1
|
Leonard UM, Kiely ME. Can micronutrient requirements be met by diets from sustainable sources: outcomes of dietary modelling studies using diet optimization. Ann Med 2024; 56:2389295. [PMID: 39129219 PMCID: PMC11321105 DOI: 10.1080/07853890.2024.2389295] [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] [Received: 12/18/2023] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Consumption of diets from sustainable sources is required for planetary health, however, large sections of the population, including females of reproductive age and children, will be at risk of not meeting their micronutrient (MN) requirements in a complete transition to plant-based foods. Constrained diet optimization methods use mathematical programming to construct diets that meet predefined parameters and may contribute towards modelling dietary solutions that meet nutritional and planetary targets. OBJECTIVE Review the evidence from diet optimization studies proposing solutions to ensure MN availability in the context of a transition to diets from sustainable sources. APPROACH Narrative review focusing on literature published over the last five years. RESULTS Dietary modelling using diet optimization can design a range of omnivorous and plant-based diets that meet individual MN requirements, have reduced environmental impacts, and minimize deviation from culturally acceptable dietary practices. Using data from large-scale dietary surveys, diet optimization can support development of food-based dietary guidelines; identify limiting MNs in a particular context or a conflict between constraints e.g. nutrition and environment; explore food-based strategies to increase nutrient supply, such as fortification; and support trial design. Methods used and outcomes reported are sources of variability. Individual-level dietary data and MN requirements for population sub-groups such as females of reproductive age and children are important requirements. Although maintaining iron and zinc intakes are regularly reported to present challenges in diets from sustainable sources, few studies have considered bioavailability, which reduces with increased dietary phytate. These and other data gaps including acceptability and affordability must be addressed to improve the applicability of modelling outcomes in population recommendations. CONCLUSIONS Dietary modelling using diet optimization can be useful in the design of more sustainable diets that meet MN requirements, however, translation of outcomes into dietary intervention studies is required to test real-world application and adoption into dietary guidelines.
Collapse
Affiliation(s)
- Ursula M. Leonard
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Mairead E. Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
- INFANT Research Centre, Ireland, University College Cork, Cork, Ireland
| |
Collapse
|
2
|
Gómez-García EF, Cueto-Manzano AM, Martínez-Ramírez HR, Cortés-Sanabria L, Avesani CM, Orozco-González CN, Rojas-Campos E. Dietary counseling, meal patterns, and diet quality in patients with type 2 diabetes mellitus with/without chronic kidney disease. J Diabetes Complications 2024; 38:108853. [PMID: 39241270 DOI: 10.1016/j.jdiacomp.2024.108853] [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] [Received: 01/03/2024] [Revised: 08/08/2024] [Accepted: 08/30/2024] [Indexed: 09/08/2024]
Abstract
BACKGROUND Aim to this study is to investigate the association of Dietary Counseling, Meal Patterns, and Diet Quality (DietQ) in Patients with Type 2 Diabetes Mellitus (T2DM) with/without chronic kidney disease (CKD) in primary healthcare. METHODS Cross-sectional study acquired data on dietary counseling and meal patterns by direct interview with a food-frequency questionnaire and one 24-h food-recall. The Healthy Eating Index (HEI) was used to classify DietQ ["good" DietQ (GDietQ, score ≥ 80) and "poor" DietQ (PDietQ, score < 80)]. PARTICIPANTS/SETTING This study included 705 patients with T2DM: 306 with normal kidney function; 236 with early nephropathy, and 163 with overt nephropathy (ON). STATISTICAL ANALYSES PERFORMED Multivariate linear-regression models for predicting HEI and χ2 tests for qualitative variables and one-way ANOVA for quantitative variables were employed. Mann-Whitney U and independent Student t were performed for comparisons between GDietQ and PDietQ. RESULTS Only 18 % of the population was classified as GDietQ. Patients with ON and PDietQ vs. with GDietQ received significantly less dietary counseling from any health professional in general (45 % vs 72 %, respectively), or from any nutrition professional (36 % vs. 61 %, respectively). A better HEI was significantly predicted (F = 42.01; p = 0.0001) by lower HbA1C (β -0.53, p = 0.0007) and better diet diversity (β 8.09, p = 0.0001). CONCLUSIONS Patients with more advanced stages of CKD had less nutritional counseling and worse dietary patterns, as well as more frequent PDietQ. Our findings reinforce the need for dietitians and nutritionists in primary healthcare to provide timely nutritional counseling.
Collapse
Affiliation(s)
- Erika F Gómez-García
- Facultad de Medicina y Psicología, Universidad Autónoma de Baja California, Tijuana, Mexico; Unidad de Investigación Médica en Enfermedades Renales, Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Mexico
| | - Alfonso M Cueto-Manzano
- Unidad de Investigación Médica en Enfermedades Renales, Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Mexico.
| | - Héctor R Martínez-Ramírez
- Unidad de Investigación Médica en Enfermedades Renales, Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Mexico
| | - Laura Cortés-Sanabria
- Unidad de Investigación Médica en Enfermedades Renales, Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Mexico
| | - Carla M Avesani
- Renal Medicine and Baxter Novum, Clintec, Karolinska Institutet, Stockholm, Sweden
| | | | - Enrique Rojas-Campos
- Unidad de Investigación Médica en Enfermedades Renales, Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Mexico
| |
Collapse
|
3
|
Cope AL, Chestnutt IG. A systematic review of the association between food insecurity and behaviours related to caries development in adults and children in high-income countries. Community Dent Oral Epidemiol 2024; 52:625-647. [PMID: 38571289 DOI: 10.1111/cdoe.12959] [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: 08/04/2023] [Revised: 12/08/2023] [Accepted: 03/18/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high-income countries. METHODS A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non-dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high-income countries. Studies specifically looking at food insecurity during the COVID-19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale (with modifications for cross-sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. RESULTS Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross-sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross-sectional studies including 336 585 participants was equivocal, particularly in the sugar-sweetened beverage (SSB) consumption post-hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross-sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross-sectional studies, 138 102 participants). A single cross-sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. CONCLUSIONS This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self-care in food insecure populations.
Collapse
Affiliation(s)
- A L Cope
- Dental Public Health, School of Dentistry, Cardiff University, Cardiff, UK
| | - I G Chestnutt
- Dental Public Health, School of Dentistry, Cardiff University, Cardiff, UK
| |
Collapse
|
4
|
Zelber-Sagi S, Carrieri P, Pericàs JM, Ivancovsky-Wajcman D, Younossi ZM, Lazarus JV. Food inequity and insecurity and MASLD: burden, challenges, and interventions. Nat Rev Gastroenterol Hepatol 2024; 21:668-686. [PMID: 39075288 DOI: 10.1038/s41575-024-00959-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2024] [Indexed: 07/31/2024]
Abstract
Liver disease prevalence, severity, outcomes and hepatic risk factors (for example, unhealthy diet) are heavily affected by socioeconomic status and food insecurity. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent liver disease globally and is likely to co-occur with other liver diseases associated with food insecurity. Though weight reduction and adopting a healthy diet can reverse the course of MASLD, gaps between recommendations and practice transcend individual responsibility and preference. Broader sociocultural determinants of food choices (social nutrition) include food insecurity, community and social norms and the local environment, including commercial pressures that target people experiencing poverty, ethnic minorities and children. Food insecurity is a barrier to a healthy diet, as a low-quality diet is often less expensive than a healthy one. Consequently, food insecurity is an 'upstream' risk factor for MASLD, advanced fibrosis and greater all-cause mortality among patients with liver disease. Intervening on food insecurity at four major levels (environment, policy, community and health care) can reduce the burden of liver disease, thereby reducing social and health inequities. In this Review, we report on the current research in the field, the need for implementing proven interventions, and the role liver specialists can have.
Collapse
Affiliation(s)
- Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
- The Global NASH Council, Washington, DC, USA.
| | - Patrizia Carrieri
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
| | - Juan M Pericàs
- Liver Unit, Vall d'Hebron University Hospital, Vall d'Hebron Institute for Research, Universitat Autònoma de Barcelona, CIBERehd, Barcelona, Spain
- Johns Hopkins University-Pompeu Fabra University Public Policy Center, Barcelona, Spain
| | - Dana Ivancovsky-Wajcman
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Zobair M Younossi
- The Global NASH Council, Washington, DC, USA
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA
| | - Jeffrey V Lazarus
- The Global NASH Council, Washington, DC, USA
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA
| |
Collapse
|
5
|
Aburto TC, Salgado JC, Rodríguez-Ramírez S, Rivera JA, Barquera S, Batis C. Adherence to the EAT-Lancet index is associated with lower diet costs in the Mexican population. Nutr J 2024; 23:108. [PMID: 39300464 DOI: 10.1186/s12937-024-01002-7] [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: 05/24/2024] [Accepted: 08/14/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Poor diet quality contributes to morbidity and mortality and affects environmental sustainability. The EAT-Lancet reference diet offers a healthy and sustainable solution. This study aimed to estimate the association between diet cost and dietary quality, measured with an EAT-Lancet Index. METHODS An EAT-Lancet index was adapted to assess adherence to this dietary pattern from 24-h recalls data from the 2012 and 2016 Mexican National Health and Nutrition Surveys (n = 14,242). Prices were obtained from the Consumer Price Index. We dichotomized cost at the median (into low- and high-cost) and compared the EAT-Lancet index scores. We also used multivariate linear regression models to explore the association between diet cost and diet quality. RESULTS Individuals consuming a low-cost diet had a higher EAT-Lancet score than those consuming a high-cost diet (20.3 vs. 19.4 from a possible scale of 0 to 42; p < 0.001) due to a lower intake of beef and lamb, pork, poultry, dairy, and added sugars. We found that for each one-point increase in the EAT-Lancet score, there was an average decrease of MXN$0.4 in the diet cost (p < 0.001). This association was only significant among low- and middle-SES individuals. CONCLUSIONS Contrary to evidence from high-income countries, this study shows that in Mexico, adhering to the EAT-Lancet reference diet is associated with lower dietar costs, particularly in lower SES groups. These findings suggest the potential for broader implementation of healthier diets without increasing the financial burden.
Collapse
Affiliation(s)
- Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, 62100, México
| | - Juan Carlos Salgado
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, 62100, México
- National Council of Humanities, Science and Technology, Benitos Juarez, CDMX, 03940, Mexico
| | - Sonia Rodríguez-Ramírez
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, 62100, México
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, 62100, Mexico
| | - Simon Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, 62100, México
| | - Carolina Batis
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, 62100, México.
| |
Collapse
|
6
|
Pujitha Gunawardhana D, Talagala IA. Factors influencing the maternal choice of packaged snacks for 6-10 years old children: A cross-sectional study from Sri Lanka. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003574. [PMID: 39231198 PMCID: PMC11373799 DOI: 10.1371/journal.pgph.0003574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 07/12/2024] [Indexed: 09/06/2024]
Abstract
Childhood overweight and obesity due to unhealthy diet result in several adverse effects. Mothers play a major role in selecting snacks for younger children. This study assessed the factors associated with the choice of packaged food/beverage snacks among mothers of 6- to 10-year-old children in the Medical Officer of Health area Balangoda. A community-based descriptive cross-sectional study with an analytical component was conducted in 2022 among 450 mothers with 6- to 10-year-old children through two-stage, stratified (year of birth considered as a stratum), simple random sampling technique in ten randomly selected Public Health Midwife areas in the medical officer of health area Balangoda. An interviewer-administered questionnaire was used to assess participants' sociodemographic, usual practices, attitudes, and knowledge toward packaged snacks. Factors associated with maternal practices related to packaged snack selection were assessed through the chi-square test at the p<0.05 significance level. The response rate was 99.3% (N = 447). Children were commonly provided with biscuits (94.4%) and flavoured milk (44.7%) daily (66.4%) at home (93.5%). The majority of mothers reported poor practices in selecting packaged snacks (88.8%), but good knowledge (62.9%) and favorable attitudes (93.5%) toward packaged snacks. The majority (75.5%) were aware that snacks are important for overcoming the hunger gap among children. Childs' preference (77.6%) was the leading influencing factor while, the nutritional value of the packaged snacks minimally influenced the maternal (2.7%) choice. Only 49.9% mothers knew that packaged fruits could be consumed as snacks. Maternal Sinhalese ethnicity (p<0.001), secondary or higher education (p<0.001), having one child (p = 0.003), residing in a rural or urban area (p = 0.011) and having favourable attitudes (p = 0.002) were significantly associated with poor maternal practices in packaged snack selection. Although mothers' knowledge toward packaged snacks were good, their practices in selecting packaged snacks were poor. Maternal ethnicity, educational level, number of children, area of residence and attitudes were significantly associated with mothers' selection of packaged snacks. The results of the study highlighted the need to plan, develop and implement focused health promotion programmes to empower mothers to select healthier packaged snack options for their 6- to 10-year-old children.
Collapse
Affiliation(s)
| | - Ishanka Ayeshwari Talagala
- Department of Community Medicine and Family Medicine, Faculty of Medicine, University of Moratuwa, Moratuwa, Sri Lanka
| |
Collapse
|
7
|
Collins RA, Ashton LM, Burrows TL, Hutchesson M, Adam MTP, Clarke ED, Collins CE. No Money No Time Culinary Nutrition Website eHealth Challenge: A Pre-Post Evaluation of Impact on Diet Quality, Food Expenditure, and Engagement. Nutrients 2024; 16:2950. [PMID: 39275264 PMCID: PMC11397432 DOI: 10.3390/nu16172950] [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: 07/30/2024] [Revised: 08/22/2024] [Accepted: 08/29/2024] [Indexed: 09/16/2024] Open
Abstract
No Money No Time (NMNT) is a culinary nutrition website designed to optimize diet quality. The primary aim was to evaluate the impact of an online targeted nutrition challenge email campaign that encouraged engagement with NMNT and goal setting to improve diet quality and weekly food expenditure. A secondary aim was to assess NMNT engagement. Australian adults ≥18 years were recruited to the eHealth nutrition challenge delivered via weekly emails. Diet quality was assessed using the Healthy Eating Quiz (HEQ) diet quality tool. Engagement was assessed using email open and click-through rates. Intention-to-treat (ITT) analysis was conducted using mixed effects linear regression. Of 481 adults (49.7 ± 13.9 years, 84% female) who enrolled 79 (16%) completed the challenge. ITT results indicated statistically significant 6-week increases in diet quality score (+3.8 points p ≤ 0.001, d = 0.58) with sub-scale improvements in vegetables (+0.9 points, p = 0.01, d = 0.32), fruit (+1.2 points, p ≤ 0.001, d = 0.55), and dairy (+0.9 points, p ≤ 0.001, d = 0.58). There were significant post-challenge reductions in household spending on takeaway/snacks/coffee of AUD 8.9 per week (p = 0.01, d = 0.29), body weight reduction (-0.6 kg, p = 0.03, d = 0.26), and BMI (-0.2 kg/m2p = 0.02, d = 0.28). The email open rate remained constant at around 67% (56% to 75%), with an average click-through rate of 18% (7.1% to 37.9%). The eHealth nutrition challenge significantly improved diet quality while reducing BMI and money spent on discretionary foods. Strategies to scale the challenge should be tested as an innovative population strategy for improving diet quality, health indicators, and managing household food budgets.
Collapse
Affiliation(s)
- Rebecca A Collins
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Lee M Ashton
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- School of Education, College of Human & Social Futures, The University of Newcastle, Callaghan, NSW 2308, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Melinda Hutchesson
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Marc T P Adam
- School of Information and Physical Sciences, College of Engineering, Science and Environment, The University of Newcastle, New Lambton Heights, NSW 2305, Australia
| | - Erin D Clarke
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| |
Collapse
|
8
|
Marty L, Dahmani J, Nicklaus S. Children's liking for vegetarian and non-vegetarian school meals at the scale of a French city. Appetite 2024; 200:107547. [PMID: 38851493 DOI: 10.1016/j.appet.2024.107547] [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: 03/21/2024] [Revised: 05/17/2024] [Accepted: 06/06/2024] [Indexed: 06/10/2024]
Abstract
In Western countries, a behavioural shift towards more plant-based diets is helpful in protecting population and planet health. School canteens are an important public policy target to achieve this transition. Increasing the frequency of vegetarian meals in school canteens has been proposed as a solution to decrease greenhouse gas emissions while maintaining a good nutritional quality. However, vegetarian meals acceptance by children is key to limit unintended consequences such as increased food waste or increased nutritional inequalities. We aimed to examine children's liking for vegetarian and non-vegetarian main dishes at school canteens; and whether it varied across socioeconomic level. Connected scoring devices displaying a five-point smiley scale were installed in all the 38 primary school canteens of a French city, located in socially diverse neighbourhoods. Every day after their school lunch, children were asked to rate the main dish they had just eaten. During one school year, from September 2021 to June 2022, we collected 208,985 votes for 125 main dishes, including 32 vegetarian (i.e., no meat or fish) and 93 non-vegetarian dishes, for an average of 1672 (SD 440) votes per day across the 38 school canteens. We showed no difference in children's liking for vegetarian and non-vegetarian dishes. Additionally, the socioeconomic level of the schools was found to interact negatively with children's liking for vegetarian main dishes whereby vegetarian main dishes tended to be more liked in schools of lower socioeconomic level. In this French city, children's acceptance would not be a barrier to increase the frequency of vegetarian school meals and would not increase social dietary inequalities.
