Neighborhood socioeconomic status in relation to dietary intake and body mass index in female Japanese dietetic students

Attitude toward breakfast mediates the associations of wake time and appetite for breakfast with frequency of eating breakfast

PURPOSE

We investigated associations among attitude toward breakfast, appetite for breakfast, wake time, personality traits, self-esteem, and frequency of eating breakfast in university students and proposed a model of factors affecting the frequency of eating breakfast.

METHODS

The participants, 555 Japanese university students (177 men, 378 women), completed a questionnaire about their height and weight, living with family, wake time, frequency of eating breakfast, appetite for breakfast, attitude toward breakfast, personality traits, and self-esteem. Appetite for breakfast was evaluated with a four-point Likert-type scale. Attitude toward breakfast was assessed with a 13-item questionnaire using a five-point Likert-type scale; responses to the items were summed, and divided by the number of items to produce a score.

RESULTS

Multiple linear regression analysis showed that frequency of eating breakfast was positively associated with appetite for breakfast and attitude toward breakfast, and inversely associated with wake time. Wake time was inversely associated with attitude toward breakfast, and appetite for breakfast was positively associated with attitude toward breakfast. Structural equation modeling showed that the structured model based on the multiple regression analysis was a good fit for both men (chi-square value to the degrees of freedom [χ²/df] = 1.096, root mean square error of approximation [RMSEA] = 0.023) and women (χ²/df = 1.510, RMSEA = 0.037).

CONCLUSIONS

These results suggest that wake time and appetite for breakfast are directly associated with frequency of eating breakfast. Attitude toward breakfast mediates the indirect association between frequency of eating breakfast and both wake time and appetite for breakfast.

LEVEL OF EVIDENCE

V, cross-sectional descriptive study.

Associations of Education With Overall Diet Quality Are Explained by Different Food Groups in Middle-aged and Old Japanese Women

Background

The disparity of overall diet quality by personal educational attainment has been a public issue. However, it remains unknown which food groups contribute to the disparity. This cross-sectional study assesses which food groups explain associations between education and overall diet quality in Japanese women.

Methods

A total of 3,788 middle-aged (mean age, 47.7 years) and 2,188 older women (mean age, 74.4 years), who lived in 47 prefectures in Japan, provided data on their education (low, middle, and high) and dietary intakes from a diet history questionnaire. A diet quality score (possible score 0–70) was calculated based on seven food components. Mean diet quality scores, with adjustment for lifestyle and neighborhood variables, were estimated by education using a general linear model, and Dunnett’s multiple comparison was conducted. Additionally, mean scores of each food component were estimated by education and compared using the same manner.

Results

After adjustment for lifestyle and neighborhood variables, mean diet quality score of high or middle education was higher than low education for both generations. Middle-aged women with high and middle education had higher scores of ‘milk’, ‘snacks, confection, and beverages’, ‘fruits’, and ‘vegetable dishes’ than those with low education. Older women with high and middle education had higher scores of ‘sodium from seasonings’ and ‘fruits’ than those with low education.

Conclusions

This study suggests that positive associations between education and diet quality are explained by different food groups in middle-aged and older Japanese women, which are independent of lifestyle and neighborhood variables.

Association of anthropometric status, perceived stress, and personality traits with eating behavior in university students

PURPOSE

We investigated the association of anthropometric status, perceived stress, and personality traits with eating behavior in university students.

METHODS

The participants, 1546 Japanese university students (964 males, 582 females), completed a questionnaire which asked for their current height and weight, ideal height and weight, eating behaviors, perceived stress, and personality traits.

RESULTS

Restrained eating was higher in normal-weight participants compared with underweight participants in both males and females (p < 0.001, both males and females). Restrained eating in normal-weight males was significantly lower in normal-weight females (p < 0.001). In addition, normal-weight males reported less stress than normal-weight females (anxiety/uncertainty, p = 0.037; tiredness/physical responses, p < 0.001; autonomic symptoms, p < 0.001; depression/feeling, p < 0.001) and underweight males (tiredness/physical responses, p = 0.018; autonomic symptoms, p = 0.001). Moreover, among normal-weight males, neuroticism was significantly lower compared with normal-weight females (p < 0.001). In multiple regression analysis, male participants revealed positive association between restrained eating and body mass index (β = 0.199, p < 0.001) or body mass index difference (β = - 0.170, p = 0.001). In contrast, female revealed more significant associations between emotional and external eating and perceived stress or personality traits compared with males.

