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Perrar I, Alexy U, Jankovic N. Changes in Total Energy, Nutrients and Food Group Intake among Children and Adolescents during the COVID-19 Pandemic-Results of the DONALD Study. Nutrients 2022; 14:nu14020297. [PMID: 35057478 PMCID: PMC8778042 DOI: 10.3390/nu14020297] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic may have changed the habitual lifestyles of children and adolescents, in particular, due to the closure of kindergartens and schools. To investigate the impact of the pandemic on nutrients and food intake of children and adolescents in Germany, we analyzed repeated 3-day weighed dietary records from 108 participants (3–18 years; females: n = 45, males: n = 63) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Polynomial mixed-effects regression models were used to identify prospective changes in dietary intake (total energy (TEI), carbohydrates, fat, protein, free sugar, ultra-processed foods, fruits and vegetables, sugar sweetened beverages and juices) before and during the first months of the COVID-19 pandemic. For the current analysis, we have chosen the first months of the pandemic (March 2020–August 2020), as this was the period with the most restrictions in Germany so far (kindergarten, school and restaurant closures; contact and outdoor activity restrictions). No significant changes in either the selected nutrients or food groups were observed. However, children and adolescents recorded a significantly lower TEI during the pandemic (β = −109.65, p = 0.0062). Results remained significant after the exclusion of participants with under-reported records (β = −95.77, p = 0.0063). While macronutrient intake did not change, descriptive data indicate a non-significant decrease in sugar sweetened beverages and ultra-processed foods intake. We suggest that children and adolescents from high socioeconomic families may have adapted lifestyle changes during the pandemic.
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Affiliation(s)
- Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115 Bonn, Germany
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
- Correspondence:
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
| | - Nicole Jankovic
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany; (U.A.); (N.J.)
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Abstract
Objectives. To assess the US food industry's response to calls from public health authorities to reduce portion sizes by comparing current with past sizes of selected examples of single-serve ultra-processed packaged and fast foods. Methods. We obtained manufacturers' information about current portion sizes and compared it with sizes when first introduced and in 2002. Results. Few companies in our sample reduced portion sizes since 2002; all still sold portions of ultra-processed foods in up to 5-times-larger sizes than when first introduced. Conclusions. Policies and practices focused on reducing portion size could help discourage the consumption of excessive amounts of ultra-processed foods. (Am J Public Health. 2021;111(12):2223-2226. https://doi.org/10.2105/AJPH.2021.306513).
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Affiliation(s)
- Lisa R Young
- The authors are with the Department of Nutrition and Food Studies, New York University, New York, NY
| | - Marion Nestle
- The authors are with the Department of Nutrition and Food Studies, New York University, New York, NY
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de Moraes MM, Oliveira B, Afonso C, Santos C, Torres D, Lopes C, de Miranda RC, Rauber F, Antoniazzi L, Levy RB, Rodrigues S. Dietary Patterns in Portuguese Children and Adolescent Population: The UPPER Project. Nutrients 2021; 13:nu13113851. [PMID: 34836107 PMCID: PMC8622610 DOI: 10.3390/nu13113851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 02/07/2023] Open
Abstract
Considering the nature, extent, and purpose of food processing, this study aims to identify dietary patterns (DPs) and their associations with sociodemographic factors and diet quality in Portuguese children and adolescents. Cross-sectional data were obtained from the National Food, Nutrition and Physical Activity Survey (2015-2016) of the Portuguese population. Dietary intake was obtained from two non-consecutive days and food items were classified according to the NOVA system. The proportion (in grams) of foods in the total daily diet was considered to identify DPs by latent class analysis, with age and sex as concomitant variables. Associations of DPs with sociodemographic characteristics were assessed using multinomial logistic regression. Linear regressions adjusted by sociodemographic characteristics tested associations of DPs with diet quality. DPs identified were: "Unhealthy" (higher sugar-sweetened beverages, industrial breads, and sausages intake), "Traditional" (higher vegetables, fish, olive oil, breads, ultra-processed yogurts, and sausages intake), and "Dairy" (higher intake of milk, yogurt, and milk-based beverages). "Unhealthy" was associated with older ages and lower intake of dietary fibre and vitamins and the highest free sugars and ultra-processed foods (UPF), although all DPs presented significant consumption of UPF. These findings should be considered for the design of food-based interventions and school-feeding policies in Portugal.
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Affiliation(s)
- Milena Miranda de Moraes
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
- Correspondence: ; Tel.: +351-22-507-4320
| | - Bruno Oliveira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Artificial Intelligence and Decision Support (LIAAD), Institute for Systems and Computer Engineering, Technology and Science (INESC TEC), 4200-465 Porto, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
| | - Cristina Santos
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Center for Health Technology and Services Research (CINTESIS), Associate Laboratory RISE-Health Research Network, University of Porto, 4200-450 Porto, Portugal
| | - Duarte Torres
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
| | - Carla Lopes
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Renata Costa de Miranda
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo 01246-90, Brazil; (R.C.d.M.); (F.R.); (L.A.); (R.B.L.)
- Department of Nutrition, Institute of Health Sciences, Federal University of Triângulo Mineiro, Uberaba 38025-440, Brazil
| | - Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo 01246-90, Brazil; (R.C.d.M.); (F.R.); (L.A.); (R.B.L.)
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-90, Brazil
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-90, Brazil
| | - Luiza Antoniazzi
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo 01246-90, Brazil; (R.C.d.M.); (F.R.); (L.A.); (R.B.L.)
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-90, Brazil
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo 01246-90, Brazil; (R.C.d.M.); (F.R.); (L.A.); (R.B.L.)
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-90, Brazil
| | - Sara Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (B.O.); (C.A.); (C.S.); (D.T.); (S.R.)
- Associated Laboratory ITR, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
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Chen L, Li J, Xia T, Matthews TA, Tseng TS, Shi L, Zhang D, Chen Z, Han X, Li Y, Li H, Wen M, Su D. Changes of Exercise, Screen Time, Fast Food Consumption, Alcohol, and Cigarette Smoking during the COVID-19 Pandemic among Adults in the United States. Nutrients 2021; 13:3359. [PMID: 34684357 PMCID: PMC8539894 DOI: 10.3390/nu13103359] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/13/2021] [Accepted: 09/21/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the impact of the COVID-19 pandemic on multiple lifestyle changes among adults in the United States (USA). METHODS We conducted a survey, the Health, Ethnicity, and Pandemic (HEAP) Study, in October 2020 among USA adults. Participants were selected from the United States using 48 sampling strata, including age, race, ethnicity, education, and gender, and were asked to report five lifestyle behaviors (i.e., exercise time, screen time, fast-food meal consumption, alcohol drinking, and cigarette smoking) before and during the COVID-19 pandemic. The associations of sociodemographic factors with each lifestyle change were estimated using weighted multivariable logistic regression models. RESULTS All 2709 HEAP participants were included in this study. Compared to pre-pandemic, the time spent on exercise decreased (32.06 vs. 38.65 min/day; p < 0.001) and screen time increased (6.79 vs. 5.06 h/day; p < 0.001) during the pandemic. The percentage of individuals who reported consuming fast-food meals ≥3 times/week decreased from 37.7% before the pandemic to 33.3% during the pandemic. The percentage of heavy drinkers (≥5 times/week) increased from 20.9% before the pandemic to 25.7% during the pandemic. Among smokers, heavy smoking (≥11 cigarettes/day) increased from 5.8% before the pandemic to 7.9% during the pandemic. We also identified subgroups who were more vulnerable to adverse influences from the pandemic, including racial/ethnic minority groups and young adults. CONCLUSIONS The COVID-19 pandemic had negative impacts on multiple lifestyle behaviors among Americans. Mitigating such negative impacts of COVID-19 requires effective interventions, particularly for some vulnerable subgroups.
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Affiliation(s)
- Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA; (J.L.); (T.A.M.)
- School of Nursing, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Tong Xia
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Timothy A. Matthews
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA; (J.L.); (T.A.M.)
| | - Tung-Sung Tseng
- Department of Behavioral and Community Health Sciences, LSUHSC School of Public Health, 2020 Gravier Street, Room 213, New Orleans, LA 70112, USA;
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA;
| | - Donglan Zhang
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA; (D.Z.); (Z.C.)
| | - Zhuo Chen
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA; (D.Z.); (Z.C.)
- School of Economics, Faculty of Humanities and Social Science, University of Nottingham Ningbo China, Ningbo 315100, China
| | - Xuesong Han
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA 30303, USA;
| | - Yan Li
- Department of Population Health Science and Policy, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Hongmei Li
- Department of Media, Journalism and Film, Miami University, Oxford, OH 45056, USA;
| | - Ming Wen
- Department of Sociology, University of Utah, Salt Lake City, UT 84112, USA;
| | - Dejun Su
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA;
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Cordova R, Kliemann N, Huybrechts I, Rauber F, Vamos EP, Levy RB, Wagner KH, Viallon V, Casagrande C, Nicolas G, Dahm CC, Zhang J, Halkjær J, Tjønneland A, Boutron-Ruault MC, Mancini FR, Laouali N, Katzke V, Srour B, Jannasch F, Schulze MB, Masala G, Grioni S, Panico S, van der Schouw YT, Derksen JWG, Rylander C, Skeie G, Jakszyn P, Rodriguez-Barranco M, Huerta JM, Barricarte A, Brunkwall L, Ramne S, Bodén S, Perez-Cornago A, Heath AK, Vineis P, Weiderpass E, Monteiro CA, Gunter MJ, Millett C, Freisling H. Consumption of ultra-processed foods associated with weight gain and obesity in adults: A multi-national cohort study. Clin Nutr 2021; 40:5079-5088. [PMID: 34455267 DOI: 10.1016/j.clnu.2021.08.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/02/2021] [Accepted: 08/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is a worldwide shift towards increased consumption of ultra-processed foods (UPF) with concurrent rising prevalence of obesity. We examined the relationship between the consumption of UPF and weight gain and risk of obesity. METHODS This prospective cohort included 348 748 men and women aged 25-70 years. Participants were recruited between 1992 and 2000 from 9 European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Two body weight measures were available, at baseline and after a median follow-up time of 5 years. Foods and drinks were assessed at baseline by dietary questionnaires and classified according to their degree of processing using NOVA classification. Multilevel mixed linear regression was used to estimate the association between UPF consumption and body weight change (kg/5 years). To estimate the relative risk of becoming overweight or obese after 5 years we used Poisson regression stratified according to baseline body mass index (BMI). RESULTS After multivariable adjustment, higher UPF consumption (per 1 SD increment) was positively associated with weight gain (0·12 kg/5 years, 95% CI 0·09 to 0·15). Comparing highest vs. lowest quintile of UPF consumption was associated with a 15% greater risk (95% CI 1·11, 1·19) of becoming overweight or obese in normal weight participants, and with a 16% greater risk (95% CI 1·09, 1·23) of becoming obese in participants who were overweight at baseline. CONCLUSIONS These results are supportive of public health campaigns to substitute UPF for less processed alternatives for obesity prevention and weight management.
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Affiliation(s)
- Reynalda Cordova
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France; Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Nathalie Kliemann
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, UK
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Karl-Heinz Wagner
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Vivian Viallon
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Corinne Casagrande
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Geneviève Nicolas
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | | | - Jie Zhang
- Department of Public Health, Aarhus University, Denmark
| | - Jytte Halkjær
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie-Christine Boutron-Ruault
- French National Institute of Health and Medical Research (INSERM), Centre for Research in Epidemiology and Population Health (CESP), UVSQ, Université Paris-Saclay, Université Paris-Sud, France; Institut Gustave Roussy, F-94805, Villejuif, France
| | - Francesca Romana Mancini
- French National Institute of Health and Medical Research (INSERM), Centre for Research in Epidemiology and Population Health (CESP), UVSQ, Université Paris-Saclay, Université Paris-Sud, France; Institut Gustave Roussy, F-94805, Villejuif, France
| | - Nasser Laouali
- French National Institute of Health and Medical Research (INSERM), Centre for Research in Epidemiology and Population Health (CESP), UVSQ, Université Paris-Saclay, Université Paris-Sud, France; Institut Gustave Roussy, F-94805, Villejuif, France
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bernard Srour
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Giovanna Masala
- Molecular and Lifestyle Epidemiology Branch, Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network ISPRO, Florence, Italy
| | - Sara Grioni
- Epidemiology and Prevention Unit Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via Venezian, 120133, Milano, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica E Chirurgia Federico II University, Naples, Italy
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jeroen W G Derksen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Charlotta Rylander
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain; Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Miguel Rodriguez-Barranco
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José María Huerta
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Murcia, Spain
| | - Aurelio Barricarte
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | | | - Stina Ramne
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Stina Bodén
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Alicia K Heath
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, UK
| | - Paolo Vineis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, UK
| | - Elisabete Weiderpass
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Carlos Augusto Monteiro
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, UK
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France.
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Marino M, Puppo F, Del Bo’ C, Vinelli V, Riso P, Porrini M, Martini D. A Systematic Review of Worldwide Consumption of Ultra-Processed Foods: Findings and Criticisms. Nutrients 2021; 13:2778. [PMID: 34444936 PMCID: PMC8398521 DOI: 10.3390/nu13082778] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 02/06/2023] Open
Abstract
A debate is ongoing on the significance and appropriateness of the NOVA classification as a tool for categorizing foods based on their degree of processing. As such, the role of ultra-processed food (UPF) on human health is still not completely understood. With this review, we aimed to investigate the actual level of consumption of UPF across countries and target populations to determine the impact in real contexts. Suitable articles published up to March 2021 were sourced through the PubMed and SCOPUS databases. Overall, 99 studies providing data on the level of UPF consumption expressed as the percentage of total energy intake were identified, for a total of 1,378,454 participants. Most of them were published in Brazil (n = 38) and the United States (n = 15), and the 24 h recall was the most-used tool (n = 63). Analysis of the results revealed that the United States and the United Kingdom were the countries with the highest percent energy intake from UPF (generally >50%), whereas Italy had the lowest levels (about 10%); the latter was inversely associated with adherence to the Mediterranean diet. High variability was also observed based on sex, age, and body mass index, with men, young people, and overweight/obese subjects generally having higher levels of consumption compared to older subjects. Overall, our findings underline the large differences in UPF intake. Since most of the observations derived from studies conducted with food questionnaires are not specifically validated for UPF, further efforts are essential to confirm the results previously obtained and to investigate further the association between UPF consumption and health status, also considering the actual contribution within different dietary patterns, which has been less investigated to date.
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Affiliation(s)
| | | | - Cristian Del Bo’
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20123 Milan, Italy; (M.M.); (F.P.); (V.V.); (P.R.); (M.P.); (D.M.)
