Low subjective socioeconomic status alters taste-based perceptual sensitivity to the energy density of beverages

Lower subjective social status is associated with increased adiposity and self-reported eating in the absence of hunger due to negative affect among children reporting teasing distress

OBJECTIVES

Low social standing and teasing are independently associated with increased body mass index (BMI) and overeating in children. However, children with low social status may be vulnerable to teasing.

METHODS

We tested the statistical interaction of subjective social status (SSS) and subjective socioeconomic status (SSES) and teasing distress on BMI, fat mass index (FMI), and eating in the absence of hunger (EAH) in children (Mage = 13.09 years, SD = 2.50 years; 27.8% overweight/obese). Multiple linear regressions identified the main effects of self-reported SSS (compared to peers in school), distress due to teasing, and their interaction on BMI (n = 115), FMI (n = 114), and child- (n = 100) and parent-reported (n = 97) EAH.

RESULTS

Teasing distress was associated with greater BMI, FMI, and child-reported EAH due to negative affect (a subscale of EAH) and total EAH scores. There were no associations of SSS with these outcomes. However, there was an interaction between SSS and teasing distress for BMI, FMI, and EAH from negative affect such that lower SSS was associated with higher BMI, FMI, and EAH from negative affect in the presence of teasing distress. However, there were no main effects or interactions (with teasing distress) of SSES on the outcomes.

CONCLUSIONS

These findings suggest that the relationship between lower SSS and increased adiposity and overeating behaviors may be exacerbated by other threats to social standing, such as teasing. Children exposed to multiple social threats may be more susceptible to eating beyond physiological need and obesity than those who experience a single form of perceived social disadvantage.

Relationships between education and non-alcoholic fatty liver disease

INTRODUCTION

Individuals with lower levels of education are at a higher risk of developing various health conditions due to limited access to healthcare and unhealthy lifestyle choices. However, the association between non-alcoholic fatty liver disease (NAFLD) and educational level remains unclear. Therefore, the aim of this study was to investigate whether there is an independent relationship between NAFLD and educational level as a surrogate marker for socioeconomic status (SES).

METHODS

This cross-sectional study included 8,727 participants from the Paracelsus 10,000 study. The association between NAFLD and educational level was assessed using multivariable logistic regression models and multivariable linear regression. The primary endpoints were NAFLD (FLI score > 60) and liver fibrosis (FIB-4 score > 1.29). Further subgroup analysis with liver stiffness measurement was done.

RESULTS

In the study, NAFLD prevalence was 23% among participants with high education, 33% among intermediate, and 40% among those with low education (p<0.01). Importantly, a significantly reduced risk of NAFLD was observed in individuals with higher education, as indicated by an adjusted relative risk of 0.52 (p < 0.01). Furthermore, higher education level was associated with significantly lower odds of NAFLD and fibrosis. Additionally, a subgroup analysis revealed that higher liver stiffness measurements were independently associated with lower levels of education.

CONCLUSION

The study's findings indicate that a lower education level increases the risk of NAFLD independent of confounding factors. Therefore, these findings highlight the potential impact of educational attainment on NAFLD risk and emphasize the need for targeted interventions in vulnerable populations.

Independent and Interactive Associations of Subjective and Objective Socioeconomic Status With Body Composition and Parent-Reported Hyperphagia Among Children

Background: Subjective socioeconomic status (SSES) and objective socioeconomic status (OSES) have been independently associated with body composition and eating behavior in children. While low OSES may constrain access to healthier foods, low SSES has been associated with increased preference for and motivation to consume higher energy foods and portions independent of OSES. Despite these distinct ways that OSES and SSES may affect children's eating behavior and adiposity, their joint contributions remain unclear. We investigated the independent and interactive associations of SSES and OSES with children's BMI, fat mass index (FMI), and caregiver-reported hyperphagia. Methods: Data were derived from the Children's Growth and Behavior Study, an ongoing observational study. Multiple linear regressions used child's SSES and OSES of the family as independent factors and modeled the statistical interaction of SSES and OSES with BMI (n = 128), FMI (n = 122), and hyperphagia and its subscales (n = 76) as dependent variables. Results: SSES was independently and negatively associated with hyperphagia severity and OSES was independently and negatively associated with both FMI and hyperphagia severity. There was a statistical interaction effect of SSES and OSES on hyperphagia severity-lower SSES was associated with greater hyperphagia severity only at lower levels of OSES. Conclusions: These findings demonstrate a relationship between low OSES and child adiposity and that the relationship between child SSES and hyperphagia severity may be most relevant for children from households with lower family OSES. Future research on socioeconomic disparities in children's body composition and eating behaviors should examine the interaction of SSES and OSES. Clinical Trial Registration: NCT02390765.

