Effectiveness of NCD-Related Fiscal Policies: Evidence from the Pacific

Obesity in Pacific Island countries (PICs) has hit crisis levels, and the consequent high non-communicable disease (NCD) burden is devastating for their developing economies. Nutrition transitions from traditional, plant and seafood diets to a dependence on processed foods are at the core of the obesity and NCD epidemic in PICs. Fiscal policies are widely promoted as an effective mechanism to reduce consumption of unhealthy foods and increase consumption of fruits and vegetables. However, there are little data to evaluate the effectiveness of these policies as rates of NCDs and obesity in PICs continue to rise. This study used an online survey to recruit 4116 adults from six PICs: Fiji, Kiribati, Samoa, Solomon Islands, Tonga and Vanuatu. The study measured the consumption of and household access to sugar-sweetened beverages, ultra-processed packaged snacks, fruits and vegetables and attitudes on food prices and unhealthy eating. The study also assessed the relationship between consumption of these foods and drink and (1) household access, (2) price as a food choice motive, and (3) unhealthy eating attitudes. This study provides novel data on food-related behaviours in PICs, offers insights into the potential impact of NCD-related fiscal policies on food consumption and identifies other variables of interest.

Evaluation of Flavonoid-rich Fraction of Portulaca Grandiflora Aerial Part Extract in Atherogenic Diet-induced Atherosclerosis

BACKGROUND

Portulaca grandiflora is a tiny, upright herb that contains a variety of chemical components, including alkaloids, glycosides, mucilage, proteins, tannins, flavonoids, saponins, polysaccharides, and triterpenoids possessing properties that may help with atherosclerosis. The reported pharmacological properties of Portulaca grandiflora are antioxidant, antidiabetic, antiasthmatic, antibacterial, antiulcer and anti-inflammatory properties.

OBJECTIVES

The yield of methanol extract is higher than that of ethanol and acetone, and its phytoconstituents, like flavonoids and polyphenols, and has potent antioxidant properties. In order to determine the effectiveness ofPortulaca grandiflora methanol extract fraction against high-fat diet (HFD)-induced hyperlipidemia, hemodynamic change, antioxidant levels, and vascular dysfunction in rats, a study was carried out on a flavonoid-rich methanol extract fraction of the aerial part of Portulaca grandiflora Hook.

METHODS

This method involves a study of 30 days involving male Wistar rats (240-250 g) (n=5) that were fed with an Ath diet. Study groups were divided into (i) The Control Group, (ii) the Diseases Control Group, (iii) Disease + Standard drug (Atorvastatin 20mg/kg, orally, (iv) Disease + Test Extract dose 1 (Portulaca grandiflora 200mg/kg orally), and (v) Disease + Test Extract dose 2 (Portulaca grandiflora 400mg/kg orally). Both the test drug Portulaca grandiflora and the standard drug Atorvastatin were given orally for 30 days.

RESULTS

At the end of the study, blood samples were taken to measure the serum lipid profile, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and levels of oxidative tissue stress. Hemodynamic parameters and aortic staining were performed. Portulaca grandiflora treatment improved the lipid profile and considerably reduced oxidative stress levels. Aortic staining examination revealed a marked reduction in atherosclerotic lesions.

CONCLUSION

These results revealed that Portulaca grandiflora is an effective treatment approach in preventing atherosclerotic lesion progression, which is attributed to its protection against oxidative stress and various enzymatic activities in the Atherogenic model.

Trait Anxiety and Unhealthy Eating in Adult Women: The Mediating Role of Cognitive Instability

Previous studies have demonstrated the influence of affective states on unhealthy eating. Heightened impulsivity has also been recognized as a risk factor for unhealthy eating. The objective of the present study was to investigate the relationship between trait anxiety and unhealthy eating and to test whether cognitive instability (trait impulsivity component) might mediate this relationship among adult women.

