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1.
BMJ ; 367: l5837, 2019 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666218

RESUMO

OBJECTIVE: To evaluate whether calorie labeling of menus in large restaurant chains was associated with a change in mean calories purchased per transaction. DESIGN: Quasi-experimental longitudinal study. SETTING: Large franchise of a national fast food company with three different restaurant chains located in the southern United States (Louisiana, Texas, and Mississippi) from April 2015 until April 2018. PARTICIPANTS: 104 restaurants with calorie information added to in-store and drive-thru menus in April 2017 and with weekly aggregated sales data during the pre-labeling (April 2015 to April 2017) and post-labeling (April 2017 to April 2018) implementation period. MAIN OUTCOME MEASURES: Primary outcome was the overall level and trend changes in mean purchased calories per transaction after implementation of calorie labeling compared with the counterfactual (ie, assumption that the pre-intervention trend would have persisted had the intervention not occurred) using interrupted time series analyses with linear mixed models. Secondary outcomes were by item category (entrees, sides, and sugar sweetened beverages). Subgroup analyses estimated the effect of calorie labeling in stratums defined by the sociodemographic characteristics of restaurant census tracts (defined region for taking census). RESULTS: The analytic sample comprised 14 352 restaurant weeks. Over three years and among 104 restaurants, 49 062 440 transactions took place and 242 726 953 items were purchased. After labeling implementation, a level decrease was observed of 60 calories/transaction (95% confidence interval 48 to 72; about 4%), followed by an increasing trend of 0.71 calories/transaction/week (95% confidence interval 0.51 to 0.92) independent of the baseline trend over the year after implementation. These results were generally robust to different analytic assumptions in sensitivity analyses. The level decrease and post-implementation trend change were stronger for sides than for entrees or sugar sweetened beverages. The level decrease was similar between census tracts with higher and lower median income, but the post-implementation trend in calories per transaction was higher in low income (change in calories/transaction/week 0.94, 95% confidence interval 0.67 to 1.21) than in high income census tracts (0.50, 0.19 to 0.81). CONCLUSIONS: A small decrease in mean calories purchased per transaction was observed after implementation of calorie labeling in a large franchise of fast food restaurants. This reduction diminished over one year of follow-up.


Assuntos
Ingestão de Energia/fisiologia , Fast Foods/efeitos adversos , Rotulagem de Alimentos , Obesidade/prevenção & controle , Restaurantes/estatística & dados numéricos , Comportamento do Consumidor/estatística & dados numéricos , Fast Foods/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Estudos Longitudinais , Ensaios Clínicos Controlados não Aleatórios como Assunto , Obesidade/epidemiologia , Obesidade/etiologia , Prevalência , Sudeste dos Estados Unidos/epidemiologia
2.
Mayo Clin Proc ; 94(11): 2178-2188, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31623843

RESUMO

OBJECTIVE: To assess the prospective association between ultra-processed food consumption and all-cause mortality and to examine the effect of theoretical iso-caloric non-processed foods substitution. PATIENTS AND METHODS: A population-based cohort of 11,898 individuals (mean age 46.9 years, and 50.5% women) were selected from the ENRICA study, a representative sample of the noninstitutionalized Spanish population. Dietary information was collected by a validated computer-based dietary history and categorized according to their degree of processing using NOVA classification. Total mortality was obtained from the National Death Index. Follow-up lasted from baseline (2008-2010) to mortality date or December 31th, 2016, whichever was first. The association between quartiles of consumption of ultra-processed food and mortality was analyzed by Cox models adjusted for the main confounders. Restricted cubic-splines were used to assess dose-response relationships when using iso-caloric substitutions. RESULTS: Average consumption of ultra-processed food was 385 g/d (24.4% of the total energy intake). After a mean follow-up of 7.7 years (93,599 person-years), 440 deaths occurred. The hazard ratio (and 95% CI) for mortality in the highest versus the lowest quartile of ultra-processed food consumption was 1.44 (95% CI, 1.01-2.07; P trend=.03) in percent of energy and 1.46 (95% CI, 1.04-2.05; P trend=.03) in grams per day per kilogram. Isocaloric substitution of ultra-processed food with unprocessed or minimally processed foods was associated with a significant nonlinear decrease in mortality. CONCLUSION: A higher consumption of ultra-processed food was associated with higher mortality in the general population. Furthermore, the theoretical iso-caloric substitution ultra-processed food by unprocessed or minimally processed foods would suppose a reduction of the mortality risk. If confirmed, these findings support the necessity of the development of new nutritional policies and guides at the national and international level. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01133093.


