Ultra-Processed Food Consumption and Obesity Among US Children

Abstract Objectives With the rise in production and consumption of ultra-processed foods (UPF), children in the US consume a significant amount of total daily calories from UPF. High UPF consumption can contribute to obesity among US children through excessive calorie intake from UPF.1 We aimed to estimate the potential impact of reducing UPF consumption on childhood obesity in the US. Methods We modelled a nationally representative cohort of 5804 US children ages 7–18 years with weight, height, body mass index (BMI) percentile, and UPF consumption estimated from the National Health and Nutrition Examination Survey (NHANES) 2013–2016. From the reported difference in ad libitum calorie intake between individuals consuming a UPF vs. non-UPF diet in a randomized controlled trial, we estimated that children reduce their proportion of calories from UPF by 17% when switching to a non-UPF diet. Under this assumption, we projected weight loss based on estimated weight reduction due to calorie reduction in children accounting for potential changes in energy expenditure and appetite.2 We compared the current and modelled BMI distribution and prevalence of overweight and obesity by age (7–11 and 12–18 years) and sex (boys and girls). NHANES survey weights were used to estimate the mean BMI and prevalence of overweight and obesity among US children. Uncertainty of model inputs were incorporated using probabilistic sensitivity analysis with 1000 simulations. Results Under this scenario, the median (95% UI) of weight-adjusted BMI among US children ages 7–18 years old was 20.2 kg/m2 (19.7, 20.8), corresponding to a −1.74 kg/m2 (–2.67, −0.67) reduction in BMI. The median (95% UI) prevalence of overweight (BMI percentile ≥85th) and obesity (BMI percentile ≥95th percentile) was reduced from 37.2% (36.1%, 38.3%) to 23.3% (17.8%, 31.4%) and from 20.2% (19.3%, 21.1%) to 12.3% (9.3%,16.9%), respectively. Adolescent boys (–1.87 kg/m2: −2.42, −1.32) experienced the largest reduction in BMI, followed by adolescent girls (–1.73 kg/m2: −2.24, −1.22), boys ages 7–11 years (–1.66 kg/m2: −2.15, −1.17), and girls ages 7–11 years (–1.62 kg/m2: −2.10, - 1.15). Conclusions Reducing current levels of UPF consumption among US children has the potential to reduce the childhood obesity rate in the US to a great extent, especially among adolescents. Funding Sources NIH/NIMHD.

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Hispanic Maternal Perception of Preschoolers’ Bodyweight Status in Samples from the United States of America and Mexico

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_173 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1101-1101

Author(s):

Summer Wilmoth ◽

Yolanda Flores-Peña ◽

Leah Carrillo ◽

Elana Martinez ◽

Erica Sosa ◽

...

Keyword(s):

United States ◽

Childhood Obesity ◽

Obesity Prevention ◽

Weight Status ◽

The United States ◽

Overweight And Obesity ◽

Actual Rate ◽

Actual Weight ◽

Hispanic Mothers ◽

The Us

Abstract Objectives Childhood obesity is a major public health concern, which disproportionally affects Hispanic children in the United States (US) and Mexico. Mothers are key influencers to their children's health and growth. As part of a pilot obesity prevention study, Hispanic mothers’ perception of their preschoolers’ weight status was assessed to inform the development of intervention strategies. Methods Study subjects were Hispanic mothers and their preschoolers between the ages of 3 and 5 enrolled in participating Head Star Centers in Texas, US or kindergartens in Northern Mexico. Upon informed consent, mothers completed a self-administered questionnaire assessing their perception of their preschoolers’ weight status. Preschoolers’ body weight and height were measured; and their actual weight status was classified using the CDC's age and gender specific BMI references. Results Preliminary data included 85 and 294 child-mother pairs from US and Mexico, respectively. The US sample had a higher rate of overweight and obesity (35%) in comparison to the Mexico sample (19%). There was a great discrepancy between mothers’ perception and their children's actual weight status in both samples. Although only approximately 5% of children were underweight, 14% of American and 24% of Mexican mothers perceived their children being underweight. Contrarily, only 4.8% of American mothers perceived their children as a little overweight or obese, as compared to the actual rate of 35%. Similarly, only 5% of Mexican mothers perceived their children as a little overweight or obese, as compared to the actual rate of 19%. Conclusions Hispanic mothers in the US and Mexico appear to worry about their normal weight children being underweight, while overlooking the overweight and obesity problem. Early childhood obesity prevention programming is needed to aggressively address Hispanic mothers’ preference of chubby children, and the mothers’ underestimation of overweight and obesity among their preschoolers. Funding Sources The Mexico's National Science and Technology Council & The Kellogg´s Institute of Nutrition and Health.

