Land of milk and honey
Intercontinental differences in overweight of adopted Koreans in the United States and Europe
Stanley Ulijaszek & Daniel Schwekendiek
Economics & Human Biology, forthcoming
Abstract:
A greater proportion of the United States (US) population is overweight or obese (with BMI over 25 kg/m2) relative to all Western European populations, and it might be expected that migrants to either the US or Western Europe would develop patterns of overweight and obesity that reflect this difference. This paper examines the effects of obesogenic environments on Asians by reporting differences in rates of overweight (which is taken to include obesity in this analysis) among 261 adult South Koreans which had been adopted in early-life into white middle class families living in the US and in Western European nations. Data collected during an international adoption survey carried out for the Korean government in 2008 were analysed. The prevalence of overweight of adopted Koreans raised in the US significantly exceeds the level among adopted Koreans in Europe by 11.3 percent. These intercontinental differences are statistically significant after controlling for sex, current age, age of adoption, and education. This paper supports the view that life-style factors are more detrimental for the weight status of people in the US than in Western Europe.
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Grocery Store Beverage Choices by Participants in Federal Food Assistance and Nutrition Programs
Tatiana Andreyeva et al.
American Journal of Preventive Medicine, October 2012, Pages 411-418
Background: Sugar-sweetened beverages are a target for reduction in the 2010 Dietary Guidelines for Americans. Concerns have been raised about sugar-sweetened beverages purchased with Supplemental Nutrition Assistance Program (SNAP) benefits.
Purpose: This paper describes purchases of non-alcoholic refreshment beverages among participants in the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and SNAP.
Methods: Grocery store scanner data from a regional supermarket chain were used to assess refreshment beverage purchases of 39,172 households in January-June 2011. The sample consisted of families with a history of WIC participation in 2009-2011; about half also participated in SNAP. Beverage spending and volume purchased were compared for WIC sampled households either using SNAP benefits (SNAP) or not (WIC-only). Analyses were completed in 2012.
Results: Refreshment beverages were a significant contributor to expenditure on groceries by SNAP and WIC households. Sugar-sweetened beverages accounted for 58% of refreshment beverage purchases made by SNAP households and 48% of purchases by WIC-only households. Soft drinks were purchased most by all households. Fruit-based beverages were mainly 100% juice for WIC-only households and sugary fruit drinks for SNAP households. SNAP benefits paid for 72% of the sugar-sweetened beverage purchases made by SNAP households. Nationwide, SNAP was estimated to pay at least $1.7 to $2.1 billion annually for sugar-sweetened beverages purchased in grocery stores.
Conclusions: Considerable amounts of sugar-sweetened beverages are purchased by households participating in WIC and SNAP. The SNAP program pays for most of the sugar-sweetened beverage purchases among SNAP households. The upcoming SNAP reauthorization could be a good time to reconsider the program priorities to align public funds with public health.
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Robert Wescott, Brendan Fitzpatrick & Elizabeth Phillips
American Journal of Public Health, October 2012, Pages 1928-1935
Objectives: We developed a data collection and monitoring system to independently evaluate the self-regulatory effort to reduce the number of beverage calories available to children during the regular and extended school day. We have described the data collection procedures used to verify data supplied by the beverage industry and quantified changes in school beverage shipments.
Methods: Using a proprietary industry data set collected in 2005 and semiannually in 2007 through 2010, we measured the total volume of beverage shipments to elementary, middle, and high schools to monitor intertemporal changes in beverage volumes, the composition of products delivered to schools, and portion sizes. We compared data with findings from existing research of the school beverage landscape and a separate data set based on contracts between schools and beverage bottling companies.
Results: Between 2004 and the 2009-2010 school year, the beverage industry reduced calories shipped to schools by 90%. On a total ounces basis, shipments of full-calorie soft drinks to schools decreased by 97%.
Conclusions: Industry self-regulation, with the assistance of a transparent and independent monitoring process, can be a valuable tool in improving public health outcomes.
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Is Psychological Well-being Linked to the Consumption of Fruit and Vegetables?
