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Wambogo EA, O'Connor LE, Shams-White MM, Herrick KA, Reedy J. Top sources and trends in consumption of total energy and energy from solid fats and added sugars among youth aged 2-18 years: United States 2009-2018. Am J Clin Nutr 2022; 116:1779-1789. [PMID: 36041175 PMCID: PMC9761793 DOI: 10.1093/ajcn/nqac238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/06/2022] [Accepted: 08/23/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND High energy intake from non-nutrient-dense sources correlates with poorer diet quality. OBJECTIVES The aims were to 1) estimate total energy intake and energy from solid fats and added sugars combined (SoFAS) and identify their top food category sources for ages 2-18 y in 2015-2018 and 2) describe trends over time in 2009-2018. METHODS Data were from the NHANES. Pairwise differences were examined using univariate t statistics (2015-2018, n = 5038), and trends by age and over time (2009-2018, n = 14,038) were examined using orthogonal polynomials. RESULTS In 2015-2018, SoFAS contributed a mean (SE) of 30.0% (0.3%) of total energy. Solid fats [16.1% (0.2%)] and added sugars [13.8% (0.2%)] each contributed >10%. The contribution of added sugars increased with age from 11.1% (2-3 y) to 14.4% (14-18 y), and was higher for all other race/Hispanic origins than non-Hispanic Asians. The top 5 sources of energy were sweet bakery products, savory snacks, pizza, other mixed dishes, and unflavored milk, and for SoFAS also included soft drinks, other desserts, candy, and snack bars. Total energy did not change between 2009 and 2018, but energy from SoFAS, and servings of solid fats, and added sugars declined. The contribution of unflavored milk to total energy declined for all ages and most race/Hispanic origins. Fruit drinks (all ages) and soft drinks (9-18 y) remained among top added sugars sources despite declines. The contribution of sweet bakery products to energy from SoFAS increased for most ages and candy and snack bars to energy from added sugars. CONCLUSIONS In 2015-2018, SoFAS contributed >30% of total energy for ages 2-18 y, which doubled the Dietary Guidelines for Americans' recommended limit of 15%. The top 5 sources of total energy were similar to those of solid fats, and those of SoFAS similar to those of added sugars. These results may inform public health efforts for improving diet quality.
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Affiliation(s)
- Edwina A Wambogo
- National Cancer Institute Risk Factor Assessment Branch 9609 Medical Center Drive Rockville, MD 20850, Hyattsville, MD, USA
| | | | | | | | - Jill Reedy
- National Cancer Institute, Rockville, MD, USA
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Fayet‐Moore F, McConnell A, Tuck K, Petocz P, Cassettari T, Rahimi‐Ardabili H, Blumfield M, Marshall S. Patterns of discretionary food intake among Australian children and their association with socio-demographic, lifestyle, and adiposity measures. Nutr Diet 2022; 79:623-635. [PMID: 35708110 PMCID: PMC9796583 DOI: 10.1111/1747-0080.12741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/21/2022] [Accepted: 04/03/2022] [Indexed: 01/01/2023]
Abstract
AIM Australian children consume 35% of energy from discretionary food and beverages which increases their risk of non-communicable diseases like type 2 diabetes. Despite this concerning statistic, broad analysis of the profile of discretionary food intake has not been fully undertaken. This study asks: what is the discretionary food and beverage intake profile, contribution to nutrient intakes, and associations with demographic and health characteristics? METHODS Cross-sectional data from the 2011-12 National Nutrition and Physical Activity Survey (n = 2812, 2-18 years) were used to profile discretionary food consumption. Dietary intake was assessed by 24-h recall. General linear models tested the difference in respondent characteristics by age group, sex, and quartiles of discretionary food energy contribution. RESULTS Ninety-nine percent of respondents consumed discretionary foods, 74% exceeded the maximum discretionary food recommended serves. Among 10 eating occasions available to select: snack, dinner, lunch and morning tea appeared to contribute 76% of discretionary food energy, with snack and dinner contributing 24% each. Age and frequency of discretionary food consumption were positively associated with energy intake from discretionary foods (p < 0.001); while sex, socio-economic status, physical activity and body composition had no association. High discretionary food consumers chose specific discretionary food items in a large quantity (1.0-3.5-serves/discretionary food) compared to low discretionary food consumers (0.4-1.4-serves/discretionary food). CONCLUSIONS Nearly all Australian children and adolescents consumed discretionary food daily. No demographic or anthropometric characteristics beyond increasing age were associated with higher discretionary food. Targeted public health policy and community interventions are required to focus on addressing the largest contributors to discretionary food intake in terms of equivalent serve sizes, popularity, and eating occasion.
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Affiliation(s)
- Flavia Fayet‐Moore
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Andrew McConnell
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Kate Tuck
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Peter Petocz
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Tim Cassettari
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | | | - Michelle Blumfield
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Skye Marshall
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia,Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and MedicineBond UniversityGold CoastQueenslandAustralia
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Lin L, Zhu F, Delp EJ, Eicher-Miller HA. Differences in Dietary Intake Exist among U.S. Adults by Diabetic Status Using NHANES 2009–2016. Nutrients 2022; 14:nu14163284. [PMID: 36014790 PMCID: PMC9415376 DOI: 10.3390/nu14163284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
The objective was to determine the most frequently consumed food items, food subcategories, and food categories, and those that contributed most to total energy intake for the group of U.S. adults reporting taking insulin, those with type 2 diabetes (T2D) not taking insulin, and those without diabetes. Laboratory tests and questionnaires of the National Health and Nutrition Examination Survey 2009–2016 classified 774 participants reporting taking insulin, 2758 participants reporting T2D not taking insulin, and 17,796 participants without diabetes. Raw and weighted frequency and energy contributions of each food item, food subcategory, and food category were calculated and ranked. Comparisons among groups by broad food category used the Rao–Scott modified chi-square test. Soft drinks ranked as the 8th and 6th most consumed food subcategory of participants with T2D not taking insulin and those without diabetes, and contributed 5th and 2nd most to energy, respectively. The group reporting taking insulin is likely to consume more protein foods and less soft drink compared to the other two groups. Lists of the most frequently reported foods and foods contributing most to energy may be helpful for nutrition education, prescribing diets, and digital-based dietary assessment for the group reporting taking insulin.
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Affiliation(s)
- Luotao Lin
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Fengqing Zhu
- School of Electrical and Computer Engineering, College of Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Edward J. Delp
- School of Electrical and Computer Engineering, College of Engineering, Purdue University, West Lafayette, IN 47907, USA
| | - Heather A. Eicher-Miller
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN 47907, USA
- Correspondence:
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Davies T, Louie JCY, Ndanuko R, Barbieri S, Perez-Concha O, Wu JHY. A Machine Learning Approach to Predict the Added-Sugar Content of Packaged Foods. J Nutr 2022; 152:343-349. [PMID: 34550390 DOI: 10.1093/jn/nxab341] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/17/2021] [Accepted: 09/16/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Dietary guidelines recommend limiting the intake of added sugars. However, despite the public health importance, most countries have not mandated the labeling of added-sugar content on packaged foods and beverages, making it difficult for consumers to avoid products with added sugar, and limiting the ability of policymakers to identify priority products for intervention. OBJECTIVE The aim was to develop a machine learning approach for the prediction of added-sugar content in packaged products using available nutrient, ingredient, and food category information. METHODS The added-sugar prediction algorithm was developed using k-nearest neighbors (KNN) and packaged food information from the US Label Insight dataset (n = 70,522). A synthetic dataset of Australian packaged products (n = 500) was used to assess validity and generalization. Performance metrics included the coefficient of determination (R2), mean absolute error (MAE), and Spearman rank correlation (ρ). To benchmark the KNN approach, the KNN approach was compared with an existing added-sugar prediction approach that relies on a series of manual steps. RESULTS Compared with the existing added-sugar prediction approach, the KNN approach was similarly apt at explaining variation in added-sugar content (R2 = 0.96 vs. 0.97, respectively) and ranking products from highest to lowest in added-sugar content (ρ = 0.91 vs. 0.93, respectively), while less apt at minimizing absolute deviations between predicted and true values (MAE = 1.68 g vs. 1.26 g per 100 g or 100 mL, respectively). CONCLUSIONS KNN can be used to predict added-sugar content in packaged products with a high degree of validity. Being automated, KNN can easily be applied to large datasets. Such predicted added-sugar levels can be used to monitor the food supply and inform interventions aimed at reducing added-sugar intake.
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Affiliation(s)
- Tazman Davies
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Jimmy Chun Yu Louie
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,School of Biological Sciences, Faculty of Science, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Rhoda Ndanuko
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Sebastiano Barbieri
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Oscar Perez-Concha
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jason H Y Wu
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Colley P, Seabrook JA, Woodruff SJ, Gilliland J. Examining Elementary School Children's Knowledge about Food and Nutrition in Southwestern Ontario, Canada. CAN J DIET PRACT RES 2022; 83:59-67. [PMID: 35014546 DOI: 10.3148/cjdpr-2021-037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: Knowledge is fundamental to helping children make nutritional choices that support lifelong healthy behaviours. This study (i) investigates elementary school children's knowledge about food and nutrition and (ii) identifies sociodemographic factors influencing children's reported knowledge.Methods: In 2017-2019, a survey was administered to 2443 students (grades 5-8) at 60 schools across southwestern Ontario, Canada, and a parent survey was used to validate self-reported sociodemographics. Multiple regression was used to analyse children's knowledge scores and related sociodemographic factors. A total knowledge score was calculated by summing correct responses derived from 46 individual questions in the student survey.Results: Mean total knowledge score was 29.2 out of a possible 46 points (63.5% correct). Students demonstrated some knowledge and awareness of strategies to encourage fruit and vegetable consumption, healthy food selection, nutrition, and food preparation skills, although knowledge of food guide recommendations and locally sourced produce were limited. Female sex, family income, and rurality were associated with higher knowledge scores.Conclusions: Results provide insight regarding strengths and gaps in elementary-school children's food and nutrition knowledge. Poor performance of students on specific food guide-related questions suggests that the general guidance of the 2019 Canada's Food Guide might be better understood by children and adolescents.
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Affiliation(s)
- Paige Colley
- Health and Rehabilitation Sciences, Western University, London, ON
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
| | | | - Jason Gilliland
- Department of Geography and Environment, Western University, London, ON
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Gračner T. Bittersweet: How prices of sugar-rich foods contribute to the diet-related disease epidemic in Mexico. JOURNAL OF HEALTH ECONOMICS 2021; 80:102506. [PMID: 34537582 DOI: 10.1016/j.jhealeco.2021.102506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 04/30/2021] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
I provide new evidence on how price changes of nutritionally similar foods, such as those rich in sugar or fats, change obesity and diet-related diseases in the context of Mexico between 1996-2010. I merge a bar-code level price dataset with product-specific nutritional composition to two datasets with health outcomes: state-level administrative and nationally representative individual-level panel data. Exploiting within-city variation in prices using fixed effects models, I show that decreased prices of sugar-rich foods increase obesity, type 2 diabetes, and hypertension prevalence; yet the prices of foods rich in other nutrients do not. Health responses to price changes are the largest for those abdominally obese or at the highest risk for chronic disease. The association between prices of sugary foods and chronic disease is meaningful: I estimate that in Mexico, price reductions of sugary foods explain roughly 15 percent of the rise in obesity and diabetes during the 15-year study period.
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Affiliation(s)
- Tadeja Gračner
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, United States.
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Ricciuto L, Fulgoni VL, Gaine PC, Scott MO, DiFrancesco L. Trends in Added Sugars Intake and Sources Among US Children, Adolescents, and Teens Using NHANES 2001-2018. J Nutr 2021; 152:568-578. [PMID: 34850066 PMCID: PMC8826875 DOI: 10.1093/jn/nxab395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/01/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Over the past 2 decades, there has been an increased emphasis on added sugars intake in the Dietary Guidelines for Americans (DGA), which has been accompanied by policies and interventions aimed at reducing intake, particularly among children, adolescents, and teens. OBJECTIVES The present study provides a comprehensive time-trends analysis of added sugars intakes and contributing sources in the diets of US children, adolescents, and teens (2-18 years) from 2001-2018, focusing on variations according to sociodemographic factors (age, sex, race and ethnicity, income), food assistance, and health-related factors (physical activity level, body weight status). METHODS Data from 9 consecutive 2-year cycles of the NHANES were combined and regression analyses were conducted to test for trends in added sugars intake and sources from 2001-2018 for the overall age group (2-18 years) and for 2 age subgroups (2-8 and 9-18 years). Trends were also examined on subsamples stratified by sex, race and ethnicity (Hispanic, non-Hispanic Asian, non-Hispanic Black, non-Hispanic White), income (household poverty income ratio), food assistance, physical activity level, and body weight status. RESULTS From 2001-2018, added sugars intakes decreased significantly (P < 0.01), from 15.6% to 12.6% kcal among children (2-8 years) and from 18.4% to 14.3% kcal among adolescents and teens (9-18 years), mainly due to significant declines in added sugars from sweetened beverages, which remained the top source. Declines in added sugars intakes were observed for all strata, albeit to varying degrees. CONCLUSIONS Declines in added sugars intakes were observed among children, adolescents, and teens from 2001-2018, regardless of sociodemographic factors, food assistance, physical activity level, or body weight status, but variations in the magnitudes of decline suggest persistent disparities related to race and ethnicity and to income. Despite these declines, intakes remain above the DGA recommendation; thus, continued monitoring is warranted.
