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Ahmadpour M, Omidvar N, Shakibazadeh E, Doustmohammadian A, Rahimiforoushani A. Development and evaluation of an intervention to improve food and nutrition literacy among Iranian Kurdish primary school children: An application of intervention mapping approach. Front Public Health 2023; 10:1059677. [PMID: 36684859 PMCID: PMC9845926 DOI: 10.3389/fpubh.2022.1059677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Background Food and nutrition literacy (FNLIT) is a relatively new term that is used to define the knowledge, skills, and behaviors necessary to achieve a healthy diet. Improving food and nutritional literacy in children is a necessary solution to eliminate nutritional disorders in this age group. The purpose of this study was to design, implement and evaluate an intervention to improve food and nutrition literacy in children aged 10-12 years old based on an intervention mapping (IM) approach. Methods This experimental study was performed in three phases. Through the first phase, an intervention was developed using the (IM) approach. In the second phase, the intervention was implemented for 6 months, and in the third phase, the intervention outcomes were evaluated and compared with the control group through a randomized controlled trial among 300 participants (each control and intervention group = 150). Results Before the intervention, there was no significant difference between the control and intervention groups in all subscales of FNLIT. After the intervention, there was a significant difference between the control and intervention groups in all subscales of FNLIT (P < 0/001). There were no differences between the two groups in terms of the FNLIT scores at baseline (P > 0.05). However, after 6 months of intervention, a significant difference was observed between the two groups (intra-group differences) (P < 0.001). Such a difference was not identified in the control group after 6 months also the results show the impact of socioeconomic factors and parental literacy on the average score of students' FNLIT and after the intervention, a significant difference was observed between the scores of control and intervention groups in all subscales of the FNLIT (P < 0.001). Conclusions The school-based intervention developed and evaluated in this study provides a basis for future programs targeting the improvement of FNLIT in children, especially in poor and deprived areas such as Kurdistan province. Clinical trial registration Iranian Clinical Trials Registry (IRCT) Code: 32094.
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Affiliation(s)
- Mohammad Ahmadpour
- Department of Health Education and Promotion, School of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimiforoushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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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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Couch SC, Helsley RN, Siegel FU, Saelens BE, Magazine M, Eckman MH, Summer S, Fenchel M, King EC, Bhatt DL, Steen DL. Design and rationale for the supermarket and web-based intervention targeting nutrition (SuperWIN) for cardiovascular risk reduction trial. Am Heart J 2022; 248:21-34. [PMID: 35218725 DOI: 10.1016/j.ahj.2022.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/16/2022] [Accepted: 02/19/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE The prevalence of chronic diseases is increasing largely due to suboptimal dietary habits. It is not known whether individualized, supermarket-based, nutrition education delivered by registered dietitians, utilizing the advantages of the in-store and online environments, and electronically collected purchasing data, can increase dietary quality. METHODS AND RESULTS The supermarket and web-based intervention targeting nutrition (SuperWIN) for cardiovascular risk reduction trial is a randomized, controlled dietary intervention study. Adults identified from a primary care network with 1 or more risk factors were randomized at their preferred store to: (1) standard of care plus individualized, point- of-purchase nutrition education; (2) standard of care plus individualized, point- of-purchase nutrition education enhanced with online shopping technologies and training; or (3) standard of care alone. Educational sessions within each store's clinic and aisles, emphasized the dietary approaches to stop hypertension (DASH) diet. The primary assessment was an intention-to-treat comparison on the effects of the dietary interventions on mean change in DASH score (90-point range) from baseline to 3 months (post-intervention). Additional outcomes included blood pressure, lipids, weight, purchasing behavior, food literacy, and intervention feedback. Between April 2019 to February 2021, 267 participants were randomized (20 excluded due to coronavirus disease pandemic). Median age was 58 years, 69% were female, 64% had a college degree, 53% worked full-time, 64% were obese, 73% were treated with blood pressure and 42% with cholesterol medications, and most had low-to-moderate diet quality. CONCLUSION The SuperWIN trial was designed to provide a rigorous evaluation of the efficacy of 2 novel, comprehensive, supermarket-based dietary intervention programs.
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Duarte CB, Spinelli MGN, Matias ACG. Avaliação da qualidade do menu infantil em restaurantes de shopping centers. REVISTA PAULISTA DE PEDIATRIA 2022. [DOI: 10.1590/1984-0462/2022/40/2021027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Resumo Objetivo: Avaliar a qualidade dos menus infantis de restaurantes localizados em shopping centers. Métodos: Para a seleção da amostra foram incluídos os restaurantes de 30% dos shopping centers de cada região da cidade de São Paulo e, após considerar-se somente um restaurante por rede, o total ficou limitado a 151 restaurantes, dos quais 30,2% (n=35) apresentaram cardápio infantil. Os dados foram coletados por meio de um formulário no Google Forms. Resultados: Dos restaurantes com menu infantil, 60% (n=21) eram convencionais e 40% (n=14) eram de takeaway/fast-food. O grande número de redes presente na maioria dos shopping centers visitados mostrou a democratização da forma de comer, com cardápios populares e acessíveis, independentemente de classe social. A maior parte dos alimentos analisados era cozida (41,5%). A maioria das preparações não utilizava gordura em seu preparo e foi notável a falta da oferta de frutas, legumes e verduras (FLV) (4%). Sobremesas doces eram oferecidas em 11,4% dos locais e 20% incluíam brindes com as refeições. Conclusões: A escassa oferta de menus infantis, as poucas opções e a baixa oferta de FLV indicam a necessidade de um novo olhar no desenvolvimento de cardápios infantis e de um maior entrosamento entre as possibilidades dos restaurantes e as expectativas de pais e crianças, no desafio de integrar a relação entre a oferta de novos alimentos, que promovam hábitos mais saudáveis, e o seu consumo.
