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Singh GK, DiBari JN, Lee H. Prevalence and Social and Built Environmental Determinants of Maternal Prepregnancy Obesity in 68 Major Metropolitan Cities of the United States, 2013-2016. J Environ Public Health 2021; 2021:6650956. [PMID: 33959163 DOI: 10.1155/2021/6650956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 11/17/2022]
Abstract
Objective Maternal prepregnancy obesity is related to increased maternal morbidity and mortality and poor birth outcomes. However, prevalence and risk factors for prepregnancy obesity in US cities are not known. This study examines the prevalence and social and environmental determinants of maternal prepregnancy obesity (BMI ≥30), overweight/obesity (BMI ≥25), and severe obesity (BMI ≥40) in the 68 largest metropolitan cities of the United States. Methods We fitted logistic and Poisson regression models to the 2013–2016 national vital statistics birth cohort data (N = 3,083,600) to derive unadjusted and adjusted city differentials in maternal obesity and to determine social and environmental determinants. Results Considerable disparities existed across cities, with the prevalence of prepregnancy obesity ranging from 10.4% in San Francisco to 36.6% in Detroit. Approximately 63.0% of mothers in Detroit were overweight or obese before pregnancy, compared with 29.2% of mothers in San Francisco. Severe obesity ranged from 1.4% in San Francisco to 8.5% in Cleveland. Women in Anchorage, Buffalo, Cleveland, Fresno, Indianapolis, Louisville, Milwaukee, Oklahoma City, Sacramento, St Paul, Toledo, Tulsa, and Wichita had >2 times higher adjusted odds of prepregnancy obesity compared to those in San Francisco. Race/ethnicity, maternal age, parity, marital status, nativity/immigrant status, and maternal education were important individual-level risk factors and accounted for 63%, 39%, and 72% of the city disparities in prepregnancy obesity, overweight/obesity, and severe obesity, respectively. Area deprivation, violent crime rates, physical inactivity rates, public transport use, and access to parkland and green spaces remained significant predictors of prepregnancy obesity even after controlling for individual-level covariates. Conclusions Substantial disparities in maternal prepregnancy obesity among the major US cities remain despite risk-factor adjustment, with women in several Southern and Midwestern cities experiencing high risks of obesity. Sound urban policies are needed to promote healthier lifestyles and favorable social and built environments for obesity reduction and improved maternal health.
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Ayala GX, Castro IA, Pickrel JL, Lin SF, Williams CB, Madanat H, Jun HJ, Zive M. A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids' Choice Restaurant Program. Int J Environ Res Public Health 2017; 14:E1494. [PMID: 29194392 PMCID: PMC5750912 DOI: 10.3390/ijerph14121494] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/20/2017] [Accepted: 11/20/2017] [Indexed: 01/01/2023]
Abstract
Evidence indicates that restaurant-based interventions have the potential to promote healthier purchasing and improve the nutrients consumed. This study adds to this body of research by reporting the results of a trial focused on promoting the sale of healthy child menu items in independently owned restaurants. Eight pair-matched restaurants that met the eligibility criteria were randomized to a menu-only versus a menu-plus intervention condition. Both of the conditions implemented new healthy child menu items and received support for implementation for eight weeks. The menu-plus condition also conducted a marketing campaign involving employee trainings and promotional materials. Process evaluation data captured intervention implementation. Sales of new and existing child menu items were tracked for 16 weeks. Results indicated that the interventions were implemented with moderate to high fidelity depending on the component. Sales of new healthy child menu items occurred immediately, but decreased during the post-intervention period in both conditions. Sales of existing child menu items demonstrated a time by condition effect with restaurants in the menu-plus condition observing significant decreases and menu-only restaurants observing significant increases in sales of existing child menu items. Additional efforts are needed to inform sustainable methods for improving access to healthy foods and beverages in restaurants.
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Affiliation(s)
- Guadalupe X Ayala
- Graduate School of Public Health and the Institute for Behavioral and Community Health (IBACH), San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Iana A Castro
- Marketing Department, Fowler College of Business and IBACH, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Julie L Pickrel
- IBACH, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA 92123, USA.
| | - Shih-Fan Lin
- IBACH, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA 92123, USA.
| | - Christine B Williams
- Department of Pediatrics, University of California, San Diego, Family Medicine and Public Health, 9500 Gilman Drive, #0725, La Jolla, CA 92093, USA.
| | - Hala Madanat
- Graduate School of Public Health and the Institute for Behavioral and Community Health (IBACH), San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Hee-Jin Jun
- IBACH, San Diego State University Research Foundation, 9245 Sky Park Court, Suite 220, San Diego, CA 92123, USA.
| | - Michelle Zive
- Department of Pediatrics, University of California, San Diego, Family Medicine and Public Health, 9500 Gilman Drive, #0725, La Jolla, CA 92093, USA.
