Food prices and body fatness among youths

The Supply of Calories, Proteins, and Fats in Low-Income Countries: A Four-Decade Retrospective Study

Over the past decades, both the quantity and quality of food supply for millions of people have improved substantially in the course of economic growth across the developing world. However, the number of undernourished people has resumed growth in the 2010s amid food supply disruptions, economic slowdowns, and protectionist restrictions to agricultural trade. Having been common to most nations, these challenges to the food security status of the population still vary depending on the level of economic development and national income of individual countries. In order to explore the long-run determinants of food supply transformations, this study employs five-stage multiple regression analysis to identify the strengths and directions of effects of agricultural production parameters, income level, price indices, food trade, and currency exchange on supply of calories, proteins, and fats across 11 groups of agricultural products in 1980-2018. To address the diversity of effects across developing nations, the study includes 99 countries of Asia, Europe, Latin America, the Middle East, and Africa categorized as low-income, lower-middle-income, and upper-middle-income economies. It is found that in low-income countries, food supply parameters are more strongly affected by production factors compared to economic and trade variables. The effect of economic factors on the food supply of higher-value food products, such as meat and dairy products, fruit, and vegetables, increases with the rise in the level of income, but it stays marginal for staples in all three groups of countries. The influence of trade factors on food supply is stronger compared to production and economic parameters in import-dependent economies irrelevant of the gross national income per capita. The approach presented in this paper contributes to the research on how food supply patterns and their determinants evolve in the course of economic transformations in low-income countries.

Association between the price of ultra-processed foods and obesity in Brazil

BACKGROUND AND AIMS

To estimate the relationship between the price of ultra-processed foods and prevalence of obesity in Brazil and examine whether the relationship differed according to socioeconomic status.

METHODS AND RESULTS

Data from the national Household Budget Survey from 2008/09 (n = 55 570 households, divided in 550 strata) were used. Weight and height of all individuals were used. Weight was measured by using portable electronic scales (maximum capacity of 150 kg). Height (or length) was measured using portable stadiometers (maximum capacity: 200 cm long) or infant anthropometers (maximum capacity: 105 cm long). Multivariate regression models (log-log) were used to estimate price elasticity. An inverse association was found between the price of ultra-processed foods (per kg) and the prevalence of overweight (Body mass index (BMI) ≥25 kg/m²) and obesity (BMI ≥30 kg/m²) in Brazil. The price elasticity for ultra-processed foods was -0.33 (95% CI: -0.46; -0.20) for overweight and -0.59 (95% CI: -0.83; -0.36) for obesity. This indicated that a 1.00% increase in the price of ultra-processed foods would lead to a decrease in the prevalence of overweight and obesity of 0.33% and 0.59%, respectively. For the lower income group, the price elasticity for price of ultra-processed foods was -0.34 (95% CI: -0.50; -0.18) for overweight and -0.63 (95% CI: -0.91; -0.36) for obesity.

CONCLUSION

The price of ultra-processed foods was inversely associated with the prevalence of overweight and obesity in Brazil, mainly in the lowest socioeconomic status population. Therefore, the taxation of ultra-processed foods emerges as a prominent tool in the control of obesity.

The price of ultra-processed foods and beverages and adult body weight: Evidence from U.S. veterans

