The immediate effect of discrimination on mental health: A meta-analytic review of the causal evidence.

This meta-analysis synthesizes experimental studies on the immediate effects of discrimination on mental health, exploring the effects of different paradigms and discrimination types on diverse facets of mental health. We analyzed data from a systematic literature search (73 studies; 12,097 participants; 245 effect sizes) for randomized controlled trials with manipulation of discrimination as a predictor and mental health as an outcome using a three-level random-effects model. Experimentally manipulated discrimination led to poorer mental health (g = -0.30), also after controlling for publication year, region, education level, and methodological quality. Moderator analyses revealed stronger effects for pervasive (g = -0.55) compared to single-event manipulations (g = -0.25) and a trend toward weaker effects for samples with nonmarginalized (g = -0.16) compared to marginalized identities (g = -0.34). Gender and age did not moderate the effect. Discrimination had the largest effects on externalizing (g = -0.66) and distress-related outcomes (g = -0.41); heterosexism (g = -0.66), racism (g = -0.32), and sexism (g = -0.30) had the largest effects on mental health. Convenience sampling compromised generalizability to subgroups and the general population, downgrading methodological quality for all included studies. When interpreting the findings, selective samples (mostly young female adults with higher education), often limited ecological validity, and ethical restrictions of lab-induced discrimination need to be considered. These constraints likely led to conservative estimates of the mental health effects of discrimination in this meta-analysis. Future research should investigate more diverse samples, further explain the heterogeneity of findings, and explore protective factors of the effects of discrimination on mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effect of Longer Family Meals on Children's Fruit and Vegetable Intake: A Randomized Clinical Trial.

Importance: Family meals are a formative learning environment that shapes children's food choices and preferences. As such, they are an ideal setting for efforts to improve children's nutritional health. Objective: To examine the effect of extending the duration of family meals on the fruit and vegetable intake in children. Design, Setting, and Participants: This randomized clinical trial used a within-dyad manipulation design and was conducted from November 8, 2016, to May 5, 2017, in a family meal laboratory in Berlin, Germany. Included in the trial were children aged 6 to 11 years who did not follow a special diet or have food allergies and adult parents who served as the nutritional gatekeeper in the household (ie, the family member responsible for at least half of the food planning and preparation). All participants underwent 2 conditions: control, defined as regular family mealtime duration, and intervention, defined as 50% longer mealtime duration (10 minutes longer on average). Participants were randomized to the condition they would complete first. Statistical analyses of the full sample were conducted between June 2 and October 30, 2022. Interventions: Participants had 2 free evening meals under different conditions. In the control or regular condition, each dyad ate in the same amount of time as their reported regular mealtime duration. In the intervention or longer condition, each dyad had 50% more time to eat than their reported regular mealtime duration. Main Outcomes and Measures: The primary outcome was the number of pieces of fruits and vegetables eaten by the child during a meal. Results: A total of 50 parent-child dyads participated in the trial. Parents had a mean (range) age of 43 (28-55 years) years and were predominantly mothers (36 [72%]). Children had a mean (range) age of 8 (6-11) years and included an equal number of girls and boys (25 [50%]). Children ate significantly more pieces of fruits (t49 = 2.36, P = .01; mean difference [MD], 3.32 [95% CI, 0.96 to ∞]; Cohen d = 0.33) and vegetables (t49 = 3.66, P < .001; MD, 4.05 [95% CI, 2.19 to ∞]; Cohen d = 0.52) in the longer condition than in the regular mealtime duration condition. Consumption of bread and cold cuts did not significantly differ between conditions. The children's eating rate (bites per minute over the regular mealtime duration) was significantly lower in the longer than in the regular condition (t49 = -7.60, P < .001; MD, -0.72 [95% CI, -0.56 to ∞]; Cohen d = 1.08). Children reported significantly higher satiety after the longer condition (V = 36.5, P < .001). Conclusions and Relevance: Results of this randomized clinical trial suggest that the simple, low-threshold intervention of increasing family mealtime duration by approximately 10 minutes can improve the quality of children's diet and eating behavior. The findings underscore the potential for such an intervention to improve public health. Trial Registration: ClinicalTrials.gov Identifier: NCT03127579.