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7
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Bui C, Lin LY, Wu CY, Chiu YW, Chiou HY. Association between Emotional Eating and Frequency of Unhealthy Food Consumption among Taiwanese Adolescents. Nutrients 2021; 13:2739. [PMID: 34444899 PMCID: PMC8401002 DOI: 10.3390/nu13082739] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 12/28/2022] Open
Abstract
Emotional eating is one factor that increases the consumption of unhealthy food. This study aimed to investigate the association between emotional eating and frequencies of consuming fast food, high-fat snacks, processed meat products, dessert foods, and sugar-sweetened beverages (SSBs) in adolescents. The baseline survey data (2015) from the Taiwan Adolescent to Adult Longitudinal Study (TAALS) were fitted into multivariate logistic regression models adjusted for sex, school type, Body Mass Index (BMI), eating while doing something, nutrition label reading, skipping breakfast, smoking, binge drinking, sedentary lifestyle, physical activity, peer and school support, and parental education level. Among the 18,461 participants (48.5% male and 51.5% female), those exhibiting emotional eating were more likely to consume fast food (Odds ratio (OR) = 2.40, 95% Confidence interval (CI): 2.18-2.64), high-fat snacks (OR = 2.30, 95% CI: 2.12-2.49), processed meat products (OR = 1.92, 95% CI: 1.78-2.08), dessert foods (OR = 2.49, 95% CI: 2.31-2.69), and sugar-sweetened beverages (OR = 1.83, 95% CI: 1.70-1.98). Factors that were positively associated with unhealthy food consumption included eating while doing other activities, binge drinking, smoking, and sedentary lifestyle. Among all the covariates, nutrition label reading was the only factor that was inversely associated with frequent unhealthy food consumption. Sex and school type may moderate the effect of emotional eating on the frequent consumption of specific unhealthy food groups. In conclusion, adolescents with high emotional eating were more likely to report frequent consumption of unhealthy foods in Taiwan. Our findings showed that male participants appeared to consume fast foods, high-fat snacks, processed meat, and SSBs more often and dessert foods less often than females. Future longitudinal studies are recommended for understanding the causal relationship between emotional eating and unhealthy food consumption.
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Affiliation(s)
- Chung Bui
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City 110, Taiwan;
- Department of Health Communication and Education, Quang Ninh Provincial Center for Disease Control (CDC) in Vietnam, 651 Le Thanh Tong St., Bach Dang Ward, Ha Long 01108, Vietnam
| | - Li-Yin Lin
- Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City 110, Taiwan;
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City 110, Taiwan
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, 365 Mingde Road, Beitou District, Taipei 11219, Taiwan
| | - Chih-Yi Wu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County 35053, Taiwan;
| | - Ya-Wen Chiu
- Ph.D. Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City 110, Taiwan;
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City 110, Taiwan
| | - Hung-Yi Chiou
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City 110, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County 35053, Taiwan;
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Wang L, Martínez Steele E, Du M, Pomeranz JL, O’Connor LE, Herrick KA, Luo H, Zhang X, Mozaffarian D, Zhang FF. Trends in Consumption of Ultraprocessed Foods Among US Youths Aged 2-19 Years, 1999-2018. JAMA 2021; 326:519-530. [PMID: 34374722 PMCID: PMC8356071 DOI: 10.1001/jama.2021.10238] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE The childhood obesity rate has been steadily rising among US youths during the past 2 decades. Increasing evidence links consumption of ultraprocessed foods to excessive calorie consumption and weight gain, but trends in the consumption of ultraprocessed foods among US youths have not been well characterized. OBJECTIVE To characterize trends in the consumption of ultraprocessed foods among US youths. DESIGN, SETTING, AND PARTICIPANTS Serial cross-sectional analysis using 24-hour dietary recall data from a nationally representative sample of US youths aged 2-19 years (n = 33 795) from 10 cycles of the National Health and Nutrition Examination Survey (NHANES) from 1999-2000 to 2017-2018. EXPOSURES Secular time. MAIN OUTCOMES AND MEASURES Percentage of total energy consumed from ultraprocessed foods as defined by NOVA, an established food classification system that categorizes food according to the degree of food processing. RESULTS Dietary intake from youths were analyzed (weighted mean age, 10.7 years; 49.1% were girls). From 1999 to 2018, the estimated percentage of total energy from consumption of ultraprocessed foods increased from 61.4% to 67.0% (difference, 5.6% [95% CI, 3.5% to 7.7%]; P < .001 for trend), whereas the percentage of total energy from consumption of unprocessed or minimally processed foods decreased from 28.8% to 23.5% (difference, -5.3% [95% CI, -7.5% to -3.2%]; P < .001 for trend). Among the subgroups of ultraprocessed foods, the estimated percentage of energy from consumption of ready-to-heat and -eat mixed dishes increased from 2.2% to 11.2% (difference, 8.9% [95% CI, 7.7% to 10.2%]) and from consumption of sweet snacks and sweets increased from 10.7% to 12.9% (difference, 2.3% [95% CI, 1.0% to 3.6%]), but the estimated percentage of energy decreased for sugar-sweetened beverages from 10.8% to 5.3% (difference, -5.5% [95% CI, -6.5% to -4.5%]) and for processed fats and oils, condiments, and sauces from 7.1% to 4.0% (difference, -3.1% [95% CI, -3.7% to -2.6%]) (all P < .05 for trend). There was a significantly larger increase in the estimated percentage of energy from consumption of ultraprocessed foods among non-Hispanic Black youths (from 62.2% to 72.5%; difference, 10.3% [95% CI, 6.8% to 13.8%]) and Mexican American youths (from 55.8% to 63.5%; difference, 7.6% [95% CI, 4.4% to 10.9%]) than the increase among non-Hispanic White youths (from 63.4% to 68.6%; difference, 5.2% [95% CI, 2.1% to 8.3%]) (P = .04 for trends). CONCLUSIONS AND RELEVANCE Based on the NHANES cycles from 1999 to 2018, the estimated proportion of energy intake from consumption of ultraprocessed foods has increased among youths in the US and has consistently comprised the majority of their total energy intake.
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Affiliation(s)
- Lu Wang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Euridice Martínez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Mengxi Du
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Jennifer L. Pomeranz
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York
| | - Lauren E. O’Connor
- Division of Cancer Control and Population Science, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Kirsten A. Herrick
- Division of Cancer Control and Population Science, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Hanqi Luo
- Department of Nutrition and Institute for Global Nutrition, University of California, Davis
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
- Tufts Institute for Global Obesity Research, Tufts University, Boston, Massachusetts
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Bonaccio M, Ruggiero E, Persichillo M, Esposito S, Olivieri M, Di Castelnuovo A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Changes in ultra-processed food consumption during the first Italian lockdown following the COVID-19 pandemic and major correlates: results from two population-based cohorts. Public Health Nutr 2021; 24:3905-3915. [PMID: 33663640 PMCID: PMC8207556 DOI: 10.1017/s1368980021000999] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/09/2021] [Accepted: 03/01/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate changes in ultra-processed food (UPF) intake and its major correlates during the first Italian lockdown (9 March-3 May 2020). DESIGN Retrospective observational study. SETTING Italy. PARTICIPANTS We analysed 2992 subjects (mean age 57·9 ± 15·3 years, 40·4 % men). Individual participant data were pooled from two retrospective cohorts: (1) The Moli-LOCK cohort consists of 1501 adults, a portion of the larger Moli-sani study (n 24 325; 2005-2010) who were administered a phone-based questionnaire to assess lifestyles and psychological factors during confinement and (2) the Analysis of Long Term Risk of Covid-19 Emergency is a web-based survey of 1491 individuals distributed throughout Italy who self-responded to the same questionnaire by using Google forms.UPF was defined according to NOVA classification based on degree of food processing. An UPF score was created by assigning 1 point to increased consumption, -1 to decreased and 0 point for unchanged intakes of nineteen food items, with higher values indicating an increase in UPF during confinement. RESULTS Overall, 37·5 % of the population reported some increase in UPF (UPF score ≥1). Adults were more likely to decrease UPF (multivariable regression coefficient β = -1·94; 95 % CI -2·72, -1·17 for individuals aged >75 years as compared with 18-39 years) as did individuals from southern Italian regions as compared with Northern inhabitants (β = -1·32; 95 % CI -1·80, -0·84), while UPF lowering associated with increased exercise (β = -0·90; 95 % CI -1·46, -0·35) and weight loss (β = -1·05; 95 % CI -1·51, -0·59) during confinement. CONCLUSIONS During the first Italian lockdown, about 40 % of our population switched to unfavourable eating as reflected by increased UPF intake and this may have long-term effects for health.
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Affiliation(s)
- Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Mariarosaria Persichillo
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Simona Esposito
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | | | | | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell’Elettronica, Pozzilli (IS) 86077, Italy
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
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Wellard-Cole L, Davies A, Chen J, Jung J, Bente KB, Kay J, Watson WL, Hughes C, Rangan A, Yacef K, Koprinska I, Chapman K, Wong NT, Gemming L, Ni Mhurchu C, Bauman A, Allman-Farinelli M. The Contribution of Foods Prepared Outside the Home to the Diets of 18- to 30-Year-Old Australians: The MYMeals Study. Nutrients 2021; 13:nu13061761. [PMID: 34064220 PMCID: PMC8224325 DOI: 10.3390/nu13061761] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 01/21/2023] Open
Abstract
Young adults are the highest consumers of food prepared outside home (FOH) and gain most weight among Australian adults. One strategy to address the obesogenic food environment is menu labelling legislation whereby outlets with >20 stores in one state and >50 Australia-wide must display energy content in kJ. The aim of this study was to assess the contribution of FOH to the energy and macronutrients, saturated fat, total sugars and sodium intakes of young Australians. One thousand and one 18 to 30-year-olds (57% female) residing in Australia’s most populous state recorded all foods and beverages consumed and the location of preparation for three consecutive days using a purpose-designed smartphone application. Group means for the daily consumption of energy, percentage energy (%E) for protein, carbohydrate, total sugars, total and saturated fats, and sodium density (mg/1000 kJ) and proportions of nutrients from FOH from menu labelling and independent outlets were compared. Overall, participants consumed 42.4% of their energy intake from FOH with other nutrients ranging from 39.8% (sugars) to 47.3% (sodium). Independent outlets not required to label menus, contributed a greater percentage of energy (23.6%) than menu labelling outlets (18.7%, p < 0.001). Public health policy responses such as public education campaigns, extended menu labelling, more detailed nutrition information and reformulation targets are suggested to facilitate healthier choices.
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Affiliation(s)
- Lyndal Wellard-Cole
- Charles Perkins Centre, Nutrition and Dietetics Group, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.D.); (J.C.); (A.R.); (N.T.W.); (L.G.); (M.A.-F.)
- Cancer Prevention and Advocacy Division, Cancer Council NSW, Sydney, NSW 2011, Australia; (W.L.W.); (C.H.)
- Correspondence: ; Tel.: +61-2-9334-1771
| | - Alyse Davies
- Charles Perkins Centre, Nutrition and Dietetics Group, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.D.); (J.C.); (A.R.); (N.T.W.); (L.G.); (M.A.-F.)
| | - Juliana Chen
- Charles Perkins Centre, Nutrition and Dietetics Group, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.D.); (J.C.); (A.R.); (N.T.W.); (L.G.); (M.A.-F.)
| | - Jisu Jung
- School of Computer Science, The University of Sydney, Sydney, NSW 2006, Australia; (J.J.); (K.B.B.); (J.K.); (K.Y.); (I.K.)
| | - Kim B. Bente
- School of Computer Science, The University of Sydney, Sydney, NSW 2006, Australia; (J.J.); (K.B.B.); (J.K.); (K.Y.); (I.K.)
| | - Judy Kay
- School of Computer Science, The University of Sydney, Sydney, NSW 2006, Australia; (J.J.); (K.B.B.); (J.K.); (K.Y.); (I.K.)
| | - Wendy L. Watson
- Cancer Prevention and Advocacy Division, Cancer Council NSW, Sydney, NSW 2011, Australia; (W.L.W.); (C.H.)
| | - Clare Hughes
- Cancer Prevention and Advocacy Division, Cancer Council NSW, Sydney, NSW 2011, Australia; (W.L.W.); (C.H.)
| | - Anna Rangan
- Charles Perkins Centre, Nutrition and Dietetics Group, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.D.); (J.C.); (A.R.); (N.T.W.); (L.G.); (M.A.-F.)
| | - Kalina Yacef
- School of Computer Science, The University of Sydney, Sydney, NSW 2006, Australia; (J.J.); (K.B.B.); (J.K.); (K.Y.); (I.K.)
| | - Irena Koprinska
- School of Computer Science, The University of Sydney, Sydney, NSW 2006, Australia; (J.J.); (K.B.B.); (J.K.); (K.Y.); (I.K.)
| | - Kathy Chapman
- Heart Foundation of Australia, Sydney, NSW 2011, Australia;
| | - Nim Ting Wong
- Charles Perkins Centre, Nutrition and Dietetics Group, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.D.); (J.C.); (A.R.); (N.T.W.); (L.G.); (M.A.-F.)
| | - Luke Gemming
- Charles Perkins Centre, Nutrition and Dietetics Group, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.D.); (J.C.); (A.R.); (N.T.W.); (L.G.); (M.A.-F.)
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, The University of Auckland, Auckland 1023, New Zealand;
- The George Institute for Global Health, Newtown, NSW 2042, Australia
- The University of New South Wales, Kensington, NSW 2052, Australia
| | - Adrian Bauman
- Prevention Research Centre, School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, Nutrition and Dietetics Group, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW 2006, Australia; (A.D.); (J.C.); (A.R.); (N.T.W.); (L.G.); (M.A.-F.)
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Choy MJY, Brownlee I, Murphy AM. Data-Driven Dietary Patterns, Nutrient Intake and Body Weight Status in a Cross-Section of Singaporean Children Aged 6-12 Years. Nutrients 2021; 13:nu13041335. [PMID: 33920618 PMCID: PMC8074157 DOI: 10.3390/nu13041335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/08/2021] [Accepted: 04/15/2021] [Indexed: 12/19/2022] Open
Abstract
Pattern analysis of children’s diet may provide insights into chronic disease risk in adolescence and adulthood. This study aimed to assess dietary patterns of young Singaporean children using cluster analysis. An existing dataset included 15,820 items consumed by 561 participants (aged 6–12 years) over 2 days of dietary recall. Thirty-seven food groups were defined and expressed as a percentage contribution of total energy. Dietary patterns were identified using k-means cluster analysis. Three clusters were identified, “Western”, “Convenience” and “Local/hawker”, none of which were defined by more prudent dietary choices. The “Convenience” cluster group had the lowest total energy intake (mean 85.8 ± SD 25.3% of Average Requirement for Energy) compared to the other groups (95.4 ± 25.9% for “Western” and 93.4 ± 25.3% for “Local/hawker”, p < 0.001) but also had the lowest calcium intake (66.3 ± 34.7% of Recommended Dietary Allowance), similar to intake in the “Local/hawker” group (69.5 ± 38.9%) but less than the “Western” group (82.8 ± 36.1%, p < 0.001). These findings highlight the need for longitudinal analysis of dietary habit in younger Singaporeans in order to better define public health messaging targeted at reducing risk of major noncommunicable disease.
