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Wiss DA, LaFata EM. Ultra-Processed Foods and Mental Health: Where Do Eating Disorders Fit into the Puzzle? Nutrients 2024; 16:1955. [PMID: 38931309 PMCID: PMC11206753 DOI: 10.3390/nu16121955] [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: 04/25/2024] [Revised: 06/01/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
Ultra-processed foods (UPFs) like pastries, packaged snacks, fast foods, and sweetened beverages have become dominant in the modern food supply and are strongly associated with numerous public health concerns. While the physical health consequences of UPF intake have been well documented (e.g., increased risks of cardiometabolic conditions), less empirical discussion has emphasized the mental health consequences of chronic UPF consumption. Notably, the unique characteristics of UPFs (e.g., artificially high levels of reinforcing ingredients) influence biological processes (e.g., dopamine signaling) in a manner that may contribute to poorer psychological functioning for some individuals. Importantly, gold-standard behavioral lifestyle interventions and treatments specifically for disordered eating do not acknowledge the direct role that UPFs may play in sensitizing reward-related neural functioning, disrupting metabolic responses, and motivating subsequent UPF cravings and intake. The lack of consideration for the influences of UPFs on mental health is particularly problematic given the growing scientific support for the addictive properties of these foods and the utility of ultra-processed food addiction (UPFA) as a novel clinical phenotype endorsed by 14-20% of individuals across international samples. The overarching aim of the present review is to summarize the science of how UPFs may affect mental health, emphasizing contributing biological mechanisms. Specifically, the authors will (1) describe how corporate-sponsored research and financial agendas have contributed to contention and debate about the role of UPFs in health; (2) define UPFs and their nutritional characteristics; (3) review observed associations between UPF intake and mental health conditions, especially with depression; (4) outline the evidence for UPFA; and (5) describe nuanced treatment considerations for comorbid UPFA and eating disorders.
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Affiliation(s)
- David A. Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA 90095, USA
- Nutrition in Recovery LLC, 1902 Westwood Blvd. #201, Los Angeles, CA 90025, USA
| | - Erica M. LaFata
- Center for Weight Eating and Lifestyle Science, Drexel University, 3201 Chestnut Street, Philadelphia, PA 19104, USA;
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2
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Coro DG, Schirmer K, van Rhoda M, McQueen B, Morris C. An environmental scan of food and drink advertising on public transport around Adelaide schools. Health Promot J Austr 2024. [PMID: 38840470 DOI: 10.1002/hpja.886] [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: 08/16/2023] [Revised: 05/08/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024] Open
Abstract
ISSUE ADDRESSED Children and adolescents are particularly receptive to cues from food and drink advertising. Several policies recommend restricting unhealthy or discretionary ('junk') food advertising on government infrastructure such as public transport. Prior research in New South Wales (NSW) and Western Australia (WA) reveals a high proportion of discretionary food advertising outdoors and on public transport. The aim of this study was to identify the landscape of food and drink advertising on public transport assets around Adelaide schools. METHODS An environmental scan of food and drink advertising on public transport assets within 500 m of 65 Adelaide schools was conducted. The Council of Australian Governments Health Council's interim guide was used to categorise advertisements as 'suitable' or 'unsuitable' for promotion. RESULTS Almost four in every five food and drink advertisements on public-transport assets observed around Adelaide schools included discretionary food or drink, and therefore were categorised as unsuitable for promotion. Advertisements on bus exteriors were more likely to promote discretionary foods, compared with bus shelters. CONCLUSIONS This proportion of 'unhealthy' food advertising was comparable to previous research conducted in WA and NSW. SO WHAT?: In light of historic state/territory actions such as the ACT preventing discretionary food advertising on public transport, these findings should prompt a review and discussion of the suitability of food and drink promotion on government-owned South Australian transport and their associated assets.
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Affiliation(s)
- Daniel G Coro
- Behavioural Research Evaluation Unit, Cancer Council South Australia, Eastwood, South Australia, Australia
| | - Kristy Schirmer
- Prevention and Advocacy Unit, Cancer Council South Australia, Eastwood, South Australia, Australia
| | - Mollie van Rhoda
- Prevention and Advocacy Unit, Cancer Council South Australia, Eastwood, South Australia, Australia
| | - Bronte McQueen
- Prevention and Advocacy Unit, Cancer Council South Australia, Eastwood, South Australia, Australia
| | - Christine Morris
- Prevention and Advocacy Unit, Cancer Council South Australia, Eastwood, South Australia, Australia
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Akl C, El-Helou N, Safadi G, Semaan A, El Sammak A, Trabelsi T, Sassi S, Akik C, El Ati J, Traissac P, Ghattas H. Urban school neighbourhoods dominated by unhealthy food retailers and advertisements in Greater Tunis: a geospatial study in the midst of the nutrition transition. Public Health Nutr 2024; 27:e44. [PMID: 38169454 PMCID: PMC10882541 DOI: 10.1017/s1368980023002860] [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: 01/05/2024]
Abstract
OBJECTIVE Food environments are a major determinant of children's nutritional status. Scarce evidence on food environments exists in low- and middle-income countries (LMIC). This study aims to fill this gap by documenting the obesogenicity of food environments around schools in Greater Tunis, Tunisia - an LMIC of the Middle East and North Africa region with an ongoing nutrition transition and increasing rates of childhood obesity. DESIGN In this cross-sectional study, we assessed built food environments around fifty primary schools. Ground-truthing was performed to collect geographic coordinates and pictures of food retailers and food advertisement sets within an 800-m road network buffer of each school. Retailers and advertisement sets were categorised as healthy or unhealthy according to a NOVA-based classification. Associations between school characteristics and retailers or advertisement sets were explored using multinomial regression models. SETTING Greater Tunis, Tunisia. PARTICIPANTS Random sample of fifty (thirty-five public and fifteen private) primary schools. RESULTS Overall, 3621 food retailers and 2098 advertisement sets were mapped. About two-thirds of retailers and advertisement sets were labelled as unhealthy. Most retailers were traditional corner stores (22 %) and only 6 % were fruit and vegetable markets. The prevailing food group promoted was carbonated and sugar-sweetened beverages (22 %). The proportion of unhealthy retailers was significantly higher in the richest v. poorest areas. CONCLUSIONS School neighbourhood food environments included predominantly unhealthy retailers and advertisements. Mapping of LMIC food environments is crucial to document the impact of the nutrition transition on children's nutritional status. This will inform policies and interventions to curb the emergent childhood obesity epidemic.
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Affiliation(s)
- Christelle Akl
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Nehmat El-Helou
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Gloria Safadi
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Aline Semaan
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Aya El Sammak
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Tarek Trabelsi
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, Tunis1007, Tunisia
| | - Sonia Sassi
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, Tunis1007, Tunisia
| | - Chaza Akik
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Jalila El Ati
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, Tunis1007, Tunisia
| | - Pierre Traissac
- MoISA - University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Hala Ghattas
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC29208, USA
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Verma M, Esht V, Alshehri MM, Aljahni M, Chauhan K, Morsy WE, Kapoor N, Kalra S. Factors Contributing to the Change in Overweight/Obesity Prevalence Among Indian Adults: A multivariate decomposition analysis of data from the National Family Health Surveys. Adv Ther 2023; 40:5222-5242. [PMID: 37755602 PMCID: PMC10611613 DOI: 10.1007/s12325-023-02670-3] [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: 07/18/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION Concerns over the escalating burden of non-communicable diseases call for the redressal of behavioral risk factors like increased body mass index. Most studies have failed to quantify the contribution of socio-demographic characteristics in a linear trend. The present study aims to estimate the current prevalence of overweight and obesity in Indian adults and the contribution of different socio-demographic factors to the increasing prevalence. METHODS We carried out a secondary data analysis of two National Family Health Survey (NFHS) rounds. The final sample includes 558,122 women and 84,477 men from round 4, and 574,099 women and 74,761 men were included from round 5, using a multi-stage stratified random sampling approach. Overweight/obesity was our primary dependent variable. Weighted bivariate analysis was used to ascertain the prevalence, and the adjusted odds ratios were computed to ascertain the potential predictors. The contribution of different factors towards rising burden over two time points was estimated using multivariate decomposition analysis for non-linear response models. RESULTS Overall weighted prevalence of overweight and obesity in males and females per NFHS-5 was 44.02% and 41.16%, respectively, compared to 37.71% and 36.14% in NFHS-4. Decomposition analyses depict that the proportion of obesity increased by 6.37% and 5.10% points among men and women, respectively, over the two rounds. Compositional differences of participants (endowment) attributed to 16.54 and 49.90% differences, and the difference in coefficient or effect accounted for 83.46 and 50.10%, respectively, of the increase in the prevalence. The most significant factors contributing to increased prevalence were age, improving socio-economic status, smoking, unclean cooking fuel, and diabetes. CONCLUSIONS The incremental rise in such a short period, mainly attributed to the effect of socio-demographic variables, is concerning. Policy interventions should prioritize health advocacy programs and aggressively target behavioral modifications while preparing the health systems to manage the people living with obesity.