Perceived inequality in society may not motivate increased food intake in the absence of personal socioeconomic disadvantage

BACKGROUND

Greater levels of socioeconomic inequality across societies have been associated with higher rates of obesity and cardiometabolic disease. While these relationships could be attributed to poorer quality of health services and lower access to healthier lifestyles among disadvantaged groups in societies with greater economic inequality, this explanation does not account for those who experience relative economic security in such unequal societies (e.g., the middle and upper classes). Here, we tested whether perceptions of greater disparities between social classes in one's society (i.e., perceived societal inequality) may promote eating behaviors that risk excess energy intake.

METHODS

In two studies, participants completed an experimental manipulation that situated them as middle class within a hypothetical society that was presented to have either large disparities in socioeconomic resources between classes (high inequality condition) or low disparities (low inequality condition), while keeping the participants' objective socioeconomic standing constant across conditions. In Study 1 (pre-registered), participants (n = 167) completed the perceived societal inequality manipulation before a computerized food portion selection task to measure desired portion sizes for a variety of foods. Study 2 (n = 154) involved a similar design as Study 1, but with inclusion of a neutral control condition (no awareness of class disparities) followed by ad libitum consumption of potato chips.

RESULTS

While the high inequality condition successfully elicited perceptions of one's society as having greater socioeconomic inequalities between classes, it did not generate consistent feelings of personal socioeconomic disadvantage. Across both studies, we observed no differences between conditions in average selected portion sizes or actual energy intake.

CONCLUSIONS

Taken together with prior research on the effects of subjective socioeconomic disadvantage on increased energy intake, these findings suggest that perceptions of inequality in one's society may be insufficient to stimulate heightened energy intake in the absence of personal socioeconomic disadvantage or inadequacy.

Fatty liver index relationship with biomarkers and lifestyle: result from RaNCD cohort study

BACKGROUND

Lifestyle intervention can effectively treat patients with non-alcoholic fatty liver disease (NAFLD). The present study aimed to investigate the association between lifestyle factors with fatty liver index (FLI) in Iranian adults.

METHODS

This study enrolled 7114 subjects from the Ravansar Non-Communicable Diseases (RaNCD) cohort study in western Iran. To compute the FLI score, anthropometric measures, and a few non-invasive liver status indicators were used. Binary logistic regression models examined the association between FLI score and lifestyle.

RESULTS

Participants with FLI < 60 had a lower daily energy intake compared to those with FLI ≥ 60 (2740.29 vs. 2840.33 kcal/day, P = < 0.001). The risk of NAFLD in males with high socioeconomic status (SES) was 72% higher than in those with low SES (OR: 1.72; 95% CIs 1.42-2.08). An adjusted logistic regression model showed a significantly negative association between high physical activity and fatty liver index in both men and women. (OR: 0.44, p-value < 0.001 and OR: 0.54, p-value < 0.001, respectively). The odds of NAFLD in female participants with depression were 71% higher than in non-depressed participants (OR: 1.71, 95% CI: 1.06-2.64). Dyslipidemia and high visceral fat area (VFA) were also associated with a significant increase in the risk of NAFLD (P < 0.05).

CONCLUSION

In our study, we found that good SES, high VFA, and dyslipidemia were associated with an increased risk of NAFLD. Conversely, high physical activity reduces the risk of NAFLD. Therefore, lifestyle modification may help improve liver function.

Socioeconomic position and the influence of food portion size on daily energy intake in adult females: two randomized controlled trials

BACKGROUND

Reducing portion sizes of commercially available foods could be an effective public health strategy to reduce population energy intake, but recent research suggests that the effect portion size has on energy intake may differ based on socioeconomic position (SEP).

OBJECTIVE

We tested whether the effect of reducing food portion sizes on daily energy intake differed based on SEP.

METHODS

Participants were served either smaller or larger portions of food at lunch and evening meals (N = 50; Study 1) and breakfast, lunch and evening meals (N = 46; Study 2) in the laboratory on two separate days, in repeated-measures designs. The primary outcome was total daily energy intake (kcal). Participant recruitment was stratified by primary indicators of SEP; highest educational qualification (Study 1) and subjective social status (Study 2), and randomisation to the order portion sizes were served was stratified by SEP. Secondary indicators of SEP in both studies included household income, self-reported childhood financial hardship and a measure accounting for total years in education.