Collapse
Affiliation(s)
- Lucile Marty
- Centre des Sciences Du Goût et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 17 Rue Sully, BP 86510, 21065, Dijon Cedex, France.
| | - Justine Dahmani
- Centre des Sciences Du Goût et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 17 Rue Sully, BP 86510, 21065, Dijon Cedex, France
| | - Sophie Nicklaus
- Centre des Sciences Du Goût et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, 17 Rue Sully, BP 86510, 21065, Dijon Cedex, France
| |
Collapse
|
9
|
Rockel JS, Potla P, Kapoor M. Transcriptomics and metabolomics: Challenges of studying obesity in osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100479. [PMID: 38774038 PMCID: PMC11103424 DOI: 10.1016/j.ocarto.2024.100479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/30/2024] [Indexed: 05/24/2024] Open
Abstract
Objective Obesity is a leading risk factor for both the incidence and progression of osteoarthritis (OA). Omic technologies, including transcriptomics and metabolomics are capable of identifying RNA and metabolite profiles in tissues and biofluids of OA patients. The objective of this review is to highlight studies using transcriptomics and metabolomics that contribute to our understanding of OA pathology in relation to obesity. Design We conducted a targeted search of PUBMED for articles, and GEO for datasets, published up to February 13, 2024, screening for those using high-throughput transcriptomic and metabolomic techniques to study human or pre-clinical animal model tissues or biofluids related to obesity-associated OA. We describe relevant studies and discuss challenges studying obesity as a disease-related factor in OA. Results Of the 107 publications identified by our search criteria, only 15 specifically used transcriptomics or metabolomics to study joint tissues or biofluids in obesity-related OA. Specific transcriptomic and metabolomic signatures associated with obesity-related OA have been defined in select local joint tissues, biofluids and other biological material. However, considerable challenges exist in understanding contributions of obesity-associated modifications of transcriptomes and metabolomes related to OA, including sociodemographic, anthropometric, dietary and molecular redundancy-related factors. Conclusions A number of additional transcriptomic and metabolomic studies are needed to comprehensively understand how obesity affects OA incidence, progression and outcomes. Integration of transcriptome and metabolome signatures from multiple tissues and biofluids, using network-based approaches will likely help to better define putative therapeutic targets that could enable precision medicine approaches to obese OA patients.
Collapse
Affiliation(s)
- Jason S. Rockel
- Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Pratibha Potla
- Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Mohit Kapoor
- Schroeder Arthritis Institute, University Health Network, Toronto, ON, Canada
- Krembil Research Institute, University Health Network, Toronto, ON, Canada
- Department of Surgery and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
10
|
Harper Z, Alvarado AV, Katz SE, Rovner AJ, Steeves EA, Raynor HA, Robson SM. Examining Food Security, Fruit and Vegetable Intake, and Cardiovascular Disease Risk Outcomes of Produce Prescription (PPR) Programs: A Systematic Review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00387-7. [PMID: 39217534 DOI: 10.1016/j.jneb.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 06/28/2024] [Accepted: 06/28/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE Outcomes from produce prescription (PPR) programs, an exemplar of a Food is Medicine intervention, have not been synthesized. The objective of this study was to conduct a systematic review to examine the impact of PPR programs on food security, fruit and vegetable (FV) intake, and/or cardiovascular risk factors (HbA1c, blood pressure, and blood lipids). DESIGN Searches were conducted across three databases (PubMed, CINAHL, and Web of Science). Eligible studies were published between August 2012 and April 2023, conducted in the US in child/family, or adult populations, written in English and had a PPR program as an exposure. OUTCOMES VARIABLES MEASURED Food security, FV intake, and/or cardiovascular risk factors. RESULTS Twenty studies ranging from a duration of between 6 weeks to 24 months were included. Of the 5 studies (3 in child/family and 4 in adult populations) that analyzed changes in food security status, all reported significant (P < 0.05) improvements after the PPR program. Approximately half of the included studies found significant (P < 0.05) increases in fruit, vegetable, and/or FV intake. Only studies in adult populations included cardiovascular risk factor outcomes. In these studies, mixed findings were reported; however, there were significant (P < 0.05) improvements in HbA1c when PPR programs enrolled individuals with type 2 diabetes. CONCLUSIONS AND IMPLICATIONS PPR programs provide an opportunity to improve food security in child/family, and adult populations. Evidence to support whether PPR programs increase FV intake and improve cardiovascular disease risk factors outside of HbA1c in adult populations with high HbA1c upon enrollment is less known.
Collapse
Affiliation(s)
- Zoe Harper
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE
| | | | - Sarah E Katz
- Library, Museums and Press, University of Delaware, Newark, DE
| | - Alisha J Rovner
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE
| | | | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN
| | - Shannon M Robson
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE.
| |
Collapse
|
11
|
Hu F, Qin W, Xu L. Association between Dietary Patterns and Cardiometabolic Multimorbidity among Chinese Rural Older Adults. Nutrients 2024; 16:2830. [PMID: 39275148 PMCID: PMC11397048 DOI: 10.3390/nu16172830] [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: 07/16/2024] [Revised: 08/16/2024] [Accepted: 08/22/2024] [Indexed: 09/16/2024] Open
Abstract
BACKGROUND The global population is aging rapidly, leading to an increase in the prevalence of cardiometabolic multimorbidity (CMM). This study aims to investigate the association between dietary patterns and CMM among Chinese rural older adults. METHODS The sample was selected using a multi-stage cluster random sampling method and a total of 3331 rural older adults were ultimately included. Multivariate logistic regression analysis was used to examine the association between the latent dietary patterns and CMM. RESULTS The prevalence of CMM among rural older adults was 44.64%. This study identified four potential categories: "Low Consumption of All Foods Dietary Pattern (C1)", "High Dairy, Egg, and Red Meat Consumption, Low Vegetable and High-Salt Consumption Dietary Pattern (C2)", "High Egg, Vegetable, and Grain Consumption, Low Dairy and White Meat Consumption Dietary Pattern (C3)" and "High Meat and Fish Consumption, Low Dairy and High-Salt Consumption Dietary Pattern (C4)". Individuals with a C3 dietary pattern (OR, 0.80; 95% CI, 0.66-0.98; p = 0.028) and a C4 dietary pattern (OR, 0.70; 95% CI, 0.51-0.97; p = 0.034) significantly reduced the prevalence of CMM compared with the C1 dietary pattern. CONCLUSIONS Rural older adults have diverse dietary patterns, and healthy dietary patterns may reduce the risk of CMM.
Collapse
Affiliation(s)
- Fangfang Hu
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Wenzhe Qin
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Lingzhong Xu
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| |
Collapse
|
12
|
Macias-Navarro L, McWhorter JW, Guevara DC, Bentley SS, Sharma SV, Torres JH, Ai D, Heredia NI. A virtual culinary medicine intervention for ethnically diverse individuals with type 2 diabetes: development of the Nourishing the Community through Culinary Medicine. Front Nutr 2024; 11:1383621. [PMID: 39221161 PMCID: PMC11362094 DOI: 10.3389/fnut.2024.1383621] [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: 02/07/2024] [Accepted: 07/22/2024] [Indexed: 09/04/2024] Open
Abstract
Virtual culinary medicine education interventions have the potential to improve dietary behaviors, nutrition knowledge, cooking skills, and health outcomes for ethnically diverse individuals with type 2 diabetes. The purpose of this study is to describe the adaptation of the Nourishing the Community through Culinary Medicine (NCCM) program for virtual delivery, and the protocol for pilot testing this intervention. The intervention includes five 90-min virtual NCCM sessions streamed live from a Teaching Kitchen. Feasibility outcomes are recruitment, retention, acceptability, and satisfaction. Short-term effectiveness outcomes are measured through self-administered questionnaires, including perceived health, average daily servings of fruits and vegetables, frequency of healthy food consumption, shopping, cooking, and eating behaviors, cooking self-efficacy, diabetes self-management, perceived barriers to healthy eating, and nutrition knowledge. Demographics and biometric outcomes are sourced from the patient's electronic medical records including glycosylated hemoglobin (HbA1c), Body Mass Index, and blood pressure. We will conduct a single-arm pilot study to test the feasibility and short-term effectiveness of NCCM program with individuals with type 2 diabetes.
Collapse
Affiliation(s)
- Lorena Macias-Navarro
- Department of Health Promotion Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| | | | - Diana C. Guevara
- Department of Health Promotion Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| | - Sarah S. Bentley
- Department of Health Promotion Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| | - Shreela V. Sharma
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| | - Jennifer H. Torres
- Department of Health Promotion Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| | - David Ai
- Baylor College of Medicine, Houston, TX, United States
| | - Natalia I. Heredia
- Department of Health Promotion Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| |
Collapse
|
13
|
Chungchunlam SMS, Moughan PJ. Diet affordability: a key dimension in the assessment of sustainable food systems and healthy diets. Front Nutr 2024; 11:1399019. [PMID: 39188980 PMCID: PMC11345210 DOI: 10.3389/fnut.2024.1399019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 08/01/2024] [Indexed: 08/28/2024] Open
Abstract
A promulgated global shift toward a plant-based diet is largely in response to a perceived negative environmental impact of animal food production, but the nutritional adequacy and economic implications of plant-sourced sustainable healthy dietary patterns need to be considered. This paper reviews recent modeling studies using Linear Programming to determine the respective roles of animal- and plant-sourced foods in developing a least-cost diet in the United States and New Zealand. In both economies, least-cost diets were found to include animal-based foods, such as milk, eggs, fish, and seafood, to meet the energy and nutrient requirements of healthy adults at the lowest retail cost. To model a solely plant-based least-cost diet, the prevailing costs of all animal-sourced foods had to be increased by 1.1 to 11.5 times their original retail prices. This led to the inclusion of fortified plant-based foods, such as fortified soymilk, and a plant-based diet that was considerably (34-45%) more costly. The first-limiting essential nutrients were mostly the vitamins and minerals, with special focus on pantothenic acid, zinc, and vitamin B-12, when transitioning from an animal- and plant-containing least-cost diet to a plant-only based least-cost diet. Modeled least-cost diets based on contemporary food costs include animal-sourced foods, at least for developed high-income US and NZ food economies, and potentially for developing low- and middle-income countries, such as Indonesia. Modeling of least-cost diets that consist exclusively of plant-based foods is feasible, but at a higher daily diet cost, and these diets are often close to limiting for several key nutrients. Diet affordability, as a key dimension of sustainable healthy diets, and the respective economic roles of animal- and plant-sourced foods need to be considered.
Collapse
|
14
|
Duarte CK, Silva LDA, Andrade PMBD, Martins TMM, Ghisi GLDM. Barriers and facilitators to nutritional recommendations identified by participants of a cardiovascular rehabilitation program in a low resource context in Brazil. Nutrition 2024; 124:112451. [PMID: 38678640 DOI: 10.1016/j.nut.2024.112451] [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: 01/23/2024] [Revised: 03/24/2024] [Accepted: 04/01/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES Nutritional recommendations, a core component of cardiovascular rehabilitation, play a vital role in managing cardiovascular diseases. However, adherence to these recommendations is complex, particularly in low-resource settings. This study explored the barriers and facilitators influencing adherence to nutritional recommendations among participants in a low-resource cardiovascular rehabilitation program in Brazil. METHODS A mixed-methods approach was employed. Sociodemographic data, the Mediterranean diet score, scale for assessing nutrition, and open-ended questions on adherence were collected. Those who completed the questionnaires (phase 1) were invited to participate in one focus group session (phase 2). The participants were characterized according to the responses provided in phase 1 (Mediterranean diet score and scale for assessing nutrition) in low adherence or high adherence to dietary practice. Descriptive statistics and thematic content analysis within the context of the theory of planned behavior were employed. RESULTS Seventy-four participants completed phase 1, with 41.9% classified into low adherence and 27.0% in high adherence; of those, 17 participated in phase 2. Focus group findings revealed 9 themes/29 subthemes. Barriers included food prices, income, knowledge, routine, food access, family patterns, disease, work, anxiety, eating habits, and food planning. Facilitators included affordable food, health considerations, taste preferences, knowledge, family/professional support, government assistance, personal willpower, income stability, easy food access, media influence, and a quiet eating place. CONCLUSIONS The study findings underscore the need for targeted interventions, including individualized meal planning, community engagement, and enhanced access to healthcare professionals, to optimize dietary adherence and improve cardiovascular outcomes.
Collapse
Affiliation(s)
- Camila Kümmel Duarte
- Nutrition and Health Post-graduation program, Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luciana de Abreu Silva
- Nutrition and Health Post-graduation program, Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Gabriela Lima de Melo Ghisi
- KITE Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
15
|
Unar-Munguía M, Cervantes-Armenta MA, Rodríguez-Ramírez S, Bonvecchio Arenas A, Fernández Gaxiola AC, Rivera JA. Mexican national dietary guidelines promote less costly and environmentally sustainable diets. NATURE FOOD 2024; 5:703-713. [PMID: 39107420 DOI: 10.1038/s43016-024-01027-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/08/2024] [Indexed: 08/25/2024]
Abstract
The 2023 Mexican Healthy and Sustainable Dietary Guidelines (HSDG 2023) were developed to include all dimensions of sustainability. Here we compare the environmental impact and cost of diets based on the HSDG 2023, current diets and the Mexican-adapted EAT healthy reference diet. Diets following HSDG 2023 are 21% less expensive, require 30% less land to be produced and have 34% less carbon emissions than current diets-particularly in Mexico City and other urban areas with higher prevalence of Westernized diets. This is driven by reduced animal-source food, especially red meat, and ultra-processed foods. In south-rural areas, the water footprint and cost of diets following HSDG 2023 were higher than those of current diets owing to increased intake of nuts, fruits and vegetables not offset by lower meat consumption (which is already close to recommendations). Diet environmental impact and cost could be further reduced with the Mexican-adapted EAT healthy reference diet compared with the HSDG 2023.
Collapse
Affiliation(s)
- Mishel Unar-Munguía
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Sonia Rodríguez-Ramírez
- Center for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Juan A Rivera
- Center for Research in Population Health, National Institute of Public Health, Cuernavaca, Mexico
| |
Collapse
|
16
|
D'Hooghe S, Inaç Y, Vandevijvere S, Deforche B, de Ridder K, Van Dyck D, Van de Weghe N, Dury S. Exploring the multiple dimensions of perceived food access in the local food environment in Flanders: perceptions of adults in socioeconomically disadvantaged situations. Appetite 2024:107609. [PMID: 39094845 DOI: 10.1016/j.appet.2024.107609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 07/15/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
Persons in socioeconomically disadvantaged situations are more susceptible and disproportionally exposed to unhealthy food environments, which results in limited access to healthy foods and poorer dietary outcomes. This qualitative paper examines the various dimensions of perceived food access to healthy and unhealthy foods (i.e., availability, affordability, accessibility, accommodation, desirability, convenience and acceptability) within the local food environment among persons in socioeconomically disadvantaged situations. A total of 23 participants in socioeconomically disadvantaged situations expressed their perceptions of food access within their local food environment and its role in their eating behaviour through participant-driven photo-elicitation in a focus group context (n=7) and researcher-driven photo-elicitation interviews (n=16). Reflexive thematic analysis has been used to analyse our data through an access framework. Four overarching themes were constructed. The first two themes concern barriers to perceived food access in respectively the home and community food environment - including the importance of kitchen infrastructure, household composition and transport options. The third theme encompasses the interaction of perceived food access with the sociocultural environment, highlighting its dual role as facilitator (e.g., through food sharing practices) and barrier (e.g., through social stigma and shame). The fourth theme concerns awareness and the ability to navigate within the information food environment, which has also been proposed as a novel dimension of food access. This study emphasizes the complexity of food access and the need for a multifaceted approach that integrates perceptions to ensure equitable access to healthy foods.
Collapse
Affiliation(s)
- Suzannah D'Hooghe
- Sciensano, Department of Epidemiology and public health, Belgium; Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium; Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium; Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Yasemin Inaç
- Sciensano, Department of Epidemiology and public health, Belgium; Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium; Ghent University, Faculty of Sciences, Department of Geography, Belgium; Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - Benedicte Deforche
- Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Belgium; Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Belgium
| | - Karin de Ridder
- Sciensano, Department of Epidemiology and public health, Belgium
| | - Delfien Van Dyck
- Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Belgium
| | - Nico Van de Weghe
- Ghent University, Faculty of Sciences, Department of Geography, Belgium
| | - Sarah Dury
- Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Belgium; Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| |
Collapse
|
17
|
Liu X, Chang Y, Jia F, Li Y, Wang Y, Cui J. Association of Life's Essential 8 with metabolic dysfunction-associated steatotic liver disease (MASLD), a cross-sectional study from the NHANES 2003-2018. Sci Rep 2024; 14:17188. [PMID: 39060338 PMCID: PMC11282211 DOI: 10.1038/s41598-024-67728-w] [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: 01/06/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
There is limited research on the relationship between Life's Essential 8 (LE8) score and metabolic dysfunction-associated steatotic liver disease (MASLD). Our aim is to investigate the relationship between overall lifestyle assessed by LE-8 score and MASLD in a nationally representative sample. We employed the LE8 score to comprehensively evaluate cardiovascular health, the assessment of MASLD primarily utilized the Fatty Liver Index. The weighted logistic regression models, restrictive cubic splines (RCS), subgroup analyses and the weighted quantile sum (WQS) regression were used to evaluate the relationship between the cardiovascular health and MASLD. Logistic regression models revealed that higher LE8 scores were associated with lower odds of having MASLD. The RCS revealed a significant nonlinear dose-response relationship between LE8 scores and MASLD. The WQS regression model indicated that blood glucose contributed the most to the risk of MASLD. The subgroup analysis indicates that there are significant differences in this association across age, educational level, and poverty income ratio. Our study suggests that an inverse correlation between LE8 and the risk of MASLD. Our findings underscore the utility of the LE8 algorithm in MASLD risk assessment and provide support for MASLD prevention through the promotion of healthy lifestyles.
