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Cooke CB, Greatwood HC, McCullough D, Kirwan R, Duckworth LC, Sutton L, Gately PJ. The effect of discretionary snack consumption on overall energy intake, weight status, and diet quality: A systematic review. Obes Rev 2024; 25:e13693. [PMID: 38226404 DOI: 10.1111/obr.13693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/27/2023] [Accepted: 12/02/2023] [Indexed: 01/17/2024]
Abstract
The consumption frequency and portion size of discretionary snacks are thought to contribute to a greater food intake and risk of overweight or obesity in the developed world but evidence from epidemiological studies is inconclusive. To investigate this, we systematically evaluated evidence on the effects of discretionary snack consumption on weight status, energy intake, and diet quality. Articles involving discretionary snacks reported against the outcome measures of any primary, peer-reviewed study using human participants from free-living conditions for all age groups were included. A total of 14,780 titles were identified and 40 eligible publications were identified. Three key outcomes were reported: weight status (n = 35), energy intake (n = 11), and diet quality (n = 3). Increased discretionary snack consumption may contribute modestly to energy intake, however, there is a lack of consistent associations with increased weight/BMI. Although cross-sectional analyses offered conflicting findings, longitudinal studies in adults showed a consistent positive relationship between discretionary snack intake and increasing weight or body mass index. Given that experimental findings suggest reducing the size of discretionary snacks could lead to decreased consumption and subsequent energy intake, food policy makers and manufacturers may find it valuable to consider altering the portion and/or packaging size of discretionary snacks.
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Affiliation(s)
- Carlton B Cooke
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | | | | | - Richard Kirwan
- School of Sports and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | | | - Louise Sutton
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Paul J Gately
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
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Levy RB, Barata MF, Leite MA, Andrade GC. How and why ultra-processed foods harm human health. Proc Nutr Soc 2024; 83:1-8. [PMID: 37424296 DOI: 10.1017/s0029665123003567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
The analysis of food using a perspective centred on nutrients seems inadequate for understanding the dietary transition and its impact on the growth of obesity and chronic diseases. Industrial food processing is now proposed as the key to explain the relationship between food and health. The NOVA food classification considers the degree and the purpose of food processing, which includes physical, biological and chemical processes used after foods are separated from nature, and before being consumed or prepared as dishes and meals. NOVA has four food groups: (1) unprocessed and minimally processed foods; (2) processed culinary ingredients; (3) processed foods and (4) ultra-processed foods, which are formulations made mostly or entirely from substances derived from group 1 foods and additives, with little if any intact group 1 food. Many investigations linking high ultra-processed food consumption with deterioration of diets and adverse health outcomes are reinforced by prospective studies, systematic reviews and meta-analyses. There are various plausible explanations of why diets high in ultra-processed foods are harmful. Their production and consumption continue to rise worldwide. Efficient and effective public policies and actions that reduce production and consumption of ultra-processed products are needed, to protect human health now and in future.
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Affiliation(s)
- Renata Bertazzi Levy
- Preventive Medicine Department, Medical School, University of Sao Paulo, Ave. Dr Arnaldo, 455, Zip Code: 01246-903, São Paulo, SP, Brazil
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
| | - Mayra Figueiredo Barata
- Preventive Medicine Department, Medical School, University of Sao Paulo, Ave. Dr Arnaldo, 455, Zip Code: 01246-903, São Paulo, SP, Brazil
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
| | - Maria Alvim Leite
- Preventive Medicine Department, Medical School, University of Sao Paulo, Ave. Dr Arnaldo, 455, Zip Code: 01246-903, São Paulo, SP, Brazil
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
| | - Giovanna Calixto Andrade
- Center for Epidemiological Studies in Nutrition and Health, University of São Paulo (Nupens/USP), Ave. Dr Arnaldo, 715, Zip Code: 01246-90, Sao Paulo, SP, Brazil
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Nowicki GJ, Polak M, Ślusarska B, Czernecki K. The Relationship between Diet and the Occurrence of Depressive Symptoms in a Community Example with High Rates of Social Deprivation: A Cross-Sectional Study. Nutrients 2023; 15:3778. [PMID: 37686809 PMCID: PMC10489963 DOI: 10.3390/nu15173778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Research suggests that various biological and psychosocial mechanisms are involved in the heterogeneous and complex relationship between dietary patterns and depressive symptoms. The occurrence of depressive symptoms is thought to be related to socioeconomic status (SES), with those with lower SES being more likely to experience persistent depression. The aim of the undertaken study was to investigate whether socioeconomic and health variables are associated with dietary assessment in a population with high rates of social deprivation and whether a relationship exists between dietary assessment and depressive symptoms (DS). The respondents' nutrition was evaluated through a qualitative method, using the Perinumeric Periodic Table questionnaire by Starzyńska. At the same time, the prevalence of DS was assessed employing the Patient Health Questionnaire-9 (PHQ-9). In the DS screening (PHQ-9 ≥ 10), in the entire study population, the risk of DS was 16.1% (n = 605). In our entire study population, up to 61.2% (n = 2297) of the respondents exhibited poor dietary patterns. In the multivariate model, women with almost adequate or poor dietary assessment were 1.62 and 2.18 times more likely to score at least 10 on the PHQ-9 questionnaire, as compared to women whose dietary assessment was good or adequate. In conclusion, it was determined that sociodemographic variables affect nutritional habits. Women who lived in rural areas limited to a vocational education had significantly poorer diets. Moreover, men, younger men, smokers, and those without chronic diseases were characterized by a poorer dietary assessment. Additionally, women who had a better dietary assessment were significantly more likely to have lower scores on the questionnaire assessing the occurrence of DS (PHQ-9 10).
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Affiliation(s)
- Grzegorz Józef Nowicki
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland; (B.Ś.); (K.C.)
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Skawińska 8 Str., PL-31-066 Krakow, Poland;
| | - Barbara Ślusarska
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland; (B.Ś.); (K.C.)
| | - Karol Czernecki
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland; (B.Ś.); (K.C.)
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Flieh SM, Miguel-Berges ML, Huybrechts I, Breidenassel C, Grammatikaki E, Donne CL, Manios Y, Widhalm K, Molnár D, Stehle P, Kafatos A, Dallongeville J, Molina-Hidalgo C, Gómez-Martínez S, Gonzalez-Gross M, De Henauw S, Béghin L, Kersting M, Moreno LA, González-Gil EM. Food portion sizes and their relationship with energy, and nutrient intakes in adolescents: The HELENA study. Nutrition 2023; 106:111893. [PMID: 36462317 DOI: 10.1016/j.nut.2022.111893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/19/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This study aimed to investigate the associations between portion sizes (PSs) from different food groups and energy, as well as nutrient intakes in European adolescents. METHODS A sample of 1631 adolescents (54.2 % girls) were included from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional (HELENA) study. Mean food PS was calculated by dividing the total intake of the items by the number of eating occasions of these consumed items. To determine the key items for analysis, foods were ranked by frequency of consumption. A one-way between-groups analysis of covariance was used to test for significant differences in means across tertiles. A multivariable linear regression analysis was carried out, adjusting for age, sex, maternal education, body mass index, and using country as a level. RESULTS Energy intake increased with elevated intakes of energy-dense foods. Large portions of rice and other grains, starch roots and potatoes, and meat substitutes, nuts, and pulses were associated with increased carbohydrate and fiber intake. Larger portions of cheese and butter and animal fat were significantly associated with a higher fat intake. Lower intakes of some vitamins and micronutrients were noticed with consumption of larger portions of high energy-dense foods, such as desserts and pudding, margarine and vegetable oil, and butter and animal fat. CONCLUSIONS Large food PSs may be associated with positive energy, as well as macro- and micronutrient intake. Moreover, the findings from this study may help the future development of dietary guidance in general and specific to PSs, and support targeted strategies to address intakes of certain nutrients in European adolescents.
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Affiliation(s)
- Sondos M Flieh
- Growth, Exercise, Nutrition and Development Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - María L Miguel-Berges
- Growth, Exercise, Nutrition and Development Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón, Zaragoza, Spain.
| | - Inge Huybrechts
- International Agency for Research on Cancer, Lyon, France; Department of Public Health, Ghent University, Ghent, Belgium
| | - Christina Breidenassel
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany; ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport, Universidad Politécnica de Madrid, Madrid, Spain
| | - Evangelia Grammatikaki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; University Lille, Inserm, Centre Hospitalier Universitarie Lille, Clinical Investigation Center, Lille, France
| | - Cinzia Le Donne
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome, Italy
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Kurt Widhalm
- Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria; Austrian Academic Institute for Clinical Nutrition, Vienna, Austria
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | | | - Jean Dallongeville
- Department of Epidemiology and Public Health, Institut Pasteur de Lille, Lille, France
| | - Cristina Molina-Hidalgo
- Evaluacion funcional y fisiologia del ejercicio, Ciencia y Tecnologia de la Salud Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Sonia Gómez-Martínez
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition, Spanish National Research Council, Madrid, Spain
| | - Marcela Gonzalez-Gross
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport, Universidad Politécnica de Madrid, Madrid, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Laurent Béghin
- University Lille, Inserm, Centre Hospitalier Universitarie Lille, Clinical Investigation Center, Lille, France; University Lille, Inserm, Institute for Translational Research in Inflammation, INFINITE, Lille, France
| | - Mathilde Kersting
- Research Department of Child Nutrition, Pediatric University Clinic, Ruhr-University Bochum, Bochum, Germany
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón, Zaragoza, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Esther M González-Gil
- Growth, Exercise, Nutrition and Development Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
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McNeil J, Koch HR, Dollar JM, Shriver LH, Keane SP, Shanahan L, Wideman L. Physiologic and Behavioral Correlates of Energy Intake in Emerging Adulthood: Cross-Sectional Analysis of the RIGHT Track Health Study. J Nutr 2023; 153:88-95. [PMID: 36913482 PMCID: PMC10196564 DOI: 10.1016/j.tjnut.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/14/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Consistent findings have reported that FFM is associated with EI. However, conjoint assessments of physiologic (body composition, fasting serum leptin) and behavioral [eating behaviors and physical activity (PA)] correlates of EI during emerging adulthood have not been examined. OBJECTIVES We assessed associations between physiologic and behavioral correlates of EI within the context of one another in emerging adults (18-28 years old). We also assessed these associations in a subsample after the removal of probable EI underreporters. METHODS Cross-sectional data from 244 emerging adults (age = 19.6 ± 1.4 y; BMI = 26.4 ± 6.6 kg/m2; 56.6% female) from the RIGHT Track Health study were used. Measures included body composition (BOD POD), eating behaviors (Three-Factor Eating Questionnaire), objective and subjective PA (accelerometer-derived total activity counts and Godin-Shephard Leisure-Time Exercise Questionnaire), fasting serum leptin, and EI (three 24-hour dietary recalls). Correlates independently associated with EI were entered into a backward stepwise linear regression model. Correlates that met the criteria of P < 0.05 were retained. Analyses were repeated in a subsample after removing probable EI underreporters (n = 48). Effect modification by sex (male and female) and BMI (BMI < 25 kg/m2, BMI ≥ 25 kg/m2) categories was also assessed. RESULTS In the full sample, FFM (β: 18.4; 95% CI: 9.9, 26.8), leptin (β: -84.8; 95% CI: -154.3, -15.4), dietary restraint (β: -35.2; 95% CI: -59.1, -11.3), and subjective PA (β: 2.5; 95% CI: 0.04, 4.9) were significantly associated with EI. After the removal of probable underreporters, only FFM remained significantly associated with EI (β: 43.9; 95% CI: 27.2, 60.6). No evidence of effect modification by sex or BMI categories was noted. CONCLUSIONS Although physiologic and behavioral correlates were associated with EI in the full sample, only FFM remained a robust correlate of EI in a subsample of emerging adults after removing probable EI underreporters.