Deliberate ignorance-a barrier for information interventions targeting reduced meat consumption?

OBJECTIVE: Despite abundant information about negative consequences of consuming meat, consumption in many Western countries is many times higher than recommended. One possible explanation for this discrepancy is that people consciously decide to ignore such information-a phenomenon called deliberate ignorance. We investigated this potential barrier for information interventions aiming to reduce meat consumption. METHODS: In three studies, a total of 1133 participants had the opportunity to see 18 information chunks on negative consequences of meat consumption or to ignore part of the information. Deliberate ignorance was measured as the number of ignored information chunks. We assessed potential predictors and outcomes of deliberate ignorance. Interventions to reduce deliberate ignorance (i.e., self-affirmation, contemplation, and self-efficacy) were experimentally tested. RESULTS: The more information participants ignored, the less they changed their intention to reduce their meat consumption (r = -.124). This effect was partially explained by cognitive dissonance induced by the presented information. While neither self-affirmation nor contemplation exercises reduced deliberate ignorance, self-efficacy exercises did. CONCLUSION: Deliberate ignorance is a potential barrier for information interventions aiming to reduce meat consumption and needs to be considered in future interventions and research. Self-efficacy exercises are a promising approach to reduce deliberate ignorance and should be further explored.

Education- and income-related differences in processed meat consumption across Europe: The role of food-related attitudes.

PURPOSE: Dietary behaviors differ between socio-economic groups and are one key determinant of health inequalities. Psychological factors such as attitudes are assumed to underlie the relation between inequality and dietary behaviors, but this assumption has rarely been tested empirically. We focus on a specific food group shown as detrimental to health: processed meat. METHODS: In two representative international surveys (Survey 1: N = 10,226 participants from nine European countries - Austria, France, Germany, Italy, Netherlands, Poland, Russia, Spain, UK; Survey 2: N = 9149 participants from the same countries, except not including Austria and the Netherlands), participants reported inequality indicators (education, income), processed meat consumption as well as their attitudes toward nutrition and food. PRINCIPAL RESULTS: There were diverging relationships between indicators of inequality and processed meat consumption: the higher the educational attainment, the lower the consumption of processed meat (rSurvey1 = -0.062, p < .001; rSurvey2 = -0.071, p < .001). At the same time, higher income was related to higher processed meat consumption (rSurvey1 = 0.088, p < .001; rSurvey2 = 0.152, p < .001). A path model showed that four of seven attitude factors mediated the relation between education and processed meat consumption (i.e., indifference toward nutrition and food, preference for regional and fresh food, processed food consumption, health efforts); none of the attitude factors mediated the relation between income and overall processed meat consumption. CONCLUSIONS: Processed meats are consumed very frequently across European countries. The relation between inequality and processed meat consumption is heterogeneous and partially mediated by attitudes. More research is needed to better understand how psychological factors explain social inequality in nutrition behaviors and health in general.

How eating-related social media postings influence healthy eating in senders and network members: Two field experiments with intensive longitudinal data.

Young adults are frequently confronted with eating-related social media content. How such exposure influences eating in those who post and their network members is largely unknown. We conducted two intensive longitudinal field experiments combining self-reports with social media data. The posting behavior of young adults was manipulated. We examined how postings about fruit and vegetables affected intake in senders and their network members (Study 1, N = 81) and in senders with a change goal (Study 2, N = 128). Potential mechanisms of action were explored. Descriptively, posting led to a stronger increase of senders' and network members' intake, but this increase was not statistically significant. Posting led to higher perceived social support and injunctive norms of senders (Study 1). Posting supported eating behavior change; the effect size was comparable to picture-based self-monitoring of intake (Study 2). Intraindividual variations in senders' daily eating-related social media activities were associated with daily eating behavior and perceived social support (both studies), daily self-efficacy, experiential and instrumental attitudes, and goal commitment (Study 2). Our studies underline that social media environments should be considered in research and interventions targeting eating behavior of young adults.