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Affiliation(s)
- Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, India
| | - Vandana Esht
- Physical Therapy Department, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Mohammed M Alshehri
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Mohammed Aljahni
- Department of Physical Education, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Kirti Chauhan
- Department of Biostatistics and Demography, International Institute for Population Sciences, Mumbai, India
| | - Walaa E Morsy
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan, Kingdom of Saudi Arabia
- Department of Pediatrics, Faculty of Physical Therapy, Cairo University, Cario, Egypt
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
- Non-Communicable Disease Unit, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India.
- University Centre for Research and Development, Chandigarh University, Mohali, India.
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Vandevijvere S, De Pauw R, Djojosoeparto S, Gorasso V, Guariguata L, Løvhaug AL, Mialon M, Van Dam I, von Philipsborn P. Upstream Determinants of Overweight and Obesity in Europe. Curr Obes Rep 2023; 12:417-428. [PMID: 37594616 DOI: 10.1007/s13679-023-00524-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE OF REVIEW To review the upstream determinants of overweight and obesity in Europe, including food and built environments, and political, commercial, and socioeconomic determinants. RECENT FINDINGS Overweight and obesity affect 60% of European adults, and one in three children, and are more common in individuals with low compared to high socioeconomic position (SEP). Individuals in low SEP groups are more exposed to unhealthy built and food environments, including higher exposure to unhealthy food marketing. Industries influencing the food system have much economic power, resulting in ignoring or silencing the role of ultra-processed foods and commercial practices in weight gain. Overall, effective policies to address overweight and obesity have been insufficiently implemented by governments. To accelerate implementation, strengthened political commitment is essential. Policies must also focus on the upstream, structural, and systemic drivers of overweight and obesity; be comprehensive; and target socioeconomic inequalities in diets and physical activity.
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Affiliation(s)
- Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium.
| | - Robby De Pauw
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Sanne Djojosoeparto
- Consumption and Healthy Lifestyles Chair Group, Wageningen University and Research, Wageningen, The Netherlands
| | - Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Leonor Guariguata
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Anne Lene Løvhaug
- Department of Nursing and Health Promotion, OsloMet-Oslo Metropolitan University, Oslo, Norway
| | | | - Iris Van Dam
- Department of Epidemiology and Public Health, Sciensano, J. Wytsmanstraat 14, 1050, Brussels, Belgium
| | - Peter von Philipsborn
- Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, Munich, Germany
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Abstract
Semaglutide (▼Ozempic solution for injection, ▼Rybelsus tablets-Novo Nordisk) was initially granted market authorisation for the treatment of type 2 diabetes as an adjunct to diet and exercise. In 2021 and 2022, regulatory agencies in the USA and Europe licensed semaglutide (▼Wegovy solution for injection-Novo Nordisk) for the treatment of individuals who are obese, or overweight and who have at least one weight-related comorbidity. Manufacturer-sponsored randomised controlled trials have shown a loss of almost 12% of body weight over a 68-week period, however, once the medication is stopped people regain most of their pretreatment weight. Gastrointestinal adverse events occur commonly with semaglutide, and pancreatitis, diabetic retinopathy and severe allergic reactions have also been reported. Extensive hype in social and general media has resulted in increased demand for semaglutide leading to supply problems across the various licensed products including those used for treatment of diabetes. In the UK, the National Institute for Health and Care Excellence has recommended semaglutide as an option for weight management for a maximum treatment duration of 2 years. Further studies are underway to assess the effect of semaglutide on longer-term health benefits.
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Affiliation(s)
- Joel Lexchin
- School of Health Policy and Management, York University - Keele Campus, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Barbara Mintzes
- School of Pharmacy and Charles Perkins Centre, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- The University of British Columbia School of Population and Public Health, Vancouver, British Columbia, Canada
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Gearhardt AN, Bueno NB, DiFeliceantonio AG, Roberto CA, Jiménez-Murcia S, Fernandez-Aranda F. Social, clinical, and policy implications of ultra-processed food addiction. BMJ 2023; 383:e075354. [PMID: 37813420 PMCID: PMC10561019 DOI: 10.1136/bmj-2023-075354] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Affiliation(s)
- Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nassib B Bueno
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil
| | - Alexandra G DiFeliceantonio
- Fralin Biomedical Research Institute at VTC, Department of Human, Nutrition Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Susana Jiménez-Murcia
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, Barcelona, Spain
| | - Fernando Fernandez-Aranda
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, Barcelona, Spain
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Ruggles PR, Thomas JE, Poulos NS, Pasch KE. School-Level Socioeconomic Status and Nutrient Content of Outdoor Food/Beverage Advertisements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6730. [PMID: 37754591 PMCID: PMC10530988 DOI: 10.3390/ijerph20186730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/01/2023] [Accepted: 09/03/2023] [Indexed: 09/28/2023]
Abstract
We examined if areas around schools with more students of lower socioeconomic status (SES) have more total food/beverage advertisements and/or more advertisements with poorer nutritional content as compared to areas around schools with fewer students with lower SES. All outdoor food/beverage advertisements within a half-mile radius of 47 middle and high schools in the United States were objectively documented in 2012 and coded for nutritional content. The total number of advertisements and the macronutrient and micronutrient contents (total calories, fat (g), protein (g), carbohydrate (g), sugar (g), and sodium (mg)) of food and beverage items depicted in the advertisements were calculated. In total, 9132 unique advertisements were recorded, with 3153 ads displaying food and beverages that could be coded for nutrient content. Schools located in areas of lower SES (≥60% students receiving free/reduced-price lunch) had significantly more advertisements displaying food and beverages that could be coded for nutrient content (z = 2.01, p = 0.04), as well as advertisements that contained more sodium (z = 2.20, p = 0.03), as compared to schools located in areas of higher SES. There were no differences in calorie, fat, protein, carbohydrate, or sugar content. Policies to reduce the prevalence of outdoor food and beverage advertising are warranted.
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Affiliation(s)
- Phoebe R. Ruggles
- Department of Kinesiology & Health Education, University of Texas at Austin, Austin, TX 78712, USA
| | - Jacob E. Thomas
- Department of Kinesiology & Health Education, University of Texas at Austin, Austin, TX 78712, USA
| | - Natalie S. Poulos
- School of Community and Rural Health, Heath Science Center, The University of Texas at Tyler, Tyler, TX 78708, USA
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Keryn E. Pasch
- Department of Kinesiology & Health Education, University of Texas at Austin, Austin, TX 78712, USA
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Scott LJ, Nobles J, Sillero-Rejon C, Brockman R, Toumpakari Z, Jago R, Cummins S, Blake S, Horwood J, de Vocht F. Advertisement of unhealthy commodities in Bristol and South Gloucestershire and rationale for a new advertisement policy. BMC Public Health 2023; 23:1078. [PMID: 37277744 DOI: 10.1186/s12889-023-15995-z] [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: 02/10/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Bristol City Council introduced a new advertisement policy in 2021/2022 which included prohibiting the advertising of unhealthy food and drink (HFSS), alcohol, gambling and payday loans across council-owned advertising spaces. This mixed methods study is part of the BEAR study, and aimed to explore the rationale and the barriers and facilitators to implementing the policy, and describe the perceived advertising environment prior to implementation. METHODS Semi-structured interviews were carried out with seven stakeholders involved in the design and implementation of the advertising policy. A stakeholder topic guide was developed before interviews took place to help standardise the lines of inquiry between interviewees. A resident survey was developed to collect socio-demographic data and, for the purpose of this study, information regarding observations of advertising for HFSS products, alcohol and gambling. RESULTS Fifty-eight percent of respondents residing in Bristol and South Gloucestershire reported seeing advertisements for unhealthy commodities in the week prior to completing the survey. This was highest for HFSS products (40%). 16% of residents reported seeing HFSS product advertisements specifically appealing to children. For HFSS products in particular, younger people were more likely to report seeing adverts than older people, as were those who were from more deprived areas. An advertisement policy that restricts the advertisement of such unhealthy commodities, and in particular for HFSS products, has the potential to reduce health inequalities. This rationale directly influenced the development of the advertisement policy in Bristol. Implementation of the policy benefitted from an existing supportive environment following the 'health in all policies' initiative and a focus on reducing health inequalities across the city. CONCLUSIONS Unhealthy product advertisements, particularly for unhealthy food and drinks, were observed more by younger people and those living in more deprived areas. Policies that specifically restrict such advertisements, therefore, have the potential to reduce health inequalities, as was the hope when this policy was developed. Future evaluation of the policy will provide evidence of any public health impact.
