Battle of the bulge
Weight Discrimination and Risk of Mortality
Angelina Sutin, Yannick Stephan & Antonio Terracciano
Psychological Science, forthcoming
Abstract:
Discrimination based on weight is a stressful social experience linked to declines in physical and mental health. We examined whether this harmful association extends to risk of mortality. Participants in the Health and Retirement Study (HRS; N = 13,692) and the Midlife in the United States Study (MIDUS; N = 5,079) reported on perceived discriminatory experiences and attributed those experiences to a number of personal characteristics, including weight. Weight discrimination was associated with an increase in mortality risk of nearly 60% in both HRS participants (hazard ratio = 1.57, 95% confidence interval = [1.34, 1.84]) and MIDUS participants (hazard ratio = 1.59, 95% confidence interval = [1.09, 2.31]). This increased risk was not accounted for by common physical and psychological risk factors. The association between mortality and weight discrimination was generally stronger than that between mortality and other attributions for discrimination. In addition to its association with poor health outcomes, weight discrimination may shorten life expectancy.
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The Incidence of Taxes on Sugar-Sweetened Beverages: The Case of Berkeley, California
John Cawley & David Frisvold
NBER Working Paper, August 2015
Abstract:
One of the most commonly-proposed policies to address the high prevalence of obesity is a tax on energy-dense foods, in particular sugar-sweetened beverages (SSBs). This is based on the assumption that such taxes are largely passed through to consumers in the form of higher retail prices, leading to reduced consumption. However, relatively little is known about the extent to which taxes on SSBs are in fact passed through to consumers. We estimate the pass-through of the first city-level tax on SSBs in the U.S., which was enacted by the voters of Berkeley, California in November, 2014. We collected the prices of various brands and sizes of SSBs and other beverages before and after the implementation of the tax from a near-census of convenience stores and supermarkets in Berkeley, California. We also collected prices from stores in a control city: San Francisco, where in 2014 a similar voter referendum failed despite majority support. Estimates from difference-in-differences and other models consistently indicate that there was relatively little pass through of the Berkeley SSB tax to consumers; across brands and sizes, we estimate that retail prices rose by less than half of the amount of the tax. This is in contrast to much of the previous literature on the pass-through of taxes, which tended to find full or even overshifting of taxes.
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Weight-control effort can increase obesity stereotyping
Alexander Mussap, Emily Manger & Ron Gold
Personality and Individual Differences, January 2016, Pages 178–181
Abstract:
This study investigated how information about weight-control effort influences obesity stereotyping. 763 participants (583 women, 172 men, 8 undeclared) read a brief vignette about a fictional woman who was described as either obese and of unhealthy weight or of normal/healthy weight, and who either did or did not make efforts to control her weight through diet and exercise, and then rated her across a number of personal characteristics. MANOVA revealed that the woman described as obese was rated as more likely to suffer from an illness in the future, more unattractive, weak-willed, lazy, unhappy, emotional, unpopular, unintelligent, unsuccessful, and less likely to find a romantic partner. Weight-control effort improved ratings of the normal-weight woman but made no difference to, or worsened, ratings of the woman described as obese. These results highlight the prevalence and persistence of obesity stereotypes, and are discussed in relation to attributional models of prejudice.
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Infection-Related Hospitalization in Childhood and Adult Metabolic Outcomes
David Burgner et al.
Pediatrics, September 2015, Pages e554-e562
Background and objectives: Identifying childhood determinants of adult cardiometabolic disease would facilitate early-life interventions. There are few longitudinal data on the contribution of childhood infections. Therefore, we investigated whether hospitalization with childhood infection is associated with adult anthropometric and metabolic outcomes in a large, well-phenotyped longitudinal cohort.