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Duarte CB, Spinelli MGN, Matias ACG. Evaluation of quality of the children’s menu in mall’s restaurants. REVISTA PAULISTA DE PEDIATRIA 2022; 40:e2021027. [PMID: 35584417 PMCID: PMC9113629 DOI: 10.1590/1984-0462/2022/40/2021027in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/24/2021] [Indexed: 11/21/2022]
Abstract
Objective: To evaluate the quality of children’s menus in restaurants located in shopping malls. Methods: To select the sample, restaurants from 30% of shopping malls in each region of the city of São Paulo were included and, after considering only one restaurant per chain, the total was limited to 151 restaurants, 30.2% of which (n=35) presented a children’s menu. Data were collected through a form on Google Forms. Results: Of the restaurants with children’s menu, 60% (n=21) were conventional restaurants and 40% (n=14) takeaway/fast-food. The large number of chains present in most visited malls showed a democratization of the way of eating, with popular and accessible menus, regardless of social status. Most of the analyzed foods were cooked (41.5%). Most preparations did not use grease in their preparation and there was a notable lack of fruit and vegetables (FV) (4%). Sweet desserts were offered in 11.4% of the places and 20% included gifts with meals. Conclusions: The scarce offer of children’s menus, few options and low FV offer indicate the need for a new look at the development of children’s menus and a greater integration between the possibilities of restaurants and the expectations of parents and children, in the challenge of integrating the relationship between the supply of new foods that promote healthier habits and their consumption.
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Impact of a School-Based Gardening, Cooking, Nutrition Intervention on Diet Intake and Quality: The TX Sprouts Randomized Controlled Trial. Nutrients 2021; 13:nu13093081. [PMID: 34578959 PMCID: PMC8471386 DOI: 10.3390/nu13093081] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022] Open
Abstract
School gardens have become common school-based health promotion strategies to enhance dietary behaviors in the United States. The goal of this study was to examine the effects of TX Sprouts, a one-year school-based gardening, cooking, and nutrition cluster randomized controlled trial, on students' dietary intake and quality. Eight schools were randomly assigned to the TX Sprouts intervention and eight schools to control (i.e., delayed intervention) over three years (2016-2019). The intervention arm received: formation and training of Garden Leadership Committees; a 0.25-acre outdoor teaching garden; 18 student lessons including gardening, nutrition, and cooking activities, taught weekly in the teaching garden during school hours; and nine parent lessons, taught monthly. Dietary intake data via two 24 h dietary recalls (24 hDR) were collected on a random subsample (n = 468). Dietary quality was calculated using the Healthy Eating Index 2015 (HEI-2015). The intervention group compared to control resulted in a modest increase in protein intake as a percentage of total energy (0.4% vs. -0.3%, p = 0.021) and in HEI-2015 total vegetables component scores (+4% vs. -2%, p = 0.003). When stratified by ethnicity/race, non-Hispanic children had a significant increase in HEI-2015 total vegetable scores in the intervention group compared to the control group (+4% vs. -8%, p = 0.026). Both the intervention and control groups increased added sugar intake; however, to a lesser extent within the intervention group (0.3 vs. 2.6 g/day, p = 0.050). School-based gardening, cooking, and nutrition interventions can result in significant improvements in dietary intake. Further research on ways to scale and sustain nutrition education programs in schools is warranted. The trial is registered at ClinicalTrials.gov (NCT02668744).
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Pereira-Figueiredo D, Nascimento AA, Cunha-Rodrigues MC, Brito R, Calaza KC. Caffeine and Its Neuroprotective Role in Ischemic Events: A Mechanism Dependent on Adenosine Receptors. Cell Mol Neurobiol 2021; 42:1693-1725. [PMID: 33730305 DOI: 10.1007/s10571-021-01077-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/05/2021] [Indexed: 02/07/2023]
Abstract
Ischemia is characterized by a transient, insufficient, or permanent interruption of blood flow to a tissue, which leads to an inadequate glucose and oxygen supply. The nervous tissue is highly active, and it closely depends on glucose and oxygen to satisfy its metabolic demand. Therefore, ischemic conditions promote cell death and lead to a secondary wave of cell damage that progressively spreads to the neighborhood areas, called penumbra. Brain ischemia is one of the main causes of deaths and summed with retinal ischemia comprises one of the principal reasons of disability. Although several studies have been performed to investigate the mechanisms of damage to find protective/preventive interventions, an effective treatment does not exist yet. Adenosine is a well-described neuromodulator in the central nervous system (CNS), and acts through four subtypes of G-protein-coupled receptors. Adenosine receptors, especially A1 and A2A receptors, are the main targets of caffeine in daily consumption doses. Accordingly, caffeine has been greatly studied in the context of CNS pathologies. In fact, adenosine system, as well as caffeine, is involved in neuroprotection effects in different pathological situations. Therefore, the present review focuses on the role of adenosine/caffeine in CNS, brain and retina, ischemic events.