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Affiliation(s)
- Laurie Ricciuto
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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Cai XY, Zhang NH, Cheng YC, Ge SW, Xu G. Sugar-sweetened beverage consumption and mortality of chronic kidney disease: results from the US National Health and Nutrition Examination Survey, 1999–2014. Clin Kidney J 2021; 15:718-726. [PMID: 35371462 PMCID: PMC8967538 DOI: 10.1093/ckj/sfab227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Indexed: 11/25/2022] Open
Abstract
Background The relationship between intake of sugar-sweetened beverages (SSBs) and the risk of death in patients with chronic kidney disease (CKD) is unclear. We evaluated the association between SSB intake and subsequent overall mortality in CKD patients. Methods We included data from 3996 CKD patients who participated in the 1999–2014 National Health and Nutrition Examination Survey (NHANES). SSB intake was assessed by a 24-h dietary recall, grouped as none, >0 to <1 serving/day, 1 to <2 servings/day and ≥2 servings/day. After adjusting for demographic variables, lifestyle, diet and comorbidities, Cox proportional risk regressions were applied to analyze the associations between the daily intake of SSBs as well as added sugar from beverages and all-cause mortality. Results In the whole research population, the median age at baseline was 67 years, 22% were Black and 54% were female. A total of 42% had stage 3 CKD. During an average follow-up period of 8.3 years, a sum of 1137 (28%) deaths from all causes was recorded. The confounder-adjusted risk of mortality was associated with an increase of 1 serving/day of SSBs, with all-cause mortality of 1.18 [95% confidence interval (95% CI)1.08–1.28], and intakes of increased 20-g added sugar/1000 kcal of total energy per day were associated with all-cause mortality of 1.14 (1.05–1.24). Equivalently substituting 1 serving/day of SSBs with unsweetened coffee [HR (95% CI) 0.82 (0.74–0.91)], unsweetened tea [HR (95% CI) 0.86 (0.76–0.98)], plain water [HR (95% CI) 0.79 (0.71–0.88)], or non- or low-fat milk [HR (95% CI) 0.75 (0.60–0.93)] were related to a 14–25% reduced risk of all-cause mortality. Conclusion Findings suggest that in the CKD population, increased SSB intake was associated with a higher risk of mortality and indicated a stratified association with dose. Plain water and unsweetened coffee/tea might be possible alternatives for SSBs to avert untimely deaths.
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Affiliation(s)
- Xiao-Yu Cai
- Division of Internal Medicine, Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan-Hui Zhang
- Department of Nephrology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, China
| | - Yi-Chun Cheng
- Division of Internal Medicine, Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shu-Wang Ge
- Division of Internal Medicine, Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Xu
- Division of Internal Medicine, Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Dietary Habits and Choices of 4-to-6-Year-Olds: Do Children Have a Preference for Sweet Taste? CHILDREN-BASEL 2021; 8:children8090774. [PMID: 34572206 PMCID: PMC8470835 DOI: 10.3390/children8090774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/20/2021] [Accepted: 08/30/2021] [Indexed: 11/26/2022]
Abstract
Children develop food preferences by coming into direct contact with various food products through the senses of taste, touch, sight and smell. The aim of this study was to analyze the food preferences of children aged 4 to 6 years and to determine whether age and gender influence children’s food preferences and whether the preference for sweet taste changes with age. The study involved a paper questionnaire containing images of 115 different food products and dishes. The respondents expressed their preferences by choosing the appropriate emoji (happy, sad or neutral face). The study was conducted between 2018 and 2020, and it involved 684 children from 10 kindergartens. Girls chose a significantly higher number of foods and dishes they liked than boys (p = 0.002), and 4-year-olds gave a higher number of “neutral” responses than 5- and 6-year-olds (p = 0.001). Dietary diversity increased with age, and younger children were familiar with fewer foods than 6-year-olds (p = 0.002). Children had a clear preference for sweet taste, regardless of age and gender. Young children (4-year-olds) were more likely to accept healthy foods despite the fact that they were familiar with fewer products and dishes.
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Neta ADCPDA, Steluti J, Ferreira FELDL, Farias Junior JCD, Marchioni DML. Dietary patterns among adolescents and associated factors: longitudinal study on sedentary behavior, physical activity, diet and adolescent health. CIENCIA & SAUDE COLETIVA 2021; 26:3839-3851. [PMID: 34468677 DOI: 10.1590/1413-81232021269.2.24922019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 02/07/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to identify dietary patterns and associations with socioeconomic characteristics, lifestyle, nutritional status, lipid profile and inflammatory profile in adolescents. A cross-sectional study was conducted with a probabilistic sample using baseline data (2014) from the Longitudinal Study on Sedentary Behavior, Physical Activity, Eating Habits and Adolescent Health. A total of 1,438 adolescents (10 to 14 years old) from public schools in the city of João Pessoa, Brazil, participated in the study. Data were collected on socioeconomic characteristics, nutritional status, lifestyle and the results of biochemical tests. Dietary data were obtained using the 24-hour recall method and dietary patterns were identified by exploratory factor analysis. Associations of interest were estimated using multiple logistic regression. Three dietary patterns were found: "Traditional", "Snacks" and "Western". These patterns were associated with age, socioeconomic status, parental education and lifestyle. The "Traditional" pattern was associated lower adiposity and a better lipid profile. However, with the increase in age, greater frequencies of the "Snacks" and "Western" patterns were found. The present findings underscore the need for strategies that encourage healthy behaviors.
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Affiliation(s)
| | - Josiane Steluti
- Departamento de Políticas Públicas e Saúde Coletiva, Instituto Saúde e Sociedade, Campus Baixada Santista da Universidade Federal de São Paulo. São Paulo SP Brasil
| | | | | | - Dirce Maria Lobo Marchioni
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo. Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
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Ce B, Kk D, Re B, Jo F. Occasions, purposes, and contexts for offering snacks to preschool-aged children: Schemas of caregivers with low-income backgrounds. Appetite 2021; 167:105627. [PMID: 34389378 DOI: 10.1016/j.appet.2021.105627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/06/2021] [Accepted: 08/04/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Snacking among preschool aged children is nearly universal and has been associated with overconsumed nutrients, particularly solid fats and added sugars (SoFAS). This research examined caregivers' schemas, or cognitive frameworks, for offering snacks to preschool-aged children. METHODS A qualitative design utilizing card sort methods was employed. Participants were 59 Black, Hispanic, and White caregivers of children aged 3-5 years with low-income backgrounds. Caregivers sorted 63 cards with images of commonly consumed foods/beverages by preschool-aged children in three separate card sorts to characterize snacking occasions, purposes, and contexts. The mean SoFAS content (kcal/100 g) of foods/beverages was evaluated by occasions (snacks vs. not-snacks), purposes, and contexts. RESULTS Just under two-thirds (38/63 food cards) of foods/beverages were classified as snacks with moderate to high agreement. Snacks were offered for non-nutritive (e.g., requests, rewards) and nutritive (e.g., hunger/thirst) purposes in routine (e.g., home, school) and social contexts (e.g., with grandparents). Snacks offered for non-nutritive purposes and in social contexts were higher in SoFAS than those offered for nutritive reasons and in routine contexts. CONCLUSIONS Caregivers of young children offered various types of foods/beverages as snacks, with higher SoFAS snacks given for non-nutritive purposes and in social contexts. Understanding of caregivers' schemas for offering snacks to young children may inform targets for obesity prevention and anticipatory guidance to promote the development of healthful eating behaviors.
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Affiliation(s)
- Blake Ce
- University of South Carolina, Department of Health Promotion, Education and Behavior, 915 Greene Street, Columbia, SC, 29208, USA
| | - Davison Kk
- Harvard T.H. Chan School of Public Health, Department of Nutrition, 665 Huntington Ave, Boston, MA, 02445, USA; Boston College School of Social Work, 140 Commonwealth Avenue, 115 McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Blaine Re
- Harvard T.H. Chan School of Public Health, Department of Nutrition, 665 Huntington Ave, Boston, MA, 02445, USA; California State University, Long Beach, Department of Family and Consumer Sciences, 1250 Bellflower Blvd, Long Beach, CA, 90840-0501, USA(1)
| | - Fisher Jo
- Temple University, Department of Social and Behavioral Sciences, Center for Obesity Research and Education, 3323 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA.
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Socioeconomic Disparities in Foods/Beverages and Nutrients Consumed by U.S. Adolescents When Snacking: National Health and Nutrition Examination Survey 2005-2018. Nutrients 2021; 13:nu13082530. [PMID: 34444690 PMCID: PMC8399168 DOI: 10.3390/nu13082530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022] Open
Abstract
Snacking contributes a significant portion of adolescents’ daily energy intake and is associated with poor overall diet and increased body mass index. Adolescents from low socioeconomic status (SES) households have poorer snacking behaviors than their higher-SES counterparts. However, it is unclear if the types of food/beverages and nutrients consumed during snacking differ by SES among adolescents. Therefore, this study examines SES disparities in the aforementioned snacking characteristics by analyzing the data of 7132 adolescents (12–19 years) from the National Health and Nutrition Examination Survey 2005–2018. Results reveal that adolescents from low-income households (poverty-to-income ratio (PIR) ≤ 1.3) have lower odds of consuming the food/beverage categories “Milk and Dairy” (aOR: 0.74; 95% CI: 0.58-0.95; p = 0.007) and “Fruits” (aOR: 0.62, 95% CI: 0.50–0.78; p = 0.001) as snacks and higher odds of consuming “Beverages” (aOR: 1.45; 95% CI: 1.19-1.76; p = 0.001) compared to those from high-income households (PIR > 3.5). Additionally, adolescents from low- and middle-income (PIR > 1.3–3.5) households consume more added sugar (7.98 and 7.78 g vs. 6.66 g; p = 0.012, p = 0.026) and less fiber (0.78 and 0.77 g vs. 0.84 g; p = 0.044, p = 0.019) from snacks compared to their high-income counterparts. Future research is necessary to understand factors that influence snacking among adolescents, and interventions are needed, especially for adolescents from low-SES communities.
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The Contribution of Foods and Beverages of Low Nutritional Value to the Diets of Swedish Adolescents, by Food Group, Time and Place. A Nationally Representative Study. Nutrients 2021; 13:nu13072450. [PMID: 34371960 PMCID: PMC8308806 DOI: 10.3390/nu13072450] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 12/13/2022] Open
Abstract
Adolescence is a time in life when lifestyle behaviours are acquired. One indicator of poor diet quality is the intake of foods and beverages with a relatively low nutritional value. Using the Australian classification of such foods, termed "discretionary", we classified the intakes of Swedish adolescents who participated in the Riksmaten Adolescent 2016-17 national dietary survey. From selected schools, 3099 adolescents in age groups 11-12, 14-15 and 17-18 years provided two 24-h recalls. Intakes and healthy dietary scores were calculated. Plasma ferritin, folate and 25(OH)D were available for a third. Almost 40% of total energy came from discretionary foods/beverages. Adolescents with higher intakes were more likely to be female, older, from a low socioeconomic position-household and born in Sweden. Most discretionary foods/beverages were consumed on weekend days and during in-between meals, outside of the home and at school. Percent energy from discretionary intake was associated with healthy dietary scores but not nutritional status. A substantial amount of energy was obtained from discretionary foods/beverages, and we found that consumption is pervasive across sociodemographic factors, time and place. Addressing this pattern will require a comprehensive approach to food environments and behaviours to reach all adolescents in an equitable manner.