METHOD

The sample was composed of 225 women (M_age = 29.70 ± 9.23; M_{BodyMass Index} = 23.39 ± 4.43). The State-Trait Anxiety Inventory (STAI), the Food Frequency Questionnaire (FFQ), and the Barratt Impulsiveness Scale (BIS) were used. We first conducted a principal components analysis to reduce the dimensionality of the FFQ data, finding four principal components. For our primary analyses, we focused on unhealthy eating. We then conducted a mediation analysis to examine whether trait anxiety was associated with unhealthy eating and, if so, whether cognitive impulsivity mediated this relationship.

RESULTS

Trait anxiety was positively associated with cognitive instability, and cognitive instability was positively associated with unhealthy eating. Trait anxiety was also positively associated with unhealthy eating, but only when controlling for cognitive instability. Consistent with our proposed mediation model, trait anxiety was positively associated with cognitive instability, which in turn predicted unhealthy eating among adult women.

CONCLUSION

Adult women who reported higher levels of trait anxiety experienced higher levels of cognitive instability and engaged in poor dietary behaviors. Identifying the factors related to unhealthy eating represents a crucial step toward findings ways of reducing their impact on food intake and replacing them with more productive ones.

Sociocultural Influences Contribute to Overeating and Unhealthy Eating: Creating and Maintaining an Obesogenic Social Environment in Indigenous Communities in Urban Fiji

Pacific Island countries (PICs), such as Fiji, lead the world statistics in obesity and deaths caused by non-communicable diseases. The impacts of obesity overburden the healthcare system and social services and have major impacts on the Fijian economy. This study is the first of its kind to undertake an in-depth exploration of the determinants of the obesity epidemic in PICs by exploring the sociocultural influences and situations that impact nutrient transitions, overconsumption, and unhealthy eating in an urban indigenous community. In-depth qualitative interviews were conducted with 15 indigenous Fijian women from the largest urban center in Fiji who self-identified as gatekeepers of family meal planning, preparing, and shopping for groceries, fruits, and vegetables. The women identified several cultural norms and expectations of both the individuals providing the food and the individuals consuming the food that create and maintain an obesogenic social environment. Moreover, participants also shared a misplaced value on meat, energy-dense foods, junk food, and fast foods that further contribute to unhealthy eating and overeating within this urban indigenous community. These novel findings highlight the importance of considering sociocultural influences on unhealthy eating and overeating and may be used to assist decision-makers in developing contextualized obesity prevention strategies and health messaging to target obesity in this community.

Longitudinal Prospective Association between Hedonic Hunger and Unhealthy Food and Drink Intake in Adolescents

Hedonic hunger (i.e., extreme responsiveness to food) has been associated with obesity and poor diet, but findings in the existing literature have primarily been cross-sectional. The current study examined hedonic hunger as a prospective predictor of the longitudinal trajectory of unhealthy food and drink intake across adolescence. Ninth grade students from Los Angeles area high schools (analyzed sample N = 3268) completed paper-and-pencil surveys across four annual waves; hedonic hunger was assessed at Wave 1, and unhealthy food and drink intake was assessed at Waves 1-4. Multilevel models showed a significant main effect of hedonic hunger and interactions between hedonic hunger and the linear and quadratic components of time. The association between hedonic hunger and unhealthy food and drink intake was strongest at Wave 1 and weakened over time, yet those with higher hedonic hunger reported greater unhealthy food and drink intake across the four years. Efforts to prevent and intervene upon hedonic hunger and its association with unhealthy food and drink intake during childhood and adolescence are warranted.

Unhealthy eating and weight dissatisfaction in adolescents who never, occasionally, or regularly use smokeless tobacco (Swedish snus)

OBJECTIVE

Although cigarette smoking has been linked to weight-related concerns and unhealthy weight control practices, little is known about weight dissatisfaction and eating among adolescents who use smokeless tobacco (SLT) products. The use of Swedish moist snuff (snus) has increased dramatically over recent years, surpassing cigarette smoking among young people in several countries. This study investigated differences in unhealthy eating behaviors and weight dissatisfaction in male and female adolescents who never, occasionally, or regularly use snus.