Collapse
Affiliation(s)
- Xiangliang Liu
- The First Hospital of Jilin University, No.1 Xinmin Street, Changchun, China
| | - Yu Chang
- The First Hospital of Jilin University, No.1 Xinmin Street, Changchun, China
| | - Feng Jia
- The First Hospital of Jilin University, No.1 Xinmin Street, Changchun, China
| | - Yuguang Li
- The First Hospital of Jilin University, No.1 Xinmin Street, Changchun, China
| | - Yao Wang
- The First Hospital of Jilin University, No.1 Xinmin Street, Changchun, China
| | - Jiuwei Cui
- The First Hospital of Jilin University, No.1 Xinmin Street, Changchun, China.
| |
Collapse
|
18
|
Shridhar SV, Beghini F, Alexander M, Singh A, Juárez RM, Brito IL, Christakis NA. Environmental, socioeconomic, and health factors associated with gut microbiome species and strains in isolated Honduras villages. Cell Rep 2024; 43:114442. [PMID: 38968070 PMCID: PMC11290354 DOI: 10.1016/j.celrep.2024.114442] [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: 01/09/2024] [Revised: 04/27/2024] [Accepted: 06/19/2024] [Indexed: 07/07/2024] Open
Abstract
Despite a growing interest in the gut microbiome of non-industrialized countries, data linking deeply sequenced microbiomes from such settings to diverse host phenotypes and situational factors remain uncommon. Using metagenomic data from a community-based cohort of 1,871 people from 19 isolated villages in the Mesoamerican highlands of western Honduras, we report associations between bacterial species and human phenotypes and factors. Among them, socioeconomic factors account for 51.44% of the total associations. Meta-analysis of species-level profiles across several datasets identified several species associated with body mass index, consistent with previous findings. Furthermore, the inclusion of strain-phylogenetic information modifies the overall relationship between the gut microbiome and the phenotypes, especially for some factors like household wealth (e.g., wealthier individuals harbor different strains of Eubacterium rectale). Our analysis suggests a role that gut microbiome surveillance can play in understanding broad features of individual and public health.
Collapse
Affiliation(s)
- Shivkumar Vishnempet Shridhar
- Yale Institute for Network Science, Yale University, New Haven, CT, USA; Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - Francesco Beghini
- Yale Institute for Network Science, Yale University, New Haven, CT, USA
| | - Marcus Alexander
- Yale Institute for Network Science, Yale University, New Haven, CT, USA
| | - Adarsh Singh
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | | | - Ilana L Brito
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA.
| | - Nicholas A Christakis
- Yale Institute for Network Science, Yale University, New Haven, CT, USA; Department of Biomedical Engineering, Yale University, New Haven, CT, USA; Department of Statistics and Data Science, Yale University, New Haven, CT, USA; Department of Medicine, Yale School of Medicine, New Haven, CT, USA.
| |
Collapse
|
19
|
Sánchez-Ortiz NA, Batis C, Castellanos-Gutiérrez A, Colchero MA. Association Between the Nutritional Quality of Food Purchases and Household Food at Home Expenditures in Mexico. J Acad Nutr Diet 2024:S2212-2672(24)00538-0. [PMID: 38971222 DOI: 10.1016/j.jand.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 06/11/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Poor-quality diets are a major risk factor for noncommunicable diseases. Few studies in Mexico have tested whether higher expenditures are needed to purchase high-quality food. OBJECTIVE The objective of the study was to assess how dietary quality of food purchases was associated with household food at home expenditures. DESIGN This study was a secondary analysis of cross-sectional data from the National Household Income and Expenditure Survey (EncuestaNacional de Ingresos y Gastos de los Hogares [ENIGH] 2018). PARTICIPANTS/SETTING The study included 74 469 households with information on food and beverage purchases in Mexico in 2018. MAIN OUTCOME MEASURES Quarterly household food at home expenditures by adult equivalent (AE) for all food groups that were scored with the Global Dietary Quality Score (GDQS) for food purchases expressed in dollars/quarterly/AE. STATISTICAL ANALYSES PERFORMED Adjusted generalized linear models were used to evaluate the association between GDQS for food purchases (expressed in tertiles: low, mid, and high) and quarterly food expenditures. The analyses were performed at the national level by place of residence and income quintile. RESULTS At the national level, the difference in food expenditures between the high- and the low-GDQS groups was +$13.85/AE. By place of residence, the difference between the high- and the low-GDQS groups was +$17.31/AE in urban and +$5.12/AE in rural areas. For income quintile 1 (lowest), there was a statistical difference of -$4.79/AE and +$43.25 for quintile 5 (highest). CONCLUSIONS Quality of food purchases can be associated with higher or lower expenditures depending on the specific food purchased. High GDQS is associated with lower expenditures among the lowest-income households as they purchase less expensive options compared with high-income households.
Collapse
Affiliation(s)
- Néstor A Sánchez-Ortiz
- Center for Evaluation and Surveys Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, México
| | - Carolina Batis
- Health and Nutrition Research Center, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, México
| | | | - M Arantxa Colchero
- Center for Evaluation and Surveys Research, National Institute of Public Health, Universidad No. 655 Colonia Santa María Ahuacatitlán, Cuernavaca, Morelos, México.
| |
Collapse
|
20
|
Palascha A, Chang BPI. Which messages about healthy and sustainable eating resonate best with consumers with low socio-economic status? Appetite 2024; 198:107350. [PMID: 38609012 DOI: 10.1016/j.appet.2024.107350] [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: 01/01/2024] [Revised: 03/27/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
Consumers with low socioeconomic status (SES) eat less healthy and sustainable diets than consumers with higher status. This is attributed, at least in part, to inequalities in health communication. An online survey with 134 socioeconomically disadvantaged consumers in Italy was conducted to test the effectiveness of tailor-made communication material (infographics) about healthy and sustainable eating (HSE). Participants were recruited at two social supermarkets by a social service organisation as well as via a crowdsourcing platform. Participants found information about HSE delivered through infographics moderately effective in increasing motivation, capability, and opportunity for HSE, and moderately useful and likely to impact their behaviour. Certain messages were more effective than others for native consumers, while migrants showed more indifferent responses to the various messages and manifested lower motivation to shift towards HSE, limited access to and seeking of nutrition-related information, and lower trust in information sources. Selecting which messages to deliver strategically, while also considering differences between segments of the target audience and their preferred sources and channels for communication, is promising; yet, structural changes related to food's affordability and availability are also needed to facilitate an effective communication.
Collapse
Affiliation(s)
| | - Betty P I Chang
- European Food Information Council, Rue Belliard 2A, 1040 Brussels, Belgium
| |
Collapse
|
21
|
Ge R, You S, Zheng D, Zhang Z, Cao Y, Chang J. Global, regional, and national temporal trends of diet-related ischemic stroke mortality and disability from 1990 to 2019. Int J Stroke 2024; 19:665-675. [PMID: 38415357 DOI: 10.1177/17474930241237932] [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: 02/29/2024]
Abstract
BACKGROUND Stroke is the second leading cause of death and the third leading cause of disability in the general population worldwide. However, the changing trend of ischemic stroke burden attributable to various dietary risk factors has not been fully revealed and may contribute to a better understanding of stroke epidemiology. AIMS Our article aimed to evaluate the temporal trend of diet-related ischemic stroke burden to inform future research and policy-making. METHODS This analysis was based on the data from the Global Burden of Disease (GBD) Study 2019 (spanning years 1990 to 2019), and we used the joinpoint regression to model temporal trends in diet-related ischemic stroke burden across countries and regions of the world during the study period. Six specific dietary factors known to influence stroke risk, including sodium, red meat, fiber, vegetables, whole grains, and fruits, were evaluated in the GBD study to determine their individual and joint impact on ischemic stroke. The changing trend was primarily measured by the average annual percent change (AAPC). Age-standardized rates (ASRs) of mortality and years lived with disability (YLD) per 100,000 population were used to evaluate disease burden. Finally, the socioeconomic background, which was quantified as sociodemographic index (SDI), and its association with diet-related ischemic stroke burden were also explored with the Pearson correlation coefficient. RESULTS During the study period, the ischemic stroke ASR of mortality attributable to overall dietary risk decreased by an average of 1.6% per year, while the ASR of YLD decreased by an average of 0.2% per year. High sodium diet was still a key driver of diet-related ischemic stroke, accounting for 8.4% and 11.0% of deaths and disabilities, respectively, in 2019. In addition, we found a negative association between temporal evolution of stroke burden and socioeconomic background (r = -0.6603 for mortality and r = -0.4224 for disability, P < 0.001), which suggested that the developing countries with weak social and economic foundation faced greater challenges from the ongoing burden of diet-related strokes compared with developed countries. CONCLUSIONS Our study found declining trends and revealed the current status of diet-related ischemic stroke mortality and disability. Interdisciplinary countermeasures involving the development of effective food policies, evidence-based guidelines, and public education are needed in the future to combat this global epidemic. DATA ACCESS STATEMENT The data used for analysis were open-access and can be obtained from https://vizhub.healthdata.org/gbd-results/.
Collapse
Affiliation(s)
- Rongguang Ge
- Department of Neurology and Clinical Research Center of Neurological Disease, Soochow Medical College, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Shoujiang You
- Department of Neurology and Clinical Research Center of Neurological Disease, Soochow Medical College, The Second Affiliated Hospital of Soochow University, Suzhou, China
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Danni Zheng
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Zengli Zhang
- Department of Occupational and Environmental Health, School of Public Health, Soochow Medical College, Soochow University, Suzhou, China
| | - Yongjun Cao
- Department of Neurology and Clinical Research Center of Neurological Disease, Soochow Medical College, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Chang
- Department of Occupational and Environmental Health, School of Public Health, Soochow Medical College, Soochow University, Suzhou, China
| |
Collapse
|
22
|
Nagao M, Okazaki K, Ohira T, Nakano H, Hayashi F, Shimabukuro M, Sakai A, Hosoya M, Kazama JJ, Takahashi A, Maeda M, Yabe H, Ohto H, Kamiya K, Yasumura S. Association between evacuation and becoming overweight after the Great East Japan Earthquake: a 7-year follow-up of the Fukushima Health Management Survey. Public Health 2024; 232:170-177. [PMID: 38788493 DOI: 10.1016/j.puhe.2024.04.029] [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: 10/15/2023] [Revised: 04/13/2024] [Accepted: 04/21/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVES Disaster evacuation increases the risk of becoming overweight or obese owing to lifestyle changes and psychosocial factors. This study evaluated the effect of evacuation on becoming overweight during a 7-year follow-up among residents of Fukushima Prefecture during the Great East Japan Earthquake. STUDY DESIGN This was a prospective cohort study. METHODS We analysed data collected from 18,977 non-overweight Japanese participants who completed the 'Comprehensive Health Checkup Program' and 'Mental Health and Lifestyle Survey', as part of the Fukushima Health Management Survey, between July 2011 and November 2012. An evacuation was defined as the moving out of residents of municipalities designated as an evacuation zone by the government or having a self-reported experience of moving into shelters or temporary housing. Follow-up examinations were conducted in March 2018 to identify patients who became overweight. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using a Cox proportional hazards regression model. RESULTS Among 15,875 participants (6091 men and 9784 women; mean age 63.0 ± 11.1 years) who received follow-up examination (mean follow-up, 4.29 years), 2042 (856 men and 1186 women) became overweight. Age-, baseline body mass index-, lifestyle-, and psychosocial status-adjusted HRs (95% CIs) for becoming overweight after evacuation were 1.44 (1.24-1.66) for men and 1.66 (1.47-1.89) for women. CONCLUSION Evacuation was associated with the risk of becoming overweight 7 years after the disaster. Thus, maintaining physical activity, healthy diet, and sleep quality and removing barriers to healthy behaviour caused by disasters, including anxiety concerning radiation, may prevent this health risk among evacuees.
Collapse
Affiliation(s)
- M Nagao
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.
| | - K Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan; Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima, Japan
| | - T Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - H Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - F Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - M Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - A Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - M Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - J J Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - A Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - M Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - H Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Mind and Brain Medicine, Fukushima Medical University, Fukushima, Japan
| | - H Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - K Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Radiation Effects Research Foundation, Hiroshima, Japan
| | - S Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| |
Collapse
|
23
|
Headey D, Hirvonen K, Alderman H. Estimating the cost and affordability of healthy diets: How much do methods matter? FOOD POLICY 2024; 126:102654. [PMID: 39086550 PMCID: PMC11287492 DOI: 10.1016/j.foodpol.2024.102654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/29/2024] [Accepted: 06/01/2024] [Indexed: 08/02/2024]
Abstract
Recently developed cost and affordability of healthy diet (CoAHD) metrics have quickly become mainstream food security indicators. However, published research on the sensitivity of estimation methods is limited. This paper focuses on two important innovations in CoAHD measurement at the global level. First, we develop a demographic scaling factor to adjust healthy diet costs for cross-country differences in age structures, since younger populations generally require fewer calories than older populations. Second, we improve the way in which household expenditure available for purchasing food ("food budgets") are derived. In addition, we explore sensitivity of global CoAHD estimates to potential problems with the representativeness and food product coverage of global food price data and vary assumptions for activity levels that shape energy expenditure requirements. We apply these explorations to the EAT-Lancet reference diet in 137 countries using price data from 2017. Relative to the conventional methods, we find that demographic scaling and improved food budget derivation substantially reduces the estimated population who cannot afford a healthy diet, from 3.02 to 2.13 billion. Adjustments for low product coverage can lead to modest reductions for specific regions and food groups, while higher physical activity assumptions increase the share of people who cannot afford a healthy diet, though perhaps implausibly so. Methods clearly matter in CoAHD estimation, and more accurate and timelier CoAHD estimates have substantial scope to improve policy analysis, design and targeting.
Collapse
Affiliation(s)
- Derek Headey
- The International Food Policy Research Institute (IFPRI), United States
| | - Kalle Hirvonen
- The International Food Policy Research Institute (IFPRI), United States
- United Nations University World Institute for Development Economics Research (UNU-WIDER), Finland
| | - Harold Alderman
- The International Food Policy Research Institute (IFPRI), United States
| |
Collapse
|
24
|
Rei M, Costa A, Sosa S, da Costa S, Torres D, Sage C, Rodrigues S. Multicriteria Measures to Assess the Sustainability of Diets: A Systematic Review. Nutr Rev 2024:nuae081. [PMID: 38942740 DOI: 10.1093/nutrit/nuae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
CONTEXT Assessing the overall sustainability of a diet is a challenging undertaking requiring a holistic approach capable of addressing the multicriteria nature of this concept. OBJECTIVE The aim was to identify and summarize the multicriteria measures used to assess the sustainability characteristics of diets reported at the individual level by healthy adults. DATA SOURCES Articles were identified via PubMed, Scopus, and Web of Science. The search strategy consisted of key words and MeSH terms, and was concluded in September 2022, covering references in English, Spanish, and Portuguese. DATA EXTRACTION This systematic review followed the PRISMA guidelines. The search identified 5663 references, from which 1794 were duplicates. Two reviewers independently screened the titles and abstracts of each of the 3869 records and the full-text of the 144 references selected. Of these, 7 studies met the inclusion criteria. DATA ANALYSIS A total of 6 multicriteria measures were identified: 3 different Sustainable Diet Indices, the Quality Environmental Costs of Diet, the Quality Financial Costs of Diet, and the Environmental Impact of Diet. All of these incorporated a health/nutrition dimension, while the environmental and economic dimensions were the second and the third most integrated, respectively. A sociocultural sustainability dimension was included in only 1 of the measures. CONCLUSION Despite some methodological concerns in the development and validation process of the identified measures, their inclusion is considered indispensable in assessing the transition towards sustainable diets in future studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022358824.
Collapse
Affiliation(s)
- Mariana Rei
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Alexandra Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Sofia Sosa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Sofia da Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Duarte Torres
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
| | - Colin Sage
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
| | - Sara Rodrigues
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
| |
Collapse
|
25
|
Tao C, Li Z, Fan Y, Huang Y, Wan T, Shu M, Han S, Qian H, Yan W, Xu Q, Xia Y, Lu C, Li Y. Estimating lead-attributable mortality burden by socioeconomic status in the USA. Int J Epidemiol 2024; 53:dyae089. [PMID: 38990179 DOI: 10.1093/ije/dyae089] [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: 10/08/2023] [Accepted: 06/27/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND This study aimed to estimate population-level and state-level lead-attributable mortality burdens stratified by socioeconomic status (SES) class in the USA. METHODS Based on the National Health and Nutrition Examination Survey (NHANES), we constructed individual-level SES scores from income, employment, education and insurance data. We assessed the association between the blood lead levels (BLL) and all-cause mortality by Cox regression in the NHANES cohort (n = 31 311, 4467 deaths). With estimated hazard ratios (HR) and prevalences of medium (2-5 μg/dL) and high (≥ 5 μg/dL) BLL, we computed SES-stratified population-attributable fractions (PAFs) of all-cause mortality from lead exposure across 1999-2019. We additionally conducted a systematic review to estimate the lead-attributable mortality burden at state-level. RESULTS The HR for every 2-fold increase in the BLL decreased from 1.23 (1.10-1.38) for the lowest SES class to 1.05 (0.90-1.23) for the highest SES class. Across all SES quintiles, medium BLL exhibited a greater mortality burden. Individuals with lower SES had higher lead-attributable burdens, and such disparities haver persisted over the past two decades. In 2017-19, annually 67 000 (32 000-112 000) deaths in the USA were attributable to lead exposure, with 18 000 (2000-41 000) of these deaths occurring in the lowest SES class. Substantial disparities in the state-level mortality burden attributable to lead exposure were also highlighted. CONCLUSIONS These findings suggested that disparities in lead-attributable mortality burden persisted within US adults, due to heterogeneities in the effect sizes of lead exposure as well as in the BLL among different SES classes.