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Affiliation(s)
- Jessica McNeil
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA.
| | - Hannah R Koch
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Jessica M Dollar
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA; Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Lenka H Shriver
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Susan P Keane
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Lilly Shanahan
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
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Food Neophobia, Familiarity with French Cuisine, Body Mass, and Restaurant Food Choices in a Sample of Polish Women. Nutrients 2022; 14:nu14071502. [PMID: 35406115 PMCID: PMC9003310 DOI: 10.3390/nu14071502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 01/27/2023] Open
Abstract
Food neophobia, a condition characterized by a reluctance or avoidance of unknown foods and meals, may influence food choice, and is also associated with body mass and familiarity with food items. This study aimed to analyze the associations between food neophobia, familiarity with French cuisine, body mass, and French restaurant menu food choices in a sample of 203 young Polish women. The Computer-Assisted Web Interview (CAWI) method was used in the study. The food choice questionnaire used for assessment was based on a model French restaurant menu, with dishes planned using a 2 × 2 factorial design for the components of neophobic potential (unfamiliar to Polish consumers) and animal-based components. Food neophobia, familiarity with French cuisine, and body mass were considered independent variables. The food neophobia scale (FNS) developed by Pliner and Hobden was used to assess food neophobia among respondents. The results showed an association between food neophobia and familiarity with French cuisine and French restaurant menu food choices (p ≤ 0.05), but no association with body mass was observed (p > 0.05). The respondents with a high level of food neophobia chose dishes with neophobic components (for soups and desserts) less often compared to those with a low neophobia level, and in the absence of such an association, they chose dishes with animal-based components (for starters and main courses) less often (p ≤ 0.05). The respondents who declared that they were familiar with French cuisine chose dishes with animal-based components (for starters and desserts) more often than those with no familiarity, but a reverse association was observed for soups (p ≤ 0.05). Based on the findings of the study, it may be concluded that food neophobia and familiarity with French cuisine may be important determinants of food choice within a French restaurant menu. The study did not show any association between body mass and the choice of dishes from the model French restaurant menu. The findings suggest that the presence of unfamiliar and animal-based ingredients may reduce the frequency of choosing specific dishes within a French restaurant menu, which may reduce the diversity of individuals’ diets.
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Tang T, Chawner LR, Chu R, Nekitsing C, Hetherington MM. Downsizing by design – Investigating acceptance, choice and willingness to pay for portion control design concepts. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Jones L, Ness A, Emmett P. Misreporting of Energy Intake From Food Records Completed by Adolescents: Associations With Sex, Body Image, Nutrient, and Food Group Intake. Front Nutr 2021; 8:749007. [PMID: 34966768 PMCID: PMC8710752 DOI: 10.3389/fnut.2021.749007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/28/2021] [Indexed: 12/13/2022] Open
Abstract
Background and Objectives: A healthy diet during adolescence is important for growth and pubertal development. Assessing the diet of adolescents may be challenging as the behavioural factors and food habits which impact on what they eat may also affect how they report dietary intake. This study assesses factors associated with the misreporting of dietary intake. Methods: Adolescents (n = 4,844; average age 13.8 years) from the Avon Longitudinal Study of Parents and Children (ALSPAC) completed a 3-day diet record. Misreporting was estimated using an individualised method, and adolescents were categorised by reporting status. Foods were categorised as core and noncore foods to evaluate diet quality. Body composition measurements were recorded at a research clinic. Information on dieting, weight concern, family socioeconomic status, and parental BMI were collected via questionnaires. Binary logistic regression was performed, in boys and girls separately, to investigate factors associated with underreporting of dietary intake. Results: Girls were much more likely than boys to be dissatisfied with their weight and to diet, but showed similar levels of underreporting (~67%). In adjusted regression analysis underreporters (UR) were more likely to be overweight or obese: OR in boys 2.8 (95% CI 1.7–4.8) and in girls 2.2 (95% CI 1.5–3.2). Dissatisfaction with weight and dieting were positively associated, and perception of being underweight negatively associated with underreporting in boys. Perception of being overweight, dieting, and exact age were positively associated with underreporting in girls. UR obtained a greater percentage of energy from protein and a smaller percentage of energy from fat; they reported greater intake of core foods and lower intakes of non-core foods than plausible reporters. Conclusion: A large proportion of adolescents underreported their dietary energy intake. This was associated with their body weight status and body image and had a differential effect on their estimated food and macronutrient intakes. Assessment of misreporting status is essential when collecting and interpreting dietary information from adolescents.
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Affiliation(s)
- Louise Jones
- Centre for Child Academic Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Andy Ness
- Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Pauline Emmett
- Centre for Child Academic Health, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Embling R, Lee MD, Price M, Wilkinson LL. Testing an online measure of portion size selection: a pilot study concerned with the measurement of ideal portion size. Pilot Feasibility Stud 2021; 7:177. [PMID: 34535184 PMCID: PMC8446476 DOI: 10.1186/s40814-021-00908-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/31/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Portion size is known to be a key driver of food intake. As consumed portions are often pre-planned, 'ideal portion size'-an individual's preferred meal size selected prior to eating-has been identified as a strong predictor of actual consumption. However, assessments of ideal portion size have predominantly relied on laboratory-based computer tasks, limiting use online. Therefore, this cross-sectional study sought to pilot test the validity of a web-based tool to measure ideal portion size. METHODS In an online study (N = 48), participants responded to images of a range of foods. Each food was photographed in a series of different portions and loaded into an 'image carousel' that would allow participants to change the size of the displayed portion by moving a slider left-to-right. Using this image carousel, participants selected their ideal portion size. They also completed measures of expected satiety and expected satiation and self-reported their age and body mass index (BMI). A non-parametric correlation matrix was used to explore associations between ideal portion size and identified predictors of food intake. RESULTS Supporting convergent validity of this measure, ideal portion size was significantly correlated with expected satiety (rs = .480) and expected satiation (rs = -.310) after controlling for effects of baseline hunger and fullness, consistent with past research. Similarly, supporting divergent validity of this measure, ideal portion size was not significantly correlated with age (rs = -.032) or BMI (rs = -.111,). CONCLUSIONS Pilot results support the validity of this web-based portion size selection tool used to measure ideal portion size, though further research is needed to validate use with comparisons to actual food intake.
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Affiliation(s)
- Rochelle Embling
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK.
| | - Michelle D Lee
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK
| | - Menna Price
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK
| | - Laura L Wilkinson
- Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea, SA2 8PP, UK
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Vargas-Alvarez MA, Navas-Carretero S, Palla L, Martínez JA, Almiron-Roig E. Impact of Portion Control Tools on Portion Size Awareness, Choice and Intake: Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13061978. [PMID: 34207492 PMCID: PMC8229078 DOI: 10.3390/nu13061978] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 02/04/2023] Open
Abstract
Portion control utensils and reduced size tableware amongst other tools, have the potential to guide portion size intake but their effectiveness remains controversial. This review evaluated the breadth and effectiveness of existing portion control tools on learning/awareness of appropriate portion sizes (PS), PS choice, and PS consumption. Additional outcomes were energy intake and weight loss. Published records between 2006–2020 (n = 1241) were identified from PubMed and WoS, and 36 publications comparing the impact of portion control tools on awareness (n = 7 studies), selection/choice (n = 14), intake plus related measures (n = 21) and weight status (n = 9) were analyzed. Non-tableware tools included cooking utensils, educational aids and computerized applications. Tableware included mostly reduced-size and portion control/calibrated crockery/cutlery. Overall, 55% of studies reported a significant impact of using a tool (typically smaller bowl, fork or glass; or calibrated plate). A meta-analysis of 28 articles confirmed an overall effect of tool on food intake (d = –0.22; 95%CI: –0.38, –0.06; 21 comparisons), mostly driven by combinations of reduced-size bowls and spoons decreasing serving sizes (d = –0.48; 95%CI: –0.72, –0.24; 8 comparisons) and consumed amounts/energy (d = –0.22; 95%CI: –0.39, –0.05, 9 comparisons), but not by reduced-size plates (d = –0.03; 95%CI: –0.12, 0.06, 7 comparisons). Portion control tools marginally induced weight loss (d = –0.20; 95%CI: –0.37, –0.03; 9 comparisons), especially driven by calibrated tableware. No impact was detected on PS awareness; however, few studies quantified this outcome. Specific portion control tools may be helpful as potentially effective instruments for inclusion as part of weight loss interventions. Reduced size plates per se may not be as effective as previously suggested.
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Affiliation(s)
- M. Angeles Vargas-Alvarez
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain; (M.A.V.-A.); (S.N.-C.)
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain;
| | - Santiago Navas-Carretero
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain; (M.A.V.-A.); (S.N.-C.)
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain;
- Navarra Institute for Health Research (IdiSNa), 31008 Pamplona, Spain
- CIBERobn, Obesity and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Luigi Palla
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, 00185 Rome, Italy;
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - J. Alfredo Martínez
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain;
- CIBERobn, Obesity and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Eva Almiron-Roig
- Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain; (M.A.V.-A.); (S.N.-C.)
- Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain;
- Navarra Institute for Health Research (IdiSNa), 31008 Pamplona, Spain
- Correspondence: ; Tel.: +34-948-425-600
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Flieh SM, Miguel-Berges ML, González-Gil EM, Gottrand F, Censi L, Widhalm K, Manios Y, Kafatos A, Molnár D, Dallongeville J, Stehle P, Gonzalez-Gross M, Marcos A, De Henauw S, Molina-Hidalgo C, Huybrechts I, Moreno LA. The Association between Portion Sizes from High-Energy-Dense Foods and Body Composition in European Adolescents: The HELENA Study. Nutrients 2021; 13:954. [PMID: 33809476 PMCID: PMC7998698 DOI: 10.3390/nu13030954] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/05/2021] [Accepted: 03/12/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity prevalence has been simultaneously increasing with high consumption of large food portion sizes (PS). However, there is scarce information on PS of energy-dense (ED) foods as a potential risk factor of obesity in adolescents. In the present study, we investigate the association between the PS of the most ED foods and body composition. A sample of 1889 adolescents (54.4% females) from the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional multicenter study (HELENA-CSS) study were included. Most ED foods (e.g., cheese) were selected according to higher fat and/or sugar content and low fiber and water. Linear and ordinal logistic regression models were adjusted for age, physical activity, total energy intake (TEI), and socioeconomic status (SES). Analysis was performed both in those adolescents reporting plausible energy intake according to the approach of Goldberg et al. and in the whole sample. In male plausible reporters, PS from "breakfast cereals" showed a significant and positive association with BMI (β = 0.012; 0.048). PS from "carbonated soft drinks" in males (OR = 1.001; 95% CI 1.000; 1.002) and "bread and rolls" in females (OR = 1.002; 95% CI 1.000; 1.004) were associated with higher probability of having obesity, while "sweet bakery products" were associated with lower probability of having obesity (OR = 0.996; 95% CI 0.991; 0.999) in females. The present study suggests association between PS of ED foods and obesity in European adolescents. Prospective studies are needed to examine the effect of prolonged exposure to large PS and obesity development.
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Affiliation(s)
- Sondos M. Flieh
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
| | - María L. Miguel-Berges
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
| | - Esther M. González-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Center of Biomedical Research (CIBM), Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, University of Granada, 18071 Granada, Spain
| | - Frédéric Gottrand
- CHU Lille, University Lille, INSERM U1286 Infinite, F-59000 Lille, France;
| | - Laura Censi
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, 00178 Roma, Italy;
| | - Kurt Widhalm
- Department of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria;
- Austrian Academic Institute for Clinical Nutrition, A-3100 Vienna, Austria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410 Heraklion, Greece
| | - Anthony Kafatos
- Faculty of Medicine, University of Crete, GR-71003 Crete, Greece;
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, H-7624 Pécs, Hungary;
| | - Jean Dallongeville
- Department of Epidemiology and Public Health, Institut Pasteur de Lille, 59000 Lille, France;
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, D-53115 Bonn, Germany;
| | - Marcela Gonzalez-Gross
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Ascensión Marcos
- Inmunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), 28040 Madrid, Spain;
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Cristina Molina-Hidalgo
- EFFECTS 262 Department of Medical Physiology, School of Medicine, University of Granada,18071 Granada, Spain;
| | - Inge Huybrechts
- International Agency for Research on Cancer (IARC), 69372 Lyon, France;
- Department of Public Health, Ghent University, 9000 Ghent, Belgium
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain; (S.M.F.); (M.L.M.-B.); (L.A.M.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Zaragoza, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain;
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Louzada MLDC, Costa CDS, Souza TN, Cruz GLD, Levy RB, Monteiro CA. Impacto do consumo de alimentos ultraprocessados na saúde de crianças, adolescentes e adultos: revisão de escopo. CAD SAUDE PUBLICA 2021; 37:e00323020. [DOI: 10.1590/0102-311x00323020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/23/2020] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste trabalho foi realizar uma revisão de escopo da literatura acerca da associação entre o consumo de alimentos ultraprocessados e desfechos em saúde. A busca foi realizada nas bases PubMed, Web of Science e LILACS. Foram elegíveis os estudos que avaliaram a associação entre o consumo de alimentos ultraprocessados identificados com base na classificação NOVA e os desfechos em saúde. O processo de revisão resultou na seleção de 63 estudos, os quais foram analisados em termos de qualidade com base em ferramenta do Instituto Nacional de Saúde dos Estados Unidos. Os desfechos encontrados incluíram indicadores de obesidade, marcadores de risco metabólico, diabetes, doenças cardiovasculares, câncer, asma, depressão, fragilidade, doenças gastrointestinais e mortalidade. A evidência foi particularmente consistente para obesidade (ou indicadores relacionados a ela) em adultos, cuja associação com o consumo de ultraprocessados foi demonstrada, com efeito dose-resposta, em estudos transversais com amostras representativas de cinco países, em quatro grandes estudos de coorte e em um ensaio clínico randomizado. Grandes estudos de coorte também encontraram associação significativa entre o consumo de alimentos ultraprocessados e o risco de doenças cardiovasculares, diabetes e câncer, mesmo após ajuste para obesidade. Dois estudos de coorte demonstraram associação do consumo de alimentos ultraprocessados com depressão e quatro estudos de coorte com mortalidade por todas as causas. Esta revisão sumarizou os resultados de trabalhos que descreveram a associação entre o consumo de alimentos ultraprocessados e as diversas doenças crônicas não transmissíveis e seus fatores de risco, o que traz importantes implicações para a saúde pública.
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Bawajeeh AO, Albar SA, Zhang H, Zulyniak MA, Evans CEL, Cade JE. Impact of Taste on Food Choices in Adolescence-Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12071985. [PMID: 32635385 PMCID: PMC7400812 DOI: 10.3390/nu12071985] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023] Open
Abstract
Studies of adults report that perceived taste affects food choices and intake, which in turn may have an impact on health. However, corresponding evidence on adolescents is limited. Our aim was to summarize current evidence of the impact of taste perception on food choice preferences or dietary intakes among adolescents (mean age 10-19.9 years). Systematic searches identified 13 papers, 12 cross-sectional and one cohort study published between 1 January 2000 to 20 February 2020 assessing the impact of taste (using phenotypic and/or genotypic markers) on food choices in adolescents without any disease conditions. Qualitative assessment in the current review indicated that individuals sensitive to bitter tastes often have a lower preference of bitter-tasting food and higher preference for sweet-tasting food. A meta-analysis of three studies on bitter-taste sensitivity revealed no difference in preference for bitter-tasting vegetables between bitter tasters and non-tasters (standardized mean difference (SMD) = 0.04; 95% CI: -0.18, 0.26; p = 0.72). Overall, a limited number of studies were available for review. As a result, we report no clear relationship between taste perception and food choices or intake in adolescents. More studies are needed to evaluate the link between adolescents' taste perceptions and dietary intake.
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Affiliation(s)
- Areej O. Bawajeeh
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (H.Z.); (M.A.Z.); (C.E.L.E.); (J.E.C.)
- School of Food Science and Nutrition, King Abdulaziz University, PO Box 42807,21551, Jeddah 21589, Saudi Arabia;
- Correspondence:
| | - Salwa A. Albar
- School of Food Science and Nutrition, King Abdulaziz University, PO Box 42807,21551, Jeddah 21589, Saudi Arabia;
- Saudi Food and Drug Authority, Northern Ring Branch Road, Dist. Unit Number: 1 4904 Dist., Riyadh 6336, Saudi Arabia
| | - Huifeng Zhang
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (H.Z.); (M.A.Z.); (C.E.L.E.); (J.E.C.)
| | - Michael A. Zulyniak
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (H.Z.); (M.A.Z.); (C.E.L.E.); (J.E.C.)
| | - Charlotte E. L. Evans
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (H.Z.); (M.A.Z.); (C.E.L.E.); (J.E.C.)
| | - Janet E. Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK; (H.Z.); (M.A.Z.); (C.E.L.E.); (J.E.C.)
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Cross-sectional associations between lunch-type consumed on a school day and British adolescents' overall diet quality. Prev Med Rep 2020; 19:101133. [PMID: 32642402 PMCID: PMC7334820 DOI: 10.1016/j.pmedr.2020.101133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 03/02/2020] [Accepted: 05/23/2020] [Indexed: 11/27/2022] Open
Abstract
Diet quality of children consuming school meals tends to be better than that of children consuming packed lunches (from home) or food bought outside school. This study investigates the association between different types of lunch consumed in a school day and diet quality of UK adolescents. A total of 2118 British adolescents were included from the National Diet and Nutrition Survey (Years 1-8; between 2008 and 2016). All participants attended school and were aged 11-18 years with valid 3 or 4-day diary records and the analyses were stratified by age group (11-14 and 15-18 years). The Diet Quality Index for Adolescents (DQI-A) tool consisting of three components; diet quality, diversity and equilibrium, was used to assess adherence to dietary recommendations. Overall DQI-A scores range from -33 to 100%. Overall mean DQI-A score for all adolescents was low at 21.1%. Fewer (17.4%) adolescents reported buying lunches from cafés and shops, compared to adolescents consuming cooked school meals and packed lunches (28.3% and 36.6%, respectively), and they had the lowest DQI-A% score of 14.8%. Adolescents having cooked school meals (reference group) had a higher overall DQI-A% of 21.8%. Diet quality scores of older adolescents having packed lunches and shop/café-bought lunches were 5.5% higher (CI 2.7 to 8.4%; p < 0.01) and 5.0% lower (CI 8.1 to 2.0%; p < 0.01) than cooked school meals respectively, after adjusting for gender, region, energy under-reporting and equivalised household income. For younger adolescents the results were attenuated particularly among packed lunch consumers. UK adolescents generally consume a poor quality diet and adolescents purchasing lunches from outside the school gates have the lowest quality diets. Unlike with older children there is little difference between school meals and packed lunches for younger children. Regulation policies on food outlets around secondary schools as well as improving food choices within school premises are needed.
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Rippin HL, Hutchinson J, Jewell J, Breda JJ, Cade JE. Assessing diet in European populations using national dietary surveys. Proc Nutr Soc 2020; 79:1-11. [PMID: 31969200 DOI: 10.1017/s0029665119001174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The WHO encourages countries to conduct national dietary surveys (NDS) to inform preventative policies targeting malnutrition and noncommunicable diseases. Previous reviews have found inadequate nutrient intakes and survey provision across Europe. This research is the first to provide an updated review of NDS provision within the whole WHO European Region, across the lifecourse, with reference to disadvantaged groups, obesity and nutrients of concern. Over a third of WHO European countries, mainly Central and Eastern European countries (CEEC), had no identifiable NDS. Where countries reported nutrient intakes, poor WHO recommended nutrient intake attainment was Europe-wide across the lifecourse, particularly in CEEC. Lower educated individuals had poorer diet quality. However, heterogeneity in age group sampled, dietary assessment method, nutrient composition database and under-reporting hindered inter-country comparisons. Average population trans fatty acid intakes below WHO recommended limits may hide inequalities in disadvantaged groups; legislative bans may help alleviate this. There were few associations between NDS-derived consumed food portion size (FPS) and BMI. However, consumed FPS was greater than on-pack serving-size in the majority of foods studied. This review illustrates how NDS can generate information on diet, nutrient intakes and the food environment. However, to enable valid inter-country comparisons, countries should be encouraged to conduct and report harmonised NDS, particularly in the age groups sampled, dietary assessment methodology, nutrient range, underpinning food composition database and treatment of under-reporters. This will aid effective, coordinated policy development that can have a real impact on dietary improvement, on a population and subgroup level, throughout Europe.