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Ricciuto L, Fulgoni VL, Gaine PC, Scott MO, DiFrancesco L. Sources of Added Sugars Intake Among the U.S. Population: Analysis by Selected Sociodemographic Factors Using the National Health and Nutrition Examination Survey 2011-18. Front Nutr 2021; 8:687643. [PMID: 34222307 PMCID: PMC8247592 DOI: 10.3389/fnut.2021.687643] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
Recent estimates of added sugars intake among the U.S. population show intakes are above recommended levels. Knowledge about the sources of added sugars contributing to intakes is required to inform dietary guidance, and understanding how those sources vary across sociodemographic subgroups could also help to target guidance. The purpose of this study was to provide a comprehensive update on sources of added sugars among the U.S. population, and to examine variations in sources according to sociodemographic factors. Regression analyses on intake data from NHANES 2011–18 were used to examine sources of added sugars intake among the full sample (N = 30,678) and among subsamples stratified by age, gender, ethnicity, and income. Results showed the majority of added sugars in the diet (61–66%) came from a few sources, and the top two sources were sweetened beverages and sweet bakery products, regardless of age, ethnicity, or income. Sweetened beverages, including soft drinks and fruit drinks, as well as tea, were the largest contributors to added sugars intake. There were some age-, ethnic-, and income-related differences in the relative contributions of added sugars sources, highlighting the need to consider sociodemographic contexts when developing dietary guidance or other supports for healthy eating.
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Affiliation(s)
- Laurie Ricciuto
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | | | | | - Maria O Scott
- The Sugar Association, Inc., Washington, DC, United States
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Della Corte K, Fife J, Gardner A, Murphy BL, Kleis L, Della Corte D, Schwingshackl L, LeCheminant JD, Buyken AE. World trends in sugar-sweetened beverage and dietary sugar intakes in children and adolescents: a systematic review. Nutr Rev 2021; 79:274-288. [PMID: 32984896 DOI: 10.1093/nutrit/nuaa070] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To provide a systematic overview of world dietary sugar and sugar-sweetened beverage (SSB) intake trends in children and adolescents. DATA SOURCES Medline, Embase, and the Cochrane Central Register of Controlled Trials in the Cochrane Library were searched through January 2019 to identify longitudinal follow-up studies with time-trend data and repeated cross-sectional studies. DATA EXTRACTION Data from studies reporting ≥ 2 measurements (sugars, SSB, or sweets/candy) over ≥ 2 years and included ≥ 20 healthy, normal- or overweight children or adolescents aged 1-19 years. DATA ANALYSIS Data from 43 articles (n = 4 prospective cohort studies; n = 39 repeated cross-sectional studies) from 15 countries (n = 8 European countries plus Australia, Canada, China, South Korea, Mexico, Russia, and the United States) are presented narratively. According to the risk of bias in nonrandomized studies of interventions tool, 34 studies were judged to have a moderate risk of bias, and 5 to have a serious risk of bias. CONCLUSIONS Consumption among US children and adolescents increased substantially in the decades preceding 2000, followed by a faster and continued decline. As a whole, other international intake trends did not reveal drastic increases and decreases in SSB and dietary sugars; they tended to change only slightly across 3 decades.
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Affiliation(s)
- Karen Della Corte
- Department of Public Health Nutrition, University of Paderborn, Paderborn, Germany.,Department of Physics and Astronomy, Brigham Young University, Provo, Utah, USA
| | - Jessica Fife
- Department of Nutrition, Dietetics & Food Science, Brigham Young University, Provo, Utah, USA
| | - Alexis Gardner
- Department of Nutrition, Dietetics & Food Science, Brigham Young University, Provo, Utah, USA
| | - Britta L Murphy
- Department of Nutrition, Dietetics & Food Science, Brigham Young University, Provo, Utah, USA
| | - Linda Kleis
- Department of Public Health Nutrition, University of Paderborn, Paderborn, Germany
| | - Dennis Della Corte
- Department of Physics and Astronomy, Brigham Young University, Provo, Utah, USA
| | - Lukas Schwingshackl
- Faculty of Medicine, Institute for Evidence in Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - James D LeCheminant
- Department of Nutrition, Dietetics & Food Science, Brigham Young University, Provo, Utah, USA
| | - Anette E Buyken
- Department of Public Health Nutrition, University of Paderborn, Paderborn, Germany
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Doherty AM, Lacko AM, Popkin BM. Sugar-sweetened beverage (SSB) consumption is associated with lower quality of the non-SSB diet in US adolescents and young adults. Am J Clin Nutr 2020; 113:657-664. [PMID: 33381808 PMCID: PMC7948860 DOI: 10.1093/ajcn/nqaa342] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/26/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Since 2003-4, the United States has seen large declines in sugar-sweetened beverage (SSB) intake overall, especially among non-Hispanic white (NHW) subpopulations. However, obesity prevalence has not shown comparable declines in the 2 highest SSB-consuming groups, adolescents and young adults. Little is understood about the quality of the diet excluding SSBs (non-SSB diet). OBJECTIVES The objective of this study was to evaluate differences in non-SSB diet quality in SSB consumers and nonconsumers in adolescents and young adults and in the 3 major race/ethnic subgroups. METHODS This study utilized data from the NHANES, a cross-sectional, nationally representative survey of the US population. Data from 6426 participants aged 12-29 y from the NHANES (2009-2014) was included. Quality of the non-SSB diet was measured using the 2015 Healthy Eating Index (HEI). Multivariate linear regressions controlled for sociodemographic characteristics and included interactions by race/ethnicity [NHWs, non-Hispanic blacks (NHBs), Hispanics]. Individuals were classified as non-, low- (<10% of daily calories), or high-SSB consumers (≥10% of daily calories), according to the US Dietary Guidelines added sugar intake recommendation. RESULTS Non-SSB HEI scores differed among SSB consumer groups (53 for adolescent nonconsumers compared with 46 for high consumers, P < 0.001; 57 for young adult nonconsumers compared with 45 for high consumers, P < 0.001), although all scores were low and require improvement. Among NHBs, significant differences in non-SSB HEI were found only between non- and low-SSB consumers. In Hispanics, associations varied by age group, with significant differences found for young adults but no association found for adolescents. CONCLUSIONS Low non-SSB HEI scores in SSB consumers suggest that reducing SSB consumption alone will not be a sufficient strategy for improving dietary quality in adolescents and young adults. Future policies must also consider improving the non-SSB diet.
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Affiliation(s)
- Alex M Doherty
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison M Lacko
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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The Impact of Micronutrient Fortified Foods on Cognitive Functioning among Low-Income Children: A Pilot and Feasibility Study. Nutrients 2020; 12:nu12113351. [PMID: 33143203 PMCID: PMC7693551 DOI: 10.3390/nu12113351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 11/17/2022] Open
Abstract
Brain development continues throughout childhood and requires micronutrients for optimal maturation, but studies have typically examined only a limited number of micronutrients and there has been inconsistent use of validated cognitive measures. This study evaluated the impact of providing low-income children with a daily fortified meal (570 kcal) in the form of a bar and shake containing >75% of the FDA Daily Values for all essential vitamins and minerals, as well as macronutrients (e.g., omega-3 and omega-6 fatty acids and protein), in an afterschool care setting (instead of the usual meal provided) on cognitive functioning. Students aged 8–12 were randomly assigned to intervention (n = 19) or control (n = 16) meals. Students completed the Stroop Color Word Task, Trail Making Test, and Conner’s Continuous Performance Task (CPT) at baseline and 3 months post-intervention. Differences in cognitive scores were examined using 2 × 2 mixed model ANOVAs (Stroop and CPT) and ANCOVAs (Trail Making Test). Significant main effects of time indicated improvements in both intervention and control groups, but there were no significant main effects of group or group*time interactions. When the amount of meal consumed was examined, most results became non-significant, suggesting that overall meal consumption significantly impacted the observed results. Overall, this pilot study suggests that there may be limited additional benefits to short-term consumption of micronutrient fortified meals among low-income children in an afterschool care setting, and potential benefits observed may be directly related to the amount of food consumed.
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Törrönen J, Samuelsson E, Roumeliotis F, Room R, Kraus L. 'Social health', 'physical health', and well-being: Analysing with bourdieusian concepts the interplay between the practices of heavy drinking and exercise among young people. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 91:102825. [PMID: 32593513 DOI: 10.1016/j.drugpo.2020.102825] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The article examines the interplay between the practices of heavy drinking and exercise among young people. The comparison helps to clarify why young people are currently drinking less than earlier and how the health-related discourses and activities are modifying young people's heavy drinking practices. METHODS The data is based on interviews (n = 56) in Sweden among 15-17-year-olds and 18-19-year-olds. By drawing on Pierre Bourdieu's concepts of habitus, field, and capital, we examine what kinds of resources young people accumulate in the fields of heavy drinking and exercise, how these resources carry symbolic value for distinction, and what kind of health-related habitus they imply. RESULTS The analysis shows that young people's practices in the social spaces of intoxication and exercise are patterned around the 'social health' and 'physical health' approaches and shaped by gendered binaries of masculine dominance. The 'physical health' approach values capable, high-performative, and attractive bodies, whereas the 'social health' approach is oriented towards accumulating social capital. The analysis demonstrates that these approaches affect the interviewees' everyday life practices so that the 'physical health' approach has more power over the 'social health' approach in transforming them. CONCLUSION As the 'physical health' approach appears to modify young people's practices of drinking to be less oriented to intoxication or away from drinking, this may partly explain why young people are drinking less today than earlier. Compared to drinking, the physical health-related social spaces also seem to provide more powerful arenas within which to bolster one's masculine and feminine habitus. This further suggests that intoxication may have lost its symbolic power among young people as a cool activity signalling autonomy, maturity, and transgression of norms.
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Affiliation(s)
- Jukka Törrönen
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-10691 Stockholm, Sweden.
| | - Eva Samuelsson
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-10691 Stockholm, Sweden; Department of Social Work, Stockholm University, SE-10691 Stockholm, Sweden
| | - Filip Roumeliotis
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-10691 Stockholm, Sweden; Department of Criminology, Stockholm University, SE-10691 Stockholm, Sweden
| | - Robin Room
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-10691 Stockholm, Sweden; Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC 3086 Australia
| | - Ludwig Kraus
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, SE-10691 Stockholm, Sweden; IFT Institut für Therapieforschung, Leopoldstraße 175, 80804 München, Germany; Institute of Psychology, ELTE Eötvös Loránd University, 1075 Budapest, Kazinczy utca 23-27, Hungary
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Nutritional problems in childhood and adolescence: a narrative review of identified disparities. Nutr Res Rev 2020; 34:17-47. [PMID: 32329426 DOI: 10.1017/s095442242000013x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To inform programmes and policies that promote health equity, it is essential to monitor the distribution of nutritional problems among young individuals. Common nutritional problems include overall low diet quality, the underconsumption and overconsumption of certain dietary components, unhealthy meal and snack patterns, problematic feeding practices and disordered eating. The objective of the present narrative review was to summarise recent evidence of disparities among US children (2-19 years) according to age, sex, socio-economic status, ethnicity/race and rural-urban location. Searches in PubMed® and MEDLINE® were completed to identify peer-reviewed research studies published between January 2009 and January 2019. Findings from the ninety-nine reviewed studies indicate adolescent females, young individuals from lower socio-economic households and individuals who identify as non-Hispanic Black race are particularly vulnerable populations for whom targeted strategies should be developed to address evidence of increased risk with regards to multiple aspects of nutritional wellbeing. Limitations of the existing evidence relate to the accuracy of self-reported dietary data; the need for consistent definitions of disordered eating; the focus on individual dietary components v. patterns; the complexities of categorising socio-economic status, ethnicity/race, and rural and urban areas; and the cross-sectional, observational nature of most research designs. There is an urgent need for research to address these limitations and fill a large gap in evidence on rural-urban differences in nutritional problems. It will further be important for future studies to build greater understanding of how nutritional problems cluster among population groups.