METHOD

Adolescents aged 16-19 years enrolled in high school (11th, 12th, and 13th grades) completed a cross-sectional, online survey of adolescent health and well-being. Meal skipping and snus use frequency were assessed in the total sample (N = 23,622), and items assessing weight dissatisfaction (n = 4,195) and eating-related pathology (n = 3,563) were administered to subsamples. Analyses were adjusted for cigarette smoking, parental education, and socioeconomic status.

RESULTS

Adolescents who used snus, especially on a daily basis, reported less regular breakfast, lunch, and dinner consumption. Females who used snus on an occasional basis reported significantly more disturbed eating pathology. Snus use was associated with weight dissatisfaction in males and females, manifesting differentially according to gender and snus use frequency.

DISCUSSION

Unhealthy eating behaviors and weight dissatisfaction were significantly elevated among snus users aged 16-19 years. An increased awareness that occasional snus use may signal disturbed eating pathology among adolescent females is important for detection and prevention efforts. Parents, schools, and health professionals should be vigilant for possible snus use among weight-dissatisfied adolescents.

Snacking Quality Is Associated with Secondary School Academic Achievement and the Intention to Enroll in Higher Education: A Cross-Sectional Study in Adolescents from Santiago, Chile

Although numerous studies have approached the effects of exposure to a Western diet (WD) on academic outcomes, very few have focused on foods consumed during snack times. We explored whether there is a link between nutritious snacking habits and academic achievement in high school (HS) students from Santiago, Chile. We conducted a cross-sectional study with 678 adolescents. The nutritional quality of snacks consumed by 16-year-old was assessed using a validated food frequency questionnaire. The academic outcomes measured were HS grade point average (GPA), the likelihood of HS completion, and the likelihood of taking college entrance exams. A multivariate analysis was performed to determine the independent associations of nutritious snacking with having completed HS and having taken college entrance exams. An analysis of covariance (ANCOVA) estimated the differences in GPA by the quality of snacks. Compared to students with healthy in-home snacking behaviors, adolescents having unhealthy in-home snacks had significantly lower GPAs (M difference: -40.1 points, 95% confidence interval (CI): -59.2, -16.9, d = 0.41), significantly lower odds of HS completion (adjusted odds ratio (aOR): 0.47; 95% CI: 0.25-0.88), and significantly lower odds of taking college entrance exams (aOR: 0.53; 95% CI: 0.31-0.88). Unhealthy at-school snacking showed similar associations with the outcome variables. Poor nutritional quality snacking at school and at home was associated with poor secondary school academic achievement and the intention to enroll in higher education.

Perceived Social Support From Friends and Parents for Eating Behavior and Diet Quality Among Low-Income, Urban, Minority Youth

OBJECTIVE

Evidence of associations between social support and dietary intake among adolescents is mixed. This study examines relationships between social support for healthy and unhealthy eating from friends and parents, and associations with diet quality.

DESIGN

Cross-sectional analysis of survey data.

SETTING

Baltimore, MD.

PARTICIPANTS

296 youth aged 9-15 years, 53% female, 91% African American, participating in the B'More Healthy Communities for Kids study.

MAIN OUTCOME MEASURE(S)

Primary dependent variable: diet quality measured using Healthy Eating Index 2010 (HEI) overall score, calculated from the Block Kids Food Frequency Questionnaire.

INDEPENDENT VARIABLES

Social support from parents and friends for healthy eating (4 questions analyzed as a scale) and unhealthy eating (3 questions analyzed individually), age, gender, race, and household income, reported via questionnaire.

ANALYSIS

Adjusted multiple linear regressions (α, P < .05).

RESULTS

Friend and parent support for healthy eating did not have statistically significant relationships with overall HEI scores. Youth who reported their parents offering high-fat foods or sweets more frequently had lower overall HEI scores (β = -1.65; SE = 0.52; 95% confidence interval, -2.66 to -0.63).

