Background: “Processed foods” are defined as any foods other than raw agricultural commodities and can be categorized by the extent of changes occurring in foods as a result of processing. ...Conclusions about the association between the degree of food processing and nutritional quality are discrepant. Objective: We aimed to determine 2000–2012 trends in the contribution of processed and convenience food categories to purchases by US households and to compare saturated fat, sugar, and sodium content of purchases across levels of processing and convenience. Design: We analyzed purchases of consumer packaged goods for 157,142 households from the 2000–2012 Homescan Panel. We explicitly defined categories for classifying products by degree of industrial processing and separately by convenience of preparation. We classified >1.2 million products through use of barcode-specific descriptions and ingredient lists. Median saturated fat, sugar, and sodium content and the likelihood that purchases exceeded maximum daily intake recommendations for these components were compared across levels of processing or convenience by using quantile and logistic regression. Results: More than three-fourths of energy in purchases by US households came from moderately (15.9%) and highly processed (61.0%) foods and beverages in 2012 (939 kcal/d per capita). Trends between 2000 and 2012 were stable. When classifying foods by convenience, ready-to-eat (68.1%) and ready-to-heat (15.2%) products supplied the majority of energy in purchases. The adjusted proportion of household-level food purchases exceeding 10% kcal from saturated fat, 15% kcal from sugar, and 2400 mg sodium/2000 kcal simultaneously was significantly higher for highly processed (60.4%) and ready-to-eat (27.1%) food purchases than for purchases of less-processed foods (5.6%) or foods requiring cooking/preparation (4.9%). Conclusions: Highly processed food purchases are a dominant, unshifting part of US purchasing patterns, but highly processed foods may have higher saturated fat, sugar, and sodium content than less-processed foods. Wide variation in nutrient content suggests food choices within categories may be important.
•The recent epidemics of metabolic diseases cannot be attributed only to genetic background and changes in diet, exercise and aging.•Metabolic diseases have their origins during development due to ...altered programming that increases susceptibility to disease later in life.•Metabolism disruptors are endocrine disruptors that increase the susceptibility to metabolic diseases.•Some metabolism disruptors may cause metabolic diseases per se while others act via increasing the sensitivity or set point for disease.•The metabolic disruptor hypotheses provides a focus on preventing metabolic diseases.
The recent epidemics of metabolic diseases, obesity, type 2 diabetes(T2D), liver lipid disorders and metabolic syndrome have largely been attributed to genetic background and changes in diet, exercise and aging. However, there is now considerable evidence that other environmental factors may contribute to the rapid increase in the incidence of these metabolic diseases. This review will examine changes to the incidence of obesity, T2D and non-alcoholic fatty liver disease (NAFLD), the contribution of genetics to these disorders and describe the role of the endocrine system in these metabolic disorders. It will then specifically focus on the role of endocrine disrupting chemicals (EDCs) in the etiology of obesity, T2D and NAFLD while finally integrating the information on EDCs on multiple metabolic disorders that could lead to metabolic syndrome. We will specifically examine evidence linking EDC exposures during critical periods of development with metabolic diseases that manifest later in life and across generations.
In the present study, we aimed to identify the changes or stability in the structure of dietary patterns and tracking, trends and factors related to the adherence to these dietary patterns in China ...from 1991 to 2009. We analysed dietary data collected during seven waves of the China Health and Nutrition Survey and included 9253 adults with complete dietary data for three or more waves. Dietary intake assessment was carried out over a 3 d period with 24 h recalls and a household food inventory. Using factor analysis in each wave, we found that the structure of the two dietary patterns identified remained stable over the studied period. The traditional southern dietary pattern was characterised by high intakes of rice, fresh leafy vegetables, low-fat red meat, pork, organ meats, poultry and fish/seafood and low intakes of wheat flour and maize/coarse grains and the modern high-wheat dietary pattern was characterised by high intakes of wheat buns/breads, cakes/cookies/pastries, deep-fried wheat, nuts/seeds, starchy root/tuber products, fruits, eggs/egg products, soya milk, animal-based milk and instant noodles/frozen dumplings. Temporal tracking (maintenance of a relative position over time) was higher for the traditional southern dietary pattern, whereas adherence to the modern high-wheat dietary pattern had an upward trend over time. Higher income, education and urbanicity levels were positively associated with both the dietary patterns, but the association became weaker in the later years. These results suggest that even in the context of rapid economic changes in China, the way people chose to combine their foods remained relatively stable. However, the increasing popularity of the modern high-wheat dietary pattern, a pattern associated with several energy-dense foods, is a cause of concern.
