1
|
Gyimah EA, Nicholas JL, Waters WF, Gallegos-Riofrío CA, Chapnick M, Blackmore I, Douglas KE, Iannotti LL. Ultra-processed foods in a rural Ecuadorian community: associations with child anthropometry and bone maturation. Br J Nutr 2023; 130:1609-1624. [PMID: 36912073 PMCID: PMC10551472 DOI: 10.1017/s0007114523000624] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 02/15/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
Frequent ultra-processed food (UPF) consumption is consistently associated with poor health outcomes. Little is known about UPF intake during early childhood and its effects on growth. We assessed UPF in relation to child anthropometry, bone maturation, and their nutrition profiles in a rural Ecuadorian community. Covariate-adjusted regression models estimated relationships between UPF intake from a 24-hour Food Frequency Questionnaire and three outcomes: linear growth, weight status and bone maturation. Nutrient Profiling Models (NPM) evaluated a convenience sample of UPF (n 28) consumed by children in the community. In this cohort (n 125; mean age = 33·92 (sd 1·75) months), 92·8 % consumed some form of UPF the previous day. On average, children consuming UPF four to twelve times per day (highest tertile) had lower height-for-age z-scores than those with none or a single instance of UPF intake (lowest tertile) (β = -0·43 [se 0·18]; P = 0·02). Adjusted stunting odds were significantly higher in the highest tertile relative to the lowest tertile (OR: 3·07, 95 % CI 1·11, 9·09). Children in the highest tertile had significantly higher bone age z-scores (BAZ) on average compared with the lowest tertile (β = 0·58 [se 0·25]; P = 0·03). Intake of savoury UPF was negatively associated with weight-for-height z-scores (β = -0·30 [se 0·14]; P = 0·04) but positively associated with BAZ (β = 0·77 [se 0·23]; P < 0·001). NPM indicated the availability of unhealthy UPF to children, with excessive amounts of saturated fats, free sugars and sodium. Findings suggest that frequent UPF intake during early childhood may be linked to stunted growth (after controlling for bone age and additional covariates), despite paradoxical associations with bone maturation.
Collapse
Affiliation(s)
- Emmanuel A. Gyimah
- Brown School, Institute of Public Health, Washington University in St. Louis, St. Louis, MO, USA
| | - Jennifer L. Nicholas
- Department of Radiology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - William F. Waters
- Institute for Research in Health and Nutrition, Universidad San Francisco de Quito, Quito, Ecuador
| | - Carlos Andres Gallegos-Riofrío
- Brown School, Institute of Public Health, Washington University in St. Louis, St. Louis, MO, USA
- Institute for Research in Health and Nutrition, Universidad San Francisco de Quito, Quito, Ecuador
- Gund Institute for Environment, University of Vermont, Burlington, VT, USA
| | - Melissa Chapnick
- Brown School, Institute of Public Health, Washington University in St. Louis, St. Louis, MO, USA
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ivy Blackmore
- Brown School, Institute of Public Health, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Lora L. Iannotti
- Brown School, Institute of Public Health, Washington University in St. Louis, St. Louis, MO, USA
| |
Collapse
|
2
|
Khadan J, Spencer N, Strobl E, Bose-Duker T. Factors Associated With Being Overweight or Obese in Suriname. Int J Public Health 2021; 66:1604101. [PMID: 34744598 PMCID: PMC8565296 DOI: 10.3389/ijph.2021.1604101] [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: 03/24/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To identify the socio-demographic risk factors that are associated with adult Body Mass Index. Methods: We apply probit and ordinal probit models to a sample of 3,803 adults aged 20 and above from the 2016/17 round of the Suriname Survey of Living Conditions. Results: Women, the elderly, and couples who are either married and/or living together are more likely to be obese or overweight. This is also true for individuals who have chronic illnesses. We also find that individuals who engage in a sport or in other forms of exercise, even if modest, have lower odds of being overweight or obese. Interestingly, our findings indicate that individuals who benefit from government social safety net programs are less likely to be associated with being overweight or obese. Conclusion: Obesity could become a serious public health issue if not addressed appropriately. Policymakers should promptly develop a national strategy to help health care systems cope with the outcomes of obesity and to tackle the risk factors that have the greatest impacts on individual Body Mass Index.
Collapse
Affiliation(s)
| | - Nekeisha Spencer
- Department of Economics, University of the West Indies, Kingston, Jamaica
| | - Eric Strobl
- Department of Economics, University of Bern, Bern, Switzerland
| | | |
Collapse
|
3
|
Hawkes C, Ruel MT, Salm L, Sinclair B, Branca F. Double-duty actions: seizing programme and policy opportunities to address malnutrition in all its forms. Lancet 2020; 395:142-155. [PMID: 31852603 DOI: 10.1016/s0140-6736(19)32506-1] [Citation(s) in RCA: 194] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 12/14/2022]
Abstract
Actions to address different forms of malnutrition are typically managed by separate communities, policies, programmes, governance structures, and funding streams. By contrast, double-duty actions, which aim to simultaneously tackle both undernutrition and problems of overweight, obesity, and diet-related non-communicable diseases (DR-NCDs) have been proposed as a way to effectively address malnutrition in all its forms in a more holisitic way. This Series paper identifies ten double-duty actions that have strong potential to reduce the risk of both undernutrition, obesity, and DR-NCDs. It does so by summarising evidence on common drivers of different forms of malnutrition; documenting examples of unintended harm caused by some undernutrition-focused programmes on obesity and DR-NCDs; and highlighting examples of double-duty actions to tackle multiple forms of malnutrition. We find that undernutrition, obesity, and DR-NCDs are intrinsically linked through early-life nutrition, diet diversity, food environments, and socioeconomic factors. Some evidence shows that programmes focused on undernutrition have raised risks of poor quality diets, obesity, and DR-NCDs, especially in countries undergoing a rapid nutrition transition. This Series paper builds on this evidence to develop a framework to guide the design of double-duty approaches and strategies, and defines the first steps needed to deliver them. With a clear package of double-duty actions now identified, there is an urgent need to move forward with double-duty actions to address malnutrition in all its forms.
Collapse
Affiliation(s)
- Corinna Hawkes
- Centre for Food Policy, City, University of London, London, UK.
| | - Marie T Ruel
- International Food Policy Research Institute, Washington, DC, USA
| | - Leah Salm
- International Food Policy Research Institute, Washington, DC, USA
| | | | | |
Collapse
|
4
|
Walls HL, Johnston D, Mazalale J, Chirwa EW. Why we are still failing to measure the nutrition transition. BMJ Glob Health 2018. [PMID: 29527351 PMCID: PMC5841499 DOI: 10.1136/bmjgh-2017-000657] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Helen L Walls
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Jacob Mazalale
- Department of Economics, University of Malawi Chancellor College, Zomba, Malawi
| | - Ephraim W Chirwa
- Department of Economics, University of Malawi Chancellor College, Zomba, Malawi
| |
Collapse
|