Problem behavior, victimization, and soda intake in high school students.

OBJECTIVE: To examine associations of problem behaviors and victimization with nondiet soda intake among a national sample of 16,188 US high school students. METHODS: We used the 2009 national Youth Risk Behavior Survey. The outcome measure was daily nondiet soda intake. RESULTS: Smoking, having any sex partners, not always wearing a seat belt, being bullied/threatened/injured on school property, and being physically hurt by their boyfriend/girlfriend were significantly associated with daily nondiet soda intake after adjustment for age, sex, race/ethnicity, and weight status. CONCLUSIONS: Our findings suggest a need to examine why nondiet soda intake is associated with these behaviors to understand potential mechanisms.

Behaviors and attitudes associated with low drinking water intake among US adults, Food Attitudes and Behaviors Survey, 2007.

INTRODUCTION: Water is vital for life, and plain water is a calorie-free option for hydration. Increasing consumption of drinking water is a strategy to reduce energy intake and lose or maintain weight; however, information on the characteristics of consumers who drink water is limited. Our objective was to describe the characteristics of people who have a low intake of drinking water and to determine associations between their behaviors and attitudes and their intake of water. METHODS: We analyzed data from a nationally representative sample of 3,397 US adults who participated in the National Cancer Institute's 2007 Food Attitudes and Behaviors Survey. Multivariable logistic regression was used to identify sociodemographic characteristics and health-related behaviors and attitudes associated with self-reported drinking water intake of less than 4 cups per day. RESULTS: Overall, 7% of adults reported no daily consumption of drinking water, 36% reported drinking 1 to 3 cups, 35% reported drinking 4 to 7 cups, and 22% reported drinking 8 cups or more. The likelihood of drinking less than 4 cups of water daily was significantly higher among participants aged 55 years or older than among those aged 18 to 34 (adjusted odds ratio [AOR], 1.3), among residents of the Northeast than among residents of the South (AOR, 1.4), among participants who consumed 1 cup or less of fruits or vegetables per day than among those who consumed 4.5 cups or more (AOR, 3.0), among participants who did not exercise than among those who exercised 150 minutes or more per week (AOR, 1.7), and among participants who were neither trying to gain nor lose weight than among those trying to lose weight (AOR, 1.3). CONCLUSION: Low drinking water intake was associated with age, region of residence, and several unhealthful behaviors and attitudes. Understanding characteristics associated with low drinking water intake may help to identify populations that could benefit from interventions to help adults drink more water.

Regular-soda intake independent of weight status is associated with asthma among US high school students.

Limited research shows an inconclusive association between soda intake and asthma, potentially attributable to certain preservatives in sodas. This cross-sectional study examined the association between regular (nondiet)-soda intake and current asthma among a nationally representative sample of high school students. Analysis was based on the 2009 national Youth Risk Behavior Survey and included 15,960 students (grades 9 through 12) with data for both regular-soda intake and current asthma status. The outcome measure was current asthma (ie, told by doctor/nurse that they had asthma and still have asthma). The main exposure variable was regular-soda intake (ie, drank a can/bottle/glass of soda during the 7 days before the survey). Multivariable logistic regression was used to estimate the adjusted odds ratios for regular-soda intake with current asthma after controlling for age, sex, race/ethnicity, weight status, and current cigarette use. Overall, 10.8% of students had current asthma. In addition, 9.7% of students who did not drink regular soda had current asthma, and 14.7% of students who drank regular soda three or more times per day had current asthma. Compared with those who did not drink regular soda, odds of having current asthma were higher among students who drank regular soda two times per day (adjusted odds ratio=1.28; 95% CI 1.02 to 1.62) and three or more times per day (adjusted odds ratio=1.64; 95% CI 1.25 to 2.16). The association between high regular-soda intake and current asthma suggests efforts to reduce regular-soda intake among youth might have benefits beyond improving diet quality. However, this association needs additional research, such as a longitudinal examination.

Factors associated with low water intake among US high school students - National Youth Physical Activity and Nutrition Study, 2010.

Drinking plain water instead of sugar-sweetened beverages is one approach for reducing energy intake. Only a few studies have examined characteristics associated with plain water intake among US youth. The purpose of our cross-sectional study was to examine associations of demographic characteristics, weight status, dietary habits, and other behavior-related factors with plain water intake among a nationally representative sample of US high school students. The 2010 National Youth Physical Activity and Nutrition Study data for 11,049 students in grades 9 through 12 were used. Multivariable logistic regression analysis was used to calculate adjusted odds ratios (ORs) and 95% CIs for variables associated with low water intake (<3 times/day). Nationwide, 54% of high school students reported drinking water <3 times/day. Variables significantly associated with a greater odds for low water intake were age ≤15 years (OR 1.1), consuming <2 glasses/day of milk (OR 1.5), nondiet soda ≥1 time/day (OR 1.6), other sugar-sweetened beverages ≥1 time/day (OR 1.4), fruits and 100% fruit juice <2 times/day (OR 1.7), vegetables <3 times/day (OR 2.3), eating at fast-food restaurants 1 to 2 days/week and ≥3 days/week (OR 1.3 and OR 1.4, respectively), and being physically active ≥60 minutes/day on <5 days/week (OR 1.6). Being obese was significantly associated with reduced odds for low water intake (OR 0.7). The findings of these significant associations of low water intake with poor diet quality, frequent fast-food restaurant use, and physical inactivity may be used to tailor intervention efforts to increase plain water intake as a substitute for sugar-sweetened beverages and to promote healthy lifestyles.