Methods: A total of 1376 subjects from the Cardiovascular Risk in Young Finns Study, aged 3 to 9 years at baseline (1980), who had lifetime data from birth onward on infection-related hospitalization (IRH) had repeated assessments through childhood and adolescence and at least once in adulthood (age 30–45 years in 2001–2011). Early childhood (<5 years), childhood/adolescence (5–18 years), adult (>18 years), and total lifetime IRHs were related to adiposity, BMI, and metabolic syndrome in adulthood. Analyses were adjusted for childhood and adulthood risk factors and potential confounders.
Results: Early-childhood IRH correlated with adverse adult but not childhood metabolic variables: increased BMI (P = .02) and metabolic syndrome (risk ratio: 1.56; 95% confidence interval: 1.03–2.35; P = .03), adjusted for age, gender, birth weight, childhood BMI and other risk factors, and family income. The age at which differences in adult BMI became persistent was related to age of IRH in childhood. The greatest increase in adult BMI occurred in those with >1 childhood IRH.
Conclusions: Childhood IRH was independently associated with adverse adult metabolic variables. This finding suggests that infections and/or their treatment in childhood may contribute to causal pathways leading to adult cardiometabolic diseases.
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What Can We Learn About the Effects of Food Stamps on Obesity in the Presence of Misreporting?
Lorenzo Almada, Ian McCarthy & Rusty Tchernis
NBER Working Paper, September 2015
Abstract:
There is an increasing perception among policy makers that food stamp benefits contribute positively to adult obesity rates. We show that these results are heavily dependent on one's assumptions regarding the accuracy of reported food stamp participation. When allowing for misreporting, we find no evidence that SNAP participation significantly increases the probability of being obese or overweight among adults. Our results also highlight the inherent bias and inconsistency of common point estimates when ignoring misreporting, with treatment effects from instrumental variable methods exceeding the non-parametric upper bounds by over 200% in some cases.
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The Cause Cue Effect: Cause-Related Marketing and Consumer Health Perceptions
Elizabeth Minton & Bettina Cornwell
Journal of Consumer Affairs, forthcoming
Abstract:
Many for-profit companies (e.g., Kraft, Kentucky Fried Chicken, Keebler, 5-Hour Energy) are partnering with health-oriented nonprofits (e.g., Academy of Nutrition and Dietetics, Susan G. Komen for Breast Cancer Research, American Red Cross) to make purchase-contingent donations. Companies use cause-related marketing to improve brand image and goodwill for their food products and companies. Prior research has examined how food-related cues can create consumer misperceptions; however, consumer perceptions related to corporate communications (e.g., the use of cause cues) has received little research attention. This research explores consumer reactions to cause cues and finds that adding a health cause to a food package significantly increases product health perceptions, and, usually, product attitude, and purchase intentions (i.e., the cause cue effect) in both a student sample (Studies 1 and 2) and an adult sample on Amazon's mTurk (Study 3). Implications for cueing and inference-making literature, and for consumer health, and policymakers are discussed.
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Mike Parent & Jessica Alquist
Health Education & Behavior, forthcoming
Abstract:
Although some popular press and nonscholarly sources have claimed that weight is largely unchangeable, the relationship between this belief and objective measures of health remains unclear. We tested the hypothesis that people who believe weight is unchangeable will have poorer objective and subjective health, and fewer exercise behaviors and poorer eating habits, than people who believe weight is changeable. Participants were 4,166 men and 4,655 women enrolled in the National Health and Nutrition Examination Survey in the 2007 to 2010 iterations. Believing that weight was uncontrollable was negatively related to exercise and healthful dietary practices and positively related to unhealthful eating. Lack of exercise and unhealthful eating were, in turn, associated with poor physical health. Age, but not gender, moderated the relationships between belief in weight changeability and exercise behaviors, healthful eating, and unhealthful eating. This study suggests that believing weight is unchangeable is associated with poor health behaviors and poorer physical health.
