The community food environment's influence on dietary behaviors

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Description
Chronic diseases are the leading causes of death in the United States. Dietary behaviors influence the risk of developing multiple chronic diseases. The U.S. population consumes too few fruits and vegetables and too much sugar sweetened beverages (SSB) and fast…

Chronic diseases are the leading causes of death in the United States. Dietary behaviors influence the risk of developing multiple chronic diseases. The U.S. population consumes too few fruits and vegetables and too much sugar sweetened beverages (SSB) and fast food. The Social Ecological Model (SEM) was created as a framework for health promotion interventions. The SEM organizes factors that can influence health into five layers: intrapersonal factors, interpersonal processes, institutional/organizational factors, community factors, and public policy. Each layer can influence dietary behaviors and other layers.

This work aims to understand how the community layer, represented by the food environment, moderates the association of two other layers and dietary behaviors: the interpersonal layer, represented by receiving health care provider’s (HCP) advice to lose weight, and the policy layer, represented by participation in the Supplemental Nutrition Assistance Program (SNAP), and a policy change within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Participant data were obtained from a household telephone survey of 2,211 adults in four cities in New Jersey from two cross-sectional panels in 2009-10 and 2014. Community food data were purchased and classified according to previously established protocol. Interaction and stratified analyses determined the differences in the association between HCP advice, SNAP participation, and time (for WIC participants) and eating behaviors by the food environment.

Interaction and stratified analyses revealed that HCP advice was associated with a decrease in SSB consumption when participants lived near a small grocery store, or far from a supermarket, limited service restaurant (LSR), or convenience store. SNAP participation was associated with a higher SSB consumption when respondents lived close to a small grocery store, supermarket, and LSR. There were no differences in fruit and vegetable consumption between two time points among WIC participants, or by food outlet.

The food environment, part of the community layer of SEM, moderated the relationship between the interpersonal layer and dietary behaviors and the policy layer and dietary behaviors. The association between HCP advice and dietary behaviors and SNAP participation and dietary behaviors were both influenced by the food environment in which participants lived.
Date Created
2017
Agent

Association Between Urinary Biomarkers of Total Sugars Intake and Measures of Obesity in a Cross-Sectional Study

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Description

Obesity is an important modifiable risk factor for chronic diseases. While there is increasing focus on the role of dietary sugars, there remains a paucity of data establishing the association between sugar intake and obesity in the general public. The…

Obesity is an important modifiable risk factor for chronic diseases. While there is increasing focus on the role of dietary sugars, there remains a paucity of data establishing the association between sugar intake and obesity in the general public. The objective of this study was to investigate associations of estimated sugar intake with odds for obesity in a representative sample of English adults. We used data from 434 participants of the 2005 Health Survey of England. Biomarkers for total sugar intake were measured in 24 h urine samples and used to estimate intake. Linear and logistic regression analyses were used to investigate associations between biomarker-based estimated intake and measures of obesity (body mass intake (BMI), waist circumference and waist-to-hip ratio) and obesity risk, respectively. Estimated sugar intake was significantly associated with BMI, waist circumference and waist-to-hip ratio; these associations remained significant after adjustment for estimated protein intake as a marker of non-sugar energy intake. Estimated sugar intake was also associated with increased odds for obesity based on BMI (OR 1.02; 95%CI 1.00–1.04 per 10g), waist-circumference (1.03; 1.01–1.05) and waist-to-hip ratio (1.04; 1.02–1.06); all OR estimates remained significant after adjusting for estimated protein intake. Our results strongly support positive associations between total sugar intake, measures of obesity and likelihood of being obese. It is the first time that such an association has been shown in a nationally-representative sample of the general population using a validated biomarker. This biomarker could be used to monitor the efficacy of public health interventions to reduce sugar intake.

Date Created
2017-07-19
Agent

Urinary Sugars - A Biomarker of Total Sugars Intake

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Description

Measurement error in self-reported sugars intake may explain the lack of consistency in the epidemiologic evidence on the association between sugars and disease risk. This review describes the development and applications of a biomarker of sugars intake, informs its future…

Measurement error in self-reported sugars intake may explain the lack of consistency in the epidemiologic evidence on the association between sugars and disease risk. This review describes the development and applications of a biomarker of sugars intake, informs its future use and recommends directions for future research. Recently, 24 h urinary sucrose and fructose were suggested as a predictive biomarker for total sugars intake, based on findings from three highly controlled feeding studies conducted in the United Kingdom. From this work, a calibration equation for the biomarker that provides an unbiased measure of sugars intake was generated that has since been used in two US-based studies with free-living individuals to assess measurement error in dietary self-reports and to develop regression calibration equations that could be used in future diet-disease analyses. Further applications of the biomarker include its use as a surrogate measure of intake in diet-disease association studies. Although this biomarker has great potential and exhibits favorable characteristics, available data come from a few controlled studies with limited sample sizes conducted in the UK. Larger feeding studies conducted in different populations are needed to further explore biomarker characteristics and stability of its biases, compare its performance, and generate a unique, or population-specific biomarker calibration equations to be applied in future studies. A validated sugars biomarker is critical for informed interpretation of sugars-disease association studies.

Date Created
2015-07-15
Agent

Exploring the weight loss strategies adopted by overweight and obese parent and child dyads

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Description
Objectives: This study examines weight loss strategies (eating, physical activity (PA), or both) adopted by overweight or obese (OWOB) parents and children in relation to age, income, gender, education, and race/ethnicity in a predominantly low-income and high minority sample. We…

Objectives: This study examines weight loss strategies (eating, physical activity (PA), or both) adopted by overweight or obese (OWOB) parents and children in relation to age, income, gender, education, and race/ethnicity in a predominantly low-income and high minority sample. We also examine if OWOB parent-child dyads employed the same strategies to lose weight, and how these strategies vary by demographic variables.

