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‘Globesization’: ecological evidence on the relationship between fast food outlets and obesity among 26 advanced economies
‘Globesization’: ecological evidence on the relationship between fast food outlets and obesity among 26 advanced economies
Source: Critical Public Health
The aim of this study was to investigate the relationship between the density of fast food restaurants and the prevalence of obesity by gender across affluent nations. Data on Subway’s restaurants per 100,000 people and proportions of men and women aged 15 years or older with a body mass index higher or equal than 30 kg/m2 were obtained for 26 of 34 advanced economies. Countries with the highest density of Subway restaurants such as the USA (7.52 per 100,000) and Canada (7.43 per 100,000) also tend to have a higher prevalence of obesity in both men (31.3% and 23.2%, respectively) and women (33.2% and 22.9%, respectively). On the other hand, countries with a relatively low density of Subway restaurants such as Japan (0.13 per 100,000) and Norway (0.19 per 100,000) had a lower prevalence of obesity in both men (2.9% and 6.4%, respectively) and women (3.3% and 5.9%, respectively). Unadjusted linear regression models showed a significant correlation between the density of Subway’s outlets and the prevalence of adult obesity (β = 0.46; p = 0.02 in men and β = 0.48; p = 0.013 in women). When the data were weighted by population size, the associations became substantially stronger in both men and women (β = 0.85; p = 0.0001 and β = 0.84; p = 0.0001, respectively). Covariate adjustment did not reduce the size of the associations. Our study raises serious concerns about the diffusion of fast food outlets worldwide and calls for coordinated political actions to address what we term ‘globesization’, the ongoing globalization of the obesity epidemic.
The effect of physicians’ body weight on patient attitudes: implications for physician selection, trust and ad herence to medical advice
Source: International Journal of Obesity
Background:
Research has documented negative stigma by health providers toward overweight and obese patients, but it is unknown whether physicians themselves are vulnerable to weight bias from patients.
Purpose:
This study assessed public perceptions of normal weight, overweight or obese physicians to identify how physicians’ body weight affects patients’ selection, trust and willingness to follow the medical advice of providers.
Methods:
An online sample of 358 adults were randomly assigned to one of three survey conditions in which they completed a questionnaire assessing their perceptions of physicians who were described as normal weight, overweight or obese. Participants also completed a measure of explicit weight bias (Fat Phobia Scale) to determine whether antifat attitudes are associated with weight-related perceptions of physicians.
Results:
Respondents reported more mistrust of physicians who are overweight or obese, were less inclined to follow their medical advice, and were more likely to change providers if the physician was perceived to be overweight or obese, compared to normal-weight physicians who elicited significantly more favorable reactions. These weight biases remained present regardless of participants’ own body weight. Inspection of interaction effects revealed opposing effects of weight bias between the obese/overweight and normal-weight physician conditions. Stronger weight bias led to higher trust, more compassion, more inclination to follow advice, and less inclination to change doctors when the physician was presented as normal weight. In contrast, stronger weight bias led to less trust, less compassion, less inclination to follow advice and higher inclination to change doctors when the physician was presented as obese.
Conclusions:
This study suggests that providers perceived to be overweight or obese may be vulnerable to biased attitudes from patients, and that providers’ excess weight may negatively affect patients’ perceptions of their credibility, level of trust and inclination to follow medical advice.
Food-Related Parenting Practices and Adolescent Weight Status: A Population-Based Study
Food-Related Parenting Practices and Adolescent Weight Status: A Population-Based Study
Source: Pediatrics
OBJECTIVE: To examine food-related parenting practices (pressure-to-eat and food restriction) among mothers and fathers of adolescents and associations with adolescent weight status within a large population-based sample of racially/ethnically and socioeconomically diverse parent-adolescent pairs.