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Affiliation(s)
- Holly L Rippin
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LeedsLS2 9JT, UK
| | - Jayne Hutchinson
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LeedsLS2 9JT, UK
| | - Jo Jewell
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, 21000Copenhagen, Denmark
| | - Joao J Breda
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, 21000Copenhagen, Denmark
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LeedsLS2 9JT, UK
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Food portion sizes, obesity, and related metabolic complications in children and adolescents. NUTR HOSP 2020; 38:169-176. [PMID: 33319578 DOI: 10.20960/nh.03118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction The purpose of this narrative review is to provide evidence for the impact of food portion sizes on the development of obesity in children and adolescents. Strategies are needed on portion size estimation and on the relationship of portion size with certain health problems such as obesity, insulin resistance, and emotional eating in all age groups, in order to provide information for parents, teachers, and health professionals aiming to promote healthy eating. A wide range of controlled laboratory studies have found that portion size (PS) had the strongest effect on the amount of food consumed. The effect of PS on total energy intake has been already observed with different types of foods and beverages, especially with energy-dense foods. The influence of large PS was persistent and happened regardless of demographic characteristics such as age, gender, income level, or body mass index. Although a direct causal link between PS and obesity remains controversial, some health and dietetics organizations recommend to moderate PS, especially for energy-dense foods. Research studies in both laboratory and free-living contexts are needed to determine the causal link between increased PS, obesity, and related metabolic complications in children and adolescents.
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Fontes AS, Pallottini AC, Vieira DADS, Fontanelli MDM, Marchioni DM, Cesar CLG, Alves MCGP, Goldbaum M, Fisberg RM. Demographic, socioeconomic and lifestyle factors associated with sugar-sweetened beverage intake: a population-based study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200003. [DOI: 10.1590/1980-549720200003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/30/2018] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT: Introduction: The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population. Objective: To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo. Methods: Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models. Results: The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages. Conclusion: Age group, sex, household per capita income, and body mass index status were associated with SSB intake.
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Snack Portion Sizes for Preschool Children Are Predicted by Caregiver Portion Size, Caregiver Feeding Practices and Children's Eating Traits. Nutrients 2019; 11:nu11123020. [PMID: 31835571 PMCID: PMC6950396 DOI: 10.3390/nu11123020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022] Open
Abstract
Caregivers are mostly responsible for the foods young children consume; however, it is unknown how caregivers determine what portion sizes to serve. This study examined factors which predict smaller or larger than recommended snack portion sizes in an online survey. Caregivers of children aged 2 to 4 years were presented with 10 snack images, each photographed in six portion sizes. Caregivers (n = 659) selected the portion they would usually serve themselves and their child for an afternoon snack. Information on child eating traits, parental feeding practices and demographics were provided by caregivers. Most caregivers selected portions in line with recommended amounts for preschool children, demonstrating their ability to match portion sizes to their child′s energy requirements. However, 16% of caregivers selected smaller than recommended low energy-dense (LED, e.g., fruits and vegetables) snacks for their child which was associated with smaller caregiver′s own portion size, reduced child food liking and increased satiety responsiveness. In contrast, 28% of caregivers selected larger than recommended amounts of high energy-dense (HED, e.g., cookies, crisps) snacks for their child which were associated with larger caregiver′s own portion size, greater frequency of consumption, higher child body mass index (BMI), greater pressure to eat and lower child food liking. These findings suggest that most caregivers in this study select portions adjusted to suit their child′s age and stage of development. Future interventions could provide support to caregivers regarding the energy and nutrient density of foods given the relatively small portion sizes of LED and large portions of HED snacks offered to some children.
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Maternal Decisions on Portion Size and Portion Control Strategies for Snacks in Preschool Children. Nutrients 2019; 11:nu11123009. [PMID: 31835341 PMCID: PMC6950145 DOI: 10.3390/nu11123009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/29/2019] [Accepted: 12/04/2019] [Indexed: 11/17/2022] Open
Abstract
Caregivers are responsible for the type and amount of food young children are served. However, it remains unclear what considerations caregivers make when serving snacks to children. The aim of the study was to explore mothers' decisions and portion control strategies during snack preparation in the home environment. Forty mothers of children aged 24-48 months participated in the study. Mothers prepared five snack foods for themselves and their child whilst verbalizing their actions and thoughts. Mothers were then asked about their portion size decisions in a semi-structured interview. Transcripts were imported into NVivo and analyzed thematically. Three key themes were identified: (1) portion size considerations, (2) portion control methods, and (3) awareness and use of portion size recommendations. Transient, food-related situational influences influenced mothers and disrupted planning and portion control. Food packaging and dishware size were used as visual cues for portion control; however, these vary widely in their size, thus emphasizing mothers' uncertainty regarding appropriate portion sizes. Mothers called for portion size information to be accessible, child-centered, and simple. These findings reveal multiple considerations when deciding on the correct snack portion sizes for children. These decisions are complex and vary across situations and time, and according to the types of snacks offered.
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Blundell-Birtill P, Hetherington MM. Determinants of Portion Size in Children and Adolescents: Insights from the UK National Diet and Nutrition Survey Rolling Programme (2008-2016). Nutrients 2019; 11:nu11122957. [PMID: 31817139 PMCID: PMC6950001 DOI: 10.3390/nu11122957] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 11/27/2019] [Accepted: 11/30/2019] [Indexed: 12/18/2022] Open
Abstract
Large portion sizes have been identified as contributing to overweight and obesity, particularly in children and adolescents. This study examined predictors of portion sizes of high energy snack foods eaten by children aged 1.5–18 years. Specifically, we examined whether portion sizes were adjusted for age, and what external features of the environment might be linked to large portion sizes. Portion sizes were derived from four-day food diaries that form the UK National Diet and Nutrition Survey. Diaries from 5942 children were examined and multilevel models were used to discover whether age, gender, location, time of day, household income, and watching TV while eating predicted portion sizes of savoury snacks, chocolate, confectionery and biscuits. Portion sizes of all the target foods were predicted by age. Boys had larger portions, and portion sizes were larger when target foods were consumed later in the day. Portion sizes were larger outside the home, for example in leisure venues, but the target foods were eaten more frequently in the home. As dietary patterns change to include more snack intake outside the home, these locations could be an important space to target for interventions for portion control.
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Sharps MA, Hetherington MM, Blundell-Birtill P, Rolls BJ, Evans CE. The effectiveness of a social media intervention for reducing portion sizes in young adults and adolescents. Digit Health 2019; 5:2055207619878076. [PMID: 31579525 PMCID: PMC6757490 DOI: 10.1177/2055207619878076] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 08/30/2019] [Indexed: 02/01/2023] Open
Abstract
Objective Adolescents and young adults select larger portions of energy-dense food than recommended. The majority of young people have a social media profile, and peer influence on social media may moderate the size of portions selected. Methods Two pilot interventions examined whether exposure to images of peers’ portions of high-energy-dense (HED) snacks and sugar-sweetened beverages (SSBs) on social media (Instagram) would influence reported desired portions selected on a survey. Confederate peers posted ‘their’ portions of HED snacks and SSBs on Instagram. At baseline and intervention end participants completed surveys that assessed desired portion sizes. Results In intervention 1, undergraduate students (n = 20, mean age=19.0 years, SD=0.65) participated in a two-week intervention in a within-subjects design. Participants reported smaller desired portions of HED snacks and SSBs following the intervention, and smaller desired portions of HED snacks for their peers. In intervention 2, adolescents (n = 44, mean age = 14.4 years, SD = 1.06) participated in a four-week intervention (n = 23) or control condition (n = 21) in a between-subjects design. Intervention 2 did not influence adolescents to reduce their reported desired portion sizes of HED snacks or SSBs relative to control. Conclusions These preliminary studies demonstrated that social media is a feasible way to communicate with young people. However, while the intervention influenced young adults’ reported desired portions and social norms regarding their peers’ portions, no significant impact on desired reported portion sizes was found for HED snacks and SSBs in adolescents. Desired portion sizes of some foods and beverages may be resistant to change via a social media intervention in this age group.
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Affiliation(s)
- Maxine A Sharps
- School of Applied Social Sciences, De Montfort University, UK
| | | | | | - Barbara J Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, USA
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Almiron-Roig E, Forde CG, Hollands GJ, Vargas MÁ, Brunstrom JM. A review of evidence supporting current strategies, challenges, and opportunities to reduce portion sizes. Nutr Rev 2019; 78:91-114. [DOI: 10.1093/nutrit/nuz047] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Although there is considerable evidence for the portion-size effect and its potential impact on health, much of this has not been successfully applied to help consumers reduce portion sizes. The objective of this review is to provide an update on the strength of evidence supporting strategies with potential to reduce portion sizes across individuals and eating contexts. Three levels of action are considered: food-level strategies (targeting commercial snack and meal portion sizes, packaging, food labels, tableware, and food sensory properties), individual-level strategies (targeting eating rate and bite size, portion norms, plate-cleaning tendencies, and cognitive processes), and population approaches (targeting the physical, social, and economic environment and health policy). Food- and individual-level strategies are associated with small to moderate effects; however, in isolation, none seem to have sufficient impact on food intake to reverse the portion-size effect and its consequences. Wider changes to the portion-size environment will be necessary to support individual- and food-level strategies leading to portion control.
