Socioeconomic Disadvantage across the Life Course Is Associated with Diet Quality in Young Adulthood

Addressing differences in cancer: a framework for synergistic programming in cancer prevention and control

Background

Cancer remains a leading cause of death worldwide and continues to disproportionately impact certain populations. Several frameworks have been developed that illustrate the multiple determinants of cancer. Expanding upon the work of others, we present an applied framework for cancer prevention and control designed to help clinicians, as well as public health practitioners and researchers, better address differences in cancer outcomes.

Methods

The framework was developed by the Cancer Prevention and Control Research Network's Health Behaviors Workgroup. An initial framework draft was developed based on workgroup discussion, public health theory, and rapid literature review on the determinants of cancer. The framework was refined through interviews and focus groups with Federally Qualified Health Center providers (n=2) and cancer patients (n=2); participants were asked to provide feedback on the framework's causal pathways, completeness, and applicability to their work and personal life.

Results

The framework provides an overview of the relationships between sociodemographic inequalities, social and structural determinants, and key risk factors associated with cancer diagnosis, survivorship, and cancer morbidity and mortality across the lifespan. The framework emphasizes how health-risk behaviors like cigarette smoking interact with psychological, psychosocial, biological, and psychosocial risk factors, as well as healthcare-related behavior and other chronic diseases. Importantly, the framework emphasizes addressing social and structural determinants that influence health behaviors to reduce the burden of cancer and improve health equity. Aligned with previous theory, our framework underscores the importance of addressing co-occurring risk factors and disease states, understanding the complex relationships between factors that influence cancer, and assessing how multiple forms of inequality or disadvantage intersect to increase cancer risk across the lifespan.

Conclusions

This paper presents an applied framework for cancer prevention and control to address cancer differences. Because the framework highlights determinants and factors that influence cancer risk at multiple levels, it can be used to inform the development, implementation, and evaluation of interventions to address cancer morbidity and mortality.

How Can We Support Healthy Eating in Young Adults with Low Diet Quality? A Survey of Users of the 'No Money No Time' Healthy Eating Website

Nutrition interventions to support young adults are needed due to low diet quality. The aims were to explore the (1) circumstances and (2) barriers regarding dietary habits of the young adult users of the No Money No Time (NMNT) healthy eating website with the lowest diet quality scores. An online cross-sectional survey was conducted from August-September 2022 with a sample of NMNT users aged 18-35 years with low diet quality (defined as Healthy Eating Quiz score 0-38/73). The survey included demographics (e.g., gender), circumstances (6-item US Food Security Survey, Cooking and Food Skills Confidence Measures), and challenges and resources used in relation to healthy eating (open-responses). Theoretical thematic analysis was used to analyse open-response questions and derive main themes. The study sample (n = 108; 71.3% female, median age 28; 28.7% food insecure) had a mean (standard deviation) Cooking Skills score 70.2 (17.5)/98, and median (interquartile range) Food Skills score 96.0 (83.5-107.5)/133. The main challenges regarding healthy eating were (1) time and (2) cost, and the main resources to support healthy eating were (1) online resources (e.g., websites, Google) and (2) recipes. Findings identify possible targets for future interventions to support healthy eating in this vulnerable group (e.g., supporting cooking and food skills).

Associations between childhood to adulthood socio-economic mobility and adult diet quality

The impact of change in socio-economic status (SES) from childhood to adulthood (SES mobility) on adult diet is not well understood. This study examined associations between three SES mobility variables (area disadvantage, education, occupation) and adult diet quality. 1482 Australian participants reported childhood area-level SES in 1985 (aged 10-15 years) and retrospectively reported highest parental education and main occupation (until participant age 12) and own area-level SES, education, occupation and dietary intake in 2004-2006 (aged 26-36 years). A Dietary Guidelines Index (DGI) was calculated from food frequency and habit questionnaires. A higher score (range 0-100) indicated better diet quality. Sex-stratified linear regression models adjusted for confounders. Area-level SES mobility was not associated with diet quality. Compared with stable high (university) education, stable low (school only) was associated with lower DGI scores (males: β = -5·5, 95 % CI: -8·9, -2·1; females: β = -6·3, 95 % CI: -9·3, -3·4), as was downward educational mobility (participant's education lower than their parents) (males: β = -5·3, 95 % CI: -8·5, -2·0; females: β = -4·5, 95 % CI: -7·2, -1·7) and stable intermediate (vocational) education among males (β = -3·9, 95 % CI: -7·0, -0·7). Compared with stable high (professional/managerial) occupation, stable low (manual/out of workforce) males (β = -4·9, 95 % CI: -7·6, -2·2), and participants with downward occupation mobility (males: β = -3·2, 95 % CI: -5·3, -1·1; females: β = -2·8, 95 % CI: -4·8, -0·8) had lower DGI scores. In this cohort, intergenerational low education and occupation, and downward educational and occupational mobility, were associated with poor adult diet quality.