METHODS: Adolescents (N = 2231; 14.4 years old [SD = 2.0]) and their parents (N = 3431) participated in 2 coordinated population-based studies designed to examine factors associated with weight status and weight-related behaviors in adolescents. Adolescents completed anthropometric measurements and surveys at school. Parents (or other caregivers) completed questionnaires via mail or phone.
RESULTS: Findings suggest that the use of controlling food-related parenting practices, including pressure-to-eat and restriction, is common among parents of adolescents. Mean restriction levels were significantly higher among parents of overweight and obese adolescents compared with nonoverweight adolescents. However, levels of pressure-to-eat were significantly higher among nonoverweight adolescents. Results indicate that fathers are more likely than mothers to engage in pressure-to-eat behaviors and boys are more likely than girls to be on the receiving end of parental pressure-to-eat. Parental report of restriction did not differ significantly by parent or adolescent gender. No significant interactions by race/ethnicity or socioeconomic status were seen in the relationship between restriction or pressure-to-eat and adolescent weight status.
CONCLUSIONS: Given that there is accumulating evidence for the detrimental effects of controlling feeding practices on children’s ability to self-regulate energy intake, these findings suggest that parents should be educated and empowered through anticipatory guidance to encourage moderation rather than overconsumption and emphasize healthful food choices rather than restrictive eating patterns.
Assessing the Online Social Environment for Surveillance of Obesity Prevalence
Assessing the Online Social Environment for Surveillance of Obesity Prevalence
Source: PLoS ONE
Background
Understanding the social environmental around obesity has been limited by available data. One promising approach used to bridge similar gaps elsewhere is to use passively generated digital data.
Purpose
This article explores the relationship between online social environment via web-based social networks and population obesity prevalence.
Methods
We performed a cross-sectional study using linear regression and cross validation to measure the relationship and predictive performance of user interests on the online social network Facebook to obesity prevalence in metros across the United States of America (USA) and neighborhoods within New York City (NYC). The outcomes, proportion of obese and/or overweight population in USA metros and NYC neighborhoods, were obtained via the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance and NYC EpiQuery systems. Predictors were geographically specific proportion of users with activity-related and sedentary-related interests on Facebook.
Results
Higher proportion of the population with activity-related interests on Facebook was associated with a significant 12.0% (95% Confidence Interval (CI) 11.9 to 12.1) lower predicted prevalence of obese and/or overweight people across USA metros and 7.2% (95% CI: 6.8 to 7.7) across NYC neighborhoods. Conversely, greater proportion of the population with interest in television was associated with higher prevalence of obese and/or overweight people of 3.9% (95% CI: 3.7 to 4.0) (USA) and 27.5% (95% CI: 27.1 to 27.9, significant) (NYC). For activity-interests and national obesity outcomes, the average root mean square prediction error from 10-fold cross validation was comparable to the average root mean square error of a model developed using the entire data set.
Conclusions
Activity-related interests across the USA and sedentary-related interests across NYC were significantly associated with obesity prevalence. Further research is needed to understand how the online social environment relates to health outcomes and how it can be used to identify or target interventions.
Regulating the Way to Obesity: Unintended Consequences of Limiting Sugary Drink Sizes
Regulating the Way to Obesity: Unintended Consequences of Limiting Sugary Drink Sizes
Source: PLoS ONE
Objectives
We examined whether a sugary drink limit would still be effective if larger-sized drinks were converted into bundles of smaller-sized drinks.
Methods
In a behavioral simulation, participants were offered varying food and drink menus. One menu offered 16 oz, 24 oz, or 32 oz drinks for sale. A second menu offered 16 oz drinks, a bundle of two 12 oz drinks, or a bundle of two 16 oz drinks. A third menu offered only 16 oz drinks for sale. The method involved repeated elicitation of choices, and the instructions did not mention a limit on drink size.
Results
Participants bought significantly more ounces of soda with bundles than with varying-sized drinks. Total business revenue was also higher when bundles rather than only small-sized drinks were sold.