CONCLUSIONS AND IMPLICATIONS

These results are novel and demonstrate the need for additional studies examining support for unhealthy eating. These preliminary findings may be relevant to researchers as they develop family-based nutrition interventions.

Extreme Weight-Control Behaviors and Suicide Risk Among High School Students

BACKGROUND

Suicide is the third leading cause of death for people ages 15-19. Research has established an association across numerous risk factors and suicide, including depression, substance abuse, bullying victimization, and feelings of alienation. However, the connection between disordered eating as manifested in extreme weight-control behaviors (EWCB), and suicidal thoughts, ideation, and attempts among adolescents is less understood. Given the prevalence of adolescent suicide, this investigation examined associations between EWCB and suicide risk among high school students.

METHODS

Data were collected from a convenience sample of 4178 students in grades 9-12 attending 5 public high schools using the Youth Risk Behavior Survey (YRBS) questionnaire. Logistic regressions were used to estimate associations between EWCB and suicide controlling for grade level and race, reported separately by sex.

RESULTS

Students who reported seriously considering suicide had higher odds of exhibiting all 3 EWCBs [adjusted odds ratio (AOR)(male) = 3.0 (confidence interval (CI): 1.4, 6.5); AOR(female) = 4.5 (CI: 2.5, 8.3)]. Moreover, students who reported they made plans about suicide were also more likely to exhibit all EWCBs [AOR(male) = 3.7 (CI: 1.7, 7.9); AOR(female) = 4.2 (CI: 2.3, 7.7)].

CONCLUSIONS

EWCBs were significantly associated with suicide risk, furthering the evidence suggesting a link between disordered eating and suicide. Findings demonstrated the need for school health services that address disordered eating in the effort to reduce adolescent suicide.

'I saw Santa drinking soda!' Advertising and children's food preferences

BACKGROUND

The influence of advertising on children's food preferences is well documented in the research literature. In this study we aim to examine the ways in which food advertising propels children's consumer behaviour and to investigate how food advertising affects the frequency of unhealthy food consumption.

METHODS

Data were drawn from a sample of elementary school children in the region of Thessaly (Greece). Three scales were used to measure children's lifestyle patterns, food consumption frequencies, and their response to advertising. Univariate and inferential statistics were used to answer the research questions.

RESULTS

The analysis revealed that a significant proportion of children (47.4%) frequently consume unhealthy foods. Children who have little understanding of the persuasive intent of advertising rate advertised foods as healthier and more nutritious. The frequency of unhealthy food consumption is influenced by the entertaining dimension of advertising and the level of the motivational arousal after children's exposure to food advertisements.

CONCLUSIONS

Food advertising impels children's consumer behaviour through four different modes. First, advertising engenders expectations, which raise purchase motivation. Second, the purchase of advertised foods is accompanied by positive feelings (happiness, satisfaction). Third, the entertaining dimension of advertising generates pleasant mood, which positively predisposes the evaluation of advertised foods. Fourth, children do not always possess the ability to recognize the persuasive nature of advertising.

Eaten up by boredom: consuming food to escape awareness of the bored self

Research indicates that being bored affectively marks an appraised lack of meaning in the present situation and in life. We propose that state boredom increases eating in an attempt to distract from this experience, especially among people high in objective self-awareness. Three studies were conducted to investigate boredom’s effects on eating, both naturally occurring in a diary study and manipulated in two experiments. In Study 1, a week-long diary study showed that state boredom positively predicted calorie, fat, carbohydrate, and protein consumption. In Study 2, a high (vs. low) boredom task increased the desire to snack as opposed to eating something healthy, especially amongst those participants high in objective self-awareness. In addition, Study 3 demonstrated that among people high in objective self-awareness, high (vs. low) boredom increased the consumption of less healthy foods and the consumption of more exciting, healthy foods. However, this did not extend to unexciting, healthy food. Collectively, these novel findings signify the role of boredom in predicting maladaptive and adaptive eating behaviors as a function of the need to distant from the experience of boredom. Further, our results suggest that more exciting, healthy food serves as alternative to maladaptive consumption following boredom.