E-waste polycyclic aromatic hydrocarbon (PAH) exposure leads to child gut-mucosal inflammation and adaptive immune response

Polycyclic aromatic hydrocarbon (PAH) exposure alters immunological responses. Research concerning PAH exposure on intestinal immunity of children in electronic waste (e-waste) areas is scarce. The aim of this study was to evaluate the effects of polycyclic aromatic hydrocarbon (PAH) pollutants on intestinal mucosal immunity of children in e-waste areas. Results showed higher hydroxylated PAH (OH-PAH) concentrations in e-waste-exposed children, accompanied with higher sialyl Lewis A (SLA) level, absolute lymphocyte and monocyte counts, decreased of percentage of CD4⁺ T cells, and had a higher risk of diarrhea. OH-PAH concentrations were negative with child growth. 1-OHNap mediated through WBCs, along with 1-OHPyr, was correlated with an increase SLA concentration. 2-OHFlu, 1-OHPhe, 2-OHPhe, 1-OHPyr, and 6-OHChr were positively correlated with secretory immunoglobulin A (sIgA) concentration. Our results indicated that PAH pollutants caused inflammation, affected the intestinal epithelium, and led to transformation of microfold cell (M cell). M cells initiating mucosal immune responses and the subsequent increasing sIgA production might be an adaptive immune respond of children in the e-waste areas. To our knowledge, this is the first study of PAH exposure on children intestinal immunity in e-waste area, showing that PAH exposure plays a negative role in child growth and impairs the intestinal immune function.

Healthy Eating Index (HEI-2015) of Female College Students According to Obesity and Exercise Participation

BACKGROUND

Individuals participating in exercise are more likely to lead a healthy lifestyle to achieve their exercise-related goals. This study aimed to examine the differences in dietary quality of female university students by exercise involvement and body mass index (BMI).

METHODS

This study was conducted with 360 female university students in Turkey. Students were asked to complete a questionnaire containing general characteristics and food consumption records. The "Healthy Eating Index (HEI-2015)" score was calculated using the results of food consumption records.

RESULTS

The findings showed that the ratio of individuals who exercised regularly was 34.2%. The ratio (44.2%) of regularly exercising participants with moderate/good diet quality was greater than that of regularly exercising participants with poor diet quality (30.6%) (P=0.016). There was no significant difference between the scores of overall diet quality according to BMI classification (P>0.05). The score (45.3±13.4) for overall diet quality of those participating in exercise in the group with normal body weight was higher than the score (41.5±12.1) for overall diet quality of those not participating in exercise (P=0.026). Those participating in exercise in the group with normal body weight consumed more greens and beans, whole grains, dairy products, seafood/vegetable proteins, and refined grains than those not participating in exercise (P<0.05).

CONCLUSION

The rate of overall participation in physical activity was low. However, students participating in physical activity and with a normal body weight had a better diet quality. Creating an ideal environment that encourages students to participate in physical activity at universities can be an effective method for improving their diet quality.

Longitudinal Associations Between Energy Drink Consumption, Health, and Norm-Breaking Behavior Among Swedish Adolescents

Objectives: To describe the intake of energy drinks (EDs) among a sample of Swedish adolescents while considering health-related variables, and to investigate the longitudinal associations between ED consumption, health, and norm-breaking behavior. Longitudinal studies on this topic are scarce. Methods: Questionnaire data were collected in the northern part of Sweden in 2010-2011 from 1,622 adolescents in grades 6-9. Analyses were performed using a chi-squared test and logistic regression. Results: Seventy-four percent of the boys and 54% of the girls had consumed EDs (P < 0.001). ED consumption was associated with variables related to low health, low support levels, and norm-breaking behavior. The associations were generally stronger among the girls and the boys who consumed EDs at least once a week. ED consumption was a predictor of worse health and norm-breaking behavior 1 year later. Adjusted odds ratios ranged from 1.53 (95% CI: 1.07, 2.20; school-related stress) to 4.88 (95% CI: 2.28, 10.43; gaming-related truancy). Conclusions: Health promotion activities benefit from a broad approach but could focus on girls who consume EDs and those boys with the highest consumption levels.