Conclusions
Our research suggests that businesses have a strong incentive to offer bundles of soda when drink size is limited. Restricting larger-sized drinks may have the unintended consequence of increasing soda consumption rather than decreasing it.
A Behavioral Weight-Loss Intervention in Persons with Serious Mental Illness
A Behavioral Weight-Loss Intervention in Persons with Serious Mental Illness
Source: New England Journal of Medicine
Background
Overweight and obesity are epidemic among persons with serious mental illness, yet weight-loss trials systematically exclude this vulnerable population. Lifestyle interventions require adaptation in this group because psychiatric symptoms and cognitive impairment are highly prevalent. Our objective was to determine the effectiveness of an 18-month tailored behavioral weight-loss intervention in adults with serious mental illness.Methods
We recruited overweight or obese adults from 10 community psychiatric rehabilitation outpatient programs and randomly assigned them to an intervention or a control group. Participants in the intervention group received tailored group and individual weight-management sessions and group exercise sessions. Weight change was assessed at 6, 12, and 18 months.Results
Of 291 participants who underwent randomization, 58.1% had schizophrenia or a schizoaffective disorder, 22.0% had bipolar disorder, and 12.0% had major depression. At baseline, the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 36.3, and the mean weight was 102.7 kg (225.9 lb). Data on weight at 18 months were obtained from 279 participants. Weight loss in the intervention group increased progressively over the 18-month study period and differed significantly from the control group at each follow-up visit. At 18 months, the mean between-group difference in weight (change in intervention group minus change in control group) was −3.2 kg (−7.0 lb, P=0.002); 37.8% of the participants in the intervention group lost 5% or more of their initial weight, as compared with 22.7% of those in the control group (P=0.009). There were no significant between-group differences in adverse events.Conclusions
A behavioral weight-loss intervention significantly reduced weight over a period of 18 months in overweight and obese adults with serious mental illness. Given the epidemic of obesity and weight-related disease among persons with serious mental illness, our findings support implementation of targeted behavioral weight-loss interventions in this high-risk population. (Funded by the National Institute of Mental Health; ACHIEVE ClinicalTrials.gov number, NCT00902694.)
Associations between Psychological Distress and Body Mass Index among Law Enforcement Officers: The National Health Interview Survey 2004-2010
Source: Safety and Health at Work
Objectives:
To investigate the association between psychological distress and obesity among law enforcement officers (LEOs) in the United States.
Methods:
Self-reported data on psychological distress based on six key questions were obtained from LEOs who participated in the National Health Interview Survey (2004-2010). We used Prochaska’s cut-point of a Kessler 6 score ≥ 5 for moderate/high mental distress in our analysis. Mean levels of body mass index (BMI) were compared across three levels of psychological distre ss.
Results:
The average age of LEOs (n = 929) was 39.3 years; 25% were female. Overall, 8.1% of LEOs had moderate or high psy- chological distress; 37.5% were obese (BMI ≥ 30). Mean BMI increased with increasing psychological distress (no distress, BMI = 27.2 kg/m 2 ; mild distress, 27.6 kg/m 2 ; and moderate/high distress, 33.1 kg/m 2 ; p = 0.016) after adjustment for age, race, income, and education level among female officers only. Physical activity modified the association between psychological distress and B MI but only among male LEOs (interaction p = 0.002). Among male LEOs reporting low physical activity, psychological distress was positively associated with BMI (30.3 kg/m 2 for no distress, 30.7 for mild distress, 31.8 for moderate/high distress; p = 0.179) after adjustment, but not significantly. This association was not significant among males reporting high physical activity.
Conclusion:
Mean BMI significantly increased as psychological distress increased among female LEOs. A longitudinal study de-sign may reveal the directionality of this association as well as the potential role that physical activity might play in this association.