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Zhang T, Au Yeung SL, Kwok MK, Hui LL, Leung GM, Schooling CM. Association of Sugar-Sweetened Beverage Frequency with Adiposity: Evidence from the "Children of 1997" Birth Cohort. Nutrients 2020; 12:nu12041015. [PMID: 32272690 PMCID: PMC7231010 DOI: 10.3390/nu12041015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 01/04/2023] Open
Abstract
Background: Observationally, sugar-sweetened beverage (SSB) consumption is associated with adiposity in Western children but could be confounded. We examined the association of SSB frequency with adiposity in the non-Western setting of Hong Kong. Methods: We examined the associations of SSB consumption frequency at 11 and 13 years assessed by using a food frequency questionnaire with subsequent body mass index (BMI) z-score and overweight/obesity up to 18 years using generalized estimating equations, and with waist circumference, waist-to-hip ratio, and body fat percentage at 16–19 years using linear regression in a population-representative Chinese birth cohort “Children of 1997” (n = 3628). Results: At 11 and 13 years, 6.8% and 8.2% of children respectively consumed SSB daily. Neither SSB frequency at 11 nor at 13 years was associated with subsequent BMI z-score or overweight/obesity up to 18 years, or with waist circumference, waist-to-hip ratio, or body fat percentage at 16–19 years adjusted for age, sex, socioeconomic position, health status, physical activity and other food consumption, although bias to the null from under-reporting cannot be eliminated. Conclusion: Although we cannot definitively exclude a small association of SSB frequency with adiposity, lack of association of SSB frequency with adiposity in a non-Western setting with low SSB consumption suggests that the role of SSB in adiposity appears to be minor.
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Affiliation(s)
- Ting Zhang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
| | - Shiu Lun Au Yeung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
| | - Man Ki Kwok
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
| | - Lai Ling Hui
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gabriel Matthew Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
| | - C. Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; (T.Z.); (S.L.A.Y.); (M.K.K.); (L.L.H.); (G.M.L.)
- CUNY School of Public Health and Health Policy, New York, NY 10027, USA
- Correspondence: ; Tel.: (852) 3917 6732; Fax: (852) 3520 1945
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Liu J, Rehm CD, Onopa J, Mozaffarian D. Trends in Diet Quality Among Youth in the United States, 1999-2016. JAMA 2020; 323:1161-1174. [PMID: 32207798 PMCID: PMC7093765 DOI: 10.1001/jama.2020.0878] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/23/2020] [Indexed: 12/13/2022]
Abstract
Importance Prior studies of dietary trends among US youth have evaluated major macronutrients or only a few foods or have used older data. Objective To characterize trends in diet quality among US youth. Design, Setting, and Participants Serial cross-sectional investigation using 24-hour dietary recalls from youth aged 2 to 19 years from 9 National Health and Nutrition Examination Survey (NHANES) cycles (1999-2016). Exposures Calendar year and population sociodemographic characteristics. Main Outcomes and Measures The primary outcomes were the survey-weighted, energy-adjusted mean consumption of dietary components and proportion meeting targets of the American Heart Association (AHA) 2020 continuous diet score (range, 0-50; based on total fruits and vegetables, whole grains, fish and shellfish, sugar-sweetened beverages, and sodium). Additional outcomes were the AHA secondary score (range, 0-80; adding nuts, seeds, and legumes; processed meat; and saturated fat) and Healthy Eating Index (HEI) 2015 score (range, 0-100). Poor diet was defined as less than 40% adherence (scores, <20 for primary and <32 for secondary AHA scores); intermediate as 40% to 79.9% adherence (scores, 20-39.9 and 32-63.9, respectively); and ideal, as at least 80% adherence (scores, ≥40 and ≥64, respectively). Higher diet scores indicate better diet quality; a minimal clinically important difference has not been quantified. Results Of 31 420 youth aged 2 to 19 years included, the mean age was 10.6 years; 49.1% were female. From 1999 to 2016, the estimated AHA primary diet score significantly increased from 14.8 (95% CI, 14.1-15.4) to 18.8 (95% CI, 18.1-19.6) (27.0% improvement), the estimated AHA secondary diet score from 29.2 (95% CI, 28.1-30.4) to 33.0 (95% CI, 32.0-33.9) (13.0% improvement), and the estimated HEI-2015 score from 44.6 (95% CI, 43.5-45.8) to 49.6 (95% CI, 48.5-50.8) (11.2% improvement) (P < .001 for trend for each). Based on the AHA primary diet score, the estimated proportion of youth with poor diets significantly declined from 76.8% (95% CI, 72.9%-80.2%) to 56.1% (95% CI, 51.4%-60.7%) and with intermediate diets significantly increased from 23.2% (95% CI, 19.8%-26.9%) to 43.7% (95% CI, 39.1%-48.3%) (P < .001 for trend for each). The estimated proportion meeting ideal quality significantly increased but remained low, from 0.07% (95% CI, 0.01%-0.49%) to 0.25% (95% CI, 0.10%-0.62%) (P = .03 for trend). Persistent dietary variations were identified across multiple sociodemographic groups. The estimated proportion of youth with a poor diet in 2015-2016 was 39.8% (95% CI, 35.1%-44.5%) for ages 2 to 5 years (unweighted n = 666), 52.5% (95% CI, 46.4%-58.5%) for ages 6 to 11 years (unweighted n = 1040), and 66.6% (95% CI, 61.4%-71.4%) for ages 12 to 19 years (unweighted n = 1195), with persistent differences across levels of parental education, household income, and household food security status. Conclusions and Relevance Based on serial NHANES surveys from 1999 to 2016, the estimated overall diet quality of US youth showed modest improvement, but more than half of youth still had poor-quality diets.
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Affiliation(s)
- Junxiu Liu
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Colin D. Rehm
- Office of Community and Population Health, Montefiore Medical Center, Bronx, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Jennifer Onopa
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
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Vaala SE, Ritter MB. Child-Oriented Marketing on Cereal Packaging: Associations With Sugar Content and Manufacturer Pledge. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:215-223. [PMID: 32146975 DOI: 10.1016/j.jneb.2020.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess sugar content and child-oriented promotional features on packaging among cereals manufactured by companies with varying Children's Food and Beverage Advertising Initiative (CFBAI) participation. DESIGN Ready-to-eat dry cereals (n = 159) were purchased from southeastern US grocery stores in September 2018. Content analysis of 159 ready-to-eat dry cereal boxes, coded for sugar content and presence of 8 child-oriented features. MAIN OUTCOME MEASURES Frequencies of each promotional feature and number of features per box, level of participation in CFBAI, and sugar content by serving and ounce. ANALYSIS Chi-square tests of independence analyzed correspondence between measures of sugar content. Extent of features per box based on sugar content and CFBAI participation were assessed with analyses of variance (ANOVAs). RESULTS Most cereals (81%) contained <13 g of sugar per serving, meeting the sugar content requirement for child-directed advertising. Cereals' sugar content classifications varied between sugar per serving and sugar per ounce metrics (P < .001). Among low-sugar per serving cereals, 28% were classified as moderate-sugar per ounce, whereas 55% of moderate-sugar per serving cereals had high-sugar per ounce. Games/activities and trade characters were especially common (62% and 49%, respectively), particularly on high-sugar per ounce cereals (P < .001, respectively). Child-oriented features were rare on low-sugar cereals and highest on cereals with higher sugar content per ounce produced by CFBAI-participating companies (F8,158 = 12.33, P < .001). CONCLUSIONS AND IMPLICATIONS Variable cereal-suggested serving sizes may contribute to consumers' misunderstanding of sugar content. CFBAI manufacturers continue to market cereals with high sugar to children. Food and beverage regulatory policy could be strengthened if CFBAI companies apply marketing pledges to brand mascots, adopt standardized metrics for sugar content, and limit added sugar content to the recommended <6 g/serving target used by the Special Supplemental Nutrition Program for Women, Infants, and Children program.
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Affiliation(s)
- Sarah E Vaala
- Nido R. Qubein School of Communication, High Point University, High Point, NC.
| | - Matthew B Ritter
- Nido R. Qubein School of Communication, High Point University, High Point, NC
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Thomson JL, Landry AS, Tussing‐Humphreys LM, Goodman MH. Diet quality of children in the United States by body mass index and sociodemographic characteristics. Obes Sci Pract 2020; 6:84-98. [PMID: 32128246 PMCID: PMC7042025 DOI: 10.1002/osp4.388] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/24/2019] [Accepted: 11/03/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The primary objective was to use the Healthy Eating Index-2015 (HEI-2015) to describe diet quality by categories of body mass index (BMI) and by sociodemographic characteristics within categories of BMI using a nationally representative sample of US children. METHODS Dietary datasets from three cycles of the National Health and Nutrition Examination Survey (2009-2014) were analysed for children 2 to 18 years of age (N = 8894). Using the population ratio method, mean and 95% confidence intervals for HEI-2015 total and component scores were computed by BMI (underweight, normal weight, overweight, and obese) and by age (2-5, 6-11, and 12-18 y), gender, race/ethnicity (non-Hispanic black, non-Hispanic white, Mexican American, other Hispanic, and other race), and family poverty to income ratio (below and at/above poverty threshold). RESULTS HEI-2015 mean total scores were 50.4, 55.2, 55.1, and 54.0 out of 100 points for children with underweight, normal weight, overweight, and obesity, respectively, and were not significantly different. Within BMI categories, significant differences in total and mean component scores were present for age and race/ethnicity groups. CONCLUSIONS Total and most components of diet quality did not significantly differ among child populations classified by BMI status. Within BMI categories, significant diet quality differences were found for age and race/ethnicity groups, although scores were low for all child groups. Researchers may need to address or target specific dietary components with low quality in various child populations to have the greatest effect on improving nutrition nationwide.
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Affiliation(s)
- Jessica L. Thomson
- US Department of AgricultureAgricultural Research ServiceStonevilleMississippi
| | - Alicia S. Landry
- Department of Family and Consumer SciencesUniversity of Central ArkansasConwayArkansas
| | | | - Melissa H. Goodman
- US Department of AgricultureAgricultural Research ServiceStonevilleMississippi
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Al-Kindi NM, Al-Farsi YM, Al-Bulushi B, Ali A, Rizvi SGA, Essa MM. Food Selection and Preferences of Omani Autistic Children. ADVANCES IN NEUROBIOLOGY 2020; 24:505-523. [PMID: 32006370 DOI: 10.1007/978-3-030-30402-7_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by core deficits in social interactions, verbal/nonverbal communication, and restricted, repetitive, and stereotyped behaviors. Children with ASD are known to have several feeding problems that are believed to affect their nutritional and health status. AIM The present study was designed to assess the food preferences in Omani children diagnosed with ASD compared with controls. METHODS A case-control study was conducted in which 375 children (males and females) aged between 4 and 13 years were recruited. The sample consisted of 163 children with ASD and a control group of 212 typically developing (TD) children. For each participant, demographic, anthropometric, and medical information and information regarding dietary intakes were gathered using the food frequency questionnaire (FFQ) to assess their food preferences. RESULTS The sociodemographic characteristics of caregivers were similar in the two groups, while their perceptions based on several nutritional parameters were different. Children's age and body mass index (BMI) were similar in both groups, while the number of male children was higher in ASD group (P < 0.001). Problematic behaviors including food refusal and selectivity were significantly higher in ASD children than in TD children. Despite that, the children with ASD were found to consume mostly traditional Omani dishes. CONCLUSION This is the first study that provides information on the eating habits and nutritional intake of Omani children diagnosed with ASD. The overall findings are promising and may contribute to further understanding of food preferences in children with ASD in Oman. Such information is highly valuable for the prevention and management of nutritional deficiencies among Omani children with autism by improving their diet quality.