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Affiliation(s)
- Michelle Jie Ying Choy
- Devan Nair Building, Newcastle Research and Innovation Institute, Newcastle University, Singapore 600201, Singapore; (M.J.Y.C.); (A.M.M.)
| | - Iain Brownlee
- Devan Nair Building, Newcastle Research and Innovation Institute, Newcastle University, Singapore 600201, Singapore; (M.J.Y.C.); (A.M.M.)
- Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK
- Correspondence: ; Tel.: +44-191-227-4187
| | - Aoife Marie Murphy
- Devan Nair Building, Newcastle Research and Innovation Institute, Newcastle University, Singapore 600201, Singapore; (M.J.Y.C.); (A.M.M.)
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12
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Doggui R, Ward S, Johnson C, Bélanger M. Trajectories of Eating Behaviour Changes during Adolescence. Nutrients 2021; 13:1313. [PMID: 33923453 PMCID: PMC8073249 DOI: 10.3390/nu13041313] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Adolescence represents a critical transition phase during which individuals acquire eating behaviours that can track into adulthood. This study aims to characterise trends in eating behaviours throughout adolescence by investigating the presence of sub-groups of individuals presenting distinct trajectories of vegetable and fruit, sugary beverage, breakfast and fast-food consumption. Data from 744 MATCH study Canadian participants followed from 11 to 18 Years old (2013-2019) were included in the analyses. Participants reported how often they ate breakfast and consumed vegetables and fruits, sugary beverages and fast foods. Trajectories of eating behaviours over seven years were identified using group-based multi-trajectory modelling. For girls, three different groups were identified, namely 'stable food intake with a decline in daily breakfast consumption' (39.9%), 'moderate food intake and worsening in overall eating behaviours' (38.0%) and 'stable high food intake' (22.1%). For boys, five different groups were identified, namely 'low food intake with stable daily breakfast consumption' (27.3%), 'breakfast-skippers and increasing fast food intake' (27.1%), 'low food intake with a decline in daily breakfast consumption' (23.9%), 'high food intake with worsening of eating behaviours' (13.3%) and 'average food intake with consistently high breakfast consumption' (8.4%). Eating behaviours evolve through various distinct trajectories and sub-group-specific strategies may be required to promote healthy eating behaviours among adolescents.
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Affiliation(s)
- Radhouene Doggui
- Centre de Formation Médicale du Nouveau-Brunswick (Université de Sherbrooke), Pavillon J.-Raymond-Frenette, Université de Moncton, 18 Antonine-Maillet Ave, Moncton, NB E1A 3E9, Canada;
| | - Stéphanie Ward
- École des Sciences des Aliments, de Nutrition et d’Études Familiales, Université de Moncton, Moncton, NB E1A 3E9, Canada;
| | - Claire Johnson
- École des Hautes Études Publiques, Université de Moncton, Moncton, NB E1A 3E9, Canada;
| | - Mathieu Bélanger
- Centre de Formation Médicale du Nouveau-Brunswick (Université de Sherbrooke), Pavillon J.-Raymond-Frenette, Université de Moncton, 18 Antonine-Maillet Ave, Moncton, NB E1A 3E9, Canada;
- Department of Family and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
- Vitalité Health Network, Moncton, NB E2A 1A9, Canada
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13
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Kelly C, Callaghan M, Gabhainn SN. 'It's Hard to Make Good Choices and It Costs More': Adolescents' Perception of the External School Food Environment. Nutrients 2021; 13:nu13041043. [PMID: 33804848 PMCID: PMC8063803 DOI: 10.3390/nu13041043] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/04/2022] Open
Abstract
Research on the impact of school and community food environments on adolescent food choice is heavily reliant on objective rather than subjective measures of food outlets around schools and homes. Gaining the perspective of adolescents and how they perceive and use food environments is needed. The aim of this study was to explore adolescent’s perception and use of the food environment surrounding their schools. Purposive sampling was used to recruit schools. Mapping exercises and discussion groups were facilitated with 95 adolescents from six schools. Thematic analysis showed that adolescents are not loyal to particular shops but are attracted to outlets with price discounts, those with ‘deli’ counters and sweets. Cost, convenience and choice are key factors influencing preference for food outlets and foods. Quality, variety and health were important factors for adolescents but these features, especially affordable healthy food, were hard to find. Social factors such as spending time with friends is also an important feature of food environments that deserves further attention. Adolescents’ perceptions of their food environment provide insights into features that can be manipulated to enable healthy choices.
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Calixto Andrade G, Julia C, Deschamps V, Srour B, Hercberg S, Kesse-Guyot E, Allès B, Chazelas E, Deschasaux M, Touvier M, Augusto Monteiro C, Bertazzi Levy R. Consumption of Ultra-Processed Food and Its Association with Sociodemographic Characteristics and Diet Quality in a Representative Sample of French Adults. Nutrients 2021; 13:nu13020682. [PMID: 33672720 PMCID: PMC7924346 DOI: 10.3390/nu13020682] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/29/2020] [Accepted: 01/09/2021] [Indexed: 01/03/2023] Open
Abstract
The present study aims to describe ultra-processed food (UPF) consumption in a representative sample of French adults and to evaluate the association between UPF consumption and socioeconomic characteristics and nutritional profile of the diet. This is a cross-sectional study using food consumption data from the Étude Nationale Nutrition Santé (ENNS), conducted with 2642 participants (18-74 years old), between February 2006 and March 2007 in France. Dietary data were collected through three 24-h dietary recalls. All food and beverages were classified according to the NOVA classification. The energy contribution of NOVA food groups to total energy intake was presented by categories of sociodemographic characteristics. Linear and logistic regression models were used to estimate the association between the percentage of UPF in the diet with nutritional indicators. The mean daily energy consumption of the adult French population was 2111 kcal, of which 31.1% came from UPF. This percentage was higher among younger individuals, and in the urban area, and lower among individuals with incomplete high school and individuals who were retired. The consumption of UPF was positively associated with the dietary energy density and the dietary contents of total carbohydrates, free sugar, and total and saturated fat, as well as with inadequate dietary energy density, saturated fat, free sugar, and fiber intakes.
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Affiliation(s)
- Giovanna Calixto Andrade
- Department of Preventive Medicine, School of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil;
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo (Nupens/USP), São Paulo 01246-904, Brazil;
- Correspondence:
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
- Public Health Department, Avicenne Hospital, AP-HP, 93017 Bobigny, France
| | - Valérie Deschamps
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
- Santé Publique France, The French Public Health Agency, Nutritional Epidemiology Surveillance Team (ESEN), 93017 Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
- Public Health Department, Avicenne Hospital, AP-HP, 93017 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Eloi Chazelas
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Mélanie Deschasaux
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center–University of Paris (CRESS), 93017 Bobigny, France; (C.J.); (V.D.); (B.S.); (S.H.); (E.K.-G.); (B.A.); (E.C.); (M.D.); (M.T.)
| | - Carlos Augusto Monteiro
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo (Nupens/USP), São Paulo 01246-904, Brazil;
- Department of Nutrition, School of Public Health, University of São Paulo (FSP/USP), São Paulo 01246-904, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo (FMUSP), São Paulo 01246-903, Brazil;
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo (Nupens/USP), São Paulo 01246-904, Brazil;
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Winpenny EM, Winkler MR, Stochl J, van Sluijs EMF, Larson N, Neumark-Sztainer D. Associations of early adulthood life transitions with changes in fast food intake: a latent trajectory analysis. Int J Behav Nutr Phys Act 2020; 17:130. [PMID: 33036629 PMCID: PMC7547405 DOI: 10.1186/s12966-020-01024-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/14/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Early adulthood is a period of rapid personal development when individuals experience major life transitions (e.g. leaving the parental home, leaving education, beginning employment, cohabitation and parenthood). Changes in social and physical environments associated with these transitions may influence development of health-related behaviours. Consumption of fast food is one behaviour associated with poor diet and long-term health outcomes. In this study we assess how frequency of fast food consumption changes across early adulthood, and how major life transitions are associated with changes in fast food intake. METHODS Data were collected across four waves of the Project EAT study, from mean age 14.9 (SD = 1.6) to mean age 31.1 (SD = 1.6) years. Participants reporting data at two or more waves were included (n = 2902). Participants reported past week frequency of eating food from a fast food restaurant and responded to questions on living arrangements, education and employment participation, and having children. To assess changes in fast food we developed a latent growth model incorporating an underlying trajectory of fast food intake, five life transitions, and time-invariant covariates. RESULTS Mean fast food intake followed an underlying quadratic trajectory, increasing through adolescence to a maximum of 1.88 (SE 0.94) times/week and then decreasing again through early adulthood to 0.76 (SE 2.06) times/week at wave 4. Beginning full-time employment and becoming a parent both contributed to increases in fast food intake, each resulting in an average increase in weekly fast food intake of 0.16 (p < 0.01) times/week. Analysis of changes between pairs of waves revealed stronger associations for these two transitions between waves 1-2 (mean age 14.9-19.4 years) than seen in later waves. Leaving the parental home and beginning cohabitation were associated with decreases in fast food intake of - 0.17 (p = 0.004) and - 0.16 (p = 0.007) times/week respectively, while leaving full-time education was not associated with any change. CONCLUSIONS The transitions of beginning full-time employment and becoming a parent were associated with increases in fast food intake. Public health policy or interventions designed to reduce fast food intake in young adults may benefit from particular focus on populations experiencing these transitions, to ameliorate their impact.
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Affiliation(s)
| | - Megan R Winkler
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Kinanthropology, Charles University in Prague, Prague, Czech Republic
| | | | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
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Bleich SN, Soto MJ, Jones-Smith JC, Wolfson JA, Jarlenski MP, Dunn CG, Frelier JM, Herring BJ. Association of Chain Restaurant Advertising Spending With Obesity in US Adults. JAMA Netw Open 2020; 3:e2019519. [PMID: 33026451 PMCID: PMC7542328 DOI: 10.1001/jamanetworkopen.2020.19519] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
IMPORTANCE Restaurants spend billions of dollars on marketing. However, little is known about the association between restaurant marketing and obesity risk in adults. OBJECTIVE To examine associations between changes in per capita county-level restaurant advertising spending over time and changes in objectively measured body mass index (BMI) for adult patients. DESIGN, SETTING, AND PARTICIPANTS This cohort study used regression models with county fixed effects to examine associations between changes in per capita county-level (370 counties across 44 states) restaurant advertising spending over time with changes in objectively measured body mass index (BMI) for US adult patients from 2013 to 2016. Different media types and restaurant types were analyzed together and separately. The cohort was derived from deidentified patient data obtained from athenahealth. The final analytic sample included 5 987 213 patients, and the analysis was conducted from March 2018 to November 2019. EXPOSURE Per capita county-level chain restaurant advertising spending. MAIN OUTCOMES AND MEASURES Individual-level mean BMI during the quarter. RESULTS The included individuals were generally older (37.1% older than 60 years), female (56.8%), and commercially insured (53.5%). For the full population of 29 285 920 person-quarters, there was no association between changes in all restaurant advertising per capita (all media types, all restaurants) and changes in BMI. However, restaurant advertising spending was positively associated with weight gain for patients in low-income counties but not in high-income counties. A $1 increase in quarterly advertising per capita across all media and restaurant types was associated with a 0.053-unit increase in BMI (95% CI, 0.001-0.102) for patients in low-income counties, corresponding to a 0.12% decrease in BMI at the 10th percentile of changes in county advertising spending vs a 0.12% increase in BMI at the 90th percentile. CONCLUSIONS AND RELEVANCE The results of this study suggest that restaurant advertising is associated with modest weight gain among adult patients in low-income counties. To date, there has been no public policy action or private sector action to limit adult exposure to unhealthy restaurant advertising. Efforts to decrease restaurant advertising in low-income communities should be intensified and rigorously evaluated to understand their potential for increasing health equity.
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Affiliation(s)
- Sara N. Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Mark J. Soto
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jesse C. Jones-Smith
- Department of Health Services, University of Washington School of Public Health, Seattle
| | - Julia A. Wolfson
- Department of Health Management and Policy, Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor
| | - Marian P. Jarlenski
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Caroline G. Dunn
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Johannah M. Frelier
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Bradley J. Herring
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Ventura Barbosa Gonçalves H, Canella DS, Bandoni DH. Temporal variation in food consumption of Brazilian adolescents (2009-2015). PLoS One 2020; 15:e0239217. [PMID: 32941494 PMCID: PMC7498085 DOI: 10.1371/journal.pone.0239217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/01/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Worldwide population has been increasingly exposed to ultra-processed foods, which are associated with obesity. Adolescence is a transition period of life and WHO recommends the surveillance of risk factors to the adolescents' health, such as diet, because experiences in this phase can result in health risks. OBJECTIVE To assess the trends in food consumption of adolescents from Brazilian capitals according to sociodemographic variables, based on data from the National Survey of School Health (PeNSE). METHODS Data from in 2009, 2012 and 2015 of a total of 173,310 9th graders enrolled in public and private schools in Brazilian capitals and in the Federal District were assessed. Food consumption was assessed from regular consumption (five or more times a week) of healthy eating markers (beans; vegetables; fruit) and unhealthy eating markers (sweets; soft drinks; fried salty snacks). For sociodemographic variables, we considered macro regions; age; race/ skin color; gender; school administrative status. We assessed these markers trends for the population and, additionally, the analyses were stratified by gender, race/ skin color, and school administrative status. Statistical significance of the temporal trends was assessed by linear regression model. RESULTS Over six years, three types of change in Brazilian adolescents' diet were observed: decreasing regular consumption of beans, sweets and soft drinks, increasing regular consumption of vegetables, and stable consumption of fruit and fried salty snacks. CONCLUSION Brazilian adolescents' diet composition has changed in a short period, and therefore it is necessary to monitor it to propose actions aimed at this public.
