Public Health Nutrition

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Food pantries select healthier foods after nutrition information is available on their food bank’s ordering platform
Public Health Nutrition - Tập 24 Số 15 - Trang 5066-5073 - 2021
Katie S. Martin, Ran Xu, Marlene B. Schwartz
AbstractObjective:

In the USA, community-based food pantries provide free groceries to people struggling with food insecurity. Many pantries obtain food from regional food banks using an online shopping platform. A food bank introduced a visible nutrition rank (i.e. green, yellow or red) onto its platform. The hypothesis was that pantry orders would increase for the healthiest options (green) and decrease for the least healthy options (red).

Design:

Interrupted time series (ITS) analysis of a natural experiment. Monthly data included nutrition ranks of available inventory and itemised records of all products ordered during the 15-month baseline period and 14-month intervention.

Setting:

A New England food bank.

Participants:

The twenty-five largest food pantries in the network based on pounds of food ordered.

Results:

Descriptive analyses of 63 922 pantry ordering records before and after the visible ranks identified an increase in the proportion of green items ordered (39·3–45·4 %) and a decrease in the proportion of red items ordered (10·5–5·1 %). ITS analyses controlling for monthly changes in inventory available and pantry variables indicated that average monthly orders of green items increased by 1286 pounds (P< 0·001) and red orders decreased by 631 pounds (P= 0·045). Among the largest changes were increases in orders of fresh produce, brown rice, low-fat dairy and low-fat meats and decreases in orders of sugary juice drinks, canned fruit with added sugar, higher fat dairy and higher fat meats.

Conclusions:

This promising practice can support system-wide efforts to promote healthier foods within the food banking network.

Dietary and non-dietary determinants of central adiposity among Tehrani women
Public Health Nutrition - Tập 11 Số 5 - Trang 528-534 - 2008
Leila Azadbakht, Ahmad Esmaillzadeh
AbstractObjective

To determine the correlates of central adiposity.

Design

Population-based cross-sectional study.

Subjects

A total of 926 women (aged 40–60 years) from all districts of Tehran.

Methods

Demographic data were collected and anthropometric indices were measured according to standard protocols. Dietary intakes were assessed by means of a semi-quantitative food-frequency questionnaire. The suggested cut-off point for waist-to-hip ratio (WHR≥0.84) for Tehrani people, adjusted for their age group, was used to determine central adiposity. Logistic regression analysis was used to determine the correlates of WHR, which were adjusted for age, taking medications and body mass index (BMI). The components of dietary intake were determined by factor analysis. Pearson correlation was used to determine the association between the dietary components and WHR. Analysis of covariance was employed to compare the mean values of WHR in different lifestyle groups, with adjustment for BMI and age.

Results

Mean WHR was 0.82 ± 0.06. The possibility of being centrally obese was higher in women with light physical activity (odds ratio: 2.11; 95% confidence interval: 1.40–2.53), depressed women (1.36; 1.02–1.93), smokers (1.21; 1.02–1.56) and unemployed women (1.41; 1.13–1.72). Marriage (1.31; 1.10–1.82), menopause (1.22; 1.02–1.61), low vitamin C intake (2.31; 1.25–4.25) and low calcium intake (1.30; 1.07–3.78) were associated with central fat accumulation. Dairy consumption was inversely correlated with central fat accumulation (r= −0.2,P< 0.05).

Conclusion

Central adiposity is associated with poor lifestyle factors including low physical activity, depression, smoking, low intake of vitamin C, low intake of calcium and dairy products and high fat consumption. Thus lifestyle modifications should be encouraged to achieve a healthier body shape.

Milk as a food for growth? The insulin-like growth factors link
Public Health Nutrition - Tập 9 Số 3 - Trang 359-368 - 2006
Imogen Rogers, Pauline Emmett, David Gunnell, David B. Dunger, Jeff M.P. Holly
AbstractObjective

The mechanisms underlying the association of insulin-like growth factor-I (IGF-I) and leg length (a marker of prepubertal growth) with cancer risk are uncertain. One hypothesis is that diet in early childhood might provide the link. The aim of the present study was to examine the association between early diet – in particular, the intakes of cows' milk and dairy products – and height, leg length and IGF-I levels at age 7–8 years.

Subjects

Children participating in the Avon Longitudinal Study of Parents and Children.