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Affiliation(s)
- Najma M Al-Kindi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
| | - Yahya M Al-Farsi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Buthaina Al-Bulushi
- Department of Food Science and Nutrition, College of Agricultural and Marine Sciences, Sultan Qaboos University, Muscat, Oman
| | - Amanat Ali
- Department of Food Science and Nutrition, College of Agricultural and Marine Sciences, Sultan Qaboos University, Muscat, Oman.,College of Agricultural and Marine Sciences, Ajax, ON, Canada
| | - Syed Gauhar Alam Rizvi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Musthafa Mohamed Essa
- Department of Food Science and Nutrition, College of Agricultural and Marine Sciences, Sultan Qaboos University, Muscat, Oman.,Ageing and Dementia Research Group, Sultan Qaboos University, Muscat, Oman
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Herrick KA, Fryar CD, Hamner HC, Park S, Ogden CL. Added Sugars Intake among US Infants and Toddlers. J Acad Nutr Diet 2020; 120:23-32. [PMID: 31735600 PMCID: PMC7512119 DOI: 10.1016/j.jand.2019.09.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/05/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Limited information is available on added sugars consumption in US infants and toddlers. OBJECTIVES To present national estimates of added sugars intake among US infants and toddlers by sociodemographic characteristics, to identify top sources of added sugars, and to examine trends in added sugars intake. DESIGN Cross-sectional analysis of 1 day of 24-hour dietary recall data. PARTICIPANTS/SETTING A nationally representative sample of US infants aged 0 to 11 months and toddlers aged 12 to 23 months (n=1,211) during the period from 2011 through 2016 from the National Health and Nutrition Examination Survey. Trends were assessed from 2005-2006 through 2015-2016 (n=2,795). MAIN OUTCOME MEASURES Among infants and toddlers, the proportion consuming any added sugars, the average amount of added sugars consumed, percent of total energy from added sugars, and top sources of added sugars intake. STATISTICAL ANALYSIS Paired t tests were used to compare differences by age, sex, race/Hispanic origin, family income level, and head of household education level. Trends were tested using orthogonal polynomials. Significance was set at P<0.05. RESULTS During 2011 to 2016, 84.4% of infants and toddlers consumed added sugars on a given day. A greater proportion of toddlers (98.3%) consumed added sugars than infants (60.6%). The mean amount of added sugars toddlers consumed was also more compared with infants (5.8 vs 0.9 tsp). Non-Hispanic black toddlers (8.2 tsp) consumed more added sugars than non-Hispanic Asian (3.7 tsp), non-Hispanic white (5.3 tsp), and Hispanic (5.9 tsp) toddlers. A similar pattern was observed for percent energy from added sugars. For infants, top sources of added sugars were yogurt, baby food snacks/sweets, and sweet bakery products; top sources among toddlers were fruit drinks, sugars/sweets, and sweet bakery products. The mean amount of added sugars decreased from 2005-2006 through 2015-2016 for both age groups; however, percent energy from added sugars only decreased among infants. CONCLUSION Added sugars intake was observed among infants/toddlers and varied by age and race and Hispanic origin. Added sugars intake, as a percent of energy, decreased only among infants from 2005 to 2016.
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Neri D, Martinez-Steele E, Monteiro CA, Levy RB. Consumption of ultra-processed foods and its association with added sugar content in the diets of US children, NHANES 2009-2014. Pediatr Obes 2019; 14:e12563. [PMID: 31364315 DOI: 10.1111/ijpo.12563] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/11/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is cumulative recognition that increases in the dietary share of ultra-processed foods result in deterioration of the nutritional quality of the overall diet and adverse health outcomes. OBJECTIVE The purpose of this study was to assess the consumption of ultra-processed foods and to examine its association with added sugar content in the diet of US children aged 2 to 19 years. METHODS We classified all food items according to the NOVA food classification system and looked at the consumption of ultra-processed foods, measured as percentage of total energy intake. We assessed dietary added sugar content by estimating its contribution to total energy intake and the proportion of individuals with diets exceeding the recommended limit of 10% of total energy intake from added sugars. We also examined the proportion of those who surpassed twice that limit. Gaussian and Poisson regressions estimated the association between consumption of ultra-processed foods and estimates of added sugar content. RESULTS Ultra-processed foods contributed to 65% of total energy intake and to 92% of energy from added sugars in the diet of US children. The mean percent energy provided by added sugars in the observed period was 14.3%. Most individuals (70.9%) had diets exceeding the recommended limit of added sugar (<10% of total energy intake), and 18.4% of the population had diets surpassing twice the recommended level (20% of total energy intake). A 5.5% point increase in the dietary share of ultra-processed foods determined a 1 percentage point increase in the dietary content of added sugars, with stronger adjusted associations among younger children. CONCLUSIONS Public health efforts to reduce added sugars in the diet of US children must put greater emphasis on decreasing the consumption of ultra-processed foods.
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Affiliation(s)
- Daniela Neri
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Euridice Martinez-Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Carlos Augusto Monteiro
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil.,Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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Pacholko AG, Wotton CA, Bekar LK. Poor Diet, Stress, and Inactivity Converge to Form a "Perfect Storm" That Drives Alzheimer's Disease Pathogenesis. NEURODEGENER DIS 2019; 19:60-77. [PMID: 31600762 DOI: 10.1159/000503451] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/17/2019] [Indexed: 11/19/2022] Open
Abstract
North American incidence of Alzheimer's disease (AD) is expected to more than double over the coming generation. Although genetic factors surrounding the production and clearance of amyloid-β and phosphorylated tau proteins are known to be responsible for a subset of early-onset AD cases, they do not explain the pathogenesis of the far more prevalent sporadic late-onset variant of the disease. It is thus likely that lifestyle and environmental factors contribute to neurodegenerative processes implicated in the pathogenesis of AD. Herein, we review evidence that (1) excess sucrose consumption induces AD-associated liver pathologies and brain insulin resistance, (2) chronic stress overdrives activity of locus coeruleus neurons, leading to loss of function (a common event in neurodegeneration), (3) high-sugar diets and stress promote the loss of neuroprotective sex hormones in men and women, and (4) Western dietary trends set the stage for a lithium-deficient state. We propose that these factors may intersect as part of a "perfect storm" to contribute to the widespread prevalence of neurodegeneration and AD. In addition, we put forth the argument that exercise and supplementation with trace lithium can counteract many of the deleterious consequences associated with excessive caloric intake and perpetual stress. We conclude that lifestyle and environmental factors likely contribute to AD pathogenesis and that simple lifestyle and dietary changes can help counteract their effects.
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Affiliation(s)
- Anthony G Pacholko
- Department of Anatomy, Physiology, and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Caitlin A Wotton
- Department of Anatomy, Physiology, and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Lane K Bekar
- Department of Anatomy, Physiology, and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada,
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Rillamas-Sun E, Bishop S, Cisneros O, Mendoza JA, Kratz M, Ko LK. Psychosocial Factors of Diet and Physical Activity among Rural, Hispanic Children: Findings from a Multilevel Health Intervention Study. J Racial Ethn Health Disparities 2019; 6:1218-1227. [PMID: 31385261 DOI: 10.1007/s40615-019-00623-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To examine the relationship of psychosocial factors, such as self-efficacy, family role modeling, and perceptions of the environment, on diet, physical activity, and sedentary behavior in Hispanic children living in rural Washington State. METHODS Gender, heights, and weights were obtained from Hispanic 8-12 year olds (n = 553) from two rural communities in Lower Yakima, Washington. A subsample of 179 children provided psychosocial measures, diet, and screen time via questionnaire and physical activity via accelerometer. Body mass index percentiles were used to calculate the prevalence of obesity. The association of demographic and psychosocial measures on the mean difference (95% confidence interval (CI)) of fruit, vegetable, and sugar consumption and minutes spent active was estimated using linear regression models. RESULTS Prevalence of obesity was 35%. Children with obesity consumed one-fifth (- 0.3, - 0.02) fewer cups of fruits, 2.2 (0.1, 4.2) more teaspoons of total added sugars, and spent 16.1 (- 22.0, - 10.2) fewer minutes in moderate-to-vigorous physical activity per day compared with children with healthy weights. Males consumed more added sugars and reported more screen time than females, but spent more daily minutes in moderate-to-vigorous physical activity. Higher fruit and vegetable self-efficacy scores were associated with more consumption of fruits and vegetables, more engagement in light physical activity, and less time spent sedentary per day. CONCLUSION Male gender and some psychosocial measures were associated with obesogenic behaviors. Insight about factors associated with obesity-related behaviors in rural, Hispanic children may help the development of successful and effective behavioral health interventions for this understudied population.
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Affiliation(s)
- Eileen Rillamas-Sun
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-A410, Seattle, WA, 98109, USA.
| | - Sonia Bishop
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-A410, Seattle, WA, 98109, USA
| | - Oralia Cisneros
- Sunnyside School District, 1110 S. 6th St., Sunnyside, WA, 98944, USA
| | - Jason A Mendoza
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-A410, Seattle, WA, 98109, USA.,Department of Pediatrics, University of Washington School of Medicine, 2001 Eighth Ave. Ste. 400, M/S: CW8-6, Seattle, WA, 98121, USA
| | - Mario Kratz
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-A410, Seattle, WA, 98109, USA
| | - Linda K Ko
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N. M3-A410, Seattle, WA, 98109, USA.,Department of Health Services, University of Washington School of Public Health, 1959 NE Pacific St, Seattle, WA, 98195, USA
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Body Mass Index Z-Score Modifies the Association between Added Sugar Intake and Arterial Stiffness in Youth with Type 1 Diabetes: The Search Nutrition Ancillary Study. Nutrients 2019; 11:nu11081752. [PMID: 31366063 PMCID: PMC6723563 DOI: 10.3390/nu11081752] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/22/2019] [Accepted: 07/25/2019] [Indexed: 01/05/2023] Open
Abstract
The relationship between added sugar and arterial stiffness in youth with type 1 diabetes (T1D) has not been well-described. We used data from the SEARCH for Diabetes in Youth Study (SEARCH), an ongoing observational cohort study, to determine the association between added sugar and arterial stiffness in individuals diagnosed with T1D <20 years of age (n = 1539; mean diabetes duration of 7.9 ± 1.9 years). Added sugar intake was assessed by a food frequency questionnaire, and arterial stiffness measures included pulse wave velocity (PWV) and augmentation index. Separate multivariate linear regression models were used to evaluate the association between added sugar and arterial stiffness. Separate interaction terms were included to test for effect modification by body mass index (BMI) z-score and physical activity (PA). Overall, there was no association between added sugar and arterial stiffness (P > 0.05); however, the association between added sugar and arterial stiffness differed by BMI z-score (P for interaction = 0.003). For participants with lower BMI z-scores, added sugar intake was positively associated with PWV trunk measurements, whereas there was no association for those who had a higher BMI z-score. PA did not significantly modify the association between added sugar and arterial stiffness. Further research is needed to determine the longitudinal relationship and to confirm that obesity differentially affects this association.
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Could the high consumption of high glycaemic index carbohydrates and sugars, associated with the nutritional transition to the Western type of diet, be the common cause of the obesity epidemic and the worldwide increasing incidences of Type 1 and Type 2 diabetes? Med Hypotheses 2019; 125:41-50. [PMID: 30902150 DOI: 10.1016/j.mehy.2019.02.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/07/2018] [Accepted: 02/08/2019] [Indexed: 12/30/2022]
Abstract
The globally increasing incidences of Type 1 diabetes (T1DM) and Type 2 diabetes (T2DM) can have a common background. If challenged by the contemporary high level of nutritional glucose stimulation, the β-cells in genetically predisposed individuals are at risk for damage which can lead to the diseases. The fat to carbohydrate dietary shift can also contribute to the associated obesity epidemic.
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Fisher JO, Serrano EL, Foster GD, Hart CN, Davey A, Bruton YP, Kilby L, Harnack L, Ruth KJ, Kachurak A, Lawman HG, Martin A, Polonsky HM. Title: efficacy of a food parenting intervention for mothers with low income to reduce preschooler's solid fat and added sugar intakes: a randomized controlled trial. Int J Behav Nutr Phys Act 2019; 16:6. [PMID: 30654818 PMCID: PMC6335764 DOI: 10.1186/s12966-018-0764-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/19/2018] [Indexed: 12/17/2022] Open
Abstract
Background Few interventions have shown efficacy to influence key energy balance behaviors during the preschool years. Objective A randomized controlled trial (RCT) was used to evaluate the efficacy of Food, Fun, and Families (FFF), a 12 week authoritative food parenting intervention for mothers with low-income levels, to reduce preschool-aged children’s intake of calories from solid fat and added sugar (SoFAS). Methods Mothers were randomly assigned to receive FFF (n = 59) or to a delayed treatment control (n = 60). The primary outcome was children’s daily energy intake from SoFAS at the end of the 12 week intervention, controlling for baseline levels, assessed by 24-h dietary recalls. Secondary outcomes included children’s daily energy intake, children’s BMI z-scores, and meal observations of maternal food parenting practices targeted in FFF (e.g. providing guided choices). Results Participating mothers were predominantly African American (91%), with 39% educated beyond high school and 66% unemployed. Baseline demographics and child SoFAS intakes did not differ by group. Lost to follow-up was 13% and did not differ between groups. At post-intervention, FFF children consumed ~ 94 kcal or 23% less daily energy from SoFAS than children in the control group, adjusting for baseline levels (307.8 (95%CI = 274.1, 341.5) kcal vs. 401.9 (95%CI = 369.8, 433.9) kcal, FFF vs. control; p < 0.001). FFF mothers also displayed a greater number of authoritative parenting practices when observed post-intervention with their child at a buffet-style meal (Wilcoxon z = − 2.54, p = 0.012). Neither child total daily energy intake nor BMI z-scores differed between groups post-intervention. Conclusions Findings demonstrate the initial efficacy of an authoritative food parenting intervention for families with low-income to reduce SoFAS intake in early childhood. Additional research is needed to evaluate longer-term effects on diet and growth. Trial registration Retrospectively registered at ClinicalTrials.gov: #NCT03646201.