•Commute mode choice analysis conducted in Barcelona, Spain.•Objective and self-reported infrastructure measures are associated with cycling.•Self-reported measures have stronger associations than ...objective measures.•Cycling and public transport are competing modes.•Education and modal integration are promising short-term cycling interventions.
Cycling for transportation has become an increasingly important component of strategies to address public health, climate change, and air quality concerns in urban centers. Within this context, planners and policy makers would benefit from an improved understanding of available interventions and their relative effectiveness for cycling promotion. We examined predictors of bicycle commuting that are relevant to planning and policy intervention, particularly those amenable to short- and medium-term action.
We estimated a travel mode choice model using data from a survey of 765 commuters who live and work within the municipality of Barcelona. We considered how the decision to commute by bicycle was associated with cycling infrastructure, bike share availability, travel demand incentives, and other environmental attributes (e.g., public transport availability). Self-reported and objective (GIS-based) measures were compared. Point elasticities and marginal effects were calculated to assess the relative explanatory power of the independent variables considered.
While both self-reported and objective measures of access to cycling infrastructure were associated with bicycle commuting, self-reported measures had stronger associations. Bicycle commuting had positive associations with access to bike share stations but inverse associations with access to public transport stops. Point elasticities suggested that bicycle commuting has a mild negative correlation with public transport availability (−0.136), bike share availability is more important at the work location (0.077) than at home (0.034), and bicycle lane presence has a relatively small association with bicycle commuting (0.039). Marginal effects suggested that provision of an employer-based incentive not to commute by private vehicle would be associated with an 11.3% decrease in the probability of commuting by bicycle, likely reflecting the typical emphasis of such incentives on public transport.
The results provide evidence of modal competition between cycling and public transport, through the presence of public transport stops and the provision of public transport-oriented travel demand incentives. Education and awareness campaigns that influence perceptions of cycling infrastructure availability, travel demand incentives that encourage cycling, and policies that integrate public transport and cycling may be promising and cost-effective strategies to promote cycling in the short to medium term.
Background: Recent experimental evidence suggests that prenatal exposure to endocrinedisrupting chemicals (EDCs) may increase postnatal obesity risk and that these effects may be sex or diet ...dependent. Objectives: We explored whether prenatal organochlorine compound (OC) concentrations polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethylene (DDE), and dichlorodiphenyltrichloroethane (DDT) were associated with overweight at 6.5 years of age and whether child sex or fat intakes modified these associations. Methods: We studied 344 children from a Spanish birth cohort established in 1997-1998. Overweight at 6.5 years was defined as a body mass index (BMI) z-score ≥ 85th percentile of the World Health Organization reference. Cord blood OC concentrations were measured and treated as categorical variables (tertiles). Children's diet was assessed by food frequency questionnaire. Relative risks (RRs) were estimated using generalized linear models. Results: After multivariable adjustment, we found an increased RR of overweight in the third tertile of PCB exposure RR = 1.70; 95% confidence interval (CI): 1.09, 2.64 and the second tertile of DDE exposure (RR = 1.67; 95% CI: 1.10, 2.55), but no association with DDT exposure in the population overall. Associations between overweight and PCB and DDE concentrations were strongest in girls (ρ-interaction between 0.01 and 0.28); DDT was associated with overweight only in boys. For DDT we observed stronger associations in children with fat intakes at or above compared with below the median, but this interaction was not significant (ρ-interaction > 0.05). Conclusions: This study suggests that prenatal OC exposures may be associated with overweight in children and that sex and high-fat intake may influence susceptibility.