Socioeconomic differences in animal food consumption: Education rather than income makes a difference.

Background/aims: Evidence points toward more sustainable and health-conscious dietary behaviors among individuals with higher socioeconomic status. However, these differences vary considerably depending on which indicator of socioeconomic status is examined. Here, we present a systematic parallel investigation of multiple indicators of socioeconomic status as predictors of animal food consumption frequency and selected food-related behaviors in Germany. Methods: Data from the German subsample of two large representative European consumer studies (Study 1 n = 1,954; Study 2 n = 2,045) was used. We assessed the associations between the socioeconomic indicators income, current occupation as well as education and consumption frequency of animal foods and selected food-related behaviors in separate ordinal logistic regressions. Results: Individuals with higher educational attainment engaged in more sustainable and health-conscious dietary behaviors, indicated by significant associations between educational attainment and the consumption frequency of animal foods. Low- and middle-income participants consumed processed meat more frequently (Study 1 only; medium income: OR 1.5, CI 1.09-2.05, p = 0.012; low income: OR 1.43, CI 1.01-2.05, p = 0.047) and fish less frequently (Study 2 only; medium income: OR 0.76, CI 0.59-0.97, p = 0.026; low income: OR 0.061, CI 0.46-0.82, p < 0.001) than participants with high income. Current occupation did not predict the consumption of animal foods or food-related behaviors. Intake frequency of animal-based foods indicates that most participants exceeded national dietary recommendations for meat and processed meat and remained below recommendations for fish and dairy/eggs intake. Conclusion: Educational attainment appears to be the strongest and most consistent socioeconomic indicator of sustainable dietary choices in Germany based on current large, representative studies. Future efforts should be directed toward education interventions about nutrition and interpretation of food labels to compensate for differences in dietary behavior among groups with different levels of education.

A theory-based video intervention to enhance communication and engagement in online health communities: two experiments.

BACKGROUND: Online communities and social networking sites have great potential for supporting health behavior change. However, interventions vary greatly in participants' engagement rates and, consequently, their effectiveness. Theory-based interventions in real-world contexts are needed to further increase engagement and effectiveness. METHODS: We experimentally tested whether a video intervention teaching Self-Determination-Theory-based communication strategies increases need-supportive communication strategy use over one week (Study 1, N = 76) and perceived need support, engagement, and goal attainment in a behavior change intervention supported by a forum-based online community (Study 2, N = 537). In Study 2, participants chose a goal (increasing either fruit or vegetable consumption or increasing moderate or vigorous physical activity) and joined an online community for 2 weeks. Data from both experiments were analyzed with mixed models and follow-up tests. RESULTS: In Study 1, participants in the intervention but not in the control group showed an increase in the number of need-supportive communication strategies used both immediately and one week after the intervention (condition × time interaction, partial η 2 = 0.31). In Study 2, participants who watched the intervention video had a higher number of postings and reported a higher subjective forum use frequency (but not a higher number of logins) compared to participants who watched the control video. However, the effect on the subjective forum visit frequency was not robust. There were no intervention effects on perceived need support, goal attainment, or secondary outcomes. The results might be explained by low application of need-supportive communication strategies. CONCLUSION: A brief video intervention may be a suitable, low-cost intervention to promote need-supportive communication strategy use, benefitting both engagement and behavior change. Future studies should incorporate additional means to further improve communication strategy uptake and engagement in online communities.

Nudging and boosting children's restaurant menus for healthier food choice: a blinded quasi-randomized controlled trial in a real life setting.