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Affiliation(s)
- Jennifer O Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA.
| | - Elena L Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 327 Wallace Hall, Blacksburg, VA, 24061, USA
| | - Gary D Foster
- Weight Watchers International, 675 6th Ave, New York, NY, USA.,Weight and Eating Disorders Program, University of Pennyslvania, Pennyslvania, USA
| | - Chantelle N Hart
- Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA
| | - Adam Davey
- Department of Behavioral Health and Nutritio, University of Deleware, 385 McDowell Hall, Neward, Newark, DE, 19716, USA
| | - Yasmeen P Bruton
- Department of Obstetrics & Gynecology, Division of Urogynecology, Duke University at Patterson Place, 5324 McFarland Drive, Suite 310, Durham, NC, 27707, USA
| | - Linda Kilby
- LDN. NORTH Inc, Philadelphia WIC program, 1300 W Lehigh Avenue, Philadelphia, PA, 19132, USA
| | - Lisa Harnack
- Division of Epidemiology and Community of Public Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Room 300 West Bank Office Building, Minneapolis, MN, 55454, USA
| | - Karen J Ruth
- Biostatistics Facility, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA
| | - Alexandria Kachurak
- Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA
| | - Hannah G Lawman
- Division of Chronic Disease Prevention, Philadelphia Department of Public Health, 1101 Market Street, 9th Floor, Philadelphia, PA, 19107, USA
| | - Anna Martin
- Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA
| | - Heather M Polonsky
- Providence Health and Services, Center for Outcomes Research & Education, 5251 NE Gilsan Street, Bldg A, Portland, OR, 97213, USA
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Mendez MA, Miles DR, Poti JM, Sotres-Alvarez D, Popkin BM. Persistent disparities over time in the distribution of sugar-sweetened beverage intake among children in the United States. Am J Clin Nutr 2019; 109:79-89. [PMID: 30535176 PMCID: PMC6698637 DOI: 10.1093/ajcn/nqy123] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/09/2018] [Accepted: 05/15/2018] [Indexed: 12/13/2022] Open
Abstract
Background Recent research suggests that sugar-sweetened beverage (SSB) consumption has been declining among US children aged 2-18 y. However, most studies focused on changes in mean intake, ignore high SSB consumers and do not examine intake among vulnerable groups and, including adolescents, low-income households, and several racial/ethnic minorities. Objective The aim was to estimate usual SSB intake from NHANES surveys from 2003-2004 to 2013-2014 to examine shifts at both the median and 90th percentile among US children, evaluating the extent to which intake disparities in total SSBs and subtypes have persisted. Design Children 2-18 y from NHANES 2003, 2005, 2007, 2009, 2011 and 2013. SSBs were all non-diet beverages sweetened with sugars including revising all beverages to as consumed status and excluding soy and dairy based beverages. The NCI usual intake method was used to estimate usual intake from two 24-hour recalls. A 2-part correlated model accounted for nonconsumers. Quantile regression was then used to examine differences in SSB usual intakes at the 50th and 90th percentiles by race-ethnicity, and examine interactions indicating whether racial-ethnic disparities in intake were modified by income. Results Despite considerable declines, children's SSB intake remains high, particularly among heavy consumers. Among adolescents, median SSB intake in 2013-2014 was on the order of 150-200 kcal/d, and heavy intake at the 90th percentile was on the order of 250-300 kcal/d. There were important disparities in intake that persisted over time. Although high household income was associated with lower SSB intake in non-Hispanic white (NHW) children, intakes of non-Hispanic black (NHB) and Mexican-American (MA) children from these households were similar to or higher than those from poor households. There were also large racial/ethnic differences in the types of SSBs consumed. The consumption of regular sodas by NHB children was somewhat lower than among MA and NHW children, whereas fruit drink intake was markedly higher. Conclusions Overall, these findings suggest that, despite recent declines, strategies are needed to further reduce SSB consumption, and particularly heavy intake, especially among NHB children where fruit drinks also are key source of SSBs.
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Affiliation(s)
- Michelle A Mendez
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Donna R Miles
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer M Poti
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Barry M Popkin
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Top food sources of percentage of energy, nutrients to limit and total gram amount consumed among US adolescents: National Health and Nutrition Examination Survey 2011–2014. Public Health Nutr 2018; 22:661-671. [DOI: 10.1017/s1368980018002884] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo identify most commonly consumed foods by adolescents contributing to percentage of total energy, added sugars, SFA, Na and total gram intake per day.DesignData from the National Health and Nutrition Examination Survey (NHANES) 2011–2014.SettingNHANES is a cross-sectional study nationally representative of the US population.ParticipantsOne 24 h dietary recall was used to assess dietary intake of 3156 adolescents aged 10–19 years. What We Eat in America food category classification system was used for all foods consumed. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were sample-weighted and ranked based on percentage contribution to intake of total amount.ResultsThree-highest ranked food subgroup sources of total energy consumed were: sugar-sweetened beverages (SSB; 7·8 %); sweet bakery products (6·9 %); mixed dishes – pizza (6·6 %). Highest ranked food sources of total gram amount consumed were: plain water (33·1 %); SSB (15·8 %); milk (7·2 %). Three highest ranked food sources of total Na were: mixed dishes – pizza (8·7 %); mixed dishes – Mexican (6·7 %); cured meats/poultry (6·6 %). Three highest ranked food sources of SFA were: mixed dishes – pizza (9·1 %); sweet bakery products (8·3 %); mixed dishes – Mexican (7·9 %). Three highest ranked food sources of added sugars were: SSB (42·1 %); sweet bakery products (12·1 %); coffee and tea (7·6 %).ConclusionsIdentifying current food sources of percentage energy, nutrients to limit and total gram amount consumed among US adolescents is critical for designing strategies to help them meet nutrient recommendations within energy needs.
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Vercammen KA, Frelier JM, Lowery CM, McGlone ME, Ebbeling CB, Bleich SN. A systematic review of strategies to reduce sugar-sweetened beverage consumption among 0-year to 5-year olds. Obes Rev 2018; 19:1504-1524. [PMID: 30019442 DOI: 10.1111/obr.12741] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/14/2018] [Accepted: 06/16/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The objective of this study is to summarize evidence for strategies designed to reduce sugar-sweetened beverage (SSB) consumption among children aged 0 to 5 years. DATA SOURCES PubMed, Web of Science, EMBASE, CINAHL, ERIC, Cab Abstracts and the Cochrane Central Register of Controlled Trials are the electronic databases searched in this systematic review. STUDY SELECTION Each included study evaluated an intervention to reduce SSB consumption in children aged 0 to 5 years, was conducted in a high-income country and was published between 1 January 2000 and 15 December 2017. DATA SYNTHESIS Twenty-seven studies met the inclusion criteria. The primary intervention settings were healthcare (n = 11), preschool/daycare (n = 4), home (n = 3), community venues (n = 3) and other settings (n = 6). Overarching strategies which successfully reduced SSB consumption included (i) in-person individual education, (ii) in-person group education, (iii) passive education (e.g. pamphlets), (iv) use of technology, (v) training for childcare/healthcare providers and (vi) changes to the physical access of beverages. Studies were of moderate methodological quality (average score of 20.7/29.0 for randomized studies; 3.1/9.0 for non-randomized studies). CONCLUSIONS Evidence suggests that interventions successful at reducing SSB consumption among 0-year to 5-year olds often focused on vulnerable populations, were conducted in preschool/daycare settings, specifically targeted only SSBs or only oral hygiene, included multiple intervention strategies and had higher intervention intensity/contact time.
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Affiliation(s)
- K A Vercammen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J M Frelier
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - C M Lowery
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M E McGlone
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - C B Ebbeling
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA
| | - S N Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Haughton CF, Waring ME, Wang ML, Rosal MC, Pbert L, Lemon SC. Home Matters: Adolescents Drink More Sugar-Sweetened Beverages When Available at Home. J Pediatr 2018; 202:121-128. [PMID: 30029864 PMCID: PMC6233293 DOI: 10.1016/j.jpeds.2018.06.046] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 05/15/2018] [Accepted: 06/14/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To examine the association between sugar-sweetened beverage availability at home and sugar-sweetened beverage consumption, and to evaluate whether this association was consistent across school and school neighborhood sugar-sweetened beverage availability. STUDY DESIGN Secondary data analyses were performed from the 2014 cross-sectional, Internet-based Family Life, Activity, Sun, Health, and Eating (FLASHE) study of 1494 adolescents (age 12-17 years). Ordinal logistic regression analyses were conducted to examine the association between sugar-sweetened beverage availability in the home and adolescents' frequency of sugar-sweetened beverage consumption (nondaily, <1; daily, 1-<2; daily, ≥2), adjusting for adolescent age, sex, race, and body mass index and parent marital status and housing insecurity. Stratified ordinal logistic regression analyses were used to examine the associations by school and school neighborhood sugar-sweetened beverage availability. RESULTS One-third (32.6%) of adolescents were nondaily consumers of sugar-sweetened beverages, 33.9% consumed 1-<2 sugar-sweetened beverages daily, and 33.5% consumed ≥2 sugar-sweetened beverages daily. Almost one-half (44.4%) reported that sugar-sweetened beverages were often or always available in the home. Frequency of sugar-sweetened beverage availability at home was associated with greater sugar-sweetened beverage consumption (OR, 2.88; 95% CI, 2.86-2.89 for rarely/sometimes available at home; OR. 5.62; 95% CI, 5.60-5.64 for often/always available at home). Similar associations were found regardless of the availability of sugar-sweetened beverages in the adolescent's school or school neighborhood. CONCLUSIONS Sugar-sweetened beverage availability in the home was associated with adolescent sugar-sweetened beverage consumption, regardless of sugar-sweetened beverage availability in other settings, and may be a key target for obesity prevention efforts.
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Affiliation(s)
- Christina F Haughton
- Department of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA.
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT; Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Monica L Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
| | - Milagros C Rosal
- Department of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Lori Pbert
- Department of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Stephenie C Lemon
- Department of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
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Trude ACB, Surkan PJ, Cheskin LJ, Gittelsohn J. A multilevel, multicomponent childhood obesity prevention group-randomized controlled trial improves healthier food purchasing and reduces sweet-snack consumption among low-income African-American youth. Nutr J 2018; 17:96. [PMID: 30373597 PMCID: PMC6206663 DOI: 10.1186/s12937-018-0406-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 10/17/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Consumption of foods and beverages rich in sugar remains high across all races and ages in the United States. Interventions to address childhood obesity and decrease sugar intake are needed, particularly in low-income settings. METHODS B'more Healthy Communities for Kids (BHCK) was a group-randomized, controlled trial implemented among 9-15-year olds in 30 low-income areas of Baltimore. We increased access to low-sugar foods and beverages at wholesalers and small food stores. Concurrently, we encouraged their purchase and consumption by children through youth-led nutrition education in recreation centers, in-store promotions, text messaging and a social media program directed at caregivers. Sugar consumption (sugar sweetened beverage (SSB), sweets) in youth was assessed pre- (n = 534) and post-intervention (n = 401) using the Block Kids Food Frequency Questionnaire. Purchasing of 38 healthier and 28 less healthier food/beverage varieties in the previous 7 days was assessed via self-report. Multilevel models at the community and individual levels were used. Analyses were stratified by age (younger: 9-12-year olds (n = 339) vs older: 13-15 (n = 170)). Models were controlled for child's sex, race, total daily caloric intake, and caregiver's age and sex. RESULTS Overall baseline mean healthier food purchasing was 2.5 (+ 3.6; min. 0, max. 34 items per week), and unhealthier food purchasing 4.6 (+ 3.7; 0-19 items per week). Mean intake at baseline for kcal from SSB was 176 (+ 189.1) and 153 (+ 142.5), and % of calories from sweets (i.e. cookies, cakes, pies, donuts, candy, ice cream, sweetened cereals, and chocolate beverages) was 15.9 (+ 9.7) and 15.9 (+ 7.7) in comparison and intervention youth, respectively. Intervention youth increased healthier foods and beverages purchases by 1.4 more items per week than comparison youth (β = 1.4; 95% CI: 0.1; 2.8). After the intervention, there was a 3.5% decrease in kcal from sweets for older intervention youth, compared to the control group (β = - 3.5; 95% CI: -7.76; - 0.05). No impact was seen on SSB consumption. CONCLUSION BHCK successfully increased healthier food purchasing variety in youth, and decreased % calories from sweet snacks in older youth. Multilevel, multicomponent environmental childhood obesity programs are a promising strategy to improve eating behaviors among low-income urban youth. TRIAL REGISTRATION NCT02181010 (July 2, 2014, retrospectively registered).