Assuntos
Dieta/efeitos adversos , Fast Foods/efeitos adversos , Mortalidade/tendências , Adulto , Doenças Cardiovasculares/mortalidade , Causas de Morte , Estudos de Coortes , Dieta/estatística & dados numéricos , Fast Foods/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Valor Nutritivo , Estudos Prospectivos , Fatores de Risco , Espanha
3.
Cien Saude Colet ; 24(7): 2387-2397, 2019 Jul 22.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31340258

RESUMO

OBJECTIVE: To verify the association of maternal and anthropometric factors with consumption of ultra-processed foods in children between 4 to 24 months. METHODS: cross-sectional study with 300 children hospitalized in a tertiary hospital and their mothers. The interview took place during the first 72 hours of hospitalization to avoid interference in the responses about the child's diet. Maternal factors investigated: age, schooling, income, parity, BMI and guidance on complementary feeding. Variables related to the child investigated: age, breastfeeding, infant school, BMI/age, height/age, weight/age and introduction of ultra-processed food. The association between the factors studied and introduction of ultra-processed food was tested by linear regression. The significance level considered was 0.05. RESULTS: . It was verified that only 21% of the children had not yet received any type of ultra-processed food, and 56.5% received any of these foods before 6 months. In the multivariate analysis, maternal schooling, family income, maternal age and parity were associated with ultra-processed food supply. CONCLUSIONS: The feeding practices of children between 4 and 24 months are inadequate when compared to the recommendations for the age group.


Assuntos
Fast Foods/estatística & dados numéricos , Comportamento Alimentar , Hospitalização , Fenômenos Fisiológicos da Nutrição do Lactente , Adulto , Aleitamento Materno/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Lactente , Entrevistas como Assunto , Masculino , Mães/estatística & dados numéricos , Adulto Jovem
4.
Cien Saude Colet ; 24(7): 2419-2430, 2019 Jul 22.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31340261

RESUMO

The present article aimed to evaluate the consumption of protective foods and predictors of cardiovascular (CV) risk and its relationship with cardiovascular risk factors (CVRF) by hypertensive individuals in the state of Alagoas. A population-based cross-sectional study was carried out from 2013 to 2016 with 655 hypertensive adults of both sexes. Food consumption was assessed by a validated food frequency questionnaire with measurements converted to scores and the foods were divided into three groups: I - processed foods/CV risk predictors; II - ultraprocessed foods/higher CV risk predictors; III - in natura or minimally processed foods/ CV risk protectors. Socioeconomic, demographic, biochemical, clinical and anthropometric variables were also analyzed. The consumption scores of food groups I, II and III were, respectively, 0.11; 0.13 and 0.24 (p = 0.001). The consumption of processed foods was correlated positively with high blood cholesterol (p = 0.045) and negatively with age (p = 0.001); while that of ultraprocessed foods was correlated with the sedentary lifestyle (p = 0.01). Thus, it was observed a relationship between the consumption of CV risk predictors foods with high blood cholesterol and sedentary lifestyle, reflecting the need for nutricional education actions.


Assuntos
Doenças Cardiovasculares/epidemiologia , Ingestão de Alimentos , Fast Foods/estatística & dados numéricos , Hipertensão/epidemiologia , Adulto , Fatores Etários , Brasil/epidemiologia , Doenças Cardiovasculares/etiologia , Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Comportamento Sedentário , Inquéritos e Questionários , Adulto Jovem
5.
Matern Child Nutr ; 15 Suppl 4: e12764, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31225706

RESUMO

Child undernutrition continues to be a national concern in Indonesia, whereas childhood overweight/obesity rises. Economic development has led to wide availability of highly processed foods and beverages, with growing evidence that children are consuming commercial snack products during the critical complementary feeding period. This study assessed the prevalence and patterns of consumption of commercially produced snack foods and sugar-sweetened beverages among Indonesian children. A cross-sectional survey was conducted with 495 mothers of children aged 6-35 months living in Bandung City, Indonesia. Among all children, 81.6% consumed a commercial snack food and 40.0% consumed a sugar-sweetened beverage in the day preceding the interview. At 6-11 months, 46.5% of children consumed a snack food and 2.0% consumed a sugar-sweetened beverage. Snack foods were consumed 3 or more times a day by 60.0% of children 24-35 months of age. Sweet biscuits and savory snacks were the most commonly consumed snack foods; sweetened milks and sweetened teas were the most common beverages. Maternal education, child age, and consumption of a commercially produced complementary food were associated with snack food consumption. Factors associated with sugar-sweetened beverage consumption were child age and consumption of a commercially produced complementary food or breastmilk substitute. These findings reflect a high presence of processed, high-sugar/salt commercial snack products in the diets of children 6-35 months. National attention should focus on interventions to reduce reliance on processed snack products and increase consumption of nutrient-rich, locally available foods during the complementary feeding period.