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Diabetes and Diet: Behavioral Response and the Value of Health
Emily Oster
NBER Working Paper, October 2015
Abstract:
Individuals with obesity often appear reluctant to undertake dietary changes. Evaluating the reasons for this reluctance, as well as appropriate policy responses, is hampered by a lack of data on behavioral response to dietary advice. I use household scanner data to estimate food purchase response to a diagnosis of diabetes, a common complication of obesity. I infer diabetes diagnosis within the scanner data from purchases of glucose testing products. Households engage in statistically significant but small calorie reductions following diagnosis. The changes are sufficient to lose 4 to 8 pounds in the first year, but are only about 10% of what would be suggested by a doctor. The scanner data allows detailed analysis of changes by food type. In the first month after diagnosis, healthy foods increase and unhealthy foods decrease. However, only the decreases in unhealthy food persist. Changes are most pronounced on large, unhealthy, food categories. Those individuals whose pre-diagnosis diet is concentrated in one or a few foods groups show bigger subsequent calorie reductions, with these reductions occurring primarily in these largest food groups. I suggest the facts may be consistent with a psychological framework in which rule-based behavior change is more successful. I compare the results to a policy of taxes or subsidies.
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José Derraik et al.
Journal of Epidemiology & Community Health, forthcoming
Background: A number of large studies have shown phenotypic differences between first-borns and later-borns among adult men. In this study, we aimed to assess whether birth order was associated with height and BMI in a large cohort of Swedish women.
Methods: Information was obtained from antenatal clinic records from the Swedish National Birth Register over 20 years (1991–2009). Maternal anthropometric data early in pregnancy (at approximately 10–12 weeks of gestation) were analysed on 13 406 pairs of sisters who were either first-born or second-born (n=26 812).
Results: Early in pregnancy, first-born women were of BMI that was 0.57 kg/m2 (2.4%) greater than their second-born sisters (p<0.0001). In addition, first-borns had greater odds of being overweight (OR 1.29; p<0.0001) or obese (OR 1.40; p<0.0001) than second-borns. First-borns were also negligibly taller (+1.2 mm) than their second-born sisters. Of note, there was a considerable increase in BMI over the 18-year period covered by this study, with an increment of 0.11 kg/m2 per year (p<0.0001).
Conclusions: Our study corroborates other large studies on men, and the steady reduction in family size may contribute to the observed increase in adult BMI worldwide.
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Prejudice and the Plate: Effects of Weight Bias in Nutrition Judgments
Jonathon Schuldt, Jamie Guillory & Geri Gay
Health Communication, forthcoming
Abstract:
As millions of people turn to social media for health information, better understanding the factors that guide health-related judgments and perceptions in this context is imperative. We report on two Web experiments (n > 400 total) examining the power of society’s widespread weight bias and related stereotypes to influence nutrition judgments in social media spaces. In Experiment 1, meals were judged as lower in nutritional quality when the person who recommended them (the source) was depicted as obese rather than of normal weight, an effect mediated by stereotypic beliefs about the source as a generally unhealthy person. Experiment 2 replicated this effect, which — notably — remained significant when controlling for objective nutritional information (calories and fat content). Results highlight spillover effects of weight bias that extend beyond person perception to color impressions of objects (here, food) that are associated with stigmatized attributes. Implications for everyday nutrition judgments and public health are considered.
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Incentives to Eat Healthy: Evidence from a Grocery Store Field Experiment
John List, Anya Savikhin Samek & Terri Zhu
University of Chicago Working Paper, September 2015
Abstract:
We use a field experiment to investigate the effect of incentives on food purchase decisions at a grocery store. We recruit over 200 participants and track their purchases for a period of 6 months, permitting us a glimpse of more than 3,500 individual shopping trips. We randomize participants to one of several treatments, in which we incentivize fresh fruit and vegetable purchases, provide tips for fruit and vegetable preparation, or both. We report several key insights. First, our informational content treatment has little effect. Second, we find an important price effect: modest pecuniary incentives more than double the proportion of dollars spent on produce in the grocery store. Third, we find an interesting pattern of consumption after the experiment ends: even when incentives are removed, the treatment group has higher fruit and vegetable purchases compared to the control group. These long-term results are in stark contrast to either a standard price model or a behavioral model of 'crowd out.' Rather, our results are consonant with a habit formation model. This opens up the distinct possibility that short term incentives can be used as a key instrument to combat obesity.