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Affiliation(s)
- Lauren J Scott
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - James Nobles
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - Carlos Sillero-Rejon
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rowan Brockman
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Zoi Toumpakari
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Russell Jago
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Steven Cummins
- Department of Public Health, Environments & Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Sarah Blake
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK
| | - Jeremy Horwood
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Frank de Vocht
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
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Dhammawati F, Fagerberg P, Diou C, Mavrouli I, Koukoula E, Lekka E, Stefanopoulos L, Maglaveras N, Heimeier R, Karavidopoulou Y, Ioakimidis I. Ultra-Processed Food vs. Fruit and Vegetable Consumption before and during the COVID-19 Pandemic among Greek and Swedish Students. Nutrients 2023; 15:nu15102321. [PMID: 37242204 DOI: 10.3390/nu15102321] [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: 03/17/2023] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has impacted children's lifestyles, including dietary behaviors. Of particular concern among these behaviors is the heightened prevalence of ultra-processed food (UPF) consumption, which has been linked to the development of obesity and related non-communicable diseases. The present study examines the changes in (1) UPF and (2) vegetable and/or fruit consumption among school-aged children in Greece and Sweden before and during the COVID-19 pandemic. METHODS The analyzed dataset consisted of main meal pictures (breakfast, lunch, and dinner) captured by 226 Greek students (94 before the pandemic and 132 during the pandemic) and 421 Swedish students (293 before and 128 during the pandemic), aged 9-18, who voluntarily reported their meals using a mobile application. The meal pictures were collected over four-month periods over two consecutive years; namely, between the 20th of August and the 20th of December in 2019 (before the COVID-19 outbreak) and the same period in 2020 (during the COVID-19 outbreak). The collected pictures were annotated manually by a trained nutritionist. A chi-square test was performed to evaluate the differences in proportions before versus during the pandemic. RESULTS In total, 10,770 pictures were collected, including 6474 pictures from before the pandemic and 4296 pictures collected during the pandemic. Out of those, 86 pictures were excluded due to poor image quality, and 10,684 pictures were included in the final analyses (4267 pictures from Greece and 6417 pictures from Sweden). The proportion of UPF significantly decreased during vs. before the pandemic in both populations (50% vs. 46%, p = 0.010 in Greece, and 71% vs. 66%, p < 0.001 in Sweden), while the proportion of vegetables and/or fruits significantly increased in both cases (28% vs. 35%, p < 0.001 in Greece, and 38% vs. 42%, p = 0.019 in Sweden). There was a proportional increase in meal pictures containing UPF among boys in both countries. In Greece, both genders showed an increase in vegetables and/or fruits, whereas, in Sweden, the increase in fruit and/or vegetable consumption was solely observed among boys. CONCLUSIONS The proportion of UPF in the Greek and Swedish students' main meals decreased during the COVID-19 pandemic vs. before the pandemic, while the proportion of main meals with vegetables and/or fruits increased.
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Affiliation(s)
- Friska Dhammawati
- Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan (the IMPACT) Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Stockholm, Sweden
| | - Petter Fagerberg
- Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan (the IMPACT) Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Stockholm, Sweden
| | - Christos Diou
- Department of Informatics and Telematics, Harokopio University of Athens, 177 78 Athens, Greece
| | - Ioanna Mavrouli
- Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan (the IMPACT) Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Stockholm, Sweden
| | | | - Eirini Lekka
- 2nd Obstetrics and Gynaecology Dept, Center of Woman Digital Health, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Leandros Stefanopoulos
- 2nd Obstetrics and Gynaecology Dept, Center of Woman Digital Health, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Image and Video Processing Laboratory, Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Nicos Maglaveras
- 2nd Obstetrics and Gynaecology Dept, Center of Woman Digital Health, Medical School, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | | | - Youla Karavidopoulou
- Laboratory of Medical Informatics, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Ioannis Ioakimidis
- Innovative Use of Mobile Phones to Promote Physical Activity and Nutrition Across the Lifespan (the IMPACT) Research Group, Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Stockholm, Sweden
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11
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Mjöberg M, Lissner L, Hunsberger M. Supermarket promotions in Western Sweden are incompatible with Nordic dietary recommendations and differ by area-level socioeconomic index. BMC Public Health 2023; 23:795. [PMID: 37118718 PMCID: PMC10148457 DOI: 10.1186/s12889-023-15729-1] [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: 02/20/2023] [Accepted: 04/22/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Large supermarket chains produce weekly advertisements to promote foods and influence consumer purchases. The broad consumer reach of these ads presents an opportunity to promote foods that align with dietary recommendations. Thus, the aim of this study was to investigate the health quality of supermarkets' weekly food promotions in a large region of Sweden with attention to more and less advantaged socioeconomic index areas. METHODS Analysis of weekly advertisements from 122 individual stores, representing seven chains, was carried out in a large region of Sweden from 2-29 March in 2020. Food promotions were divided into categories according to the Nordic Nutrition Recommendations and World Health Organization Regional Office for Europe's nutrient profile model, and defined as 'most healthy', 'healthy', 'unhealthy' and 'most unhealthy'. A mean socioeconomic index was used to classify each store location to determine whether proportions of the 'most unhealthy' foods differed between more advantaged and more disadvantaged socioeconomic index areas. RESULTS In total, 29,958 food items were analyzed. Two-thirds of promotions belonged to the food groups considered 'most unhealthy' and 'unhealthy'. In the 'most unhealthy' food group 'sugar-rich beverages and foods' constituted approximately 23.0% of the promotions. Food promotions had 25% increased odds to be from the 'most unhealthy' group (odds ratio 1.25, confidence interval 1.17, 1.33) in more disadvantaged socioeconomic index areas. This association could be explained by the supermarket chain the stores belonged to. CONCLUSIONS Our findings indicate that Swedish supermarkets promote a large proportion of unhealthy foods as classified by the Nordic Nutrition Recommendations. We also observe that certain national supermarket chains tend to locate their stores in more disadvantaged areas and promote a greater proportion of unhealthy foods in their weekly advertisements compared to the more advantaged areas. There is an urgent need for supermarkets to shift promotions toward healthier food items.