Collapse
Affiliation(s)
- Chengzhe Tao
- Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhi Li
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yun Fan
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yuna Huang
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Tingya Wan
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Mingxue Shu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shuwen Han
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hong Qian
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wenkai Yan
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qiaoqiao Xu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yankai Xia
- Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chuncheng Lu
- Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - You Li
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Changzhou Third People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| |
Collapse
|
26
|
Saijo Y, Yoshioka E, Sato Y, Kunori Y, Kanaya T, Nakanishi K, Kato Y, Nagaya K, Takahashi S, Ito Y, Iwata H, Yamaguchi T, Miyashita C, Itoh S, Kishi R. Maternal pre-pregnancy body mass index and related factors: A cross-sectional analysis from the Japan Environment and Children's Study. PLoS One 2024; 19:e0304844. [PMID: 38833493 PMCID: PMC11149848 DOI: 10.1371/journal.pone.0304844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/21/2024] [Indexed: 06/06/2024] Open
Abstract
Socioeconomic status and smoking are reportedly associated with underweight and obesity; however, their associations among pregnant women are unknown. This study aimed to investigate whether socioeconomic factors, namely educational attainment, household income, marital status, and employment status, were associated with pre-pregnancy body mass index (BMI) categories, including severe-moderate underweight (BMI ≤ 16.9 kg/m2), mild underweight (BMI, 17.0-18.4 kg/m2), overweight (BMI, 25.0-29.9 kg/m2), and obese (BMI ≥ 30.0 kg/m2) among Japanese pregnant women using data from the Japan Environment and Children's Study (JECS). In total, pregnant women were included 96,751. Age- and parity-adjusted multivariable multinomial logistic regression analyses assessed socioeconomic factors and smoking associations with falling within abnormal BMI categories (normal BMI as the reference group). Lower education and lower household were associated with overweight and obesity, and, especially, lowest education and household income had relatively higher point estimate relative ratios (RRs) of 3.97 and 2.84, respectively. Regarding the risks for underweight, however, only junior high school education had a significantly higher RR for severely to moderately underweight. Regarding occupational status, homemakers or the unemployed had a higher RR for severe-moderate underweight, overweight, and obesity. Unmarried, divorced, or bereaved women had significantly higher RRs for mildly underweight status. Quitting smoking early in pregnancy/still smoking had higher RRs for all four not having normal BMI outcomes; however, quitting smoking before pregnancy had a higher RR only for obese individuals. Lower educational attainment and smoking are essential intervention targets for obesity and severe-moderate underweight prevention in younger women. Lower household income is also a necessary target for obesity.
Collapse
Affiliation(s)
- Yasuaki Saijo
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Hokkaido, Japan
| | - Eiji Yoshioka
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Hokkaido, Japan
| | - Yukihiro Sato
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Hokkaido, Japan
| | - Yuki Kunori
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Hokkaido, Japan
| | - Tomoko Kanaya
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Hokkaido, Japan
| | - Kentaro Nakanishi
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yasuhito Kato
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Ken Nagaya
- Division of Neonatology, Perinatal Medical Center, Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan
| | - Satoru Takahashi
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yoshiya Ito
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Hokkaido, Japan
| | - Hiroyoshi Iwata
- Center for Environmental and Health Sciences, Hokkaido University Sapporo, Hokkaido, Japan
| | - Takeshi Yamaguchi
- Center for Environmental and Health Sciences, Hokkaido University Sapporo, Hokkaido, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University Sapporo, Hokkaido, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University Sapporo, Hokkaido, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University Sapporo, Hokkaido, Japan
| | | |
Collapse
|
27
|
Maredia MK, Nakasone E, Porter M, Nordhagen S, Caputo V, Djimeu EW, Jones AD, Mbuya MNN, Ortega DL, Toure D, Tschirley D. Using Novel Multimethod Evaluation Approaches to Understand Complex Food System Interventions: Insights from a Supply Chain Intervention Intended to Improve Nutrition. Curr Dev Nutr 2024; 8:103776. [PMID: 38979104 PMCID: PMC11228647 DOI: 10.1016/j.cdnut.2024.103776] [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: 12/31/2023] [Revised: 04/18/2024] [Accepted: 05/09/2024] [Indexed: 07/10/2024] Open
Abstract
Background A "food system" approach to improve diet quality by intervening within areas such as food supply chains is gaining prominence. However, evidence of such interventions' impact, and understanding of appropriate methods to evaluate them, is lacking. Objectives We present an impact evaluation of an intervention that aimed to increase consumption of nutritious foods by supporting food-producing firms in Kenya. In doing so, we demonstrate how multiple methods, including those from other disciplines, can be used to evaluate a complex food systems intervention. Methods Four methods focused on food-producing firms and their management, including a survey of intervention participants (n = 83 individuals), a "laboratory-in-the-field" experiment (n = 83 individuals), baseline/endline data on firm performance (n = 71 firms), and semistructured interviews (n = 19 firms). Three methods focused on consumers in neighborhoods targeted by a supported firm: a randomized field experiment tested effects of making a supported product exhaustively available on consumers' purchases and consumption (n = 1295 consumers); 3 discrete choice experiments (n = 1295 consumers) tested factors influencing consumers' willingness to pay for foods with relevant characteristics. Results Among firms, we saw suggestive evidence of increased networking and business relationships, while laboratory-in-the-field experiments indicated the intervention might foster cooperation among participants. Qualitative interviews suggested that the intervention enabled firms to increase production, improve management, increase revenues, and lower costs. Baseline/endline data confirmed a positive effect only on the launch of new products and hiring workers. In the field experiment, consumption of the supported product increased in areas where it was made available relative to a control group, but this did not increase overall consumption of the food type or dietary diversity. Conclusions Results showed positive signs of the intervention improving firm-level outcomes but limited impact on consumers' diet quality. The evaluation also demonstrates how diverse methods can be used to evaluate complex interventions.
Collapse
Affiliation(s)
- Mywish K Maredia
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States
| | - Eduardo Nakasone
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States
| | - Maria Porter
- Department of Political Economy and Moral Science, University of Arizona, Tucson, AZ, United States
| | - Stella Nordhagen
- Knowledge Leadership Team, Global Alliance for Improved Nutrition, Geneva, Switzerland
| | - Vincenzina Caputo
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States
| | - Eric W Djimeu
- Results for Development, Washington, DC, United States
| | - Andrew D Jones
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Mduduzi NN Mbuya
- Knowledge Leadership Team, Global Alliance for Improved Nutrition, Washington, DC, United States
| | - David L Ortega
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States
| | - Djeinam Toure
- Africa Regional Office, Helen Keller International, Dakar, Senegal
| | - David Tschirley
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, United States
| |
Collapse
|
28
|
Bozorg SR, Lee AR, Mårild K, Murray JA. The Economic Iceberg of Celiac Disease: More Than the Cost of Gluten-Free Food. Gastroenterology 2024; 167:172-182. [PMID: 38670283 DOI: 10.1053/j.gastro.2024.02.051] [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] [Received: 11/07/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024]
Abstract
Celiac disease (CeD) is a chronic autoimmune disorder of global relevance, with the potential for acute and long-term complications. However, the economic burden of CeD is rarely considered and largely thought of as limited to the cost of gluten-free food. Fortunately, recent research has shed light on the various societal costs of CeD across the health care continuum. This article summarizes the current evidence on the economic impacts of CeD, which suggest that the societal economic burden of CeD stretches beyond the cost of gluten-free food. This review provides ample evidence of larger but hidden costs related to excess health care use for complications and comorbidities, as well as reduced productivity. Although significant advances are expected in the management of CeD, their effect on the economic burden of CeD remain uncertain. The aim of this review was to inform stakeholders across society and contribute to improved policies to support patients with CeD.
Collapse
Affiliation(s)
- Soran R Bozorg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Division of Gastroenterology, Karolinska University Hospital, Solna, Sweden.
| | - Anne R Lee
- Celiac Disease Center, Columbia University Medical Center, New York, New York
| | - Karl Mårild
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | | |
Collapse
|
29
|
Dos Santos EA, Cavalheiro LAM, Rodrigues D, Machado-Rodrigues A, Silva MR, Nogueira H, Padez C. Are sun exposure time, dietary patterns, and vitamin D intake related to the socioeconomic status of Portuguese children? Am J Hum Biol 2024:e24109. [PMID: 38804593 DOI: 10.1002/ajhb.24109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/16/2024] [Accepted: 05/18/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES To investigate the association among sun exposure time, vitamin D intake, dietary patterns, and socioeconomic status in Portuguese children. METHODS Participants aged 3-11 years (50.1% females) were recruited from public and private schools (n = 118) in the districts of Coimbra (n = 2980), Lisbon (n = 3066), and Porto (n = 2426). Parents reported their children's daily sun exposure time during the summer season and reported children's food consumption, including vitamin D food sources, using standardized questionnaires. Parents' education level was used as a proxy measure to the socioeconomic status (SES). The principal component factor analysis (PCA) method was used to identify dietary patterns. The eight dietary patterns identified were labeled in: "fast food", "rich in vitamin D", "sugary drinks", "vitamin D", "candies", "supplements", "rich in calcium" and "vegetables/healthy". Linear regression analyses were performed to investigate the association between sun exposure time and dietary patterns according to SES. RESULTS A total of 4755 children were included. Children from high SES had significantly longer sun exposure time (p < .001) and more frequently consumed vitamin D supplements (p < .001). "Fast food" pattern showed a negative association with sun exposure time in medium and high SES (p = .014 and p < .001, respectively). CONCLUSION Children with lower SES spend less time exposed to the sun, consume fewer dietary sources of vitamin D, and consume more foods rich in fat and sugar.
Collapse
Affiliation(s)
- Elizabete A Dos Santos
- Nutrition Department, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Daniela Rodrigues
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Maria-Raquel Silva
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
- Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
- Comprehensive Health Research Centre-Group of Sleep, Chronobiology and Sleep Disorders-Nova Medical School, University of Lisbon, Lisbon, Portugal
| | - Helena Nogueira
- Research Centre for Anthropology and Health, Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Cristina Padez
- Research Centre for Anthropology and Health, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| |
Collapse
|
30
|
Alves R, Perelman J, Chang K, Millett C. Environmental impact of dietary patterns in 10 European countries; a cross-sectional analysis of nationally representative dietary surveys. Eur J Public Health 2024:ckae088. [PMID: 38776529 DOI: 10.1093/eurpub/ckae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Changing dietary patterns is essential to reducing the substantial environment impact of agriculture and food production systems. We performed a cross-country comparison of dietary patterns and their associated environmental impact in Europe, including by sociodemographic factors. METHODS We analyzed pooled cross-sectional dietary records collected during 2010-18 from 10 European countries using the European Food Safety Authority (EFSA) Comprehensive European Food Database (16 508 adults; aged 18-79 years). Each food consumed was mapped to the corresponding environmental impact data using the SHARP Indicators Database, which provides greenhouse gas emission (GHGE) and land use (LU) values of approximately 900 foods. Total diet-associated environmental impact was calculated for each person and averaged across multiple days. Multivariable linear regression models were used to compare diet-associated GHGE and LU between population subgroups (gender, age, education and diet type) with country-level fixed effects. RESULTS The mean dietary GHGE and LU per capita ranged from 4.0 kgCO2/day and 5.0 m2*year/day in Spain to 6.5 kgCO2eq/day and 8.2 m2*year/day in France. Diet-related GHGE and LU (per kg/food) were lower among females (2.6 kgCO2eq/day, B = -0.08, P < 0.01; 3.2 m2*year/day, B = -0.11, P < 0.01), older population aged 66-79 (2.6 kgCO2eq/day, B = -0.03, P < 0.01; 3.4 m2*year/day, B = -0.4, P < 0.01), people following vegetarian diets (1.7 kgCO2eq/day, B = -0.07, P < 0.01; 2.0 m2*year/day, B = -0.07, P < 0.01), and higher among individuals with secondary education (2.7 kgCO2eq/day, B = 0.05, P < 0.01; 3.6 m2*year/day, B = -0.05, P < 0.01). CONCLUSIONS Environmental footprints vary substantially across countries, dietary patterns and between different sociodemographic groups in Europe. These findings are crucial for the development of country-specific food policies aimed at promoting environmentally sustainable diets.
Collapse
Affiliation(s)
- Ricardo Alves
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - Julian Perelman
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - Kiara Chang
- School of Public Health, Imperial College London, Public Health Policy Evaluation Unit, London, UK
| | - Christopher Millett
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
- School of Public Health, Imperial College London, Public Health Policy Evaluation Unit, London, UK
| |
Collapse
|
31
|
Lonati E, Cazzaniga E, Adorni R, Zanatta F, Belingheri M, Colleoni M, Riva MA, Steca P, Palestini P. Health-Related Lifestyles among University Students: Focusing on Eating Habits and Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:626. [PMID: 38791840 PMCID: PMC11120768 DOI: 10.3390/ijerph21050626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
The transition to higher education at University is a critical moment for young adults to acquire unhealthy habits regarding physical activity (PA) and adherence to a healthy diet. Negative behaviors might be maintained in the years to come with a major risk of suffering from a Non-Communicable Disease. This study aims to determine the relationship between diet and PA in the student community of University of Milano-Bicocca. Students between 18 and 30 years old completed an online survey (6949 students). Two analyses of covariance (ANCOVA), chi-square tests of independence, and a binomial logistic regression were performed to examine the relationship between adequacy of food consumption and PA, in association also with sociodemographic characteristics. Data show a strong correlation between behaviors analyzed, with a proportional positive association between PA and healthy diet. Nevertheless, a third of the sample students incur in incorrect habits for both diet and PA. Further, students performing intensive PA have the healthiest food consumption in general but the worst red meat and pork intake. Accordingly, men practice more PA but have a less adequate diet, exactly contrary to women. In conclusion, policies promoting consciousness of well-being would transform Universities into healthy hubs for virtuous habits.
Collapse
Affiliation(s)
- Elena Lonati
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48, 20900 Monza, Italy; (E.C.); (M.B.); (M.A.R.); (P.P.)
| | - Emanuela Cazzaniga
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48, 20900 Monza, Italy; (E.C.); (M.B.); (M.A.R.); (P.P.)
| | - Roberta Adorni
- Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy; (F.Z.); (P.S.)
| | - Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy; (F.Z.); (P.S.)
| | - Michael Belingheri
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48, 20900 Monza, Italy; (E.C.); (M.B.); (M.A.R.); (P.P.)
| | - Matteo Colleoni
- Department of Sociology and Social Research, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy;
- BASE Bicocca Sustainability Committee, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy
| | - Michele Augusto Riva
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48, 20900 Monza, Italy; (E.C.); (M.B.); (M.A.R.); (P.P.)
- BASE Bicocca Sustainability Committee, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy; (F.Z.); (P.S.)
- BASE Bicocca Sustainability Committee, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy
| | - Paola Palestini
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48, 20900 Monza, Italy; (E.C.); (M.B.); (M.A.R.); (P.P.)
- BASE Bicocca Sustainability Committee, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy
| |
Collapse
|
32
|
Stone RA, Brown A, Douglas F, Green MA, Hunter E, Lonnie M, Johnstone AM, Hardman CA. The impact of the cost of living crisis and food insecurity on food purchasing behaviours and food preparation practices in people living with obesity. Appetite 2024; 196:107255. [PMID: 38367913 DOI: 10.1016/j.appet.2024.107255] [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: 11/01/2023] [Revised: 01/12/2024] [Accepted: 02/06/2024] [Indexed: 02/19/2024]
Abstract
Lower income households are at greater risk of food insecurity and poor diet quality than higher income households. In high-income countries, food insecurity is associated with high levels of obesity, and in the UK specifically, the cost of living crisis (i.e., where the cost of everyday essentials has increased quicker than wages) is likely to have exacerbated existing dietary inequalities. There is currently a lack of understanding of the impact of the current UK cost of living crisis on food purchasing and food preparation practices of people living with obesity (PLWO) and food insecurity, however this knowledge is critical in order to develop effective prevention and treatment approaches to reducing dietary inequalities. Using an online survey (N = 583) of adults residing in England or Scotland with a body mass index (BMI) of ≥30 kg/m2, participants self-reported on food insecurity, diet quality, perceived impact of the cost of living crisis, and their responses to this in terms of food purchasing behaviours and food preparation practices. Regression analyses found that participants adversely impacted by the cost of living crisis reported experiencing food insecurity. Additionally, food insecurity was associated with use of specific purchasing behaviours (i.e., use of budgeting, use of supermarket offers) and food preparation practices (i.e., use of energy-saving appliances, use of resourcefulness). Exploratory analyses indicated that participants adversely impacted by the cost of living crisis and who used budgeting had low diet quality, whereas use of meal planning was associated with high diet quality. These findings highlight the fragility of food budgets and the coping strategies used by PLWO and food insecurity during the cost of living crisis. Policy measures and interventions are urgently needed that address the underlying economic factors contributing to food insecurity, to improve access to and affordability of healthier foods for all.
Collapse
Affiliation(s)
- Rebecca A Stone
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, L69 7ZA, UK.
| | - Adrian Brown
- Department of Medicine, Centre for Obesity Research, University College London, London, WC1E 6JF, UK.
| | - Flora Douglas
- School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Aberdeen, AB10 7QE, UK.
| | - Mark A Green
- Department of Geography & Planning, University of Liverpool, Liverpool, L69 7ZT, UK.
| | - Emma Hunter
- School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Aberdeen, AB10 7QE, UK.
| | - Marta Lonnie
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Alexandra M Johnstone
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
| | - Charlotte A Hardman
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, L69 7ZA, UK.
| |
Collapse
|
33
|
Zielinska-Pukos MA, Michalska-Kacymirow M, Kurek E, Bulska E, Grabowicz-Chądrzyńska I, Wesołowska A, Hamulka J. Breastmilk mineral composition among well-educated mothers from Central Poland - Associations with maternal dietary intake, dietary patterns and infant psychomotor development. J Trace Elem Med Biol 2024; 83:127393. [PMID: 38271826 DOI: 10.1016/j.jtemb.2024.127393] [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] [Received: 10/30/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Maternal dietary habits could affect breastmilk mineral composition, which may influence infant development. Mineral dietary intake or supplementation slightly affects its breastmilk concentration. However, the intake of selected food groups or dietary patterns that reflect diet complexity could have a greater impact. Hence, the aim of the study was to assess breastmilk mineral composition at one, three, and six months of lactation among mothers living in urban area of Central Poland, as well as the evaluate maternal dietary determinants and associations with infant anthropometric and psychomotor development. METHODS The study was conducted among 43 healthy and exclusively breastfeeding mothers. In the first, third, and sixth months of lactation, we collected breastmilk samples and assessed the concentration of Ca, P, Zn, Fe, Se, Ni, As, Pb, and Cd using the ICP-MS method. Maternal dietary habits were evaluated by a food frequency questionnaire in the first month of lactation, whereas in the third and sixth by the three-day food record. Based on the collected data adherence to the Polish-adapted Mediterranean (Pl-aMED; 1 month) and the DASH diet (Mellen's Index; 3 and 6 months) was assessed. In the third and sixth months of lactation infant anthropometric parameters and the sixth month of lactation psychomotor development were evaluated. RESULTS Breastmilk Se, Ni, As, Pb, and Cd levels were under the LOQ in all the breastmilk samples at all study visits. Median breastmilk mineral concentrations of Ca, P, Zn, and Fe in the first, third, and sixth months of lactation varied from 381.9 to 332.7 mg/L, 161.6 to 139.1 mg/L, 2.2 to 0.8 mg/L, and 0.26 to 0.17 mg/L, respectively. Maternal dietary intake and supplementation did not affect breastmilk Ca, P, Zn, and Fe. Pl-aMED scores were associated with breastmilk Ca (β = 0.489, 95% CI 0.180 - 0.799, p = 0.003) and Zn (β = 0.499, 95% CI 0.199 - 0.798, p = 0.002) in the first month of lactation, whereas no association with the DASH diet were observed in the third and sixth month of lactation. Breastmilk Fe in the third month was associated with infant motor development (β = 0.420, 95% CI 0.113 - 0.727, p = 0.009) in the sixth month of life, but no other associations with anthropometric or psychomotor development were observed. Moreover, we estimated that few infants meet their adequate intake (AI) requirements for P, Zn, and Fe. CONCLUSION Our study showed that maternal adherence to Pl-aMED is a significant predictor of breastmilk Ca and Zn in the first month of lactation, which may be especially important considering that more than 75% of infants had inadequate Zn intake. Moreover, we found that breastmilk Fe positively influenced infant motor development, despite the majority of infants having inadequate intake. On the other hand, no infant had deficiency symptoms, which emphasizes the necessity to evaluate of AI norms for infants.