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Affiliation(s)
- D Pereira-Figueiredo
- Neurobiology of the Retina Laboratory, Biomedical Sciences Program, Biomedical Institute, Fluminense Federal University, Niterói, RJ, Brazil
| | - A A Nascimento
- Neurobiology of the Retina Laboratory, Program of Neurosciences, Institute of Biology, Fluminense Federal University, Niterói, RJ, Brazil
| | - M C Cunha-Rodrigues
- Neurobiology of the Retina Laboratory, Program of Neurosciences, Institute of Biology, Fluminense Federal University, Niterói, RJ, Brazil
| | - R Brito
- Laboratory of Neuronal Physiology and Pathology, Cellular and Molecular Biology Department, Institute of Biology, Fluminense Federal University, Niterói, RJ, Brazil
| | - K C Calaza
- Neurobiology of the Retina Laboratory, Biomedical Sciences Program, Biomedical Institute, Fluminense Federal University, Niterói, RJ, Brazil. .,Neurobiology of the Retina Laboratory, Program of Neurosciences, Institute of Biology, Fluminense Federal University, Niterói, RJ, Brazil. .,Neurobiology Department, Biology Institute of Fluminense Federal University, Niteroi, RJ, Brazil.
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Desbouys L, Rouche M, De Ridder K, Pedroni C, Castetbon K. Ten-year changes in diet quality among adolescents and young adults (Food Consumption Survey 2004 and 2014, Belgium). Eur J Nutr 2021; 60:3225-3235. [PMID: 33570658 DOI: 10.1007/s00394-021-02499-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/22/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE To estimate the 10-year change in the overall nutritional quality of adolescent and young adult's diet, as measured by the modified Nutrient Profiling System of the British Food Standards Agency individual Dietary Index (FSAm-NPS-DI) which funds the Nutri-Score development, and in different components of this score, overall and according to the individual characteristics. METHODS Two 24-h dietary recalls were carried out in 15- to 39-year-old respondents included in the Belgian Food Consumption Surveys in 2004 (n = 1186) and 2014 (n = 952). The weighted mean individual FSAm-NPS-DI was computed from all foods and beverages consumed, converted into a scale from 0 to 100 (from the poorest to the most favorable diet), and compared between survey years. Subject characteristics associated with the score, along with the mean daily intake of food groups, energy, and nutrients were explored in multiple linear regressions stratified by survey year and age group. RESULTS The weighted mean daily FSAm-NPS-DI significantly increased between 2004 and 2014 [2004: 55.3 (SEM: 0.2) vs. 2014: 57.4 (0.5), P < 0.001 in 15- to 18-year olds; 55.0 (0.6) vs. 58.1 (0.4), P < 0.001 in 19- to 25-year olds; 57.1 (0.4) vs. 58.5 (0.3), P < 0.01 in 26- to 39-year olds]. SFA intake decreased in all age groups, and sugar-sweetened beverage, sugar, sodium, and fiber intakes decreased among 15‒18-year olds. The nutritional quality changed unevenly according to sociocultural characteristics, levels of education and regions being the main sources of disparities. CONCLUSION The quality of diet improved overall between 2004 and 2014 among young people in Belgium, an uneven change that need to be confirmed in future surveys, following the implementation of the Nutri-Score.
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Affiliation(s)
- Lucille Desbouys
- Research Center in "Epidemiology, Biostatistics and Clinical Trials", CR2, School of Public Health, Université Libre de Bruxelles (ULB), Route de Lennik 808, CP598, 1070, Brussels, Belgium.
| | - Manon Rouche
- Research Center in "Epidemiology, Biostatistics and Clinical Trials", CR2, School of Public Health, Université Libre de Bruxelles (ULB), Route de Lennik 808, CP598, 1070, Brussels, Belgium
| | - Karin De Ridder
- Sciensano, Department of Epidemiology and Public Health, 1050, Brussels, Belgium
| | - Camille Pedroni
- Research Center in "Epidemiology, Biostatistics and Clinical Trials", CR2, School of Public Health, Université Libre de Bruxelles (ULB), Route de Lennik 808, CP598, 1070, Brussels, Belgium
| | - Katia Castetbon
- Research Center in "Epidemiology, Biostatistics and Clinical Trials", CR2, School of Public Health, Université Libre de Bruxelles (ULB), Route de Lennik 808, CP598, 1070, Brussels, Belgium
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Examining the consumer restaurant environment and dietary intake in children. Prev Med Rep 2020; 20:101274. [PMID: 33354495 PMCID: PMC7744926 DOI: 10.1016/j.pmedr.2020.101274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/09/2020] [Accepted: 11/24/2020] [Indexed: 12/03/2022] Open
Abstract
Within the away-from-home food environment there is a need to account for individual exposure (e.g., frequency of visitation) to that environment. The present study examined the consumer environment in both proximal and visited restaurants and their association with childrens’ diet quality and anthropometrics. A cross-sectional analysis used baseline data from the Neighborhood Impact on Kids (NIK) study (2007–2009). Participants were 6–12-year-olds living in King County, WA and San Diego County, CA. This analysis (conducted 2019–2020) examined relationships between nearby restaurant count, Nutrition Environment Measures Survey in Restaurants (NEMS-R) within the child’s block group, and weighted NEMS-R scores based on the restaurant where the child ate most frequently in relation to child energy intake, Healthy Eating Index (HEI-2010) total score and anthropometrics. Children’s HEI-2010 scores were associated with NEMS-R scores within block groups, with children in the lowest NEMS-R tertile having significantly higher HEI scores than participants in the middle tertile. Weighted NEMS-R scores were significantly associated with waist circumference, with children in the highest NEMS-R tertile having a lower waist circumference than children in the lowest tertile. Nearby restaurant count was not associated with children’s diet quality or anthropometrics. Our findings suggest the relationship between nutrition environment and child diet and anthropometrics varied depending on how nutrition environment was defined. However, findings may be limited by the low frequency of eating out reported in this sample. Food environment measures that account for individual-level behavior are needed to better understand the influence of food environments on diet and anthropometrics