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Affiliation(s)
- Melissa Mjöberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Monica Hunsberger
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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12
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Logan AC, D'Adamo CR, Prescott SL. The Founder: Dispositional Greed, Showbiz, and the Commercial Determinants of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095616. [PMID: 37174136 PMCID: PMC10178243 DOI: 10.3390/ijerph20095616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/04/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
Marketing unhealthy products by multinational corporations has caused considerable harm to individual health, collective wellbeing, and environmental sustainability. This is a growing threat to all societies and a significant contributor to the rising global burden of non-communicable diseases and early mortality. While there is growing consideration of the commercial determinants of health, this is largely focused on the methods by which unhealthy products are marketed and disseminated, including efforts to manipulate policy. Little attention has been paid to the underlying psychological traits and worldviews that are driving corporate greed. Here, we consider the role of "dispositional greed" in the commercial determinants of health with a focus on the historical attitudes and culture in the ultra-processed food industry-exemplified by "The Founder" of the McDonald's franchise. We argue that greed and associated psychological constructs, such as social dominance orientation and collective narcissism, permeate the commercial determinants of health at a collective level. This includes how a culture of greed within organizations, and individual dispositional greed, can magnify and cluster at scale, perpetuated by social dominance orientation. We also consider the ways in which "showbiz" marketing specifically targets marginalized populations and vulnerable groups, including children-in ways that are justified, or even celebrated despite clear links to non-communicable diseases and increased mortality. Finally, we consider how greed and exploitative mindsets mirror cultural values and priorities, with trends for increasing collective narcissism at scale, recognizing that many of these attitudes are cultivated in early life. A healthier future will depend on navigating a path that balances material prosperity with physical and spiritual wellbeing. This will require cultural change that places higher value on kindness, reciprocity, and mutualistic values especially in early life, for more equitable flourishing.
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Affiliation(s)
- Alan C Logan
- Nova Institute for Health, Baltimore, MD 21231, USA
| | - Christopher R D'Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Susan L Prescott
- Nova Institute for Health, Baltimore, MD 21231, USA
- Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Medical School, University of Western Australia, Nedlands, WA 6009, Australia
- The ORIGINS Project, Telethon Kids Institute, Nedlands, WA 6009, Australia
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13
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Frías JRG, Cadena LH, Villarreal AB, Piña BGB, Mejía MC, Cerros LAD, Gil GB, Montes JOA. Effect of ultra-processed food intake on metabolic syndrome components and body fat in children and adolescents: A systematic review based on cohort studies. Nutrition 2023; 111:112038. [PMID: 37167924 DOI: 10.1016/j.nut.2023.112038] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/25/2023] [Accepted: 03/13/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES The aim of this study was to thoroughly review the scientific literature related to cohort studies that evaluated the association between the intake of ultra-processed foods, according to the NOVA classification, and the increase in the components of metabolic syndrome and body fat in children and adolescents. METHODS We consulted the PubMed, Scielo, Lilacs, and ScienceDirect databases and selected cohort studies that met the main objective of this review and included the age group of interest. We used an adaptation of the Newcastle-Ottawa scale to evaluate cohort studies. RESULTS Of 383 articles identified, 367 were excluded after reading the title, abstract, and methodology. Only nine met the selection criteria defined for this review. Of the nine articles, two reported a positive association between high consumption of ultra-processed foods and total cholesterol levels; one reported a positive association with low-density lipoprotein cholesterol, one with triacylglycerols, one with diastolic blood pressure, three with body mass index, two with waist circumference, and two with body fat. CONCLUSIONS Seven of nine studies found at least one association with components of metabolic syndrome. This highlights the importance of early intervention to prevent non-communicable diseases in the future.
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Affiliation(s)
- Jesús Ricardo Gómez Frías
- Facultad de Enfermería y Nutriología, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, Chihuahua, México
| | - Leticia Hernández Cadena
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Albino Barraza Villarreal
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Blanca Gladiana Beltrán Piña
- Facultad de Enfermería y Nutriología, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, Chihuahua, México
| | - Mariana Cardona Mejía
- Facultad de Enfermería y Nutriología, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, Chihuahua, México
| | - Luis Alberto Delgado Cerros
- Facultad de Enfermería y Nutriología, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, Chihuahua, México
| | - Giovanni Barraza Gil
- Facultad de Enfermería y Nutriología, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, Chihuahua, México
| | - Jorge Octavio Acosta Montes
- Facultad de Enfermería y Nutriología, Universidad Autónoma de Chihuahua, Circuito Universitario Campus II, Chihuahua, México.
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14
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Hall PA, Best JR, Beaton EA, Sakib MN, Danckert J. Morphology of the prefrontal cortex predicts body composition in early adolescence: cognitive mediators and environmental moderators in the ABCD Study. Soc Cogn Affect Neurosci 2023; 18:nsab104. [PMID: 34471927 PMCID: PMC11305164 DOI: 10.1093/scan/nsab104] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/26/2021] [Accepted: 09/01/2021] [Indexed: 11/14/2022] Open
Abstract
Morphological features of the lateral prefrontal cortex (PFC) in late childhood and early adolescence may provide important clues as to the developmental etiology of clinical conditions such as obesity. Body composition measurements and structural brain imaging were performed on 11 226 youth at baseline (age 9 or 10 years) and follow-up (age 11 or 12 years). Baseline morphological features of the lateral PFC were examined as predictors of body composition. Findings revealed reliable associations between middle frontal gyrus volume, thickness and surface area and multiple indices of body composition. These findings were consistent across both time points and remained significant after covariate adjustment. Cortical thicknesses of the inferior frontal gyrus and lateral orbitofrontal cortex were also reliable predictors. Morphology effects on body composition were mediated by performance on a non-verbal reasoning task. Modest but reliable moderation effects were observed with respect to environmental self-regulatory demand after controlling for sex, race/ethnicity, income and methodological variables. Overall findings suggest that PFC morphology is a reliable predictor of body composition in early adolescence, as mediated through select cognitive functions and partially moderated by environmental characteristics.
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Affiliation(s)
- Peter A Hall
- School of Public Health Sciences, University of
Waterloo, Waterloo, ON N2L 3G1, Canada
| | - John R Best
- Gerontology Research Centre, Simon Fraser
University, Burnaby, BC V6B 5K3, Canada
| | - Elliott A Beaton
- Department of Psychology, University of New
Orleans, New Orleans, LA 70148, USA
| | - Mohammad N Sakib
- School of Public Health Sciences, University of
Waterloo, Waterloo, ON N2L 3G1, Canada
| | - James Danckert
- Department of Psychology, University of
Waterloo, Waterloo, ON N2L 3G1, Canada
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15
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Haynes A, Bayly M, Dixon H, McAleese A, Martin J, Chen YJM, Wakefield M. Obesity prevention and related public health advertising versus competing commercial advertising expenditure in Australia. Health Promot Int 2022; 37:6827736. [DOI: 10.1093/heapro/daac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Summary
Mass media campaigns can change attitudes and behaviours to improve population health. However, a key challenge is achieving share of voice in a complex and cluttered media environment. The aim of this study was to compare advertising expenditure on public health campaigns for obesity prevention (and related healthy eating and physical activity campaigns) with competing commercial categories of (a) sugary drinks, (b) artificially sweetened drinks and (c) diet/weight loss products and programmes. These commercial products may either undermine or dilute public health messages by directly contributing to poor health or confusing the public about the best ways to sustain a healthy lifestyle. Monthly estimates of advertising expenditure in Australian media (television, outdoor, cinema, radio, newspapers, magazines and digital) were obtained from Nielsen Media for 2016–18. Eligible public health advertising expenditure for the entire period (total AUD$27M) was vastly outweighed by the commercial categories of sugary drinks (AUD$129M) and diet/weight loss products and services (AUD$122M). Artificially sweetened drinks accounted for an additional AUD$23M of expenditure. These results highlight the need to rebalance the ratio of advertising to support public health in Australia through increased funding for obesity prevention and related campaigns, and critically, through government regulation to limit competing commercial advertising.