Collapse
Affiliation(s)
- Monika A Zielinska-Pukos
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska St. 159c, 02-776 Warsaw, Poland.
| | - Magdalena Michalska-Kacymirow
- Faculty of Chemistry, Biological and Chemical Research Centre, University of Warsaw, Żwirki i Wigury St. 101, 02-089 Warsaw, Poland
| | - Eliza Kurek
- Faculty of Chemistry, Biological and Chemical Research Centre, University of Warsaw, Żwirki i Wigury St. 101, 02-089 Warsaw, Poland
| | - Ewa Bulska
- Faculty of Chemistry, Biological and Chemical Research Centre, University of Warsaw, Żwirki i Wigury St. 101, 02-089 Warsaw, Poland
| | | | - Aleksandra Wesołowska
- Department of Medical Biology, Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska St. 159c, 02-776 Warsaw, Poland
| |
Collapse
|
34
|
Greenthal E, Marx K, Grossman ER, Ruffin M, Lucas SA, Benjamin-Neelon SE. Incentives and penalties tied to sales volume in contracts between beverage companies and public universities in the United States. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1279-1288. [PMID: 35623032 DOI: 10.1080/07448481.2022.2076098] [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: 04/21/2021] [Revised: 03/16/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To assess whether and how beverage companies incentivize universities to maximize sugar-sweetened beverage (SSB) sales through pouring rights contracts. METHODS Cross-sectional study of contracts between beverage companies and public U.S. universities with 20,000 or more students active in 2018 or 2019. We requested contracts from 143 universities. The primary measures were presence of financial incentives and penalties tied to sales volume. RESULTS 124 universities (87%) provided 131 unique contracts (64 Coca-Cola, 67 Pepsi). 125 contracts (95%) included at least one provision tying payments to sales volume. The most common incentive type was commissions, found in 104 contracts (79%). Nineteen contracts (15%) provided higher commissions or rebates for carbonated soft drinks compared to bottled water. CONCLUSIONS Most contracts between universities and beverage companies incentivized universities to market and sell bottled beverages, particularly SSBs. Given the health risks associated with consumption of SSBs, universities should consider their role in promoting them.
Collapse
Affiliation(s)
- Eva Greenthal
- Center for Science in the Public Interest, Washington, DC
| | - Katherine Marx
- Center for Science in the Public Interest, Washington, DC
| | - Elyse R Grossman
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Martha Ruffin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Stephanie A Lucas
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| |
Collapse
|
35
|
Hernández-Martínez A, Duarte-Junior MA, Sotos-Prieto M, Ortolá R, Banegas JR, Rodríguez-Artalejo F, Soriano-Maldonado A, Martínez-Gómez D. Cardiovascular health in Spain based on the Life's Essential 8 and its association with all-cause and cardiovascular mortality: the ENRICA cohort. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:372-380. [PMID: 37783370 DOI: 10.1016/j.rec.2023.09.001] [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: 05/09/2023] [Accepted: 09/07/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES The American Heart Association has recently developed the Life's Essential 8 (LE8) score to encourage prevention of cardiovascular disease (CVD). This study assessed the distribution of LE8 in the Spanish adult population and its association with all-cause and CVD death. METHODS We used data from 11 616 individuals aged 18 years and older (50.5% women) from the ENRICA study, recruited between 2008 and 2010 and followed up until 2020 to 2022. The LE8 score includes 8 metrics (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids and glucose, and blood pressure) and ranges from 0 to 100. The association of LE8 score with mortality was summarized with hazard ratios (HR), obtained from Cox regression. RESULTS In total, 13.2% of participants (range, 6.1%-16.9% across regions) had low cardiovascular health (LE8 ≤ 49). During a median follow-up of 12.9 years, 908 total deaths occurred, and, during a median follow-up of 11.8 years, 207 CVD deaths were ascertained. After adjustment for the main potential confounders and compared with being in the least healthy (lowest) quartile of LE8, the HR (95%CI) of all-cause mortality for the second, third and fourth quartiles were 0.68 (0.56-0.83), 0.63 (0.51-0.78), and 0.53 (0.39-0.72), respectively. The corresponding figures for CVD mortality, after accounting for competing mortality risks, were 0.62 (0.39-0.97), 0.55 (0.32-0.93), and 0.38 (0.16-0.89). CONCLUSIONS A substantial proportion of the Spanish population showed low cardiovascular health. A higher LE8 score, starting from the second quartile, was associated with lower all-cause and CVD mortality.
Collapse
Affiliation(s)
- Alba Hernández-Martínez
- Departamento de Educación, Facultad de Ciencias de la Educación, Universidad de Almería, Almería, Spain; SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.
| | - Miguel Angelo Duarte-Junior
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Rosario Ortolá
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José R Banegas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain
| | - Alberto Soriano-Maldonado
- Departamento de Educación, Facultad de Ciencias de la Educación, Universidad de Almería, Almería, Spain; SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.
| | - David Martínez-Gómez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain
| |
Collapse
|
36
|
Fogelholm M, Vepsäläinen H, Meinilä J, McRae C, Saarijärvi H, Erkkola M, Nevalainen J. The dynamics in food selection stemming from price awareness and perceived income adequacy: a cross-sectional study using 1-year loyalty card data. Am J Clin Nutr 2024; 119:1346-1353. [PMID: 38458401 PMCID: PMC11130695 DOI: 10.1016/j.ajcnut.2024.03.003] [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: 08/19/2023] [Revised: 02/07/2024] [Accepted: 03/04/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Higher cost of healthy foods may explain unhealthy dietary patterns in lower-income households. Unfortunately, combining food selection and nutrient intake data to price and expenditure is challenging. Food retailer's customer loyalty card data, linked to nutrient composition database, is a novel method for simultaneous exploration of food purchases, price, and nutrition. OBJECTIVES We studied the associations between perceived income adequacy (PIA) as a grouping variable with price (per kilogram or megajoule) and the volume of purchases (percentage of expenditure or energy) simultaneously as outcome variables for 17 most purchased food groups. METHODS We used 1-year (2018) loyalty card data from the largest grocery chain in Finland. Participants were 28,783 loyalty cardholders who made ≥41% of food purchases from the retailer and answered an online questionnaire at the midpoint of data collection. The 5-level PIA described the perceived financial situation in the household. Energy and nutrient content of foods purchased were from the Finnish Food Composition Database Fineli. We calculated the Nutrient Rich Food Index per 100 g food using 11 nutrients. Trends in prices and expenditures between PIA levels were analyzed using 2-sided Jonckheere-Terpstra tests, with false discovery rate control (Benjamini-Hochberg method) and confounder adjustments (inverse probability weighting). RESULTS Lower PIA participants selected cheaper foods per kilogram and megajoule within most food groups. They also favored unhealthy food groups cheap in energy [<1 € (USD 1.18)/MJ]. Despite lower purchase price, the expenditure (%) among lower PIA was higher on alcohol, snacks, sugar-sweetened beverages, and sweets and chocolates. CONCLUSIONS Participants with lower PIA showed stronger price awareness. It is crucial to consider the pricing of competing alternative food groups, when steering toward environmentally sustainable and healthier food purchases. Package labeling might also direct the selection of healthier choices among the less expensive items within a food group.
Collapse
Affiliation(s)
- Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Jelena Meinilä
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Cameron McRae
- Desautels Faculty of Management, McGill University, Montreal, Canada; McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, Canada
| | - Hannu Saarijärvi
- Faculty of Management and Business, Tampere University, Tampere, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Jaakko Nevalainen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
| |
Collapse
|
37
|
Liu A, Zhuang Z, Li J, Wang Q, Liu S, Fang H, Huang T, Zhou M. Burden and trend of dietary risk-related colorectal cancer in China and its provinces: findings from the Global Burden of Disease Study 2019. Public Health 2024; 230:21-28. [PMID: 38484622 DOI: 10.1016/j.puhe.2023.11.038] [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: 08/21/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 04/16/2024]
Abstract
OBJECTIVES The objective of this experiment was to evaluate the spatial pattern and temporal trend of colorectal cancer (CRC) burden attributed to dietary risk factors in China from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. METHODS Numbers and age-standardised rates of deaths, disability-adjusted life years (DALYs) and corresponding average annual percentage change (AAPC) were determined. The joinpoint regression analysis was used to assess the temporal trends of CRC deaths and DALYs from 1990 to 2019. RESULTS In China, the number of diet-attributable CRC deaths and DALYs in 2019 were 90.41 (95% uncertainty interval: 65.69, 114.67) and 2234.06 (1609.96, 2831.24) per-1000 population, marking 2.05% and 1.68% annual increases since 1990, respectively. The region with the highest increase in age-standardised rates (ASRs) of diet-related CRC deaths and DALYs was in Taiwan with an AAPC of 2.00% (1.51, 2.48), whereas the highest decline in ASRs of CRC deaths and DALYs was observed in Hong Kong with an AAPC of -0.63% (-0.90, -0.35) (all P < 0.05). Nationally, men suffered higher CRC deaths and DALY burdens attributable to dietary risks than did women. Regarding the specific diet group, diets low in calcium, milk, and whole grains contributed to CRC deaths and DALYs the most. CONCLUSIONS Diet is an important contributor to increasing CRC burden in China. Necessary measures should be taken to kerb the growing burden attributed to dietary factors, particularly in males and in regions with middle Socio-demographic Index or lower.
Collapse
Affiliation(s)
- A Liu
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Z Zhuang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China
| | - J Li
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Q Wang
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - S Liu
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - H Fang
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - T Huang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China; Center for Intelligent Public Health, Academy for Artificial Intelligence, Peking University, Beijing, China.
| | - M Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| |
Collapse
|
38
|
Dlamini SN, Mtintsilana A, Craig A, Mapanga W, Norris SA. Food insecurity and coping strategies associate with higher risk of anxiety and depression among South African households with children. Public Health Nutr 2024; 27:e116. [PMID: 38576137 PMCID: PMC11036448 DOI: 10.1017/s1368980024000879] [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: 12/21/2023] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To investigate food insecurity and related coping strategies, and their associations with the risk of anxiety and depression, among South African households with children. DESIGN Nationally representative cross-sectional study. Tools for assessing food insecurity, coping strategies, risk of anxiety and depression were assessed from the Community Childhood Hunger Identification Project, Coping Strategies Index, Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9, respectively. We used ordered logistic regression to test associations of food insecurity and coping strategies with the risk of anxiety and depression. Moderating effects of each coping strategy were tested in the associations of food insecurity with anxiety and depression. SETTING South Africa, post COVID-19 restrictions, May-June 2022. PARTICIPANTS 1,774 adults, weighted to 20,955,234 households. RESULTS Food insecurity prevalence was 23·7 % among households with children. All coping strategies were used to some extent, but relying on less preferred and less expensive foods was the most used strategy (85·5 % of food-insecure households). Moving to a higher level of food insecurity was associated with >1·6 greater odds of being in a higher risk of anxiety and depression. Sending a household member to beg for food was the strongest associated factor (OR = 1·7, P < 0·001). All coping strategies partly moderated (lessened) the associations of food insecurity with a higher risk of anxiety and depression. CONCLUSIONS Food insecurity among households with children was high following the COVID-19 pandemic. Collaborative efforts between government, private sector and civil society to eradicate food insecurity should prioritise poorer households with children, as these populations are the most vulnerable.
Collapse
Affiliation(s)
- Siphiwe N Dlamini
- School of Physiology, Faculty of Health Sciences, University
of the Witwatersrand, Johannesburg, South
Africa
| | - Asanda Mtintsilana
- School of Physiology, Faculty of Health Sciences, University
of the Witwatersrand, Johannesburg, South
Africa
| | - Ashleigh Craig
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of
Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa
| | - Witness Mapanga
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of
Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa
- Strengthening Oncology Services Research Unit, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg,
South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of
Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa
- School of Human Development and Health, University of
Southampton, Southampton, UK
| |
Collapse
|
39
|
Agurs-Collins T, Alvidrez J, ElShourbagy Ferreira S, Evans M, Gibbs K, Kowtha B, Pratt C, Reedy J, Shams-White M, Brown AG. Perspective: Nutrition Health Disparities Framework: A Model to Advance Health Equity. Adv Nutr 2024; 15:100194. [PMID: 38616067 PMCID: PMC11031378 DOI: 10.1016/j.advnut.2024.100194] [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: 09/14/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 04/16/2024] Open
Abstract
Disparities in nutrition, such as poor diet quality and inadequate nutrient intake, arise from multiple factors and are related to adverse health outcomes such as obesity, diabetes, cardiovascular disease, and some cancers. The aim of the current perspective is to present a nutrition-centric socioecological framework that delineates determinants and factors that contribute to diet and nutrition-related disparities among disadvantaged populations. The Nutrition Health Disparities Framework (NHDF) describes the domains (biological, behavioral, physical/built environment, sociocultural environment, and healthcare system) that influence nutrition-related health disparities through the lens of each level of influence (that is, individual, interpersonal, community, and societal). On the basis of the scientific literature, the authors engaged in consensus decision making in selecting nutrition-related determinants of health within each domain and socioecological level when creating the NHDF. The framework identifies how neighborhood food availability and access (individual/built environment) intersect with cultural norms and practices (interpersonal/sociocultural environment) to influence dietary behaviors, exposures, and risk of diet-related diseases. In addition, the NHDF shows how factors such as genetic predisposition (individual/biology), family dietary practices (interpersonal/behavioral), and food marketing policies (societal) may impact the consumption of unhealthy foods and beverages and increase chronic disease risk. Family and peer norms (interpersonal/behavior) related to breastfeeding and early childhood nutrition interact with resource-poor environments such as lack of access to preventive healthcare settings (societal/healthcare system) and low usage of federal nutrition programs (societal/behavioral), which may increase risk of poor nutrition during childhood and food insecurity. The NHDF describes the synergistic interrelationships among factors at different levels of the socioecological model that influence nutrition-related outcomes and exacerbate health disparities. The framework is a useful resource for nutrition researchers, practitioners, food industry leaders, and policymakers interested in improving diet-related health outcomes and promoting health equity in diverse populations.
