adjusted for adiposity, elevated SSB and FJ consumption was associated with increased odds of having abnormally high TG (SSB: odds ratio [OR] = 1.28 (95% confidence interval [CI] = [1.07-1.52], P = .007); FJ: 1.35 ([1.09-1.69], P = .007)) and abnormally low HDL (SSB: 1.47 ([1.17-1.86], P = .001); FJ: 1.35 ([1.02-1.78], P = .03)). Adjusting for adiposity, a likely mediator of the relationship, attenuated these associations. These findings support the need for identifying unhealthy beverage consumption habits during childhood health care visits as a modifiable behavior associated with cardiometabolic risk.
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Affiliation(s)
- Ankitha Iyer
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Fang-Chi Hsu
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Alex Bonnecaze
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Joseph A Skelton
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Deepak Palakshappa
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Kristina H Lewis
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Kay MC, Pankiewicz AR, Schildcrout JS, Wallace S, Wood CT, Shonna Yin H, Rothman RL, Sanders LM, Orr C, Delamater AM, Flower KB, Perrin EM. Early Sweet Tooth: Juice Introduction During Early Infancy is Related to Toddler Juice Intake. Acad Pediatr 2023; 23:1343-1350. [PMID: 37150479 PMCID: PMC10592660 DOI: 10.1016/j.acap.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To assess if 100% fruit juice intake prior to 6 months is associated with juice and sugar-sweetened beverage (SSB) intake at 24 months and whether this differs by sociodemographic factors. METHODS We used longitudinal data from infants enrolled in the control (no obesity intervention) arm of Greenlight, a cluster randomized trial to prevent childhood obesity which included parent-reported child 100% fruit juice intake at all well child checks between 2 and 24 months. We studied the relationship between the age of juice introduction (before vs after 6 months) and juice and SSB intake at 24 months using negative binomial regression while controlling for baseline sociodemographic factors. RESULTS We report results for 187 participants (43% Hispanic, 39% non-Hispanic Black), more than half (54%) of whom had reported 100% fruit juice intake before 6 months. Average 100% fruit juice intake at 24 months was greater than the recommended amount (of 4 oz) and was 8.2 oz and 5.3 oz for those who had and had not, respectively, been introduced to juice before 6 months. In adjusted models, early introduction of juice was associated with a 43% (95% confidence interval: 5%-96%) increase in juice intake at 24 months. CONCLUSIONS 100% fruit juice intake exceeding recommended levels at 6 and 24 months in this diverse cohort was prevalent. Introducing 100% fruit juice prior to 6 months may put children at greater risk for more juice intake as they age. Further research is necessary to determine if early guidance can reduce juice intake.
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Affiliation(s)
- Melissa C Kay
- Department of Pediatrics (MC Kay, AR Pankiewicz, and CT Wood), Duke University, Durham, NC.
| | - Aaron R Pankiewicz
- Department of Pediatrics (MC Kay, AR Pankiewicz, and CT Wood), Duke University, Durham, NC.
| | - Jonathan S Schildcrout
- Department of Biostatistics (JS Schildcrout), Vanderbilt University Medical Center, Nashville, Tenn.
| | - Shelby Wallace
- Division of General Pediatrics (S Wallace and RL Rothman), Vanderbilt University Medical Center, Nashville, Tenn.
| | - Charles T Wood
- Department of Pediatrics (MC Kay, AR Pankiewicz, and CT Wood), Duke University, Durham, NC.
| | - H Shonna Yin
- Departments of Pediatrics and Population Health (H Shonna Yin), New York University Grossman School of Medicine.
| | - Russell L Rothman
- Division of General Pediatrics (S Wallace and RL Rothman), Vanderbilt University Medical Center, Nashville, Tenn.
| | - Lee M Sanders
- Department of Pediatrics (LM Sanders), Stanford University, Calif.
| | - Colin Orr
- General Pediatrics and Adolescent Medicine (C Orr and KB Flower), University of North Carolina, Chapel Hill.
| | - Alan M Delamater
- Department of Pediatrics (AM Delamater), University of Miami, Coral Gables, Fla.
| | - Kori B Flower
- General Pediatrics and Adolescent Medicine (C Orr and KB Flower), University of North Carolina, Chapel Hill.
| | - Eliana M Perrin
- Department of Pediatrics (EM Perrin), Johns Hopkins University Schools of Medicine and Nursing, Baltimore, Md.
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Muñoz-Urtubia N, Vega-Muñoz A, Estrada-Muñoz C, Salazar-Sepúlveda G, Contreras-Barraza N, Castillo D. Healthy Behavior and Sports Drinks: A Systematic Review. Nutrients 2023; 15:2915. [PMID: 37447239 PMCID: PMC10346316 DOI: 10.3390/nu15132915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
This review article aims to systematically identify the relationship between sports drinks and healthy behavior. This systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline criteria, and eligibility criteria were established using the PICOS tool (population, interventions, comparators, outcomes, and study) from about 1000 records of sports drinks articles identified in the various Web of Science Core Collection databases. The literature review stages determined a reduced set of 15 articles relating these drinkable supplements to healthy behavior. This study concludes that water consumption should be emphasized for non-athletes, sports drinks should be labeled to indicate water consumption and carry a warning label, and more randomized clinical trials should be considered to ensure conclusive results for health decision making.