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Leung CW, Wolfson JA, Hsu R, Soster K, Mangan S, Falbe J. Warning Labels Reduce Sugar-Sweetened Beverage Intake among College Students. J Nutr 2020; 151:179-185. [PMID: 33245125 PMCID: PMC7779215 DOI: 10.1093/jn/nxaa305] [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: 07/07/2020] [Revised: 08/24/2020] [Accepted: 09/15/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Health-related warning labels may reduce the intake of sugar-sweetened beverages (SSBs), but the effectiveness of such labels in real-world settings is not well established. OBJECTIVES We investigated the influence of warning labels on SSB intake among college students at a large public Midwestern university. METHODS We conducted a quasi-experimental intervention study among 840 undergraduate students recruited from 3 dining halls on 1 university campus. One dining hall was selected as the intervention (I) site, whereas the other dining halls served as control (C) sites. In January 2019, warning labels were posted on SSB dispensers at the I site. All students reported their beverage intake using a modified beverage frequency questionnaire 2 mo before and 2 mo after the warning label implementation. Generalized linear models examined the influence of the warning labels on SSB consumption at the I site compared with the C sites, adjusting for students' sociodemographic characteristics. RESULTS In the sample, 68% were aged 17-18 y old at baseline, and 51% identified as female. From baseline to follow-up, there was a 19% decrease in SSB intake at the I site, compared with a 5% decrease at the C sites (P = 0.049 comparing I with C). This difference was driven by significant decreases in the intakes of fruit-flavored drinks, sweetened teas, and flavored milk at the I site compared with the C sites. Although not an SSB, 100% fruit juce consumption decreased 21% at the I site, compared with a 1% increase at the C sites (P = 0.01 comparing I with C). No significant differences were observed in the intakes of soda, energy drinks, sweetened coffees, and nonsugary drinks at the I site compared with the C sites. CONCLUSIONS Warning labels were effective in reducing SSB intake among college students, particularly for fruit-flavored drinks, sweetened teas, and flavored milk.This trial was registered at clinicaltrials.gov as NCT04435145.
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Affiliation(s)
| | - Julia A Wolfson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA,Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Robert Hsu
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Keith Soster
- Michigan Dining, University of Michigan, Ann Arbor, MI, USA
| | - Steve Mangan
- Michigan Dining, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer Falbe
- Human Development and Family Studies Program, Department of Human Ecology, University of California, Davis, Davis, CA, USA
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Xu H, Wu X, Wan Y, Zhang S, Yang R, Wang W, Zeng H, Geng M, Dou L, Zhang G, Xu H, Tao F. Interaction effects of co-consumption of fast food and sugar-sweetened beverages on psychological symptoms: Evidence from a nationwide survey among Chinese adolescents. J Affect Disord 2020; 276:104-111. [PMID: 32697688 DOI: 10.1016/j.jad.2020.07.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 03/06/2020] [Accepted: 07/02/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although fast food and sugar-sweetened beverages (SSBs) consumption have been closely linked to childhood and adolescent obesity, the data regarding their co-consumption and relationship to mental health remains controversial. METHODS A multi-centered population-based survey was conducted among Chinese adolescents from grades 7 to 12. Data about participants' consumption of fast foods and SSBs were obtained from self-reported questionnaires. Psychological symptoms were assessed using the Multi-dimensional Sub-health Questionnaire of Adolescents (MSQA). The association between co-consumption of fast food and SSBs and psychological symptoms was assessed using quantile regression analysis, adjusting for covariates. RESULTS Approximately one-fifth of the 14,500 participants reported psychological symptoms. The regression coefficient (β) value increased as the quantile of fast food, SSBs, and co-consumption increased in the quantile regression model, and the model had an excellent goodness-of-fit (F = 192.51, p < 0.001). In the interaction model, fast food and SSBs in combination were associated with greater odds of psychological symptoms (aOR = 1.90, 95% CI: 1.69, 2.12). The synergy index, relative excess risk of interaction, and attributable proportions were 1.86 (95% CI: 1.17, 2.96), 0.4 (95% CI: 0.20, 0.63), and 0.22 (95% CI: 0.11, 0.33), respectively. LIMITATIONS Information bias is inevitable in self-reported data among participants. The ability to assess causal relationships is reduced by a cross-sectional study design. CONCLUSIONS Our findings suggest that co-consumption of fast food and SSBs was cross-sectionally associated with mental health problems among adolescents.
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Affiliation(s)
- Honglv Xu
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Xiaoyan Wu
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Yuhui Wan
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Shichen Zhang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Rong Yang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Wei Wang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Hanjun Zeng
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Menglong Geng
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Lianjie Dou
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Guobao Zhang
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Huiqiong Xu
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Fangbiao Tao
- School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, PR China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, PR China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, PR China.