Design

Diet was assessed using a 3-day unweighed food record. Anthropometry, IGF-I and insulin-like growth factor-binding protein-3 (IGFBP-3) were measured by standard methods.

Results

Data on both diet and height were available for 744 children (404 boys) and on diet and IGF for 538 (295 boys). After adjusting for energy, both cows' milk and dairy product intakes were positively associated with IGF-I (P=0.040 and 0.027, respectively) and IGFBP-3 levels (P=0.082 and 0.067, respectively). These associations persisted on adjustment for potential confounders, but were abolished on controlling for protein intake. In energy-adjusted models there was only weak evidence of associations of milk and dairy product intakes with anthropometry. In boys only, dairy product intake was positively associated with leg length (equivalent to a 0.058 (0.002, 0.114) standard deviation score increase in leg length per 100 g increase in daily intake).

Conclusions

These data provide some evidence that variation in childhood milk and dairy product intakes underlies associations of leg length, IGF-I and cancer risk. The association appears to be due to the protein content of milk.

Women respondents report higher household food insecurity than do men in similar Canadian households
Public Health Nutrition - Tập 17 Số 1 - Trang 40-48 - 2014
Jesse Matheson, Lynn McIntyre
AbstractObjective

We investigated factors accounting for the consistently higher levels of household food insecurity reported by women in Canada.

Design

Two cycles of the Canadian Community Health Survey for the years 2005/2006 and 2007/2008 were pooled to examine the association between household food insecurity, measured using the Household Food Security Survey Module and other metrics, and respondent sex. We stratified households as married/cohabiting (in which case, the household respondent was chosen randomly) or non-married (single/widowed/separated/divorced) and adjusted for differences in household characteristics, including the presence of children.

Setting

Canada.

Subjects

Analysis was restricted to households dependent on employment/self-employment and whose reported annual household income was below $CAN 100 000. Exclusions included respondents less than 18 years of age, any welfare receipt, and missing food insecurity, marital status, income source and amount, or household composition data.

Results

For non-married households, increased food insecurity in female-v. male-led households was accounted for by significant differences in household socio-economic characteristics. In contrast, in married/cohabiting households with or without children, higher food insecurity rates were reported when the respondent was female and neither respondent characteristics nor socio-economic factors accounted for the differences.

Conclusions

Higher rates of food insecurity in non-married households in Canada are largely attributable to women's socio-economic disadvantage. In married households, women appear to report higher levels of food insecurity than men. These findings suggest a possible bias in the measurement of population-level household food insecurity in surveys that do not account for the sex of the respondent in married/cohabiting households.

Women respondents report higher household food insecurity than do men in similar Canadian households
Public Health Nutrition - Tập 17 Số 1 - Trang 40-48 - 2014
Jesse Matheson, Lynn McIntyre
AbstractObjective

We investigated factors accounting for the consistently higher levels of household food insecurity reported by women in Canada.

Design

Two cycles of the Canadian Community Health Survey for the years 2005/2006 and 2007/2008 were pooled to examine the association between household food insecurity, measured using the Household Food Security Survey Module and other metrics, and respondent sex. We stratified households as married/cohabiting (in which case, the household respondent was chosen randomly) or non-married (single/widowed/separated/divorced) and adjusted for differences in household characteristics, including the presence of children.

Setting

Canada.

Subjects

Analysis was restricted to households dependent on employment/self-employment and whose reported annual household income was below $CAN 100 000. Exclusions included respondents less than 18 years of age, any welfare receipt, and missing food insecurity, marital status, income source and amount, or household composition data.

Results

For non-married households, increased food insecurity in female-v. male-led households was accounted for by significant differences in household socio-economic characteristics. In contrast, in married/cohabiting households with or without children, higher food insecurity rates were reported when the respondent was female and neither respondent characteristics nor socio-economic factors accounted for the differences.

Conclusions

Higher rates of food insecurity in non-married households in Canada are largely attributable to women's socio-economic disadvantage. In married households, women appear to report higher levels of food insecurity than men. These findings suggest a possible bias in the measurement of population-level household food insecurity in surveys that do not account for the sex of the respondent in married/cohabiting households.