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Affiliation(s)
- Eva Almiron-Roig
- E. Almiron-Roig and M. Ángeles Vargas are with the Centre for Nutrition Research, University of Navarra, Pamplona, Spain
- E. Almiron-Roig is with the Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
| | - Ciaran G Forde
- C.G. Forde is with the Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Singapore
| | - Gareth J Hollands
- G.J. Hollands is with the Behaviour and Health Research Unit, University of Cambridge, Cambridge, United Kingdom
| | - M Ángeles Vargas
- E. Almiron-Roig and M. Ángeles Vargas are with the Centre for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Jeffrey M Brunstrom
- J.M. Brunstrom is with the Nutrition and Behaviour Unit, School of Psychological Science, and the National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, United Kingdom
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Lai HT, Hutchinson J, Evans CEL. Non-Milk Extrinsic Sugars Intake and Food and Nutrient Consumption Patterns among Adolescents in the UK National Diet and Nutrition Survey, Years 2008-16. Nutrients 2019; 11:E1621. [PMID: 31319451 PMCID: PMC6682974 DOI: 10.3390/nu11071621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/08/2019] [Accepted: 07/12/2019] [Indexed: 11/28/2022] Open
Abstract
The revised guidelines from the Department of Health (DoH) in the UK state that mean population intakes of free sugars should be below 5% of the total energy (TE) consumption of the British population. However, very few studies have assessed the impact of this recommendation on diet quality in the UK. We explored the dietary patterns and intakes of micronutrients of British adolescents with low intakes of non-milk extrinsic sugars (NMES) (similar to free sugars but not equal, with slight differences in the categorisation of fruit sugars from dried, stewed or canned fruit and smoothies), using the National Diet and Nutrition Survey Rolling Programme, years 1-8 (NDNS RP). The sample included 2587 adolescents aged 11-18 years. Four percent (112) of adolescents reported consuming 5% or lower NMES as a proportion of TE. The odds of being categorised as a low-sugar consumer in adolescents (≤5% TE from NMES) were significantly lower with higher intakes of sweetened drinks, fruit juice, cakes, biscuits, sugar and sweet spreads, chocolate confectionery and sugar confectionery, and significantly higher with higher intakes of pasta and rice, wholemeal and brown bread, and fish. Across the five categories of NMES intakes, micronutrient intakes were lowest for those consuming either ≤5% TE or more than 20% TE from NMES, and optimal for those consuming between 10-15% of energy from NMES. These findings confirm the difficulties of meeting the free sugars recommended intake for adolescents. Care needs to be taken to ensure that an adequate consumption of micronutrients is achieved in those adhering to the revised guidelines on free sugars.
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Affiliation(s)
- Heidi T Lai
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA
| | - Jayne Hutchinson
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK
| | - Charlotte E L Evans
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
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Hetherington MM. The portion size effect and overconsumption – towards downsizing solutions for children and adolescents – An update. NUTR BULL 2019. [DOI: 10.1111/nbu.12375] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Food-variety-focused labelling does not increase ideal portion size, expected fullness or snack intake. Food Qual Prefer 2019. [DOI: 10.1016/j.foodqual.2018.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Pelusi C, Altieri P, Gambineri A, Repaci A, Cavazza C, Fanelli F, Morselli-Labate AM, Pagotto U, Pasquali R. Behavioral, socio-environmental, educational and demographic correlates of excess body weight in Italian adolescents and young adults. Nutr Metab Cardiovasc Dis 2019; 29:279-289. [PMID: 30718143 DOI: 10.1016/j.numecd.2018.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS Excess body weight (EBW) is the most prevalent nutritional disorder among adolescents worldwide. Identifying determinants of EBW may help find new intervention strategies. Behavioral, socio-economic, educational and demographic correlates of EBW were examined in a population of Italian adolescents, separately for males and females. METHODS AND RESULTS As many as 1039 male and 2052 female students (aged 16-19 ys) attending the last three years of different types of high-school of the Emilia-Romagna region in Italy were offered participation, with 552 males and 841 females being finally evaluated. The prevalence of EBW was 21.0% in males and 14.1% in females. Step-wise multivariate logistic regression analyses were performed showing that EBW was negatively related to energy intake in males (odds ratio for 100 kcal/day (OR) = 0.94, 95% confidence interval (CI): 0.89 to 0.98; P = 0.008), and to father's educational attainment (OR = 0.70, 95% CI: 0.52 to 0.95; P = 0.020), but positively related to parental obesity (OR = 2.80, 95% CI: 1.65 to 4.76; P < 0.001). In females, EBW was positively related to parental obesity (OR = 1.94, 95% CI: 1.15 to 3.29; P = 0.013), but negatively to mother's educational attainment (OR = 0.66, 95% CI: 0.45 to 0.97; P = 0.034) and type of attended school (OR = 0.66, 95% CI: 0.49 to 0.89; P = 0.007). Mother's occupation was also an independent determinant of EBW status in females (OR = 0.39, 95% CI: 0.18 to 0.85; P = 0.018 for being unemployed vs blue-collar). CONCLUSION Parental obesity is associated with EBW in male and female adolescents. Importantly, we found sex differences in socio-economic and educational factors impacting on EBW, supporting possible distinct area of investigation.
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Affiliation(s)
- C Pelusi
- Division of Endocrinology, Dept. of Medical & Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
| | - P Altieri
- Division of Endocrinology, Dept. of Medical & Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - A Gambineri
- Division of Endocrinology, Dept. of Medical & Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - A Repaci
- Division of Endocrinology, Dept. of Medical & Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - C Cavazza
- Division of Endocrinology, Dept. of Medical & Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - F Fanelli
- Division of Endocrinology, Dept. of Medical & Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - A M Morselli-Labate
- Division of Endocrinology, Dept. of Medical & Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - U Pagotto
- Division of Endocrinology, Dept. of Medical & Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - R Pasquali
- Division of Endocrinology, Dept. of Medical & Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
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Rippin HL, Hutchinson J, Jewell J, Breda JJ, Cade JE. Comparison of consumed portion sizes and on-pack serving sizes of UK energy dense foods. Appetite 2019; 134:193-203. [DOI: 10.1016/j.appet.2018.12.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/16/2018] [Accepted: 12/14/2018] [Indexed: 11/30/2022]
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Discretionary intake among Australian adults: prevalence of intake, top food groups, time of consumption and its association with sociodemographic, lifestyle and adiposity measures. Public Health Nutr 2019; 22:1576-1589. [PMID: 30681049 DOI: 10.1017/s1368980018003361] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To profile discretionary food and beverage (DF) consumption among Australian adults. DESIGN Cross-sectional analysis. Dietary and sociodemographic data were used to profile DF intake. Prevalence of DF consumption, DF servings (1 serving=600 kJ), nutrient contribution from DF and top DF food groups by self-reported eating occasions were determined. DF consumers (>0 g) were classified according to quartile of DF intake and general linear models adjusted for age and sex were used to determine associations. SETTING 2011-12 National Nutrition and Physical Activity Survey (NNPAS).ParticipantsAdults aged ≥19 years (n 9341) who participated in the NNPAS 2011-12. RESULTS Most adults consumed DF (98 %) and over 60 % exceeded 3 DF servings/d, with a mean of 5·0 (se 0·0) DF servings/d. Cakes, muffins, scones, cake-type desserts contributed the most DF energy (8·4 %) of all food groups, followed by wines (8·1 %), pastries (8·0 %) and beers (6·1 %), with all these food groups consumed in large portions (2·3-3·0 DF servings). Lunch and dinner together contributed 45 % of total DF energy intake. High DF consumers had an average of 10 DF servings, and this group contained more younger adults, males, low socio-economic status, lower usual fruit intake and higher mean waist circumference, but not higher BMI. CONCLUSIONS A focus on DF consumed in large portions at lunch and dinner may help improve interventions aimed at reducing DF intake and addressing negative adiposity-related measures found in high DF consumers.
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Rippin HL, Hutchinson J, Jewell J, Breda JJ, Cade JE. Portion Size of Energy-Dense Foods among French and UK Adults by BMI Status. Nutrients 2018; 11:nu11010012. [PMID: 30577527 PMCID: PMC6356251 DOI: 10.3390/nu11010012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 12/14/2022] Open
Abstract
Evidence links consumed food portion size (FPS) and excess weight via increased energy intake. Policies to regulate on-pack serving sizes may be needed; determining consumed FPS of popular energy-dense foods for normal weight and overweight or obese (OWOB) adults, as reported here, may provide evidence to assist this. Data were analysed from national cross-sectional surveys, the French Étude Individuelle Nationale des Consommations Alimentaires2 2005⁻2007 (n = 2117), and UK National Diet and Nutrition Survey 2008⁻2014 (n = 3413). The impact of body mass index (BMI) on FPS is also investigated, adjusting for age, sex and under-reporting. Effects of under-reporting on relationships between FPS and BMI; and BMI on consumption frequency (UK only) were explored. OWOB reported larger FPS than normal-weight individuals in many, but not all food subgroups; however, there were only two significant FPS differences. In adjusted analyses, French individuals consumed 1.0 g (99% CI 0.01⁻2.1 p = 0.01) greater FPS in cakes for 1 point difference in BMI. 'Other cakes' and 'dark chocolate' were also significantly positively associated with BMI. High-fat bar snacks, but no UK main food groups, were positively associated with BMI. There was limited evidence of links between FPS and BMI in UK and French national cross-sectional data, possibly due to data limitations such as under-reporting. Future work should explore this and relationships between consumed FPS and on-pack suggested serving sizes to provide evidence to assist obesity-prevention policies.
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Affiliation(s)
- Holly L Rippin
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
| | - Jayne Hutchinson
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
| | - Jo Jewell
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark.
| | - Joao J Breda
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark.
| | - Janet E Cade
- Nutritional Epidemiology Group (NEG), School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
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Carstairs SA, Caton SJ, Blundell-Birtill P, Rolls BJ, Hetherington MM, Cecil JE. Can Reduced Intake Associated with Downsizing a High Energy Dense Meal Item be Offset by Increased Vegetable Variety in 3⁻5-year-old Children? Nutrients 2018; 10:E1879. [PMID: 30513873 PMCID: PMC6315468 DOI: 10.3390/nu10121879] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 11/15/2018] [Accepted: 11/23/2018] [Indexed: 12/16/2022] Open
Abstract
Large portions of energy dense foods promote overconsumption but offering small portions might lead to compensatory intake of other foods. Offering a variety of vegetables could help promote vegetable intake and offset the effect of reducing the portion size (PS) of a high energy dense (HED) food. Therefore, we tested the effect on intake of reducing the PS of a HED unit lunch item while varying the variety of the accompanying low energy dense (LED) vegetables. In a within-subjects design, 43 3⁻5-year-old pre-schoolers were served a lunch meal in their nursery on 8 occasions. Children were served a standard (100%) or downsized (60%) portion of a HED sandwich with a side of LED vegetables offered as a single (carrot, cherry tomato, cucumber) or variety (all 3 types) item. Reducing the PS of a HED sandwich reduced sandwich (g) (p < 0.001) and total meal intake (kcal) consumption (p = 0.001) without an increased intake of other foods in the meal (LED vegetables (p = 0.169); dessert (p = 0.835)). Offering a variety of vegetables, compared with a single vegetable, increased vegetable intake (g) (p = 0.003) across PS conditions. Downsizing and variety were effective strategies individually for altering pre-schoolers' intakes of HED and LED meal items, however, using variety to offset HED downsizing was not supported in the present study.