CONCLUSIONS

These results indicate that associations between eating behavior and anthropometric status or psychological factors are different by each eating behavior, which is partly influenced by gender difference.

LEVEL OF EVIDENCE

V, cross-sectional descriptive study.

Influence of individual life course and neighbourhood socioeconomic position on dietary intake in African Americans: the Jackson Heart Study

OBJECTIVE

African Americans, especially those in the Southeastern USA, have different dietary behaviours from the general US population, and have the highest prevalence, incidence and mortality of diet-related disease outcomes, such as cardiovascular disease. However, there are scant data regarding factors such as socioeconomic position (SEP) across the life course that influence dietary behaviours in this high-risk population. Our aim was to examine the impact of life course and neighbourhood SEPs on dietary intake among African Americans.

PARTICIPANTS AND SETTING

Data for this cross-sectional analysis came from the community-based Jackson Heart Study (JHS). We analysed a total of 3948 JHS participants (mean age: 55.4±12.5; 63.9% women), who had complete dietary intake and covariate information.

METHODS

We examined the associations of childhood SEP (CSEP), adulthood SEP (ASEP) and neighbourhood SEP (NSEP) with 10 selected dietary intake measures, using multilevel log-gamma generalised linear regression models.

OUTCOME MEASURES

Dietary intake measures include daily saturated fat, sodium, protein, fibre, fruits and vegetables, whole grains, sugar-sweetened beverage, nuts, fish and processed meat.

RESULTS

In age, sex and total energy intake adjusted models, most dietary intakes were associated with these three SEP measures. After additional adjustment for other SEP measures, most of the significant associations with CSEP and NSEP were attenuated, except for the associations of fibre with CSEP (relative rate [RR] [95% CI] 1.05 [1.00-1.10]) and whole grains with NSEP (RR [95% CI] 1.28 [1.02-1.61]). The associations (shown as RR [95% CI]) between ASEP and sugar-sweetened beverage: 0.70 (0.59-0.83), processed meat: 0.75 (0.63-0.90), sodium: 0.99 (0.94-1.00), fibre: 1.10 (1.03-1.16), protein: 1.05 (1.01-1.09), fruits and vegetables: 1.21 (1.11-1.32), nuts: 2.13 (1.59-2.87), and fish: 1.57 (1.27-1.95) generally persisted after additional adjustment for both CSEP and NSEP. However, the association between ASEP and whole grains was attenuated.

CONCLUSIONS

High ASEP may have a more beneficial influence on dietary practices in African Americans than CSEP or NSEP.

Influences of peers' and family members' body shapes on perception of body image and desire for thinness in Japanese female students

PURPOSE

The present study investigated the influence of peers' and family members' body shapes on the perception of body image and desire for thinness in Japanese female students.

METHODS

The study included 342 female, Japanese university students between the ages of 18 years and 22 years. They completed an anonymous questionnaire, which included questions related to anthropometry and body perception. Eating behavior was assessed by the Japanese version of the Eating Attitude Test-26.

RESULTS

Many students overestimated their body shape (81.2% of underweight students and 74.6% of normal students) and had a desire for thinness (41.0% of underweight students, 88.2% of normal students, and 100% of overweight students). One of the main reasons for the overestimation of their body shape was comparison with others. Participants who were interested in a friend's body shape were almost three times more likely to have a desire for thinness than those who were not interested in a female friend's body shape (odds ratio: 3.06, P=0.014).

CONCLUSION

The results indicate a possibility that a female Japanese student's young female friends' body shapes, influences her desire for thinness or her perception of her own body shape.

Neighbourhood socioeconomic disadvantage and fruit and vegetable consumption: a seven countries comparison

BACKGROUND

Low fruit and vegetable consumption is a risk factor for poor health. Studies have shown consumption varies across neighbourhoods, with lower intakes in disadvantaged neighbourhoods. However, findings are inconsistent, suggesting that socio-spatial inequities in diet could be context-specific, highlighting a need for international comparisons across contexts. This study examined variations in fruit and vegetable consumption among adults from neighbourhoods of varying socioeconomic status (SES) across seven countries (Australia, Canada, Netherlands, New Zealand, Portugal, Scotland, US).