BACKGROUND: Restaurants are ideal settings for implementing food interventions targeted at children. Studies with adults suggest that changes to the physical menu can lead to healthier food choices; online studies with parents indicate that specific menu designs facilitate healthier choices. However, it is unknown whether applying well-established nudging and boosting methods to children's menus also increases their choice of healthier meals in a real-world restaurant setting. METHODS: The effects of two versions of a restaurant menu on the frequency of choosing a healthy meal (newly created, healthy target dish) were tested in a blinded quasi-randomized controlled trial. The menu in the control condition contained all dishes (including the healthy target dish) in a standardized format. The intervention menu included nudging (e.g. comic character, fun attractive name for the dish) and boosting elements (e.g. information on low calorie density) next to the healthy target dish. Over five months, the control and intervention menus were switched every two weeks and records were made of how often the healthy target dish was ordered. RESULTS: In total, 607 orders were made from the children's restaurant menu (57% from the intervention menu). During the intervention phase, 4.2% of all ordered dishes from the children's menu were the healthy target dish, during the control phase, 4.4% of orders were for the target dish (p=.896). CONCLUSIONS: Contrary to our hypothesis, a modified children's menu did not lead to a significant increase in the number of orders for a healthy dish compared with a neutral control menu. Importantly, given that parents and children often choose the child's dish together, particularly boosting methods that focus on social processes and joint decision making could be promising to increase children's frequency of healthy food choices in restaurants. TRIAL REGISTRATION: DRKS00027039 , registered on 11/22/2021, (Retrospectively registered).

Happy and healthy: How family mealtime routines relate to child nutritional health.

Children eat most of their meals in a family context, making family meals a key environment in which to learn about healthy food. What makes a family meal "healthy"? This diary study examined the practice of seven family mealtime routines (e.g., positive mealtime atmosphere, parental modeling, and longer meal duration) and their predictive value for children's healthier nutrition focusing on everyday family meal settings. Over 7 consecutive days, parents from N = 310 families (Mage = 42 years) described their most important family meal of the day and food intake for an index child (Mage = 9 years) and indicated what mealtime routines were practiced during the family meal. On average, each parent responded to 5.6 (SD = 1.4) of seven daily surveys. Mean correlations between mealtime routines were small (rs between -0.14 and 0.25), suggesting independent and distinct routines. Creating a positive atmosphere and turning TV and smartphones off were reported most often (on average, 91.2% and 90.5%, respectively). Parent's fruit and vegetable intake and creating a positive mealtime atmosphere were the strongest predictors for children's higher nutritional quality (i.e., higher vegetable and fruit intake; ps < .001). Findings indicate that mealtime routines obtained from independent meta-analyses represent distinct routines. Families practiced these independent and distinct routines to different degrees. Parental modeling and a positive mealtime atmosphere were most predictive of healthier child nutrition in daily family meal settings. More experimental research is needed to better understand causality and provide a better basis for effective interventions.

Health behaviors and mental health during the COVID-19 pandemic: A longitudinal population-based survey in Germany.

OBJECTIVE: To understand the mental health response to repeated and prolonged stress during the COVID-19 related lockdown and the role of specific health behaviors to buffer against this stress. METHODS: In a longitudinal study with several measurement points covering three months during the COVID-19 pandemic, about 3500 randomly selected participants representative of the German population reported on their mental health (anxiety, depression, loneliness) and health behaviors (screen time, snack consumption, physical activity). RESULTS: Symptoms of anxiety, depression, and loneliness were highest shortly after the lockdown came into effect. Over time, the symptoms were stable or went down slightly, corresponding to patterns of habituation. Among people with higher vulnerability to poor mental health during the lockdown (e.g., women), the proportion with high levels of anxiety, depression, and loneliness was considerably larger. These groups also reported fewer health-promoting behaviors. More screen time, more snacking, and less physical activity were related to higher symptoms of anxiety, depression, and loneliness across all time points. Changes in health behaviors over time mostly did not predict changes in mental health symptoms. CONCLUSIONS: Mental health and engagement in protective health behaviors was lowest at the start of the lockdown. Health behaviors mostly returned to pre-lockdown levels within three months. Engaging in healthier behaviors was associated with better mental health. Policy implications of these findings are discussed. This study provides important insights into (unintended) side effects of an international crisis and can contribute to a better understanding of how to preserve mental health.

Equity Effects of Dietary Nudging Field Experiments: Systematic Review.