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12
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Vasco M, Costa D, Scognamiglio M, Signoriello G, Alfano R, Magnussen K, Napoli C. Evidences on overweight of regular blood donors in a center of Southern Italy. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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13
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Gillis L, Whibbs R, Li A. Future Chefs’ Beliefs on the Role of Nutrition, Diet, and Healthy Cooking Techniques in Culinary Arts Training for Foodservice: A Cross-Cultural and Gender Perspective. JOURNAL OF CULINARY SCIENCE & TECHNOLOGY 2020. [DOI: 10.1080/15428052.2020.1808138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- L. Gillis
- Centre for Hospitality and Culinary Arts, George Brown College, Toronto, Canada
| | - R. Whibbs
- Manitoba Institute of Culinary Arts, Assiniboine Community College, Brandon, Manitoba, Canada
| | - A. Li
- Centre for Hospitality and Culinary Arts, George Brown College, Toronto, Canada
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Palla L, Chapman A, Beh E, Pot G, Almiron-Roig E. Where Do Adolescents Eat Less-Healthy Foods? Correspondence Analysis and Logistic Regression Results from the UK National Diet and Nutrition Survey. Nutrients 2020; 12:nu12082235. [PMID: 32726981 PMCID: PMC7468703 DOI: 10.3390/nu12082235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/08/2020] [Accepted: 07/21/2020] [Indexed: 12/23/2022] Open
Abstract
This study investigates the relationship between the consumption of foods and eating locations (home, school/work and others) in British adolescents, using data from the UK National Diet and Nutrition Survey Rolling Program (2008-2012 and 2013-2016). A cross-sectional analysis of 62,523 food diary entries from this nationally representative sample was carried out for foods contributing up to 80% total energy to the daily adolescent's diet. Correspondence analysis (CA) was used to generate food-location relationship hypotheses followed by logistic regression (LR) to quantify the evidence in terms of odds ratios and formally test those hypotheses. The less-healthy foods that emerged from CA were chips, soft drinks, chocolate and meat pies. Adjusted odds ratios (99% CI) for consuming specific foods at a location "other" than home (H) or school/work (S) in the 2008-2012 survey sample were: for soft drinks, 2.8 (2.1 to 3.8) vs. H and 2.0 (1.4 to 2.8) vs. S; for chips, 2.8 (2.2 to 3.7) vs. H and 3.4 (2.1 to 5.5) vs. S; for chocolates, 2.6 (1.9 to 3.5) vs. H and 1.9 (1.2 to 2.9) vs. S; and for meat pies, 2.7 (1.5 to 5.1) vs. H and 1.3 (0.5 to 3.1) vs. S. These trends were confirmed in the 2013-2016 survey sample. Interactions between location and BMI were not significant in either sample. In conclusion, public health policies to discourage less-healthy food choices in locations away from home and school/work are warranted for adolescents, irrespective of their BMI.
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Affiliation(s)
- Luigi Palla
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8521, Japan
- Correspondence: ; Tel.: +44-20-79275026
| | - Andrew Chapman
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Eric Beh
- School of Mathematical and Physical Sciences, University of Newcastle, Callaghan NSW 2308, Australia;
| | - Gerda Pot
- Department Nutritional Sciences, Faculty of Life Sciences & Medicine, King’s College London, London WC2R 2LS, UK;
- Louis Bolk Institute, Nutrition and Health Team, 3981 AJ Bunnik, The Netherlands
| | - Eva Almiron-Roig
- Centre for Nutrition Research, University of Navarra, 31009 Pamplona, Spain;
- MRC Elsie Widdowson Laboratory, Cambridge CB2 0SL, UK
- Navarra Institute for Health Research (IdiSNa), 31008 Pamplona, Spain
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15
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Wong MCS, Huang J, Wang J, Chan PSF, Lok V, Chen X, Leung C, Wang HHX, Lao XQ, Zheng ZJ. Global, regional and time-trend prevalence of central obesity: a systematic review and meta-analysis of 13.2 million subjects. Eur J Epidemiol 2020; 35:673-683. [PMID: 32448986 PMCID: PMC7387368 DOI: 10.1007/s10654-020-00650-3] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 05/18/2020] [Indexed: 01/01/2023]
Abstract
We aimed to examine the global prevalences of central obesity according to age, sex, race, place of residence, geographical region, national income level, and the definitions of central obesity. MEDLINE and Embase were searched. Studies with sample size of ≥ 500 and investigated individuals aged ≥ 15 years were included. Metaprop (a Stata command) was adopted to conduct a meta-analysis of prevalence, and the Freeman-Tukey Double Arcsine Transformation was used to stabilize the variances. A random-effects model was used to evaluate the prevalence and 95% confidence intervals (CI) of central obesity. There were 288 studies involving 13,233,675 individuals in this analysis. The overall prevalence of central obesity was 41.5% (95% CI 39.9–43.2%). A higher prevalence was found in older individuals, female subjects, urban residents, Caucasians, and populations of higher income level countries. Regarding regional variations, the highest prevalence was found in Sothern America (55.1%, 95% CI 45.8–64.3%) and Central American (52.9%, 95% CI 32.7–72.7%). Its prevalence was rapidly rising from 1985 to 2014. From 1985–1999 to 2010–2014, younger subjects aged 15–40 years showed a more drastic rise in prevalence (16.3 to 33.9%) than subjects aged > 40 years (43.6 to 57.9%). Male individuals have a more drastic rise (25.3 to 41.6%) than females (38.6 to 49.7%). Major increasing in prevalence of the condition in the past three decades, particularly in certain subgroups. These findings could act as a useful reference to inform public health strategies to minimize the impact of central obesity on population health.