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Prevalence and Trends of Adult Obesity in the US, 1999–2012

ISRN Obesity ◽

10.1155/2014/185132 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

Ruopeng An

Keyword(s):

Overweight And Obesity ◽

Close Monitoring ◽

Health And Nutrition ◽

Measured Weight ◽

Significant Difference ◽

The Us ◽

Before And After ◽

Prevalence Of Obesity ◽

Grade 3 ◽

Socioeconomic Consequences

Aim. To provide national estimates of obesity among US adults aged 20 years and older in 2011-2012 and track its trends from 1999 to 2012. Methods. Measured weight/height from National Health and Nutrition Examination Survey 1999–2012 waves was used to calculate body mass index (BMI) and prevalence measures. Piecewise logistic regressions were conducted to test the differential trends before and after 2010. Results. In 2011-2012, the age-adjusted prevalence of overweight and obesity combined (BMI≥25) was 71.1% (95% CI: 68.0%–74.2%) among men and 65.5% (61.8%–69.3%) among women, and the prevalence of obesity (BMI≥30) was 33.3% (30.5%–36.2%) among men and 35.8% (32.3%–39.4%) among women. From 1990–2000 to 2009-2010, the prevalence of overweight and obesity combined, obesity, grades 2 and 3 obesity combined (BMI≥35), and grade 3 obesity (BMI≥40) increased by 7.2%, 17.8%, 17.6%, and 33.0%, respectively. Compared to 2009-2010, most gender- and race/ethnicity-specific prevalence measures remained unchanged or slightly decreased in 2011-2012. No significant difference in trends among prevalence measures was found before and after 2010. Conclusions. Concurrent evidence on the leveling off of obesity in the US is thin. Given its high prevalence and profound socioeconomic consequences, close monitoring of the trend is warranted.

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Replacing the nutrients in dairy foods with non-dairy foods will increase cost, energy intake and require large amounts of food: National Health and Nutrition Examination Survey 2011–2014

Public Health Nutrition ◽

10.1017/s1368980020001937 ◽

2020 ◽

pp. 1-12

Author(s):

Christopher J Cifelli ◽

Nancy Auestad ◽

Victor L Fulgoni

Keyword(s):