Collapse
Affiliation(s)
- Tanya Agurs-Collins
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD, United States.
| | | | - Sanae ElShourbagy Ferreira
- National Center for Advancing Translational Sciences, Division of Clinical Innovation, Bethesda, MD, United States
| | - Mary Evans
- National Institute of Diabetes and Digestive and Kidney Diseases, Division of Digestive Diseases and Nutrition, Bethesda, MD, United States
| | - Kimberlea Gibbs
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Extramural Research, Pediatric Growth and Nutrition Branch, Bethesda, MD, United States
| | | | - Charlotte Pratt
- National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD, United States
| | - Jill Reedy
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD, United States
| | - Marissa Shams-White
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD, United States
| | - Alison Gm Brown
- National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD, United States
| |
Collapse
|
40
|
Phelps NH, Singleton RK, Zhou B, Heap RA, Mishra A, Bennett JE, Paciorek CJ, Lhoste VPF, Carrillo-Larco RM, Stevens GA, Rodriguez-Martinez A, Bixby H, Bentham J, Di Cesare M, Danaei G, Rayner AW, Barradas-Pires A, Cowan MJ, Savin S, Riley LM, Aguilar-Salinas CA, Baker JL, Barkat A, Bhutta ZA, Branca F, Caixeta RB, Cuschieri S, Farzadfar F, Ganapathy S, Ikeda N, Iotova V, Kengne AP, Khang YH, Laxmaiah A, Lin HH, Ma J, Mbanya JCN, Miranda JJ, Pradeepa R, Rodríguez-Artalejo F, Sorić M, Turley M, Wang L, Webster-Kerr K, Aarestrup J, Abarca-Gómez L, Abbasi-Kangevari M, Abdeen ZA, Abdrakhmanova S, Abdul Ghaffar S, Abdul Rahim HF, Abdurrahmonova Z, Abu-Rmeileh NM, Abubakar Garba J, Acosta-Cazares B, Adam I, Adamczyk M, Adams RJ, Adu-Afarwuah S, Aekplakorn W, Afsana K, Afzal S, Agbor VN, Agdeppa IA, Aghazadeh-Attari J, Ågren Å, Aguenaou H, Agyemang C, Ahmad MH, Ahmad NA, Ahmadi A, Ahmadi N, Ahmadi N, Ahmed I, Ahmed SH, Ahrens W, Aitmurzaeva G, Ajlouni K, Al-Hazzaa HM, Al-Hinai H, Al-Lahou B, Al-Lawati JA, Al-Raddadi R, Al Asfoor D, Al Hourani HM, Al Qaoud NM, Alarouj M, AlBuhairan F, AlDhukair S, Aldwairji MA, Alexius S, Ali MM, Alieva AV, Alkandari A, Alkerwi A, Alkhatib BM, Allin K, Alomary SA, Alomirah HF, Alshangiti AM, Alvarez-Pedrerol M, Aly E, Amarapurkar DN, Amiano Etxezarreta P, Amoah J, Amougou N, Amouyel P, Andersen LB, Anderssen SA, Androutsos O, Ängquist L, Anjana RM, Ansari-Moghaddam A, Anufrieva E, Aounallah-Skhiri H, Araújo J, Ariansen I, Aris T, Arku RE, Arlappa N, Aryal KK, Assefa N, Aspelund T, Assah FK, Assembekov B, Assunção MCF, Aung MS, Aurélio de Valois CJM, Auvinen J, Avdičová M, Avi S, Azad K, Azevedo A, Azimi-Nezhad M, Azizi F, Babu BV, Bacopoulou F, Bæksgaard Jørgensen M, Baharudin A, Bahijri S, Bajramovic I, Bakacs M, Balakrishna N, Balanova Y, Bamoshmoosh M, Banach M, Banegas JR, Baran J, Baran R, Barbagallo CM, Barbosa Filho V, Barceló A, Baretić M, Barnoya J, Barrera L, Barreto M, Barros AJD, Barros MVG, Bartosiewicz A, Basit A, Bastos JL, Bata I, Batieha AM, Batista AP, Batista RL, Battakova Z, Baur LA, Bayauli PM, Beaglehole R, Bel-Serrat S, Belavendra A, Ben Romdhane H, Benedek T, Benedics J, Benet M, Benitez Rolandi GE, Benzeval M, Bere E, Berger N, Bergh IH, Berhane Y, Berkinbayev S, Bernabe-Ortiz A, Bernotiene G, Berrios Carrasola X, Bettiol H, Beutel ME, Beybey AF, Bezerra J, Bhagyalaxmi A, Bharadwaj S, Bhargava SK, Bi H, Bi Y, Bia D, Biasch K, Bika Lele EC, Bikbov MM, Bista B, Bjelica DJ, Bjerregaard AA, Bjerregaard P, Bjertness E, Bjertness MB, Björkelund C, Bloch KV, Blokstra A, Blychfeld Magnazu M, Bo S, Bobak M, Boddy LM, Boehm BO, Boer JMA, Boggia JG, Bogova E, Boissonnet CP, Bojesen SE, Bonaccio M, Bongard V, Bonilla-Vargas A, Bopp M, Borghs H, Botomba S, Bourne RRA, Bovet P, Boymatova K, Braeckevelt L, Braeckman L, Bragt MCE, Braithwaite T, Brajkovich I, Breckenkamp J, Breda J, Brenner H, Brewster LM, Brian GR, Briceño Y, Brinduse L, Bringolf-Isler B, Brito M, Brophy S, Brug J, Bruno G, Bugge A, Buoncristiano M, Burazeri G, Burns C, Cabrera de León A, Cacciottolo J, Cai H, Cama T, Cameron C, Camolas J, Can G, Cândido APC, Cañete F, Capanzana MV, Čapková N, Capuano E, Capuano R, Capuano V, Cardol M, Cardoso VC, Carlsson AC, Carmuega E, Carvalho J, Casajús JA, Casanueva FF, Casas M, Celikcan E, Censi L, Cervantes-Loaiza M, Cesar JA, Chamnan P, Chamukuttan S, Chan A, Chan Q, Charchar FJ, Charles MA, Chaturvedi HK, Chaturvedi N, Che Abdul Rahim N, Chee ML, Chen CJ, Chen F, Chen H, Chen LS, Chen S, Chen Z, Cheng CY, Cheng YJ, Cheraghian B, Chetrit A, Chikova-Iscener E, Chinapaw MJM, Chinnock A, Chiolero A, Chiou ST, Chirita-Emandi A, Chirlaque MD, Cho B, Christensen K, Christofaro DG, Chudek J, Cifkova R, Cilia M, Cinteza E, Cirillo M, Claessens F, Clare P, Clarke J, Clays E, Cohen E, Cojocaru CR, Colorado-Yohar S, Compañ-Gabucio LM, Concin H, Confortin SC, Cooper C, Coppinger TC, Corpeleijn E, Cortés LY, Costanzo S, Cottel D, Cowell C, Craig CL, Crampin AC, Cross AJ, Crujeiras AB, Cruz JJ, Csányi T, Csilla S, Cucu AM, Cui L, Cureau FV, Czenczek-Lewandowska E, D'Arrigo G, d'Orsi E, da Silva AG, Dacica L, Dahm CC, Dallongeville J, Damasceno A, Damsgaard CT, Dankner R, Dantoft TM, Dasgupta P, Dastgiri S, Dauchet L, Davletov K, de Assis Guedes de Vasconcelos F, de Assis MAA, De Backer G, De Bacquer D, De Bacquer J, de Bont J, De Curtis A, de Fragas Hinnig P, de Gaetano G, De Henauw S, De Miguel-Etayo P, De Neve JW, Duarte de Oliveira P, De Ridder D, De Ridder K, de Rooij SR, de Sá ACMGN, De Smedt D, Deepa M, Deev AD, DeGennaro VJ, Delisle H, Delpeuch F, Demarest S, Dennison E, Dereń K, Deschamps V, Devrishov RD, Dhimal M, Di Castelnuovo A, Dias-da-Costa JS, Díaz-Sánchez ME, Diaz A, Díaz Fernández P, Díez Ripollés MP, Dika Z, Djalalinia S, Djordjic V, Do HTP, Dobson AJ, Dominguez L, Donati MB, Donfrancesco C, Dong G, Dong Y, Donoso SP, Döring A, Dorobantu M, Dorosty AR, Dörr M, Doua K, Dragano N, Drygas W, Du S, Duan JL, Duante CA, Duboz P, Duleva VL, Dulskiene V, Dumith SC, Dushpanova A, Dwyer T, Dyussupova A, Dzerve V, Dziankowska-Zaborszczyk E, Ebrahimi N, Echeverría G, Eddie R, Eftekhar E, Efthymiou V, Egbagbe EE, Eggertsen R, Eghtesad S, Eiben G, Ekelund U, El-Khateeb M, El Ammari L, El Ati J, Eldemire-Shearer D, Elliott P, Enang O, Endevelt R, Engle-Stone R, Erasmus RT, Erem C, Ergor G, Eriksen L, Eriksson JG, Escobedo-de la Peña J, Eslami S, Esmaeili A, Evans A, Evans RG, Faeh D, Fagherazzi G, Fakhradiyev I, Fakhretdinova AA, Fall CH, Faramarzi E, Farjam M, Farrugia Sant'Angelo V, Farzi Y, Fattahi MR, Fawwad A, Fawzi WW, Felix-Redondo FJ, Ferguson TS, Fernandes RA, Fernández-Bergés D, Ferrante D, Ferrao T, Ferrari G, Ferrari M, Ferrario MM, Ferreccio C, Ferreira HS, Ferrer E, Ferrieres J, Figueiró TH, Fijalkowska A, Fink G, Fisberg M, Fischer K, Foo LH, Forsner M, Fottrell EF, Fouad HM, Francis DK, Franco MDC, Fras Z, Fraser B, Frontera G, Fuchs FD, Fuchs SC, Fujiati II, Fujita Y, Fumihiko M, Furdela V, Furusawa T, Gabriela SA, Gaciong Z, Gafencu M, Galán Cuesta M, Galbarczyk A, Galcheva SV, Galenkamp H, Galeone D, Galfo M, Galvano F, Gao J, Gao P, Garcia-de-la-Hera M, García Mérida MJ, García Solano M, Gareta D, Garnett SP, Gaspoz JM, Gasull M, Gaya ACA, Gaya AR, Gazzinelli A, Gehring U, Geiger H, Geleijnse JM, George R, Gerdts E, Ghaderi E, Ghamari SH, Ghanbari A, Ghasemi E, Gheorghe-Fronea OF, Gialluisi A, Giampaoli S, Gianfagna F, Gieger C, Gill TK, Giovannelli J, Gironella G, Giwercman A, Gkiouras K, Glushkova N, Godara R, Godos J, Gogen S, Goldberg M, Goltzman D, Gómez G, Gómez Gómez JH, Gomez LF, Gómez SF, Gomula A, Gonçalves Cordeiro da Silva B, Gonçalves H, Gonçalves M, González-Alvarez AD, Gonzalez-Chica DA, González-Gil EM, Gonzalez-Gross M, González-Leon M, González-Rivas JP, González-Villalpando C, González-Villalpando ME, Gonzalez AR, Gottrand F, Graça AP, Grafnetter D, Grajda A, Grammatikopoulou MG, Gregg EW, Gregor RD, Gregório MJ, Grøholt EK, Grøntved A, Grosso G, Gruden G, Gu D, Guajardo V, Gualdi-Russo E, Guallar-Castillón P, Gualtieri A, Gudmundsson EF, Gudnason V, Guerchet M, Guerrero R, Guessous I, Guimaraes AL, Gujral UP, Gulliford MC, Gunnlaugsdottir J, Gunter MJ, Guo XH, Guo Y, Gupta PC, Gupta R, Gureje O, Gurinović MA, Gutiérrez González E, Gutierrez L, Gutzwiller F, Gwee X, Ha S, Hadaegh F, Hadjigeorgiou CA, Haghshenas R, Hakimi H, Halkjær J, Hambleton IR, Hamzeh B, Hanekom WA, Hange D, Hanif AAM, Hantunen S, Hao J, Hardman CM, Hardy L, Hari Kumar R, Harmer Lassen T, Harooni J, Hashemi-Shahri SM, Hassapidou M, Hata J, Haugsgjerd T, Hayes AJ, He J, He Y, He Y, Heidinger-Felső R, Heier M, Heinen M, Hejgaard T, Hendriks ME, Henrique RDS, Henriques A, Hernandez Cadena L, Herrala S, Herrera-Cuenca M, Herrera VM, Herter-Aeberli I, Herzig KH, Heshmat R, Heude B, Hill AG, Ho SY, Ho SC, Hobbs M, Höfelmann DA, Holdsworth M, Homayounfar R, Homs C, Hoogendijk E, Hopman WM, Horimoto ARVR, Hormiga CM, Horta BL, Houti L, Howitt C, Htay TT, Htet AS, Htike MMT, Hu Y, Huerta JM, Huhtaniemi IT, Huiart L, Huidumac Petrescu C, Husseini A, Huu CN, Huybrechts I, Hwalla N, Hyska J, Iacoviello L, Iakupova EM, Ibarluzea J, Ibrahim MM, Ibrahim Wong N, Igland J, Ijoma C, Ikram MA, Iñiguez C, Irazola VE, Ishida T, Isiguzo GC, Islam M, Islam SMS, Islek D, Ittermann T, Ivanova-Pandourska IY, Iwasaki M, Jääskeläinen T, Jackson RT, Jacobs JM, Jadoul M, Jafar T, Jallow B, James K, Jamil KM, Jamrozik K, Jan N, Jansson A, Janszky I, Janus E, Jarani J, Jarnig G, Jarvelin MR, Jasienska G, Jelaković A, Jelaković B, Jennings G, Jiang CQ, Jimenez RO, Jöckel KH, Joffres M, Jokelainen JJ, Jonas JB, Jonnagaddala J, Jøran Kjerpeseth L, Jørgensen T, Joshi P, Joshi R, Josipović J, Joukar F, Jóźwiak JJ, Judge DS, Juolevi A, Jurak G, Jurca Simina I, Juresa V, Kaaks R, Kaducu FO, Kadvan AL, Kafatos A, Kaj M, Kajantie EO, Kakutia N, Kállayová D, Kalmatayeva Z, Kalter-Leibovici O, Kameli Y, Kanala KR, Kannan S, Kapantais E, Karaglani E, Karakosta A, Kårhus LL, Karki KB, Karlsson O, Kassi Anicet A, Katchunga PB, Katibeh M, Katz J, Katzmarzyk PT, Kauhanen J, Kaur P, Kavousi M, Kazakbaeva GM, Kaze FF, Kazembe BM, Ke C, Keil U, Keinan Boker L, Keinänen-Kiukaanniemi S, Kelishadi R, Kelleher C, Kemper HCG, Keramati M, Kerimkulova A, Kersting M, Key T, Khader YS, Khaledifar A, Khalili D, Kheiri B, Kheradmand M, Khosravi A, Khouw IMSL, Kiechl-Kohlendorfer U, Kiechl SJ, Kiechl S, Killewo J, Kim HC, Kim J, Kindblom JM, Kingston A, Klakk H, Klanarong S, Klanova J, Klimek M, Klimont J, Klumbiene J, Knoflach M, Kobel S, Koirala B, Kolle E, Kolo SM, Kolsteren P, König J, Korpelainen R, Korrovits P, Korzycka M, Kos J, Koskinen S, Kouda K, Koussoh Simone M, Kovács É, Kovacs VA, Kovalskys I, Kowlessur S, Koziel S, Kratenova J, Kratzer W, Kriaucioniene V, Kriemler S, Kristensen PL, Krizan H, Kroker-Lobos MF, Krokstad S, Kromhout D, Kruger HS, Kruger R, Kryst Ł, Kubinova R, Kuciene R, Kujala UM, Kujundzic E, Kulaga Z, Kulimbet M, Kulothungan V, Kumar RK, Kumari M, Kunešová M, Kurjata P, Kusuma YS, Kutsenko V, Kuulasmaa K, Kyobutungi C, La QN, Laamiri FZ, Laatikainen T, Labadarios D, Lachat C, Lackner KJ, Lai D, Laid Y, Lall L, Lam TH, Landaeta Jimenez M, Landais E, Lankila T, Lanska V, Lappas G, Larijani B, Larissa SP, Lateva MP, Latt TS, Laurenzi M, Lauria L, Lazo-Porras M, Le Coroller G, Le Nguyen Bao K, Le Port A, Le TD, Lee J, Lee J, Lee PH, Lehtimäki T, Lemogoum D, Leong E, Leskošek B, Leszczak J, Leth-Møller KB, Leung GM, Levitt NS, Li Y, Liivak M, Lilly CL, Lim C, Lim WY, Lima-Costa MF, Lin X, Lind L, Lingam V, Linkohr B, Linneberg A, Lissner L, Litwin M, Liu J, Liu L, Liu L, Liu X, Lo WC, Loit HM, Long KQ, Longo Abril G, Lopes L, Lopes MSS, Lopes O, Lopez-Garcia E, Lopez T, Lotufo PA, Lozano JE, Lukrafka JL, Luksiene D, Lundqvist A, Lunet N, Lunogelo C, Lustigová M, Łuszczki E, M'Buyamba-Kabangu JR, Ma G, Ma X, Machado-Coelho GLL, Machado-Rodrigues AM, Macia E, Macieira LM, Madar AA, Madraisau S, Madsen AL, Maestre GE, Maggi S, Magliano DJ, Magnacca S, Magriplis E, Mahasampath G, Maire B, Majer M, Makdisse M, Mäki P, Malekpour MR, Malekzadeh F, Malekzadeh R, Malhotra R, Mallikharjuna Rao K, Malta DC, Malyutina SK, Maniego LV, Manios Y, Mann JI, Mannix MI, Mansour-Ghanaei F, Manyanga T, Manzato E, Mapatano MA, Marcil A, Margozzini P, Maria-Magdalena R, Mariño J, Markaki A, Markey O, Markidou Ioannidou E, Marques-Vidal P, Marques LP, Marrugat J, Martin-Prevel Y, Martin R, Martorell R, Martos E, Maruf FA, Maruszczak K, Marventano S, Masala G, Mascarenhas LP, Masinaei M, Masoodi SR, Mathiesen EB, Mathur P, Matijasevich A, Matłosz P, Matsha TE, Matsudo V, Matteo G, Maulik PK, Mavrogianni C, Mazur A, McFarlane SR, McGarvey ST, McKee M, McLean RM, McLean SB, McNairy ML, McNulty BA, Mediene Benchekor S, Medzioniene J, Mehlig K, Mehrparvar AH, Meirhaeghe A, Meisfjord J, Meisinger C, Melgarejo JD, Melkumova M, Mello J, Méndez F, Mendivil CO, Menezes AMB, Menon GR, Mensink GBM, Menzano MT, Meshram II, Meto DT, Meyer HE, Mi J, Michaelsen KF, Michels N, Mikkel K, Miłkowska K, Miller JC, Milushkina O, Minderico CS, Mini GK, Miquel JF, Mirjalili MR, Mirkopoulou D, Mirrakhimov E, Mišigoj-Duraković M, Mistretta A, Mocanu V, Modesti PA, Moghaddam SS, Mohamed SF, Mohammad K, Mohammadi MR, Mohammadi Z, Mohammadifard N, Mohammadpourhodki R, Mohan V, Mohanna S, Mohd Yusoff MF, Mohebbi I, Moitry M, Møllehave LT, Møller NC, Molnár D, Momenan A, Mondo CK, Monroy-Valle M, Montenegro Mendoza RA, Monterrubio-Flores E, Monyeki KDK, Moon JS, Moosazadeh M, Mopa HT, Moradpour F, Moreira LB, Morejon A, Moreno LA, Morey F, Morgan K, Morin SN, Mortensen EL, Moschonis G, Moslem A, Mosquera M, Mossakowska M, Mostafa A, Mostafavi SA, Mota-Pinto A, Mota J, Motlagh ME, Motta J, Moura-dos-Santos MA, Movsesyan Y, Mridha MK, Msyamboza KP, Mu TT, Muc M, Muca F, Mugoša B, Muiesan ML, Müller-Nurasyid M, Münzel T, Mursu J, Murtagh EM, Musa KI, Musić Milanović S, Musil V, Musinguzi G, Muyer MT, Nabipour I, Nagel G, Najafi F, Nakamura H, Nalecz H, Námešná J, Nang EEK, Nangia VB, Nankap M, Narake S, Narayan KMV, Nardone P, Naseri T, Nathalie M, Neal WA, Neelapaichit N, Nejatizadeh A, Nekkantti C, Nelis K, Nenko I, Neovius M, Nervi F, Ng TP, Nguyen CT, Nguyen ND, Nguyen QN, Ni MY, Nicolescu R, Nie P, Nieto-Martínez RE, Nikitin YP, Ning G, Ninomiya T, Nishi N, Nishtar S, Noale M, Noboa OA, Nogueira H, Nordendahl