Self-reported academic grades and other correlates of sugar-sweetened soda intake among US adolescents.

High consumption of sugar-sweetened drinks has been associated with obesity and other adverse health consequences. This cross-sectional study examined the association of demographic characteristics, weight status, self-reported academic grades, and behavioral factors with sugar-sweetened soda intake among a nationally representative sample of US high school students. Analysis was based on the 2009 national Youth Risk Behavior Survey and included 16,188 students in grades 9 through 12. The main outcome measure was daily sugar-sweetened soda intake (eg, drank a can, bottle, or glass of soda [excluding diet soda] at least one time per day during the 7 days before the survey). Nationally, 29.2% of students reported drinking sugar-sweetened soda at least one time per day. Logistic regression analyses showed factors significantly associated with sugar-sweetened soda intake at least one time per day included male sex (adjusted odds ratio [OR]=1.47), Hispanic ethnicity (vs whites; OR=0.81), earning mostly B, C, and D/F grades (vs mostly As; OR=1.26, 1.66, and 2.19, respectively), eating vegetables fewer than three times per day (OR=0.72), trying to lose weight (OR=0.72), sleeping <8 hours (OR=1.18), watching television >2 hours/day (OR=1.71), playing video or computer games or using a computer for other than school work >2 hours/day (OR=1.53), being physically active at least 60 minutes/day on <5 days during the 7 days before the survey (OR=1.19), and current cigarette use (OR=2.01). The significant associations with poor self-reported academic grades, inadequate sleep, sedentary behaviors, and cigarette smoking suggest research should examine why soda consumption is associated with these behaviors to inform the design of future nutrition interventions.

Use of parks or playgrounds: reported access to drinking water fountains among US adults, 2009.

BACKGROUND: As a first step to determining the public availability of drinking water, self-reported access to water fountains in parks and playgrounds was examined. METHODS: A cross-sectional analysis was conducted on a convenience sample of 4163 US adults (aged ≥ 18 years) using the 2009 HealthStyles Survey. The outcome measure was reported access to water fountains in parks/playgrounds. Among those who reported using parks/playgrounds, multivariable logistic regression was used to examine the associations between sociodemographic variables and reported access to water fountains. RESULTS: About half (54.7%) of participants used parks/playgrounds. Among those, 55.0% reported access to water fountains. Factors significantly associated with reported access to water fountains were being male [odds ratio (OR) = 1.42; 95% confidence interval (CI) = 1.09, 1.85] and living in the Pacific region (versus East North Central region, OR = 2.56; 95% CI = 1.61, 4.06). Age, race/ethnicity, household income, marital status, education, smoking and physical activity were not significantly associated with reported access to water fountains. CONCLUSIONS: Among 54.7% of adults using parks/playgrounds, reported access to water fountains was significantly differed by sex and region. This study provides information that can be considered when developing interventions to increase access to drinking water in public facilities.

Factors associated with low drinking water intake among adolescents: the Florida Youth Physical Activity and Nutrition Survey, 2007.

There is limited information on which characteristics are associated with water intake among adolescents. This cross-sectional study examined the association between demographic, dietary, and behavioral factors and low water intake as the outcome measure. Analyses were based on the 2007 Florida Youth Physical Activity and Nutrition Survey using a representative sample of 4,292 students in grades six through eight in 86 Florida public middle schools. Multivariable logistic regression was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals for factors associated with low water intake (<3 glasses water per day). About 64% of students had low water intake. Factors significantly associated with low water intake were Hispanic ethnicity and non-Hispanic other (vs non-Hispanic white; ORs 0.79 and 0.76, respectively), drinking no 100% juice, drinking it <1 time/day, and drinking it 1 to 2 times/day (vs drinking it ≥3 times/day; ORs 1.83, 1.91, and 1.32, respectively), drinking no milk and drinking <2 glasses of milk/day (vs drinking ≥2 glasses/day; ORs 1.42 and 1.41, respectively), drinking <1 soda/day (vs drinking none; OR 1.40), drinking fruit-flavored drinks/sports drinks <1 time/day and drinking it ≥1 time/day (vs drinking none; ORs 1.49 and 1.41, respectively), eating at a fast-food restaurant ≥3 days/week (vs none; OR 1.38, respectively), not participating on team sports or participating on 1 to 2 team sports in previous 12 months (vs participating on ≥3 teams; ORs 1.77 and 1.24, respectively), and consuming snack/soda while watching television/movies "sometimes" and "most/every time" (vs never; ORs 1.65 and 2.20, respectively). The strongest factor associated with low water intake was frequent consumption of snacks/sodas while watching television/movies. Although study findings should be corroborated in other states and in a nationally representative sample, they may be useful in targeting adolescents for increased water consumption.

