Objective
This study aimed to provide the most recent national estimates for beverage consumption among children and adults in the United States.
Methods
Dietary data were collected from 18,600 ...children aged 2 to 19 years and from 27,652 adults aged ≥ 20 years in the 2003 to 2014 National Health and Nutrition Examination Survey. Total beverage and sugar‐sweetened beverage (SSB) consumption was measured by 24‐hour dietary recall.
Results
From 2003 to 2014, per capita consumption of all beverages declined significantly among children (473.8‐312.6 calories; P < 0.001) and adults (425.0‐341.1 calories; P < 0.001). In the 2013‐2014 survey, 60.7% of children and 50.0% of adults drank SSBs on a given day, which is significantly lower than 2003‐2004, when 79.7% of children and 61.5% of adults reported drinking SSBs. From 2003 to 2014, per capita consumption of SSBs declined from 224.6 calories to 132.5 calories (P < 0.001) for children and from 190.4 calories to 137.6 calories (P < 0.001) for adults. The absolute levels for the percentage of SSB drinkers and per capita consumption of SSBs were highest among black, Mexican American, and non‐Mexican Hispanic children, adolescents, and young adults for all years of the study.
Conclusions
Overall, beverage and SSB consumption declined for children and adults from 2003 to 2014. The levels of consumption are highest among black, Mexican American, and non‐Mexican Hispanic participants.
Estimates of health care costs associated with excess weight are needed to inform the development of cost-effective obesity prevention efforts. However, commonly used cost estimates are not sensitive ...to changes in weight across the entire body mass index (BMI) distribution as they are often based on discrete BMI categories.
We estimated continuous BMI-related health care expenditures using data from the Medical Expenditure Panel Survey (MEPS) 2011-2016 for 175,726 respondents. We adjusted BMI for self-report bias using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2016, and controlled for potential confounding between BMI and medical expenditures using a two-part model. Costs are reported in $US 2019.
We found a J-shaped curve of medical expenditures by BMI, with higher costs for females and the lowest expenditures occurring at a BMI of 20.5 for adult females and 23.5 for adult males. Over 30 units of BMI, each one-unit BMI increase was associated with an additional cost of $253 (95% CI $167-$347) per person. Among adults, obesity was associated with $1,861 (95% CI $1,656-$2,053) excess annual medical costs per person, accounting for $172.74 billion (95% CI $153.70-$190.61) of annual expenditures. Severe obesity was associated with excess costs of $3,097 (95% CI $2,777-$3,413) per adult. Among children, obesity was associated with $116 (95% CI $14-$201) excess costs per person and $1.32 billion (95% CI $0.16-$2.29) of medical spending, with severe obesity associated with $310 (95% CI $124-$474) excess costs per child.
Higher health care costs are associated with excess body weight across a broad range of ages and BMI levels, and are especially high for people with severe obesity. These findings highlight the importance of promoting a healthy weight for the entire population while also targeting efforts to prevent extreme weight gain over the life course.
This study predicts a continued increase in the prevalence of obesity and severe obesity in adults nationwide, with large disparities across states and demographic subgroups. These conclusions are ...based on an analysis of BMI data reported by more than 6 million adults (1993–1994 and 1999–2016), with the data corrected for bias.
This article provides reflections on federal service in the Executive Branch, including recent experiences, key lessons learned, and advice to researchers interested in interacting with policymakers.
U.S. government programs serve nearly 35 million children daily, delivering vital nutrition and financial assistance to families in need. With such programs interrupted, an essential element of the ...Covid-19 response will be feeding children from low-income families.
To examine national patterns in cooking frequency and diet quality among adults in the USA, overall and by weight-loss intention.
Analysis of cross-sectional 24 h dietary recall and interview data. ...Diet quality measures included total kilojoules per day, grams of fat, sugar and carbohydrates per day, fast-food meals per week, and frozen/pizza and ready-to-eat meals consumed in the past 30 d. Multivariable regression analysis was used to test associations between frequency of cooking dinner per week (low (0-1), medium (2-5) and high (6-7)), dietary outcomes and weight-loss intention.
The 2007-2010 National Health and Nutrition Examination Survey.
Adults aged 20 years and over (n 9569).