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Affiliation(s)
- Ashleigh Haynes
- Centre for Behavioural Research in Cancer, Cancer Council Victoria , 615 St Kilda Rd, Melbourne, VIC 3004 , Australia
- Melbourne School of Psychological Sciences, The University of Melbourne , Parkville, VIC , Australia
| | - Megan Bayly
- Centre for Behavioural Research in Cancer, Cancer Council Victoria , 615 St Kilda Rd, Melbourne, VIC 3004 , Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria , 615 St Kilda Rd, Melbourne, VIC 3004 , Australia
- Melbourne School of Psychological Sciences, The University of Melbourne , Parkville, VIC , Australia
| | - Alison McAleese
- Prevention Division, Cancer Council Victoria , Melbourne, VIC , Australia
| | - Jane Martin
- Obesity Policy Coalition, Cancer Council Victoria , Melbourne, VIC , Australia
| | - Yan Jun Michelle Chen
- Centre for Behavioural Research in Cancer, Cancer Council Victoria , 615 St Kilda Rd, Melbourne, VIC 3004 , Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria , 615 St Kilda Rd, Melbourne, VIC 3004 , Australia
- Melbourne School of Psychological Sciences, The University of Melbourne , Parkville, VIC , Australia
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16
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Santos BMC, Praxedes DRS, Silva-Junior AE, Macena MDL, Florêncio TMDMT, Bueno NB. Underreporting of energy intake is not associated with the reported consumption of NOVA-classified food groups in socially vulnerable women. NUTR BULL 2022; 47:461-472. [PMID: 36350182 DOI: 10.1111/nbu.12587] [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: 05/09/2022] [Revised: 09/10/2022] [Accepted: 10/05/2022] [Indexed: 11/11/2022]
Abstract
Few studies have investigated which types of food are least reported among underreporters of energy intake (EI). This study assessed the association between the underreporting of EI and the consumption report of food groups according to NOVA classification in women in social vulnerability. EI was measured through three 24-h dietary recalls administered by the research team. Total energy expenditure (TEE) was evaluated using the doubly labelled water method. The percentage of EI arising from each NOVA group food classification (unprocessed/minimally processed foods, culinary ingredients, processed foods and ultra-processed foods [UPF]) was calculated. The agreement between the EI and the TEE was assessed using the ratio EI:TEE. Associations were assessed with Pearson's correlation and multivariable linear regression, adjusted for age, education and body fat. The sample (63 women, age: 30.8 years, Body Mass Index: 27.6 kg/m2 ) reported an EI of 1849 kcal and a TEE of 2223 kcal, with a mean EI:TEE of 0.85. There were no significant correlations between the EI:TEE and the reported food intake according to NOVA classifications. Multivariable linear regression also did not show any significant associations (UPF: 8.47, 95% CI: [-3.65; 20.60] %kcal; Processed: -6.85, [-19.21; 7.71] %kcal; Culinary ingredients: 1.30 [-5.10; 7.71] %kcal; Unprocessed/minimally processed: -2.92 [-10.98; 5.13] %kcal). In conclusion, socially vulnerable women that underreport their EI do not report a lower intake of any specific group of foods according to NOVA classification.
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Affiliation(s)
| | - Dafiny R S Praxedes
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | - André Eduardo Silva-Junior
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mateus de Lima Macena
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | - Telma Maria de Menezes Toledo Florêncio
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil.,Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
| | - Nassib Bezerra Bueno
- Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brazil.,Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, Brazil
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17
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Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an update on the available data regarding the associations of Ultra-processed food (UPF) consumption with food intake and possible underlying mechanisms relating UPF consumption to weight gain and co-morbidities. RECENT FINDINGS In primarily observational studies, UPF consumption is consistently associated with an increased risk for weight gain among adults and children and increased risk for adiposity-related co-morbidities in adults. In a single mechanistic study, consumption of UPFs led to increased energy intake and weight gain relative to whole foods. UPFs tend to be more energy-dense than nutrient-dense, and UPF consumption is associated with increased adiposity and co-morbidity risk. These data suggest that recommendations to limit UPF consumption may be beneficial to health - though further mechanistic studies are needed.
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Affiliation(s)
- Anthony Crimarco
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Matthew J Landry
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Christopher D Gardner
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA.
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18
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Finlay A, Robinson E, Jones A, Maden M, Cerny C, Muc M, Evans R, Makin H, Boyland E. A scoping review of outdoor food marketing: exposure, power and impacts on eating behaviour and health. BMC Public Health 2022; 22:1431. [PMID: 35896996 PMCID: PMC9330687 DOI: 10.1186/s12889-022-13784-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/12/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is convincing evidence that unhealthy food marketing is extensive on television and in digital media, uses powerful persuasive techniques, and impacts dietary choices and consumption, particularly in children. It is less clear whether this is also the case for outdoor food marketing. This review (i) identifies common criteria used to define outdoor food marketing, (ii) summarises research methodologies used, (iii) identifies available evidence on the exposure, power (i.e. persuasive creative strategies within marketing) and impact of outdoor food marketing on behaviour and health and (iv) identifies knowledge gaps and directions for future research. METHODS A systematic search was conducted of Medline (Ovid), Scopus, Science Direct, Proquest, PsycINFO, CINAHL, PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials and a number of grey literature sources. Titles and abstracts were screened by one researcher. Relevant full texts were independently checked by two researchers against eligibility criteria. RESULTS Fifty-three studies were conducted across twenty-one countries. The majority of studies (n = 39) were conducted in high-income countries. All measured the extent of exposure to outdoor food marketing, twelve also assessed power and three measured impact on behavioural or health outcomes. Criteria used to define outdoor food marketing and methodologies adopted were highly variable across studies. Almost a quarter of advertisements across all studies were for food (mean of 22.1%) and the majority of advertised foods were unhealthy (mean of 63%). The evidence on differences in exposure by SES is heterogenous, which makes it difficult to draw conclusions, however the research suggests that ethnic minority groups have a higher likelihood of exposure to food marketing outdoors. The most frequent persuasive creative strategies were premium offers and use of characters. There was limited evidence on the relationship between exposure to outdoor food marketing and eating behaviour or health outcomes. CONCLUSIONS This review highlights the extent of unhealthy outdoor food marketing globally and the powerful methods used within this marketing. There is a need for consistency in defining and measuring outdoor food marketing to enable comparison across time and place. Future research should attempt to measure direct impacts on behaviour and health.
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Affiliation(s)
- Amy Finlay
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK.
| | - Eric Robinson
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Andrew Jones
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, L69 3GB, UK
| | - Caroline Cerny
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
- Obesity Health Alliance, Liverpool, UK
| | - Magdalena Muc
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Rebecca Evans
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Harriet Makin
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
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19
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Chung A, Zorbas C, Riesenberg D, Sartori A, Kennington K, Ananthapavan J, Backholer K. Policies to restrict unhealthy food and beverage advertising in outdoor spaces and on publicly owned assets: A scoping review of the literature. Obes Rev 2022; 23:e13386. [PMID: 34783421 DOI: 10.1111/obr.13386] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 01/25/2023]
Abstract
Unhealthy food marketing influences attitudes, preferences, and consumption of unhealthy foods, leading to excess weight gain. Outdoor advertising is highly visible (often displayed on publicly owned assets), but the evidence supporting regulation is unclear. This systematic scoping review of academic and grey literature aimed to (1) describe potential health and economic impacts of implementing government-led policies that restrict unhealthy food advertising in outdoor spaces or on public assets (including studies examining prevalence of advertising, associations with health outcomes and interventional studies); (2) identify and describe existing policies; and (3) identify factors perceived to have influenced policy implementation. Thirty-six academic studies were eligible for inclusion. Most reported on prevalence of unhealthy food advertising, demonstrating high prevalence around schools and in areas of lower socioeconomic position. None examined health and economic impacts of implemented policies. Four jurisdictions were identified with existing regulations; five had broader marketing or consumer protection policies that captured outdoor food marketing. Facilitators of policy implementation included collaboration, effective partnerships, and strong political leadership. Barriers included lobbying by food, media, and advertising industries. Implementation of food marketing policies in outdoor spaces and on public assets is feasible and warranted. Strong coalitions and leadership will be important to drive the policy agenda forward.
