Heavy burden
Obesity prevalence among youth investigated for maltreatment in the United States
Jesse Helton & Janet Liechty
Child Abuse & Neglect, forthcoming
Abstract:
The objective of this study is to determine the prevalence and correlates of obesity among youth investigated for maltreatment in the United States. Participants were drawn from the National Survey of Child and Adolescent Well-Being II, a national probability study of 5,873 children aged birth to 17 years under investigation for maltreatment in 2008. From child weight reported by caregivers, we estimated obesity (weight-for-age ≥95th percentile) prevalence among children aged 2 through 17 (n = 2,948). Sex-specific logistic regression models by developmental age were used to identify obesity risk factors, including child age, race/ethnicity, and maltreatment type. Obesity prevalence was 25.4% and was higher among boys than girls (30.0% vs. 20.8%). African American adolescent boys had a lower risk for obesity than white boys (OR = 0.28, 95% CI [0.08, 0.94]). Compared with girls aged 2–5 with a neglect allegation, girls with a sexual abuse allegation were at greater risk for obesity (OR = 3.54, 95% CI [1.01, 12.41]). Compared with adolescent boys with a neglect allegation, boys with a physical abuse allegation had a lower risk for obesity (OR = 0.24, 95% CI [0.06, 0.99]). Adolescent girls with a prior family history of investigation were at greater risk for obesity than those without a history of investigation (OR = 3.97, 95% CI [1.58, 10.02]). Youth investigated for maltreatment have high obesity rates compared with national peers. Opportunities to modify and evaluate related child welfare policies and health care practices should be pursued.
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Determinants of state laws addressing obesity
Michael Marlow
Applied Economics Letters, Winter 2014, Pages 84-89
Abstract:
Little is known about why some states enact more laws addressing obesity than others. This study examines what factors influence the enactment of laws using a data set of the 90 laws enacted over 2001–2010 in 30 states. Odds of enacting laws are mostly unrelated to state variation in education, population density, income, political party structure and obesity prevalence. Factors that significantly influence number of laws include education, black and Hispanic percentages of population and age. Examination of categories of laws indicates cases where political party structure and obesity prevalence influence cumulative numbers of laws, but often in conflicting directions. The negative but weak (p = 0.054) effect of obesity prevalence on the cumulative number of all laws also suggests that state governments that enact most laws are those with relatively low obesity prevalence. This study indicates opportunities for future research to examine which laws addressing obesity are most effective among the diverse experiments taking place across the states.
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Sabrina Jones Niggel et al.
Social Science Journal, forthcoming
Abstract:
This study explores the relationship between adult obesity prevalence and obesity-related state policymaking in the United States. We examine whether 2009 obesity prevalence and the change in prevalence between 2000 and 2009 are associated with obesity-related state laws and regulations introduced or enacted between 2009 and 2011. Policies that exclusively target youth are eliminated from our analysis. Adult obesity prevalence increased in all 50 states over the decade studied, with a slight decrease in Washington, DC. Increases in prevalence are significantly associated with fewer policies in the South and Midwest Census regions and the East North Central and South Atlantic Census divisions. Findings suggest the need for greater advocacy and an opportunity for obesity to rise on state policy agendas.
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A Wallet Full of Calories: The Effect of Financial Dissatisfaction on the Desire for Food Energy
Barbara Briers & Sandra Laporte
Journal of Marketing Research, forthcoming
Abstract:
This study shows that people experiencing financial dissatisfaction may choose and consume food for its energy value. Because money and food are closely related, exchangeable resources, financially dissatisfied people may be motivated to replenish their need for financial resources by consuming caloric resources or food energy. Five experiments provide support for this hypothesis across various measures of caloric desire and actual eating behavior. The findings have notable implications for marketing and public policy. Whereas marketing researchers have increasingly investigated the interplay of taste and health considerations in food consumption, this research demonstrates the importance of investigating food energy considerations.