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Affiliation(s)
| | - Daniela Silva Canella
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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18
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Kwon S, Wang-Schweig M, Kandula NR. Body Composition, Physical Activity, and Convenience Food Consumption among Asian American Youth: 2011-2018 NHANES. Int J Environ Res Public Health 2020; 17:E6187. [PMID: 32858944 PMCID: PMC7504455 DOI: 10.3390/ijerph17176187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/20/2022]
Abstract
The primary purpose of this study was to describe obesity, body composition, convenience food consumption, physical activity, and muscle strength among Asian American youth compared to other racial/ethnic groups. The secondary purpose was to examine whether obesity, body composition, convenience food consumption, physical activity, and muscle strength differed by acculturation levels among Asian American youth. A secondary analysis was conducted using data from 12,763 children aged 2 to 17 years that participated in the 2011-2018 US National Health and Nutrition Examination Survey (NHANES). In the NHANES interview, acculturation, dietary behavior, and physical activity questionnaires were administered. The acculturation level was indicated by the language spoken at home. In the NHANES examination, anthropometry, dual-energy X-ray absorptiometry (DXA), and muscle strength assessments were conducted. Compared to non-Hispanic White American boys, Asian American boys had similar levels of obesity, central obesity, and fat mass. Among the five racial/ethnic groups examined, lean body mass, muscle mass, convenience food consumption, and daily physical activity were the lowest in the Asian group. More acculturated Asian American boys, but not girls, were more likely to be obese (OR = 3.28 (1.63, 6.60)). More acculturated Asian American youth more frequently consumed convenience food (1.4 more meals/month (1.2, 1.6)). This study highlights the obesity problem among Asian American boys, which worsens with acculturation to America. The study results also suggest that although Asian American youth consume less convenience food overall than non-Hispanic White American youth, increasing acculturation may negatively influence food choices.
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Affiliation(s)
- Soyang Kwon
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL 60611, USA
| | - Meme Wang-Schweig
- Division of Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL 60607, USA;
| | - Namratha R. Kandula
- Department of Medicine and Preventive Medicine, Northwestern University, Chicago, IL 60611, USA;
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Fryar CD, Carroll MD, Ahluwalia N, Ogden CL. Fast Food Intake Among Children and Adolescents in the United States, 2015-2018. NCHS Data Brief 2020:1-8. [PMID: 33054908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Fast food has been associated with higher caloric intake and poorer diet quality in children and adolescents (1). In 2011-2012, children and adolescents aged 2-19 years consumed on average 12.4% of their daily calories from fast food on a given day (2). This report presents 2015-2018 estimates of the percentage of calories consumed from fast food on a given day among U.S. children and adolescents by demographic characteristics and trends since 2003.
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20
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Johnson KA, Jones-Smith J, Curriero FC, Cheskin LJ, Benjamin-Neelon SE, Perin J, Caicedo MR, Thornton RLJ. Low-Income Black and Hispanic Children's Neighborhood Food Environments and Weight Trajectories in Early Childhood. Acad Pediatr 2020; 20:784-792. [PMID: 31783182 PMCID: PMC7324231 DOI: 10.1016/j.acap.2019.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND High obesity rates among young black and Hispanic children place them at a higher risk for adult obesity and its comorbidities. Neighborhoods with predominately racial and ethnic minority residents have fewer healthful food options, which may contribute to obesity disparities. Few studies have assessed the relationship between neighborhood food environments and obesity in this population. METHODS Electronic health records from 2 pediatric primary care clinics serving predominately low-income, black, and Hispanic children were used to create a cohort of 3724 2- to 5-year olds, encompassing 7256 visits from 2007 to 2012 (mean 1.9 visits per patient, range: 1-5 visits per child). Longitudinal regression was used to model the association of mean body mass index z-score (BMI-z) over time and 3 measures of the neighborhood food environment: healthful food availability, availability of stores accepting the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) benefits, and fast food availability. RESULTS Compared to peers in neighborhoods with no or few stores accepting WIC, children in neighborhoods with many WIC stores had higher BMI-z at age 2 years (average difference of 0.272; 95% confidence interval: 0.041-0.503; P = .021). No relationship was found for healthful food or fast food availability. Although children in neighborhoods with low fast food availability did not have statistically significantly different BMI-z at age 2 as compared to children in areas with high fast food availability, they did have a statistically significantly higher change in average BMI-z over time (0.006 per month, 0.000-0.012, P = .024). CONCLUSIONS Access to WIC stores was associated with lower obesity rates and more healthful average BMI-z over time and represents a potentially important neighborhood food environment characteristic influencing racial/ethnic disparities in childhood obesity among young black and Hispanic children. More studies are needed to assess what aspects of WIC stores may underlie the observed association.
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Affiliation(s)
- Katherine Abowd Johnson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health (KA Johnson, SE Benjamin-Neelon, and RLJ Thornton), Baltimore, Md
| | - Jessica Jones-Smith
- University of Washington School of Public Health (J Jones-Smith), Seattle, Wash
| | - Frank C Curriero
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health (FC Curriero), Baltimore, Md
| | - Lawrence J Cheskin
- Department of Nutrition and Food Studies, George Mason University, College of Health & Human Services (LJ Cheskin), Fairfax, Va
| | - Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health (KA Johnson, SE Benjamin-Neelon, and RLJ Thornton), Baltimore, Md
| | - Jamie Perin
- Department of International Health, Johns Hopkins Bloomberg School of Public Health (J Perin), Baltimore, Md
| | - Mariana Rincon Caicedo
- Department of Pediatrics, Johns Hopkins School of Medicine (MR Caicedo and RLJ Thornton), Baltimore, Md
| | - Rachel L J Thornton
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health (KA Johnson, SE Benjamin-Neelon, and RLJ Thornton), Baltimore, Md; Department of Pediatrics, Johns Hopkins School of Medicine (MR Caicedo and RLJ Thornton), Baltimore, Md.
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21
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Martínez Steele E, Khandpur N, da Costa Louzada ML, Monteiro CA. Association between dietary contribution of ultra-processed foods and urinary concentrations of phthalates and bisphenol in a nationally representative sample of the US population aged 6 years and older. PLoS One 2020; 15:e0236738. [PMID: 32735599 PMCID: PMC7394369 DOI: 10.1371/journal.pone.0236738] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/13/2020] [Indexed: 11/27/2022] Open
Abstract
Ultra-processed food consumption has been associated with several health outcomes such as obesity, hypertension, cardiovascular disease and cancer. The deleterious nutrient profile of these products, and the presence of food additives, neoformed contaminants and contact materials such as phthalates and bisphenol may be some of the potential pathways through which ultra-processed food influences disease outcomes. The aim of this study was to examine the association between dietary contribution of ultra-processed foods and urinary biomarker concentrations of parent compounds or their metabolites including Di(2-ethylhexyl) phthalate (ΣDEHP), Di-isononyl phthalate (ΣDiNP), Monocarboxynonyl phthalate (mCNP), Mono (3-carboxypropyl) phthalate (mCPP), Monobenzyl phthalate (mBzP), Bisphenol A (BPA), Bisphenol F (BPF) and Bisphenol S (BPS), in the US. Participants from the cross-sectional 2009-2016 National Health and Nutrition Examination Survey, aged 6+ years, with urinary measures and with one 24-hour dietary recall were included in the study. Ultra-processed foods were identified based on the NOVA classification system, a four-group food classification based on the extent and purpose of industrial food processing. Linear regression was used to compare average urinary creatinine-standardized concentrations across quintiles of energy contribution of ultra-processed foods. Models incorporated survey sample weights and were adjusted for different sociodemographic and life-style variables. Adjusted geometric means of ΣDiNP, mCNP, mCPP, mBzP and BPF increased monotonically from the lowest to the highest quintile of ultra-processed food consumption. As both phthalates/bisphenol and ultra-processed foods have been previously associated with insulin resistance, diabetes, general/abdominal obesity and hypertension, our results suggest the possibility of contact materials in ultra-processed foods as one link between ultra-processed food and these health outcomes. Future studies could confirm findings and further explore these mechanisms of action.
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Affiliation(s)
- Eurídice Martínez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Neha Khandpur
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Maria Laura da Costa Louzada
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Carlos Augusto Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
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22
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Tian X, von Cramon-Taubadel S. Are only children in China more likely to be obese/overweight than their counterparts with siblings? Econ Hum Biol 2020; 37:100847. [PMID: 31981790 DOI: 10.1016/j.ehb.2020.100847] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/01/2019] [Accepted: 01/04/2020] [Indexed: 06/10/2023]
Abstract
Family planning policy in China has resulted in a large number of one-child families. According to Becker's "quantity-quality trade-off" theory there is an inverse relationship between the number of children in a family, and spending per child. We test whether this has led to significant differences in the height, weight and BMI of only-children compared with children with siblings in China using 4414 observations derived from four recent waves (2004, 2006, 2009, and 2011) of the China Health and Nutrition Survey. We use propensity score matching and instrumental variables to control for the possible endogeneity of the number of siblings. Results show that only-children are significantly heavier (1.88 %-3.86 %), and have higher BMI (2.59 %-3.50 %). Moreover, they are more likely to be obese than children with siblings (2.33 %-3.00 %). Further analysis shows that these differences in health outcomes might be attributable to higher consumption of animal-source food (23.90-27.13 g), a higher frequency of eating western fast food (0.48-0.70 times/3-month) and drinking sweetened soft drinks (0.29-0.36 times/month), a higher share of meals eaten away from home (4.67 %-5.31 %), and more sedentary activity (20.04-34.35 minutes/week) by only children. Our study indicates that the growing share of only children due to China's family planning policies also contributes to the increasing prevalence of overweight and obesity in China. This policy has been eased in recent years, which might slow the increase in the prevalence of overweight and obesity and thus reduce the corresponding health burden for Chinese society as a whole.
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Affiliation(s)
- Xu Tian
- China Center for Food Security Studies, Nanjing Agricultural University, 1# Weigang, Xuanwu District, Nanjing, China.
| | - Stephan von Cramon-Taubadel
- Department of Agricultural Economics and Rural Development, University of Göttingen, Wilhelm-Weber-Str. 2, Goettingen, 37073, Germany.
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Peng K, Rodríguez DA, Peterson M, Braun LM, Howard AG, Lewis CE, Shikany JM, Gordon-Larsen P. GIS-Based Home Neighborhood Food Outlet Counts, Street Connectivity, and Frequency of Use of Neighborhood Restaurants and Food Stores. J Urban Health 2020; 97:213-225. [PMID: 32086738 PMCID: PMC7101458 DOI: 10.1007/s11524-019-00412-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Researchers have linked neighborhood food availability to the overall frequency of using food outlets without noting if those outlets were within or outside of participants' neighborhoods. We aimed to examine the association of neighborhood restaurant and food store availability with frequency of use of neighborhood food outlets, and whether such an association was modified by neighborhood street connectivity using a large and diverse population-based cohort of middle-aged U.S. adults. We used self-reported frequency of use of fast food restaurants, sit-down restaurants, and grocery stores in respondents' home neighborhoods using data from the Coronary Artery Risk Development in Young Adults study Year 20 exam in 2005-2006 (n = 2860; Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA) and geographically matched GIS-measured neighborhood-level food resource, street, and U.S. Census data. We used mixed-effects logistic regression to examine the associations of the GIS-measured count of neighborhood fast food restaurants, sit-down restaurants, and grocery stores with self-reported frequency of using neighborhood restaurants and food stores and whether such associations differed by GIS-measured neighborhood street connectivity among those who perceived at least one such food outlet. In multivariate analyses, we observed a positive association between the GIS-measured count of neighborhood sit-down restaurants (OR = 1.02, 95% CI 1.00-1.04) and the self-reported frequency of using neighborhood sit-down restaurants. We observed no statistically significant association between GIS-measured count of neighborhood fast food restaurants and self-reported frequency of using neighborhood fast food restaurants, nor did we observe a statistically significant association between GIS-measured count of neighborhood grocery stores and self-reported frequency of using neighborhood grocery stores. We observed inverse associations between GIS-measured neighborhood street connectivity and the self-reported frequencies of using neighborhood fast food restaurants (OR = 0.42, 95% CI 0.26-0.68) and grocery stores (OR = - 2.26, 95% CI - 4.52 to - 0.01). Neighborhood street connectivity did not modify the association between GIS-measured neighborhood restaurant and food store count and the self-reported frequency of using neighborhood restaurants and food stores. Our findings suggest that, for those who perceived at least one sit-down restaurant in their neighborhood, individuals who have more GIS-measured sit-down restaurants in their neighborhoods reported more frequent use of sit-down restaurants than those whose neighborhoods contain fewer such restaurants. Our results also suggest that, for those who perceived at least one fast food restaurant in their neighborhood, individuals who live in neighborhoods with greater GIS-measured street connectivity reported less use of neighborhood fast food restaurants than those who live in neighborhoods with less street connectivity. The count of neighborhood sit-down restaurants and the connectivity of neighborhood street networks appear important in understanding the use of neighborhood food resources.
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Grants
- HHSN268201800004I NHLBI NIH HHS
- HHSN268201800003I NHLBI NIH HHS
- HHSN268201800007I NHLBI NIH HHS
- R01 HL114091 NHLBI NIH HHS
- P30 DK056350 NIDDK NIH HHS
- R24 HD050924 NICHD NIH HHS
- HHSN268201800006I NHLBI NIH HHS
- R01 HL104580 NHLBI NIH HHS
- R01 HL143885 NHLBI NIH HHS
- P30 ES010126 NIEHS NIH HHS
- HHSN268201800005I NHLBI NIH HHS
- P2C HD050924 NICHD NIH HHS
- National Heart, Lung, and Blood Institute
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Institute for Environmental Health Sciences
- National Heart, Lung, and Blood Institute and University of Alabama at Birmingham
- National Heart, Lung, and Blood Institute and University of Minnesota
- National Heart, Lung, and Blood Institute and Northwestern University
- National Heart, Lung, and Blood Institute and Kaiser Foundation Research Institute
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Affiliation(s)
- Ke Peng
- Department of Urban Planning, School of Architecture, Hunan University, Changsha, China
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514 USA
| | - Daniel A. Rodríguez
- Department of City and Regional Planning,, University of California, Berkeley, Berkeley, CA 94720 USA
| | - Marc Peterson
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514 USA
| | - Lindsay M. Braun
- Department of Urban and Regional Planning, University of Illinois at Urbana Champaign, Champaign, IL 61820 USA
| | - Annie Green Howard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514 USA
| | - Cora E. Lewis
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35205 USA
| | - James M. Shikany
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35205 USA
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 123 W. Franklin Street, Chapel Hill, NC USA
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Blanchet R, Willows N, Johnson S, Salmon Reintroduction Initiatives ON, Batal M. Traditional Food, Health, and Diet Quality in Syilx Okanagan Adults in British Columbia, Canada. Nutrients 2020; 12:nu12040927. [PMID: 32230797 PMCID: PMC7230592 DOI: 10.3390/nu12040927] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 11/16/2022] Open
Abstract
In Canada, store-bought food constitutes the majority of First Nations (FN) people’s diets; however, their traditional foods (TF; wild fish, game, fowl, and plants) remains vital for their health. This study compares health indicators and diet quality among 265 Syilx Okanagan adults according to whether or not they reported eating TF during a 24-h dietary recall. Three methods assessed diet quality: nutrient intakes and adequacy, Healthy Eating Index (HEI-C), and contributions of ultra-processed products (UPP) to %energy using the NOVA classification. Fifty-nine participants (22%) reported eating TF during the dietary recall; TF contributed to 13% of their energy intake. There were no significant differences in weight status or prevalence of chronic disease between TF eaters and non-eaters. TF eaters had significantly higher intakes of protein; omega-3 fatty acids; dietary fibre; copper; magnesium; manganese; phosphorus; potassium; zinc; niacin; riboflavin; and vitamins B6, B12, D, and E than non-eaters. TF eaters also had significantly better diet quality based on the HEI-C and the %energy from UPP. Findings support that TF are critical contributors to the diet quality of FN individuals. Strength-based FN-led interventions, such as Indigenous food sovereignty initiatives, should be promoted to improve access to TF and to foster TF consumption.