National Health ◽

Tap Water ◽

Phase 1 ◽

Dietary Guidelines ◽

Nutrition Examination Survey ◽

Dairy Foods ◽

Health And Nutrition ◽

The Us ◽

Dietary Guidelines For Americans ◽

Nationally Representative

Abstract Objective: The US Dietary Guidelines for Americans recommends increased consumption of the dairy group to three daily servings for ages 9+ years to help achieve adequate intakes of prominent shortfall nutrients. Identifying affordable, consumer-acceptable foods to replace dairy’s shortfall nutrients is important especially for people who avoid dairy. Design: Linear programming identified food combinations to replace dairy’s protein and shortfall nutrients. We examined cost, energy and dietary implications of replacing dairy with food combinations optimised for lowest cost, fewest kJ or the smallest amount of food by weight. Setting: National Health and Nutrition Examination Survey (2011–2014). Participants: Nationally representative sample of US population; 2 years and older (n 15 830). Results: Phase 1 (only dairy foods excluded): when optimised for lowest cost or fewest kJ, all non-dairy food replacements required large amounts (2·5–10 cups) of bottled/tap water. Phase 2 (dairy and unreasonable non-dairy foods excluded (e.g. baby foods; tap/bottled water): when intake of non-dairy foods was constrained to <90th percentile of current intake, the lowest cost food combination replacements for dairy cost 0·5 times more and provide 5·7 times more energy; the lowest energy food combinations cost 5·9 times more, provide 2·5 times more energy and require twice the amount of food by weight; and food combinations providing the smallest amount of food by weight cost 3·5 times more and provide five times more energy than dairy. Conclusions: Identifying affordable, consumer-acceptable foods that can replace dairy’s shortfall nutrients at both current and recommended dairy intakes remains a challenge.

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Prevalence and characteristics of misreporting of energy intake in US children and adolescents: National Health and Nutrition Examination Survey (NHANES) 2003–2012

British Journal Of Nutrition ◽

10.1017/s0007114515004304 ◽

2015 ◽

Vol 115 (2) ◽

pp. 294-304 ◽

Cited By ~ 31

Author(s):

Kentaro Murakami ◽

M. Barbara E. Livingstone

Keyword(s):

Physical Activity ◽

Children And Adolescents ◽

Energy Intake ◽

National Health ◽

Normal Weight ◽

Activity Level ◽

Nutrition Examination Survey ◽

Health And Nutrition ◽

The Us ◽

Us Children

AbstractUsing data from the National Health and Nutrition Examination Survey (NHANES) 2003–2012, we investigated the prevalence and characteristics of under- and over-reporting of energy intake (EI) among 14 044 US children and adolescents aged 2–19 years. For the assessment of EI, two 24-h dietary recalls were conducted with the use of the US Department of Agriculture Automated Multiple-Pass Method. Under-, plausible and over-reporters of EI were identified using two methods: based on the 95 % confidence limits (1) for agreement between the ratio of EI:BMR and a physical activity level for sedentary lifestyle (1·55) and (2) of the expected ratio of EI:estimated energy requirement (EER) of 1·0. BMR was calculated using Schofield’s equations. EER was calculated using equations from the US Dietary Reference Intakes, assuming ‘low active’ level of physical activity. The risk of being an under- or over-reporter compared with a plausible reporter was analysed using multiple logistic regression. Percentages of under-, plausible and over-reporters were 13·1, 81·5 and 5·4 %, respectively, based on EI:BMR and 18·8, 72·3 and 8·8 %, respectively, based on EI:EER. Under-reporting was associated with older age, non-Hispanic blacks (compared with non-Hispanic whites) and overweight and obesity (compared with normal weight). Over-reporting was associated with younger age, lower family poverty income ratio, normal weight and the first survey cycle. Similar findings were obtained when analysing only the first 24-h recall data from NHANES 1999–2012 (n 22 949). In conclusion, we found that EI misreporting remains prevalent and differential in US children and adolescents.

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Urinary Phenols and Parabens Metabolites with Cardiovascular Disease in United States Adult

10.21203/rs.3.rs-562561/v1 ◽

2021 ◽

Author(s):

Ting Yin ◽

Xu Zhu ◽

Iokfai Cheang ◽

Yufei Zhou ◽

Shengen Liao ◽

...