RESULTS

In both studies, smaller (vs larger) meal portions led to a reduction in daily energy intake (ps < .02). Smaller portions resulted in a reduction of 235 kcal per day (95% CI: 134, 336) in Study 1 and 143 kcal per day (95% CI: 24, 263) in Study 2. There was no evidence in either study that effects of portion size on energy intake differed by SEP. Results were consistent when examining effects on portion-manipulated meal (as opposed to daily) energy intake.

CONCLUSIONS

Reducing meal portion sizes could be an effective way to reduce overall daily energy intake and contrary to other suggestions it may be a socioeconomically equitable approach to improving diet.

TRIAL REGISTRATION

These trials were registered at www.

CLINICALTRIALS

gov as NCT05173376 and NCT05399836.

Low subjective social status is associated with daily selection of fewer healthy foods and more high-fat/high sugar foods

Socioeconomic status has been related to poorer eating behaviors, potentially due to feeling of lower status relative to peers. Despite experimental evidence that temporarily feeling of lower status can contribute to greater caloric intake, it remains unclear how feeling of lower social status relate to eating behavior in daily life. This study aimed to test whether lower subjective social status (SSS)-the feeling of having relatively lower social status-in American society and relative to college peers were related to daily food selection. A sample of 131 young adults (Mage = 20.3, SD = 0.8; 60% female; 46% Latinos; 34% European American; 15% Asian American; 5% of other ethnicities) reported their SSS in society and in college and completed 15 daily reports regarding the number of daily servings they had of fruits, vegetables, fried foods, fast foods, desserts, and sugary drinks. Multilevel models with days nested within individuals were used to test whether low SSS in society or college related to daily food intake. Next, we examined whether associations were driven by young adults' perceived stress and daily stressors. Analyses controlled for age, gender, ethnicity, family and personal income, and parents' education to test the unique associations between subjective status and food intake. Whereas SSS in society was not related to food intake, young adults with lower SSS in their college consumed fewer daily servings of healthy foods and more daily servings of high-fat/high-sugar foods. Although lower college SSS was related to greater perceived stress, perceived stress and daily stressors were consistently unrelated to daily food intake. Findings suggested that lower SSS in local environments (e.g., college) may impact young adults' daily food choices through processes beyond heightened stress.

Vegans, vegetarians and omnivores differ in nutrient hedonics, salt and sweet preference and flavouring

BACKGROUND

Dietary content can influence taste responses. Therefore, we compared nutrient hedonics (liking foods by nutrient content), and seasoning, including taste responses to the prime flavours salt and sweet in 30 vegan, 37 vegetarian and 56 omnivore men and women.

METHODOLOGY

Questionnaires and taste tests examined macronutrient and electrolyte intake and hedonics, seasoning, salt and sweet preferences and psychophysical taste responses.

RESULTS

Compared to omnivores, vegans had lower protein, Ca⁺⁺, Na⁺ intake, and increased carbohydrate (CHO) intake. Independently of intake, hedonics for protein Ca⁺⁺ and Na⁺ were reduced and increased for CHO. Psychophysical responses to NaCl and sucrose also differed slightly, vegans and vegetarians scoring high concentrations of sucrose as more intense, Vegans reported more sweetening and less salting of food, added more sucrose to a test tea, less salt to a test soup, but did not differ in seasoning with oil or hot spice.

PRINCIPAL CONCLUSIONS

Habitual vegan, vegetarian and omnivore diets may alter taste responses to nutrient content and salt and sweet, the latter more pronounced in vegan and vegetarian women. Recognising diet-dependent changes in taste hedonics can inform diets and products.

The impact of increasing the availability of lower energy foods for home delivery and socio-economic position: a randomised control trial examining effects on meal energy intake and later energy intake

Increasing the availability of lower energy food options is a promising public health approach. However, it is unclear the extent to which availability interventions may result in consumers later 'compensating' for reductions in energy intake caused by selecting lower energy food options and to what extent these effects may differ based on socio-economic position (SEP). Our objective was to examine the impact of increasing availability of lower energy meal options on immediate meal energy intake and subsequent energy intake in participants of higher v. lower SEP. In a within-subjects design, seventy-seven UK adults ordered meals from a supermarket ready meal menu with standard (30 %) and increased (70 %) availability of lower energy options. The meals were delivered to be consumed at home, with meal intake measured using the Digital Photography of Foods Method. Post-meal compensation was measured using food diaries to determine self-reported energy intake after the meal and the next day. Participants consumed significantly less energy (196 kcal (820 kJ), 95 % CI 138, 252) from the menu with increased availability of lower energy options v. the standard availability menu (P < 0·001). There was no statistically significant evidence that this reduction in energy intake was substantially compensated for (33 % compensated, P = 0·57). The effects of increasing availability of lower energy food items were similar in participants from lower and higher SEP. Increasing the availability of lower energy food options is likely to be an effective and equitable approach to reducing energy intake which may contribute to improving diet and population health.