Methods: Data was compiled from the New Jersey Childhood Obesity Study (NJCOB). A random digit dial household phone survey was used to select 1,708 households with at least one child aged 3-18 years from five cities in New Jersey. There were 231 OWOB parent-child dyads in this sample. Bivariate and multivariate analyses were performed to determine the demographic variables significantly associated with the type of weight loss strategy chosen.

Results: Males had higher odds of using PA and both eating and PA when compared to females. Higher income adults had higher odds of using all types of weight loss strategies compared to lower income adults. Adults with college education had higher odds of using eating and both eating and PA when compared to those with high school education. Older children (6-11 and 12-19 years) had higher odds of using PA when compared to younger children (2-5 years). Children of foreign-born parents (> 10 years in the US) had higher odds of using eating to lose weight compared to the children of US born parents. Children overall had higher odds of adopting a weight loss strategy if it was also adopted by the parent. In subgroup analysis, parent-child dyads had higher odds of adopting similar strategies among older children (12-19) and among girls, but this association did not hold true for younger children (2-11 years) and among boys for PA.

Conclusion: Older OWOB children (12-19) and female children had higher odds of adopting their parents’ weight loss strategies. Younger children did not follow the same pattern as their parents and among boys concordance was observed only for eating strategies. Results from the study may inform future family-based weight management interventions.
Date Created
2016
Agent

The Effect of Vitamin D Supplementation on Plasma Aβ in an Older Population: A Randomized Control Trial

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Description
Vitamin D deficiency has been previously associated with a higher Alzheimer’s disease (AD) risk, a condition marked by dependent living and severe cognitive impairment. AD is histologically defined by the presence of brain amyloid beta (Aβ) plaques and neurofibrillary tangles.…

Vitamin D deficiency has been previously associated with a higher Alzheimer’s disease (AD) risk, a condition marked by dependent living and severe cognitive impairment. AD is histologically defined by the presence of brain amyloid beta (Aβ) plaques and neurofibrillary tangles. Ways to enhance Aβ clearance have been examined in order to sustain cognition and delay AD onset. In vitro and in vivo studies suggest that vitamin D might enhance brain Aβ transportation to the periphery by up-regulating P-glycoprotein production. The purpose of this study was to examine the effect of vitamin D supplementation on plasma Aβ in an older population.

This study was a parallel-arm, double-blinded, randomized control trial. Participants consumed either a vitamin D supplement or placebo once a week for eight weeks (n=23). Only vitamin D insufficient (serum total 25-OH, D < 30 ng/mL) people were included in the study, and all participants were considered to be cognitively normal (MMSE scores > 27). Serum total 25-OH, D and plasma Aβ1-40 measurements were recorded before and after the eight-week trial. The plasma Aβ1-40 change was compared between the vitamin D group and control group.

The vitamin D group experienced a 45% greater change in plasma Aβ1-40 than the control group. The effect size was 0.228 when controlling for baseline plasma Aβ1-40 (p=0.045), 0.197 when controlling for baseline plasma Aβ1-40 and baseline physical activity (p=0.085), and 0.179 when controlling for baseline plasma Aβ1-40, baseline physical activity, and age (p=0.116). In conclusion, vitamin D supplementation might increase brain Aβ clearance in humans, but physical activity and age also appear to modulate Aβ metabolism.
Date Created
2015
Agent

Diet quality of omnivores, vegans and vegetarians as measured by the Healthy Eating Index 2010 and the Rapid Eating and Activity Assessment for Participants short version

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Description
Diet quality is closely intertwined with overall health status and deserves close examination. Healthcare providers are stretched thin in the current stressed system and would benefit from a validated tool for rapid assessment of diet quality. The Rapid Eating and…

Diet quality is closely intertwined with overall health status and deserves close examination. Healthcare providers are stretched thin in the current stressed system and would benefit from a validated tool for rapid assessment of diet quality. The Rapid Eating and Activity Assessment for Participants Short Version (REAP-S) represents one such option. The objective of the current study was to evaluate the effectiveness of the REAP-S and Healthy Eating Index 2010 (HEI-2010) for scoring the diet quality of omnivorous, vegetarian and vegan diets. Eighty-one healthy male and female subjects with an average age of 30.9 years completed the REAP-S as well as a 24-hour dietary recall. REAP-S and HEI-2010 scores were calculated for each subject and evaluated against each other using Spearman correlations and Chi Square. Further analysis was completed to compare diet quality scores of the HEI-2010 and REAP-S by tertiles to examine how closely these two tools score diet quality. The mean HEI-2010 score was 47.4/100 and the mean REAP-S score was 33.5/39. The correlation coefficient comparing the REAP-S to the HEI-2010 was 0.309 (p=0.005), and the REAP-S exhibited a precision of 44.4% to the HEI-2010 for diet quality. The REAP-S significantly correlated with the HEI-2010 for whole fruit (r=0.247, p=0.026), greens and beans (r=0.276, p=0.013), seafood proteins (r=0.298, p=0.007), and fatty acids (r=0.400, p<0.001). When evaluated by diet type, the REAP-S proved to have increased precision in plant-based diets, 50% for vegetarian and 52% for vegan, over omnivorous diets (32%). The REAP-S is a desirable tool to rapidly assess diet quality in the community setting as it is significantly correlated to the HEI-2010 and requires less time, labor and money to score and assess than the HEI-2010. More studies are needed to evaluate the precision and validity of REAP-S in a broader, more diverse population.
Date Created
2015
Agent
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