Keyword(s):

Heart Attack ◽

Cross Sectional Study ◽

Spline Regression ◽

Multivariate Logistic Regression ◽

Cvd Risk ◽

Cross Sectional ◽

Health And Nutrition ◽

The Us ◽

Nationally Representative ◽

Positive Correlations

Abstract Environmental health has begun to examine the effects of higher-order chemical combinations. The current literature lacks studies exploring associations between multiple organic chemicals mixture and cardiometabolic disease (CVD). This study aimed to evaluate associations between urinary phenol and paraben metabolites and total and individual CVD among a nationally representative sample of adults in the US. This cross-sectional study analyzed 7 urinary chemicals detected among the general population from the 2005–2016 National Health and Nutrition Examination Survey (NHANES, n = 10,428). Multivariate logistic regression and weighted quantile sum (WQS) regression were applied to examine relationships between phenol and paraben metabolites, alone and combined, and total and individual CVD prevalence. WQS regression showed that phenol and paraben indices were independently correlated with total CVD (adjusted odds ratios [OR]: 1.16; 95% confidence interval [CI]:1.06–1.28; P = 0.002), angina (adjusted OR: 1.30; 95% CI: 1.07–1.59; P = 0.009), and heart attack (adjusted OR: 1.30; 95% CI: 1.12–1.51, P < 0.001). Urinary bisphenol A (URBPA, weight = 0.636) was the most heavily weighted component in the total CVD model. Compared with the lowest quartile, URBPA (OR: 1.52; 95% CI: 1.20–1.91; P = 0.001) levels in the highest quartile were independently associated with increased total CVD. Restricted cubic spline regression demonstrated positive correlations and non-linear associations between URBPA and both total CVD (P for nonlinearity = 0.032) and individual CVD (heart attack; P for nonlinearity = 0.031). Our findings suggested that high combined levels of phenols and parabens are associated with an increased CVD risk, with the URBPA contributing the highest risk.

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Apolipoprotein B/Apolipoprotein A-I Ratio Is a Better Predictor of Cancer Mortality Compared with C-Reactive Protein: Results from Two Multi-Ethnic US Populations

Journal of Clinical Medicine ◽

10.3390/jcm9010170 ◽

2020 ◽

Vol 9 (1) ◽

pp. 170 ◽

Cited By ~ 1

Author(s):

Mohsen Mazidi ◽

Niki Katsiki ◽

Dimitri P. Mikhailidis ◽

Dina Radenkovic ◽

Daniel Pella ◽

...

Keyword(s):

Cancer Mortality ◽

Apolipoprotein B ◽

Adult Population ◽

C Reactive Protein ◽

Reactive Protein ◽

Health And Nutrition ◽

The Us ◽

Nationally Representative ◽

Adjusted Model

Background: There is a lack of evidence regarding the link between apolipoproteins and cancer mortality. By using two nationally representative samples of US adults, we prospectively evaluated the associations between apolipoprotein B (apoB) levels and apoB/apoA-I ratio with cancer mortality. We also examined the role of C-reactive protein (CRP) in these associations. Materials and Methods: Adults aged ≥20 years, enrolled in the 3rd National Health and Nutrition Examination Survey (NHANES III, 1988–1994) and continuous NHANES (2005–2010), and followed up to 31 December 2011, were included in the analysis. Multiple Cox regressions were applied to evaluate the associations between the variables of interest and cancer mortality. Results: Overall, 7695 participants were included (mean age: 49.2 years; 50.4% men, median follow-up: 19.1 years). In the fully adjusted model, participants in the highest quartile (Q4) of apoB/apoA-I had a significantly greater risk for cancer mortality (hazard ratio (HR): 1.40; 95% confidence interval (CI): 1.25–1.93) compared with those in the first quartile (Q1). In the same model, a positive and significant association between apoB levels and cancer mortality was observed for individuals in Q3 (HR: 1.12; 95% CI: 1.09–1.16) and Q4 (HR: 1.17; 95% CI: 1.09–1.25) compared with those in Q1. When CRP levels were added in the analysis, the apoB/apoA-I ratio, but not apoB levels, remained significantly related to cancer mortality (Q4 = HR: 1.17; 95% CI: 1.09–1.25). In contrast, CRP levels were not able to predict cancer death after correction for apoB/apoA-I ratio. Conclusions: In a large representative sample of the US adult population, the apoB/apoA-I ratio and apoB levels significantly predicted cancer mortality, independently of several cardiometabolic risk factors. The predictive value of apoB/apoA-I, but not apoB levels, remained significant after taking into account CRP, whereas CRP was not associated with cancer mortality after adjustment for apoB/apoA-I ratio. If further evidence supports our findings, apoA-I and apoB measurements could be considered in general healthcare policies.