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Affiliation(s)
- Alexandra Chung
- Global Obesity Centre, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Christina Zorbas
- Global Obesity Centre, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Devorah Riesenberg
- Global Obesity Centre, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | | | | | - Jaithri Ananthapavan
- Global Obesity Centre, Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Obesity Centre, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
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20
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Finlay AH, Lloyd S, Lake A, Armstrong T, Fishpool M, Green M, Moore HJ, O’Malley C, Boyland EJ. An analysis of food and beverage advertising on bus shelters in a deprived area of Northern England. Public Health Nutr 2022; 25:1-12. [PMID: 34974851 PMCID: PMC9991712 DOI: 10.1017/s1368980021005048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To quantify the extent of food and beverage advertising on bus shelters in a deprived area of the UK, to identify the healthfulness of advertised products, and any differences by level of deprivation. The study also sought to assess the creative strategies used and extent of appeal to young people. DESIGN Images of bus shelter advertisements were collected via in person photography (in 2019) and Google Street View (photos recorded in 2018). Food and beverage advertisements were grouped into one of seventeen food categories and classified as healthy/less healthy using the UK Nutrient Profile Model. The deprivation level of the advertisement location was identified using the UK Index of Multiple Deprivation. SETTING Middlesbrough and Redcar and Cleveland in South Teesside. PARTICIPANTS N/A. RESULTS Eight hundred and thirty-two advertisements were identified, almost half (48·9 %) of which were for foods or beverages. Of food and non-alcoholic beverage adverts, 35·1 % were less healthy. Most food advertisements (98·9 %) used at least one of the persuasive creative strategies. Food advertisements were found to be of appeal to children under 18 years of age (71·9 %). No differences in healthiness of advertised foods were found by level of deprivation. CONCLUSIONS Food advertising is extensive on bus shelters in parts of the UK, and a substantial proportion of this advertising is classified as less healthy and would not be permitted to be advertised around television programming for children. Bus shelter advertising should be considered part of the UK policy deliberations around restricting less healthy food marketing exposure.
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Affiliation(s)
| | - Scott Lloyd
- Public Health South Tees, Middlesbrough, UK
- School of Health & Life Sciences, Teesside University and Fuse – Centre for Translational Research in Public Health, London, UK
| | - Amelia Lake
- SHLS Allied Health Professions Centre for Public Health, Teesside University, and Fuse – Centre for Translational Research in Public Health, London, UK
| | - Thomas Armstrong
- SHLS Allied Health Professions Centre for Public Health, Teesside University, Middlesbrough, UK
| | | | - Mark Green
- Department of Geography and Planning, University of Liverpool, Liverpool, UK
| | - Helen J Moore
- SHLS Allied Health Professions Centre for Public Health, Teesside University, and Fuse – Centre for Translational Research in Public Health, London, UK
| | - Claire O’Malley
- SHLS Allied Health Professions Centre for Public Health, Teesside University, and Fuse – Centre for Translational Research in Public Health, London, UK
| | - Emma J Boyland
- Department of Psychology, University of Liverpool, LiverpoolL69 7ZA, UK
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21
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Associated factors to the consumption of ultra-processed foods and its relation with dietary sources in Portugal. J Nutr Sci 2021; 10:e89. [PMID: 34733501 PMCID: PMC8532074 DOI: 10.1017/jns.2021.61] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/13/2021] [Accepted: 07/30/2021] [Indexed: 12/15/2022] Open
Abstract
Ultra-processed foods (UPFs) are common worldwide and associated with poorer health outcomes. This work aimed to explore the UPF consumption associated factors and its main dietary sources, by sex, in Portugal. Participants from the National Food, Nutrition and Physical Activity Survey (IAN-AF) 2015-2016, aged 3-84 years, were included (n 5005). Dietary intake was assessed through two 1-day food diaries/24 h recalls. UPFs were identified using the NOVA classification. Associations were evaluated through linear regression models. Median UPF consumption was 257 g/d (10⋅6 % of total quantity; 23⋅8 % of total energy). Adolescents were those with higher consumption (490 g/d). Compared to adults, younger ages were positively associated with UPF consumption (e.g. adolescents (-females: 192, 95 % confidence interval (CI): 135, 249; -males: 327, 95 % CI: 277, 377)). A lower educational level was associated with lower UPF consumption (-females: -63; 95 % CI: -91, -34; -males: -68; 95 % CI: -124, -12). Also, a lower UPF consumption was observed in married males/couples compared to singles (: -48, 95 % CI: -96, -1). Furthermore, female current/former smokers were associated with a higher UPF consumption v. never smokers (: 79, 95 % CI: 41, 118; : 42, 95 % CI: 8, 75, respectively). Main UPF sources were yoghurts, soft drinks and cold meats/sausages differing strongly by sex, age and education level. Yoghurts containing additives were the main contributors to the UPF consumption in children and adult females from all education (~20 %). Soft drinks were leaders in adolescents (females: 26⋅0 %; males: 31⋅6 %) and young male adults (24⋅4 %). Cold meats/sausages stood out among low-educated males (20⋅5 %). Males, younger age groups, higher education, children with less-educated parents, married/couple males and smoking females were positively associated with UPF consumption.
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22
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Abstract
AbstractFood systems that deliver healthy diets without exceeding the planet’s resources are essential to achieve the worlds’ ambitious development goals. Healthy diets need to be safe, accessible, and affordable for all, including for disadvantaged and nutritionally vulnerable groups such as of smallholder producers, traders, and consumers in low- and middle-income countries. Globally, food systems are experiencing rapid and drastic changes and are failing to fulfil these multiple duties simultaneously. The international community therefore calls for rigorous food systems transformations and policy solutions to support the achievement of healthy diets for all. Most strategies, however, are essentially supply- and market-oriented. Incorporation of a healthy diet perspective in food system transformation is essential to enable food systems to deliver not only on supplying nutritious foods but also on ensuring that consumers have access can afford and desire healthy, sustainable, and culturally acceptable diets. This paper argues that this should be guided by information on diets, dietary trends, consumer motives, and food environment characteristics. Transformational approaches and policies should also take into account the stage of food system development requiring different strategies to ensure healthier diets for consumers. We review current knowledge on drivers of consumer choices at the individual and food environment level with special emphasis on low- and middle income countries, discuss the converging and conflicting objectives that exist among multiple food-system actors, and argue that failure to strengthen synergies and resolve trade-offs may lead to missed opportunities and benefits, or negative unintended consequences in food system outcomes. The paper proposes a menu of promising consumer- and food-environment- oriented policy options to include in the food systems transformation agenda in order to shift LMIC consumer demand towards healthier diets in low- and middle income countries.
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Mohamed Elfadil O, Patel J, Patel I, Ewy MW, Hurt RT, Mundi MS. Processed Foods - Getting Back to The Basics. Curr Gastroenterol Rep 2021; 23:20. [PMID: 34643777 DOI: 10.1007/s11894-021-00828-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE OF REVIEW Real-world data suggested that more than half of daily energy intake is coming from processed and ultra-processed foods in most western countries. This high consumption of processed foods is of concern, given laboratory and epidemiological studies' findings that prove overwhelming harms of processed foods on human health. RECENT FINDINGS Data demonstrate that consumption of processed foods is increasing with more reports linking ultra-processed foods to various medical conditions; namely, obesity, metabolic syndrome, atherosclerotic cardiovascular diseases, and certain types of cancer. Scientific community's understanding of the mechanisms and substances by which processed foods are affecting human health is expanding. Holistic approach to the current critical situation is advisable and requires collaborative public health strategies. The current review describes recent classification of processed foods and highlights the pertinent findings in the relationship between processed foods and health. It also outlines key clinical data relevant to the topic.
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Affiliation(s)
- Osman Mohamed Elfadil
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Jalpan Patel
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Ishani Patel
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Matthew W Ewy
- Division of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ryan T Hurt
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Division of Internal Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Manpreet S Mundi
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
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A Sustainable and Global Health Perspective of the Dietary Pattern of French Population during the 1998–2015 Period from INCA Surveys. SUSTAINABILITY 2021. [DOI: 10.3390/su13137433] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In France, the evolution of dietary pattern relative to sustainability and global health remains insufficiently studied. The objective of this study was to assess dietary changes during 1998–2015 through three generic metrics potentially related to sustainability. Food consumption data were collected from three French National Individual Study of Food Consumption surveys (INCA) for children (0–17 years) and adults (18–79 years) representative of the French population. The consumed foods were converted into plant (metric 1) and non-ultra-processed (UPF, metric 2) calories, and analyzed in meeting dietary recommended intakes (metric 3). French children and adults consumed high levels of animal and UPF calories, and nutrient deficiencies were observed in adults from the 2015 survey, e.g., fiber, EPA, DHA, magnesium, retinol, and vitamin C. In children, UPF daily calories increased from 42.8 to 45.5% and decreased in adults from 39.2 to 35.0%. In children and adults, diet revegetation was observed. While the level of physical activity decreased, overweight, obesity and type 2 diabetes prevalence increased in French adults. The French dietary pattern is not sustainable for global health unless public health policy is reinforced, with at least a twofold decrease in animal and UPF calories and improved food diversity.