M, Nordestgaard BG, Norton KI, Noto D, Nowak-Szczepanska N, Nsour MA, Nuhoğlu I, Nunes B, Nurk E, Nuwaha F, Nyirenda M, O'Neill TW, O'Reilly D, Obreja G, Ochimana C, Ochoa-Avilés AM, Oda E, Odili AN, Oh K, Ohara K, Ohlsson C, Ohtsuka R, Olafsson Ö, Oldenburg B, Olinto MTA, Oliveira IO, Omar MA, Omar SM, Onat A, Ong SK, Onland-Moret NC, Ono LM, Onodugo O, Ordunez P, Ornelas R, Ortiz AP, Ortiz PJ, Osler M, Osmond C, Ostojic SM, Ostovar A, Otero JA, Ottendahl CB, Otu A, Overvad K, Owusu-Dabo E, Oyeyemi AY, Oyeyemi AL, Paccaud FM, Padez CP, Pagkalos I, Pahomova E, de Paiva KM, Pająk A, Pajula N, Palloni A, Palmieri L, Pan WH, Panda-Jonas S, Pandey A, Pang Z, Panza F, Paoli M, Papadopoulou SK, Papandreou D, Pareja RG, Park SW, Park S, Parnell WR, Parsaeian M, Pascanu IM, Pasquet P, Patel ND, Pattussi M, Pavlyshyn H, Pechlaner R, Pećin I, Pednekar MS, Pedro JM, Peer N, Peixoto SV, Peltonen M, Pereira AC, Peres MA, Perez-Londoño A, Pérez CM, Peterkova V, Peters A, Petkeviciene J, Petrauskiene A, Petrovna Kovtun O, Pettenuzzo E, Peykari N, Pfeiffer N, Phall MC, Pham ST, Phiri FP, Pichardo RN, Pierannunzio D, Pierre-Marie P, Pigeot I, Pikhart H, Pilav A, Piler P, Pilotto L, Pistelli F, Pitakaka F, Piwonska A, Pizarro AN, Plans-Rubió P, Platonova AG, Poh BK, Pohlabeln H, Polka NS, Pop RM, Popkin BM, Popovic SR, Porta M, Posch G, Poudyal A, Poulimeneas D, Pouraram H, Pourfarzi F, Pourshams A, Poustchi H, Price AJ, Price JF, Prista A, Providencia R, Puder JJ, Pudule I, Puhakka S, Puiu M, Punab M, Qadir MS, Qasrawi RF, Qiao Q, Qorbani M, Quintana HK, Quiroga-Padilla PJ, Quoc Bao T, Rach S, Radic I, Radisauskas R, Rahimikazerooni S, Rahman M, Rahman M, Raitakari O, Raj M, Rajabov T, Rakhmatulloev S, Rakovac I, Ramachandra Rao S, Ramachandran A, Ramadan OPC, Ramires VV, Ramirez-Zea M, Ramke J, Ramos E, Ramos R, Rampal L, Rampal S, Ramsay SE, Rangelova LS, Rarra V, Rascon-Pacheco RA, Rashidi MM, Rech CR, Redon J, Reganit PFM, Regecová V, Renner JDP, Repasy JA, Reuter CP, Revilla L, Reynolds A, Rezaei N, Rezaianzadeh A, Rho Y, Ribas-Barba L, Ribeiro R, Riboli E, Rigo F, Rigotti A, Rinaldo N, Rinke de Wit TF, Risérus U, Rito AI, Ritti-Dias RM, Rivera JA, Roa RG, Robinson L, Roccaldo R, Rodrigues D, Rodriguez-Perez MDC, Rodríguez-Villamizar LA, Rodríguez AY, Roggenbuck U, Rohloff P, Rohner F, Rojas-Martinez R, Rojroongwasinkul N, Romaguera D, Romeo EL, Rosario RV, Rosengren A, Rouse I, Rouzier V, Roy JGR, Ruano MH, Rubinstein A, Rühli FJ, Ruidavets JB, Ruiz-Betancourt BS, Ruiz-Castell M, Ruiz Moreno E, Rusakova IA, Rusek W, Russell Jonsson K, Russo P, Rust P, Rutkowski M, Saamel M, Saar CG, Sabanayagam C, Sabbaghi H, Sacchini E, Sachdev HS, Sadjadi A, Safarpour AR, Safi S, Safiri S, Saghi MH, Saidi O, Saieva C, Sakata S, Saki N, Šalaj S, Salanave B, Salazar Martinez E, Salhanova A, Salmerón D, Salomaa V, Salonen JT, Salvetti M, Samoutian M, Sánchez-Abanto J, Sánchez Rodríguez I, Sandjaja, Sans S, Santa-Marina L, Santacruz E, Santos DA, Santos IS, Santos LC, Santos MP, Santos O, Santos R, Santos TR, Saramies JL, Sardinha LB, Sarrafzadegan N, Sathish T, Saum KU, Savva S, Savy M, Sawada N, Sbaraini M, Scazufca M, Schaan BD, Schaffrath Rosario A, Schargrodsky H, Schienkiewitz A, Schindler K, Schipf S, Schmidt B, Schmidt CO, Schmidt IM, Schneider A, Schnohr P, Schöttker B, Schramm S, Schramm S, Schröder H, Schultsz C, Schultz G, Schulze MB, Schutte AE, Sebert S, Sedaghattalab M, Selamat R, Sember V, Sen A, Senbanjo IO, Sepanlou SG, Sequera G, Serra-Majem L, Servais J, Ševčíková Ľ, Sewpaul R, Shalnova S, Shamah-Levy T, Shamshirgaran SM, Shanthirani CS, Sharafkhah M, Sharma SK, Sharman A, Shaw JE, Shayanrad A, Shayesteh AA, Shengelia L, Shi Z, Shibuya K, Shimizu-Furusawa H, Shimony T, Shiri R, Shrestha N, Si-Ramlee K, Siani A, Siantar R, Sibai AM, Sidossis LS, Silitrari N, Silva AM, Silva CRDM, Silva DAS, Silva KS, Sim X, Simon M, Simons J, Simons LA, Sjöberg A, Sjöström M, Skoblina EV, Skoblina NA, Slazhnyova T, Slowikowska-Hilczer J, Slusarczyk P, Smeeth L, So HK, Soares FC, Sobek G, Sobngwi E, Sodemann M, Söderberg S, Soekatri MYE, Soemantri A, Sofat R, Solfrizzi V, Solovieva YV, Somi MH, Sonestedt E, Song Y, Soofi S, Sørensen TIA, Sørgjerd EP, Sossa Jérome C, Soto-Rojas VE, Soumaré A, Sousa-Poza A, Sovic S, Sparboe-Nilsen B, Sparrenberger K, Spencer PR, Spinelli A, Spiroski I, Staessen JA, Stamm H, Stang A, Starc G, Staub K, Stavreski B, Steene-Johannessen J, Stehle P, Stein AD, Steinsbekk S, Stergiou GS, Stessman J, Stevanović R, Stieber J, Stöckl D, Stokwiszewski J, Stoyanova E, Stratton G, Stronks K, Strufaldi MW, Sturua L, Suárez-Medina R, Suarez-Ortegón MF, Suebsamran P, Sugiyama M, Suka M, Sulo G, Sun CA, Sun L, Sund M, Sundström J, Sung YT, Sunyer J, Suriyawongpaisal P, Sweis NWG, Swinburn BA, Sy RG, Sylva RC, Szponar L, Tabone L, Tai ES, Takuro F, Tambalis KD, Tammesoo ML, Tamosiunas A, Tan EJ, Tang X, Tanrygulyyeva M, Tanser F, Tao Y, Tarawneh MR, Tarp J, Tarqui-Mamani CB, Taxová Braunerová R, Taylor A, Taylor J, Tchibindat F, Te Velde S, Tebar WR, Tell GS, Tello T, Tessema M, Tham YC, Thankappan KR, Theobald H, Theodoridis X, Thomas N, Thorand B, Thrift AG, Tichá Ľ, Timmermans EJ, Tjandrarini DH, Tjonneland A, Tolonen HK, Tolstrup JS, Tomaszewski M, Topbas M, Topór-Mądry R, Torheim LE, Tornaritis MJ, Torrent M, Torres-Collado L, Toselli S, Touloumi G, Traissac P, Tran TTH, Tremblay MS, Triantafyllou A, Trichopoulos D, Trichopoulou A, Trinh OTH, Trivedi A, Tshepo L, Tsigga M, Tsintavis P, Tsugane S, Tuitele J, Tuliakova AM, Tulloch-Reid MK, Tullu F, Tuomainen TP, Tuomilehto J, Twig G, Tynelius P, Tzala E, Tzotzas T, Tzourio C, Udoji N, Ueda P, Ugel E, Ukoli FAM, Ulmer H, Unal B, Usupova Z, Uusitalo HMT, Uysal N, Vaitkeviciute J, Valdivia G, Vale S, Valvi D, van Dam RM, van den Born BJ, Van der Heyden J, van der Schouw YT, Van Herck K, Van Lippevelde W, Van Minh H, Van Schoor NM, van Valkengoed IGM, Vanderschueren D, Vanuzzo D, Varbo A, Varela-Moreiras G, Vargas LN, Varona-Pérez P, Vasan SK, Vasques DG, Vatasescu R, Vega T, Veidebaum T, Velasquez-Melendez G, Velika B, Verloigne M, Veronesi G, Verschuren WMM, Victora CG, Viegi G, Viet L, Vik FN, Vilar M, Villalpando S, Vioque J, Viriyautsahakul N, Virtanen JK, Visser M, Visvikis-Siest S, Viswanathan B, Vladulescu M, Vlasoff T, Vocanec D, Vollenweider P, Völzke H, Vourli G, Voutilainen A, Vrijheid M, Vrijkotte TGM, Vuletić S, Wade AN, Waldhör T, Walton J, Wambiya EOA, Wan Bebakar WM, Wan Mohamud WN, Wanderley Júnior RDS, Wang C, Wang H, Wang MD, Wang N, Wang Q, Wang X, Wang YX, Wang YW, Wannamethee SG, Wareham N, Wartha O, Weber A, Wedderkopp N, Weghuber D, Wei W, Weres A, Werner B, Westbury LD, Whincup PH, Wichstrøm L, Wickramasinghe K, Widhalm K, Widyahening IS, Więcek A, Wild PS, Wilks RJ, Willeit J, Willeit P, Williams J, Wilsgaard T, Wirth JP, Wojtyniak B, Woldeyohannes M, Wolf K, Wong-McClure RA, Wong A, Wong EB, Wong JE, Wong TY, Woo J, Woodward M, Wu FC, Wu HY, Wu J, Wu LJ, Wu S, Wyszyńska J, Xu H, Xu L, Yaacob NA, Yamborisut U, Yan L, Yan W, Yang L, Yang X, Yang Y, Yardim N, Yasuharu T, Yépez García M, Yiallouros PK, Yngve A, Yoosefi M, Yoshihara A, Yotov Y, You QS, You SL, Younger-Coleman NO, Yu YL, Yu Y, Yusof SM, Yusoff AF, Zaccagni L, Zafiropulos V, Zainuddin AA, Zakavi SR, Zamani F, Zambon S, Zampelas A, Zamrazilová H, Zapata ME, Zargar AH, Zaw KK, Zayed AA, Zdrojewski T, Żegleń M, Zejglicova K, Zeljkovic Vrkic T, Zeng Y, Zentai A, Zhang B, Zhang L, Zhang ZY, Zhao D, Zhao MH, Zhao W, Zhecheva YV, Zhen S, Zheng W, Zheng Y, Zholdin B, Zhou M, Zhu D, Zimmet P, Zins M, Zitt E, Zocalo Y, Zoghlami N, Zuñiga Cisneros J, Zuziak M, Ezzati M. Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet 2024; 403:1027-1050. [PMID: 38432237 PMCID: PMC7615769 DOI: 10.1016/s0140-6736(23)02750-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. METHODS We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). FINDINGS From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. INTERPRETATION The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. FUNDING UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union.
Collapse
|
41
|
Dally D, Amith M, Mauldin RL, Thomas L, Dang Y, Tao C. A Semantic Approach to Describe Social and Economic Characteristics That Impact Health Outcomes (Social Determinants of Health): Ontology Development Study. Online J Public Health Inform 2024; 16:e52845. [PMID: 38477963 PMCID: PMC10973958 DOI: 10.2196/52845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/28/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Social determinants of health (SDoH) have been described by the World Health Organization as the conditions in which individuals are born, live, work, and age. These conditions can be grouped into 3 interrelated levels known as macrolevel (societal), mesolevel (community), and microlevel (individual) determinants. The scope of SDoH expands beyond the biomedical level, and there remains a need to connect other areas such as economics, public policy, and social factors. OBJECTIVE Providing a computable artifact that can link health data to concepts involving the different levels of determinants may improve our understanding of the impact SDoH have on human populations. Modeling SDoH may help to reduce existing gaps in the literature through explicit links between the determinants and biological factors. This in turn can allow researchers and clinicians to make better sense of data and discover new knowledge through the use of semantic links. METHODS An experimental ontology was developed to represent knowledge of the social and economic characteristics of SDoH. Information from 27 literature sources was analyzed to gather concepts and encoded using Web Ontology Language, version 2 (OWL2) and Protégé. Four evaluators independently reviewed the ontology axioms using natural language translation. The analyses from the evaluations and selected terminologies from the Basic Formal Ontology were used to create a revised ontology with a broad spectrum of knowledge concepts ranging from the macrolevel to the microlevel determinants. RESULTS The literature search identified several topics of discussion for each determinant level. Publications for the macrolevel determinants centered around health policy, income inequality, welfare, and the environment. Articles relating to the mesolevel determinants discussed work, work conditions, psychosocial factors, socioeconomic position, outcomes, food, poverty, housing, and crime. Finally, sources found for the microlevel determinants examined gender, ethnicity, race, and behavior. Concepts were gathered from the literature and used to produce an ontology consisting of 383 classes, 109 object properties, and 748 logical axioms. A reasoning test revealed no inconsistent axioms. CONCLUSIONS This ontology models heterogeneous social and economic concepts to represent aspects of SDoH. The scope of SDoH is expansive, and although the ontology is broad, it is still in its early stages. To our current understanding, this ontology represents the first attempt to concentrate on knowledge concepts that are currently not covered by existing ontologies. Future direction will include further expanding the ontology to link with other biomedical ontologies, including alignment for granular semantics.
Collapse
Affiliation(s)
- Daniela Dally
- The University of Texas Health Science Center at Houston School of Public Health, The Brownsville Region, Brownsville, TX, United States
| | - Muhammad Amith
- Department of Biostatistics and Data Science, University of Texas Medical Branch, Galveston, TX, United States
- Department of Internal Medicine, University of Texas Medical Branch, Galveton, TX, United States
| | - Rebecca L Mauldin
- School of Social Work, The University of Texas at Arlington, Arlington, TX, United States
| | - Latisha Thomas
- School of Social Work, The University of Texas at Arlington, Arlington, TX, United States
| | - Yifang Dang
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Cui Tao
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Jacksonville, FL, United States
| |
Collapse
|
42
|
Gaona-Pineda EB, López-Olmedo N, Moreno-Macías H, Shamah-Levy T. Three approaches to assessing dietary quality in Mexican adolescents from 2006 to 2018 with data from national health and nutrition surveys. Public Health Nutr 2024; 27:e97. [PMID: 38465375 PMCID: PMC10993068 DOI: 10.1017/s1368980024000648] [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: 02/12/2023] [Revised: 01/18/2024] [Accepted: 02/21/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To assess trends in the dietary quality of Mexican adolescents from 2006 to 2018, both overall and by sociodemographic indicators, using adaptations of the EAT-Lancet Planetary Health (PH) recommendations, optimal intake estimated by the Global Burden of Disease (GBD) and 2015 Mexican Dietary Guidelines (MDG) in nationally representative samples. DESIGN Using dietary data from a semi-quantitative FFQ, dietary quality indexes were constructed as adaptations of three dietary intake recommendations. Trends in adherence to recommendations were evaluated with multivariate quantile regression models with survey year as the main independent variable and adjusted for age, sex, energy intake, dwelling area, geographical region, household assets condition, and student/non-student status. P values and CI were Bonferroni-corrected. SETTING Mexico. PARTICIPANTS Non-pregnant or lactating adolescents aged 12-19 years (n 16 520). RESULTS Adherence to the PH index was about 40 %, GBD was nearly 35 % and MDG was about 37 %. The lowest adherences were for added sugars, sugar-sweetened beverages, nuts and seeds, red meats, processed meats, and legumes (<28 %). No 2006-2018 trends in total adherence were found in any index. Nevertheless, negative adherence trends were identified for poultry (β = -2·4), and saturated fats (β = -0·93), and positive for unsaturated oils (β = 1·23), in the PH. In MDG, relevant trends were found for plain water (β = 1·63) and foods rich in fats (β = -1·24). CONCLUSIONS Mexican adolescents have demonstrated poor dietary quality by these three approaches. Therefore, this population has a high-risk profile for diet-associated chronic diseases. Further research and appropriate public policies are needed.