David Blanchflower, Andrew Oswald & Sarah Stewart-Brown
Social Indicators Research, forthcoming
Abstract:
Humans run on a fuel called food. Yet economists and other social scientists rarely study what people eat. We provide simple evidence consistent with the existence of a link between the consumption of fruit and vegetables and high well-being. In cross-sectional data, happiness and mental health rise in an approximately dose-response way with the number of daily portions of fruit and vegetables. The pattern is remarkably robust to adjustment for a large number of other demographic, social and economic variables. Well-being peaks at approximately 7 portions per day. We document this relationship in three data sets, covering approximately 80,000 randomly selected British individuals, and for seven measures of well-being (life satisfaction, WEMWBS mental well-being, GHQ mental disorders, self-reported health, happiness, nervousness, and feeling low). Reverse causality and problems of confounding remain possible. We discuss the strengths and weaknesses of our analysis, how government policy-makers might wish to react to it, and what kinds of further research -- especially randomized trials -- would be valuable.
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Does Legal Heritage Affect Obesity? The Channel of Motor Vehicle Dependence
Paul Carlin, Michael Kidd & Mehmet Ulubaşoğlu
Journal of Comparative Economics, forthcoming
Abstract:
We find a robust relationship between motor vehicle ownership, its interaction with legal heritage and obesity in OECD countries. Our estimates indicate that an increase of 100 motor vehicles per thousand residents is associated with about a six percentage point increase in obesity in common law countries, whereas it has a much smaller or insignificant impact in civil law countries. These relations hold whether we examine trend data and simple correlations, or conduct cross-section or panel data regression analysis. Our results suggest that obesity rises with motor vehicle ownership in countries following a common law tradition where individual liberty is encouraged, whereas the link is small or statistically non-existent in countries with a civil law background where the rights of the individual tend to be circumscribed by the power of the state.
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Janet Tomiyama et al.
Annals of Behavioral Medicine, forthcoming
Background: One of the largest health disparities in the USA is in obesity rates between Black and White females.
Purpose: The objective of this study was to test the hypothesis that the stress-obesity link is stronger in Black females than in White females aged 10-19.
Methods: Multilevel modeling captured the dynamic of acute (1 month) and chronic (10 years) stress and body mass index (BMI; weight in kilograms divided by height in meters squared) change in the National Heart, Lung, and Blood Institute Growth and Health Study, which consists of 2,379 Black and White girls across a span of socioeconomic status. The girls were assessed longitudinally from ages 10 to 19.
Results: Higher levels of stress during the 10 years predicted significantly greater increases in BMI over time compared to lower levels of stress. This relationship was significantly stronger for Black compared to White girls.
Conclusion: Psychological stress is a modifiable risk factor that may moderate early racial disparities in BMI.
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Christie Befort, Niaman Nazir & Michael Perri
Journal of Rural Health, forthcoming
Purpose: Rural residents have higher rates of chronic diseases compared to their urban counterparts, and obesity may be a major contributor to this disparity. This study is the first analysis of obesity prevalence in rural and urban adults using body mass index classification with measured height and weight. In addition, demographic, diet, and physical activity correlates of obesity across rural and urban residence are examined.
Methods: Analysis of body mass index (BMI), diet, and physical activity from 7,325 urban and 1,490 rural adults in the 2005-2008 National Health and Nutrition Examination Survey (NHANES).
Findings: The obesity prevalence was 39.6% (SE = 1.5) among rural adults compared to 33.4% (SE = 1.1) among urban adults (P= .006). Prevalence of obesity remained significantly higher among rural compared to urban adults controlling for demographic, diet, and physical activity variables (odds ratio = 1.18, P= .03). Race/ethnicity and percent kcal from fat were significant correlates of obesity among both rural and urban adults. Being married was associated with obesity only among rural residents, whereas older age, less education, and being inactive was associated with obesity only among urban residents.
Conclusions: Obesity is markedly higher among adults from rural versus urban areas of the United States, with estimates that are much higher than the rates suggested by studies with self-reported data. Obesity deserves greater attention in rural America.