Background: Dietary behaviours are among the key modifiable risk factors for non-communicable diseases. Importantly, dietary behaviours vary substantially between groups and individuals with different socioeconomic positions, with more disadvantaged groups and individuals being exposed to more dietary risk factors. The goal of this review is to summarise the existing research on equity effects of dietary nudging interventions. Methods: Systematic review of nudging interventions conducted in a field setting that report an observable indicator of dietary behaviour, include a control group, and report effect sizes stratified by indicators of socioeconomic status as outlined in the PROGRESS-Plus framework. Two databases (scopus, Pubmed) were searched (last search June 2021), and 18 articles with 19 studies (k = 46 equity comparisons) were included. Risk of bias was assessed using the ROBINS-I tool. Due to heterogeneity in equity dimensions and study outcomes, a harvest plot was used to summarise data. Results: The majority of equity comparisons (38 out of 46) were available for cognitive nudges. Most of these (22 out of 38 comparisons) found that cognitive nudges worked equally well in more and less disadvantaged populations; however, in 12 out of the 38 comparisons, they favoured those who were less disadvantaged. Two out of four comparisons on behavioural nudges favoured more disadvantaged persons. Conclusions: The differential effects of dietary nudging interventions in this review can contribute to increases in health inequalities. At the same time, a substantial number of interventions showed no equity effects. Importantly, this review suggests that more research on nudging interventions and health equity is needed. Future interventions should report effect sizes stratified by indicators of social inequality. Systematic Review Registration: PROSPERO (CRD42019137469).

Soft drink consumption and mental health problems: Longitudinal relations in children and adolescents.

BACKGROUND: Increased soft drink consumption has been proposed as both predictor and result of mental health problems. Although possible mechanisms for both directions have been suggested, understanding of the association is limited. Most previous research has been cross-sectional and could not assess directionality. METHOD: This study investigated the directionality of the association between soft drink consumption and mental health using longitudinal panel data of 5882 children and adolescents from the nationally representative German KiGGS baseline study (2003-2006) and KiGGS Wave 1 (2009-2012). Soft drink consumption and mental health problems were assessed by standardized questionnaire (baseline) and telephone interview (Wave 1). Four cross-lagged panel models were specified and compared regarding their fit indices. Specific paths were tested for significance. RESULTS: Positive cross-sectional associations between soft drink consumption and mental health problems were found at both measurement points (ps < .01), even after controlling for third variables (including age, gender, and socioeconomic status). Only the lagged effect of mental health problems on soft drink consumption reached statistical significance (ß = 0.031, p = .020), but not the effect in the opposite direction. The corresponding model also showed the best model fit overall. CONCLUSIONS: Mental health problems predicted soft drink consumption over an average of six years, but not vice versa. These findings suggest that consuming soft drinks might be a dysfunctional strategy of coping with mental health problems for children and adolescents and highlight the importance of considering mental health problems in the prevention of soft drink overconsumption and obesity.

Relations between sweetened beverage consumption and individual, interpersonal, and environmental factors: a 6-year longitudinal study in German children and adolescents.

OBJECTIVES: This study aims to characterize the consumption of sweetened beverages (SB) among young people in Germany in terms of individual and interpersonal-environmental correlates. METHODS: A representative sample of children and adolescents from Germany was assessed twice, 6 years apart (total longitudinal sample n = 11,691 children and adolescents aged between 0 and 17 years old; weighted). The relations between individual and interpersonal-environmental factors at baseline with SB intake 6 years later were analysed using bivariate and multivariate methods. RESULTS: The majority of children and adolescents in Germany consume sweetened beverages weekly, 23% daily. SB consumption is particularly high in boys and often accompanied by other unhealthy lifestyle behaviours including a high level of tobacco and media consumption with a concurrent deficiency in fruit and vegetable consumption. Interpersonal factors associated with higher sweetened beverage consumption include low socio-economic status, tobacco consumption of parents, and older maternal age. CONCLUSIONS: Research on factors that correlate with sweetened beverage consumption is crucial to design effective interventions. Our findings underline the importance of complex, multi-level interventions to target sweetened beverage intake and obesity.