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Affiliation(s)
- Rosanne Blanchet
- Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, AB T6G 2P5, Canada
- Correspondence: (R.B.); (N.W.); Tel.: +1-780-492-3989 (N.W.)
| | - Noreen Willows
- Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, AB T6G 2P5, Canada
- Correspondence: (R.B.); (N.W.); Tel.: +1-780-492-3989 (N.W.)
| | | | | | - Malek Batal
- Department of Nutrition, Faculty of Medicine, University of Montreal, P.O. Box 6128, succ. Centre-ville, Montreal, QC H3C 3J7, Canada;
- Centre de recherche en santé publique du Québec (CReSP), Montreal, QC H3C 3J7, Canada
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Spaniol AM, da Costa THM, Bortolini GA, Gubert MB. Breastfeeding reduces ultra-processed foods and sweetened beverages consumption among children under two years old. BMC Public Health 2020; 20:330. [PMID: 32171266 PMCID: PMC7071637 DOI: 10.1186/s12889-020-8405-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breastfeeding and adequate complementary feeding are associated with healthy eating habits, prevention of nutritional deficiencies, obesity and non-communicable diseases. Our aim was to identify feeding practices and to evaluate the association between breastmilk intake and complementary feeding, focusing on ultra-processed foods (UPF) and sweetened beverages, among children under 2 years old. METHODS We conducted a cross-sectional study including 847 children from 20 Primary Health Units. We evaluated children's food consumption using a food intake markers questionnaire. We conducted a logistic regression to evaluate the effect of breastmilk intake on feeding practices. RESULTS The breastmilk intake was associated with lower odds of consuming non-recommended foods, such as cookies or crackers (OR: 0.29; IC 95%: 0.20-0.41) for children under 6 months, yogurt (OR: 0.33; CI 95%: 0.12-0.88) for children between 6 and 12 months and soft drinks (OR: 0.36; CI 95%: 0.17-0.75) for children between 12 and 24 months. Moreover, the breastmilk intake was associated with lower odds of consuming UPF (OR: 0.26; CI 95%: 0.09-0.74) and sweetened beverages (OR: 0.13; CI 95%: 0.05-0.33) for children under 6 months. For children between 12 and 24 months, breastmilk intake was associated with lower odds of consuming sweetened beverages (OR: 0.40; CI 95%: 0.24-0.65). CONCLUSION Breastmilk intake was associated with a reduced consumption of UPF and sweetened beverages. Investment in actions to scale up breastfeeding can generate benefits, besides those of breastmilk itself, translating into better feeding habits and preventing health problems in childhood.
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Affiliation(s)
- Ana Maria Spaniol
- Postgraduate Program in Human Nutrition, Center for Epidemiological Studies in Health and Nutrition – NESNUT, University of Brasilia, Brasilia, Federal District Brazil
| | | | - Gisele Ane Bortolini
- General Coordination of Food and Nutrition, Ministry of Health, Brasília, Federal District Brazil
| | - Muriel Bauermann Gubert
- Department of Nutrition, Center for Epidemiological Studies in Health and Nutrition – NESNUT, University of Brasilia, Brasilia, Federal District Brazil
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Thike TZ, Saw YM, Lin H, Chit K, Tun AB, Htet H, Cho SM, Khine AT, Saw TN, Kariya T, Yamamoto E, Hamajima N. Association between body mass index and ready-to-eat food consumption among sedentary staff in Nay Pyi Taw union territory, Myanmar. BMC Public Health 2020; 20:206. [PMID: 32041555 PMCID: PMC7011543 DOI: 10.1186/s12889-020-8308-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/31/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Ready-to-eat (RTE) food consumption has become popular in the working community with the increase in full-time jobs and the limited time to prepare food. Although RTE food is essential for this community, its consumption causes obesity. In Myanmar, obesity is a modifiable risk factor for non-communicable diseases, causing increases in morbidity and mortality. This study aimed to identify the association between body mass index (BMI) and RTE food consumption among sedentary staff in Nay Pyi Taw Union Territory, Myanmar. METHODS A cross-sectional study was conducted in 2018, in which 400 respondents participated in face-to-face interviews. The study area was selected using simple random sampling and drawing method. Measuring tape and digital weighing scale were used to measure the height and weight of the respondents. BMI was calculated by dividing the weight by height squared (kg/m2). Overweight and obesity were categorized by World Health Organization cut-off points. The collected data were analyzed using multiple logistic regression to estimate the adjusted odds ratio (AOR), and the 95% confidence interval (CI). RESULTS This study revealed that sedentary staff who consumed RTE food once or more per month were nearly five times more likely to be overweight and obese (AOR = 4.78, 95% CI 1.44-15.85) than those who consumed RTE food less frequently. In addition, five factors namely being older than 32 years (AOR = 3.97, 95% CI 1.82-8.69), preference for RTE food (AOR = 8.93, 95% CI 2.54-31.37), light-intensity of physical exercise (AOR = 3.55, 95% CI 1.63-7.73), sedentary leisure activities (AOR = 3.32, 95% CI 1.22-9.03), and smoking (AOR = 5.62, 95% CI 1.06-29.90) were positively associated with overweight and obesity. CONCLUSION Frequent consumers of RTE food and less physically active sedentary staff were more likely to be overweight and obese. This study highlights the urgent need to raise awareness regarding healthy lifestyle behaviors among the working community to reduce the burden of obesity-related chronic diseases. Moreover, sedentary workers should be aware of the food-based dietary guidelines of the country. Policy makers should strictly enforce nutritional labeling of RTE food, and strictly prohibit over-branding of RTE food.
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Affiliation(s)
- Thin Zar Thike
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Htin Lin
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Khin Chit
- Department of Food and Drug Administration, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Aung Ba Tun
- Directorate of Medical Service, Nay Pyi Taw, Myanmar
| | - Hein Htet
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Department of Preventative and Social Medicine, University of Medicine, Mandalay, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
| | - Aye Thazin Khine
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Thu Nandar Saw
- Department of Community and Global Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University, Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan
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Rummo PE, Feldman JM, Lopez P, Lee D, Thorpe LE, Elbel B. Impact of Changes in the Food, Built, and Socioeconomic Environment on BMI in US Counties, BRFSS 2003-2012. Obesity (Silver Spring) 2020; 28:31-39. [PMID: 31858733 DOI: 10.1002/oby.22603] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/02/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Researchers have linked geographic disparities in obesity to community-level characteristics, yet many prior observational studies have ignored temporality and potential for bias. METHODS Repeated cross-sectional data were used from the Behavioral Risk Factor Surveillance System (BRFSS) (2003-2012) to examine the influence of county-level characteristics (active commuting, unemployment, percentage of limited-service restaurants and convenience stores) on BMI. Each exposure was calculated using mean values over the 5-year period prior to BMI measurement; values were standardized; and then variables were decomposed into (1) county means from 2003 to 2012 and (2) county-mean-centered values for each year. Cross-sectional (between-county) and longitudinal (within-county) associations were estimated using a random-effects within-between model, adjusting for individual characteristics, survey method, and year, with nested random intercepts for county-years within counties within states. RESULTS A negative between-county association for active commuting (β = -0.19; 95% CI: -0.23 to -0.16) and positive associations for unemployment (β = 0.17; 95% CI: 0.14 to 0.19) and limited-service restaurants (β = 0.13; 95% CI: 0.11 to 0.14) were observed. An SD increase in active commuting within counties was associated with a 0.51-kg/m2 (95% CI: -0.72 to -0.31) decrease in BMI over time. CONCLUSIONS These results suggest that community-level characteristics play an important role in shaping geographic disparities in BMI between and within communities over time.
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Affiliation(s)
- Pasquale E Rummo
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Justin M Feldman
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Priscilla Lopez
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - David Lee
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Lorna E Thorpe
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Brian Elbel
- Department of Population Health, New York University School of Medicine, New York, New York, USA
- Wagner Graduate School of Public Service, New York University, New York, New York, USA
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Elbel B, Tamura K, McDermott ZT, Wu E, Schwartz AE. Childhood Obesity and the Food Environment: A Population-Based Sample of Public School Children in New York City. Obesity (Silver Spring) 2020; 28:65-72. [PMID: 31675159 PMCID: PMC6925337 DOI: 10.1002/oby.22663] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 09/06/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to examine the relationship between proximity to healthy and unhealthy food outlets around children's homes and their weight outcomes. METHODS A total of 3,507,542 student-year observations of height and weight data from the 2009-2013 annual FitnessGram assessment of New York City public school students were used. BMI z scores were calculated, student obesity or obesity/overweight was determined using Centers for Disease Control and Prevention growth charts, and these data were combined with the locations of four food outlet types (fast-food restaurants, wait-service restaurants, corner stores, and supermarkets) to calculate distance to the nearest outlet. Associations between weight status outcomes and distance to these food outlet types were examined using neighborhood (census tract) fixed effects. RESULTS Living farther than 0.025 mile (about half of a city block) from the nearest fast-food restaurant was associated with lower obesity and obesity/overweight risk and lower BMI z scores. Results ranged from 2.5% to 4.4% decreased obesity. Beyond this distance, there were generally no impacts of the food environment and little to no impact of other food outlet types. CONCLUSIONS Proximity to fast-food restaurants was inversely related to childhood obesity, but no relationships beyond that were seen. These findings can help better inform policies focused on food access, which could, in turn, reduce childhood obesity.
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Affiliation(s)
- Brian Elbel
- Department of Population Health, School of Medicine, New York University, New York, New York, USA
- Wagner Graduate School of Public Service, New York University, New York, New York, USA
| | - Kosuke Tamura
- Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Zachary T McDermott
- Wagner Graduate School of Public Service, New York University, New York, New York, USA
| | - Erilia Wu
- Department of Population Health, School of Medicine, New York University, New York, New York, USA
| | - Amy Ellen Schwartz
- Center for Policy Research, Maxwell School for Citizenship and Public Affairs, Syracuse University, Syracuse, New York, USA
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Walker BB, Shashank A, Gasevic D, Schuurman N, Poirier P, Teo K, Rangarajan S, Yusuf S, Lear SA. The Local Food Environment and Obesity: Evidence from Three Cities. Obesity (Silver Spring) 2020; 28:40-45. [PMID: 31774254 PMCID: PMC6972660 DOI: 10.1002/oby.22614] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/10/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aimed to identify the association between the food environment and obesity. METHODS BMI and waist circumference (WC) were measured in 8,076 participants from three cities. The number of fast-food restaurants, full-service restaurants, bars/pubs, markets, and liquor stores within 500 m of each participant was documented. The association between the food environment (ratio of fast-food to full-service restaurants, ratio of bars/pubs to liquor stores, and presence of markets) with obesity (BMI ≥ 30 kg/m2 ) and abdominal obesity (WC ≥ 102 cm for males or WC ≥ 88 cm for females) was investigated, adjusted for age, sex, education level, neighborhood deprivation, neighborhood type, and total hours per week of walking and taking into account city-level clustering. RESULTS The ratios of fast-food to full-service restaurants and of bars/pubs to liquor stores were positively associated with obesity (OR = 1.05 [CI: 1.02-1.09] and OR = 1.08 [CI: 1.04-1.13], respectively). The ratio of bars/pubs to liquor stores was positively associated with abdominal obesity (OR = 1.10 [CI: 1.05-1.14]). There was no association between markets and either obesity or abdominal obesity. CONCLUSIONS Features of the food environment have varying associations with obesity. These features have an additive effect, and future studies should not focus on only one feature in isolation.
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Affiliation(s)
| | - Aateka Shashank
- Department of GeographySimon Fraser UniversityBurnabyBritish ColumbiaCanada
| | - Danijela Gasevic
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Nadine Schuurman
- Department of GeographySimon Fraser UniversityBurnabyBritish ColumbiaCanada
| | - Paul Poirier
- Institut de cardiologie et de pneumologie de QuébecUniversité LavalQuébec CityQuébecCanada
| | - Koon Teo
- Population Health Research InstituteHamiltonOntarioCanada
| | | | - Salim Yusuf
- Population Health Research InstituteHamiltonOntarioCanada
| | - Scott A. Lear
- Faculty of Health SciencesSimon Fraser UniversityBurnabyBritish ColumbiaCanada
- Division of CardiologyProvidence Health CareVancouverBritish ColumbiaCanada
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Abstract
PURPOSE OF REVIEW The Inuit population living in North Canada is facing a drastic change in lifestyle, which has brought about a dramatic nutrition transition characterized by a decrease in the traditional foods consumption and an increasing reliance on processed, store-bought foods. This rapid dietary shift leads to a significant public health concern, as wild-harvested country foods are rich in many micronutrients including vitamins, trace elements and minerals while the most frequently eaten Western foods mainly provide energy, fat, carbohydrates and sodium. This review addresses the emerging strategies to tackle food insecurity in this population. RECENT FINDINGS Recent studies indicate that diets with a higher fraction of traditional foods (and a lower fraction of ultra-processed foods) exhibit a better Healthy Eating Index. This provides a basis to develop new dietary policies anchored in contemporary food realities. SUMMARY In Northern remote communities, improving food security requires holistic approaches. A mixed strategy that targets the revitalization of traditional foods systems and local food production initiatives seems the most promising strategy, to meet the dietary needs in terms of micronutrients, with respect to the cultural identity of local populations.