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25
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A study of ultra-processing marker profiles in 22,028 packaged ultra-processed foods using the Siga classification. J Food Compost Anal 2021. [DOI: 10.1016/j.jfca.2021.103848] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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26
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Homs C, Berruezo P, Según G, Estrada L, de Bont J, Riera-Romaní J, Carrillo-Álvarez E, Schröder H, Milà R, Gómez SF. Family-based intervention to prevent childhood obesity among school-age children of low socioeconomic status: study protocol of the FIVALIN project. BMC Pediatr 2021; 21:246. [PMID: 34020614 PMCID: PMC8139065 DOI: 10.1186/s12887-021-02697-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 05/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Childhood obesity represents a global public health crisis: the number of obese children and adolescents (aged 519years) worldwide has risen tenfold in the past four decades. The vast majority of overweight and obese children live in high-income countries, and low socio-economic status (SES) is a significant risk factor. Family Based Interventions (FBI) have demonstrated positive results in preventing obesity, although these results are strongly influenced by SES. Moreover, we still poorly understand how FBI can determine a positive trend in weight status in low-income communities. Therefore, there is an urgent need to define and evaluate innovative and multi-target projects to reduce obesity risk behaviors and health inequalities and the present study aims to present the study protocol of FIVALIN a FBI that pretends to achieve this goal. Methods We will conduct a quasi-experimental design within 60 Community Child Centers (CCC) in Barcelona metropolitan area. Each cluster (CCC) will be assigned by convenience to the intervention and control groups. For the whole study, a total of 810 children aged 812years and 600 parents will be recruited during 3 consecutive editions (1st 2019/2020; 2nd 2020/2021; 3rd 2021/2022) of 10months each. The action is a regular multicomponent health-promotion intervention targeting children, families, and CCC. All activities are based on the Motivational Interviewing (MI) approach and will focus on promoting good dietary habits, physical activity, appropriate screen time and sleep duration, and psychological well-being. The control group participate in a unique workshop on general awareness of healthy lifestyles for families. We will perform a comparative analysis of the evolution of weight status, healthy lifestyles, and socioeconomic variables, between the intervention and control groups. Discussion There is a need for more evidence on how to target and evaluate holistic interventions in low SES families. Our multi-targeting intervention for obesity prevention tackles risky behaviors that go beyond diet and physical activity (PA). Therefore, future interventions can effectively promote all the behavioral domains that determine trends in the weight status. Trial registration ISRCTN Registry: ISRCRN12682870. Registered 9 July 2020. Retrospectively registered. Protocol version: 30 April 2021, version 5. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02697-x.
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Affiliation(s)
- C Homs
- Gasol Foundation, Sant Boi de Llobregat, Spain.,Faculty of Psychology, PSITIC Research Group, Education and Sport Sciences Blanquerna - Universitat Ramon Llull, Císter, 34 08032, Barcelona, Spain
| | - P Berruezo
- Gasol Foundation, Sant Boi de Llobregat, Spain
| | - G Según
- Gasol Foundation, Sant Boi de Llobregat, Spain
| | - L Estrada
- Gasol Foundation, Los Angeles, CA, USA
| | - J de Bont
- ISGlobal, Barcelona, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - J Riera-Romaní
- Faculty of Psychology, PSITIC Research Group, Education and Sport Sciences Blanquerna - Universitat Ramon Llull, Císter, 34 08032, Barcelona, Spain
| | - E Carrillo-Álvarez
- Global Research on Wellbeing (GRoW) research group, Blanquerna School of Health Sciences - Universitat Ramon Llull, Padilla, 326-332 08025, Barcelona, Spain
| | - H Schröder
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain.,Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - R Milà
- Global Research on Wellbeing (GRoW) research group, Blanquerna School of Health Sciences - Universitat Ramon Llull, Padilla, 326-332 08025, Barcelona, Spain
| | - S F Gómez
- Gasol Foundation, Sant Boi de Llobregat, Spain. .,GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, Lleida, Spain.
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Abstract
We aimed to evaluate the association between eating context patterns and ultraprocessed food consumption at two main meal occasions in a representative sample of UK adolescents. Data were acquired from 4-d food records of adolescents aged 11-18 years, who participated in the 2014-2016 UK National Diet and Nutrition Survey (n 542). The eating context was assessed considering the location of the meal (lunch and dinner) occasion, the individuals present, whether the television was on and if the food was consumed at a table. Ultraprocessed foods were identified using the NOVA classification. Exploratory factor analysis was used to identify eating context patterns for lunch and dinner. Linear regression models adjusted for the covariates were utilised to test the association between eating context patterns and the proportion of total daily energy intake derived from ultraprocessed foods. Their contribution was about 67 % to energy intake. Three patterns were retained for lunch ('At school with friends', 'TV during family meal' and 'Out-of-home (no school)'), and three patterns were retained for dinner ('Watching TV alone in the bedroom', 'TV during family meal' and 'Out-of-home with friends'). At lunch, there was no significant association between any of the three patterns and ultraprocessed food consumption. At dinner, the patterns 'Watching TV alone in the bedroom' (coefficient: 4·95; 95 % CI 1·87, 8·03) and 'Out-of-home with friends' (coefficient: 3·13; 95 % CI 0·21, 6·14) were associated with higher consumption of ultraprocessed food. Our findings suggest a potential relationship between the immediate eating context and ultraprocessed food consumption by UK adolescents.
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28
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Olsen JR, Patterson C, Caryl FM, Robertson T, Mooney SJ, Rundle AG, Mitchell R, Hilton S. Exposure to unhealthy product advertising: Spatial proximity analysis to schools and socio-economic inequalities in daily exposure measured using Scottish Children's individual-level GPS data. Health Place 2021; 68:102535. [PMID: 33636594 PMCID: PMC9227708 DOI: 10.1016/j.healthplace.2021.102535] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 11/25/2022]
Abstract
This study aimed to understand socio-spatial inequalities in the placement of unhealthy commodity advertisements at transportation stops within the Central Belt of Scotland and to measure advertisement exposure using children's individual-level mobility data. We found that children who resided within more deprived areas had greater contact with the transport network and also greater exposure to unhealthy food and drink product advertising, compared to those living in less deprived areas. Individual-level mobility data provide evidence that city- or country-wide restrictions to advertising on the transport network might be required to reduce inequalities in children's exposure to unhealthy commodity advertising.
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Affiliation(s)
- Jonathan R Olsen
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Glasgow, UK.
| | - Chris Patterson
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Glasgow, UK
| | - Fiona M Caryl
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Glasgow, UK
| | - Tony Robertson
- Faculty of Health Sciences & Sport, University of Stirling, Stirling, UK
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Andrew G Rundle
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Richard Mitchell
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Glasgow, UK
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences, University of Glasgow, Glasgow, UK
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Diou C, Sarafis I, Papapanagiotou V, Alagialoglou L, Lekka I, Filos D, Stefanopoulos L, Kilintzis V, Maramis C, Karavidopoulou Y, Maglaveras N, Ioakimidis I, Charmandari E, Kassari P, Tragomalou A, Mars M, Ngoc Nguyen TA, Kechadi T, O'Donnell S, Doyle G, Browne S, O'Malley G, Heimeier R, Riviou K, Koukoula E, Filis K, Hassapidou M, Pagkalos I, Ferri D, Perez I, Delopoulos A. BigO: A public health decision support system for measuring obesogenic behaviors of children in relation to their local environment. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:5864-5867. [PMID: 33019308 DOI: 10.1109/embc44109.2020.9175361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Obesity is a complex disease and its prevalence depends on multiple factors related to the local socioeconomic, cultural and urban context of individuals. Many obesity prevention strategies and policies, however, are horizontal measures that do not depend on context-specific evidence. In this paper we present an overview of BigO (http://bigoprogram.eu), a system designed to collect objective behavioral data from children and adolescent populations as well as their environment in order to support public health authorities in formulating effective, context-specific policies and interventions addressing childhood obesity. We present an overview of the data acquisition, indicator extraction, data exploration and analysis components of the BigO system, as well as an account of its preliminary pilot application in 33 schools and 2 clinics in four European countries, involving over 4,200 participants.