The association between weight stigma and mental health: A meta-analysis.

In recent years, there has been considerable research on the relation between weight stigma and mental health, but no quantitative synthesis of the empirical evidence is available to date. This meta-analysis (105 studies, 59 172 participants, and 497 effect sizes) fills this gap by quantifying the association between weight stigma and mental health. Age, gender, and factors presumed to exert a protective role (i.e., adaptive coping strategies and perceived social support) were tested as potential moderators. The three-level meta-analytic model estimated under a random effects assumption revealed a medium to large negative association between weight stigma and mental health (r = -0.35). The overall association remained significant when controlling for publication year, education, and body weight. There was substantial heterogeneity in effect sizes between studies (I2 = 43%) and within studies (I2 = 56%). Surprisingly, all moderator hypotheses had to be rejected. Body weight was a significant moderator, indicating a stronger association between weight stigma and diminished mental health with increasing body mass index. Future research might focus on explaining the heterogeneity of findings and on testing causality as well as potential underlying mechanisms.

Quality matters: A meta-analysis on components of healthy family meals.

OBJECTIVE: A greater frequency of family meals is associated with better diet quality and lower body mass index (BMI) in children. However, the effect sizes are small, and it remains unclear which qualitative components of family meals contribute to these positive health outcomes. This meta-analysis synthesizes studies on social, environmental, and behavioral attributes of family meals and identifies components of family meals that are related to better nutritional health in children. METHOD: A systematic literature search (50 studies; 49,137 participants; 61 reported effect sizes) identified 6 different components of healthy family mealtimes. Separate meta-analyses examined the association between each component and children's nutritional health. Age (children vs. adolescents), outcome type (BMI vs. diet quality), and socioeconomic status (SES; controlled vs. not controlled for SES) were examined as potential moderators. RESULTS: Positive associations consistently emerged between 5 components and children's nutritional health: turning the TV off during meals (r = .09), parental modeling of healthy eating (r = .12), higher food quality (r = .12), positive atmosphere (r = .13), children's involvement in meal preparation (r = .08), and longer meal duration (r = .20). No moderating effects were found. CONCLUSIONS: How a family eats together shows significant associations with nutritional health in children. Randomized control trials are needed to further verify these findings. The generalizability of the identified mealtime components to other contexts of social eating is also discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Autonomous Goal Striving Promotes a Nonlimited Theory About Willpower.

People who believe that willpower is not limited exhibit higher self-regulation and well-being than people who believe that willpower is a limited resource. So far, only little is known about the antecedents of people's beliefs about willpower. Three studies examine whether autonomous goal striving promotes the endorsement of a nonlimited belief and whether this relationship is mediated by vitality, the feeling of being awake and energetic. Study 1 (n = 208) showed that autonomous goal striving predicts a change in willpower beliefs over 4 months and that this change is mediated by vitality. Study 2 (n = 92) replicated this finding using experience sampling assessments of vitality. Experimental Study 3 (n = 243) showed that inducing an autonomous mind-set enhances people's endorsement of a nonlimited belief by fostering vitality. The studies support the idea that what people believe about willpower depends, at least in part, on recent experiences with tasks as being energizing or draining.

Accuracy of food preference predictions in couples.

The goal of this study was to identify and empirically test variables that indicate how well partners in relationships know each other's food preferences. Participants (n = 2,854) lived in the same household and were part of a large, nationally representative panel study in Germany. Each partner independently predicted the other's preferences for several common food items. Results show that predictive accuracy was higher for likes and for extreme and stereotypical preferences as compared to dislikes and for moderate and idiosyncratic preferences. Accuracy was also higher for couples with a high similarity in preferences and with longer relationship duration but was independent of participants' age after controlling for relationship duration. The data also show that relationship duration was accompanied by higher similarity in couples' food preferences. There was a small positive correlation between partner knowledge and both partner similarity and satisfaction with family life, but no correlation between partner knowledge and general life satisfaction. The results reconcile both valence and base-rate accounts of preference prediction accuracy.