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Affiliation(s)
- Thora M Herrmann
- Department of Geography, Université de Montréal, Montréal, Quebec, Canada INRA, UMR 1019, UNH, CRNH Auvergne Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, Clermont-Ferrand, France
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31
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Falcão RCTMDA, Lyra CDO, de Morais CMM, Pinheiro LGB, Pedrosa LFC, Lima SCVC, Sena-Evangelista KCM. Processed and ultra-processed foods are associated with high prevalence of inadequate selenium intake and low prevalence of vitamin B1 and zinc inadequacy in adolescents from public schools in an urban area of northeastern Brazil. PLoS One 2019; 14:e0224984. [PMID: 31800573 PMCID: PMC6892533 DOI: 10.1371/journal.pone.0224984] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 10/26/2019] [Indexed: 12/12/2022] Open
Abstract
Changes in eating behavior of adolescents are associated with high consumption of processed and ultra-processed foods. This study evaluated the association between these foods and the prevalence of inadequate micronutrient intake in adolescents. A cross-sectional study was conducted with 444 adolescents from public schools in the city of Natal, northeastern Brazil. The adolescents’ habitual food consumption was evaluated using two 24-hour dietary recalls. Foods were categorized according to the degree of processing (processed and ultra-processed) and distributed into energy quartiles, using the NOVA classification system. Inadequacies in micronutrient intake were assessed using the estimated average requirement (EAR) as the cutoff point. Multivariate logistic regression models were used to estimate the relationship between energy percentage from processed and ultra-processed foods and prevalence of inadequate micronutrient intake. The mean (Standard Deviation (SD)) consumption of total energy from processed foods ranged from 5.8% (1.7%) in Q1 to 20.6% (2.9%) in Q4, while the mean consumption of total energy from ultra-processed foods ranged from 21.4% (4.9%) in Q1 to 61.5% (11.7%) in Q4. The rates of inadequate intake of vitamin D, vitamin E, folate, calcium, and selenium were above 80% for both sexes across all age groups. Energy consumption from processed foods was associated with higher prevalence of inadequate selenium intake (p < 0.01) and lower prevalence of inadequate vitamin B1 intake (p = 0.04). Energy consumption from ultra-processed foods was associated with lower prevalence of inadequate zinc and vitamin B1 intake (p < 0.01 and p = 0.03, respectively). An increase in the proportion of energy obtained from processed and ultra-processed foods may reflect higher prevalence of inadequate selenium intake and lower prevalence of vitamin B1 and zinc inadequacy.
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Affiliation(s)
| | - Clélia de Oliveira Lyra
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | - Lucia Fátima Campos Pedrosa
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Severina Carla Vieira Cunha Lima
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Karine Cavalcanti Maurício Sena-Evangelista
- Postgraduate Nutrition Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil
- * E-mail:
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Blanco-Rojo R, Sandoval-Insausti H, López-Garcia E, Graciani A, Ordovás JM, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillón P. Consumption of Ultra-Processed Foods and Mortality: A National Prospective Cohort in Spain. Mayo Clin Proc 2019; 94:2178-2188. [PMID: 31623843 DOI: 10.1016/j.mayocp.2019.03.035] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/19/2019] [Accepted: 03/27/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess the prospective association between ultra-processed food consumption and all-cause mortality and to examine the effect of theoretical iso-caloric non-processed foods substitution. PATIENTS AND METHODS A population-based cohort of 11,898 individuals (mean age 46.9 years, and 50.5% women) were selected from the ENRICA study, a representative sample of the noninstitutionalized Spanish population. Dietary information was collected by a validated computer-based dietary history and categorized according to their degree of processing using NOVA classification. Total mortality was obtained from the National Death Index. Follow-up lasted from baseline (2008-2010) to mortality date or December 31th, 2016, whichever was first. The association between quartiles of consumption of ultra-processed food and mortality was analyzed by Cox models adjusted for the main confounders. Restricted cubic-splines were used to assess dose-response relationships when using iso-caloric substitutions. RESULTS Average consumption of ultra-processed food was 385 g/d (24.4% of the total energy intake). After a mean follow-up of 7.7 years (93,599 person-years), 440 deaths occurred. The hazard ratio (and 95% CI) for mortality in the highest versus the lowest quartile of ultra-processed food consumption was 1.44 (95% CI, 1.01-2.07; P trend=.03) in percent of energy and 1.46 (95% CI, 1.04-2.05; P trend=.03) in grams per day per kilogram. Isocaloric substitution of ultra-processed food with unprocessed or minimally processed foods was associated with a significant nonlinear decrease in mortality. CONCLUSION A higher consumption of ultra-processed food was associated with higher mortality in the general population. Furthermore, the theoretical iso-caloric substitution ultra-processed food by unprocessed or minimally processed foods would suppose a reduction of the mortality risk. If confirmed, these findings support the necessity of the development of new nutritional policies and guides at the national and international level. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01133093.
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Affiliation(s)
- Ruth Blanco-Rojo
- Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain
| | - Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Esther López-Garcia
- Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Auxiliadora Graciani
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Jose M Ordovás
- Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Jose R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain
| | - Pilar Guallar-Castillón
- Instituto Madrileño De Estudios Avanzados-alimentacion-Food Institute, Campus de Excelencia Internacional Universidad Autónoma de Madrid + Centro Superior de Investigaciones Científicas, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Centro de Investigación Biomedica en Red of Epidemiology and Public Health, Madrid, Spain; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD.
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Petimar J, Zhang F, Cleveland LP, Simon D, Gortmaker SL, Polacsek M, Bleich SN, Rimm EB, Roberto CA, Block JP. Estimating the effect of calorie menu labeling on calories purchased in a large restaurant franchise in the southern United States: quasi-experimental study. BMJ 2019; 367:l5837. [PMID: 31666218 PMCID: PMC6818731 DOI: 10.1136/bmj.l5837] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate whether calorie labeling of menus in large restaurant chains was associated with a change in mean calories purchased per transaction. DESIGN Quasi-experimental longitudinal study. SETTING Large franchise of a national fast food company with three different restaurant chains located in the southern United States (Louisiana, Texas, and Mississippi) from April 2015 until April 2018. PARTICIPANTS 104 restaurants with calorie information added to in-store and drive-thru menus in April 2017 and with weekly aggregated sales data during the pre-labeling (April 2015 to April 2017) and post-labeling (April 2017 to April 2018) implementation period. MAIN OUTCOME MEASURES Primary outcome was the overall level and trend changes in mean purchased calories per transaction after implementation of calorie labeling compared with the counterfactual (ie, assumption that the pre-intervention trend would have persisted had the intervention not occurred) using interrupted time series analyses with linear mixed models. Secondary outcomes were by item category (entrees, sides, and sugar sweetened beverages). Subgroup analyses estimated the effect of calorie labeling in stratums defined by the sociodemographic characteristics of restaurant census tracts (defined region for taking census). RESULTS The analytic sample comprised 14 352 restaurant weeks. Over three years and among 104 restaurants, 49 062 440 transactions took place and 242 726 953 items were purchased. After labeling implementation, a level decrease was observed of 60 calories/transaction (95% confidence interval 48 to 72; about 4%), followed by an increasing trend of 0.71 calories/transaction/week (95% confidence interval 0.51 to 0.92) independent of the baseline trend over the year after implementation. These results were generally robust to different analytic assumptions in sensitivity analyses. The level decrease and post-implementation trend change were stronger for sides than for entrees or sugar sweetened beverages. The level decrease was similar between census tracts with higher and lower median income, but the post-implementation trend in calories per transaction was higher in low income (change in calories/transaction/week 0.94, 95% confidence interval 0.67 to 1.21) than in high income census tracts (0.50, 0.19 to 0.81). CONCLUSIONS A small decrease in mean calories purchased per transaction was observed after implementation of calorie labeling in a large franchise of fast food restaurants. This reduction diminished over one year of follow-up.
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Affiliation(s)
- Joshua Petimar
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Fang Zhang
- Division of Health Policy and Insurance Research, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Lauren P Cleveland
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Denise Simon
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Steven L Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michele Polacsek
- Westbrook College of Health Professions, University of New England, Portland, ME, USA
| | - Sara N Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric B Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jason P Block
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
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Zupanič N, Hribar M, Fidler Mis N, Pravst I. Free Sugar Content in Pre-Packaged Products: Does Voluntary Product Reformulation Work in Practice? Nutrients 2019; 11:nu11112577. [PMID: 31717724 PMCID: PMC6893660 DOI: 10.3390/nu11112577] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 11/16/2022] Open
Abstract
Ultra-processed, pre-packaged foods are becoming a growing part of our diet, while displacing whole and minimally processed foods. This results in an increased intake of free sugar, salt, and saturated fats, that have a profoundly negative effect on health. We aimed to assess the trend in free sugar content in pre-packaged foods in Slovenia and evaluate the efficacy of industry self-regulations designed to combat the excess consumption of free sugar. A nation-wide data collection of the Slovenian food supply was performed in 2015 and repeated in 2017. In 2017, 54.5% of all products (n = 21,115) contained free sugars (median: 0.26 g free sugar/100 g). Soft drinks became the main free sugar source among pre-packaged goods (28% of all free sugar sold on the market) in place of chocolates and sweets, of which relative share decreased by 4.4%. In the categories with the highest free sugar share, market-leading brands were often sweeter than the average free sugar value of the category. This indicates that changes in on-shelf availability towards a greater number of healthier, less sweet products are not necessarily reflected in healthier consumers’ choices. Relying solely on voluntary industrial commitments to reduce free sugar consumption will likely not be sufficient to considerably improve public health. While some further improvements might be expected over the longer term, voluntarily commitments are more successful in increasing the availability of healthier alternatives, rather than improving the nutritional composition of the market-leading products. Additional activities are, therefore, needed to stimulate reformulation of the existing market-leading foods and drinks, and to stimulate the consumption of healthier alternatives.
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Affiliation(s)
- Nina Zupanič
- Nutrition Institute, Tržaška cesta 40, SI-1000 Ljubljana, Slovenia; (N.Z.); (M.H.)
| | - Maša Hribar
- Nutrition Institute, Tržaška cesta 40, SI-1000 Ljubljana, Slovenia; (N.Z.); (M.H.)
| | - Nataša Fidler Mis
- Department of Gastroenterology, Hepatology and Nutrition, University Children’s Hospital, University Medical Centre Ljubljana, Bohoričeva 20, SI-1000 Ljubljana, Slovenia;
| | - Igor Pravst
- Nutrition Institute, Tržaška cesta 40, SI-1000 Ljubljana, Slovenia; (N.Z.); (M.H.)
- Correspondence: ; Tel.: +386-590-68871; Fax: +386-310-07981
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McGuirt JT, Huebner G, Ward R, Jilcott Pitts SB. Food and Beverage Options at Highway Rest Areas in North Carolina: A Mixed-Methods Audit and Geospatial Approach. Prev Chronic Dis 2019; 16:E142. [PMID: 31625869 PMCID: PMC6824145 DOI: 10.5888/pcd16.190129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Each year, millions of people purchase food at highway rest areas. Rest areas are potential sites for health promotion because they are operated by the public sector; they are frequently visited by professional truck drivers, who have a disproportionate burden of chronic disease; and they are easily accessible. To our knowledge, no research has systematically examined the healthfulness of food offerings at rest areas. The objective of this study was to determine the accessibility and healthfulness of food and beverages offered at highway rest areas in North Carolina using a mixed-methods audit and geospatial approach. METHODS We conducted a cross-sectional audit of all rest areas offering foods and beverages in North Carolina (N = 30) in summer 2018. We used the Nutrition Environment Measures Survey-Vending (NEMS-V) to record the 1) type, price, and size of all foods and beverages and 2) healthfulness of items offered (based on NEMS-V categorization). Two researchers independently double coded NEMS-V data. We used geospatial analysis to examine proximity of rest areas to food stores. We analyzed data by using univariate and bivariate analysis. RESULTS The mean number of vending machines per site was 8.0 (range, 2-12, standard deviation, 2.8). The healthfulness of offerings varied across sites. Most food items (88.1%; 2,922 of 3,315) and beverage items (63.7%; 1,567 of 2,459) were classified as least healthful. Cold beverage machines had a greater percentage of healthful items (38.2%; 778 of 2,036) than snack machines (11.4%; 374 of 3,270) (P < .001), mainly because of water and diet soda in beverage machines. CONCLUSION Policy changes are needed to increase the number and presentation of healthful food options at highway rest areas. Policy changes could provide travelers with more healthful options conveniently located along their travel route.
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Affiliation(s)
- Jared T McGuirt
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, North Carolina
- The University of North Carolina at Greensboro, 319 College Ave, 318 Stone Building, Greensboro, NC 27412.
| | - Grace Huebner
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Rachel Ward
- Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, Tennessee
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Theis DRZ, Adams J. Differences in energy and nutritional content of menu items served by popular UK chain restaurants with versus without voluntary menu labelling: A cross-sectional study. PLoS One 2019; 14:e0222773. [PMID: 31618202 PMCID: PMC6795485 DOI: 10.1371/journal.pone.0222773] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 09/06/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Poor diet is a leading driver of obesity and morbidity. One possible contributor is increased consumption of foods from out of home establishments, which tend to be high in energy density and portion size. A number of out of home establishments voluntarily provide consumers with nutritional information through menu labelling. The aim of this study was to determine whether there are differences in the energy and nutritional content of menu items served by popular UK restaurants with versus without voluntary menu labelling. METHODS AND FINDINGS We identified the 100 most popular UK restaurant chains by sales and searched their websites for energy and nutritional information on items served in March-April 2018. We established whether or not restaurants provided voluntary menu labelling by telephoning head offices, visiting outlets and sourcing up-to-date copies of menus. We used linear regression to compare the energy content of menu items served by restaurants with versus without menu labelling, adjusting for clustering at the restaurant level. Of 100 restaurants, 42 provided some form of energy and nutritional information online. Of these, 13 (31%) voluntarily provided menu labelling. A total of 10,782 menu items were identified, of which total energy and nutritional information was available for 9605 (89%). Items from restaurants with menu labelling had 45% less fat (beta coefficient 0.55; 95% CI 0.32 to 0.96) and 60% less salt (beta coefficient 0.40; 95% CI 0.18 to 0.92). The data were cross-sectional, so the direction of causation could not be determined. CONCLUSION Menu labelling is associated with serving items with less fat and salt in popular UK chain restaurants. Mandatory menu labelling may encourage reformulation of items served by restaurants. This could lead to public health benefits.
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Affiliation(s)
- Dolly R. Z. Theis
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Jean Adams
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Shi L, Zhang D, Rajbhandari-Thapa J, Katapodis N, Su D, Li Y. Neighborhood immigrant density and population health among native-born Americans. Prev Med 2019; 127:105792. [PMID: 31398413 PMCID: PMC6744955 DOI: 10.1016/j.ypmed.2019.105792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/05/2019] [Accepted: 08/06/2019] [Indexed: 11/17/2022]
Abstract
The healthy immigrant effect-whereby immigrants are on average healthier than the native-born-have been well studied. However, little is known about the relationship between immigration and the health of the native-born. This study fills this important research gap by examining the association between neighborhood immigrant density and several population health measures among native-born Americans. We used data from the Los Angeles County Health Survey to analyze four individual-level health behaviors and outcomes, including regular fast food consumption, fruit and vegetable consumption, body mass index, and hypertension. We conducted multilevel logistic regressions to assess the association between neighborhood immigrant density and the four health behaviors and outcomes. The results showed that neighborhood immigrant density was negatively associated with regular fast food consumption (OR = 0.33; 95% CI, 0.18-0.59), BMI (β = -2.16, 95% CI, -3.13 to -1.19), and hypertension (OR = 0.58; 95% CI, 0.38-0.89), and positively associated with fruit/vegetable consumption (OR = 1.64; 95% CI, 1.01-2.66) among native-born Americans. In conclusion, native-born Americans who lived in a neighborhood with a high density of immigrants had healthier behaviors and better health outcomes compared to those who lived in a neighborhood with a low density of immigrants.