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Morbid obesity rates continue to rise rapidly in the United States
R. Sturm & A. Hattori
International Journal of Obesity, forthcoming
Abstract:
Clinically severe or morbid obesity (body mass index (BMI) >40 or 50 kg m-2) entails far more serious health consequences than moderate obesity for patients, and creates additional challenges for providers. The paper provides time trends for extreme weight categories (BMI >40 and >50 kg m-2) until 2010, using data from the Behavioral Risk Factor Surveillance System. Between 2000 and 2010, the prevalence of a BMI >40 kg m-2 (type III obesity), calculated from self-reported height and weight, increased by 70%, whereas the prevalence of BMI >50 kg m-2 increased even faster. Although the BMI rates at every point in time are higher among Hispanics and Blacks, there were no significant differences in trends between them and non-Hispanic Whites. The growth rate appears to have slowed down since 2005. Adjusting for self-report biases, we estimate that in 2010 15.5 million adult Americans or 6.6% of the population had an actual BMI >40 kg m-2. The prevalence of clinically severe obesity continues to be increasing, although less rapidly in more recent years than prior to 2005.
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Margaret Weden, Peter Brownell & Michael Rendall
American Journal of Public Health, November 2012, Pages 2057-2067
Objectives: We investigated early childhood disparities in high body mass index (BMI) between Black and White US children.
Methods: We compared differences in Black and White children's prevalence of sociodemographic, prenatal, perinatal, and early life risk and protective factors; fit logistic regression models predicting high BMI (≥ 95th percentile) at age 4 to 5 years to 2 nationally representative samples followed from birth; and performed separate and pooled-survey estimations of these models.
Results: After adjustment for sample design-related variables, models predicting high BMI in the 2 samples were statistically indistinguishable. In the pooled-survey models, Black children's odds of high BMI were 59% higher than White children's (odds ratio [OR] = 1.59; 95% confidence interval [CI]= 1.32, 1.92). Sociodemographic predictors reduced the racial disparity to 46% (OR = 1.46; 95% CI = 1.17, 1.81). Prenatal, perinatal, and early life predictors reduced the disparity to nonsignificance (OR = 1.18; 95% CI = 0.93, 1.49). Maternal prepregnancy obesity and short-duration or no breastfeeding were among predictors for which racial differences in children's exposures most disadvantaged Black children.
Conclusions: Racial disparities in early childhood high BMI were largely explained by potentially modifiable risk and protective factors.
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A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight
Cara Ebbeling et al.
New England Journal of Medicine, 11 October 2012, Pages 1407-1416
Background: Consumption of sugar-sweetened beverages may cause excessive weight gain. We aimed to assess the effect on weight gain of an intervention that included the provision of noncaloric beverages at home for overweight and obese adolescents.
Methods: We randomly assigned 224 overweight and obese adolescents who regularly consumed sugar-sweetened beverages to experimental and control groups. The experimental group received a 1-year intervention designed to decrease consumption of sugar-sweetened beverages, with follow-up for an additional year without intervention. We hypothesized that the experimental group would gain weight at a slower rate than the control group.
Results: Retention rates were 97% at 1 year and 93% at 2 years. Reported consumption of sugar-sweetened beverages was similar at baseline in the experimental and control groups (1.7 servings per day), declined to nearly 0 in the experimental group at 1 year, and remained lower in the experimental group than in the control group at 2 years. The primary outcome, the change in mean body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) at 2 years, did not differ significantly between the two groups (change in experimental group minus change in control group, -0.3; P=0.46). At 1 year, however, there were significant between-group differences for changes in BMI (-0.57, P=0.045) and weight (-1.9 kg, P=0.04). We found evidence of effect modification according to ethnic group at 1 year (P=0.04) and 2 years (P=0.01). In a prespecified analysis according to ethnic group, among Hispanic participants (27 in the experimental group and 19 in the control group), there was a significant between-group difference in the change in BMI at 1 year (-1.79, P=0.007) and 2 years (-2.35, P=0.01), but not among non-Hispanic participants (P>0.35 at years 1 and 2). The change in body fat as a percentage of total weight did not differ significantly between groups at 2 years (-0.5%, P=0.40). There were no adverse events related to study participation.