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Slim by Design: Serving Healthy Foods First in Buffet Lines Improves Overall Meal Selection
Brian Wansink & Andrew Hanks
PLoS ONE, October 2013
Objective: Each day, tens of millions of restaurant goers, conference attendees, college students, military personnel, and school children serve themselves at buffets – many being all-you-can-eat buffets. Knowing how the food order at a buffet triggers what a person selects could be useful in guiding diners to make healthier selections.
Method: The breakfast food selections of 124 health conference attendees were tallied at two separate seven-item buffet lines (which included cheesy eggs, potatoes, bacon, cinnamon rolls, low-fat granola, low-fat yogurt, and fruit). The food order between the two lines was reversed (least healthy to most healthy, and vise-versa). Participants were randomly assigned to choose their meal from one line or the other, and researchers recorded what participants selected.
Results: With buffet foods, the first ones seen are the ones most selected. Over 75% of diners selected the first food they saw, and the first three foods a person encountered in the buffet comprised 66% of all the foods they took. Serving the less healthy foods first led diners to take 31% more total food items (p<0.001). Indeed, diners in this line more frequently chose less healthy foods in combinations, such as cheesy eggs and bacon (r = 0.47; p<0.001) or cheesy eggs and fried potatoes (r =0.37; p<0.001). This co-selection of healthier foods was less common.
Conclusions: Three words summarize these results: First foods most. What ends up on a buffet diner’s plate is dramatically determined by the presentation order of food. Rearranging food order from healthiest to least healthy can nudge unknowing or even resistant diners toward a healthier meal, helping make them slim by design. Health-conscious diners, can proactively start at the healthier end of the line, and this same basic principle of “first foods most” may be relevant in other contexts – such as when serving or passing food at family dinners.
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How Images of Other Consumers Influence Subsequent Taste Perceptions
Morgan Poor, Adam Duhachek & Shanker Krishnan
Journal of Marketing, November 2013, Pages 124-139
Abstract:
Images of food are seemingly everywhere, and yet the influence that such images have on important consumer outcomes is not well understood. The authors propose that the effect that image exposure has on taste perceptions largely depends on the interaction between the type of food (healthy vs. unhealthy) and whether the image shows the food alone (food image) or the food being consumed by a person (consummatory image). Specifically, the authors show that exposure to consummatory images of unhealthy (vs. healthy) foods increases taste perceptions relative to food images. To explain this effect, the authors argue that seeing an image of someone else indulging in an unhealthy food serves as social proof of the appropriateness and acceptability of indulgent consumption. As such, images of consumers eating act as a justification agent for real consumers, thereby reducing the conflict associated with the subsequent indulgent consumption experience and, in effect, increasing taste perceptions. The authors test this effect across five studies and eliminate rival explanations pertaining to emotional contagion, goal contagion, and source attractiveness.
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Athlete Endorsements in Food Marketing
Marie Bragg et al.
Pediatrics, November 2013, Pages 805-810
Objective: This study quantified professional athletes’ endorsement of food and beverages, evaluated the nutritional quality of endorsed products, and determined the number of television commercial exposures of athlete-endorsement commercials for children, adolescents, and adults.
Methods: One hundred professional athletes were selected on the basis of Bloomberg Businessweek’s 2010 Power 100 rankings, which ranks athletes according to their endorsement value and prominence in their sport. Endorsement information was gathered from the Power 100 list and the advertisement database AdScope. Endorsements were sorted into 11 endorsement categories (eg, food/beverages, sports apparel). The nutritional quality of the foods featured in athlete-endorsement advertisements was assessed by using a Nutrient Profiling Index, whereas beverages were evaluated on the basis of the percentage of calories from added sugar. Marketing data were collected from AdScope and Nielsen.