Collapse
Affiliation(s)
- Elsa Berenice Gaona-Pineda
- Center for Evaluation and Survey Research, National Institute
of Public Health of Mexico, Cuernavaca,
Mexico
- Master’s and Doctoral Program in Medical, Odontological and Health
Sciences, National Autonomous University of Mexico, Mexico
City, Mexico
| | - Nancy López-Olmedo
- Center for Population Health Research, National Institute of
Public Health of Mexico, Cuernavaca, Mexico
| | | | - Teresa Shamah-Levy
- Center for Evaluation and Survey Research, National Institute
of Public Health of Mexico, Cuernavaca,
Mexico
| |
Collapse
|
43
|
Guo Y, Su D, Chen H, Ding Y, Zhang S, Sun H, Chen D, Yin W, Li X, Zeng G. Does an antihypertensive diet cost more? Analysis from the Chinese Heart-Healthy diet trial. Public Health Nutr 2024; 27:e73. [PMID: 38445388 DOI: 10.1017/s1368980024000430] [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: 03/07/2024]
Abstract
OBJECTIVE To determine whether the Chinese heart-healthy diet (Sichuan cuisine version) (CHH diet-SC) was more expensive than the conventional Sichuan diet and explore the food groups and nutrients that mainly affected the cost of CHH diet-SC. DESIGN Cost analysis of 4-week intervention diets in the Sichuan center representing southwestern China in the CHH diet study. SETTING A multicentre, parallel-group, single-blind, randomised feeding trial evaluating the efficacy of lowering blood pressure with the cuisine-based CHH diet. PARTICIPANTS Totally, fifty-three participants with hypertension aged 25-75 years in the Sichuan center were randomised into the control group (n 26) or the CHH diet-SC group (n 27). RESULTS The CHH diet-SC was more expensive than the control diet (¥27·87 ± 2·41 v. ¥25·18 ± 2·79 equals $3·90 ± 0·34 v. $3·52 ± 0·39, P < 0·001), and the incremental cost-effectiveness ratio for a 1-mm Hg systolic blood pressure reduction was ¥9·12 ($1·28). Intakes and the cost of seafood, dairy products, fruits, soybeans and nuts, whole grains and mixed beans were higher for the CHH diet-SC than for the control diet (P < 0·001). Intakes of vitamin B1, vitamin B6, vitamin C, Mg and phosphorus were positively correlated with the cost (P < 0·05). CONCLUSIONS The CHH diet-SC costs more than the conventional Sichuan diet, partly due to the high cost of specific food groups. Positive correlations between the intakes of vitamin B1, vitamin B6, vitamin C, Mg, phosphorus and the dietary cost could be a direction to adjust the composition within the food groups to reduce the cost of the CHH diet-SC.
Collapse
Affiliation(s)
- Yishan Guo
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Danping Su
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanxi Ding
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shiyu Zhang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong Sun
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dandi Chen
- West China School Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Wenya Yin
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiang Li
- Sichuan Tourism University, Chengdu, Sichuan, China
| | - Guo Zeng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
44
|
van der Veer A, Madern T, van Lenthe FJ. Tunneling, cognitive load and time orientation and their relations with dietary behavior of people experiencing financial scarcity - an AI-assisted scoping review elaborating on scarcity theory. Int J Behav Nutr Phys Act 2024; 21:26. [PMID: 38439067 PMCID: PMC10910771 DOI: 10.1186/s12966-024-01576-9] [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: 09/14/2023] [Accepted: 02/14/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The concept of a financial scarcity mindset has raised much attention as an explanation for poor decision-making and dysfunctional behavior. It has been suggested that financial scarcity could also impair dietary behavior, through a decline in self-control. Underlying cognitive mechanisms of tunneling (directing attention to financial issues and neglecting other demands), cognitive load (a tax on mental bandwidth interfering with executive functioning) and time orientation (a shift towards a present time horizon, versus a future time horizon) may explain the association between financial scarcity and self-control related dietary behavior. The current scoping review gathers recent evidence on how these mechanisms affect dietary behavior of people experiencing financial scarcity. It builds on a theoretical framework based on insights from behavioral economics and health psychology. METHODS A literature search was executed in six online databases, which resulted in 9.975 papers. Search terms were tunneling, cognitive load and time orientation, financial scarcity, and dietary behavior. Screening was performed with ASReview, an AI-ranking tool. In total, 14 papers were included in the scoping review. We used PRISMA-ScR guidelines for reporting. RESULTS Limited evidence indicates that a scarcity mindset could increase tunneling, through attentional narrowing on costs of food, which then directly impacts dietary behavior. A scarcity mindset involves experiencing financial stress, which can be understood as cognitive load. Cognitive load decreases attentional capacity, which could impair self-control in dietary choices. Financial scarcity is related to a present time orientation, which affects dietary choices by shifting priorities and decreasing motivation for healthy dietary behavior. CONCLUSIONS A scarcity mindset affects dietary behavior in different ways. Tunneling and a shift in time orientation are indicative of an attentional redirection, which can be seen as more adaptive to the situation. These may be processes indirectly affecting self-control capacity. Cognitive load could decrease self-control capacity needed for healthy dietary behavior because it consumes mental bandwidth. How a changing time orientation when experiencing financial scarcity relates to motivation for self-control in dietary behavior is a promising theme for further inquiry.
Collapse
Affiliation(s)
- Annemarieke van der Veer
- Research Group of Debt and Debt Collection, University of Applied Sciences Utrecht, Utrecht, PO Box 85397, 3508 AJ, The Netherlands.
| | - Tamara Madern
- Research Group of Debt and Debt Collection, University of Applied Sciences Utrecht, Utrecht, PO Box 85397, 3508 AJ, The Netherlands
| | - Frank J van Lenthe
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands
| |
Collapse
|
45
|
Zhu Y, Mierau JO, Riphagen IJ, Heiner-Fokkema MR, Dekker LH, Navis GJ, Bakker SJL. Types of fish consumption differ across socioeconomic strata and impact differently on plasma fish-based omega-3 fatty acids: a cross-sectional study. Eur J Nutr 2024; 63:435-443. [PMID: 37985508 PMCID: PMC10899282 DOI: 10.1007/s00394-023-03274-x] [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: 02/18/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE We investigated the associations of socioeconomic position (SEP) with total and type of fish intake in a large general population and validated whether types of fish intake were differently associated with plasma EPA and DHA in a subset of the population. METHODS From the Lifelines Cohort Study, 94,246 participants aged 44 ± 13 years old were included to test the association of two SEP indicators, i.e., education level and household income level, with dietary intakes of total, oily, lean, fried, and other types of fish. In a subset of 575 participants (mean age: 50 ± 13 years), EPA and DHA levels were measured in plasma phospholipids and triglycerides. Dietary fish intake was assessed using Food Frequency Questionnaire. Linear regressions were applied and adjusted for relevant covariates. RESULTS Compared to the high education level, lower education levels were negatively associated with total, oily, lean, and other fish intake (p < 0.001 for all), and positively associated with fried fish intake (β (SE): 0.04 (0.04), p < 0.001 for middle education; 0.07 (0.04), p < 0.001 for low education), independently of relevant covariates. Similar results were observed for income levels. In the subset population, total and oily fish intakes were positively associated with plasma EPA and DHA (p < 0.02 for all). Lean and other fish intakes were positively associated with only DHA (p < 0.008 for all), but not EPA, while fried fish was not associated with either EPA or DHA in plasma (p > 0.1 for all). CONCLUSION Lower SEP was associated with a lower total intake of fish, and of oily and lean fish, but with higher intake of fried fish. Fried fish was not associated with the fish-based EPA and DHA in plasma. Hence, SEP-related differences in fish consumption are both quantitative and qualitative.
Collapse
Affiliation(s)
- Yinjie Zhu
- Division of Nephrology, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Jochen O Mierau
- Department of Economics, Econometrics & Finance, Faculty of Economics and Business, University of Groningen, University Complex, 9747 AJ, Groningen, The Netherlands
- Lifelines Cohort Study and Biobank, Groningen, The Netherlands
- Team Strategy & External Relations, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Ineke J Riphagen
- Certe Medical Diagnostics and Advice, Medical Center Leeuwarden, 8934 AD, Leeuwarden, The Netherlands
| | - M Rebecca Heiner-Fokkema
- Laboratory of Metabolic Diseases, University Medical Center Groningen, University of Groningen, Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Louise H Dekker
- Division of Nephrology, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- National Institute for Public Health and the Environment (RIVM), 3720 BA, Bilthoven, The Netherlands
| | - Gerjan J Navis
- Division of Nephrology, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Centre Groningen, University of Groningen, Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| |
Collapse
|
46
|
Campbell EK, Taillie L, Blanchard LM, Wixom N, Harrington DK, Peterson DR, Wittlin SD, Campbell TM. Post hoc analysis of food costs associated with Dietary Approaches to Stop Hypertension diet, whole food, plant-based diet, and typical baseline diet of individuals with insulin-treated type 2 diabetes mellitus in a nonrandomized crossover trial with meals provided. Am J Clin Nutr 2024; 119:769-778. [PMID: 38160802 DOI: 10.1016/j.ajcnut.2023.12.023] [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: 09/05/2023] [Revised: 11/28/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Americans consume diets that fall short of dietary recommendations, and the cost of healthier diets is often cited as a barrier to dietary change. We conducted a nonrandomized crossover trial with meals provided utilizing 2 diets: Dietary Approaches to Stop Hypertension (DASH) and whole food, plant-based (WFPB), and thus had intake data from baseline and both intervention diets. OBJECTIVES Using actual diet records, describe food costs of baseline diets of individuals with type 2 diabetes (T2DM) as well as therapeutic DASH and WFPB diets. METHODS Three-day food records were collected and analyzed for each 7-d diet phase: baseline, DASH, and WFPB. Nutrient content was analyzed using the Nutrient Data System for Research and cost was determined using Fillet, an application to manage menu pricing. Food costs were calculated for each diet as consumed and adjusted to a standardized 1800 kcal/d. Ingredient-only costs of food away from home (FAFH) were approximated and analyzed. Costs were analyzed using linear mixed-effect models as a function of diet. RESULTS Fifteen subjects enrolled; 12 completed all dietary phases. The baseline, DASH, and WFPB diets, as consumed, cost $15.72/d (95% CI; $13.91, $17.53), $12.74/d ($11.23, $14.25), and $9.78/d ($7.97, $11.59), respectively. When adjusted to an 1800 kcal/d intake, the baseline, DASH, and WFPB diets cost $15.69/d ($13.87, $17.52), $14.92/d ($13.59, $16.26), and $11.96/d ($10.14, $13.78), respectively. When approximated ingredient-only costs of FAFH were analyzed, as consumed baseline [$11.01 ($9.53, $12.49)] and DASH diets [$11.81 ($10.44, $13.18)] had similar costs; WFPB diet [$8.83 ($7.35, $10.31)] cost the least. CONCLUSIONS In this short-term study with meals provided, the food costs of plant-predominant diets offering substantial metabolic health benefits were less than or similar to baseline food costs of adults with insulin-treated T2DM. Longer-term data without meal provision are needed for more generalizable results. This trial was registered at clinicaltrials.gov as NCT04048642.
Collapse
Affiliation(s)
- Erin K Campbell
- Department of Public Health Sciences, University of Rochester Medical Center, NY, United States.
| | - Laurie Taillie
- Department of Family Medicine, University of Rochester Medical Center, NY, United States
| | - Lisa M Blanchard
- Department of Family Medicine, University of Rochester Medical Center, NY, United States
| | - Nellie Wixom
- Clinical Research Center, University of Rochester Medical Center, NY, United States
| | - Donald K Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, NY, United States
| | - Derick R Peterson
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, NY, United States
| | - Steven D Wittlin
- Division of Endocrinology, University of Rochester Medical Center, NY, United States
| | - Thomas M Campbell
- Department of Family Medicine, University of Rochester Medical Center, NY, United States
| |
Collapse
|
47
|
Verdeau B, Monnery-Patris S. When food is uncertain, how much does sustainability matter? A qualitative exploration of food values and behaviours among users of a social grocery store. Appetite 2024; 194:107175. [PMID: 38128764 DOI: 10.1016/j.appet.2023.107175] [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: 09/04/2023] [Revised: 11/23/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
A transition towards sustainable diets ensuring food security while preserving ecosystems is necessary, but remains challenging. Low-income consumers, particularly those experiencing food insecurity, require specific consideration since they face financial constraints when making food choices, leading to poorer diets. However, little is known about the place given to sustainability in their choices. This study thus aims to identify the role played by sustainability in the food values of food-insecure consumers in France. Twenty-nine semi-structured interviews with users of a social grocery store were conducted to investigate food values and actual behaviours, with a focus on the four dimensions of sustainable diets - health, economic, sociocultural and environmental. Verbatims were analysed through thematic analysis. Five core values were identified, namely health and nutrition, naturalness, trust and control, solidarity and frugality, and preferences. Participants valued all dimensions of food sustainability but notably valued less the environmental dimension. Despite various strategies, participants felt unable to adhere to their values in practice, mainly because of their socioeconomic vulnerability. They insisted on their lack of control over their food behaviour. These findings provide insights into the disempowerment experienced by consumers with low financial resources regarding more sustainable food choices. Our study calls for interventions addressing affordability issues and considering consumers' food values, while providing opportunities to make consumers feel involved in the transition of the food system.
Collapse
Affiliation(s)
- Basile Verdeau
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, F-21000, Dijon, France.
| | - Sandrine Monnery-Patris
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, F-21000, Dijon, France
| |
Collapse
|
48
|
Chapman LE, Berkowitz SA, Ammerman A, De Marco M, Ng SW, Zimmer C, Caspi CE. Examining Changes in Food Security, Perceived Stress, and Dietary Intake in a Cohort of Low-Wage Workers Experiencing an Increase in Hourly Wage. Health Promot Pract 2024; 25:263-273. [PMID: 36373653 PMCID: PMC10183054 DOI: 10.1177/15248399221128005] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine whether an increase in hourly wages was associated with changes in food security and perceived stress among low-wage workers. We also determined whether changes in food security and stress were associated with changes in diet. SETTING Wages is a prospective cohort study following 974 low-wage workers in Minneapolis, MN, where an ordinance is incrementally increasing minimum wage to US$15/hr from 2018 to 2022, and a comparison community with no minimum wage ordinance (Raleigh, NC). Interaction models were estimated using generalized estimating equations. PARTICIPANTS Analyses used two waves of data (2018 [baseline], 2019) and included 219 and 321 low-wage workers in Minneapolis and Raleigh (respectively). RESULTS Average hourly wages increased from US$9.77 (SD US$1.69) to US$11.67 (SD US$4.02). Changes in wages were not associated with changes in food security (odds ratio = 1.05, 95% confidence interval [CI] [0.89, 1.23], p = .57) or stress (β = -0.01, 95% CI [-0.04, 0.03], p = .70) after 1 year of policy implementation. Changes in food security were not associated with changes in diet. However, we found significant changes in the frequency of fruit and vegetable intake across time by levels of stress, with decreased intake from Wave 1 to 2 at low levels of stress, and increased intake at high levels of stress (incidence rate ratio = 1.17, 95% CI [1.05, 1.31], p = .01). CONCLUSIONS Changes in wages were not associated with changes in food security or stress in a sample of low-wage workers. Future research should examine whether full implementation of a minimum wage increase is associated with changes in these outcomes.
Collapse
Affiliation(s)
| | - Seth A. Berkowitz
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alice Ammerman
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Molly De Marco
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shu Wen Ng
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Catherine Zimmer
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | |
Collapse
|
49
|
Conroy D, Young J, Errmann A. Participant Insights From a Family-based Meal Kit Delivery Intervention. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:162-172. [PMID: 38244012 DOI: 10.1016/j.jneb.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 11/07/2023] [Accepted: 12/01/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVE To explore the lived experiences of prediabetic participants in an in-home, family-based meal kit delivery intervention for 12 weeks. Delivered foods followed a plant-dominant pattern, including small meat portions, to encourage long-term adoption of this pattern. METHODS Qualitative in-depth individual interviews (n = 21) were undertaken online with 7 pilot participants, at 3-time points (preintervention, during intervention, and postintervention). Three online focus groups were also undertaken postintervention with 12 participants. RESULTS Postintervention, most participants reported positive changes in eating patterns and mindset changes enabling future healthier eating. The deliveries inspired enthusiasm for tastier cooking and family involvement. Although participants indicated they felt well-being improvements, they often became focused on the outcome of their physical test results (eg, weight), leading to some disappointment and feelings of failure. CONCLUSIONS AND IMPLICATIONS Participant engagement with the intervention was high, but other underlying emotions, outside diet behavior, can affect long-term adoption outcomes. This has implications for designing future interventions.
Collapse
Affiliation(s)
- Denise Conroy
- New Zealand Institute for Plant and Food Research Ltd, Auckland, New Zealand
| | - Jennifer Young
- New Zealand Institute for Plant and Food Research Ltd, Auckland, New Zealand.
| | - Amy Errmann
- Department of Marketing, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
50
|
Lawton RI, Stanford FC. The Role of Racism in Childhood Obesity. Curr Obes Rep 2024; 13:98-106. [PMID: 38172479 PMCID: PMC10939728 DOI: 10.1007/s13679-023-00538-9] [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] [Accepted: 11/01/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW Obesity rates continue to rise among children and have shown persistent racial disparities. Racism plays a potentially essential and actionable role in these disparities. This report reviews some mechanisms through which racism may shape childhood obesity. RECENT FINDINGS From the youngest ages, disparities in childhood obesity prevalence are already present. Racism may shape intergenerational and prenatal factors that affect obesity and various stressors and environments where children grow up. The relationships between clinicians and patients may also be shaped by everyday racism and legacies of past racism, which may affect obesity prevalence and treatment efficacy. Comprehensive data on the extent to which racism shapes childhood obesity is limited. However, compelling evidence suggests many ways through which racism ultimately does affect childhood obesity. Interventions to address racism at multiple points where it shapes childhood obesity, including intergenerational and prenatal mechanisms, may help to close disparities.
Collapse
Affiliation(s)
| | - Fatima Cody Stanford
- Harvard Medical School, Boston, MA, USA.
- MGH Weight Center, Department of Medicine-Division of Endocrinology-Neuroendocrine, Massachusetts General Hospital, Weight Center, 50 Staniford Street, 4th Floor, Boston, MA, 02114, USA.
- Department of Pediatrics-Division of Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Weight Center, 50 Staniford Street, 4th Floor, Boston, MA, USA.
| |
Collapse
|