Conclusions: Among overweight and obese adolescents, the increase in BMI was smaller in the experimental group than in the control group after a 1-year intervention designed to reduce consumption of sugar-sweetened beverages, but not at the 2-year follow-up (the prespecified primary outcome).
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Body Size at Birth Is Associated with Food and Nutrient Intake in Adulthood
Mia-Maria Perälä et al.
PLoS ONE, September 2012
Background: Small body size at birth is associated with an increased risk of cardiovascular disease and type 2 diabetes. Dietary habits are tightly linked with these disorders, but the association between body size at birth and adult diet has been little studied. We examined the association between body size at birth and intake of foods and macronutrients in adulthood.
Methodology/Principal Findings: We studied 1797 participants, aged 56 to 70, of the Helsinki Birth Cohort Study, whose birth weight and length were recorded. Preterm births were excluded. During a clinical study, diet was assessed with a validated food-frequency questionnaire. A linear regression model adjusted for potential confounders was used to assess the associations. Intake of fruits and berries was 13.26 g (95% confidence interval [CI]: 0.56, 25.96) higher per 1 kg/m3 increase in ponderal index (PI) at birth, and 83.16 g (95% CI: 17.76, 148.56) higher per 1 kg higher birth weight. One unit higher PI at birth was associated with 0.14% of energy (E%) lower intake of fat (95% CI: -0.26, -0.03) and 0.18 E% higher intake of carbohydrates (95% CI: 0.04, 0.32) as well as 0.08 E% higher sucrose (95% CI: 0.00, 0.15), 0.05 E% higher fructose (95% CI: 0.01, 0.09), and 0.18 g higher fiber (95% CI: 0.02, 0.34) intake in adulthood. Similar associations were observed between birth weight and macronutrient intake.
Conclusions: Prenatal growth may modify later life food and macronutrient intake. Altered dietary habits could potentially explain an increased risk of chronic disease in individuals born with small body size.
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Ann Forsyth et al.
Health & Place, November 2012, Pages 1261-1269
Abstract:
This population-based study examined whether residential or school neighborhood access to fast food restaurants is related to adolescents' eating frequency of fast food. A classroom-based survey of racially/ethnically diverse adolescents (n=2,724) in 20 secondary schools in Minneapolis/St. Paul, Minnesota was used to assess eating frequency at five types of fast food restaurants. Black, Hispanic, and Native American adolescents lived near more fast food restaurants than white and Asian adolescents and also ate at fast food restaurants more often. After controlling for individual-level socio-demographics, adolescent males living near high numbers of fast food restaurants ate more frequently from these venues compared to their peers.
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Jessica Soldavini, Patricia Crawford & Lorrene Ritchie
Journal of Nutrition Education and Behavior, forthcoming
Objective: To determine whether children perceive food with nutrition claims as healthier and tasting differently than those without claims.
Methods: Fourth- and fifth-graders (n = 47) from 3 California schools participated. Two identical products (cookies, crackers, or juice) were placed in front of product packages, 1 with a nutrition claim, the other without. Each child was asked which product was healthier and which tasted better.
Results: The percentage of children who identified the reduced-fat cookie, whole-grain cracker, or 100% juice as healthier was 81%, 83% and 81%, respectively. The taste of the "healthier" product (ie, with nutrition claim) was preferred by 72%, 67%, and 54%, respectively.
Conclusions and Implications: A convenience sample of children perceived products with a nutrition claim as healthier and identified the "healthier" cookies and crackers as tasting better. Future research should examine whether food labeling can be used to encourage children to consume healthier diets.
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Tanja Kral et al.
American Journal of Clinical Nutrition, September 2012, Pages 574-583
Background: An impaired ability to compensate for calories and increased eating in the absence of hunger (EAH) has been associated with increased energy intake and weight gain in unrelated children.
Objective: The aims of this study were to compare caloric compensation [the percentage compensation index (%COMPX)] and EAH in weight-discordant siblings aged 5-12 y.