The Impact of Bariatric Surgery on Psychological Health
The Impact of Bariatric Surgery on Psychological Health (PDF)
Source: Journal of Obesity
Obesity is associated with a relatively high prevalence of psychopathological conditions, which may have a significant negative impact on the quality of life. Bariatric surgery is an effective intervention in the morbidly obese to achieve marked weight loss and improve physical comorbidities, yet its impact on psychological health has yet to be determined. A review of the literature identified a trend suggesting improvements in psychological health after bariatric surgery. Majority of mental health gain is likely attributed to weight loss and resultant gains in body image, self-esteem, and self-concept; however, other important factors contributing to postoperative mental health include a patient’s sense of taking control of his/her life and support from health care staff. Preoperative psychological health also plays an important role. In addition, the literature suggests similar benefit in the obese pediatric population. However, not all patients report psychological benefits after bariatric surgery. Some patients continue to struggle with weight loss, maintenance and regain, and resulting body image dissatisfaction. Severe preoperative psychopathology and patient expectation that life will dramatically change after surgery can also negatively impact psychological health after surgery. The health care team must address these issues in the perioperative period to maximize mental health gains after surgery.
Strategies To Prevent Weight Gain Among Adults
Strategies To Prevent Weight Gain Among Adults (PDF)
Source: Agency for Healthcare Research and Quality
Objectives.
Adults tend to gain weight progressively through middle age. Although the average weight gain is 0.5 to 1 kg per year, this modest accumulation of weight can lead to obesity over time. We aimed to compare the effectiveness, safety, and impact on quality of life of strategies to prevent weight gain among adults. Self-management, dietary, physical activity, orlistat and combinations of these strategies were considered.
Data sources.
We searched MEDLINE ® , Embase ® , theCochrane Central Register of Controlled Trials, CINAHL® , and PsycINFO® through June 2012 for published articles that were potentially eligible for this review.
Review methods.
Two reviewers independently reviewed titles, abstracts, and articles, and included English-language articles that reported on maintenance of weight or prevention of weight gain among adults. Studies targeting a combination of weight loss with weight maintenance or weight loss exclusively were considered to be outside of the scope of this review. Trials of interventions and observational studies of approaches with at least 1 year of followup with a weight outcome were included. Data were abstracted on measures of weight, adherence, obesity-related outcomes, safety, and quality of life. The timepoints of interest for weight outcomes were: 1 year, 2 years, 5 years, and the last reported timepoint after 5 years. For the other outcomes, we abstracted data only from the last reported timepoint on or after 1 year. We selected a meaningful difference threshold in addition to a statistically significant threshold (p<0.05) for the outcomes. A meaningful between group difference was defined as 0.5 kg of weight, 0.2 units of BMI (based on a 0.5-kg change for an individual with a BMI of 27), or 1 cm of waist circumference per year of followup. We considered an intervention or approach effective if the difference between groups met the meaningful between group difference threshold and was statistically significant. We qualitatively synthesized the studies by population, intervention, and outcome.
Results.
We included 58 publications (describing 51 studies) involving 555,783 patients. Two interventions may be effective compared with no intervention at preventing weight gain with moderate strengths of evidence: workplace interventions having individual and environmental components and exercise performed at home by women with cancer. Potentially effective interventions with low strength of evidence include a clinic-based program to teach heart rate monitoring, a combination intervention for mothers of young children, small group sessions to educate college women, and physical activity among individuals at risk of cardiovascular disease and diabetes. Potentially effective approaches described in observational studies having low strength of evidence include eating meals prepared at home among college graduates and less television viewing among individuals with colorectal cancer. When reported, adherence to interventions tended to be below 80 percent. There were no adverse events among the few trials that reported on adverse events. Trial study quality tended to be poor due to knowledge of the intervention by the study personnel who measured the weight of the participants or lack of reporting on this item. This lack of blinding of the outcome assessor along with inclusion of studies that were not designed to prevent weight gain resulted in a low strength of evidence for the majority of comparisons.
Conclusions.
The literature provides some, although limited, evidence about interventions and approaches that may prevent weight gain. Although there is not strong evidence to promote a particular weight gain prevention strategy, there is no evidence that not adopting a strategy to prevent weight gain is preferable.