How cohabitation, marriage, separation, and divorce influence BMI: A prospective panel study.

OBJECTIVE: This study examines how changes in cohabitation or marital status affect Body Mass Index (BMI) over time in a large representative sample. METHOD: Participants were 20,950 individuals (50% female; 19 to 100 years), representative of the German population, who provided 81,926 observations over 16 years. Face-to-face interviews were used to obtain demographic data, including cohabitation and marital status, height, body weight, and weight-relevant behaviors (exercise, healthy eating, and smoking). Control variables included age, notable changes in status (life events such as having children or change in employment status), perceived stress, and subjective health. RESULTS: Cohabitation led to significant weight gain in men and women-after four years or longer, about twice the gain associated with marriage (controlling for weight-related behaviors, age, children, employment, stress, and health). BMI after separation was largely comparable to BMI before starting cohabitation; women lost some weight in the first year, men gained some weight after four or more years of separation. Divorce generally predicted weight gain. Changes in exercise, healthy eating, and smoking did not attenuate the effect of changes in relationship status on BMI. CONCLUSIONS: This is among the first longitudinal studies to directly compare the effects of key changes in relationship status on BMI. The findings extend and qualify previous results by showing that the benefits of marriage or cohabitation do not necessarily include a healthier BMI. They also suggest that relationship transitions-particularly moving in with a partner and divorce-may be important time windows for weight gain prevention. (PsycINFO Database Record

Public Beliefs About Obesity Relative to Other Major Health Risks: Representative Cross-Sectional Surveys in the USA, the UK, and Germany.

Background: Overweight and obesity are among the leading risk factors for death worldwide. Scientists believe that the increase in obesity is primarily due to environmental changes and thus favor obesity prevention measures targeting the environment. However, it is less clear what lay people perceive as causes of obesity, and which measures they deem acceptable and promising in fighting it. Purpose: This article compares lay beliefs about obesity with beliefs about other major health risks sharing certain similarities with obesity (alcohol and tobacco dependence, depression) in three countries with high obesity rates. Methods: Computer-assisted face-to-face interviews with representative samples in the UK (N = 1,216) and Germany (N = 973) and an online survey in the USA (N = 982) tapping beliefs about locus of responsibility, liability for treatment costs, and effectiveness of policy measures. Results: In each country, respondents attributed responsibility for obesity primarily to the individual; the same pattern emerged for alcohol and tobacco dependence, but not for depression (ps < .01). The higher the attribution of personal responsibility, the more strongly respondents endorsed individual liability for treatment costs (ps < .01). Respondents judged information and fiscal policies as most and least effective, respectively, in obesity prevention. Conclusions: Respondents' views about obesity are similar to those about addictions; however, they regard fiscal and regulatory policies as less effective for obesity than for addictions. Raising awareness about environmental drivers of obesity and framing policy measures by reference to the fight against tobacco and alcohol could increase public support of obesity-targeted policies.

Parents' considerable underestimation of sugar and their child's risk of overweight.

High sugar intake is associated with an increased risk of overweight. For parents, as their children's nutritional gatekeepers, knowledge about sugar is a prerequisite for regulating sugar consumption. Yet little is known about parental ability to estimate the sugar content of foods and beverages and how this ability is associated with children's body mass index (BMI). In 305 parent-child pairs, we investigated to what extent parents systematically under- or overestimate the sugar content of foods and beverages commonly found in children's diets as well as potential associations with children's z-BMI. Parents considerably underestimated the sugar content of most foods and beverages (e.g., 92% of parents underestimated the sugar content of yogurt by, on average, seven sugar cubes). After controlling for parental education and BMI, parental sugar underestimation was significantly associated with a higher risk of their child being overweight or obese (odds ratio = 2.01). There was a small dose-response relationship between the degree of underestimation and the child's z-BMI. These findings suggest that providing easily accessible and practicable knowledge about sugar content through, for instance, nutritional labeling may improve parents' intuition about sugar. This could help curtail sugar intake in children and thus be a preventive measure for overweight.