Abstract
Error and bias in self-reported intakes make estimating relationships among dietary factors, obesity, and related health outcomes a complex challenge in observational studies. In the absence ...of measures that can be applied in calibration adjustments of dietary data, simple methods to identify persons who misreport their intakes have been used to assess the impact of screening out reports characterized by energy intakes that are implausible when compared with estimated energy needs. Sensitivity analyses in cross-sectional studies have shown these methods to yield more plausible associations between diet and obesity, but few longitudinal studies have evaluated this approach. In this issue of the Journal, findings reported by Rhee et al. (Am J Epidemiol. 2015;181(4):237) underscore the need for caution in drawing conclusions on how self-reported diet may influence such outcomes based on cross-sectional associations but suggest that this approach might have little impact on the more credible associations derived from prospective analyses. However, other prospective studies have found that diet-disease relationships emerge or are substantially strengthened with the use of calibration adjustments using recovery biomarkers. To better understand the influence of diet on obesity-related health outcomes, efforts to reduce dietary measurement error through improved collection, evaluation, and analysis of consumption data are still urgently needed.
Recent research suggests that sugar-sweetened beverage (SSB) consumption has been declining among US children aged 2–18 y. However, most studies focused on changes in mean intake, ignore high SSB ...consumers and do not examine intake among vulnerable groups and, including adolescents, low-income households, and several racial/ethnic minorities.
The aim was to estimate usual SSB intake from NHANES surveys from 2003–2004 to 2013–2014 to examine shifts at both the median and 90th percentile among US children, evaluating the extent to which intake disparities in total SSBs and subtypes have persisted.
Children 2–18 y from NHANES 2003, 2005, 2007, 2009, 2011 and 2013. SSBs were all non-diet beverages sweetened with sugars including revising all beverages to as consumed status and excluding soy and dairy based beverages. The NCI usual intake method was used to estimate usual intake from two 24-hour recalls. A 2-part correlated model accounted for nonconsumers. Quantile regression was then used to examine differences in SSB usual intakes at the 50th and 90th percentiles by race-ethnicity, and examine interactions indicating whether racial-ethnic disparities in intake were modified by income.
Despite considerable declines, children's SSB intake remains high, particularly among heavy consumers. Among adolescents, median SSB intake in 2013–2014 was on the order of 150–200 kcal/d, and heavy intake at the 90th percentile was on the order of 250–300 kcal/d. There were important disparities in intake that persisted over time. Although high household income was associated with lower SSB intake in non-Hispanic white (NHW) children, intakes of non-Hispanic black (NHB) and Mexican-American (MA) children from these households were similar to or higher than those from poor households. There were also large racial/ethnic differences in the types of SSBs consumed. The consumption of regular sodas by NHB children was somewhat lower than among MA and NHW children, whereas fruit drink intake was markedly higher.
Overall, these findings suggest that, despite recent declines, strategies are needed to further reduce SSB consumption, and particularly heavy intake, especially among NHB children where fruit drinks also are key source of SSBs.
We examined the association between dietary patterns and diabetes using the strengths of two methods: principal component analysis (PCA) to identify the eating patterns of the population and reduced ...rank regression (RRR) to derive a pattern that explains the variation in glycated Hb (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR) and fasting glucose.
We measured diet over a 3 d period with 24 h recalls and a household food inventory in 2006 and used it to derive PCA and RRR dietary patterns. The outcomes were measured in 2009.
Adults (n 4316) from the China Health and Nutrition Survey.
The adjusted odds ratio for diabetes prevalence (HbA1c≥6·5 %), comparing the highest dietary pattern score quartile with the lowest, was 1·26 (95 % CI 0·76, 2·08) for a modern high-wheat pattern (PCA; wheat products, fruits, eggs, milk, instant noodles and frozen dumplings), 0·76 (95 % CI 0·49, 1·17) for a traditional southern pattern (PCA; rice, meat, poultry and fish) and 2·37 (95 % CI 1·56, 3·60) for the pattern derived with RRR. By comparing the dietary pattern structures of RRR and PCA, we found that the RRR pattern was also behaviourally meaningful. It combined the deleterious effects of the modern high-wheat pattern (high intakes of wheat buns and breads, deep-fried wheat and soya milk) with the deleterious effects of consuming the opposite of the traditional southern pattern (low intakes of rice, poultry and game, fish and seafood).