Challenges and Opportunities for Change in Food Marketing to Children and Youth: Workshop Summary
Challenges and Opportunities for Change in Food Marketing to Children and Youth: Workshop Summary
Source: Institute of Medicine
The childhood obesity epidemic is an urgent public health problem. The most recent data available show that nearly 19 percent of boys and about 15 percent of girls aged 2-19 are obese, and almost a third of U.S. children and adolescents are overweight or obese (Ogden et al., 2012). The obesity epidemic will continue to take a substantial toll on the health of Americans. In the midst of this epidemic, children are exposed to an enormous amount of commercial advertising and marketing for food. In 2009, children aged 2-11 saw an average of more than 10 television food ads per day (Powell et al., 2011). Children see and hear advertising and marketing messages for food through many other channels as well, including radio, movies, billboards, and print media. Most notably, many new digital media venues and vehicles for food marketing have emerged in recent years, including Internet-based advergames, couponing on cell phones, and marketing on social networks, and much of this advertising is invisible to parents.
The marketing of high-calorie, low-nutrient foods and beverages is linked to overweight and obesity. A major 2006 report from the Institute of Medicine (IOM) documents evidence that television advertising influences the food and beverage preferences, requests, and short-term consumption of children aged 2-11 (IOM, 2006). Challenges and Opportunities for Change in Food Marketing to Children and Youth also documents a body of evidence showing an association of television advertising with the adiposity of children and adolescents aged 2-18. The report notes the prevailing pattern that food and beverage products marketed to children and youth are often high in calories, fat, sugar, and sodium; are of low nutritional value; and tend to be from food groups Americans are already overconsuming. Furthermore, marketing messages that promote nutrition, healthful foods, or physical activity are scarce (IOM, 2006). To review progress and explore opportunities for action on food and beverage marketing that targets children and youth, the IOM’s Standing Committee on Childhood Obesity Prevention held a workshop in Washington, DC, on November 5, 2012, titled "New Challenges and Opportunities in Food Marketing to Children and Youth."
Caloric Intake From Fast Food Among Adults: United States, 2007–2010
Caloric Intake From Fast Food Among Adults: United States, 2007–2010
Source: National Center for Health Statistics
Key findings
Data from the National Health and Nutrition Examination Survey
- During 2007–2010, adults consumed, on average, 11.3% of their total daily calories from fast food.
- The consumption of calories from fast food significantly decreased with age.
- Non-Hispanic black adults consumed a higher percentage of calories from fast food compared with non-Hispanic white and Hispanic adults.
- No difference was observed by income status in the percentage of calories consumed from fast food among all adults. Among young adults, however, as income increased, the percentage of calories from fast food decreased.
- The percentage of total daily calories from fast food increased as weight status increased.
As lifestyles become more hectic, fast-food consumption has become a growing part of the American diet (1,2). Fast food is food usually sold at eating establishments for quick availability or takeout (3). More than one-third of U.S. adults are obese (4), and frequent fast-food consumption has been shown to contribute to weight gain (1–6). This report presents the percentage of calories consumed from fast food by adults in the United States, including differences by sociodemographic characteristics and weight status.
USDA Proposes Standards to Provide Healthy Food Options in Schools
USDA Proposes Standards to Provide Healthy Food Options in Schools
Source: U.S. Department of Agriculture
USDA today announced it will seek public comment on proposed new standards to ensure that children have access to healthy food options in school.
…
The Healthy, Hunger-Free Kids Act of 2010 requires USDA to establish nutrition standards for all foods sold in schools — beyond the federally-supported school meals programs. The “Smart Snacks in School” proposed rule, to be published soon in the Federal Register, is the first step in the process to create national standards. The new proposed standards draw on recommendations from the Institute of Medicine, existing voluntary standards already implemented by thousands of schools around the country, and healthy food and beverage offerings already available in the marketplace.