METHODS

Data from seven existing studies, identified through literature searches and knowledge of co-authors, which collected measures of both neighbourhood-level SES and fruit and vegetable consumption were used. Logistic regression was used to examine associations between neighbourhood-level SES and binary fruit and vegetable consumption separately, adjusting for neighbourhood clustering and age, gender and education. As much as possible, variables were treated in a consistent manner in the analysis for each study to allow the identification of patterns of association within study and to examine differences in the associations across studies.

RESULTS

Adjusted analyses showed evidence of an association between neighbourhood-level SES and fruit consumption in Canada, New Zealand and Scotland, with increased odds of greater fruit intake in higher SES neighbourhoods. In Australia, Canada, New Zealand and Portugal, those residing in higher SES neighbourhoods had increased odds of greater vegetable intake. The other studies showed no evidence of a difference by neighbourhood-level SES.

CONCLUSIONS

Acknowledging discrepancies across studies in terms of sampling, measures, and definitions of neighbourhoods, this opportunistic study, which treated data in a consistent manner, suggests that associations between diet and neighbourhood-level socioeconomic status vary across countries. Neighbourhood socioeconomic disadvantage may differentially impact on access to resources in which produce is available in different countries. Neighbourhood environments have the potential to influence behaviour and further research is required to examine the context in which these associations arise.

Impact of neighborhood socioeconomic conditions on the risk of stroke in Japan

BACKGROUND

Neighborhood deprivation has been shown in many studies to be an influential factor in cardiovascular disease risk. However, no previous studies have examined the effect of neighborhood socioeconomic conditions on the risk of stroke in Asian countries.

METHODS

This study investigated whether neighborhood deprivation was associated with the risk of stroke and stroke death using data from the Japan Public Health Center-based Prospective Study. We calculated the adjusted hazard ratios of stroke mortality (mean follow-up, 16.4 years) and stroke incidence (mean follow-up, 15.4 years) according to the area deprivation index (ADI) among 90 843 Japanese men and women aged 40-69 years. A Cox proportional-hazard regression model using a shared frailty model was applied.

RESULTS

The adjusted hazard ratios of stroke incidence, in order of increasing deprivation with reference to the least deprived area, were 1.16 (95% CI, 1.04-1.29), 1.12 (95% CI, 1.00-1.26), 1.18 (95% CI, 1.02-1.35), and 1.19 (95% CI, 1.01-1.41), after adjustment for individual socioeconomic conditions. Behavioral and psychosocial factors attenuated the association, but the association remained significant. The associations were explained by adjusting for biological cardiovascular risk factors. No significant association with stroke mortality was identified.

CONCLUSIONS

Our results indicate that the neighborhood deprivation level influences stroke incidence in Japan, suggesting that area socioeconomic conditions could be a potential target for public health intervention to reduce the risk of stroke.

Eating behavior and perception of body shape in Japanese university students

PURPOSE

We investigated the relationship between eating behavior measured by the Dutch Eating Behaviour Questionnaire (DEBQ) and perception of body shape, examining the current physical status and 'ideal' physical parameters in females and males.

METHODS

The participants, 548 Japanese university students (age 19.2 ± 0.9 years, mean ± SD; 252 males, 296 females), completed a questionnaire which asked for their current physical status (e.g., weight and height), their ideal physical parameters, their perception of their current body shape, their ideal body shape, and their eating behaviors.

RESULTS

The ideal weight and ideal body mass index (BMI) were significantly higher than the current weight and BMI in the males, but significantly lower in the females. Among the females, the ideal body shape was smaller than their perception of current body shape. The DEBQ scores for restrained, emotional, and external eating were higher in the females than the males among the normal-weight participants, and among the underweight participants, the restrained eating and external eating scores were higher in the females than the males. Restrained eating was negatively associated with the discrepancy between the current and ideal weight, BMI, and body shape in both the males and females. Emotional eating was negatively associated with the discrepancy in current/ideal BMI and body shape only in the females.