Subjective socioeconomic disadvantage is indirectly associated with food portion selection through perceived disruption of personal resources during a nationwide COVID-19 stay-at-home order

In addition to its public health implications, the global COVID-19 pandemic has also produced significant disruptions to individuals' socioeconomic resources and opportunities. Prior research has suggested that low subjective socioeconomic status (SSES) may stimulate appetite and motivate increased energy intake. Here, we tested whether individuals experiencing lower levels of SSES (SSES disadvantage) during a nationwide stay-at-home order for COVID-19 exhibited preferences for larger food portion sizes through perceived disruptions to personal financial and material resources. Data was collected near the conclusion of a nationwide partial lockdown (Singapore's “Circuit-Breaker” from April to June 2020). Participants (N = 295) completed an online survey involving a measure of SSES, the Coronavirus Impacts Questionnaire, and a food portion selection task where participants estimated the portion size they prefer to consume for a range of common foods. SSES disadvantage was associated with selection of smaller average portion sizes. Yet, a significant indirect effect of coronavirus impact was observed in this relationship, such that participants experiencing greater SSES disadvantage selected larger portion sizes through the effect of greater perceived impacts of COVID-19 to one's financial/material resources (controlling for one's actual level of income). These findings further support the idea that perceived deprivation and insecurity of important resources (financial, social, material) may influence intentions to consume greater amounts of energy. Consequently, systematic societal disruptions to such resources may reinforce and perpetuate potentially obesogenic eating behaviors of populations that are especially vulnerable to such shocks (i.e., people experiencing SSES disadvantage).

Earth Dreams: Reimagining ARPA for Health of People, Places and Planet

Bold new approaches are urgently needed to overcome global health challenges. The proposed Advanced Research Projects Agency for Health (ARPA-H) is intended to provide rapid health breakthroughs. While new technologies for earlier disease detection and more effective treatment are critical, we urge equal attention be given to the wider (physical, emotional, social, political, and economic) environmental ecosystems driving the non-communicable disease (NCD) crisis in the first place. This requires an integrated, cross-sectoral vision that spans the interwoven connections affecting health across the scales of people, places, and planet. This wider "exposome" perspective considers biopsychosocial factors that promote resilience and reduce vulnerabilities of individuals and communities over time-the many variables driving health disparities. Since life course health is strongly determined by early life environments, early interventions should be prioritized as a matter of effectiveness and social justice. Here, we explore the origins of the Advanced Research Project Agency and point to its potential to build integrated solutions, with wisdom and ethical value systems as a compass. Since the planned ARPA-H is anticipated to spawn international collaborations, the imagined concept is of relevance to a broad audience of researchers. With appropriate input, the quest for health equity through personalized, precision medicine while deconstructing unacceptable structural inequities may be accelerated.

Relationships between Socioeconomic Status, Handgrip Strength, and Non-Alcoholic Fatty Liver Disease in Middle-Aged Adults

Although low socioeconomic status (SES) and decreased muscle strength have been found to be associated with the risk factors of non-alcoholic fatty liver disease (NAFLD), including insulin resistance, obesity, and metabolic syndrome, the associations among SES, muscle strength, and NAFLD are still unclear. We aimed to investigate the combined effect of SES and relative handgrip strength (HGS) on the risk of NAFLD in middle-aged adults. Data from 5272 middle-aged adults who participated in the Korea National Health and Nutrition Examination Surveys (KNHANES) from 2014–2018 were analyzed. NAFLD was defined using the hepatic steatosis index (HSI) > 36 and the comprehensive NAFLD score (CNS) ≥ 40 in the absence of other causes of liver disease. SES was based on a self-reported questionnaire. Overall, individuals with low SES (odds ratio (OR) = 1.703, 95% confidence interval (CI): 1.424–2.037, p < 0.001) or low HGS (OR = 12.161, 95% CI: 9.548–15.488, p < 0.001) had a significantly higher risk of NAFLD. The joint association analysis showed that a low SES combined with a low HGS (OR = 2.479, 95% CI: 1.351–4.549, p = 0.003) further significantly increased the risk of NAFLD when adjusted for all the covariates, compared with individuals with a high SES and a high HGS (OR = 1). The current findings suggest that both low SES and low HGS were independently and synergistically associated with an increased risk of NAFLD in middle-aged Korean adults.