Assuntos
Fast Foods/estatística & dados numéricos , Valor Nutritivo , Lanches , /estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Humanos , Indonésia , Lactente , Masculino , Mães , Estado Nutricional , Prevalência
6.
BMC Med ; 17(1): 99, 2019 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-31117993

RESUMO

BACKGROUND: School neighborhood food environment is recognized as an important contributor to childhood obesity; however, large-scale and longitudinal studies remain limited. This study aimed to examine this association and its variation across gender and urbanicity at multiple geographic scales. METHODS: We used the US nationally representative Early Childhood Longitudinal Study-Kindergarten cohort data and included 7530 kindergarteners followed up from 1998 to 2007. The Census, road network, and Dun and Bradstreet commercial datasets were used to construct time-varying measurements of 11 types of food outlet within 800-m straight-line and road-network buffer zones of schools and school ZIP codes, including supermarket, convenience store, full-service restaurant, fast-food restaurant, retail bakery, dairy product store, health/dietetic food store, candy store, fruit/vegetable market, meat/fish market, and beverage store. Two-level mixed-effect and cluster-robust logistic regression models were performed to examine the association. RESULTS: A higher body mass index (BMI) in 2007 was observed among children experiencing an increase of convenience stores in school neighborhoods during 1998-2007 (ß = 0.39, p < 0.05), especially among girls (ß = 0.50) and urban schoolchildren (ß = 0.41), as well as among children with a decrease of dairy product stores (ß = 0.39, p < 0.05), especially among boys (ß = 1.86) and urban schoolchildren (ß = 0.92). The higher obesity risk was associated with the increase of fast-food restaurants in urban schoolchildren (OR = 1.27 [95% CI = 1.02-1.59]) and of convenience stores in girls (OR = 1.41 [95% CI = 1.09-1.82]) and non-urban schoolchildren (OR = 1.60 [95% CI = 1.10-2.33]). The increase of full-service restaurants was related to lower obesity risk in boys (OR = 0.74 [95% CI = 0.57-0.95]). The decrease of dairy product stores was associated with the higher obesity risk (OR = 1.68 [95% CI = 1.07-2.65]), especially boys (OR = 2.92 [95% CI = 1.58-5.40]) and urban schoolchildren (OR = 1.67 [95% CI = 1.07-2.61]). The schoolchildren exposed to the decrease of meat/fish markets showed the lower obesity risk (OR = 0.57 [95% CI = 0.35-0.91]), especially urban schoolchildren (OR = 0.53 [95% CI = 0.32-0.87]). Results from analyses within 800-m straight-line buffer zones of schools were more consistent with our theory-based hypotheses than those from analyses within 800-m road-network buffer zones of schools and school ZIP codes. CONCLUSIONS: National data in the USA suggest that long-term exposure to the food environment around schools could affect childhood obesity risk; this association varied across gender and urbanicity. This study has important public health implications for future school-based dietary intervention design and urban planning.


Assuntos
Fast Foods/estatística & dados numéricos , Obesidade Pediátrica/epidemiologia , Características de Residência/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos de Coortes , Meio Ambiente , Feminino , Frutas , Humanos , Estudos Longitudinais , Masculino , População , Restaurantes/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Verduras
7.
Artigo em Inglês | MEDLINE | ID: mdl-30934650