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Affiliation(s)
- Sharon A Carstairs
- Population and Behavioral Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK.
| | - Samantha J Caton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK.
| | | | - Barbara J Rolls
- Department of Nutritional Sciences, College of Health and Human Development, Pennsylvania State University, University Park, PA 16802, USA.
| | | | - Joanne E Cecil
- Population and Behavioral Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK.
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Okada E, Saito A, Takimoto H. Association between the Portion Sizes of Traditional Japanese Seasonings-Soy Sauce and Miso-and Blood Pressure: Cross-Sectional Study Using National Health and Nutrition Survey, 2012⁻2016 Data. Nutrients 2018; 10:nu10121865. [PMID: 30513805 PMCID: PMC6316062 DOI: 10.3390/nu10121865] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 12/26/2022] Open
Abstract
While previous studies have reported the association between food portion size and health outcomes, the association between food seasonings and blood pressure (BP) has not been clarified. This study aimed to investigate the association between the portion sizes of traditional Japanese seasonings and BP. Data on 25,738 Japanese participants (10,154 men and 15,584 women) aged ≥20 years registered in the 2012–2016 National Health and Nutrition Survey (NHNS) were used for this cross-sectional study. The portion sizes of soy sauce or miso were calculated from the reported weight of soy sauce or miso, and the number of dishes. Regression models were used to estimate BP and prevalence of hypertension, and their 95% confidence intervals according to the portion size of soy sauce or miso. We did not observe an association between the portion sizes of soy sauce or miso and BP. A larger portion size of soy sauce or miso was associated with a higher prevalence of hypertension in the crude model among women, but no significant associations were observed in the multivariate model in both sexes. Our findings suggest that the portion sizes of soy sauce or miso are not associated with BP among Japanese adults.
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Affiliation(s)
- Emiko Okada
- Department of Nutritional Epidemiology, National Institute of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama Shinjuku-ku, Tokyo 162-8636, Japan.
| | - Aki Saito
- Department of Nutritional Epidemiology, National Institute of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama Shinjuku-ku, Tokyo 162-8636, Japan.
- Office of Nutrition, Health Service Division, Health Service Bureau, Ministry of Health, Labour and Welfare, 1-2-2 Kasumigaseki Chiyoda-ku, Tokyo 100-8916, Japan.
| | - Hidemi Takimoto
- Department of Nutritional Epidemiology, National Institute of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama Shinjuku-ku, Tokyo 162-8636, Japan.
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Abstract
The WHO encourages national diet survey (NDS) implementation to obtain relevant data to inform policies addressing all forms of malnutrition, which remains a pressing issue throughout Europe. This paper provides an up-to-date review on energy, macro- and selected micronutrient intakes in children across WHO Europe using the latest available NDS intakes. It assesses these against WHO recommended nutrient intakes (RNI) to highlight vulnerable groups and areas of concern. Dietary survey information was gathered by Internet searches, contacting survey authors and nutrition experts. Survey characteristics, energy and nutrient intakes were extracted and weighted means calculated and presented by region. Child energy and nutrient intakes were extracted from twenty-one NDS across a third (n 18) of the fifty-three WHO Europe countries. Of these, 38 % (n 6) reported intakes by socio-economic group, but by various indicators. Energy and macronutrients, where boys and older children had higher intakes, were more widely reported than micronutrients. Most countries met under half of the WHO RNI for nutrients reported in their NDS. Micronutrient attainment was higher than macronutrients, but worst in girls and older children. Only a third, mainly Western, WHO European member states provided published data on child nutrient intakes. Gaps in provision mean that dietary inadequacies may go unidentified, preventing evidence-based policy formation. WHO RNI attainment was poor, particularly in girls and older children. Inconsistent age groups, dietary methodologies, nutrient composition databases and under-reporting hinder inter-country comparisons. Future efforts should encourage countries to conduct NDS in a standardised format by age and sociodemographic variables.
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Reale S, Kearney CM, Hetherington MM, Croden F, Cecil JE, Carstairs SA, Rolls BJ, Caton SJ. The Feasibility and Acceptability of Two Methods of Snack Portion Control in United Kingdom (UK) Preschool Children: Reduction and Replacement. Nutrients 2018; 10:E1493. [PMID: 30322090 PMCID: PMC6212871 DOI: 10.3390/nu10101493] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 01/23/2023] Open
Abstract
Large portions of high energy dense (HED) snacks are offered to children from a young age and are pervasive in our food environment. This study aimed to explore the feasibility, acceptability, and preliminary efficacy of two strategies of snack portion control: reduction and replacement. Forty-six mother-child dyads aged 22⁻56 months (36.6 ± 9.5 m, 48% female) completed a three-week intervention. In week 1 (baseline) no changes were made to the child's diet; week 2 (acclimation) children received a standardised selection of HED snacks, and in week 3 (intervention) participants were randomly assigned to snack replacement (n = 24) or snack reduction (n = 22). Snack replacement involved swapping HED snacks for fruits and vegetables, whilst snack reduction involved reducing the size of HED snacks by 50%. Food and energy intake were measured using a weighed food diary for four consecutive days. Snack replacement resulted in more positive changes to children's diets; vegetable intake increased (p < 0.01), and total daily energy intake decreased when compared to snack reduction (p < 0.05). Mothers expressed a more favourable attitude to snack replacement, although snack reduction was also well received by mothers. Despite increased preliminary efficacy of snack replacement on dietary intake, both strategies were feasible and acceptable. The current pilot study provides the necessary information to inform the design of future interventions.
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Affiliation(s)
- Sophie Reale
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK.
| | - Colette M Kearney
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK.
| | | | - Fiona Croden
- School of Psychology, University of Leeds, Leeds LS2 9JT, UK.
| | - Joanne E Cecil
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK.
| | - Sharon A Carstairs
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK.
| | - Barbara J Rolls
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Samantha J Caton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK.
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Pereira JL, Félix PV, Mattei J, Fisberg RM. Differences over 12 Years in Food Portion Size and Association with Excess Body Weight in the City of São Paulo, Brazil. Nutrients 2018; 10:E696. [PMID: 29848971 PMCID: PMC6024366 DOI: 10.3390/nu10060696] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/24/2018] [Accepted: 05/28/2018] [Indexed: 12/21/2022] Open
Abstract
Although changes in Brazilian diet have occurred over the last decades, there is no evidence about differences in food portion sizes (FPS) over time. Therefore, we aimed to evaluate the association of FPS with excess body weight (EBW), and to monitor differences in the population from São Paulo, Brazil, from 2003 to 2015. Data came from three cross-sectional population-based studies with 5270 individuals aged ≥12 years in 2003, 2008, and 2015. Dietary data were obtained from 24-h recalls. Logistic regression models were used to evaluate the association between FPS and EBW. Over the years, there was a diverse variation in FPS, with an increase in some groups (white meat, salted snacks, coffee/tea, eggs) and decrease in others (rice, red meat, sweets, pasta, sandwiches, cold cuts). The percentage of people reporting the intake of six food groupings (rice, white meat, sweets, fruits, commercial juices, toasts/biscuits) increased in the period. In this population, EBW was associated with larger FPS of 11 of the 30 food groupings investigated (cold cuts, fried snacks, fruit and commercial juices, pizza, red meat, rice, salted snacks, soft drinks, soups, sugar). These findings could support future interventions and policies for optimal food intake in Brazil.
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Affiliation(s)
- Jaqueline Lopes Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo SP 01246-904, Brazil.
| | - Paula Victória Félix
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo SP 01246-904, Brazil.
| | - Josiemer Mattei
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo SP 01246-904, Brazil.
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Abstract
Offering large portions of high-energy-dense (HED) foods increases overall intake in children and adults. This is known as the portion size effect (PSE). It is robust, reliable and enduring. Over time, the PSE may facilitate overeating and ultimately positive energy balance. Therefore, it is important to understand what drives the PSE and what might be done to counter the effects of an environment promoting large portions, especially in children. Explanations for the PSE are many and diverse, ranging from consumer error in estimating portion size to simple heuristics such as cleaning the plate or eating in accordance with consumption norms. However, individual characteristics and hedonic processes influence the PSE, suggesting a more complex explanation than error or heuristics. Here PSE studies are reviewed to identify interventions that can be used to downsize portions of HED foods, with a focus on children who are still learning about social norms for portion size. Although the scientific evidence for the PSE is robust, there is still a need for creative downsizing solutions to facilitate portion control as children and adolescents establish their eating habits.
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Hetherington MM, Blundell-Birtill P. The portion size effect and overconsumption - towards downsizing solutions for children and adolescents. NUTR BULL 2018. [DOI: 10.1111/nbu.12307] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Café ACC, Lopes CADO, Novais RLR, Bila WC, da Silva DK, Romano MCC, Lamounier JA. INTAKE OF SUGAR-SWEETENED BEVERAGES, MILK AND ITS ASSOCIATION WITH BODY MASS INDEX IN ADOLESCENCE: A SYSTEMATIC REVIEW. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2018; 36:91-99. [PMID: 29513855 PMCID: PMC5849383 DOI: 10.1590/1984-0462/;2018;36;1;00010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 04/04/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To systematize literature references addressing the association of sugar-sweetened beverage (SSB) and milk intake with body mass index (BMI) in adolescents. DATA SOURCE A search was carried out in PubMed (US National Library of Medicine National Institutes of Health) and BVS (Virtual Library in Health). The descriptors used were: adolescents, young adult, beverages, drinking, obesity, overweight, BMI, and nutritional status. The following filters were applied: age ranging from 10 to 19 years, studies published in Portuguese or English language between 2011-2015. DATA SYNTHESIS Thirty studies were selected (22 cross-sectional studies, 4 cohort studies, 1 randomized clinical trial, 1 case-control study, and 1 quasi-experimental study). There was association between the intake of these beverages and increase in BMI in 55% of all 20 studies that dealt with sugary drinks. When it came to soft drinks, 100% of studies reported association with increase in BMI. As to milk intake, only one article showed association with increased BMI. Three articles reported milk as a protection factor against increase in BMI; three studies found no association between this intake and BMI. Nineteen studies had representative samples and 20 surveys reported random samples. Among papers using questionnaires, 84% had been validated. CONCLUSIONS There is no consensus in the literature about the association between SSB or milk intake and BMI in adolescents.