Highlights of USDA’s proposal include:
- More of the foods we should encourage. Promoting availability of healthy snack foods with whole grains, low fat dairy, fruits, vegetables or protein foods as their main ingredients.
- Less of the foods we should avoid. Ensuring that snack food items are lower in fat, sugar, and sodium and provide more of the nutrients kids need.
- Targeted standards. Allowing variation by age group for factors such as beverage portion size and caffeine content.
- Flexibility for important traditions. Preserving the ability for parents to send in bagged lunches of their choosing or treats for activities such as birthday parties, holidays, and other celebrations; and allowing schools to continue traditions like occasional fundraisers and bake sales.
- Reasonable limitations on when and where the standards apply. Ensuring that standards only affect foods that are sold on school campus during the school day. Foods sold at an afterschool sporting event or other activity will not be subject to these requirements.
- Flexibility for state and local communities. Allowing significant local and regional autonomy by only establishing minimum requirements for schools. States and schools that have stronger standards than what is being proposed will be able to maintain their own policies.
- Significant transition period for schools and industry. The standards will not go into effect until at least one full school year after public comment is considered and an implementing rule is published to ensure that schools and vendors have adequate time to adapt.
Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-analysis
Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index Categories: A Systematic Review and Meta-analysis
Source: Journal of the American Medical Association
Importance
Estimates of the relative mortality risks associated with normal weight, overweight, and obesity may help to inform decision making in the clinical setting.Objective
To perform a systematic review of reported hazard ratios (HRs) of all-cause mortality for overweight and obesity relative to normal weight in the general population.Data Sources
PubMed and EMBASE electronic databases were searched through September 30, 2012, without language restrictions.Study Selection
Articles that reported HRs for all-cause mortality using standard body mass index (BMI) categories from prospective studies of general populations of adults were selected by consensus among multiple reviewers. Studies were excluded that used nonstandard categories or that were limited to adolescents or to those with specific medical conditions or to those undergoing specific procedures. PubMed searches yielded 7034 articles, of which 141 (2.0%) were eligible. An EMBASE search yielded 2 additional articles. After eliminating overlap, 97 studies were retained for analysis, providing a combined sample size of more than 2.88 million individuals and more than 270 000 deaths.Data Extraction
Data were extracted by 1 reviewer and then reviewed by 3 independent reviewers. We selected the most complex model available for the full sample and used a variety of sensitivity analyses to address issues of possible overadjustment (adjusted for factors in causal pathway) or underadjustment (not adjusted for at least age, sex, and smoking).Results
Random-effects summary all-cause mortality HRs for overweight (BMI of 25-<30), obesity (BMI of ≥30), grade 1 obesity (BMI of 30-<35), and grades 2 and 3 obesity (BMI of ≥35) were calculated relative to normal weight (BMI of 18.5-<25). The summary HRs were 0.94 (95% CI, 0.91-0.96) for overweight, 1.18 (95% CI, 1.12-1.25) for obesity (all grades combined), 0.95 (95% CI, 0.88-1.01) for grade 1 obesity, and 1.29 (95% CI, 1.18-1.41) for grades 2 and 3 obesity. These findings persisted when limited to studies with measured weight and height that were considered to be adequately adjusted. The HRs tended to be higher when weight and height were self-reported rather than measured.Conclusions and Relevance
Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons.
Integrating Technology Into Standard Weight Loss Treatment
Integrating Technology Into Standard Weight Loss Treatment
Source: Archives of Internal Medicine
Background
A challenge in intensive obesity treatment is making care scalable. Little is known about whether the outcome of physician-directed weight loss treatment can be improved by adding mobile technology.