Results: Of 512 brands endorsed by 100 different athletes, sporting goods/apparel represented the largest category (28.3%), followed by food/beverages (23.8%) and consumer goods (10.9%). Professional athletes in this sample were associated with 44 different food or beverage brands during 2010. Seventy-nine percent of the 62 food products in athlete-endorsed advertisements were energy-dense and nutrient-poor, and 93.4% of the 46 advertised beverages had 100% of calories from added sugar. Peyton Manning (professional American football player) and LeBron James (professional basketball player) had the most endorsements for energy-dense, nutrient-poor products. Adolescents saw the most television commercials that featured athlete endorsements of food.
Conclusions: Youth are exposed to professional athlete endorsements of food products that are energy-dense and nutrient-poor.
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Fitness vs. Fatness on All-cause Mortality: A Meta-Analysis
Vaughn Barry et al.
Progress in Cardiovascular Diseases, forthcoming
Abstract:
The purpose of this study was to quantify the joint association of cardiorespiratory fitness (CRF) and weight status on mortality from all causes using meta-analytical methodology. Studies were included if they were (1) prospective, (2) objectively measured CRF and body mass index (BMI), and (3) jointly assessed CRF and BMI with all-cause mortality. Ten articles were included in the final analysis. Pooled hazard ratios were assessed for each comparison group (i.e. normal weight-unfit, overweight-unfit and -fit, and obese-unfit and -fit) using a random-effects model. Compared to normal weight-fit individuals, unfit individuals had twice the risk of mortality regardless of BMI. Overweight and obese-fit individuals had similar mortality risks as normal weight-fit individuals. Furthermore, the obesity paradox may not influence fit individuals. Researchers, clinicians, and public health officials should focus on physical activity and fitness-based interventions rather than weight-loss driven approaches to reduce mortality risk.
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The Poverty Effects of a ‘Fat-Tax’ in Ireland
David Madden
Health Economics, forthcoming
Abstract:
To combat growing levels of obesity, health-related taxes have been suggested with taxes on foods high in fat or sugar. Such taxes have been criticised on the basis of their regressivity and potentially adverse impact upon poverty. This paper analyses the effect of such taxes on a range of poverty measures and also examines the effect of a revenue-neutral tax subsidy mixed with a tax on unhealthy food combined with a subsidy on more healthy food. Using Irish expenditure data, the results indicate that taxes on high fat/sugar goods on their own will be regressive but that a tax-subsidy combination can be broadly neutral with respect to poverty.
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Effect of Carbonation on Brain Processing of Sweet Stimuli in Humans
Francesco Di Salle et al.
Gastroenterology, September 2013, Pages 537-539
Abstract:
Little is known about how CO2 affects neural processing of taste. We used functional magnetic resonance imaging to investigate the effects of carbonation on brain processing of sweet stimuli, which has relevance to studies of food selection and satiety. The presence of carbonation produced an overall decrease in the neural processing of sweetness-related signals, especially from sucrose. CO2 reduced the neural processing of sucrose more than that of artificial sweeteners. These findings might be relevant to dietary interventions that include noncaloric beverages, whereas the combination of CO2 and sucrose might increase consumption of sucrose.
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The Bright Side of Stress-Induced Eating: Eating More When Stressed but Less When Pleased
Gudrun Sproesser, Harald Schupp & Britta Renner
Psychological Science, forthcoming
Abstract:
Previous research suggests that approximately 40% to 50% of the population increase food consumption under stressful conditions. The prevailing view is that eating in response to stress is a type of maladaptive self-regulation. Past research has concentrated mainly on the negative effects of social stress on eating. We propose that positive social experiences may also modulate eating behavior. In the present study, participants were assigned to social-exclusion, neutral, and social-inclusion conditions. In a subsequent bogus taste test, the amount of ice cream eaten and habitual stress-related eating were measured. After being socially excluded, people who habitually eat more in response to stress (stress hyperphagics) ate significantly more than people who habitually eat less in response to stress (stress hypophagics). Conversely, after being socially included, stress hyperphagics ate significantly less than stress hypophagics. The present findings provide the first evidence for complementary adjustments of food consumption across positive and negative situations. Implications of these findings for the relationship of stress and body weight are discussed.