Comparison of diet quality of US adults based on primary motivation for following a vegetarian diet: A cross-sectional online study

Adults adopt a vegetarian diet for various motivations, but it is unknown their overall diet quality based on a primary motivation. The purpose of the study was to compare overall diet quality, nutrient intake and related food groups based on primary motivation for following a vegetarian diet. It was hypothesized that vegetarians who chose the diet for health-related motivations would have a higher diet quality based on the Healthy Eating Index (HEI)-2015 scores compared to those following the diet for other motivations. A cross-sectional study was conducted online in the United States. Participants (n = 511) completed an 18-item questionnaire and a 24-hour recall using the Automated Self-Administered 24-hour Dietary Recall (ASA24-2018) and were divided into one of three groups (Health, Animal, Other [family, religious beliefs, or environment]) based on their primary motivation for following a vegetarian diet. Total HEI-2015 scores were determined and Kruskal-Wallis ANOVA on Ranks with a Dunn's Method for all pairwise comparisons (p < 0.05) were conducted. Results showed that total HEI-2015 scores differed among groups (p = 0.022) with the Health group having a higher score than the Other group (70.2 [57.0, 79.1] versus 63.6 [52.2, 77.1], median 25th, 75th) but not the animal rights group (66.5 [55.1, 77.0]). Higher component scores for total protein foods, seafood and plant proteins and fatty acids contributed to the significant difference. Adults who were motivated by health to follow a vegetarian diet had a higher diet quality than those who cited Other as their primary motivation. As motivations may impact diet quality of vegetarians, it is necessary to account for them.

Individual, social-environmental and physical-environmental correlates of diet quality in young adults aged 18-30 years

Many young adults eat a poor-quality diet. However, understanding of the social-ecological correlates of diet quality in young adults is limited. The aim of the present study was to examine the correlates of diet quality in a cohort of young Australian adults. Data from the cross-sectional Measuring EAting in everyday Life Study were used. Young adults (n = 625; 18-30 years; 73% female) were included if they provided dietary data over three or four non-consecutive days using 'FoodNow', a real-time food diary smartphone application. Diet quality was estimated using the 2013 Dietary Guidelines Index (DGI). Thirty correlates from three levels of the social-ecological framework were collected using an online questionnaire: individual (e.g., self-efficacy), social-environmental (e.g., social support) and physical-environmental (e.g., living situation). Linear regression analyses were used to examine associations between correlates and DGI. Six individual-level correlates were associated with DGI: perceived time scarcity (b = -0.664, CI: 1.160, -0.168), food insecurity (b = -0.962, CI: 1.746, -0.178), self-efficacy (b = 0.230, CI: 0.137, 0.323), being born in Australia (b = -3.165, CI: 5.521, -0.808), being employed in non-trade roles (b = -4.578, CI: 8.903, -0.252) and preparing a meals with vegetables daily (b = 4.576, CI: 1.652, 7.500). No social-environmental or physical-environmental correlates were associated with DGI. Overall, this study showed that young adults had a higher diet quality if they had higher self-efficacy, perceived themselves to be less time scarce and less food insecure, were born in Australia, were employed in non-trade roles and prepared a meal with vegetables daily. Healthy eating policies and interventions in young adults may benefit from targeting individual-level correlates.

Young adult nutrition and weight correlates of picky eating during childhood

OBJECTIVE

To identify whether picky eating during childhood is associated with dietary intake, weight status and disordered eating behaviour during young adulthood.

DESIGN

A population-based study using data from young adults who responded online or by mail to the third wave of the Project EAT (Eating and Activity in Teens and Young Adults) study in 2008-2009. Participants retrospectively reported the extent to which they were a picky eater in childhood, sociodemographic characteristics, disordered eating behaviours, usual dietary intake, and weight and height.

SETTING

Participants were initially recruited in the Minneapolis/St. Paul metropolitan area of Minnesota, USA, in 1998-1999.

PARTICIPANTS

The analytic sample included 2275 young adults (55 % female, 48 % non-Hispanic White, mean age 25·3 (sd 1·6) years).

RESULTS

Young adults who reported picky eating in childhood were found to currently have lower intakes of fruit, vegetables and whole grains, and more frequent intakes of snack foods, sugar-sweetened beverages and foods from fast-food restaurants. No associations were observed between picky eating in childhood and young adults' weight status, use of weight-control strategies or report of binge eating.

CONCLUSIONS

While young adults who report picky eating during childhood are not at higher risk for disordered eating, those who were picky eaters tend to have less healthy dietary intake. Food preferences and dietary habits established by picky eaters during childhood may persist into adulthood.