In 2007-2010, 8 % of adults lived in households in which someone cooked dinner 0-1 times/week and consumed, on an average day, 9627 total kilojoules, 86 g fat and 135 g sugar. Overall, compared with low cookers (0-1 times/week), a high frequency of cooking dinner (6-7 times/week) was associated with lower consumption of daily kilojoules (9054 v. 9627 kJ, P=0·002), fat (81 v. 86 g, P=0·016) and sugar (119 v. 135 g, P<0·001). Individuals trying to lose weight consumed fewer kilojoules than those not trying to lose weight, regardless of household cooking frequency (2111 v. 2281 kJ/d, P<0·006).
Cooking dinner frequently at home is associated with consumption of a healthier diet whether or not one is trying to lose weight. Strategies are needed to encourage more cooking among the general population and help infrequent cookers better navigate the food environment outside the home.
This study systematically reviewed community-based childhood obesity prevention programs in the United States and high-income countries.
We searched Medline, Embase, PsychInfo, CINAHL, ...clinicaltrials.gov, and the Cochrane Library for relevant English-language studies. Studies were eligible if the intervention was primarily implemented in the community setting; had at least 1 year of follow-up after baseline; and compared results from an intervention to a comparison group. Two independent reviewers conducted title scans and abstract reviews and reviewed the full articles to assess eligibility. Each article received a double review for data abstraction. The second reviewer confirmed the first reviewer's data abstraction for completeness and accuracy.
Nine community-based studies were included; 5 randomized controlled trials and 4 non-randomized controlled trials. One study was conducted only in the community setting, 3 were conducted in the community and school setting, and 5 were conducted in the community setting in combination with at least 1 other setting such as the home. Desirable changes in BMI or BMI z-score were found in 4 of the 9 studies. Two studies reported significant improvements in behavioral outcomes (1 in physical activity and 1 in vegetable intake).
The strength of evidence is moderate that a combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. More research and consistent methods are needed to understand the comparative effectiveness of childhood obesity prevention programs in the community setting.
Despite the importance of cooking in American life and evidence suggesting that meals cooked at home are healthier, little is known about perceptions of what it means to cook in the United States. ...The objective of this study was to describe perceptions of cooking and factors important to how cooking is perceived and practiced among American adults. Seven focus groups (N = 53; 39 female; 35 Black, 16 White, 2 Asian) were conducted from November 2014 to January 2015 in Baltimore City, Maryland. Participants were recruited from two neighborhoods; one with higher median income and access to healthy food and the other with lower income and low access to healthy food. Focus groups were audio recorded, transcribed verbatim and analyzed using a grounded theory approach. Participants' perceptions of cooking varied considerably, regardless of neighborhood income or food access, and spanned a continuum from all scratch cooking to anything made at home. Perceptions of cooking incorporated considerations of whether or how food was heated and the degree of time, effort and love involved if convenience foods were used. Key barriers to cooking included affordability, lack of time, and lack of enjoyment. Key facilitators of frequent cooking included extensive organization and time management to enable participants to incorporate cooking into their daily lives. Cooking is a complex concept and not uniformly understood. Efforts to encourage healthy cooking at home should consider the broad spectrum of activities Americans recognize as cooking as well as the barriers and facilitators to preparing food at home. Public health messages to encourage more frequent cooking should account for the heterogeneity in perspectives about cooking. More research should explore differences in perceptions about cooking in other diverse populations.
Evidence showing the effectiveness of policies to reduce the consumption of sugar-sweetened beverages (SSBs) is growing. SSBs are one of the largest sources of added sugar in the diet and are linked ...to multiple adverse health conditions. This review presents a framework illustrating the various types of policies that have been used to reduce SSB exposure and consumption; policies are organized into four categories (financial, information, defaults, and availability) and take into consideration crosscutting policy considerations (feasibility, impact, and equity). Next, for each category, we describe a specific example and provide evidence of impact. Finally, we discuss crosscutting policy considerations, the challenge of choosing among the various policy options, and important areas for future research. Notably, no single policy will reduce SSB consumption to healthy levels, so an integrated policy approach that adapts to changing market and consumption trends; evolving social, political, and public health needs; and emerging science is critical.
PDF