Methods
We conducted a 2-arm, 12-month study (October 1, 2007, through September 31, 2010). Seventy adults (body mass index >25 and ≤40 [calculated as weight in kilograms divided by height in meters squared]) were randomly assigned either to standard-of-care group treatment alone (standard group) or to the standard and connective mobile technology system (+mobile group). Participants attended biweekly weight loss groups held by the Veterans Affairs outpatient clinic. The +mobile group was provided personal digital assistants to self-monitor diet and physical activity; they also received biweekly coaching calls for 6 months. Weight was measured at baseline and at 3-, 6-, 9-, and 12-month follow-up.
Results
Sixty-nine adults received intervention (mean age, 57.7 years; 85.5% were men). A longitudinal intent-to-treat analysis indicated that the +mobile group lost a mean of 3.9 kg more (representing 3.1% more weight loss relative to the control group; 95% CI, 2.2-5.5 kg) than the standard group at each postbaseline time point. Compared with the standard group, the +mobile group had significantly greater odds of having lost 5% or more of their baseline weight at each postbaseline time point (odds ratio, 6.5; 95% CI, 2.5-18.6).
Conclusions
The addition of a personal digital assistant and telephone coaching can enhance short-term weight loss in combination with an existing system of care. Mobile connective technology holds promise as a scalable mechanism for augmenting the effect of physician-directed weight loss treatment.
Estimation of Newborn Risk for Child or Adolescent Obesity: Lessons from Longitudinal Birth Cohorts
Estimation of Newborn Risk for Child or Adolescent Obesity: Lessons from Longitudinal Birth Cohorts
Source: PLoS ONE
Objectives
Prevention of obesity should start as early as possible after birth. We aimed to build clinically useful equations estimating the risk of later obesity in newborns, as a first step towards focused early prevention against the global obesity epidemic.
Methods
We analyzed the lifetime Northern Finland Birth Cohort 1986 (NFBC1986) (N = 4,032) to draw predictive equations for childhood and adolescent obesity from traditional risk factors (parental BMI, birth weight, maternal gestational weight gain, behaviour and social indicators), and a genetic score built from 39 BMI/obesity-associated polymorphisms. We performed validation analyses in a retrospective cohort of 1,503 Italian children and in a prospective cohort of 1,032 U.S. children.
Results
In the NFBC1986, the cumulative accuracy of traditional risk factors predicting childhood obesity, adolescent obesity, and childhood obesity persistent into adolescence was good: AUROC = 0·78[0·74–0.82], 0·75[0·71–0·79] and 0·85[0·80–0·90] respectively (all p<0·001). Adding the genetic score produced discrimination improvements ≤1%. The NFBC1986 equation for childhood obesity remained acceptably accurate when applied to the Italian and the U.S. cohort (AUROC = 0·70[0·63–0·77] and 0·73[0·67–0·80] respectively) and the two additional equations for childhood obesity newly drawn from the Italian and the U.S. datasets showed good accuracy in respective cohorts (AUROC = 0·74[0·69–0·79] and 0·79[0·73–0·84]) (all p<0·001). The three equations for childhood obesity were converted into simple Excel risk calculators for potential clinical use.
Conclusion
This study provides the first example of handy tools for predicting childhood obesity in newborns by means of easily recorded information, while it shows that currently known genetic variants have very little usefulness for such prediction.
Visual Diet versus Associative Learning as Mechanisms of Change in Body Size Preferences
Visual Diet versus Associative Learning as Mechanisms of Change in Body Size Preferences
Source: PLoS ONE
Systematic differences between populations in their preferences for body size may arise as a result of an adaptive ‘prepared learning’ mechanism, whereby cues to health or status in the local population are internalized and affect body preferences. Alternatively, differences between populations may reflect their ‘visual diet’ as a cognitive byproduct of mere exposure. Here we test the relative importance of these two explanations for variation in body preferences. Two studies were conducted where female observers were exposed to pictures of high or low BMI women which were either aspirational (healthy, attractive models in high status clothes) or non-aspirational (eating disordered patients in grey leotards), or to combinations thereof, in order to manipulate their body-weight preferences which were tested at baseline and at post–test. Overall, results showed good support for visual diet effects (seeing a string of small or large bodies resulted in a change from pre- to post-test whether the bodies were aspirational or not) and also some support for the associative learning explanation (exposure to aspirational images of overweight women induced a towards preferring larger bodies, even when accompanied by equal exposure to lower weight bodies in the non-aspirational category). Thus, both influences may act in parallel.