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Sanjay Basu et al.
American Journal of Public Health, November 2013, Pages 2071-2077
Objectives: We estimated the relationship between soft drink consumption and obesity and diabetes worldwide.
Methods: We used multivariate linear regression to estimate the association between soft drink consumption and overweight, obesity, and diabetes prevalence in 75 countries, controlling for other foods (cereals, meats, fruits and vegetables, oils, and total calories), income, urbanization, and aging. Data were obtained from the Euromonitor Global Market Information Database, the World Health Organization, and the International Diabetes Federation. Bottled water consumption, which increased with per-capita income in parallel to soft drink consumption, served as a natural control group.
Results: Soft drink consumption increased globally from 9.5 gallons per person per year in 1997 to 11.4 gallons in 2010. A 1% rise in soft drink consumption was associated with an additional 4.8 overweight adults per 100 (adjusted B; 95% confidence interval [CI] = 3.1, 6.5), 2.3 obese adults per 100 (95% CI = 1.1, 3.5), and 0.3 adults with diabetes per 100 (95% CI = 0.1, 0.8). These findings remained robust in low- and middle-income countries.
Conclusions: Soft drink consumption is significantly linked to overweight, obesity, and diabetes worldwide, including in low- and middle-income countries.
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Personality Disorders and Body Weight
Johanna Catherine Maclean et al.
Economics & Human Biology, forthcoming
Abstract:
We examine the impact of Axis II personality disorders (PDs) on body weight. PDs are psychiatric conditions that develop early in life from a mixture of genetics and environment, are persistent, and lead to substantial dysfunction for the affected individual. The defining characteristics of PDs conceptually link them with body weight, but the direction of the relationship likely varies across PD type. To investigate these links, we analyze data from Wave II of the National Epidemiological Survey of Alcohol and Related Conditions. We measure body weight with the body mass index (BMI) and a dichotomous indicator for obesity (BMI ≥ 30). We find that women with PDs have significantly higher BMI and are more likely to be obese than otherwise similar women. We find few statistically significant or economically meaningful effects for men. Paranoid, schizotypal, and avoidant PDs demonstrate the strongest adverse impacts on women's body weight while dependent PD may be protective against elevated body weight among men. Findings from unconditional quantile regressions demonstrate a positive gradient between PDs and BMI in that the effects are greater for higher BMI respondents.
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Abdominal obesity and chronic stress interact to predict blunted cardiovascular reactivity
Kulwinder Singh & Biing-Jiun Shen
International Journal of Psychophysiology, October 2013, Pages 73–79
Abstract:
Abdominal obesity and chronic stress have independent effects on cardiac autonomic regulation, and may also interact to influence cardiovascular reactivity. In addition to main effects, we hypothesized that abdominal obesity and chronic stress would interact and predict blunted cardiovascular reactivity. One hundred and twenty-two undergraduate students engaged in two stressful laboratory tasks while cardiovascular activity was assessed. Results indicated that higher abdominal obesity significantly predicted blunted systolic blood pressure (SBP) and mean arterial pressure (MAP) change, while chronic stress was not directly associated with any measure of cardiovascular reactivity. Furthermore, there was a significant interaction between abdominal obesity and chronic stress on SBP and MAP change such that among participants with higher chronic stress, higher abdominal obesity was significantly associated with reduced SBP and MAP reactivity. In addition, body-mass index (BMI), a measure of overall obesity, also had both main and interaction effects with chronic stress to predict blunted cardiovascular reactivity. These results suggest that abdominally obese individuals may incur difficulty in mounting appropriately-sized cardiovascular responses during acute stress, particularly when under high levels of chronic stress.
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Alison Miller et al.