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Affiliation(s)
| | | | | | - Wendell Costa Bila
- Universidade Federal de São João del-Rei (UFSJ), Divinópolis, MG,
Brasil
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40
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Abstract
The automation of the process of extracting sugars in the 1900s reduced cost and increased availability of sugars leading to a dramatic rise in consumption, which reached a peak in the 1970s. There are different definitions for sugars not naturally available in foods, and free sugars is the term used by WHO. The epidemiological evidence of the associations between sugars and obesity and type 2 diabetes mellitus is fairly strong and consistent, particularly for sugar sweetened drinks in adults. The Department of Health in the UK and many other countries have recently updated their recommendations for free sugars as a result of this scientific evidence. In the UK the recommended amount of free sugars is currently 5 % of energy (reduced from 10 %), which is difficult to meet and very different from current British dietary patterns. Reducing intakes of free sugars is a challenge and will necessitate a range of different actions and policies. Public Health England has put forward eight suggestions but the four most likely to improve dietary behaviour based on available evidence are social marketing, reduction of marketing of high sugar foods and drinks to children, reformulation and reductions in portion size and a sugar excise tax. Any action taken needs to be evaluated to check inequalities are not widened. The new childhood obesity strategy has incorporated some but not all of these strategies and may not go far enough. It is likely that government policies alone will not be sufficient and a change in the food culture is necessary to see real progress.
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Iffland Y, Müller R, Groneberg D, Gerber A. High particulate matter emission from additive-free Natural American Spirit cigarettes. SPRINGERPLUS 2016; 5:1958. [PMID: 27933238 PMCID: PMC5106410 DOI: 10.1186/s40064-016-3635-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 11/02/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Involuntary exposure to health-threatening environmental tobacco smoke (Combined Mainstream and Side-stream Smoke, CMSS) is a worldwide problem, causing premature death of thousands of people. CMSS consists of particulate matter (PM), one of the main sources of indoor air pollution. PM constitutes a considerable health risk for passive smokers. It is important to inform the public about brand-specific differences in CMSS-associated PM, especially in the case of brands without additives, which are therefore promoted as natural and less health-threatening. METHODS Mean concentrations and the area under the curve of PM10, PM2.5 and PM1 generated by Natural American Spirit cigarettes without additives and the 3R4F standard research cigarette (University of Kentucky, USA) were measured, analyzed and compared with each other. An automatic environmental tobacco smoke emitter was used to smoke 100 cigarettes, 20 of each brand, according to a standardized smoking protocol. RESULTS This study could show that CMSS-associated PM released from tobacco brands without additives, which are therefore promoted as natural and less harmful, are higher than expected. CONCLUSIONS It is highly improbable that Natural American Spirit tobacco products are a less harmful choice-at least not for passive smokers as this study could show. We conclude, the CMSS-associated PM level of every single customized brand should be measured because the origin of the tobacco and not the amount of CO, tar and nicotine (given as product information) seem to be responsible for the brand-specific PM release. This data is urgently needed to adequately inform the public about CMSS-associated PM exposure and the related health risk especially for passive smokers.
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Affiliation(s)
- Yvonne Iffland
- Center for Health Sciences, Institute of Occupational, Public and Environmental Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Ruth Müller
- Center for Health Sciences, Institute of Occupational, Public and Environmental Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - David Groneberg
- Center for Health Sciences, Institute of Occupational, Public and Environmental Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Alexander Gerber
- Center for Health Sciences, Institute of Occupational, Public and Environmental Medicine, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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McGowan L, Pot GK, Stephen AM, Lavelle F, Spence M, Raats M, Hollywood L, McDowell D, McCloat A, Mooney E, Caraher M, Dean M. The influence of socio-demographic, psychological and knowledge-related variables alongside perceived cooking and food skills abilities in the prediction of diet quality in adults: a nationally representative cross-sectional study. Int J Behav Nutr Phys Act 2016; 13:111. [PMID: 27782841 PMCID: PMC5080680 DOI: 10.1186/s12966-016-0440-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 10/20/2016] [Indexed: 02/07/2023] Open
Abstract
Background Interventions to increase cooking skills (CS) and food skills (FS) as a route to improving overall diet are popular within public health. This study tested a comprehensive model of diet quality by assessing the influence of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. The correspondence of two measures of diet quality further validated the Eating Choices Index (ECI) for use in quantitative research. Methods A cross-sectional survey was conducted in a quota-controlled nationally representative sample of 1049 adults aged 20–60 years drawn from the Island of Ireland. Surveys were administered in participants’ homes via computer-assisted personal interviewing (CAPI) assessing a range of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. Regression models were used to model factors influencing diet quality. Correspondence between 2 measures of diet quality was assessed using chi-square and Pearson correlations. Results ECI score was significantly negatively correlated with DINE Fat intake (r = -0.24, p < 0.001), and ECI score was significantly positively correlated with DINE Fibre intake (r = 0.38, p < 0.001), demonstrating a high agreement. Findings indicated that males, younger respondents and those with no/few educational qualifications scored significantly lower on both CS and FS abilities. The relative influence of socio-demographic, knowledge, psychological variables and CS and FS abilities on dietary outcomes varied, with regression models explaining 10–20 % of diet quality variance. CS ability exerted the strongest relationship with saturated fat intake (β = -0.296, p < 0.001) and was a significant predictor of fibre intake (β = -0.113, p < 0.05), although not for healthy food choices (ECI) (β = 0.04, p > 0.05). Conclusion Greater CS and FS abilities may not lead directly to healthier dietary choices given the myriad of other factors implicated; however, CS appear to have differential influences on aspects of the diet, most notably in relation to lowering saturated fat intake. Findings suggest that CS and FS should not be singular targets of interventions designed to improve diet; but targeting specific sub-groups of the population e.g. males, younger adults, those with limited education might be more fruitful. A greater understanding of the interaction of factors influencing cooking and food practices within the home is needed.
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Affiliation(s)
- Laura McGowan
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Gerda K Pot
- Diabetes and Nutritional Sciences Division, King's College London, London, UK.,Department of Health and Life, Vrije Universiteit Amsterdam, Faculty of Earth and Life Sciences, Amsterdam, The Netherlands
| | - Alison M Stephen
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Fiona Lavelle
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, University Road, Belfast, BT7 1NN, UK
| | - Michelle Spence
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, University Road, Belfast, BT7 1NN, UK
| | - Monique Raats
- Food, Consumer Behaviour and Health Research Centre, School of Psychology, University of Surrey, Guildford, UK
| | - Lynsey Hollywood
- Department of Hospitality and Tourism Management, Ulster Business School, Ulster University, Coleraine, UK
| | - Dawn McDowell
- Department of Hospitality and Tourism Management, Ulster Business School, Ulster University, Coleraine, UK
| | - Amanda McCloat
- Department of Home Economics, St Angela's College, Sligo, Ireland
| | - Elaine Mooney
- Department of Home Economics, St Angela's College, Sligo, Ireland
| | - Martin Caraher
- Department of Sociology, School of Arts and Social Sciences, City University of London, London, UK
| | - Moira Dean
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, University Road, Belfast, BT7 1NN, UK.
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Pereira JL, Mendes A, Crispim SP, Marchioni DM, Fisberg RM. Association of Overweight with Food Portion Size among Adults of São Paulo - Brazil. PLoS One 2016; 11:e0164127. [PMID: 27706222 PMCID: PMC5051931 DOI: 10.1371/journal.pone.0164127] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 09/20/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Although studies show that portion size affects energy intake, few have demonstrated a link between portion size and weight status, especially in free-living populations. The objective of the present study was to assess the relationship between food portion sizes and overweight in a representative population of adults of São Paulo, Brazil. METHODS Cross-sectional population-based study with 1005 adults from São Paulo, Brazil. Dietary data were obtained from two 24-hour recalls. Reported foods were classified into groups and energy contribution, prevalence of consumers and portion sizes were calculated. Individuals were classified according to BMI in with and without overweight. Logistic regression models were used to evaluate the association between food portion sizes and being overweight. RESULTS The most consumed food groups were: beans, breads/rolls, coffee/tea, milk, rice, and sugar. Rice, red meat, breads/rolls, and white meat were the groups with the highest percentage of contribution to total energy intake. Butter/margarine, toasts/biscuits, sugar, and cakes were the groups with the highest energy density. After adjustment for confounding variables, overweight was associated with larger portions of pizza (OR = 1.052; p = 0.048), red meat (OR = 1.025; p = 0.043), rice (OR = 1.033; p<0.001), salted snacks (OR = 1.078; p = 0.022), and soft drinks (OR = 1.016; p = 0.007). CONCLUSIONS Larger portions of few food groups with different energy densities were associated with being overweight, suggesting that overweight may be related to the consumption of larger portion sizes of a series of food groups, not a food group alone. Additionally, we highlight the importance of considering underreporting as a confounding factor in these associations.
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Affiliation(s)
- Jaqueline Lopes Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Aline Mendes
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Schmitz KE, Liles S, Hyman AN, Hofstetter CR, Obayashi S, Parker M, Surillo SA, Noel D, Hovell MF. Youth receiving orthodontic care are not immune to poor diet and overweight: a call for dental providers to participate in prevention efforts. PEDIATRIC DIMENSIONS 2016; 1:59-64. [PMID: 28164164 PMCID: PMC5289703 DOI: 10.15761/pd.1000113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES While obesity is common in the US, disparities exist. Orthodontic samples are assumed to be more affluent than the general population and not in need of assistance in developing or maintaining healthy lifestyles. This paper evaluates the need of the orthodontic population for intervention by examining diet and weight status of an orthodontic patient sample and describes a role for dental clinicians in obesity prevention efforts. METHODS 552 patients age 8-14 years, 54% female, 51% non-Hispanic white, 26% Hispanic were recruited from orthodontic practices in Southern California to participate in a randomized controlled trial of clinician-delivered health promotion. Height, weight, demographics, and diet were recorded. Chi-Square analyses were used to test for differences at baseline by gender, age, ethnicity, and income. RESULTS 13% of the sample was overweight and 9% was obese. Males had a higher rate of obesity than females. Lower income youth had a higher rate than higher income youth. Hispanic youth had a higher rate than non-Hispanic white youth. Failure to meet national dietary guidelines was common, differing significantly by demographic group. CONCLUSIONS Within a sample not typically thought of as needing assistance, nearly 25% were overweight or obese and the majority failed to meet dietary recommendations. While most patients could benefit from intervention, male, Hispanic, and lower income groups were in greatest need of assistance. Dental providers, who see youth frequently and already discuss nutrition in the context of oral health, have the opportunity to contribute to obesity prevention.