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A Field Experiment on the Impact of Incentives on Milk Choice in the Lunchroom
John List & Anya Samek
Public Finance Review, forthcoming
Abstract:
Almost a third of US children ages two to nineteen are deemed overweight or obese, and part of the problem is the habitual decision to consume high-calorie, low-nutrient foods. We propose that the school lunchroom provides a “teachable moment” to engage children in making healthful choices. We conduct a field experiment with over 1,500 participants in grades K to 8 from low-income households in the Chicago Heights, Illinois, School District and then evaluate the impact of small nonmonetary incentives on the selection of milk in the school lunchroom. At baseline, only 16 percent of children select white milk relative to 84 percent choosing chocolate milk. We find a significant effect of incentives, which increase white milk selection by 2.5 times, to 40 percent. One concern with incentives is that they may decrease intrinsic motivation to eat healthy, called “crowd-out of intrinsic motivation.” However, we do not find evidence of “crowd-out”; rather, we see some suggestive evidence of the positive habit forming effect of incentives.
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Weight Gain, Executive Functioning, and Eating Behaviors Among Girls
Andrea Goldschmidt et al.
Pediatrics, October 2015, Pages e856-e863
Objective: Executive functioning and excess weight have been associated in cross-sectional and prospective studies, but mechanisms explaining this relationship are unclear. The current study aimed to further explore the longitudinal relationship between executive functioning and changes in body weight and to determine whether binge eating behaviors mediate this relationship.
Methods: Community-based girls (N = 2450) were assessed by using the behavioral measure of planning, Mazes subtest, and a parent-report measure of impulsivity at age 10; a self-report measure of binge eating at ages 10, 12, and 14; and investigator-measured BMI annually between ages 10 and 16. Regression and bootstrapping analyses explored the relations among age 10 impulsivity and planning, age 12 and age 14 binge eating frequency, and age 10 to 16 BMI changes.
Results: Age 10 impulsivity and planning each independently predicted age 10 to 16 BMI changes, after accounting for demographics, verbal comprehension, and BMI at age 10 (Ps < .001). Binge eating tendencies at age 12 mediated the relation between age 10 impulsivity and age 10 to 16 BMI changes, after controlling for demographics, verbal comprehension, binge eating frequency, and BMI at age 10 (indirect effect estimate = 0.0007; 95% confidence interval = 0.0001–0.0020).
Conclusions: Results support the hypothesis that poorer executive functioning predicts weight gain from middle childhood through adolescence in girls, and that this effect may be partially explained by binge-eating behaviors in early adolescence.
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Lotte Van Dillen & Jackie Andrade
Appetite, January 2016, Pages 102–110
Abstract:
People who are sensitive to food temptations are prone to weight gain and obesity in food-rich environments. Understanding the factors that drive their desire to eat is key to limiting their reactions to available food. This study tested whether individual differences in sensitivity to hedonic food cues are cognitively based and, accordingly, can be regulated by blocking cognitive resources. To this end, one lab study (study 1; N=91) and one field study (study 2; N=63) measured sensitivity to hedonic food cues using the Power of Food Scale (PFS; Lowe et al., 2009) and assessed participants’ appetitive responses to high-calorie food options. To test the role of cognitive elaboration of food cues, participants completed a menu-selection task to induce food cravings and then were free to elaborate those cravings (control group) or were blocked from doing so by cognitive distraction (playing Tetris, solving puzzles; experimental group). Compared to non-sensitive participants, sensitive participants displayed a greater attentional bias to high-calorie food (Study 1), reported stronger cravings (Study 2), and more often chose an unhealthy snack (Studies 1 & 2), but only when they had not been distracted. When distracted, all participants were similarly unresponsive to high-calorie food. This finding suggests that temptation can be effectively controlled by blocking people’s cognitive resources, even for people highly sensitive to hedonic food cues.