Psychoneuroendocrinology, November 2013, Pages 2611–2617
Abstract:
No known studies have tested the hypothesis that a blunted pattern of cortisol reactivity to stress, which is often found following exposure to chronic life stressors, is associated with a higher body mass index (BMI) in very young children. Low-income children (n = 218, mean age 56.6 (range: 38.1–78.5; SD 7.0) months, 49.1% male, 56.4% white, 16.1% black, 11.5% Hispanic/Latino) participated in a series of behavioral tasks designed to elicit stress. Cortisol was sampled in saliva 5 times during the protocol, and area under the curve (AUC), representing total cortisol output during stress elicitation, was calculated. Children were weighed and height measured and body mass index (BMI) z-score was calculated. Linear regression was used to evaluate the association between cortisol AUC and BMI z-score, controlling for child age, sex, and race/ethnicity (non-Hispanic white vs. not); primary caregiver weight status (overweight, defined as BMI ≥ 25 vs. not); and family income-to-needs ratio. Mean child BMI z-score was 0.88 (SD = 1.03). Mean cortisol AUC was 6.11 μg/dL/min (SD = 10.44). In the fully adjusted model, for each 1-standard deviation unit decrease in cortisol AUC, the child's BMI z-score increased by 0.17 (SE 0.07) standard deviation units (p < 0.02). A blunted cortisol response to stress, as is often seen following chronic stress exposure, is associated with increased BMI z-score in very young children. Further work is needed to understand how associations between stress, cortisol, and elevated body mass index may develop very early in the lifespan.
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Megan LoDolce, Jennifer Harris & Marlene Schwartz
Journal of Health Communication, November 2013, Pages 1293-1309
Abstract:
Marketing that targets children with energy-dense, nutrient-poor foods is a likely contributor to the childhood obesity crisis. High-sugar ready-to-eat cereals are the packaged food most frequently promoted in child-targeted food advertising on television. The authors combined content analysis of product nutritional quality and messages presented in cereal television advertisements with syndicated data on exposure to those ads. The analysis quantifies children's exposure to specific products and messages that appear in advertisements and compares it with adult exposure. Children viewed 1.7 ads per day for ready-to-eat cereals, and 87% of those ads promoted high-sugar products; adults viewed half as many ads, and ads viewed were equally likely to promote high- and low-sugar cereals. In addition, the messages presented in high-sugar ads viewed by children were significantly more likely to convey unrealistic and contradictory messages about cereal attributes and healthy eating. For example, 91% of high-sugar cereal ads viewed by children ascribed extraordinary powers to these products, and 67% portrayed healthy and unhealthy eating behaviors. Given children's vulnerability to the influence of advertising, the emotional and mixed messages used to promote high-sugar cereals are confusing and potentially misleading.
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Body size and time-to-pregnancy in black women
Lauren Wise, Julie Palmer & Lynn Rosenberg
Human Reproduction, October 2013, Pages 2856-2864
Study question: Are overall and central obesity associated with reduced fecundability in US black women?
Summary answer: Overall and central obesity — based on self-reported measures of body mass index (BMI, kg/m2), waist circumference and waist-to-hip ratio — were independent risk factors for subfertility in our cohort.
Study design, size, duration: Data were derived from the Black Women's Health Study, a prospective cohort study. During 1995–2011, there were 2239 planned pregnancy attempts reported by 1697 women, resulting in 2022 births. Cohort retention was greater than 80%.
Participants/materials, setting, methods: Eligible women were aged 21–40 years and reported at least one planned pregnancy attempt during 1995–2011. Height and weight were reported in 1995, with weight updated every two years; waist and hip circumferences were reported in 1995 and updated in 2003. A validation study within the cohort showed high correlations between self-reported and technician-measured weight (r = 0.97), height (r = 0.93), waist circumference (r = 0.75) and hip circumference (r = 0.74). In 2011, TTP was reported in months. Proportional probabilities regression models were used to estimate fecundability ratios (FRs) and 95% confidence intervals (CI), adjusting for covariates.