RESUMO

BACKGROUND: The frequency of take-out food consumption has increased rapidly among Chinese college students, which has contributed to high obesity prevalence. However, the relationships between take-out food consumption, body mass index (BMI), and other individual factors influencing eating behavior among college students are still unclear. This study explored the association of take-out food consumption with gender, BMI, physical activity, preference for high-fat and high-sugar (HFHS) food, major category, and degree level among Chinese college students. METHODS: Cross-sectional data were collected from 1220 college students in Beijing, China, regarding information about take-out food consumption, physical activity, and preference for HFHS food using a self-reported questionnaire. The logistic linear regression model was used to analyze the association between take-out food consumption and personal and lifestyle characteristics. RESULTS: Out of 1220 college students, 11.6% of college students were overweight or obese. Among the personal and lifestyle characteristics, high frequency of take-out food consumption was significantly associated with a non-medical major, high preference for HFHS food, degree level, and higher BMI, but not physical activity. CONCLUSION: Among Chinese college students, consumption of take-out food may be affected by major category, preference for HFHS food, degree level, and BMI. This could provide guidance on restrictions of high take-out food consumption, which contributes to high obesity prevalence and high risk for metabolic diseases.


Assuntos
Fast Foods/estatística & dados numéricos , Comportamento Alimentar , Obesidade/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Estilo de Vida , Modelos Lineares , Modelos Logísticos , Masculino , Obesidade/etiologia , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Prevalência , Universidades , Adulto Jovem
8.
Prev Chronic Dis ; 16: E39, 2019 03 28.
Artigo em Inglês | MEDLINE | ID: mdl-30925139

RESUMO

INTRODUCTION: Psychosocial stress is associated with obesity in adult and pediatric populations, but few studies have examined the relationship between parent-perceived stress and risk of child obesity and related behaviors. METHODS: We studied 689 pairs of parents and children aged 2 to 12 in Massachusetts with a body mass index (BMI) at or above the 85th percentile. Recruitment occurred from June 2014 to March 2015, and data collection ended in March 2016. We asked parents about their perceived stress and categorized responses as low, moderate, or high. We examined associations of parents' stress with children's BMI, expressed as a percentage of the 95th percentile (%BMIp95), and obesity-related behaviors by using multivariable regression models adjusted for child and parent characteristics. We stratified results by race/ethnicity, annual household income, and the child's age. RESULTS: In fully adjusted models, the association between high versus low parent-reported stress and children's %BMIp95 remained significant only for children in low-income households (ß = 5.12; 95% confidence interval [CI], 0.94-9.30) and for non-Hispanic black children (ß = 7.76; 95% CI, 1.85-13.66). Parents with high or moderate stress versus low stress were less likely to report that their children met recommendations for fast-food consumption (high stress, prevalence ratio [PR] = 0.79; 95% CI, 0.65-0.96; moderate stress, PR = 0.70; 95% CI, 0.59-0.82), but parents with high versus low stress were more likely to report meeting daily physical activity recommendations (PR = 1.21; 95% CI, 1.01-1.45). CONCLUSION: Among children with overweight or obesity, parent-perceived stress was associated with fast-food consumption and physical activity. Parent-perceived stress was associated with child %BMIp95 among children in low-income households and non-Hispanic black children. Obesity interventions should consider parent-perceived stress and potential differences in the nature of stress experienced by parents of different racial/ethnic and socioeconomic backgrounds.


Assuntos
Pais/psicologia , Obesidade Pediátrica/epidemiologia , Estresse Psicológico/epidemiologia , Afro-Americanos/estatística & dados numéricos , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Exercício , Fast Foods/estatística & dados numéricos , Feminino , Humanos , Masculino , Massachusetts/epidemiologia , Obesidade Pediátrica/psicologia , Fatores Socioeconômicos
9.
Cien Saude Colet ; 24(3): 983-996, 2019 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30892519

RESUMO

The aim of this study was to analyze the spatial distribution of excess weight in Brazil and its correlation with household food insecurity, purchase of foods by type of processing, and Human Development Index (HDI). An ecological study was undertaken using data from three surveys conducted by the Brazilian Institute of Geography and Statistics. Spatial analysis techniques were used to perform univariate and bivariate analysis. The prevalence of excess weight was 34.2% (CI 95% 33.8-34.6%). Excess weight showed a moderate and significant spatial autocorrelation (0.581; p = 0.01), with higher prevalence in states in the South, Southeast and Center-West regions. A positive moderate spatial correlation was shown between the prevalence of excess weight and HDI (0.605; p < 0.05) and purchase of ultra-processed foods (0.559; p < 0.05), while a negative moderate spatial correlation was observed between prevalence of excess weight and household food insecurity (-0.561; p < 0.05). It can be concluded that there is an unequal distribution of excess weight across Brazil. The highest prevalence rates were found in states in the Southeast, South, and Center-West regions, associated with higher HDI values and higher ultra-processed food purchases as a proportion of overall household food purchases.