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Affiliation(s)
- Martin C. S. Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Junjie Huang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Jingxuan Wang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Paul S. F. Chan
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Veeleah Lok
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Xiao Chen
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Colette Leung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Harry H. X. Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, 38, Xue Yuan Road, Haidian District, Beijing, China
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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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Yoon SR, Fogleman SK, Kim H, Lee KE, Kim OY. Breakfast Intake Effect on the Association between Fast-Food Consumption and the Risk of Obesity and Dyslipidemia in Korean Adults Aged 20-39 Years Based on the Korea National Health and Nutrition Examination Survey IV 2013-2014. Clin Nutr Res 2020; 9:107-121. [PMID: 32395441 PMCID: PMC7192669 DOI: 10.7762/cnr.2020.9.2.107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 11/19/2022] Open
Abstract
We investigated the association between fast-food (FF) consumptions and the risk of overweight/obesity and dyslipidemia in Korean adults (20-39 years) based on the Korea National Health and Nutrition Examination Survey (2013-2014). We also examined the effect of breakfast intake on the risk of overweight/obesity and dyslipidemia according to their frequencies of FF consumption. FF consumption was categorized into 3 groups: < 1 time/month (n = 79); 1-3 times/month (n = 1,173); and ≥ 1 time/week (n = 474). People consuming FF ≥ 1 time/week had unhealthy lifestyles, higher intake of total calorie, fat, and protein, and higher levels of blood pressure, total cholesterol (TC) and low-density lipoprotein (LDL)-cholesterol than those consuming FF < 1 time/month. Logistic regression analysis showed higher risk of overweight/obesity in people consuming FF 1-3 times/month (odds ratio [OR], 2.525; confidence intervals [CIs], 1.169-5.452; p = 0.018) and ≥ 1 time/week (OR, 2.646; CIs, 1.128-6.208; p = 0.025) than those consuming FF < 1 time/month after the adjustment. The risk of dyslipidemia was also higher in people consuming FF ≥ 1 time/week than those consuming FF < 1 time/month after the adjustment (OR, 2.444; CIs, 1.047-5.704; p = 0.039). Furthermore, among people consuming FF ≥ 1 time/week, irregular breakfast consumers (≤ 2 times/week, n = 215) had significantly higher levels of triglyceride, TC, and LDL-C than regular breakfast consumers (5-6 times/week, n=180). Irregular breakfast consumers also showed a higher risk of dyslipidemia than regular breakfast consumers after the adjustment (OR, 2.913; CIs, 1.463-5.801; p = 0.002). In conclusion, frequent FF consumption increases the risk of obesity and dyslipidemia in Korean adults aged 20-39 years. Particularly among the frequent FF consumers, irregular breakfast intake may contribute to the increased risk of dyslipidemia. It may provide an evidence for proper dietary education to reduce the risk of overweight/obesity and dyslipidemia in Koreans adults aged 20-39 years.
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Affiliation(s)
- So Ra Yoon
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
- Center for Silver-targeted Biomaterials, Brain Busan 21 Plus Program, Dong A University, Busan 49315, Korea
- Institute of Health Insurance and Clinical Research, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea
| | - Sockju K. Fogleman
- Department of Food and Nutrition, Meredith College, Raleigh, NC 27607-5298, USA
| | - Hyunyoung Kim
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
- Center for Silver-targeted Biomaterials, Brain Busan 21 Plus Program, Dong A University, Busan 49315, Korea
| | - Kyung Eun Lee
- Divison of Applied Food System, College of Natural Sciences, Seoul Women's University, Seoul 01797, Korea
| | - Oh Yoen Kim
- Department of Food Science and Nutrition, Dong-A University, Busan 49315, Korea
- Center for Silver-targeted Biomaterials, Brain Busan 21 Plus Program, Dong A University, Busan 49315, Korea
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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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Dietary Sodium Intake and Food Sources Among Chinese Adults: Data from the CNNHS 2010-2012. Nutrients 2020; 12:nu12020453. [PMID: 32054013 PMCID: PMC7071264 DOI: 10.3390/nu12020453] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 12/18/2022] Open
Abstract
The present study was done to examine the status of dietary sodium intake and dietary sources of sodium among Chinese adults. Data were obtained from China National Nutrition and Health Surveillance (CNNHS) 2010–2012. All adults recruited in this study provided complete dietary data on three-day consecutive 24-h dietary recalls combining with the household weighing method. Sodium intake was adjusted for energy to 2000 kcal/day using the residual method. Average sodium intake was 5013 (95% Confidence Interval, CI: 4858, 5168) mg/day, and 92.6% of adults’ sodium intake exceeded the standard in the Chinese proposed intake for preventing non-communicable chronic diseases (PI-NCD). The salt added to food was the main contributor to daily sodium intake, representing 69.2% of the total sodium consumption. The proportion of sodium from salt was different in some subgroups. The contribution ranged from 64.8% for those who came from urban areas aged 18–49 years old to 74.7% for those who came from rural areas with education levels of primary school or less, and sodium from soy sauce was the next highest contributor (8.2%). The proportion of the subjects with sodium intake contributed by flour products was higher in the north with 7.1% than the south with 1.4%. The average consumption of sodium among Chinese was more than the recommended amount, and salt was the main source of sodium.