Our findings suggest that using both PCA and RRR provided useful insights when studying the association of dietary patterns with diabetes.
Experimental animal studies and limited epidemiologic evidence suggest that prenatal exposure to phthalates may be obesogenic, with potential sex-specific effects of phthalates having anti-androgenic ...activity.
We aimed to assess associations between prenatal phthalate exposures and childhood fat mass in a prospective cohort study.
We measured phthalate metabolite concentrations in third-trimester maternal urine in a cohort of women enrolled in New York City between 1998 and 2002 (n = 404). Among 180 children (82 girls and 98 boys), we evaluated body composition using a Tanita scale at multiple follow-up visits between ages 4 and 9 years (363 total visits). We estimated associations of standard deviation differences or tertiles of natural log phthalate metabolite concentrations with percent fat mass using linear mixed-effects regression models with random intercepts for repeated outcome measurements. We assessed associations in multiple metabolite models and adjusted for covariates including prepregnancy body mass index, gestational weight gain, maternal smoking during pregnancy, and breastfeeding.
We did not observe associations between maternal urinary phthalate concentrations and percent body fat in models examining continuous exposures. Fat mass was 3.06% (95% CI: -5.99, -0.09%) lower among children in the highest tertile of maternal urinary concentrations of summed di(2-ethylhexyl) phthalate (ΣDEHP) metabolites than in children in the lowest tertile. Though estimates were imprecise, there was little evidence that associations between maternal urinary phthalate concentrations and percent fat mass were modified by child's sex.
Prenatal phthalate exposures were not associated with increased body fat among children 4-9 years of age, though high prenatal DEHP exposure may be associated with lower fat mass in childhood.
Buckley JP, Engel SM, Mendez MA, Richardson DB, Daniels JL, Calafat AM, Wolff MS, Herring AH. 2016. Prenatal phthalate exposures and childhood fat mass in a New York City cohort. Environ Health Perspect 124:507-513; http://dx.doi.org/10.1289/ehp.1509788.
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DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Background: Increasing experimental evidence suggests that prenatal bisphenol A (BPA) exposure induces offspring weight gain, but these effects remain largely unexplored in humans. We examined the ...effects of prenatal BPA exposure on postnatal growth and obesity. Methods: BPA concentrations were measured in two spot-urine samples collected in the 1st and 3rd trimesters of pregnancy from mothers in a Spanish birth cohort study (n = 402). We used the average of the two creatinine-adjusted BPA concentrations as the exposure variable. Rapid child growth was defined as a weight gain Z score >0.67 in the first 6 months of life. Age- and sex-specific Z scores for body mass index (BMI) were calculated at age 14 months and 4 years, based on the World Health Organization referent; overweight was defined as a BMI Z score greater than or equal to the 85th percentile. Age- and sex-specific waist circumference Z scores were calculated at age 14 months and 4 years using the analysis population mean. Results: Twenty-six percent of children were rapid growers; 25% were overweight at 14 months and 21% at 4 years. Geometric mean BPA concentrations were 2.6 μg/g creatinine (standard deviation = 2.3) in 1st trimester and 2.0 (2.3) in 3rd trimester samples (Pearson r = 0.13). At 4 years, BPA exposure was associated with increased waist circumference (β per log10 μg/g = 0.28 95% confidence interval = 0.01 to 0.57) and BMI (β = 0.28 −0.06 to 0.63). BPA was not associated with obesity-related outcomes at earlier ages. Conclusions: This study provides some evidence for an association between prenatal BPA exposure and obesity-related outcomes in childhood, although not in infancy. The large uncertainties in BPA exposure assessment require that findings be interpreted with caution.
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