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Affiliation(s)
- Lu Shi
- Public Health Science, College of Behavioral, Social and Health Science, Clemson University, Clemson, SC, USA
| | - Donglan Zhang
- Department of Health Policy and Management, University of Georgia, Athens, GA, USA
| | | | - Nicole Katapodis
- Department of Health Policy and Management, University of Georgia, Athens, GA, USA
| | - Dejun Su
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yan Li
- Center for Health Innovation, The New York Academy of Medicine, New York, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Oddo VM, Maehara M, Rah JH. Overweight in Indonesia: an observational study of trends and risk factors among adults and children. BMJ Open 2019; 9:e031198. [PMID: 31562157 PMCID: PMC6773342 DOI: 10.1136/bmjopen-2019-031198] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 08/07/2019] [Accepted: 08/29/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To conduct a secondary data analysis detailing overweight prevalence and associations between key hypothesised determinants and overweight. DESIGN This observational study used publicly available data from the Indonesian Family Life Survey (IFLS) (1993-2014). The IFLS is a home-based survey of adults and children that collected data on household characteristics (size, physical infrastructure, assets, food expenditures), as well as on individual-level educational attainment, occupation type, smoking status and marital status. These analyses used data on the self-reported consumption of ultra-processed foods and physical activity. Anthropometrics were measured. SETTING Indonesia. PRIMARY OUTCOME MEASURES We described the distribution of overweight by gender among adults (body mass index (BMI) ≥25 kg/m2) and by age among children, over time. Overweight was defined as weight-for-height z-score >2 among children aged 0-5 years and as BMI-for-age z-score >1 among children aged 6-18 years. We also described individuals who were overweight by selected characteristics over time. Finally, we employed multivariable logistic regression models to investigate risk factors in relation to overweight in 2014. RESULTS One-third of adults were overweight in 2014. Between 1993 and 2014, the prevalence of overweight among adults doubled from 17.1% to 33.0%. The prevalence of overweight among children under 5 years increased from 4.2% to 9.4% between 1993 and 2007, but then remained relatively stagnant between 2007 and 2014. Among children aged 6-12 years and 13-18 years, the prevalence of overweight increased from 5.1% to 15.6% and from 7.1% to 14.1% between 1993 and 2014, respectively. Although overweight prevalence remains higher in urban areas, the increase in overweight prevalence was larger among rural (vs urban) residents, and by 2014, the proportions of overweight adults were evenly distributed in each wealth quintile. Data suggest that the consumption of ultra-processed foods was common and levels of physical activity have decreased over the last decade. In multivariable models, urban area residence, higher wealth, higher education and consumption of ultra-processed foods were associated with higher odds of overweight among most adults and children. CONCLUSION Urgent programme and policy action is needed to reduce and prevent overweight among all ages.
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Affiliation(s)
- Vanessa M Oddo
- Department of Health Services, University of Washington School of Public Health, Seattle, Washington, USA
| | - Masumi Maehara
- Child Survival and Development, United Nations Children's Fund, Jakarta, Indonesia
| | - Jee Hyun Rah
- Child Survival and Development, United Nations Children's Fund, Jakarta, Indonesia
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Vega-Solano J, Blanco-Metzler A, Benavides-Aguilar KF, Arcand J. An Evaluation of the Sodium Content and Compliance with the National Sodium Reduction Targets among Packaged Foods Sold in Costa Rica in 2015 and 2018. Nutrients 2019; 11:nu11092226. [PMID: 31540146 PMCID: PMC6770815 DOI: 10.3390/nu11092226] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/27/2019] [Accepted: 09/09/2019] [Indexed: 01/31/2023] Open
Abstract
High blood pressure is a leading cause of death in Costa Rica, with an estimated mortality rate of 30%. The average household sodium intake is two times higher than the World Health Organization recommendation. The consumption of processed foods is an important and growing contributor to sodium intake. The objective of this study was to describe the sodium content of packaged foods (mg/100 g) sold in Costa Rica in 2015 (n = 1158) and 2018 (n = 1016) and to assess their compliance with the national sodium reduction targets. All 6 categories with national targets were analyzed: condiments, cookies and biscuits, bread products, processed meats, bakery products, and sauces. A significant reduction in mean sodium content was found in only 3 of the 19 subcategories (cakes, tomato-based sauces, and tomato paste). No subcategories had statistically significant increases in mean sodium levels, but seasonings for sides/mains, ham, and sausage categories were at least 15% higher in sodium. Compliance with the national sodium targets among all foods increased from 80% in 2015 to 87% in 2018. The results demonstrate that it is feasible to reduce the sodium content in packaged foods in Costa Rica, but more work is needed to continually support a gradual reduction of sodium in packaged foods, including more stringent sodium targets.
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Affiliation(s)
- Jaritza Vega-Solano
- Costa Rican Institute of Research and Teaching in Nutrition and Health (INCIENSA), Tres Ríos Box 4-2250, Costa Rica
| | - Adriana Blanco-Metzler
- Costa Rican Institute of Research and Teaching in Nutrition and Health (INCIENSA), Tres Ríos Box 4-2250, Costa Rica.
| | | | - JoAnne Arcand
- Faculty of Health Sciences, Ontario Tech University (University of Ontario Institute of Technology), 2000 Simcoe St N, Oshawa, ON L1H 7K4, Canada
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Vercammen KA, Frelier JM, Moran AJ, Dunn CG, Musicus AA, Wolfson JA, Bleich SN. Calorie and Nutrient Profile of Combination Meals at U.S. Fast Food and Fast Casual Restaurants. Am J Prev Med 2019; 57:e77-e85. [PMID: 31377086 DOI: 10.1016/j.amepre.2019.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The nutrient profile of combination meals in large chain restaurants is not well understood. METHODS Combination meals from 34 U.S. fast food and fast casual restaurants (lunch/dinner, n=1,113; breakfast, n=366) were identified from online menus in 2017-2018 and corresponding nutrition information for each menu item was obtained from a restaurant nutrition database (MenuStat). Three options for each combination meal were analyzed: (1) default (as advertised on menu), (2) minimum (low-calorie option), and (3) maximum (high-calorie option). In 2018, meal nutrient composition was compared with the Healthier Restaurant Meal Guidelines, and linear models examined to what extent each meal component (entrée, side, beverage) drove differences in nutrients across meal options. RESULTS There was substantial variation across the default, minimum, and maximum options of lunch/dinner combination meals for calories (default,: 1,193 kilocalories;, minimum,: 767 kilocalories;, maximum,: 1,685 kilocalories), saturated fat (14 g, 11 g, 19 g), sodium (2,110 mg, 1,783 mg, 2,823 mg), and sugar (68 g, 10 g, 117 g). Most default meals exceeded the Healthier Restaurant Meal Guidelines for calories (97%) and sodium (99%); fewer exceeded the standards for saturated fat (50%) and total sugar (6%). Comparing the maximum and default lunch/dinner combination meals, beverages were the largest driver of differences in calories (178 kilocalories, 36% of difference) and sugar (46 g, 93% of difference), and entrées were the largest driver of differences in saturated fat (3 g, 59% of difference) and sodium (371 g, 52% of difference). Results were similar for breakfast meals. CONCLUSIONS Combination meals offered by large U.S. chain restaurants are high in calories, sodium, saturated fat, and sugar, with most default meals exceeding recommended limits for calories and sodium.
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Affiliation(s)
- Kelsey A Vercammen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Johannah M Frelier
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Alyssa J Moran
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Caroline G Dunn
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Aviva A Musicus
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Julia A Wolfson
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Sara N Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Sanchez-Vaznaugh EV, Weverka A, Matsuzaki M, Sánchez BN. Changes in Fast Food Outlet Availability Near Schools: Unequal Patterns by Income, Race/Ethnicity, and Urbanicity. Am J Prev Med 2019; 57:338-345. [PMID: 31377084 PMCID: PMC6816308 DOI: 10.1016/j.amepre.2019.04.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Previous research has observed income or racial/ethnic inequalities in fast food restaurant availability near schools. The purpose of this study was to investigate changes in fast food restaurant availability near schools between 2000 and 2010 by school neighborhood income, race/ethnicity, and urbanicity. METHODS Using data from 7,466 California public schools, negative binomial regression models estimated the relative ratios to evaluate the income gradient in fast food restaurant availability, examine differences in the income gradient in fast food restaurant availability between 2000 and 2010, and investigate if fast food restaurant availability changed in 2010 versus 2000, stratified by race/ethnicity and urbanicity. The analyses were conducted in 2018 and early 2019. RESULTS In urban areas, there was a negative school neighborhood income gradient in fast food restaurant availability in both 2000 and 2010, and across all race/ethnic groups, except majority African American schools. The income gradient in fast food restaurant availability was steeper in 2010 relative to 2000 among Latino majority urban schools. Fast food restaurant availability increased in 2010 relative to 2000 among majority African American, majority Latino, and majority Asian schools in the least affluent neighborhoods. Among majority white schools in similar neighborhoods the availability of fast food restaurants did not change but declined in the most affluent school neighborhoods. In nonurban areas, the income patterns in fast food restaurant availability were less clear, and fast food restaurant availability increased among majority white and Latino schools within the middle neighborhood income tertile. CONCLUSIONS These findings suggest the need for future interventions to target schools in low-income urban neighborhoods. Additionally, reducing child health disparities and improving health for all children requires monitoring changes in the food environment near schools.
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Affiliation(s)
- Emma V Sanchez-Vaznaugh
- Department of Health Education, San Francisco State University, San Francisco, California; Center for Health Equity, University of California, San Francisco, San Francisco, California.
| | - Aiko Weverka
- Department of Health Education, San Francisco State University, San Francisco, California
| | - Mika Matsuzaki
- Department of Health Education, San Francisco State University, San Francisco, California
| | - Brisa N Sánchez
- Department of Epidemiology & Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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Galvão De Podestá OP, Peres SV, Salaroli LB, Cattafesta M, De Podestá JRV, von Zeidler SLV, de Oliveira JC, Kowalski LP, Ikeda MK, Brennan P, Curado MP. Consumption of minimally processed foods as protective factors in the genesis of squamous cell carcinoma of the head and neck in Brazil. PLoS One 2019; 14:e0220067. [PMID: 31344089 PMCID: PMC6657870 DOI: 10.1371/journal.pone.0220067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/08/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Head and neck cancer (HNC) is the sixth most common cancer, and two-fifths of cases could be avoided by changing lifestyle and eating habits. METHODS This multicenter case-control study was conducted under the International Consortium on Head and Neck Cancer and Genetic Epidemiology, coordinated by the International Agency for Research on Cancer. This consortium evaluated associations between minimally processed food consumption and the risk of HNC in three Brazilian states. RESULTS We evaluated 1740 subjects (847 cases and 893 controls). In multiple analyses including recognized risk factors for HNC, the consumption of apples and pears was associated with reduced risks of oral cavity and laryngeal cancers; the consumption of citrus fruits and fresh tomatoes was associated with a reduced risk of oral cavity cancer; the consumption of bananas was associated with a reduced risk of oropharynx cancer; the consumption of broccoli, cabbage, and collard greens was associated with reduced risks of laryngeal and hypopharyngeal cancers; and the consumption of carrots and fresh fruits was associated with a reduced risk of hypopharyngeal cancer. CONCLUSIONS The consumption of a heathy diet rich in fruits and vegetables was associated with a reduced risk of HNC. Public policies, including government subsidies, are essential to facilitate logistical and financial access to minimally processed foods, thereby strengthening environments that promote healthy behavior.
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Affiliation(s)
| | - Stela Verzinhasse Peres
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
| | | | - Monica Cattafesta
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória—ES / BR
| | | | | | | | - Luiz Paulo Kowalski
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
| | - Mauro Kasuo Ikeda
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Maria Paula Curado
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
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Abstract
OBJECTIVES The socioeconomic disparity in childhood and early adult obesity prevalence has been well characterised. Takeaway outlets may cluster in lower socioeconomic areas and their proximity to schools is of concern. This study aimed to map takeaway food outlets, characterise takeaway types and their proximity to educational institutions within a low socioeconomic ward in Manchester. DESIGN The Rusholme ward and a 2 km Euclidean buffer were included as the study area. Local authority Environmental Health data were used to map the takeaway outlets, using QGIS V.2.18.0 (OPENGIS.ch LLC, Einsiedeln, Switzerland). The types of takeaway outlets and major roads were included. Number of outlets within a 400 m Euclidean walking buffer of educational institutions were mapped. SETTING Rusholme, Manchester, UK. RESULTS Within the study area, 202 takeaway food outlets were identified and mapped as cluster points. Of these, 62.3% are located on major (A and B) roads, while the remaining outlets were located on minor roads. The majority (57.4%) of takeaway outlets sold similar items (fried chicken, burgers, pizzas, kebabs), with the remainder offering more diverse menus. Of the 53 schools, colleges and universities within the study area, 28 (52.8%) had 1-5 takeaway food outlets within 400 m, 9 (17.0%) had 6-10 outlets; 4 (7.5%) more than 11 outlets with 12 (22.6%) having zero outlets within 400 m. CONCLUSION Within this low socioeconomic area, there was a high concentration of takeaway food outlets, predominantly along major roads and in easy walking distance of educational establishments with the majority offering similar foods. In addition, a high proportion of these outlets were in easy walking distance of educational establishments. Public health policy needs to consider the implications of current takeaway food outlets and not just the proliferation of these outlets with current planning laws.