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Association of sugar-sweetened beverage intake with risk of metabolic syndrome among children and adolescents in urban China. Public Health Nutr 2020; 23:2770-2780. [PMID: 31915093 DOI: 10.1017/s1368980019003653] [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] [Indexed: 12/27/2022]
Abstract
OBJECTIVE High sugar-sweetened beverage (SSB) intake has been shown to correlate with a higher risk for CVD and metabolic disorders, while the association between SSB intake and the risk of metabolic syndrome (MetS) remains unclear. The present study aimed to explore the association between SSB intake and MetS among children and adolescents in urban China. DESIGN A cross-sectional study involving 7143 children and adolescents was conducted in urban China. MetS definition proposed by the International Diabetes Federation was adopted. Data on SSB intake, diet, physical activity and family environment factors were obtained through questionnaires. Logistic regression models with multivariable adjustment were adopted to analyse the association between SSB intake and the risk of MetS and its components. SETTING Primary and secondary schools in three urban cities of China. PARTICIPANTS Children and adolescents (n 5258) aged 7-18 years. RESULTS Among the participants, 29·9 % of them had high SSB intake (at least 0·3 servings/d) and the overall MetS prevalence was 2·7 %. Participants with high SSB intake were at higher risk for MetS (OR = 1·60; 95 % CI 1·03, 2·54) and abdominal obesity (OR = 1·55; 95 % CI 1·28, 1·83) compared with their counterparts with no SSB intake (0 servings/d). CONCLUSIONS High SSB intake is significantly associated with increased MetS and abdominal obesity risk among children and adolescents in urban China. These results suggest that strong policies focusing on controlling SSB intake might be effective in preventing MetS and abdominal obesity.
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Han S, Wu L, Wang W, Li N, Wu X. Trends in Dietary Nutrients by Demographic Characteristics and BMI among US Adults, 2003-2016. Nutrients 2019; 11:nu11112617. [PMID: 31683900 PMCID: PMC6893675 DOI: 10.3390/nu11112617] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Limited data were available on trends of US dietary nutrients especially for specific subgroups; Methods: Dietary intakes of energy and 36 kinds of nutrients were analyzed in the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2016 and by age and sex, socioeconomic status, race/ethnicity, and body mass index, which were evaluated by whether not they meet the dietary reference intakes (DRIs); Results: Significantly decreased trends were observed for carbohydrate, total sugars, fiber, calcium, magnesium, phosphorus, selenium, vitamin B6, E, K, and choline, while increased trends were observed for saturated fatty acids, iron, zinc, copper, potassium, sodium, vitamin B1, B2, B12, C and folate DFE (as dietary folate equivalents). A decreased trend of exceeding the estimated energy requirement was found. Population with low socioeconomic status and non-Hispanic blacks accounted for the largest proportion not meeting DRIs for most of nutrients; Conclusions: Most dietary nutrients were improved among US adults from 2003 to 2016 but were still far from optimal levels. Populations with low socioeconomic status and non-Hispanic blacks should be paid more attention to improve their dietary nutrient intake.
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Affiliation(s)
- Shan Han
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin 150081, China.
| | - Lanlan Wu
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin 150081, China.
| | - Wenjie Wang
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin 150081, China.
| | - Na Li
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin 150081, China.
| | - Xiaoyan Wu
- Department of Nutrition and Food Hygiene, the National Key Discipline, School of Public Health, Harbin Medical University, Harbin 150081, China.
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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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Eck KM, Dinesen A, Garcia E, Delaney CL, Famodu OA, Olfert MD, Byrd-Bredbenner C, Shelnutt KP. "Your Body Feels Better When You Drink Water": Parent and School-Age Children's Sugar-Sweetened Beverage Cognitions. Nutrients 2018; 10:E1232. [PMID: 30189588 PMCID: PMC6165219 DOI: 10.3390/nu10091232] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 08/30/2018] [Accepted: 09/02/2018] [Indexed: 12/21/2022] Open
Abstract
Sugar-sweetened beverages (SSBs) are a leading source of added sugar in the American diet. Further, ingestion of added sugars from SSBs exceeds recommendations. Thus, interventions that effectively reduce SSB consumption are needed. Focus group discussions with parents (n = 37) and school-aged children between the ages of 6 and 11 years (n = 41) from Florida, New Jersey, and West Virginia were led by trained moderators using Social Cognitive Theory as a guide. Trends and themes that emerged from the content analysis of the focus group data indicated that both parents and children felt that limiting SSBs was important to health and weight control. However, parents and children reported consuming an average of 1.85 ± 2.38 SD and 2.13 ± 2.52 SD SSB servings/week, respectively. Parents and children were aware that parent behaviors influenced kids, but parents reported modeling healthy SSB behaviors was difficult. Busy schedules, including more frequent parties and events as children get older, were another barrier to limiting SSBs. Parents were most successful at limiting SSBs when they were not in the house. This qualitative research provides novel insights into parents' and children's cognitions (e.g., beliefs, attitudes), barriers, and facilitators related to SSB ingestion. Consideration of these insights during nutrition intervention development has the potential to improve intervention effectiveness in reducing SSB intake.
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Affiliation(s)
- Kaitlyn M Eck
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA.
| | - Aleksandr Dinesen
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA.
| | - Elder Garcia
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL 32611, USA.
| | - Colleen L Delaney
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA.
| | - Oluremi A Famodu
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL 32611, USA.
| | - Melissa D Olfert
- Division of Animal and Nutritional Sciences, West Virginia University, 1194 Evansdale Dr. G28, West Virginia University, Morgantown, WV 26506, USA.
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ 08901, USA.
| | - Karla P Shelnutt
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL 32611, USA.