Stunting coexisting with overweight in 2·0–4·9-year-old Indonesian children: prevalence, trends and associated risk factors from repeated cross-sectional surveys
Public Health Nutrition - Tập 19 Số 15 - Trang 2698-2707 - 2016
Cut Novianti Rachmi, Kingsley Agho, Mu Li, Louise A. Baur
AbstractObjective

The persistence of undernutrition, along with overweight and obesity, constitute the double burden of malnutrition. The present study aimed to: (i) describe the prevalence and trends of concurrent stunting and overweight in Indonesian children; (ii) identify potentially associated risk factors; and (iii) determine whether stunted children are at greater risk of overweight compared with those of healthy height.

Design

A secondary data analysis of children aged 2·0–4·9 years in four cross-sectional studies of the Indonesian Family Life Survey. Children’s height and BMI Z-scores were calculated based on the WHO Child Growth Standards (2006). We defined ‘concurrent stunting and overweight’ as height-for-age Z-score <−2 and BMI Z-score >+1. Multivariate generalised linear latent and mixed models were used to determine associated risk factors.

Setting

Thirteen out of twenty-seven provinces in Indonesia.

Subjects

Children (n 4101) from four waves of the Indonesian Family Life Survey (1993–2007).

Results

There were inconsistent trends in the prevalence of concurrent stunting and overweight from waves 1 to 4. Children were more likely to be stunted and overweight when they were in the youngest age group (2·0–2·9 years), were weaned after the age of 6 months, had short-statured mothers or lived in rural areas. Stunted children were significantly more likely to be overweight than healthy-height children (OR>1) but did not differ significantly different across each wave (OR=1·34–2·01).

Conclusions

Concurrent stunting and overweight occurs in Indonesian children aged 2·0–4·9 years. Current policies and programmes need to be tailored for the management of this phenomenon.

Double burden of malnutrition and its association with infant and young child feeding practices among children under-five in Thailand
Public Health Nutrition - Tập 24 Số 10 - Trang 3058-3065 - 2021
Leshawn Benedict, Seo Ah Hong, Pattanee Winichagoon, Phudit Tejativaddhana, Vijj Kasemsup
AbstractObjective:

This study examined the prevalence of stunting-overweight and socio-demographic determinants among children under-five years of age, as well as associations with infant and young child feeding (IYCF) among children aged 6–23 months.

Design:

Secondary data analysis based on the Thailand Multiple Indicator Cluster Survey 2015–2016.

Setting:

Cross-national study.

Participants:

Nationally representative sample of children under-five years of age (n 12 313).

Results:

The prevalence of wasting, stunting, overweight and stunting-overweight was 5·3, 10·5, 10·1 and 1·6 %, respectively. In multivariate analyses, children under 6 months, children from low and middle wealth tertiles, and children living in rural areas were prone to being wasted. Male children, low wealth tertile and a non-Thai speaking household head were positively and children aged 48–59 months and a one-child household were inversely associated with stunting. Children from a low wealth tertile were less likely to be overweight, while older age, male children and children from a one-child household were more likely to be overweight. Stunting-overweight was associated with children aged 24–47 months, male children, mothers having secondary education, a one-child household, a non-Thai speaking household head and an urban area. In terms of IYCF indicators, despite no association with stunting and stunted-overweight children, current breast-feeding and inadequate meal frequency were associated with being wasting, while current breast-feeding and dietary diversity were inversely associated with being overweight.

Conclusions:

This study revealed the double burden of malnutrition at the individual and population levels among Thai children under-five, which calls for concrete integrated interventions to tackle all forms of malnutrition.

Design and development of an instrument to measure overall lifestyle habits for epidemiological research: the Mediterranean Lifestyle (MEDLIFE) index
Public Health Nutrition - Tập 18 Số 6 - Trang 959-967 - 2015
Mercedes Sotos‐Prieto, Belén Moreno‐Franco, José M. Ordovás, Montse León, José A. Casasnovas, José L. Peñalvo
AbstractObjective

To design and develop a questionnaire that can account for an individual’s adherence to a Mediterranean lifestyle including the assessment of diet and physical activity patterns, as well as social interaction.

Design

The Mediterranean Lifestyle (MEDLIFE) index was created based on the current Spanish Mediterranean food guide pyramid. MEDLIFE is a twenty-eight-item derived index consisting of questions about food consumption (fifteen items), traditional Mediterranean dietary habits (seven items) and physical activity, rest and social interaction habits (six items). Linear regression models and Spearman rank correlation were fitted to assess content validity and internal consistency.