The consumption of ultra-processed foods in the U.S. and globally has increased and is associated with lower diet quality, higher energy intake, higher body weight, and poorer health outcomes. This study drew on individual-level data on measured height and weight from U.S. Department of Veterans Affairs medical records for adults aged 20 to 64 from 2009 through 2014 linked to food and beverage price data from the Council for Community and Economic Research to examine the association between the price of ultra-processed foods and beverages and adult body mass index (BMI). We estimated geographic fixed effects models to control for unobserved heterogeneity of prices. We estimated separate models for men and women and we assessed differences in price sensitivity across subpopulations by socioeconomic status (SES). The results showed that a one-dollar increase in the price of ultra-processed foods and beverages was associated with 0.08 lower BMI units for men (p ≤ 0.05) (price elasticity of BMI of -0.01) and 0.14 lower BMI units for women (p ≤ 0.10) (price elasticity of BMI of -0.02). Higher prices of ultra-processed foods and beverages were associated with lower BMI among low-SES men (price elasticity of BMI of -0.02) and low-SES women (price elasticity of BMI of -0.07) but no statistically significant associations were found for middle- or high-SES men or women. Robustness checks based on the estimation of an individual-level fixed effects model found a consistent but smaller association between the price of ultra-processed foods and beverages and BMI among women (price elasticity of BMI of -0.01) with a relatively larger association for low-SES women (price elasticity of BMI of -0.04) but revealed no association for men highlighting the importance of accounting for individual-level unobserved heterogeneity.

State Agency Support of Weight-Related School Policy Implementation

BACKGROUND

In this study, we describe state agency strategies to support weight-related policy implementation in schools, and examine the association among state support, obesity prevalence, and strength of state policies governing school nutrition and physical education.

METHODS

The 2012 School Health Policies and Practices Study describes prevalence of implementation support state agencies provided to schools/districts. Implementation support items were analyzed by weight-related policy area (eg, advertising, wellness policy) and by type of support (eg, technical assistance). Results were summed to create a total weight-related policy support score. Linear regression was used to examine associations between policy support and state youth obesity prevalence (2011-2012 National Survey for Children's Health), overall and stratified by state policy strength (2012 Classification of Laws Associated with School Students).

RESULTS

States provided support most commonly for school meals and wellness policies (89% and 81%, respectively) and least often for after-school PE (26%). Most states (80%) provided technical assistance. The total weight-related policy support score had a significant positive association with state-level youth overweight/obesity prevalence (p = .03).

CONCLUSION

State agencies appear to be responding to their youth obesity prevalence with technical support. Schools and state agencies should work in collaboration to provide a healthy school environment for all students.

On the distributional and evolutionary nature of the obesity wage penalty

The economics literature supports a link between labor market measures, such as earnings, and health conditions, such as obesity. There is reason to believe the effects of obesity on wages may vary for high- and low-earning individuals and that obesity wage effects may evolve over a lifecycle or from generation to generation. Drawing on data from two longitudinal surveys, we estimate quantile and fixed effect quantile regressions, among others, to further examine the obesity wage effect. Results suggest an increasingly severe penalty across the wage distribution for females. Specifically, the highest-earning women may be penalized as much as five times that of the lowest earners. Results for males suggest that penalties may be present at select wage levels, while prior research has generally found no male obesity penalty. We also provide evidence that the obesity penalty has increased across generations and limited evidence that it may slow earnings growth over one's lifetime.

WOMEN’S EMPOWERMENT AND GENDER INEQUALITY IN ADOLESCENT NUTRITIONAL STATUS: EVIDENCE FROM THE INDONESIAN FAMILY LIFE SURVEY

In contrast to the extensive knowledge on the association between women’s empowerment and the nutritional status of children under the age of five, relatively little is known about the influence of women’s empowerment on adolescents’ nutritional status. This study aimed to assess the association between women’s empowerment and gender inequalities in adolescent nutritional status. Data were from the Indonesian Family Life Survey (IFLS) covering the period 1997 to 2015, and consisted of 16,683 observations from 13,396 adolescents between the ages of 10 and 19 years born in 6781 families. Three indicators of women’s empowerment were used: mother’s education, mother’s bargaining power and mother’s working status. Multivariate linear regression with robust standard errors was used to examine whether and how these indicators of women’s empowerment influenced adolescent nutritional status. Interaction terms were added to analyse how the association between women’s empowerment and adolescent nutritional status differed by gender. The results showed that mother’s education and mother’s working status were significantly associated with adolescent nutritional status, particularly with height-for-age. Adolescents of well-educated mothers had a higher height-for-age while those who were raised by mothers with a blue-collar job had a lower height-for-age. Although no gender differences were found for height-for-age, gender differences for BMI-for-age were obvious, with boys having a lower BMI-for-age than girls. Interactions between indicators of mother’s empowerment and gender showed that the gender gap in BMI-for-age was smaller for adolescents of more educated mothers. However, further analyses of food consumption patterns showed that boys whose mothers were more educated consumed more fast food and had higher instant noodle consumption than girls, thus suggesting gender bias in new disguise.