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Fruit and vegetable intake of US adults estimated by two methods: What We Eat In America, National Health and Nutrition Examination Survey 2009–2012

Public Health Nutrition ◽

10.1017/s1368980016000628 ◽

2016 ◽

Vol 19 (14) ◽

pp. 2508-2512 ◽

Cited By ~ 6

Author(s):

M Katherine Hoy ◽

Joseph D Goldman ◽

Rhonda S Sebastian

Keyword(s):

National Health ◽

Vegetable Intake ◽

Nutrition Examination Survey ◽

Fruit And Vegetable ◽

Validity Of Results ◽

Added Sugar ◽

Health And Nutrition ◽

The Us ◽

Nationally Representative ◽

Definition Of

AbstractObjectiveEstimates of fruit and vegetable (FV) consumption vary depending on intake definition, which may be determined by research purpose. Researchers have used two methods to evaluate intake: epidemiological and behavioural. The present study describes FV intake by adults using epidemiological v. behavioural approaches.DesignOne-day dietary intake data from What We Eat In America, National Health and Nutrition Examination Survey 2009–2012 were used. Sample weights were used to produce nationally representative estimates. FV intake (in cup-equivalents (CE)) was estimated using the Food Patterns Equivalents Database. The epidemiological method considered all FV after disaggregating foods and beverages. The behavioural method included foods that provided at least 0·2 CE FV per 100 g, and excluded sources high in fat, added sugar and Na.SettingNationally representative survey of the US population.SubjectsAdults (n 10 563) aged ≥20 years.ResultsFor epidemiological v. behavioural, fruit intake was 1·1 v. 1·0 CE for males and 1·0 v. 0·9 CE for females. Vegetable intake was 1·8 v. 1·1 CE for males and 1·5 v. 1·0 CE for females.ConclusionsThe definition of FV intake affects estimates of consumption by the population and is an important consideration when planning and comparing research studies. The method used should align with research goals to assure accurate interpretation and validity of results.

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Childhood Obesity in Serbia on the Rise

Children ◽

10.3390/children8050409 ◽

2021 ◽

Vol 8 (5) ◽

pp. 409

Author(s):

Lidija Marković ◽

Višnja Đorđić ◽

Nebojša Trajković ◽

Predrag Božić ◽

Szabolcs Halaši ◽

...

Keyword(s):

Childhood Obesity ◽

Primary School ◽

School Children ◽

Body Height ◽

Overweight And Obesity ◽

Primary School Children ◽

Obesity Prevalence ◽

Cross Sectional ◽

Monitoring And Surveillance ◽

Nationally Representative

The aim of the study was to examine changes in obesity prevalence among primary school children in Serbia between 2015 and 2019 rounds of the national WHO European Childhood Obesity Surveillance Initiative (COSI-Serbia). Cross-sectional studies were conducted in 2015 and 2019. The nationally representative samples of primary school children were measured for body height and weight, following the COSI protocol. Body Mass Index was calculated, and the IOTF and WHO definitions were used to classify children as overweight or obese. Participants were children of both sexes aged 7.00–8.99 years (n = 6105). Significant differences in overweight (obesity included) prevalence between two COSI rounds were identified regardless of definitions applied. According to the WHO definitions, prevalence of overweight and obesity combined increased in 7–9-year-old children in Serbia from 30.7% in 2015 to 34.8% in 2019 (z = −3.309, p < 0.05), and according to the IOTF standards, the increase from 22.8% to 30% was registered (z = −6.08, p = 0.00). The childhood overweight/obesity rate is increasing in Serbia, which places monitoring and surveillance of children’s nutritional status high on the public health agenda.