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Ziauddeen N, Page P, Penney TL, Nicholson S, Kirk SFL, Almiron-Roig E. Eating at food outlets and leisure places and "on the go" is associated with less-healthy food choices than eating at home and in school in children: cross-sectional data from the UK National Diet and Nutrition Survey Rolling Program (2008-2014). Am J Clin Nutr 2018; 107:992-1003. [PMID: 29741556 PMCID: PMC5985724 DOI: 10.1093/ajcn/nqy057] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 03/06/2018] [Indexed: 12/25/2022] Open
Abstract
Background Where children eat has been linked to variations in diet quality, including the consumption of low-nutrient, energy-dense food, a recognized risk factor for obesity. Objective The aim of this study was to provide a comprehensive analysis of consumption patterns and nutritional intake by eating location in British children with the use of a nationally representative survey. Design Cross-sectional data from 4636 children (80,075 eating occasions) aged 1.5-18 y from the UK National Diet and Nutrition Survey Rolling Program (2008-2014) were analyzed. Eating locations were categorized as home, school, work, leisure places, food outlets, and "on the go." Foods were classified into core (considered important or acceptable within a healthy diet) and noncore (all other foods). Other variables included the percentage of meals eaten at home, sex, ethnicity, body mass index, income, frequency of eating out, takeaway meal consumption, alcohol consumption, and smoking. Results The main eating location across all age groups was at home (69-79% of eating occasions), with the highest energy intakes. One-third of children from the least-affluent families consumed ≤25% of meals at home. Eating more at home was associated with less sugar and takeaway food consumption. Eating occasions in leisure places, food outlets, and "on the go" combined increased with age, from 5% (1.5-3 y) to 7% (11-18 y), with higher energy intakes from noncore foods in these locations. The school environment was associated with higher intakes of core foods and reduced intakes of noncore foods in children aged 4-10 y who ate school-sourced foods. Conclusions Home and school eating are associated with better food choices, whereas other locations are associated with poor food choices. Effective, sustained initiatives targeted at behaviors and improving access to healthy foods in leisure centers and food outlets, including food sold to eat "on the go," may improve food choices. Home remains an important target for intervention through family and nutrition education, outreach, and social marketing campaigns. This trial was registered with the ISRTCN registry (https://www.isrctn.com) as ISRCTN17261407.
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Affiliation(s)
- Nida Ziauddeen
- Medical Research Council (MRC) Elsie Widdowson Laboratory, Cambridge, United Kingdom
- Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Polly Page
- Medical Research Council (MRC) Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Tarra L Penney
- UKCRC Center for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom
| | - Sonja Nicholson
- Medical Research Council (MRC) Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Sara FL Kirk
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Eva Almiron-Roig
- Medical Research Council (MRC) Elsie Widdowson Laboratory, Cambridge, United Kingdom
- Center for Nutrition Research, University of Navarra, Pamplona, Spain
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Tick H, Nielsen A, Pelletier KR, Bonakdar R, Simmons S, Glick R, Ratner E, Lemmon RL, Wayne P, Zador V. Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care: The Consortium Pain Task Force White Paper. Explore (NY) 2018; 14:177-211. [PMID: 29735382 DOI: 10.1016/j.explore.2018.02.001] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 02/08/2018] [Indexed: 02/06/2023]
Abstract
Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain. Therapies reviewed include acupuncture therapy, massage therapy, osteopathic and chiropractic manipulation, meditative movement therapies Tai chi and yoga, mind body behavioral interventions, dietary components and self-care/self-efficacy strategies. Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence-informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices.
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Affiliation(s)
- Heather Tick
- Departments of Family Medicine, Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA.
| | - Arya Nielsen
- Department of Family Medicine & Community Health, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Kenneth R Pelletier
- Department of Medicine, University of California School of Medicine, San Francisco, CA
| | - Robert Bonakdar
- Department of Pain Management, Scripps Center for Integrative Medicine, La Jolla, CA
| | | | - Ronald Glick
- Departments of Psychiatry and Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Emily Ratner
- MedStar Health, Institute for Innovation, Integrative Medicine Initiatives, MedStar Montgomery Medical Center, Washington, DC
| | - Russell L Lemmon
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Peter Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Veronica Zador
- Beaumont Hospital Integrative Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI
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Kraak V, Englund T, Misyak S, Serrano E. Progress Evaluation for the Restaurant Industry Assessed by a Voluntary Marketing-Mix and Choice-Architecture Framework That Offers Strategies to Nudge American Customers toward Healthy Food Environments, 2006-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E760. [PMID: 28704965 PMCID: PMC5551198 DOI: 10.3390/ijerph14070760] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 07/01/2017] [Accepted: 07/04/2017] [Indexed: 12/02/2022]
Abstract
Consumption of restaurant food and beverage products high in fat, sugar and sodium contribute to obesity and non-communicable diseases. We evaluated restaurant-sector progress to promote healthy food environments for Americans. We conducted a desk review of seven electronic databases (January 2006-January 2017) to examine restaurant strategies used to promote healthful options in the United States (U.S.). Evidence selection (n = 84) was guided by the LEAD principles (i.e., locate, evaluate, and assemble evidence to inform decisions) and verified by data and investigator triangulation. A marketing-mix and choice-architecture framework was used to examine eight voluntary strategies (i.e., place, profile, portion, pricing, promotion, healthy default picks, priming or prompting and proximity) to evaluate progress (i.e., no, limited, some or extensive) toward 12 performance metrics based on available published evidence. The U.S. restaurant sector has made limited progress to use pricing, profile (reformulation), healthy default picks (choices), promotion (responsible marketing) and priming and prompting (information and labeling); and some progress to reduce portions. No evidence was available to assess progress for place (ambience) and proximity (positioning) to promote healthy choices during the 10-year review period. Chain and non-chain restaurants can apply comprehensive marketing-mix and nudge strategies to promote healthy food environments for customers.
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Affiliation(s)
- Vivica Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Tessa Englund
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Sarah Misyak
- Virginia Cooperative Extension's Family Nutrition Program, Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Elena Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA.
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