Calorie intake and diet quality are influenced by the source of food and the place of consumption. This study examines the impacts of fast-food and full-service restaurant consumption on daily energy ...and nutrient intakes in US adults.
Nationally representative data of 18,098 adults 18 years of age and above from the National Health and Nutrition Examination Survey 2003-2010 waves were analyzed. Outcomes included daily intake of total calories and 24 nutrients of public health concern. The key predictors were any food/beverage consumption in a day from fast-food or full-service restaurant, differentiated by consumption at home versus away from home. First-difference estimator addressed confounding bias from time-invariant unobservables such as personal food/beverage preferences by using within-individual variations in diet and restaurant consumption status between two nonconsecutive 24-h dietary recalls.
Fast-food and full-service restaurant consumption, respectively, were associated with a net increase in daily total energy intake of 190.29 and 186.74 kcal, total fat of 10.61 and 9.58 g, saturated fat of 3.49 and 2.46 g, cholesterol of 10.34 and 57.90 mg, and sodium of 297.47 and 411.92 mg. The impact of fast-food and full-service restaurant consumption on energy and nutrient intakes differed by sex, race/ethnicity, education, income and weight status. Increased total energy, total fat, saturated fat, cholesterol and sodium intake were substantially larger when full-service restaurant food was consumed away from home than at home.
A holistic policy intervention is warranted to target the American's overall dining-out behavior rather than fast-food consumption alone.
Abstract Objectives Obesity and smoking are two leading health risk factors and consume substantial health care resources. This study estimates and tracks annual per-capita health care expenses ...associated with obesity and smoking among U.S. adults aged 18 years and older from 1998 to 2011. Study design Retrospective data analysis. Methods Individual-level data came from the National Health Interview Survey 1996–2010 waves and the Medical Expenditure Panel Survey 1998–2011 waves. Annual per-capita health care expenses associated with obesity and smoking were estimated in two-part models, accounting for individual characteristics and sampling design. Results Obesity and smoking were associated with an increase in annual per-capita total health care expenses (2011 US$) by $1360 (95% confidence interval: $1134-$1587) and $1046 ($846-$1247), out-of-pocket expenses by $143 ($110-$176) and $70 ($37-$104), hospital inpatient expenses by $406 ($283-$529) and $405 ($291-$519), hospital outpatient expenses by $164 ($119-$210) and $95 ($52-$138), office-based medical provider service expenses by $219 ($157-$280) and $117 ($62-$172), emergency room service expenses by $45 ($28-$63) and $57 ($44-$71), and prescription expenses by $439 ($382-$496) and $251 ($199-$302), respectively. From 1998 to 2011, the estimated per-capita expenses associated with obesity and smoking increased by 25% and 30% for total health care, 41% and 48% for office-based medical provider services, 59% and 66% for emergency room services, and 62% and 70% for prescriptions but decreased by 16% and 15% for out-of-pocket health care expenses, 3% and 0.3% for inpatient care, and 6% and 2% for outpatient care, respectively. Health care expenses associated with obesity and smoking were considerably larger among women, Non-Hispanic whites, and older adults compared with their male, racial/ethnic minority, and younger counterparts. Conclusions Health care costs associated with obesity and smoking are substantial and increased noticeably during 1998–2011. They also vary significantly across gender, race/ethnicity and age.
Summary
Anthropometric measures are simple, inexpensive, noninvasive tools to assess the risk of morbidity and mortality. This systematic review assessed the performance of A Body Shape Index (ABSI) ...in predicting hypertension, cardiovascular disease, type 2 diabetes and all‐cause mortality and compared the differential predictability between ABSI and two other common anthropometric measures – body mass index and waist circumference. A keyword and reference search were conducted in the PubMed and Web of Science for articles published until 1 November 2017. Thirty‐eight studies were included in the review, including 24 retrospective cohort studies and 14 cross‐sectional studies conducted in 15 countries. Meta‐analysis found that a standard deviation increase in ABSI was associated with an increase in the odds of hypertension by 13% and type 2 diabetes by 35% and an increase in cardiovascular disease risk by 21% and all‐cause mortality risk by 55%. ABSI outperformed body mass index and waist circumference in predicting all‐cause mortality but underperformed in predicting chronic diseases. ABSI is highly clustered around the mean with a rather small variance, making it difficult to define a clinical cutoff for clinical practice. Future studies are warranted to assess ABSI's potential usefulness as an anthropometric measure in population‐level health surveillance.
Excess calorie intake from sugar-sweetened beverages (SSBs) and energy-dense, nutrient-poor foods occupies a significant proportion of Western diet. The aim of this study was to examine consumption ...of SSBs and discretionary foods in US adults by purchase location.
Nationally representative 24-h dietary recall data came from the 2011-2012 National Health and Nutrition Examination Survey. The discretionary food category identifies energy-dense, nutrient-poor foods that do not necessarily contain essential nutrients but may add variety and enjoyment. Linear regressions were performed to estimate daily calorie intake from SSBs and discretionary foods by purchase location (supermarket/grocery store, convenience store, vending machine, fast-food restaurant, full-service restaurant and other source), adjusting for individual characteristics and sampling design.