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Affiliation(s)
- Katharine E. Schmitz
- Research Associate, San Diego State University, Graduate School of Public Heath, The Center for Behavioral Epidemiology and Community Health, 9245 Sky Park Court, Ste 230, San Diego, CA 92123, USA, telephone: 858-505-4770 ext 151, fax: 858-505-8614
| | - Sandy Liles
- Research Associate, San Diego State University, Graduate School of Public Heath, The Center for Behavioral Epidemiology and Community Health, 9245 Sky Park Court, Ste 230, San Diego, CA 92123, USA, telephone: 858-505-4770 ext 112, fax: 858-505-8614
| | - Ashley N. Hyman
- Research Associate, San Diego State University, Graduate School of Public Heath, The Center for Behavioral Epidemiology and Community Health, 9245 Sky Park Court, Ste 230, San Diego, CA 92123, USA, telephone: 858-505-4770 ext 155, fax: 858-505-8614
| | - C. Richard Hofstetter
- Adjunct Professor, Graduate School of Public Health, Professor Emeritus, Department of Political Science, and Associate Director, CBEACH, San Diego State University, San Diego State University, Graduate School of Public Health and Department of Political Science, The Center for Behavioral Epidemiology and Community Health, 9245 Sky Park Court, Ste 230, San Diego, CA 92123, USA, telephone: 858-505-4770 ext 142, fax: 858-505-8614
| | - Saori Obayashi
- Research Associate and Adjunct Assistant Professor, San Diego State University, Graduate School of Public Heath, The Center for Behavioral Epidemiology and Community Health, 9245 Sky Park Court, Ste 230, San Diego, CA 92123, USA, telephone: 858-505-4770 ext 128, fax: 858-505-8614
| | - Melanie Parker
- Orthodontist in private practice of Dr. Melanie Parker and volunteer faculty at the University of California San Diego School of Medicine, 3737 Moraga Ave. # A-303, San Diego, CA 92117, USA, telephone: 858-274-0777, fax: 858-274-7604
| | - Santiago A. Surillo
- Orthodontist & Pediatric Dentist in private practice of “Children’s Braces & Dentistry”, 4700 Spring St., Suite #104, La Mesa, CA 91942, USA, telephone: 619-461-6166, fax: 619-461-2508
| | - David Noel
- Chief Dental Program Consultant, State of California (retired), 10456 Ananda Lane, Rancho Cordova, CA 95670, USA, telephone: 916-708-6321
| | - Melbourne F. Hovell
- Principal Investigator, Distinguished Professor, and Director, San Diego State University, Graduate School of Public Heath, The Center for Behavioral Epidemiology and Community Health, 9245 Sky Park Court, Ste 230, San Diego, CA 92123, USA, telephone: 858-505-4772, fax: 858-505-8614
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Adolescents' non-core food intake: a description of what, where and with whom adolescents consume non-core foods. Public Health Nutr 2016; 19:1645-53. [PMID: 26878965 DOI: 10.1017/s1368980016000124] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Little is known about adolescents' non-core food intake in the UK and the eating context in which they consume non-core foods. The present study aimed to describe types of non-core foods consumed by British adolescents in total and across different eating contexts. DESIGN A descriptive analysis, using cross-sectional data from food diaries. Non-core foods were classified based on cut-off points of fat and sugar from the Australian Guide to Healthy Eating. Eating context was defined as 'where' and 'with whom' adolescents consumed each food. Percentages of non-core energy were calculated for each food group in total and across eating contexts. A combined ranking was then created to account for each food's contribution to non-core energy intake and its popularity of consumption (percentage of consumers). SETTING The UK National Diet and Nutrition Survey 2008-2011. SUBJECTS Adolescents across the UK aged 11-18 years (n 666). RESULTS Non-core food comprised 39·5 % of total energy intake and was mostly 'Regular soft drinks', 'Crisps & savoury snacks', 'Chips & potato products', 'Chocolate' and 'Biscuits'. Adolescents ate 57·0 % and 51·3 % of non-core food at 'Eateries' or with 'Friends', compared with 33·2 % and 32·1 % at 'Home' or with 'Parents'. Persistent foods consumed across eating contexts were 'Regular soft drinks' and 'Chips & potato products'. CONCLUSIONS Regular soft drinks contribute the most energy and are the most popular non-core food consumed by adolescents regardless of context, and represent a good target for interventions to reduce non-core food consumption.
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The pack size effect: Influence on consumer perceptions of portion sizes. Appetite 2016; 96:225-238. [DOI: 10.1016/j.appet.2015.09.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 09/21/2015] [Accepted: 09/22/2015] [Indexed: 12/21/2022]
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Louzada MLDC, Baraldi LG, Steele EM, Martins APB, Canella DS, Moubarac JC, Levy RB, Cannon G, Afshin A, Imamura F, Mozaffarian D, Monteiro CA. Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. Prev Med 2015; 81:9-15. [PMID: 26231112 DOI: 10.1016/j.ypmed.2015.07.018] [Citation(s) in RCA: 346] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 07/17/2015] [Accepted: 07/21/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the relationship between the consumption of ultra-processed foods and obesity indicators among Brazilian adults and adolescents. METHODS We used cross-sectional data on 30,243 individuals aged ≥10 years from the 2008-2009 Brazilian Dietary Survey. Food consumption data were collected through 24-h food records. We classified food items according to characteristics of food processing. Ultra-processed foods were defined as formulations made by the food industry mostly from substances extracted from foods or obtained with the further processing of constituents of foods or through chemical synthesis, with little if any whole food. Examples included candies, cookies, sugar-sweetened beverages, and ready-to-eat dishes. Regression models were fitted to evaluate the association of the consumption of ultra-processed foods (% of energy intake) with body-mass-index, excess weight, and obesity status, controlling for socio-demographic characteristics, smoking, and physical activity. RESULTS Ultra-processed foods represented 30% of the total energy intake. Those in the highest quintile of consumption of ultra-processed foods had significantly higher body-mass-index (0.94 kg/m(2); 95% CI: 0.42,1.47) and higher odds of being obese (OR=1.98; 95% CI: 1.26,3.12) and excess weight (OR=1.26; 95% CI: 0.95,1.69) compared with those in the lowest quintile of consumption. CONCLUSION Our findings support the role of ultra-processed foods in the obesity epidemic in Brazil.
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Affiliation(s)
- Maria Laura da Costa Louzada
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, 2° floor, São Paulo 01246-907, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil.
| | - Larissa Galastri Baraldi
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, 2° floor, São Paulo 01246-907, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil.
| | - Euridice Martinez Steele
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, 2° floor, São Paulo 01246-907, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil.
| | - Ana Paula Bortoletto Martins
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil.
| | - Daniela Silva Canella
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil.
| | - Jean-Claude Moubarac
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil.
| | - Renata Bertazzi Levy
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil; Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Arnaldo, 455, S27, São Paulo 01246-903, Brazil.
| | - Geoffrey Cannon
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil.
| | - Ashkan Afshin
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, United States.
| | - Fumiaki Imamura
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0SP, UK.
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, United States.
| | - Carlos Augusto Monteiro
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, Av. Dr. Arnaldo, 715, 2° floor, São Paulo 01246-907, Brazil; Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, Av. Dr. Arnaldo, 715, S27, São Paulo 01246-907, Brazil.
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Mazidi M, Rezaie P, Norouzy A, Saeb MH, Mehdizadeh Hakkak A, Balali S, Nematy M. Investigating the relation between macronutrients intake and anthropometric indices. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2015. [DOI: 10.3233/mnm-150038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Mohsen Mazidi
- Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China
| | - Peyman Rezaie
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Abdolreza Norouzy
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Mohammad Hasan Saeb
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Atieh Mehdizadeh Hakkak
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Sara Balali
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Mohsen Nematy
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
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Abstract
PURPOSE To describe the effects of number of eating occasions and snacks on dietary quality (DQ), defined as adherence to dietary recommendations. METHODS A sample of 884 adolescents (11-18 years) in the UK National Diet and Nutrition Survey (NDNS) were included. The Diet Quality Index for Adolescents (DQI-A) was implemented. The total number of eating occasions and snacks was frequency of food or beverages consumed over 24 h and frequency of foods or beverages consumed outside of the three mealtimes, respectively. Results were generated with and without low-energy food under 210 kJ (50 kcal). Regression models were generated with DQ score as the outcome variable and number of eating occasions and snacks as predictors. RESULTS The mean (95 % CI) DQ score was 31.1 % (30.2, 32.0). The mean number of eating occasions and snacks was 7.5 (7.3, 7.7) and 2.6 (2.6, 2.7) times/day, respectively. When low-energy events were excluded, the mean number of eating occasions and snacks reduced to 6.2 (6.1, 6.4) and 2.0 (2.0, 2.1) times/day, respectively. DQ score increased by 0.74 points (0.42, 1.05; p < 0.01) and 0.55 points (-0.08, 0.69; p = 0.17) for total eating occasions and snacks, respectively. When low-energy events were excluded, DQ score increased by 0.30 points (-0.84, 0.69; p = 0.13) for each eating occasion and decreased by 1.20 points (-2.1, -0.3; p < 0.01) for each snack. CONCLUSION Eating more frequently improves dietary quality especially if some eating occasions are low in energy. A focus on replacing high-energy snacks with low-energy alternatives rather than reducing the number of eating occasions may result in improved dietary quality in adolescents.
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WHO European Childhood Obesity Surveillance Initiative: health-risk behaviours on nutrition and physical activity in 6-9-year-old schoolchildren. Public Health Nutr 2015; 18:3108-24. [PMID: 26132808 PMCID: PMC4642225 DOI: 10.1017/s1368980015001937] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Objective To assess to what extent eight behavioural health risks related to breakfast and food
consumption and five behavioural health risks related to physical activity, screen time
and sleep duration are present among schoolchildren, and to examine whether health-risk
behaviours are associated with obesity. Design Cross-sectional design as part of the WHO European Childhood Obesity Surveillance
Initiative (school year 2007/2008). Children’s behavioural data were reported by their
parents and children’s weight and height measured by trained fieldworkers. Descriptive
statistics and logistic regression analyses were performed. Setting Primary schools in Bulgaria, Lithuania, Portugal and Sweden; paediatric clinics in the
Czech Republic. Subjects Nationally representative samples of 6–9-year-olds (n 15 643). Results All thirteen risk behaviours differed statistically significantly across countries.
Highest prevalence estimates of risk behaviours were observed in Bulgaria and lowest in
Sweden. Not having breakfast daily and spending screen time ≥2 h/d were clearly
positively associated with obesity. The same was true for eating ‘foods like pizza,
French fries, hamburgers, sausages or meat pies’ >3 d/week and playing outside
<1 h/d. Surprisingly, other individual unhealthy eating or less favourable
physical activity behaviours showed either no or significant negative associations with
obesity. A combination of multiple less favourable physical activity behaviours showed
positive associations with obesity, whereas multiple unhealthy eating behaviours
combined did not lead to higher odds of obesity. Conclusions Despite a categorization based on international health recommendations, individual
associations of the thirteen health-risk behaviours with obesity were not consistent,
whereas presence of multiple physical activity-related risk behaviours was clearly
associated with higher odds of obesity.
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