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Hillier-Brown FC, Summerbell CD, Moore HJ, Routen A, Lake AA, Adams J, White M, Araujo-Soares V, Abraham C, Adamson AJ, Brown TJ. The impact of interventions to promote healthier ready-to-eat meals (to eat in, to take away or to be delivered) sold by specific food outlets open to the general public: a systematic review. Obes Rev 2017; 18:227-246. [PMID: 27899007 PMCID: PMC5244662 DOI: 10.1111/obr.12479] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Ready-to-eat meals sold by food outlets that are accessible to the general public are an important target for public health intervention. We conducted a systematic review to assess the impact of such interventions. METHODS Studies of any design and duration that included any consumer-level or food-outlet-level before-and-after data were included. RESULTS Thirty studies describing 34 interventions were categorized by type and coded against the Nuffield intervention ladder: restrict choice = trans fat law (n = 1), changing pre-packed children's meal content (n = 1) and food outlet award schemes (n = 2); guide choice = price increases for unhealthier choices (n = 1), incentive (contingent reward) (n = 1) and price decreases for healthier choices (n = 2); enable choice = signposting (highlighting healthier/unhealthier options) (n = 10) and telemarketing (offering support for the provision of healthier options to businesses via telephone) (n = 2); and provide information = calorie labelling law (n = 12), voluntary nutrient labelling (n = 1) and personalized receipts (n = 1). Most interventions were aimed at adults in US fast food chains and assessed customer-level outcomes. More 'intrusive' interventions that restricted or guided choice generally showed a positive impact on food-outlet-level and customer-level outcomes. However, interventions that simply provided information or enabled choice had a negligible impact. CONCLUSION Interventions to promote healthier ready-to-eat meals sold by food outlets should restrict choice or guide choice through incentives/disincentives. Public health policies and practice that simply involve providing information are unlikely to be effective.
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Affiliation(s)
- F C Hillier-Brown
- Obesity Related Behaviours Research Group, School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK.,Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
| | - C D Summerbell
- Obesity Related Behaviours Research Group, School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK.,Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
| | - H J Moore
- Obesity Related Behaviours Research Group, School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK.,Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
| | - A Routen
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - A A Lake
- Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK.,Centre for Public Policy & Health, School of Medicine, Pharmacy & Health, Durham University, Stockton-on-Tees, UK
| | - J Adams
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - M White
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.,Institute of Health & Society, Newcastle University, Newcastle Upon Tyne, UK
| | - V Araujo-Soares
- Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK.,Institute of Health & Society, Newcastle University, Newcastle Upon Tyne, UK
| | - C Abraham
- Psychology Applied to Heath, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - A J Adamson
- Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK.,Institute of Health & Society, Newcastle University, Newcastle Upon Tyne, UK.,Human Nutrition Research Centre, Newcastle University, Newcastle Upon Tyne, UK
| | - T J Brown
- Obesity Related Behaviours Research Group, School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK.,Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle Upon Tyne, UK
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Hillier-Brown FC, Summerbell CD, Moore HJ, Wrieden WL, Adams J, Abraham C, Adamson A, Araújo-Soares V, White M, Lake AA. A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis. BMC Public Health 2017; 17:93. [PMID: 28103846 PMCID: PMC5244522 DOI: 10.1186/s12889-016-3980-2] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 12/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ready-to-eat meals (to eat in, to take away or to be delivered) sold by food outlets are often more energy dense and nutrient poor compared with meals prepared at home, making them a reasonable target for public health intervention. The aim of the research presented in this paper was to systematically identify and describe interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England. METHODS A systematic search and sift of the literature, followed by evidence mapping of relevant interventions, was conducted. Food outlets were included if they were located in England, were openly accessible to the public and, as their main business, sold ready-to-eat meals. Academic databases and grey literature were searched. Also, local authorities in England, topic experts, and key health professionals and workers were contacted. Two tiers of evidence synthesis took place: type, content and delivery of each intervention were summarised (Tier 1) and for those interventions that had been evaluated, a narrative synthesis was conducted (Tier 2). RESULTS A total of 75 interventions were identified, the most popular being awards. Businesses were more likely to engage with cost neutral interventions which offered imperceptible changes to price, palatability and portion size. Few interventions involved working upstream with suppliers of food, the generation of customer demand, the exploration of competition effects, and/or reducing portion sizes. Evaluations of interventions were generally limited in scope and of low methodological quality, and many were simple assessments of acceptability. CONCLUSIONS Many interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England are taking place; award-type interventions are the most common. Proprietors of food outlets in England that, as their main business, sell ready-to-eat meals, can be engaged in implementing interventions to promote healthier ready-to-eat-food. These proprietors are generally positive about such interventions, particularly when they are cost neutral and use a health by stealth approach.