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Affiliation(s)
| | - Alejandro Vega-Muñoz
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
- Public Policy Observatory, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Carla Estrada-Muñoz
- Departamento de Ergonomía, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción 4070386, Chile;
| | - Guido Salazar-Sepúlveda
- Departamento de Ingeniería Industrial, Facultad de Ingeniería, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile
- Facultad de Ingeniería y Negocios, Universidad de Las Américas, Concepción 4090940, Chile
| | | | - Dante Castillo
- Centro de Estudios e Investigación Enzo Faletto, Universidad de Santiago de Chile, Santiago 9170022, Chile;
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Murtha JA, Venkatesh M, Liu N, Jawara D, Hanlon BM, Hanrahan LP, Funk LM. Association between neighborhood food environments and bariatric surgery outcomes. Surg Obes Relat Dis 2022; 18:1357-1364. [PMID: 36123294 PMCID: PMC9722637 DOI: 10.1016/j.soard.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/22/2022] [Accepted: 08/05/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Individual characteristics associated with weight loss after bariatric surgery are well established, but the neighborhood characteristics that influence outcomes are unknown. OBJECTIVES The objective of this study was to determine if neighborhood characteristics, including social determinants and lifestyle characteristics, were associated with weight loss after bariatric surgery. SETTING Single university healthcare system, United States. METHODS In this retrospective cohort study, all patients who underwent primary bariatric surgery from 2008 to 2017 and had at least 1 year of follow-up data were included. Patient-level demographics and neighborhood-level social determinants (area deprivation index, urbanicity, and walkability) and lifestyle factors (organic food use, fresh fruit/vegetable consumption, diet to maintain weight, soda consumption, and exercise) were analyzed. Median regression with percent total body weight (%TBW) loss as the outcome was applied to examine factors associated with weight loss after surgery. RESULTS Of the 647 patients who met inclusion criteria, the average follow-up period was 3.1 years, and the mean %TBW loss at the follow-up was 22%. In adjusted median regression analyses, Roux-en-Y gastric bypass was associated with greater %TBW loss (11.22%, 95% confidence interval [8.96, 13.48]) compared to sleeve, while longer follow-up time (-2.42% TBW loss per year, 95% confidence interval [-4.63, -0.20]) and a preoperative diagnosis of diabetes (-1.00% TBW loss, 95% confidence interval [-1.55, -0.44]) were associated with less. None of the 8 neighborhood level characteristics was associated with weight loss. CONCLUSIONS Patient characteristics rather than neighborhood-level social determinants and lifestyle factors were associated with weight loss after bariatric surgery in our cohort of bariatric surgery patients. Patients from socioeconomically deprived neighborhoods can achieve excellent weight loss after bariatric surgery.
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Affiliation(s)
| | - Manasa Venkatesh
- Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | - Natalie Liu
- Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | - Dawda Jawara
- Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | - Bret M Hanlon
- Department of Surgery, University of Wisconsin, Madison, Wisconsin; Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin
| | - Lawrence P Hanrahan
- Department of Family Medicine and Community Health, University of Wisconsin, Madison, Wisconsin
| | - Luke M Funk
- Department of Surgery, University of Wisconsin, Madison, Wisconsin; Department of Surgery, William S. Middleton Memorial VA, Madison, Wisconsin.
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Hanson C, Samson K, Anderson-Berry AL, Slotkowski RA, Su D. Racial disparities in caesarean delivery among nulliparous women that delivered at term: cross-sectional decomposition analysis of Nebraska birth records from 2005-2014. BMC Pregnancy Childbirth 2022; 22:329. [PMID: 35428241 PMCID: PMC9013155 DOI: 10.1186/s12884-022-04666-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/28/2022] [Indexed: 11/21/2022] Open
Abstract
Background Previous studies suggest higher rates of caesarean section among women who identify as racial/ethnic minorities. The objective of this study was to understand factors contributing to differences in caesarean rates across racial and ethnic groups. Methods Data was collected from 2005 to 2014 Nebraska birth records on nulliparous, singleton births occurring on or after 37 weeks gestation (n = 87,908). Risk ratios (RR) and 95% confidence intervals (CI) for caesarean were calculated for different racial and ethnic categories, adjusting for maternal age, marital status, county of residence, education, insurance status, pre-pregnancy BMI, and smoking status. Fairlie decomposition technique was utilized to quantify the contribution of individual variables to the observed differences in caesarean. Results In the adjusted analysis, relative to non-Hispanic (NH) White race, both Asian-NH (RR 1.21, 95% CI 1.14, 1.28) and Black-NH races (RR 1.13, 95% CI 1.08, 1.19) were associated with a significantly higher risk for caesarean. The decomposition analysis showed that among the variables assessed, maternal age, education, and pre-pregnancy BMI contributed the most to the observed differences in caesarean rates across racial/ethnic groups. Conclusion This analysis quantified the effect of social and demographic factors on racial differences in caesarean delivery, which may guide public health interventions aimed towards reducing racial disparities in caesarean rates. Interventions targeted towards modifying maternal characteristics, such as reducing pre-pregnancy BMI or increasing maternal education, may narrow the gap in caesarean rates across racial and ethnic groups. Future studies should determine the contribution of physician characteristics, hospital characteristics, and structural determinants of health towards racial disparities in caesarean rates.
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Barnhill A, Ramírez AS, Ashe M, Berhaupt-Glickstein A, Freudenberg N, Grier SA, Watson KE, Kumanyika S. The Racialized Marketing of Unhealthy Foods and Beverages: Perspectives and Potential Remedies. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2022; 50:52-59. [PMID: 35243999 PMCID: PMC9014864 DOI: 10.1017/jme.2022.8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We propose that marketing of unhealthy foods and beverages to Black and Latino consumers results from the intersection of a business model in which profits come primarily from marketing an unhealthy mix of products, standard targeted marketing strategies, and societal forces of structural racism, and contributes to health disparities.
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