Setting

A subset of participants in the Aragon Workers’ Health Study cohort (Zaragoza, Spain) provided the data for development of MEDLIFE.

Subjects

Participants (n 988) of the Aragon Workers’ Health Study cohort in Spain.

Results

Mean MEDLIFE score was 11·3 (sd 2·6; range: 0–28), and the quintile distribution of MEDLIFE score showed a significant association with each of the individual items as well as with specific nutrients and lifestyle indicators (intra-validity). We also quantified MEDLIFE correspondence with previously reported diet quality indices and found significant correlations (ρ range: 0·44–0·53; P<0·001) for the Alternate Healthy Eating Index, the Alternate Mediterranean Diet Index and Mediterranean Diet Adherence Screener.

Conclusions

MEDLIFE is the first index to include an overall assessment of lifestyle habits. It is expected to be a more holistic tool to measure adherence to the Mediterranean lifestyle in epidemiological studies.

First evaluation steps of a new method for dietary intake estimation regarding a list of key food groups in adults and in different sociodemographic and health-related behaviour strata
Public Health Nutrition - Tập 20 Số 15 - Trang 2660-2669 - 2017
Luís Béjar
AbstractObjective

A new method known as ‘current-day dietary recall’ (current-day recall) is based on an application for mobile phones called ‘electronic 12 h dietary recall’ (e-12HR). This new method was designed to rank participants into categories of habitual intake regarding a series of key food groups. The present study compared current-day recall against a previously validated short paper FFQ.

Design

Participants recorded the consumption of selected food groups using e-12HR during twenty-eight consecutive days and then filled out a short paper FFQ at the end of the study period. To evaluate the association and agreement between both methods, Spearman’s correlation coefficients (SCC), cross-classification analysis and weighted kappa statistics (κw) were used.

Setting

Andalusia, Spain, Southern Europe.

Subjects

University students and employees over the age of 18 years.

Results

One hundred and eighty-seven participants completed the study (64·2 % female, 35·8 % male). For all particpants, for all food group intakes, the mean SCC was 0·70 (SCC≥0·62 were observed for all strata); the mean percentage of participants cross-classified into categories of ‘exact agreement+adjacent’ was 90·1 % (percentages≥87·8 % were observed for all strata); and the meanκwwas 0·55 (κw≥0·53 in ten of the twelve strata).

Conclusions

For the whole sample and for all strata thereof, the current-day recall has good agreement with the previously validated short paper FFQ for assessing food group intakes, rendering it a useful method for ranking individuals.

Reducing meat consumption in the USA: a nationally representative survey of attitudes and behaviours
Public Health Nutrition - Tập 21 Số 10 - Trang 1835-1844 - 2018
Roni Neff, Danielle Edwards, Anne Palmer, Rebecca Ramsing, Allison Righter, Julia A. Wolfson
AbstractObjective

Excess meat consumption, particularly of red and processed meats, is associated with nutritional and environmental health harms. While only a small portion of the population is vegetarian, surveys suggest many Americans may be reducing their meat consumption. To inform education campaigns, more information is needed about attitudes, perceptions, behaviours and foods eaten in meatless meals.

Design

A web-based survey administered in April 2015 assessed meat reduction behaviours, attitudes, what respondents ate in meatless meals and sociodemographic characteristics.

Setting

Nationally representative, web-based survey in the USA.

Subjects

US adults (n1112) selected from GfK Knowledgeworks’ 50 000-member online panel. Survey weights were used to assure representativeness.

Results

Two-thirds reported reducing meat consumption in at least one category over three years, with reductions of red and processed meat most frequent. The most common reasons for reduction were cost and health; environment and animal welfare lagged. Non-meat reducers commonly agreed with statements suggesting that meat was healthy and ‘belonged’ in the diet. Vegetables were most often consumed ‘always’ in meatless meals, but cheese/dairy was also common. Reported meat reduction was most common among those aged 45–59 years and among those with lower incomes.

Conclusions

The public and environmental health benefits of reducing meat consumption create a need for campaigns to raise awareness and contribute to motivation for change. These findings provide rich information to guide intervention development, both for the USA and other high-income countries that consume meat in high quantities.

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