Assuntos
Comportamento do Consumidor/estatística & dados numéricos , Fast Foods/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Sobrepeso/epidemiologia , Adolescente , Adulto , Peso Corporal , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Análise Espacial , Adulto Jovem
10.
Econ Hum Biol ; 33: 124-133, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30825861

RESUMO

In this study, we estimate the effect of fast food environment surrounding schools on childhood body mass index (BMI). We use two methods that arrive at a similar conclusion, but with different implications. Using school distance from the nearest federal highway to instrument for restaurant location, we find the surrounding restaurants to only marginally affect a student's BMI measure. The effect size also decreases with increasing radial distances from school, 0.016 standard deviations at one-third of a mile and 0.0032 standard deviations at a mile radial distance. This indicates the decreasing influence of restaurants on a child's BMI as its distance from school increases. On a subset of students who were exogenously assigned to different school food environment, we find no effect of the fast food restaurants. An important contextual aspect is that nearly all schools in this sample observed closed campus policy, which does not allow students to leave campus during lunch hours.


Assuntos
Índice de Massa Corporal , Fast Foods/estatística & dados numéricos , Restaurantes/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Adolescente , Arkansas , Criança , Feminino , Humanos , Masculino , Características de Residência , Fatores Socioeconômicos
11.
Artigo em Inglês | MEDLINE | ID: mdl-30866407

RESUMO

Considering the association between the neighborhood food environment and individual eating behaviors, this study aimed to assess the association between parents' reported use of food facilities by their children, and parental perceived travel time to food facilities, with their children's dietary patterns. Parents reported the use of supermarkets, full-service and fast-food restaurants, and perceived travel time to these food retailers. To assess school children's food consumption, a previous day dietary recall was applied. Factor analysis was conducted to identify dietary patterns. To test the association between reported use and perceived travel time to food retailers and school children's dietary patterns, we performed multilevel linear regression analyses. Parents' reported use of supermarkets was associated with children's higher score in the "Morning/Evening Meal" pattern. The use of full-service and fast-food restaurants was associated with children's higher score in the "Fast Food" pattern. Higher parental perceived travel time to full-service and fast-food restaurants was associated with children's lower score in the "Fast Food" pattern. Although the use of full-service and fast-food restaurants was associated with a less healthy dietary pattern, the perception of living further away from these food retailers may pose a barrier for the use of these facilities.


Assuntos
Dieta/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Pais/psicologia , Características de Residência/estatística & dados numéricos , Transportes/estatística & dados numéricos , Brasil , Criança , Estudos Transversais , Fast Foods/estatística & dados numéricos , Comportamento Alimentar/psicologia , Feminino , Humanos , Masculino , Refeições , Restaurantes/estatística & dados numéricos , Fatores Socioeconômicos , Viagem
12.
Spat Spatiotemporal Epidemiol ; 28: 43-53, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30739654

RESUMO

This study investigated if the relationship between residential fast-food outlet availability and obesity varied due to methodological diversity or by age. Cross-sectional data (n = 22,889) from the Yorkshire Health Study, England were used. Obesity was defined using self-reported height and weight (BMI ≥ 30). Food outlets ("fast-food", "large supermarkets", and "convenience or other food retail outlets") were mapped using Ordnance Survey Points of Interest (PoI) database. Logistic regression was used for all analyses. Methodological diversity included adjustment for other food outlets as covariates and continuous count vs. quartile. The association between residential fast-food outlets and obesity was inconsistent and effects remained substantively the same when considering methodological diversity. This study contributes to evidence by proposing the use of a more comprehensive conceptual model adjusting for wider markers of the food environment. This study offers tentative evidence that the association between fast-food outlets and obesity varies by age.