During 2011-2012, 46.3% and 88.8% of US adults consumed SSBs and discretionary foods on any given day, respectively. SSB consumers on average consumed 213.0 kcal from SSBs daily, of which 111.6 kcal (52.4%) were purchased from supermarkets/grocery stores, 33.0 kcal (15.5%) from fast-food restaurants, 23.9 kcal (11.2%) from convenience stores, 17.1 kcal (8.0%) from full-service restaurants, 8.5 kcal (4.0%) from vending machines and 19.0 kcal (8.9%) from other sources. Discretionary food consumers on average consumed 439.0 kcal from discretionary foods daily, of which 280.1 kcal (63.8%) were purchased from supermarkets/grocery stores, 45.8 kcal (10.4%) from fast-food restaurants, 30.0 kcal (6.8%) from full-service restaurants, 21.1 kcal (4.8%) from convenience stores, 4.1 kcal (0.9%) from vending machines and 58.0 kcal (13.2%) from other sources.
Supermarkets/grocery stores were by far the single largest source for SSB and discretionary food purchases in US adults.
The gastrointestinal (GI) microbiota of vertebrates plays critical roles in nutrition, development, immunity and resistance against invasive pathogens. In the past decade, research of the GI ...microbiota of mammals has drastically increased our knowledge on the microbiota and their relationship with health and disease. However, our understanding of fish intestinal microbiota is limited. This review provides an overview of research on fish gut microbiota, including microbial composition, formation, factors that affect the GI microbes and characteristics of fish intestinal microbiota compared with human and mice. Further, the updated research on gnotobiotic zebrafish is elaborated and the insights gained on functions of the fish intestinal microbiota are discussed. Understanding the intestinal microbiota of fish will guide the development of probiotics, prebiotics and hopefully probiotic effectors as novel additives to improve the health of fish.
Summary
Global warming and the obesity epidemic are two unprecedented challenges mankind faces today. A literature search was conducted in the PubMed, Web of Science, EBSCO and Scopus for articles ...published until July 2017 that reported findings on the relationship between global warming and the obesity epidemic. Fifty studies were identified. Topic‐wise, articles were classified into four relationships – global warming and the obesity epidemic are correlated because of common drivers (n = 21); global warming influences the obesity epidemic (n = 13); the obesity epidemic influences global warming (n = 13); and global warming and the obesity epidemic influence each other (n = 3). We constructed a conceptual model linking global warming and the obesity epidemic – the fossil fuel economy, population growth and industrialization impact land use and urbanization, motorized transportation and agricultural productivity and consequently influences global warming by excess greenhouse gas emission and the obesity epidemic by nutrition transition and physical inactivity; global warming also directly impacts obesity by food supply/price shock and adaptive thermogenesis, and the obesity epidemic impacts global warming by the elevated energy consumption. Policies that endorse deployment of clean and sustainable energy sources, and urban designs that promote active lifestyles, are likely to alleviate the societal burden of global warming and obesity.
Summary
People's health behaviours and outcomes can be profoundly shaped by the social networks they are embedded in. Based on graph theory, social network analysis is a research framework for the ...study of social interactions and the structure of these interactions among social actors. A literature search was conducted in PubMed and Web of Science for articles published until August 2017 that applied social network analysis to examine obesity and social networks. Eight studies (three cross‐sectional and five longitudinal) conducted in the US (n = 6) and Australia (n = 2) were identified. Seven focused on adolescents' and one on adults' friendship networks. They examined structural features of these networks that were associated with obesity, including degree distribution, popularity, modularity maximization and K‐clique percolation. All three cross‐sectional studies that used exponential random graph models found individuals with similar body weight status and/or weight‐related behaviour were more likely to share a network tie than individuals with dissimilar traits. Three longitudinal studies using stochastic actor‐based models found friendship network characteristics influenced change in individuals' body weight status and/or weight‐related behaviour over time. Future research should focus on diverse populations and types of social networks and identifying the mechanisms by which social networks influence obesity to inform network‐based interventions.
Abstract Objectives There is mounting evidence documenting the adverse health effects of short- and long-term exposure to ambient fine particulate matter (PM2.5 ) air pollution, but population-based ...evidence linking PM2.5 and health behaviour remains lacking. This study examined the relationship between ambient PM2.5 air pollution and leisure-time physical inactivity among US adults 18 years of age and above. Study design Retrospective data analysis. Methods Participant-level data ( n = 2,381,292) from the Behavioral Risk Factor Surveillance System 2003–2011 surveys were linked with Wide-ranging Online Data for Epidemiologic Research air quality data by participants' residential county and interview month/year. Multilevel logistic regressions were performed to examine the effect of ambient PM2.5 air pollution on participants' leisure-time physical inactivity, accounting for various individual and county-level characteristics. Regressions were estimated on the overall sample and subsamples stratified by sex, age cohort, race/ethnicity and body weight status. Results One unit (μg/m3 ) increase in county monthly average PM2.5 concentration was found to be associated with an increase in the odds of physical inactivity by 0.46% (95% confidence interval = 0.34%–0.59%). The effect was similar between the sexes but to some extent (although not always statistically significant) larger for younger adults, Hispanics, and overweight/obese individuals compared with older adults, non-Hispanic whites or African Americans, and normal weight individuals, respectively. Conclusions Ambient PM2.5 air pollution is found to be associated with a modest but measurable increase in individuals' leisure-time physical inactivity, and the relationship tends to differ across population subgroups.