Design: In a crossover, behavioral genetics design, 47 same-sex sibling pairs (53% female, 55% full siblings) were served dinner once a week for 3 wk. Across conditions, siblings were served the same dinner, but 25 min before dinner, they either consumed in full or did not consume 1 of 2 preloads that varied in energy density (ED; 0.57 or 0.97 kcal/g). On the day when no preload was consumed, EAH was assessed after dinner and defined as the number of calories consumed from snacks.
Results: Overweight/obese siblings undercompensated [%COMPX: -48.8 ± 56.3 (mean ± SEM)] and therefore overate after the high-ED preload, whereas normal-weight siblings showed accurate compensation (%COMPX: 101.3 ± 51.9; P = 0.03). Furthermore, overweight/obese siblings consumed 34% more calories (93 kcal) in the absence of hunger than did normal-weight siblings (P = 0.01). Within-pair resemblances for %COMPX and EAH were stronger for full siblings (P < 0.049) than for half siblings (P > 0.23).
Conclusions: An impaired ability to regulate short-term energy intake, which includes incomplete adjustment for calorie differences in a preload and eating when satiated, may represent a behavioral phenotype for obesity in children. Future studies should test whether teaching children to focus on internal satiety cues may prevent at-risk children from overeating.
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Mariane Héroux et al.
Health & Place, November 2012, Pages 1240-1247
Abstract:
This study examined the relation between the chain food retail environment surrounding schools, youths' lunchtime eating behavior, and youths' obesity levels across three countries. Participants consisted of 26,778 students 13-15 years old from 687 schools across Canada, Scotland and the US. The density of convenience stores, chain fast food restaurants, and chain cafés within 1 km of each school was measured. Lunchtime eating behaviors, weight, and height were self-reported. Although the density of chain food retailers was highest in the US, fewer American students (2.6%) routinely ate their lunch at a food retailer during the school week than did Canadian (7.7%) and Scottish (43.7%) students. The density of chain food retailers was associated with eating lunch at a food retailer in Canada only whereby students attending schools with 1-2, 3-4, and 5+ chain food retailers within 1 km from their schools were 1.39 (95% CI: 0.84-2.29), 1.87 (95% CI: 1.10-3.20), and 2.50 (95% CI: 1.56-4.01) times more likely to eat at a chain food retailer compared to students attending schools with no nearby chain food retailers. No associations were found between chain food retailer density and obesity.
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FTO genotype is associated with phenotypic variability of body mass index
Jian Yang et al.
Nature, 11 October 2012, Pages 267-272
Abstract:
There is evidence across several species for genetic control of phenotypic variation of complex traits, such that the variance among phenotypes is genotype dependent. Understanding genetic control of variability is important in evolutionary biology, agricultural selection programmes and human medicine, yet for complex traits, no individual genetic variants associated with variance, as opposed to the mean, have been identified. Here we perform a meta-analysis of genome-wide association studies of phenotypic variation using ~170,000 samples on height and body mass index (BMI) in human populations. We report evidence that the single nucleotide polymorphism (SNP) rs7202116 at the FTO gene locus, which is known to be associated with obesity (as measured by mean BMI for each rs7202116 genotype), is also associated with phenotypic variability. We show that the results are not due to scale effects or other artefacts, and find no other experiment-wise significant evidence for effects on variability, either at loci other than FTO for BMI or at any locus for height. The difference in variance for BMI among individuals with opposite homozygous genotypes at the FTO locus is approximately 7%, corresponding to a difference of ~0.5 kilograms in the standard deviation of weight. Our results indicate that genetic variants can be discovered that are associated with variability, and that between-person variability in obesity can partly be explained by the genotype at the FTO locus. The results are consistent with reported FTO by environment interactions for BMI, possibly mediated by DNA methylation. Our BMI results for other SNPs and our height results for all SNPs suggest that most genetic variants, including those that influence mean height or mean BMI, are not associated with phenotypic variance, or that their effects on variability are too small to detect even with samples sizes greater than 100,000.