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Affiliation(s)
- Frances C Hillier-Brown
- Obesity Related Behaviours Research Group, School of Medicine, Pharmacy & Health, Wolfson Research Institute, Durham University, Durham, UK.,Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon-Tyne, UK
| | - Carolyn D Summerbell
- Obesity Related Behaviours Research Group, School of Medicine, Pharmacy & Health, Wolfson Research Institute, Durham University, Durham, UK.,Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon-Tyne, UK
| | - Helen J Moore
- Obesity Related Behaviours Research Group, School of Medicine, Pharmacy & Health, Wolfson Research Institute, Durham University, Durham, UK.,Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon-Tyne, UK
| | - Wendy L Wrieden
- Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon-Tyne, UK.,Human Nutrition Research Centre, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.,Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jean Adams
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.,Present address: CEDAR - UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Charles Abraham
- Psychology Applied to Heath, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Ashley Adamson
- Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon-Tyne, UK.,Human Nutrition Research Centre, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.,Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Vera Araújo-Soares
- Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon-Tyne, UK.,Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Martin White
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.,Present address: CEDAR - UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Amelia A Lake
- Fuse - UKCRC Centre for Translational Research in Public Health, Newcastle University, Newcastle-upon-Tyne, UK. .,Centre for Public Policy & Health, School of Medicine, Pharmacy & Health, Wolfson Research Institute, Durham University, Durham, UK.
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Abstract
Aims: Obesity is one of the most significant global health and social problems, with rates rising dramatically over the past few decades. While the basic drivers of obesity are obvious (more energy consumed than expended), the causes are multifactorial and complex. A decade ago, it was suggested that exploring the ways in which the built environment influenced physical activity and dietary behaviours might provide fertile ground for investigation. This article overviews current evidence and, in particular, emergent themes that are of significance for the United Kingdom. Methods: This article is based on literature extracted from keyword searching of electronic databases. A timeframe of 2006–2016 was used. Results: In the past decade, the research base has grown significantly; while frustratingly some results are still inconclusive or contradictory, it might be argued enough evidence exists to act upon. Themes such as the importance of the journey to school for young people and the multiple environments in which people spend their time are examples of where real progress has been made in the evidence base. Conclusion: Progress towards real change in policy and practice may seem slow; however, the opportunities afforded for health and planning professionals to work together provide a step towards the whole systems approaches to tackle obesity that are desperately needed.
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Adams J, Hillier-Brown FC, Moore HJ, Lake AA, Araujo-Soares V, White M, Summerbell C. Searching and synthesising 'grey literature' and 'grey information' in public health: critical reflections on three case studies. Syst Rev 2016; 5:164. [PMID: 27686611 PMCID: PMC5041336 DOI: 10.1186/s13643-016-0337-y] [Citation(s) in RCA: 190] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 09/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Grey literature includes a range of documents not controlled by commercial publishing organisations. This means that grey literature can be difficult to search and retrieve for evidence synthesis. Much knowledge and evidence in public health, and other fields, accumulates from innovation in practice. This knowledge may not even be of sufficient formality to meet the definition of grey literature. We term this knowledge 'grey information'. Grey information may be even harder to search for and retrieve than grey literature. METHODS On three previous occasions, we have attempted to systematically search for and synthesise public health grey literature and information-both to summarise the extent and nature of particular classes of interventions and to synthesise results of evaluations. Here, we briefly describe these three 'case studies' but focus on our post hoc critical reflections on searching for and synthesising grey literature and information garnered from our experiences of these case studies. We believe these reflections will be useful to future researchers working in this area. RESULTS Issues discussed include search methods, searching efficiency, replicability of searches, data management, data extraction, assessing study 'quality', data synthesis, time and resources, and differentiating evidence synthesis from primary research. CONCLUSIONS Information on applied public health research questions relating to the nature and range of public health interventions, as well as many evaluations of these interventions, may be predominantly, or only, held in grey literature and grey information. Evidence syntheses on these topics need, therefore, to embrace grey literature and information. Many typical systematic review methods for searching, appraising, managing, and synthesising the evidence base can be adapted for use with grey literature and information. Evidence synthesisers should carefully consider the opportunities and problems offered by including grey literature and information. Enhanced incentives for accurate recording and further methodological developments in retrieval will facilitate future syntheses of grey literature and information.