Assuntos
Fast Foods/estatística & dados numéricos , Obesidade/epidemiologia , Restaurantes/estatística & dados numéricos , Análise Espacial , Adolescente , Adulto , Distribuição por Idade , Idoso , Estudos de Coortes , Estudos Transversais , Inglaterra/epidemiologia , Feminino , Abastecimento de Alimentos/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Adulto Jovem
13.
Am J Clin Nutr ; 109(1): 99-108, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30596809

RESUMO

Background: Air pollution exposures are novel contributors to the growing childhood obesity epidemic. One possible mechanism linking air pollution exposures and obesity is through changes in food consumption patterns. Objective: The aim of this study was to examine the longitudinal association between childhood exposure to air pollutants and changes in diet among adolescents. Design: School-age children were enrolled in the Southern California Children's Health Study during 1993-1994 (n = 3100) and were followed for 4-8 y. Community-level regional air pollutants [e.g., nitrogen dioxide (NO2), elemental carbon (EC), and fine particles with aerodynamic diameter <2.5 µm (PM2.5)] were measured at central monitoring stations. Line dispersion modeling was used to estimate concentrations of traffic-related air pollutants based on nitrogen oxides (NOx) at participants' residential addresses. In addition, self-reported diet information was collected annually using a structured youth/adolescent food-frequency questionnaire during 1997-2001. Generalized linear mixed-effects models were used in the association analyses. Results: Higher exposures to regional and traffic-related air pollutants were associated with intake of a high-trans-fat diet, after adjusting for confounders including socioeconomic status and access to fast food in the community. A 2-SD (12.2 parts per billion) increase in regional NO2 exposure was associated with a 34% increased risk of consuming a high-trans-fat diet compared with a low-trans-fat diet (OR: 1.34; 95% CI: 1.05, 1.72). In addition, higher exposures to acid vapor, EC, PM2.5, and non-freeway NOx were all associated with higher consumption of dietary trans fat (all P < 0.04). Notably, higher exposures to regional NO2, acid vapor, and EC were also associated with a higher consumption of fast food (all P < 0.05). Conclusions: Childhood exposures to regional and traffic-related air pollutants were associated with increased consumption by adolescents of trans fat and fast foods. Our results indicate that air pollution exposures may contribute to obesogenic behaviors. This study was registered at clinicaltrials.gov as NCT03379298.


Assuntos
Dieta , Exposição Ambiental , Fast Foods/estatística & dados numéricos , Ácidos Graxos Trans/administração & dosagem , Emissões de Veículos , Adolescente , Comportamento do Adolescente , Poluentes Atmosféricos/análise , California , Criança , Registros de Dieta , Grupos Étnicos , Seguimentos , Preferências Alimentares , Comportamentos Relacionados com a Saúde , Humanos , Estudos Longitudinais , Dióxido de Nitrogênio/efeitos adversos , Obesidade , Fatores Socioeconômicos , Inquéritos e Questionários
14.
Am J Public Health ; 109(2): 267-269, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30571297

RESUMO

OBJECTIVES: To describe time trends in the availability of healthier children's menu items in the top selling quick service restaurant (QSR) chains. METHODS: We used Technomic Inc.'s MenuMonitor to construct a data set of side and beverage items available on children's menus from 2004 to 2015 at 20 QSR chains in the United States. We evaluated the significance of time trends in the average availability of healthier fruit and nonfried vegetable sides and nonsugary beverages offered as options and by default in children's meal bundles. RESULTS: Healthier sides and beverages offered as options increased by 57.5 and 25.0 percentage points, respectively, from 2004 to 2015 but leveled off starting in 2013. Healthier items bundled by default also increased during this time frame, with most adoption occurring after 2010. However, these items remain relatively uncommon, with less than 20% of meal bundles including healthier items by default. All tests evaluating time trends in the availability of healthier items in meal bundles were significant at P < .001. CONCLUSIONS: The QSRs evaluated made improvements in the quality of sides and beverages offered on children's menus from 2004 to 2015. Additional efforts are needed to increase the percentage of healthier options offered by default.


Assuntos
Fast Foods/estatística & dados numéricos , Promoção da Saúde/estatística & dados numéricos , Restaurantes/estatística & dados numéricos , Bebidas , Criança , Abastecimento de Alimentos/estatística & dados numéricos , Frutas , Promoção da Saúde/métodos , Humanos , Verduras
15.
Nutrients ; 10(12)2018 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-30572568

RESUMO

BACKGROUND: Sodium intake is related to several adverse health outcomes, such as hypertension and cardiovascular diseases. Processed foods are major contributors to the population's sodium intake. The aim of the present study was to determine sodium levels in Mexican packaged foods, as well as to evaluate the proportion of foods that comply with sodium benchmark targets set by the United Kingdom Food Standards Agency (UK FSA) and those set by the Mexican Commission for the Protection of Health Risks (COFEPRIS). We also evaluated the proportion of foods that exceeded the Pan American Health Organization (PAHO) targets. METHODS: This was a cross-sectional study that comprised data collected from the package of 2248 processed foods from selected supermarkets in Mexico. RESULTS: Many processed food categories contained an excessive amount of sodium. Processed meats, ham, bacon and sausages, had the highest concentrations. The proportion of foods classified as compliant in our sample was lower for international targets (FSA UK and PAHO) compared to the Mexican COFEPRIS criteria. CONCLUSIONS: These data provided a critical baseline assessment for monitoring sodium levels in Mexican processed foods.