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Economic precarity, social isolation, and suicidal ideation during the COVID-19 pandemic

10.1101/2020.10.05.20205955 ◽

2020 ◽

Author(s):

Julia Raifman ◽

Catherine K. Ettman ◽

Lorraine Dean ◽

Colleen Barry ◽

Sandro Galea

Keyword(s):

Suicidal Ideation ◽

Social Isolation ◽

Low Income ◽

Job Loss ◽

Well Being ◽

Health And Nutrition ◽

The Us ◽

Nationally Representative ◽

Policies And Programs ◽

The Relationship

AbstractImportanceThe US population faces stressors associated with suicide brought on by the COVID-19 pandemic. Understanding the relationship between stressors and suicidal ideation may inform policies and programs to prevent suicide.ObjectiveTo evaluate the relationship between stressors and suicidal ideation during the COVID-19 pandemic.DesignWe compared suicidal ideation in 2017-2018 to suicidal ideation in 2020. We estimated the association between stressors and suicidal ideation in bivariable and multivariable Poisson regression models with robust variance.SettingUnited StatesParticipantsParticipants were from two, nationally representative surveys of US adults: The 2017-2017 National Health and Nutrition Examination Survey and the 2020 COVID-19 and Life Stressors Impact on Mental Health and Well-being study (conducted March 31 to April 13), analyzed April 28 to September 30, 2020.ExposuresEconomic precarity as measured through job loss or difficulty paying rent and social isolation based on reporting “feeling alone.”Main outcome measureSuicidal ideation based on reporting “Thoughts that you would be better off dead or of hurting yourself in some way” over the past two weeks.ResultsSuicidal ideation increased more than fourfold, from 3.4% in the 2017-2018 NHANES to 16.3% in the 2020 CLIMB survey, and from 5.8% to 26.4% among participants in low-income households. Suicidal ideation was more prevalent among people facing difficulty paying rent (31.5%), job loss (24.1%), and loneliness (25.1%), with each stressor associated with suicidal ideation in bivariable models. In the multivariable model, difficulty paying rent was associated with suicidal ideation (aPR: 1.5, 95% CI: 1.2 to 2.1), while losing a job was not (aPR: 0.9, 95% CI: 0.6 to 1.2). Feeling alone was associated with suicidal ideation (aPR: 1.9, 95% CI: 1.5 to 2.4).Conclusions and relevanceSuicidal ideation increased more than fourfold during the COVID-19 pandemic. Difficulty paying rent and loneliness were most associated with suicidal ideation. Policies and programs to support people experiencing economic precarity and loneliness may contribute to suicide prevention.

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Reframing the US Attendance Crisis: School Absences Send Powerful Signals about Children Nationally

10.35542/osf.io/rys96 ◽

2022 ◽

Author(s):

Jaymes Pyne ◽

Eric Grodsky

Keyword(s):

Student Achievement ◽

Test Score ◽

Student Attendance ◽

Underserved Students ◽

Increase Student Achievement ◽

The Us ◽

Systemic Level ◽

Underlying Causes ◽

Nationally Representative ◽

Us Children

Some believe that holding schools accountable for student attendance will lead schools to act to reduce student absences and by doing so will increase student achievement, particularly for historically underserved students. We question both the premise that reducing absence will lead to substantial improvements in student achievement and fairness of holding school accountable for increasing attendance. Using two cohorts of nationally-representative data on kindergarteners, we find that factors unrelated to missed instruction account for at least 77 percent of the association between attendance and test score achievement among US children with twenty or more absences. We argue the attendance crisis conceals more troubling crises that will produce inequalities even if every child attends school every day, and that schools are ill-suited to address all the underlying causes of student absence. Absence is a symptom of the myriad challenges students and their families face—challenges that need to be addressed at a larger systemic level.

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