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Affiliation(s)
- Jean Adams
- Present address: Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, CB2 0QQ Cambridge, UK
- Institute of Health and Society, Newcastle University, NE2 4AA Newcastle, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle, UK
| | - Frances C. Hillier-Brown
- Fuse, The Centre for Translational Research in Public Health, Newcastle, UK
- School of Medicine, Pharmacy and Health, Durham University, TS17 3BA Stockton-on-Tees, UK
| | - Helen J. Moore
- Fuse, The Centre for Translational Research in Public Health, Newcastle, UK
- School of Medicine, Pharmacy and Health, Durham University, TS17 3BA Stockton-on-Tees, UK
| | - Amelia A. Lake
- Fuse, The Centre for Translational Research in Public Health, Newcastle, UK
- School of Medicine, Pharmacy and Health, Durham University, TS17 3BA Stockton-on-Tees, UK
- Centre for Public Policy & Health, Durham University, TS17 6BH Stockton-on-Tees, UK
| | - Vera Araujo-Soares
- Institute of Health and Society, Newcastle University, NE2 4AA Newcastle, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle, UK
| | - Martin White
- Present address: Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, CB2 0QQ Cambridge, UK
- Institute of Health and Society, Newcastle University, NE2 4AA Newcastle, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle, UK
| | - Carolyn Summerbell
- Fuse, The Centre for Translational Research in Public Health, Newcastle, UK
- School of Medicine, Pharmacy and Health, Durham University, TS17 3BA Stockton-on-Tees, UK
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Goffe L, Hillier-Brown F, Doherty A, Wrieden W, Lake AA, Araujo-Soares V, Summerbell C, White M, Adamson AJ, Adams J. Comparison of sodium content of meals served by independent takeaways using standard versus reduced holed salt shakers: cross-sectional study. Int J Behav Nutr Phys Act 2016; 13:102. [PMID: 27670137 DOI: 10.1186/s12966-016-0429-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/16/2016] [Indexed: 12/02/2022] Open
Abstract
Background Takeaway food has a relatively poor nutritional profile. Providing takeaway outlets with reduced-holed salt shakers is one method thought to reduce salt use in takeaways, but effects have not been formally tested. We aimed to determine if there was a difference in sodium content of standard fish and chip meals served by Fish & Chip Shops that use standard (17 holes) versus reduced-holed (5 holes) salt shakers, taking advantage of natural variations in salt shakers used. Methods We conducted a cross-sectional study of all Fish & Chip Shops in two local government areas (n = 65), where servers added salt to meals as standard practice, and salt shaker used could be identified (n = 61). Standard fish and chip meals were purchased from each shop by incognito researchers and the purchase price and type of salt shaker used noted. Sodium content of full meals and their component parts (fish, chips, and fish batter) was determined using flame photometry. Differences in absolute and relative sodium content of meals and component parts between shops using reduced-holed versus standard salt-shakers were compared using linear regression before and after adjustment for purchase price and area. Results Reduced-holed salt shakers were used in 29 of 61 (47.5 %) included shops. There was no difference in absolute sodium content of meals purchased from shops using standard versus reduced-holed shakers (mean = 1147 mg [equivalent to 2.9 g salt]; SD = 424 mg; p > 0.05). Relative sodium content was significantly lower in meals from shops using reduced-holed (mean = 142.5 mg/100 g [equivalent to 0.4 g salt/100 g]; SD = 39.0 mg/100 g) versus standard shakers (mean = 182.0 mg/100 g; [equivalent to 0.5 g salt/100 g]; SD = 68.3 mg/100 g; p = 0.008). This was driven by differences in the sodium content of chips and was extinguished by adjustment for purchase price and area. Price was inversely associated with relative sodium content (p < 0.05). Conclusions Using reduced-holed salt shakers in Fish & Chip Shops is associated with lower relative sodium content of fish and chip meals. This is driven by differences in sodium content of chips, making our results relevant to the wide range of takeaways serving chips. Shops serving higher priced meals, which may reflect a more affluent customer base, may be more likely to use reduced-holed shakers.
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