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Affiliation(s)
- Angela C. B. Trude
- Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Pamela J. Surkan
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Lawrence J. Cheskin
- Department of Health Behavior and Society, and the Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 550 N. Broadway, Baltimore, MD 21205 USA
| | - Joel Gittelsohn
- Department of International Health, Global Obesity Prevention Center, and Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
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Damari Y, Kissinger M. Quantity-based analysis of household food consumption patterns and drivers: The case of Israel. Appetite 2018; 127:373-385. [PMID: 29782893 DOI: 10.1016/j.appet.2018.05.130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 02/12/2018] [Accepted: 05/16/2018] [Indexed: 01/06/2023]
Abstract
The interest in better understanding the characteristics and drivers of food consumption by individuals and social groups has grown in recent years, because of various social, environmental, health and economic issues. Most analyses have focused either on the macro or national scale, using food balance/disappearance data, or on the micro scale, focusing on nutrition analysis in limited groups of individual consumers. While various household characteristics are expected to influence food-purchasing habits, the scope and methodology of most previous studies limited their ability to relate to multiple factors, and integrate all into specific consumption patterns. A third, mezzo approach focuses on analyzing household food purchasing, mostly using expenditure surveys. However, focusing on the value spent may result in different quantities of food purchased. This paper aims capturing the amount of food purchased by Israeli households and to analyze the socio-economic factors shaping that consumption. It joins limited number of studies worldwide that focused on the quantity purchased, and the first such analysis of household food purchasing in the State of Israel. It quantified food purchased by more than 30,000 households, and analyzed key shaping factors e.g., income, household size and age. It first, established the need for quantity based analysis. Then, an extensive breakdown of consumed food is presented and the unique diets of different parts of the society were identified. Finally, it examined the consumption of different lifestyles to find that couples lifestyles tend to consume more per capita, and that income has a crucial role in determining the rate of consumption both in terms of quantity and variety purchased. However it highlights that other variables should also be examined in order to assess properly why households consume the way they do. Nevertheless, the findings of this research can be used as the basis for examining the health, social, or environmental implications of the different identified food consumption habits, support long-term research that examines changes over time, and may be the basis for examining the potential benefits of implementing specific policies.
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Affiliation(s)
- Yuval Damari
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Israel
| | - Meidad Kissinger
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Israel.
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Cohen JFW, Rifas-Shiman SL, Young J, Oken E. Associations of Prenatal and Child Sugar Intake With Child Cognition. Am J Prev Med 2018; 54:727-735. [PMID: 29674185 PMCID: PMC5962431 DOI: 10.1016/j.amepre.2018.02.020] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 02/05/2018] [Accepted: 02/26/2018] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Sugar consumption among Americans is above recommended limits, and excess sugar intake may influence cognition. The aim of this study was to examine associations of pregnancy and offspring sugar consumption (sucrose, fructose) with child cognition. Additionally, associations of maternal and child consumption of sugar-sweetened beverages (SSBs), other beverages (diet soda, juice), and fruit with child cognition were examined. METHODS Among 1,234 mother-child pairs enrolled 1999-2002 in Project Viva, a pre-birth cohort, in 2017 diet was assessed during pregnancy and early childhood, and cognitive outcomes in early and mid-childhood (median ages 3.3 and 7.7 years). Analyses used linear regression models adjusted for maternal and child characteristics. RESULTS Maternal sucrose consumption (mean 49.8 grams/day [SD=12.9]) was inversely associated with mid-childhood Kaufman Brief Intelligence Test (KBIT-II) non-verbal scores (-1.5 points per 15 grams/day, 95% CI= -2.8, -0.2). Additionally, maternal SSB consumption was inversely associated with mid-childhood cognition, and diet soda was inversely associated with early and mid-childhood cognition scores. Early childhood consumption of SSBs was inversely associated with mid-childhood KBIT-II verbal scores (-2.4 points per serving/day, 95% CI= -4.3, -0.5) while fruit consumption was associated with higher cognitive scores in early and mid-childhood. Maternal and child fructose and juice consumption were not associated with cognition. After adjusting for multiple comparisons, the association between maternal diet soda consumption and mid-childhood KBIT-II verbal scores remained significant. CONCLUSIONS Sugar consumption, especially from SSBs, during pregnancy and childhood, and maternal diet soda consumption may adversely impact child cognition, while child fruit consumption may lead to improvements. Interventions and policies that promote healthier diets may prevent adverse effects on childhood cognition.
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Affiliation(s)
- Juliana F W Cohen
- Department of Health Sciences, Merrimack College, North Andover, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Jessica Young
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Emily Oken
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
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Kueppers J, Stein KF, Groth S, Fernandez ID. Maternal and child dietary intake: The role of maternal healthy-eater self-schema. Appetite 2018; 125:527-536. [PMID: 29382553 PMCID: PMC5937934 DOI: 10.1016/j.appet.2018.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 11/17/2017] [Accepted: 01/11/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Mothers play a key role in shaping the dietary intake of their young children through their own dietary intake and the foods they make available at home. Therefore, understanding the mechanisms underlying maternal food choices is crucial. Cognitions about the self as a healthy eater, referred to as healthy-eater self-schema (HESS), predict dietary intake in diverse samples, but the linkage has not been investigated in mothers and their feeding behaviors. This study examined the relationship between a maternal HESS, maternal and child intake of fruits, vegetables, saturated fat, and added sugar, and home food availability. METHODS A cross-sectional, descriptive design was used with mothers and their 2-5 year old children (N = 124 dyads). Kendzierski's Healthy-Eater Self-Schema questionnaire was used to measure HESS. Block Food Frequency Screeners were used to measure diets (mother and child) and the Home Environment Survey was used to measure home availability of fruits/vegetables and fats/sweets. Multiple regression and multiple mediation analyses were performed. RESULTS Maternal HESS was positively associated with maternal intake of fruits and vegetables, and negatively associated with intake of added sugar. Maternal HESS was not directly associated with child dietary intake, but was indirectly associated with child intake of fruits, vegetables, and added sugar through maternal intake of the same foods. Home food availability was not significantly associated with HESS. CONCLUSION This study found that a mother's HESS was positively associated with her diet, which was subsequently associated with aspects of her child's diet. Interventions to foster development of HESS in mothers may be an effective means to promote healthy dietary intake in mothers and their young children.
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Affiliation(s)
- Julie Kueppers
- University of Rochester, School of Nursing, 255 Crittenden Blvd., Rochester, NY 14642, USA.
| | - Karen Farchaus Stein
- University of Rochester, School of Nursing, 255 Crittenden Blvd., Rochester, NY 14642, USA.
| | - Susan Groth
- University of Rochester, School of Nursing, 255 Crittenden Blvd., Rochester, NY 14642, USA.
| | - I Diana Fernandez
- University of Rochester, School of Medicine and Dentistry, Department of Public Health Sciences, 265 Crittenden Blvd., Rochester, NY 14642, USA.
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Asgari-Taee F, Zerafati-Shoae N, Dehghani M, Sadeghi M, Baradaran HR, Jazayeri S. Association of sugar sweetened beverages consumption with non-alcoholic fatty liver disease: a systematic review and meta-analysis. Eur J Nutr 2018; 58:1759-1769. [PMID: 29761318 DOI: 10.1007/s00394-018-1711-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 05/07/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE The relationship between consumption of sugar sweetened beverages (SSB) and NAFLD has been reported in several epidemiological studies, but the results are inconsistent. The present systematic review and meta-analysis of observational studies was carried out to assess the relationship between sugar sweetened beverages consumption and NAFLD. METHODS Online databases were searched systematically through December, 2016 for studies investigating association between SSB consumption and NAFLD but limited to observational studies in human. Pooled odds ratio (OR) and 95% confidence intervals were calculated using Der-Simonian and Laird method while random effects meta-analysis was used, taking into account conceptual heterogeneity. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I2 statistic. RESULTS Of the 1015 identified articles, 42 were reviewed in depth and six studies (four cross-sectional, one case-control, and one cohort) met the criteria for inclusion in our systematic review with 6326 participants and 1361 cases of NAFLD in both men and women. Finally, four cross-sectional studies were included in the meta-analysis. Higher intake of SSBs (highest compared to lowest categories) was significantly associated with NAFLD, with a 40% increased Odds of NAFLD after adjusting for important potential confounders (pooled odds ratio 1.40; 95% CI 1.07, 1.82). There was no evidence for significant heterogeneity across studies [P = 0.226 (Q statistics), I2 = 31.0%]. A significant positive association between SSB consumption and NAFLD was observed consistently in a sensitivity analysis [range of summary ORs 1.39-1.49]. There was no evidence of publication bias for the association between SSB and NAFLD. CONCLUSIONS This meta-analysis supports a positive significant association between higher consumption of SSB and NAFLD in both men and women. These findings strengthen the evidence that intake of SSBs should be limited to reduce fatty liver disease.
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Affiliation(s)
- Farzaneh Asgari-Taee
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Zerafati-Shoae
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Dehghani
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Sadeghi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hamid R Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Shima Jazayeri
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Borges CA, Marchioni DML, Levy RB, Slater B. Dietary patterns associated with overweight among Brazilian adolescents. Appetite 2018; 123:402-409. [DOI: 10.1016/j.appet.2018.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 11/22/2017] [Accepted: 01/02/2018] [Indexed: 10/18/2022]
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Afeiche MC, Koyratty BNS, Wang D, Jacquier EF, Lê KA. Intakes and sources of total and added sugars among 4 to 13-year-old children in China, Mexico and the United States. Pediatr Obes 2018; 13:204-212. [PMID: 28960843 PMCID: PMC5873457 DOI: 10.1111/ijpo.12234] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 06/01/2017] [Accepted: 06/11/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Intakes of dietary sugars is a global concern, and many national and international organizations have set targets to limit consumption. However, it is unclear to what extent intakes of total and added sugars vary between geographies. OBJECTIVES The aim of this study was to assess the differences in intakes of total and added sugars in 4 to 13-year-old children in China, Mexico and the United States. The secondary aim was to identify main sources of total and added sugars in the diets of these children. METHODS Secondary data analysis was conducted using the 2011 China Health and Nutrition Survey, 2012 Mexican National Health and Nutrition Survey, and 2009-2012 US National Health and Nutrition Examination Surveys. Total and added sugar intakes were calculated using the US Food Patterns Equivalents Database. RESULTS Mean intakes of total and added sugars were 26 and 9 g d-1 among Chinese children, 92 and 55 g d-1 among Mexican children, and 124 and 76 g d-1 among US children, respectively. The top food sources of total sugars were fruits among Chinese children, and sugar-sweetened beverages and milk-based beverages among Mexican and US children. CONCLUSIONS These data highlight the heterogeneity of food patterns worldwide and the need for adapted country-specific public health recommendations on sugars.
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Affiliation(s)
| | - B. N. S. Koyratty
- Department of Epidemiology and Environmental HealthState University of New York at BuffaloBuffaloNY14214‐8001USA
| | - D. Wang
- Nestlé Research CenterLausanneSwitzerland
| | | | - K.‐ A. Lê
- Nestlé Research CenterLausanneSwitzerland
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Dunford E, Popkin B. 37 year snacking trends for US children 1977-2014. Pediatr Obes 2018; 13:247-255. [PMID: 28508580 PMCID: PMC5685944 DOI: 10.1111/ijpo.12220] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/01/2017] [Accepted: 03/24/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND Previous studies have indicated that snacking is contributing to increased calorie intake of American children and that the energy density of snacks in US diets has increased in recent decades. OBJECTIVE Examine short-term and long-term trends in the energy density and food sources of snacks for US children from 1977 to 2014, and examine whether trends differ between socio-demographic groups. METHODS We used data collected from eight nationally representative surveys of food intake in 49,952 US children age 2-18 years, between 1977 and 2014. Overall patterns of snacking, trends in energy intake from snacking, trends in food and beverage sources and energy density of snacks across race-ethnic, age, gender, education and income groups were examined. RESULTS In all socio-demographic groups, there was a significant increase in per capita energy intake deriving from snacks from 1977 to 2014 (P < 0.01). Salty snack intake doubled over the study period, and sugar-sweetened beverage intake decreased overall from 1977 to 2014 but increased in Non-Hispanic Blacks. Non-Hispanic Blacks had the largest increase in per capita intake from foods as a snack from 1977 to 2014. Children in the lowest poverty level and household education groups had more than 100% increase in calorie intake from snacks from 1977 to 2014. CONCLUSIONS We found that snacking behaviour in the USA differs between race-ethnic, household education, gender and income groups, yet snacking remains a significant component of children's diets and the foods consumed at these snacks are not the types of foods recommended by the US dietary guidelines.