Poor air quality has become a national public health concern in China. This study examines the impact of ambient fine particulate matter (PM2.5) air pollution on health behaviors among college ...students in Beijing, China.
Prospective cohort study.
Health surveys were repeatedly administered among 12,000 newly admitted students at Tsinghua University during 2012–2015 over their freshman year. Linear individual fixed-effect regressions were performed to estimate the impacts of ambient PM2.5 concentration on health behaviors among survey participants, adjusting for various time-variant individual characteristics and environmental measures.
Ambient PM2.5 concentration was found to be negatively associated with time spent on walking, vigorous physical activity and sedentary behavior in the last week, but positively associated with time spent on nighttime/daytime sleep among survey participants. An increase in the ambient PM2.5 concentration by one standard deviation (36.5 μg/m³) was associated with a reduction in weekly total minutes of walking by 7.3 (95% confidence interval CI = 5.3–9.4), a reduction in weekly total minutes of vigorous physical activity by 10.1 (95% CI = 8.5–11.7), a reduction in daily average hours of sedentary behavior by 0.06 (95% CI = 0.02–0.10) but an increase in daily average hours of nighttime/daytime sleep by 1.07 (95% CI = 1.04–1.11).
Ambient PM2.5 air pollution was inversely associated with physical activity level but positively associated with sleep duration among college students. Future studies are warranted to replicate study findings in other Chinese cities and universities, and policy interventions are urgently called to reduce air pollution level in China's urban areas.
•We assess the impact of particulate matter (PM2.5) air pollution on physical activity in Chinese freshmen.•PM2.5 level was negatively related to walking time and vigorous physical activity.•PM2.5 level was positively associated with daily hours of nighttime/daytime sleep.
This study evaluated maintenance treatment with niraparib, a potent inhibitor of poly(ADP-ribose) polymerase 1/2, in patients with platinum-sensitive recurrent ovarian cancer.
In this phase III, ...double-blind, placebo-controlled study conducted at 30 centers in China, adults with platinum-sensitive recurrent ovarian cancer who had responded to their most recent platinum-containing chemotherapy were randomized 2 : 1 to receive oral niraparib (300 mg/day) or matched placebo until disease progression or unacceptable toxicity (NCT03705156). Following a protocol amendment, patients with a bodyweight <77 kg or a platelet count <150 × 103/μl received 200 mg/day, and all other patients 300 mg/day, as an individualized starting dose (ISD). Randomization was carried out by an interactive web response system and stratified by BRCA mutation, time to recurrence following penultimate chemotherapy, and response to most recent chemotherapy. The primary endpoint was progression-free survival (PFS) assessed by blinded independent central review.
Between 26 September 2017 and 2 February 2019, 265 patients were randomized to receive niraparib (n = 177) or placebo (n = 88); 249 patients received an ISD (300 mg, n = 14; 200 mg, n = 235) as per protocol. In the intention-to-treat population, median PFS was significantly longer for patients receiving niraparib versus placebo: 18.3 95% confidence interval (CI), 10.9-not evaluable versus 5.4 (95% CI, 3.7-5.7) months hazard ratio (HR) = 0.32; 95% CI, 0.23-0.45; P < 0.0001, and a similar PFS benefit was observed in patients receiving an ISD, regardless of BRCA mutation status. Grade ≥3 treatment-emergent adverse events occurred in 50.8% and 19.3% of patients who received niraparib and placebo, respectively; the most common events were neutrophil count decreased (20.3% versus 8.0%) and anemia (14.7% versus 2.3%).
Niraparib maintenance treatment reduced the risk of disease progression or death by 68% and prolonged PFS compared to placebo in patients with platinum-sensitive recurrent ovarian cancer. Individualized niraparib dosing is effective and safe and should be considered standard practice in this setting.
•Chinese patients with platinum-sensitive recurrent ovarian cancer received maintenance niraparib (n = 177) or placebo (n = 88).•Median PFS was longer for niraparib versus placebo: 18.3 versus 5.4 months (HR = 0.32; 95% CI, 0.23-0.45; P < 0.0001).•Niraparib had a similar PFS benefit for 249 patients receiving individualized dosing based on bodyweight and platelet count.•Grade ≥3 treatment-emergent adverse events occurred in 50.8% and 19.3% of patients who received niraparib and placebo, respectively.•In the niraparib group, Grade ≥3 platelet count decreased/thrombocytopenia occurred in 11.3% of patients.
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