CONCLUSIONS

At least in Japanese university students, the gender differences in ideal body shape are related to eating behavior.

Dietary fat intake, body composition and blood lipids of university men and women

BACKGROUND

Cardiovascular disease rates are high in the U.K., particular in men, and are related to dietary fat intake. We conducted a pilot study to investigate relationships between saturated and unsaturated dietary fat intakes, body composition and blood lipid parameters in Caucasian men and women at university.

METHODS

Volunteers (52 men and 52 women; age range 20-50 years) were recruited from staff and students of London Metropolitan University. Dietary intake, body composition, blood pressure and fasting blood glucose and lipids were assessed. Gender differences between the measured variables and their relationships were assessed by Mann-Whitney U-test, and by multi-linear (stepwise) regression, respectively.

RESULTS

Men consumed more saturated fat (29.5 vs. 20.5 g/day, p < 0.001), and had elevated levels of glucose (5.34 + 0.74 vs. 4.85 + 0.49 mmol/l, p < 0.001), low-density lipoprotein (LDL) cholesterol (2.99 + 1.5 vs. 2.62+ 0.74 mmol/l, p < 0.05), systolic blood pressure (126.4 + 11.0 vs. 112.6 + 17.2 mm/Hg, p < 0.001), and lower high-density lipoprotein (HDL) cholesterol (1.41 ± 0.34 vs. 1.83 ± 0.43, p < 0.001). Saturated fat was positively associated with total body fat ( p < 0.05), trunk fat ( p < 0.001), HDL cholesterol ( p < 0.05) and systolic blood pressure ( p < 0.001) in women, while in men docosahexaenoic acid and total cholesterol ( p < 0.05), total omega-3 fatty acids and LDL cholesterol ( p < 0.001), total omega-3 fatty acids and triglycerides ( p < 0.01) were positively related. Similar n-3 fatty acid intakes were reported in nutritionally aware students and other university subjects.

CONCLUSIONS

The data of this study indicate gender-related differences in response to dietary fat, and widespread low compliance with n-3 fatty acid recommendations. Although the men are highly health conscious and physically active, their blood lipid levels are indicative of a risk of cardiovascular disease. In addition to enhanced nutritional education to increase seafood intakes in this age group of men and women, customised dietary and lifestyle advice may be required in the men.

Neighborhood restaurant availability and frequency of eating out in relation to dietary intake in young Japanese women

Exposure to food service establishments is considered to encourage consumption and contribute to poorer diet quality, and hence adverse health profiles. However, empirical verification of these links remains rare, particularly in young adults and non-Western populations. The objective of this cross-sectional study was to test the hypothesis that neighborhood restaurant availability and frequency of eating out are associated with unfavorable patterns of dietary intake and thus possibly higher body mass index (BMI) and waist circumference in young Japanese women. The subjects were 989 female Japanese dietetic students 18 to 22 y of age. Dietary intake and frequency of eating out (i.e., consumption of commercially prepared meals) during the preceding month were assessed using a comprehensive, self-administered diet history questionnaire. Neighborhood restaurant availability was defined as the number of restaurants within a 0.5-mile (0.8-km) radius of residence (i.e., full-service restaurants, limited-service restaurants, and cafeterias). Increasing frequency of eating out was associated with higher intake of meat, confectionery and bread, and dietary fat, lower intake of fruit and vegetables, rice, and dietary fiber, and higher dietary energy density. However, neighborhood restaurant availability was not associated with either the frequency of eating out or any of the dietary variables examined. Further, frequency of eating out and neighborhood restaurant availability were not associated with BMI or waist circumference. In conclusion, although frequency of eating out was positively associated with unfavorable dietary intake patterns in a group of young Japanese women, neighborhood restaurant availability was not associated with frequency of eating out or dietary intake.