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Affiliation(s)
- Elizabeth Dunford
- Carolina Population Center, The University of North Carolina at Chapel Hill, USA
- Food Policy Division, The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Barry Popkin
- Carolina Population Center, The University of North Carolina at Chapel Hill, USA
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, USA
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Food sources of free sugars in children's diet and identification of lifestyle patterns associated with free sugars intake: the GRECO (Greek Childhood Obesity) study. Public Health Nutr 2018; 19:2326-35. [PMID: 27515790 DOI: 10.1017/s1368980015003146] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Excessive free sugars consumption has a possible role in health issues, diet quality and obesity development. The present cross-sectional study aimed to identify the major food sources of free sugars in Greek children's diet and investigate possible associations of dietary patterns with free sugars intake. DESIGN Anthropometric measurements and information on dietary and physical activity habits were obtained. Energy and free sugars intake coming from foods were estimated and principal components analysis was applied to identify dietary patterns. SETTING The GRECO (Greek Childhood Obesity) study. SUBJECTS Nationwide sample of 3089 children (aged 10-12 years). RESULTS Adopting WHO criteria, 44·2 % of participants were categorized as having free sugars intake above 10 % of total energy intake. Mean contribution of free sugars to energy intake was 11·2 %, and the major food sources of free sugars differed from those of other childhood populations. Free sugars intake was not associated with overweight/obesity. Multiple linear regression analysis revealed that two lifestyle and dietary patterns, characterized by higher consumption of sweets, fast foods, fries, sugared drinks, frequently ordering/eating outside home and having meals in front of a screen (pattern 1) and higher consumption of whole fruits, 100 % fruit juices, vegetables, legumes and honey/jam (pattern 2), were positively associated with free sugars intake. CONCLUSIONS A large proportion of children exceeded the recommended cut-off and free sugars intake was associated with lifestyle patterns rather than single foods. Public health programmes aiming to reduce free sugars consumption should be tailored on promoting the correct dietary habits of specific childhood populations.
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Romo-Palafox MJ, Ranjit N, Sweitzer SJ, Roberts-Gray C, Byrd-Williams CE, Briley ME, Hoelscher DM. Contribution of Beverage Selection to the Dietary Quality of the Packed Lunches Eaten by Preschool-Aged Children. J Acad Nutr Diet 2018; 118:1417-1424. [PMID: 29478941 DOI: 10.1016/j.jand.2017.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 11/10/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Sweet drinks early in life could predispose to lifelong consumption, and the beverage industry does not clearly define fruit drinks as part of the sweet drink category. OBJECTIVES To ascertain the relationship between beverage selection and dietary quality of the lunches packed for preschool-aged children evaluated using the Healthy Eating Index-2010. METHODS Foods packed by parents (n=607) were observed at 30 early care and education centers on two nonconsecutive days. Three-level regression models were used to examine the dietary quality of lunches by beverage selection and the dietary quality of the lunch controlling for the nutrient composition of the beverage by removing it from the analysis. RESULTS Fruit drinks were included in 25% of parent-packed lunches, followed by 100% fruit juice (14%), milk (14%), and flavored milk (3.7%). Lunches with plain milk had the highest Healthy Eating Index-2010 scores (59.3) followed by lunches with 100% fruit juice (56.9) and flavored milk (53.2). Lunches with fruit drinks had the lowest Healthy Eating Index-2010 scores at 48.6. After excluding the nutrient content of the beverage, the significant difference between lunches containing milk and flavored milk persisted (+5.5), whereas the difference between fruit drinks and 100% fruit juice did not. CONCLUSIONS Dietary quality is associated with the type of beverage packed and these differences hold when the lunch is analyzed without the nutrient content of the beverage included.
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Bailey RL, Fulgoni VL, Cowan AE, Gaine PC. Sources of Added Sugars in Young Children, Adolescents, and Adults with Low and High Intakes of Added Sugars. Nutrients 2018; 10:E102. [PMID: 29342109 PMCID: PMC5793330 DOI: 10.3390/nu10010102] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/08/2018] [Accepted: 01/11/2018] [Indexed: 01/02/2023] Open
Abstract
High intake of added sugars is associated with excess energy intake and poorer diet quality. The objective of this cross-sectional study (n = 16,806) was to estimate usual intakes and the primary food sources of added sugars across the range of intakes (i.e., deciles) among U.S. children (2-8 years), adolescents and teens (9-18 years), and adults (≥19 years) using the National Health and Nutrition Examination (NHANES) data from 2009-2012. The percent energy contributed by added sugars was 14.3 ± 0.2% (2-8 years), 16.2 ± 0.2% (9-18 years), and 13.1 ± 0.2% (≥19 years), suggesting the highest intakes are among adolescents and teens. However, the primary foods/beverages that contribute to added sugars were remarkably consistent across the range of intakes, with the exception of the lowest decile, and include sweetened beverages and sweet bakery products. Interestingly across all age groups, even those in the lowest decile of added sugars exceed the 10% guidelines. Additional foods contributing to high intakes were candy and other desserts (e.g., ice cream) in children and adolescents, and coffee and teas in adults. Tailoring public health messaging to reduce intakes of these identified food groups may be of utility in designing effective strategies to reduce added sugar intake in the U.S.
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Affiliation(s)
- Regan L Bailey
- Department of Nutrition Science, Purdue University, Stone Hall, Room 143A, 700 West State Street, West Lafayette, IN 47906, USA.
| | - Victor L Fulgoni
- Nutrition Impact LLC, 9725 D Drive North, Battle Creek, MI 49014, USA.
| | - Alexandra E Cowan
- Department of Nutrition Science, Purdue University, Room 143, 700 West State Street, West Lafayette, IN 47906, USA.
| | - P Courtney Gaine
- The Sugar Association, Inc., 1300 L Street, NW, Suite 1001, Washington, DC 20005, USA.
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Abstract
OBJECTIVE The purpose of the current study was to examine associations of individual and aggregated screen-based behaviours, and total sitting time, with healthy and unhealthy dietary intakes among adolescents. DESIGN Cross-sectional study of adolescents. Participants self-reported durations of television viewing, computer use, playing electronic games (e-games), total sitting time, daily servings of fruits and vegetables, and frequency of consumption of sugar-sweetened beverages (SSB), diet beverages, fast foods and discretionary snacks. Logistic regression models were conducted to identify associations of screen-based behaviours, total screen time and total sitting time with dietary intakes. SETTING Victoria, Australia. SUBJECTS Adolescents (n 939) in School Year 11 (mean age 16·8 years). RESULTS The results showed that watching television (≥2 h/d) was positively associated with consuming SSB and diet beverages each week and consuming discretionary snacks at least once daily, whereas computer use (≥2 h/d) was inversely associated with daily fruit and vegetable intake and positively associated with weekly fast-food consumption. Playing e-games (any) was inversely associated with daily vegetable intake and positively associated with weekly SSB consumption. Total screen (≥2 h/d) and sitting (h/d) times were inversely associated with daily fruit and vegetable consumption, with total screen time also positively associated with daily discretionary snack consumption and weekly consumption of SSB and fast foods. CONCLUSIONS Individual and aggregated screen-based behaviours, as well as total sitting time, are associated with a number of indicators of healthy and unhealthy dietary intake. Future research should explore whether reducing recreational screen time improves adolescents' diets.
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Abstract
BACKGROUND Use of nonnutritive sweeteners (NNSs), which provide sweet taste with few to no calories, has increased, but data on whether children's hedonic responses to NNSs differ from nutritive sugars or from adults' hedonic responses are limited. METHODS Most preferred levels of sucrose and the NNS sucralose were determined via a forced-choice tracking procedure in 48 children, 7-14 years (mean = 10 years), and 34 adults. Each participant also rated the liking of these taste stimuli, as well as varying concentrations of aspartame on 3- and 5-point facial hedonic scales. Anthropometric measures were obtained, and motives for palatable food intake were assessed with the Palatable Eating Motives Scale (PEMS, adults) and Kids PEMS. RESULTS While use of the 3-point scale showed no age-related differences in liking of sweeteners, the 5-point scale showed that more children than adults liked higher concentrations of sucrose, sucralose, and aspartame, and the tracking procedure showed that children most preferred higher concentrations of sucrose and sucralose than adults. Regardless of age, sweet preference did not differ between obese and nonobese participants and showed no association with motives for eating palatable foods. Children's body mass index z-scores were positively associated with social and conformity motive scores for eating palatable foods. CONCLUSION Research should move beyond measures of variation in sweet taste hedonics to include identifying motives, and the physiological and psychological consequences of eating sweets, to shed light on what children are more vulnerable to develop unfavorable eating habits, increasing risk for obesity, and other diseases.
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Affiliation(s)
- Nuala Bobowski
- Monell Chemical Senses Center, Philadelphia, PA
- Department of Nutrition and Exercise Sciences, St. Catherine University, St. Paul, MN
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49
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Divaris K, Bhaskar V, McGraw KA. Pediatric obesity-related curricular content and training in dental schools and dental hygiene programs: systematic review and recommendations. J Public Health Dent 2017; 77 Suppl 1:S96-S103. [PMID: 28708273 DOI: 10.1111/jphd.12236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/14/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The authors conducted a systematic review to determine: a) What dental schools and dental hygiene programs are doing to promote knowledge and skills related to addressing childhood obesity and to reduce consumption of sugar-sweetened beverages (SSBs) and b) What else these schools and programs could do to better equip future oral health professionals to address childhood obesity and reduce consumption of SSBs. METHODS The authors searched PubMed, Scopus, Education Full Text (EBSCOHost), and ERIC (EBSCOHost) to identify peer-reviewed publications reporting on obesity or dietetic-related curricula in dental and dental hygiene education within the last 20 years. Three studies met inclusion and exclusion criteria. Outcomes of the identified studies were abstracted and summarized independently by two investigators. RESULTS The first study describes a 2009 survey of pediatric dentistry residents. Approximately, half had received formal training yet they lacked essential knowledge or skills for managing children who were obese. The second study describes nutrition-related coursework offered in the second year of a predoctoral dental school curriculum in Saudi Arabia, and the third study reports on the development of an "oral health rotation" dietetic internship in a pediatric dentistry clinic, in the context of interprofessional education (IPE). CONCLUSIONS Evidence of dental schools' and dental hygiene programs' efforts to address obesity and SSB consumption in children in their curricula is scant, while Commission on Dental Accreditation standards make sporadic mentions of diet and nutrition. Opportunities exist to leverage existing resources and innovative, experiential approaches, including IPE, to formally, and effectively address this important issue in predoctoral oral health education.
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Affiliation(s)
- Kimon Divaris
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, NC, USA.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
| | - Vaishnavi Bhaskar
- ITDP program, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Kathleen A McGraw
- User Services & School of Dentistry Liaison, Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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50
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Mennella JA, Colquhoun TA, Bobowski NK, Olmstead JW, Bartoshuk L, Clark D. Farm to Sensory Lab: Taste of Blueberry Fruit by Children and Adults. J Food Sci 2017; 82:1713-1719. [DOI: 10.1111/1750-3841.13760] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/10/2017] [Accepted: 04/24/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Julie A. Mennella
- Monell Chemical Senses Center; 3500 Market Street Philadelphia PA 19104-3308 U.S.A
| | - Thomas A. Colquhoun
- Environmental Horticulture Dept.; Univ. of Florida; 2550 Hull Road, Room 1549 (W.M. Fifield Hall), P.O. Box 110670 Gainesville FL 32611 U.S.A
| | - Nuala K. Bobowski
- Monell Chemical Senses Center; 3500 Market Street Philadelphia PA 19104-3308 U.S.A
| | - James W. Olmstead
- Horticultural Sciences Dept.; Univ. of Florida; 1253 Fifield Hall, P.O. Box 110690 Gainesville FL 32611 U.S.A
| | - Linda Bartoshuk
- Univ. of Florida; Food Science and Human Nutrition Dept; P.O. Box 110370 359 FSHN Building, 572 Newell Drive Gainesville FL 32611 U.S.A
| | - Dave Clark
- Environmental Horticulture Dept.; Univ. of Florida; 2550 Hull Road, Room 1549 (W.M. Fifield Hall), P.O. Box 110670 Gainesville FL 32611 U.S.A
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