See: What’s Your Ideal Weight? Answer Depends On What You See (Science Daily)
Calories Consumed From Alcoholic Beverages by U.S. Adults, 2007–2010
Calories Consumed From Alcoholic Beverages by U.S. Adults, 2007–2010
Source: National Center for Health Statistics
- The U.S. adult population consumes an average of almost 100 calories per day from alcoholic beverages.
- Men consume more calories from alcoholic beverages than women.
- Younger adults consume more calories from alcoholic beverages than older adults.
- Men consume more beer than other types of alcohol.
- Average calories consumed from alcoholic beverages do not differ by race and ethnicity.
Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender
Source: PLoS ONE
Overweight patients report weight discrimination in health care settings and subsequent avoidance of routine preventive health care. The purpose of this study was to examine implicit and explicit attitudes about weight among a large group of medical doctors (MDs) to determine the pervasiveness of negative attitudes about weight among MDs. Test-takers voluntarily accessed a public Web site, known as Project Implicit®, and opted to complete the Weight Implicit Association Test (IAT) (N = 359,261). A sub-sample identified their highest level of education as MD (N = 2,284). Among the MDs, 55% were female, 78% reported their race as white, and 62% had a normal range BMI. This large sample of test-takers showed strong implicit anti-fat bias (Cohen’s d = 1.0). MDs, on average, also showed strong implicit anti-fat bias (Cohen’s d = 0.93). All test-takers and the MD sub-sample reported a strong preference for thin people rather than fat people or a strong explicit anti-fat bias. We conclude that strong implicit and explicit anti-fat bias is as pervasive among MDs as it is among the general public. An important area for future research is to investigate the association between providers’ implicit and explicit attitudes about weight, patient reports of weight discrimination in health care, and quality of care delivered to overweight patients.
See: Anti-fat bias may be equally prevalent in general public and medical community (EurekAlert!)
Special Feature: Is Impulse Marketing a Public Health Risk?
Special Feature: Is Impulse Marketing a Public Health Risk?
Source: RAND Corporation
While the prominence of unhealthy food in U.S. retail locations is perhaps never more pronounced than it is now, in the days leading up to Halloween, store placement of candy and other junk food has a significant effect on consumer behavior year-round.
A clear example of this influence is the placement of candy at the cash register, widely acknowledged to be a promotional strategy called “impulse marketing,” which encourages spur-of-the-moment, emotional purchases.
In a recent editorial, RAND Health’s Deborah Cohen, who studies how environmental and contextual factors influence health, argues that we should consider treating prominent store placement of unhealthy items as a hidden risk factor. Impulse marketing influences our food choices in a way that is largely automatic and out of our conscious control, which affects our risk of diet-related chronic diseases.
Addressing the Proximal Causes of Obesity: The Relevance of Alcohol Control Policies
Addressing the Proximal Causes of Obesity: The Relevance of Alcohol Control Policies
Source: Preventing Chronic Disease (CDC)
Many policy measures to control the obesity epidemic assume that people consciously and rationally choose what and how much they eat and therefore focus on providing information and more access to healthier foods. In contrast, many regulations that do not assume people make rational choices have been successfully applied to control alcohol, a substance – like food – of which immoderate consumption leads to serious health problems. Alcohol-use control policies restrict where, when, and by whom alcohol can be purchased and used. Access, salience, and impulsive drinking behaviors are addressed with regulations including alcohol outlet density limits, constraints on retail displays of alcoholic beverages, and restrictions on drink "specials." We discuss 5 regulations that are effective in reducing drinking and why they may be promising if applied to the obesity epidemic.