Assuntos
Fast Foods/estatística & dados numéricos , Fast Foods/normas , Sódio/análise , Estudos Transversais , Produtos da Carne , México , Política Nutricional/legislação & jurisprudência , Valor Nutritivo
16.
BMJ ; 363: k4982, 2018 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-30541906

RESUMO

OBJECTIVES: To examine the energy content of main meals served in major UK restaurant chains and compare the energy content of meals in fast food and "full service" restaurant chains. DESIGN: Observational study. SETTING: Menu and nutritional information provided by major UK restaurant chains. MAIN OUTCOME MEASURES: Mean energy content of meals, proportion of meals meeting public health recommendations for energy consumption (≤600 kcal), and proportion of meals with excessive energy content (≥1000 kcal). RESULTS: Main meals from 27 restaurant chains (21 full service; 6 fast food) were sampled. The mean energy content of all eligible restaurant meals (13 396 in total) was 977 (95% confidence interval 973 to 983) kcal. The percentage of all meals that met public health recommendations for energy content was low (9%; n=1226) and smaller than the percentage of meals with an excessive energy content (47%; 6251). Compared with fast food restaurants, full service restaurants offered significantly more excessively calorific main meals, fewer main meals meeting public health recommendations, and on average 268 (103 to 433) kcal more in main meals. CONCLUSIONS: The energy content of a large number of main meals in major UK restaurant chains is excessive, and only a minority meet public health recommendations. Although the poor nutritional quality of fast food meals has been well documented, the energy content of full service restaurant meals in the UK tends to be higher and is a cause for concern. REGISTRATION: Study protocol and analysis strategy pre-registered on Open Science Framework (https://osf.io/w5h8q/).


Assuntos
Ingestão de Energia , Rotulagem de Alimentos/estatística & dados numéricos , Refeições , Restaurantes/estatística & dados numéricos , Calorimetria , Fast Foods/estatística & dados numéricos , Rotulagem de Alimentos/normas , Humanos , Tamanho da Porção/estatística & dados numéricos , Recomendações Nutricionais , Reino Unido
18.
BMC Public Health ; 18(1): 1257, 2018 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-30428860

RESUMO

BACKGROUND: Men of low socioeconomic position (SEP) are less likely than those of higher SEP to consume fruits and vegetables, and more likely to eat processed discretionary foods. Education level is a widely used marker of SEP. Few studies have explored determinants of socioeconomic inequalities in men's eating behaviours. The present study aimed to explore intrapersonal, social and environmental factors potentially contributing to educational inequalities in men's eating behaviour. METHODS: Thirty Australian men aged 18-60 years (15 each with tertiary or non-tertiary education) from two large metropolitan sites (Melbourne, Victoria; and Newcastle, New South Wales) participated in qualitative, semi-structured, one-on-one telephone interviews about their perceptions of influences on their and other men's eating behaviours. The social ecological model informed interview question development, and data were examined using abductive thematic analysis. RESULTS: Themes equally salient across tertiary and non-tertiary educated groups included attitudes about masculinity; nutrition knowledge and awareness; 'moralising' consumption of certain foods; the influence of children on eating; availability of healthy foods; convenience; and the interplay between cost, convenience, taste and healthfulness when choosing foods. More prominent influences among tertiary educated men included using advanced cooking skills but having relatively infrequent involvement in other food-related tasks; the influence of partner/spouse support on eating; access to healthy food; and cost. More predominant influences among non-tertiary educated men included having fewer cooking skills but frequent involvement in food-related tasks; identifying that 'no-one' influenced their diet; having mobile worksites; and adhering to food budgets. CONCLUSIONS: This study identified key similarities and differences in perceived influences on eating behaviours among men with lower and higher education levels. Further research is needed to determine the extent to which such influences explain socioeconomic variations in men's dietary intakes, and to identify feasible strategies that might support healthy eating among men in different socioeconomic groups.