The impact of the availability of school vending machines on eating behavior during lunch: the Youth Physical Activity and Nutrition Survey.

Childhood obesity is a major public health concern and is associated with substantial morbidities. Access to less-healthy foods might facilitate dietary behaviors that contribute to obesity. However, less-healthy foods are usually available in school vending machines. This cross-sectional study examined the prevalence of students buying snacks or beverages from school vending machines instead of buying school lunch and predictors of this behavior. Analyses were based on the 2003 Florida Youth Physical Activity and Nutrition Survey using a representative sample of 4,322 students in grades six through eight in 73 Florida public middle schools. Analyses included χ2 tests and logistic regression. The outcome measure was buying a snack or beverage from vending machines 2 or more days during the previous 5 days instead of buying lunch. The survey response rate was 72%. Eighteen percent of respondents reported purchasing a snack or beverage from a vending machine 2 or more days during the previous 5 school days instead of buying school lunch. Although healthier options were available, the most commonly purchased vending machine items were chips, pretzels/crackers, candy bars, soda, and sport drinks. More students chose snacks or beverages instead of lunch in schools where beverage vending machines were also available than did students in schools where beverage vending machines were unavailable: 19% and 7%, respectively (P≤0.05). The strongest risk factor for buying snacks or beverages from vending machines instead of buying school lunch was availability of beverage vending machines in schools (adjusted odds ratio=3.5; 95% confidence interval, 2.2 to 5.7). Other statistically significant risk factors were smoking, non-Hispanic black race/ethnicity, Hispanic ethnicity, and older age. Although healthier choices were available, the most common choices were the less-healthy foods. Schools should consider developing policies to reduce the availability of less-healthy choices in vending machines and to reduce access to beverage vending machines.

The association between an objective measure of physical activity and weight status in preschoolers.

OBJECTIVE: Our objective was to determine the association between physical activity and BMI among racially diverse low-income preschoolers. RESEARCH METHODS AND PROCEDURES: This was a cross-sectional study of 2- to 5-year-olds (n = 56) enrolled in Massachusetts Special Supplemental Nutrition Program for Women, Infants & Children (WIC). Physical activity was measured for 7 consecutive days with an accelerometer. Height and weight were obtained from WIC records, and BMI-for-age percentiles were calculated based on the Centers for Disease Control and Prevention's (CDC) 2000 Growth Charts. At-risk-for-overweight (BMI-for-age of > or = 85th to < 95th percentile) and overweight (BMI-for-age > or = 95th percentile) groups were combined and referred to as overweight. Final analysis inclusion criteria were: completion of 4.5 days of activity assessment and anthropometric data obtained within 90 and 120 days of the activity assessment for children ages 24 to 35.99 and 36 to 59.99 months, respectively. RESULTS: Overweight children had significantly lower mean daily very vigorous minutes (VVM) (2.6 mins vs. 4.6 mins, p < 0.05) and lower very active minutes (VAM) [i.e., sum of vigorous minutes (VM) and VVM] per day (22.9 mins vs. 32.1 mins, p < 0.05) than children who were not overweight. Daily VVM [odds ratio (OR) = 0.68; 95% confidence interval (CI), 0.49 to 0.96], VM (OR = 0.94; CI, 0.88 to 1.00), and VAM (OR = 0.94; 95% CI, 0.89 to 1.00) were all associated with significantly lower odds of being overweight. DISCUSSION: This study suggests that, in a diverse group of preschoolers, vigorous and very vigorous activity are associated with lower odds of overweight. However, these findings require corroboration in a diverse sample of preschoolers using a longitudinal design.

Parent-child feeding strategies and their relationships to child eating and weight status.

Parental feeding styles may promote overeating or overweight in children. A comprehensive literature review was undertaken to summarize the associations between parental feeding styles and child eating and weight status. Twenty-two studies were identified. We systematically coded study attributes and outcomes and tested for patterns of association. Nineteen studies (86%) reported at least one significant association between parental feeding style and child outcome, although study methodology and results varied considerably. Studies measuring parental feeding restriction, as opposed to general feeding control or another feeding domain, were more likely to report positive associations with child eating and weight status. Certain associations differed by gender and by outcome measurement (e.g., rate of eating as opposed to total energy intake). Parental feeding restriction, but no other feeding domain, was associated with increased child eating and weight status. Longitudinal studies are needed to test underlying causal pathways, including bidirectional causal models, and to substantiate findings in the presence of other obesity risk factors.