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Affiliation(s)
- Jennifer Blow
- Health Professionals, Faculty of Health Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Rebecca Gregg
- Health Professionals, Faculty of Health Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Ian G Davies
- Education, Health and Community, Liverpool John Moores University, Liverpool, UK
| | - Sumaiya Patel
- Health Professionals, Faculty of Health Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
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Young M, Coppinger T, Reeves S. The Nutritional Value of Children's Menus in Chain Restaurants in the United Kingdom and Ireland. J Nutr Educ Behav 2019; 51:817-825. [PMID: 31126724 DOI: 10.1016/j.jneb.2019.04.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/09/2019] [Accepted: 04/18/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Obesity in the United Kingdom and the Republic of Ireland is rising, as is the frequency of eating out in restaurants. The aim of this study was to investigate the nutritional quality of children's menus in restaurants. DESIGN Cross-sectional review of menus aimed at children from 20 popular chain restaurants in the United Kingdom and Ireland. MAIN OUTCOME MEASURES Total energy, fat, saturated fat, and salt were collected from every food item on the menu in each restaurant. All potential meal combinations were created. A total of 39,266 meals were analysed. ANALYSIS Meals were compared with UK nutritional guidelines. Meals from fast food and full-service restaurants and main meals and meal deals were compared. RESULTS The average meal for younger children (aged 2-5 years) contained 609 ±117 kcal, and for older children (6-12 years) 653 ± 136 kcal compared with guidelines of 364 and 550 kcal, respectively. A total of 68% of younger children's and 55% of older children's meals contained more total fat than recommended and more than 4 times the amount of saturated fat. Fast food restaurant meals contained less energy, fat, and salt than did full-service restaurants, and meal deals were less likely to meet dietary guidelines than were main meals alone. CONCLUSION AND IMPLICATIONS Eating in chain restaurants, in particular meal deals, does not contribute positively to the diet of children in the United Kingdom and Ireland.
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Affiliation(s)
- Michelle Young
- Department of Life Sciences, University of Roehampton, London, United Kingdom
| | - Tara Coppinger
- Department of Sport Leisure and Childhood Studies, Cork Institute of Technology, Cork, Ireland
| | - Sue Reeves
- Department of Life Sciences, University of Roehampton, London, United Kingdom.
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Elbel B, Tamura K, McDermott ZT, Duncan DT, Athens JK, Wu E, Mijanovich T, Schwartz AE. Disparities in food access around homes and schools for New York City children. PLoS One 2019; 14:e0217341. [PMID: 31188866 PMCID: PMC6561543 DOI: 10.1371/journal.pone.0217341] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 05/10/2019] [Indexed: 11/19/2022] Open
Abstract
Demographic and income disparities may impact food accessibility. Research has not yet well documented the precise location of healthy and unhealthy food resources around children's homes and schools. The objective of this study was to examine the food environment around homes and schools for all public school children, stratified by race/ethnicity and poverty status. This cross-sectional study linked data on the exact home and school addresses of a population-based sample of public school children in New York City from 2013 to all corner stores, supermarkets, fast-food restaurants, and wait-service restaurants. Two measures were created around these addresses for all children: 1) distance to the nearest outlet, and 2) count of outlets within 0.25 miles. The total analytic sample included 789,520 K-12 graders. The average age was 11.78 years (SD ± 4.0 years). Black, Hispanic, and Asian students live and attend schools closer to nearly all food outlet types than White students, regardless of poverty status. Among not low-income students, Black, Hispanic, and Asian students were closer from home and school to corner stores and supermarkets, and had more supermarkets around school than White students. The context in which children live matters, and more nuanced data is important for development of appropriate solutions for childhood obesity. Future research should examine disparities in the food environment in other geographies and by other demographic characteristics, and then link these differences to health outcomes like body mass index. These findings can be used to better understand disparities in food access and to help design policies intended to promote healthy eating among children.
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Affiliation(s)
- Brian Elbel
- Department of Population Health, New York University School of Medicine, New York, NY, United States of America
- Wagner Graduate School of Public Service, New York University, New York, NY, United States of America
- * E-mail:
| | - Kosuke Tamura
- Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Zachary T. McDermott
- Wagner Graduate School of Public Service, New York University, New York, NY, United States of America
| | - Dustin T. Duncan
- Department of Population Health, New York University School of Medicine, New York, NY, United States of America
- College of Global Public Health, New York University, New York, NY, United States of America
| | - Jessica K. Athens
- Department of Population Health, New York University School of Medicine, New York, NY, United States of America
| | - Erilia Wu
- Department of Population Health, New York University School of Medicine, New York, NY, United States of America
| | - Tod Mijanovich
- Department of Humanities and Social Sciences, New York University Steinhardt School of Culture, Education, and Human Development, New York, NY, United States of America
| | - Amy Ellen Schwartz
- Center for Policy Research, Maxwell School, Syracuse University, Syracuse, NY, United States of America
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Noll PRES, Noll M, de Abreu LC, Baracat EC, Silveira EA, Sorpreso ICE. Ultra-processed food consumption by Brazilian adolescents in cafeterias and school meals. Sci Rep 2019; 9:7162. [PMID: 31073127 PMCID: PMC6509257 DOI: 10.1038/s41598-019-43611-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 04/29/2019] [Indexed: 01/30/2023] Open
Abstract
This cross-sectional study utilized the National School Health Survey 2015 database to assess the association between school cafeterias; the meals offered by the Brazilian School Food Program (PNAE); and the consumption of industrialized/ultra-processed salty foods, sweets, and soft drinks among Brazilian adolescents. A sample of 102,072 adolescents, aged 11-19 years, who were enrolled in the 9th grade completed the survey. The evaluated outcome was the consumption of industrialized/ultra-processed salty foods, sweets, and soft drinks. A Poisson regression model-based multivariate analysis was performed. The effect measure was the prevalence ratio (PR) with its respective 95% confidence intervals (CIs). The results indicated that Brazilian adolescents who attended schools without meals offered through the PNAE had a higher probability of regularly (≥5 times/week) consuming ultra-processed salty foods [PR = 1.06, CI = 1.01-1.11] and soft drinks [PR = 1.08, CI = 1.03-1.14] compared to those who attended schools that offered PNAE meals. Moreover, the presence of a school cafeteria was associated with a higher probability to consume industrialized/ultra-processed salty foods [PR = 1.05, CI = 1.02-1.08], sweets [PR = 1.09, CI = 1.07-1.11], and soft drinks [PR = 1.10, CI = 1.07-1.13]. School meals appear to be associated with the consumption of ultra-processed foods by Brazilian adolescents, indicating areas for health promotion programs.
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Affiliation(s)
- Priscilla Rayanne E Silva Noll
- Gynecology Discipline, Department of Obstetrics and Gynecology, Faculdade de Medicina, Universidade de São Paulo (FMUSP), Universidade de São Paulo, São Paulo, Brazil.
- Instituto Federal Goiano - Campus Ceres, Goiás, Brazil.
| | - Matias Noll
- Instituto Federal Goiano - Campus Ceres, Goiás, Brazil
| | | | - Edmund Chada Baracat
- Gynecology Discipline, Department of Obstetrics and Gynecology, Faculdade de Medicina, Universidade de São Paulo (FMUSP), Universidade de São Paulo, São Paulo, Brazil
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculdade de Medicina, Universidade Federal de Goiás (UFG), Goiás, Brazil
| | - Isabel Cristina Esposito Sorpreso
- Gynecology Discipline, Department of Obstetrics and Gynecology, Faculdade de Medicina, Universidade de São Paulo (FMUSP), Universidade de São Paulo, São Paulo, Brazil
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Asirvatham J, Thomsen MR, Nayga RM, Goudie A. Do fast food restaurants surrounding schools affect childhood obesity? Econ Hum Biol 2019; 33:124-133. [PMID: 30825861 PMCID: PMC6584617 DOI: 10.1016/j.ehb.2019.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/03/2018] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
In this study, we estimate the effect of fast food environment surrounding schools on childhood body mass index (BMI). We use two methods that arrive at a similar conclusion, but with different implications. Using school distance from the nearest federal highway to instrument for restaurant location, we find the surrounding restaurants to only marginally affect a student's BMI measure. The effect size also decreases with increasing radial distances from school, 0.016 standard deviations at one-third of a mile and 0.0032 standard deviations at a mile radial distance. This indicates the decreasing influence of restaurants on a child's BMI as its distance from school increases. On a subset of students who were exogenously assigned to different school food environment, we find no effect of the fast food restaurants. An important contextual aspect is that nearly all schools in this sample observed closed campus policy, which does not allow students to leave campus during lunch hours.
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Affiliation(s)
- Jebaraj Asirvatham
- Department of Agribusiness Economics, Southern Illinois University Carbondale, IL, United States.
| | - Michael R Thomsen
- Department of Agricultural Economics and Agribusiness, University of Arkansas, Fayetteville, AR, United States
| | - Rodolfo M Nayga
- Department of Agricultural Economics and Agribusiness, University of Arkansas, Fayetteville, AR, United States
| | - Anthony Goudie
- Arkansas Center for Health Improvement Arkansas Center for Health Improvement (ACHI), Little Rock, AR, United States
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Niven P, Morley B, Dixon H, Martin J, Jones A, Petersen K, Wakefield M. Effects of health star labelling on the healthiness of adults' fast food meal selections: An experimental study. Appetite 2019; 136:146-153. [PMID: 30684644 DOI: 10.1016/j.appet.2019.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/09/2019] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
Abstract
The addition of Health Star Rating (HSR) labelling to menus at fast food outlets is feasible, however how this would impact consumer menu selection remains unclear. The aim of this study was to test whether the addition of HSR labelling to kilojoule (kJ) labelling on menus at fast food outlets would prompt consumers to select healthier meals. Using a between-subjects experimental design, 1007 adults aged 18-49 were allocated to one of four menu labelling conditions: (i) no labelling; (ii) kilojoule labelling; (iii) HSR labelling; and (iv) kilojoule + HSR labelling. Respondents were presented with their assigned menu online and instructed to select an evening meal as they would at a fast food restaurant. The main analyses tested differences by menu labelling condition in the total mean kilojoule content and Nutrient Profiling Score (NPS) of respondents' evening meal selections using one-way ANOVA. The mean kilojoule content of meals did not differ significantly by menu labelling condition. However, respondents in the kilojoule + HSR labelling condition selected healthier meals (lower mean NPS) than those who viewed menu boards with kilojoule labelling only (M = 2.88 cf. M = 3.78, p = 0.046). In addition, in a post hoc per-protocol analysis of respondents who reported using menu labelling to assist their meal selection, respondents shown kilojoule + HSR menu labelling selected meals with a significantly lower kilojoule content compared to those shown HSR labelling only (4751 kJ cf. 5745 kJ, p = 0.038). Findings provide evidence that adding HSRs to kilojoule labelling on menu boards at fast food outlets has the potential to assist adults to make healthier evening meal selections.
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Affiliation(s)
- Philippa Niven
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.
| | - Jane Martin
- Obesity Policy Coalition, Melbourne, Victoria, Australia
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia; Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Kristina Petersen
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia; The Pennsylvania State University, Department of Nutritional Sciences, University Park, PA, USA
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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Chen JL, Guedes CM, Lung AE. Smartphone-based Healthy Weight Management Intervention for Chinese American Adolescents: Short-term Efficacy and Factors Associated With Decreased Weight. J Adolesc Health 2019; 64:443-449. [PMID: 30409751 DOI: 10.1016/j.jadohealth.2018.08.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/02/2018] [Accepted: 08/22/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE This study aimed to examine the short-term efficacy of a smartphone-based intervention for Chinese American adolescents who are overweight or obese and to explore factors associated with decreased body mass index (BMI). METHODS A randomized controlled study design was used. Intervention group received culturally appropriate and tailored educational program for weight management while control group received general health information. Anthropometrics, blood pressure, levels of physical and sedentary activity, diet, self-efficacy, and quality of life were assessed at baseline, 3 months, and 6 months. Linear mixed-effects models and regression models were used to analyze outcomes. RESULTS The study included 40 adolescent participants. Adolescents in the intervention reduced their BMI (z = -4.89, p < .001), BMI z score (z = -4.72, p < .001), sugary beverage (z = -.44, P = .001), and TV and computer time (z = -.51, p < .001) and increasing in self-efficacy in nutrition and physical activity significantly more than those in the control group. BMI reduction was significantly correlated with decreased fast food consumption and increased physical activity (F = 6.99, p = .007, r2 = .40). Being female and decreased sugary beverage consumption were related to decreased BMI z score (F = 8.38, p = .003, r2 = .511). CONCLUSIONS A culturally appropriate smartphone-based intervention has great potential to reduce obesity and improve adherence to a healthy lifestyle. Reducing sugary beverages and fast food intake and decreasing sedentary time are associated with decreased BMI among adolescents who are overweight or obese.
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Affiliation(s)
- Jyu-Lin Chen
- University of California San Francisco, San Francisco, California.
| | - Claudia Maria Guedes
- Department of Kinesiology, San Francisco State University, San Francisco, California
| | - Audrey E Lung
- North East Medical Services, San Francisco, California
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Alves MDA, Pinho MGM, Corrêa EN, das Neves J, de Assis Guedes de Vasconcelos F. Parental Perceived Travel Time to and Reported Use of Food Retailers in Association with School Children's Dietary Patterns. Int J Environ Res Public Health 2019; 16:ijerph16050824. [PMID: 30866407 PMCID: PMC6427110 DOI: 10.3390/ijerph16050824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/21/2019] [Accepted: 03/01/2019] [Indexed: 11/16/2022]
Abstract
Considering the association between the neighborhood food environment and individual eating behaviors, this study aimed to assess the association between parents’ reported use of food facilities by their children, and parental perceived travel time to food facilities, with their children’s dietary patterns. Parents reported the use of supermarkets, full-service and fast-food restaurants, and perceived travel time to these food retailers. To assess school children’s food consumption, a previous day dietary recall was applied. Factor analysis was conducted to identify dietary patterns. To test the association between reported use and perceived travel time to food retailers and school children’s dietary patterns, we performed multilevel linear regression analyses. Parents’ reported use of supermarkets was associated with children’s higher score in the “Morning/Evening Meal” pattern. The use of full-service and fast-food restaurants was associated with children’s higher score in the “Fast Food” pattern. Higher parental perceived travel time to full-service and fast-food restaurants was associated with children’s lower score in the “Fast Food” pattern. Although the use of full-service and fast-food restaurants was associated with a less healthy dietary pattern, the perception of living further away from these food retailers may pose a barrier for the use of these facilities.
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Affiliation(s)
- Mariane de Almeida Alves
- Department of Nutrition, Centre of Health Sciences, Federal University of Santa Catarina, Trindade, Florianópolis, Santa Catarina 88040-900, Brazil.
| | - Maria Gabriela M Pinho
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, F wing, De Boelelaan 1089a, 1081 HV Amsterdam, The Netherlands.
| | - Elizabeth Nappi Corrêa
- Department of Nutrition, Centre of Health Sciences, Federal University of Santa Catarina, Trindade, Florianópolis, Santa Catarina 88040-900, Brazil.
| | - Janaina das Neves
- Department of Nutrition, Centre of Health Sciences, Federal University of Santa Catarina, Trindade, Florianópolis, Santa Catarina 88040-900, Brazil.
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