Assuntos
Dieta/estatística & dados numéricos , Comportamento Alimentar/psicologia , Homens/psicologia , Classe Social , Adolescente , Adulto , Fast Foods/estatística & dados numéricos , Frutas , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales , Pesquisa Qualitativa , Verduras , Vitória , Adulto Jovem
19.
Prev Chronic Dis ; 15: E141, 2018 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-30468423

RESUMO

INTRODUCTION: Adolescents spend a substantial amount of time consuming media, including watching television, playing video games, and using electronic devices to access the internet. We examined the relationship between prolonged media use on screen devices and its potential association with obesity through several mechanisms. METHODS: We used data from 659,288 eighth and eleventh grade students who participated in the 2015-2016 School Physical Activity and Nutrition (SPAN) survey in Texas to examine the associations between hours of media use per day and 3 behaviors related to obesity: timing of last food intake, unhealthy eating behavior, and sleep hours. Also, mediation analyses were conducted to examine the pathways between hours of media use and body mass index (BMI). RESULTS: Compared with adolescents who used media 2 hours or less per day, those who used media 6 hours or more had higher odds of nighttime eating (odds ratio [OR], 3.16; 95% confidence interval [CI], 1.76-5.66) and inadequate sleep (OR, 1.57; 95% CI, 1.05-2.36) and a higher coefficient for Unhealthy Eating Index score (3.87; 95% CI, 1.3-6.37). Mediation analysis demonstrated that for males sleep hours and timing of last food intake mediated the pathway between hours of media use and BMI. For females, unhealthy eating behavior mediated this pathway. CONCLUSION: Adolescents who used electronic media 6 or more hours at night had higher odds of unhealthy eating behavior and inadequate sleep hours than those with 2 hours' use or less. Attention to behaviors associated with adolescents' prolonged media use is needed to reduce risk of obesity.


Assuntos
Comportamento do Adolescente , Peso Corporal , Obesidade/epidemiologia , Tempo de Tela , Adolescente , Índice de Massa Corporal , Estudos Transversais , Fast Foods/estatística & dados numéricos , Feminino , Humanos , Modelos Lineares , Masculino , Inquéritos Nutricionais , Higiene do Sono/fisiologia , Texas/epidemiologia
20.
Asia Pac J Clin Nutr ; 27(5): 1146-1154, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30272863

RESUMO

BACKGROUND AND OBJECTIVES: Menstrual irregularities in adolescents are a concern because they are considered a subjective indicator of poor physical and reproductive health. Menstrual regularity is associated with many genetic and mental health factors, and lifestyle changes can markedly influence an individual's level of menstrual regularity. Therefore, we investigated associations between lifestyle factors and menstrual irregularities in Korean adolescents by analysing data collected from the Korea National Health and Nutrition Examination Survey from 2009 to 2013. METHODS AND STUDY DESIGN: A total of 463 female adolescents aged 15-18 years participated in this study; they were divided into two groups based on their menstrual regularity. We assessed the between-group differences in relation to lifestyle-related factors, fast food consumption, and diet quality. RESULTS: The frequencies of consumption of soda, coffee, and fried foods were significantly higher in the irregular menstruation group. However, the nutritional quality index was not significantly different between the two groups. Logistic regression analysis revealed that younger age at menarche (odds ratio [OR]=0.69, 95% confidence interval [CI]=0.54-0.88), higher family income (OR=0.37, 95% CI=0.15-0.91), lack of exercise (OR=10.42, 95% CI=2.73-39.8), and high stress levels (OR=4.18, 95% CI=1.02-17.12) were associated with menstrual irregularity, whereas sufficient sleep (OR=0.49, 95% CI=0.39-0.60) and low frequency of eating out accounted for menstrual regularity. CONCLUSIONS: Lifestyle factors and stress levels influence menstrual regularity in Korean adolescents. Appropriate and accessible education on lifestyle management is required.


Assuntos
Exercício , Fast Foods/estatística & dados numéricos , Distúrbios Menstruais/epidemiologia , Inquéritos Nutricionais/estatística & dados numéricos , Sono , Estresse Psicológico/epidemiologia , Adolescente , Comorbidade , Estudos Transversais , Feminino , Humanos , República da Coreia/epidemiologia , Fatores de Risco , Classe Social , Inquéritos e Questionários , Fatores de Tempo
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