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30
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Steele EM, Rauber F, Costa CDS, Leite MA, Gabe KT, Louzada MLDC, Levy RB, Monteiro CA. Dietary changes in the NutriNet Brasil cohort during the covid-19 pandemic. Rev Saude Publica 2020; 54:91. [PMID: 32901755 PMCID: PMC7454165 DOI: 10.11606/s1518-8787.2020054002950] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the dietary characteristics of participants in the NutriNet Brasil cohort immediately before and during the covid-19 pandemic. METHODS Our data stem from an adult cohort created to prospectively investigate the relationship between diet and morbidity and mortality from chronic non-communicable diseases in Brazil. For this study, we selected the first participants (n = 10,116) who answered twice to a simplified questionnaire on their diet the day before, the first time when entering the study, between January 26 and February 15, 2020, and the second between May 10 and 19, 2020. The questionnaire inquiries about the consumption of healthy (vegetables, fruits and legumes) and unhealthy (ultra-processed foods) eating markers. Comparisons of indicators based on the consumption of these markers before and during the pandemic are presented for the study population and according to gender, age group, macro-region of residence and schooling. Chi-square tests and t-tests were used to compare proportions and means, respectively, adopting p < 0.05 to identify significant differences. RESULTS For all participants, we found a modest but statistically significant increase in the consumption of healthy eating markers and stability in the consumption of unhealthy food markers. This favorable pattern of dietary changes during the pandemic occurred in most sociodemographic strata. We observed a less favorable changing pattern, with a tendency to increasing consumption of healthy and unhealthy food markers, in the Northeast and North macro-regions and among people with less schooling, suggesting social inequalities in the response to the pandemic. CONCLUSIONS If confirmed, the trend of increased consumption of ultra-processed foods in underdeveloped regions and by people with less schooling is concerning, as eating these foods increases the risk of obesity, hypertension and diabetes, whose presence increases the severity and lethality of covid-19.
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Affiliation(s)
- Eurídice Martínez Steele
- Universidade de São Paulo . Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde da USP (NUPENS). São Paulo , SP , Brasil
| | - Fernanda Rauber
- Universidade de São Paulo . Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde da USP (NUPENS). São Paulo , SP , Brasil.,Universidade de São Paulo . Faculdade de Medicina . Departamento de Medicina Preventiva . São Paulo , SP , Brasil.,Universidade de São Paulo . Faculdade de Saúde Pública . Departamento de Nutrição . São Paulo , SP , Brasil
| | - Caroline Dos Santos Costa
- Universidade de São Paulo . Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde da USP (NUPENS). São Paulo , SP , Brasil.,Universidade de São Paulo . Faculdade de Saúde Pública . Departamento de Nutrição . São Paulo , SP , Brasil
| | - Maria Alvim Leite
- Universidade de São Paulo . Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde da USP (NUPENS). São Paulo , SP , Brasil.,Universidade de São Paulo . Faculdade de Medicina . Departamento de Medicina Preventiva . São Paulo , SP , Brasil
| | - Kamila Tiemann Gabe
- Universidade de São Paulo . Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde da USP (NUPENS). São Paulo , SP , Brasil.,Universidade de São Paulo . Faculdade de Saúde Pública . Departamento de Nutrição . São Paulo , SP , Brasil
| | - Maria Laura da Costa Louzada
- Universidade de São Paulo . Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde da USP (NUPENS). São Paulo , SP , Brasil.,Universidade de São Paulo . Faculdade de Saúde Pública . Departamento de Nutrição . São Paulo , SP , Brasil
| | - Renata Bertazzi Levy
- Universidade de São Paulo . Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde da USP (NUPENS). São Paulo , SP , Brasil.,Universidade de São Paulo . Faculdade de Medicina . Departamento de Medicina Preventiva . São Paulo , SP , Brasil
| | - Carlos Augusto Monteiro
- Universidade de São Paulo . Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde da USP (NUPENS). São Paulo , SP , Brasil.,Universidade de São Paulo . Faculdade de Saúde Pública . Departamento de Nutrição . São Paulo , SP , Brasil
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Tragomalou A, Moschonis G, Manios Y, Kassari P, Ioakimidis I, Diou C, Stefanopoulos L, Lekka E, Maglaveras N, Delopoulos A, Charmandari E. Novel e-Health Applications for the Management of Cardiometabolic Risk Factors in Children and Adolescents in Greece. Nutrients 2020; 12:E1380. [PMID: 32408523 PMCID: PMC7284613 DOI: 10.3390/nu12051380] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 01/17/2023] Open
Abstract
Obesity in childhood and adolescence represents a major health problem. Novel e-Health technologies have been developed in order to provide a comprehensive and personalized plan of action for the prevention and management of overweight and obesity in childhood and adolescence. We used information and communication technologies to develop a "National Registry for the Prevention and Management of Overweight and Obesity" in order to register online children and adolescents nationwide, and to guide pediatricians and general practitioners regarding the management of overweight or obese subjects. Furthermore, intelligent multi-level information systems and specialized artificial intelligence algorithms are being developed with a view to offering precision and personalized medical management to obese or overweight subjects. Moreover, the Big Data against Childhood Obesity platform records behavioral data objectively by using inertial sensors and Global Positioning System (GPS) and combines them with data of the environment, in order to assess the full contextual framework that is associated with increased body mass index (BMI). Finally, a computerized decision-support tool was developed to assist pediatric health care professionals in delivering personalized nutrition and lifestyle optimization advice to overweight or obese children and their families. These e-Health applications are expected to play an important role in the management of overweight and obesity in childhood and adolescence.
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Affiliation(s)
- Athanasia Tragomalou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (P.K.); (E.C.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne VIC 3086, Australia;
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, 70 El Venizelou Avenue, Kallithea, 17671 Athens, Greece;
| | - Penio Kassari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (P.K.); (E.C.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Ioannis Ioakimidis
- Department of Biosciences and Nutrition, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Christos Diou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.D.); (A.D.)
| | - Leandros Stefanopoulos
- Department of Medicine, Lab of Computing Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki Medical School, 54124 Thessaloniki, Greece; (L.S.); (E.L.); (N.M.)
| | - Eirini Lekka
- Department of Medicine, Lab of Computing Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki Medical School, 54124 Thessaloniki, Greece; (L.S.); (E.L.); (N.M.)
| | - Nicos Maglaveras
- Department of Medicine, Lab of Computing Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki Medical School, 54124 Thessaloniki, Greece; (L.S.); (E.L.); (N.M.)
| | - Anastasios Delopoulos
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (C.D.); (A.D.)
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (P.K.); (E.C.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
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Bus Stops Near Schools Advertising Junk Food and Sugary Drinks. Nutrients 2020; 12:nu12041192. [PMID: 32344514 PMCID: PMC7230930 DOI: 10.3390/nu12041192] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/31/2020] [Accepted: 04/11/2020] [Indexed: 11/17/2022] Open
Abstract
Children rarely understand the full extent of the persuasive purpose of advertising on their eating behaviours. Addressing the obesogenic environments in which children live, through a quantification of outdoor advertising, is essential in informing policy changes and enforcing stricter regulations. This research explores the proportion of bus stop advertisements promoting non-core food and beverages within walking distance (500 m) from schools in Auckland, New Zealand while using Google Street View. Information was collected on: school type, decile, address, Walk Score®, and Transit Score for all 573 schools in the Auckland region. Ground-truthing was conducted on 10% of schools and showed an alignment of 87.8%. The majority of advertisements on bus shelters were for non-food items or services (n = 541, 64.3%). Of the advertisements that were for food and/or beverages, the majority were for non-core foods (n = 108, 50.2%). There was no statistically significant difference between the variables core and non-core food and beverages and School decile (tertiles), Walk Score (quintiles), and Transit Score (quintiles). 12.8% of all bus stop advertisements in this study promoted non-core dietary options; highlighting an opportunity for implementing stricter regulations and policies preventing advertising unhealthy food and drink to children in New Zealand.
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