No meaningful association of neighborhood food store availability with dietary intake, body mass index, or waist circumference in young Japanese women

The affordability of food is considered as an important factor influencing people's diet and hence health status. The objective of this cross-sectional study was to test the hypothesis that neighborhood food store availability is associated with some aspects of dietary intake and thus possibly with body mass index (BMI) and waist circumference in young Japanese women. Subjects were 989 female Japanese dietetic students 18 to 22 years of age. Neighborhood food store availability was defined as the number of food stores within a 0.5-mile (0.8-km) radius of residence (meat stores, fish stores, fruit and vegetable stores, confectionery stores/bakeries, rice stores, convenience stores, and supermarkets/grocery stores). Dietary intake was estimated using a validated, comprehensive self-administered diet history questionnaire. No association was seen between any measure of neighborhood food store availability and dietary intake, except for a positive association between confectionery and bread availability (based on confectionery stores/bakeries, convenience stores, and supermarkets/grocery stores) and intake of these items (P for trend = .02). Further, no association was seen for BMI or waist circumference, except for an inverse relationship between availability of convenience stores and BMI and a positive relationship between store availability for meat (meat stores and supermarkets/grocery stores) and fish (fish stores and supermarkets/grocery stores) and waist circumference. In conclusion, this study of young Japanese women found no meaningful association between neighborhood food store availability and dietary intake, BMI, or waist circumference, with the exception of a positive relationship between availability and intake for confectionery and bread.

Neighbourhood food store availability in relation to 24 h urinary sodium and potassium excretion in young Japanese women

Previous studies on the relationship of local food environment with residents' diets have relied exclusively on self-reported information on diet, producing inconsistent results. Evaluation of dietary intake using biomarkers may obviate the biases inherent to the use of self-reported dietary information. This cross-sectional study examined the association between neighbourhood food store availability and 24 h urinary Na and K excretion. The subjects were 904 female Japanese dietetic students aged 18-22 years. Neighbourhood food store availability was defined as the number of food stores within a 0.5-mile (0.8-km) radius of residence. Urinary Na and K excretion and the ratio of urinary Na to K were estimated from a single 24 h urine sample. After adjustment for potential confounding factors, neighbourhood availability of confectionery stores/bakeries was inversely associated with urinary K, and was positively associated with the ratio of Na to K (P for trend = 0.008 and 0.03, respectively). Neighbourhood availability of rice stores showed an independent inverse association with urinary K (P for trend = 0.03), whereas neighbourhood availability of supermarkets/grocery stores conversely showed an independent positive association with this variable (P for trend = 0.03). Furthermore, neighbourhood availability of fruit/vegetable stores showed an independent inverse association with the ratio of Na to K (P for trend = 0.049). In a group of young Japanese women, increasing neighbourhood availability of supermarkets/grocery stores and fruit/vegetable stores and decreasing availability of confectionery stores/bakeries and rice stores were associated with favourable profiles of 24 h urinary K (and Na) excretion.

Neighborhood socioeconomic status in relation to dietary intake and insulin resistance syndrome in female Japanese dietetic students

OBJECTIVE

An increasing number of studies in Western countries have shown that living in a socioeconomically disadvantaged neighborhood is associated with unfavorable dietary intake patterns and health status. However, information on such neighborhood socioeconomic differences in diet and health among different cultural settings, including Japan, is limited. This cross-sectional study examined the association of neighborhood socioeconomic status (SES) with dietary intake and a summary score of the insulin resistance syndrome (IRS) in a group of young Japanese women.

METHODS

Subjects were 1081 female Japanese dietetic students aged 18 to 22 y residing in 295 municipalities in Japan. Neighborhood SES index was defined by seven municipal-level variables, namely unemployment, household overcrowding, poverty, education, income, home ownership, and vulnerable group, with an increasing index signifying increasing neighborhood socioeconomic disadvantage. Dietary intake was estimated using a validated, comprehensive self-administered diet-history questionnaire. Measurements of body mass index, systolic blood pressure, fasting high-density lipoprotein cholesterol, triacylglycerol, glucose, and insulin were combined into an IRS score, with an increasing score signifying increasing levels of components of the IRS.

RESULTS

Neighborhood SES index was not associated with most of the dietary variables, body mass index, high-density lipoprotein cholesterol, triacylglycerol, or glucose. However, neighborhood SES index was significantly positively associated with systolic blood pressure, insulin, and IRS score, after adjustment for potential confounding or mediating factors, including household SES, dietary, and lifestyle factors.

CONCLUSION

Neighborhood socioeconomic disadvantage was associated with unfavorable profiles of the IRS score, but not dietary intake, in a group of young Japanese women.