Food and beverage television advertising exposure and youth consumption, body mass index and adiposity outcomes

This study examined the relationships between exposure to food and beverage product television advertisements and consumption and obesity outcomes among youth. Individual-level data on fast-food and soft drink consumption and body mass index (BMI) for young adolescents from the Early Childhood Longitudinal Study - Kindergarten Cohort (1998-1999) and adiposity measures for children from the U.S. National Health and Nutrition Examination Survey (2003-2004) were combined with designated market area (DMA) Nielsen media advertising ratings data. To account for unobserved individual-level and DMA-level heterogeneity, various fixed- and random-effects models were estimated. The results showed that exposure to soft drink and sugar-sweetened beverage advertisements are economically and statistically significantly associated with higher frequency of soft drink consumption among youth even after controlling for unobserved heterogeneity, with elasticity estimates ranging from 0.4 to 0.5. The association between fast-food advertising exposure and fast-food consumption disappeared once we controlled for unobservables. Exposure to cereal advertising was significantly associated with young adolescents' BMI percentile ranking but exposures to fast-food and soft drink advertisements were not. The results on adiposity outcomes revealed that children's exposure to cereal advertising was associated with both percent body and trunk fatness; fast-food advertising was significantly associated with percent trunk fatness and marginally significantly associated with percent body fatness; and, exposure to SSB advertising was marginally significantly associated with percent body and trunk fatness. The study results suggest that continued monitoring of advertising is important and policy debates regarding the regulation of youth-directed marketing are warranted.

Non-separable time preferences, novelty consumption and body weight: Theory and evidence from the East German transition to capitalism

This paper develops a dynamic model to illustrate how diet and body weight change when novel food products become available to consumers. We propose a microfounded test to empirically discriminate between habit and taste formation in intertemporal preferences. Moreover, we show that 'novelty consumption' and endogenous preferences can explain the persistent correlation between economic development and obesity. By empirically studying the German reunification, we find that East Germans consumed more novel Western food and gained more weight than West Germans when a larger variety of food products became readily accessible after the fall of the Wall. The observed consumption patterns suggest that food consumption features habit formation.

The incidence of calorie labeling on fast food choices: A comparison between stated preferences and actual choices

In order to test the effect of calorie information on fast food choices, we conducted a questionnaire employing two types of stated preferences methods (the best-worst-scaling and intentional questions) and a follow-up randomized field experiment in a sample of 119 participants. This combined approach allowed us to test the internal validity of preferences for fast food meals across elicitation scenarios. The results showed that calorie information reduces the probability of selecting high calorie meals only in the questionnaire, while it did not have any significant impact on actual purchasing behavior in the field experiment. Thus, the findings show that there is a clear difference between the role of calorie information on immediate stated preference choices, and the relatively low level of responsiveness in real choices in a restaurant. We believe that the current results are quite suggestive, indicating the limits of predicting actual fast food behavior, and may open the way to using data sources that combine stated methods with field experiments.

Relative food prices and obesity in US Metropolitan areas: 1976-2001

This study investigates the impact of food price on obesity, by exploring the co-occurrence of obesity growth with relative food price reduction between 1976 and 2001. Analyses control for female labor participation and metropolitan outlet densities that might affect body weight. Both the first-difference and fixed effects approaches provide consistent evidence suggesting that relative food prices have substantial impacts on obesity and such impacts were more pronounced among the low-educated. These findings imply that relative food price reductions during the time period could plausibly explain about 18% of the increase in obesity among the U.S. adults in metropolitan areas.