Main results and the role of change: High BMI was associated with delayed conception: relative to BMI 18.5–24.9, FRs for BMI categories of <18.5, 25.0–29.9, 30.0–34.9 and ≥35.0 were 0.92 (CI: 0.64–1.32), 0.93 (CI: 0.84–1.03), 0.92 (CI: 0.79–1.06) and 0.73 (CI: 0.61–0.87), respectively. Associations were stronger among nulliparous women (P-interaction = 0.003). After controlling for BMI, reduced fecundability was observed among women with large waist circumferences (≥33 versus <26 inches: FR = 0.73, CI: 0.60–0.88) and large waist-to-hip ratios (≥0.85 versus <0.71: FR = 0.83, CI: 0.71–0.97).
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Changes in the Energy and Sodium Content of Main Entrées in US Chain Restaurants from 2010 to 2011
Helen Wu & Roland Sturm
Journal of the Academy of Nutrition and Dietetics, forthcoming
Objectives: To track changes in the energy and sodium content of US chain restaurant main entrées between spring 2010 (when the Affordable Care Act was passed, which included a federal menu labeling requirement) and spring 2011.
Design: Nutrition information was collected from top US chain restaurants' websites, comprising 213 unique brands. Descriptive statistics and regression analysis evaluated change across main entrées overall and compared entrées that were added, removed, and unchanged. Tests of means and proportions were conducted for individual restaurant brands to see how many made significant changes. Separate analyses were conducted for children's menus.
Results: Mean energy and sodium did not change significantly overall, although mean sodium was 70 mg lower across all restaurants in added vs removed menu items at the 75th percentile. Changes were specific to restaurant brands or service model: family-style restaurants reduced sodium among higher-sodium entrées at the 75th percentile, but not on average, and entrées still far exceeded recommended limits. Fast-food restaurants decreased mean energy in children's menu entrées by 40 kcal. A few individual restaurant brands made significant changes in energy or sodium, but the vast majority did not, and not all changes were in the healthier direction. Among those brands that did change, there were slightly more brands that reduced energy and sodium compared with those that increased it.
Conclusions: Industry marketing and pledges may create a misleading perception that restaurant menus are becoming substantially healthier, but both healthy and unhealthy menu changes can occur simultaneously. Our study found no meaningful changes overall across a 1-year time period. Longer-term studies are needed to track changes over time, particularly after the federal menu labeling law is implemented.
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Sarah Mustillo, Kristen Budd & Kimber Hendrix
Social Psychology Quarterly, September 2013, Pages 268-289
Abstract:
The stigma of childhood obesity has the potential to affect psychological development during the early life course, but few studies examine whether experiencing stigma in childhood and adolescence has lasting ramifications for mental health during the transition to adulthood. Integrating modified labeling theory with a life course perspective, this study examined how obesity at different ages affects psychological distress in late adolescence using longitudinal data on black and white girls. We tested whether parent or friend labeling mediates this relationship and whether distal effects on psychological distress are further mediated through proximal distress using data from the National Growth and Health Study (n = 2,379). Findings showed significant proximal and distal effects of obesity on psychological distress through both parent and friend labeling among white girls. Distal effects on psychological distress were also mediated by proximal psychological distress. Among black girls, there were no distal effects, suggesting weight-based stigma is more consequential for white girls compared to black girls.
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Implications of fast food restaurant concentration for preschool-aged childhood obesity
Christopher Newman, Elizabeth Howlett & Scot Burton
Journal of Business Research, forthcoming
Abstract:
In this research, the authors examine the effects on preschool-aged childhood obesity rates associated with the direct and moderating influence of fast food restaurant density levels, consumer poverty, and urbanization. Results show that higher levels of fast food restaurant saturation are associated with increased levels of childhood obesity in both urban and poor areas, with the largest negative effect of fast food availability on obesity occurring in more economically disadvantaged, urban areas. Findings highlight why the societal impacts of targeting vulnerable populations through corporate location selection strategies should be fully considered in social marketing initiatives, especially given that unhealthy products with long term health risks are increasingly accessible.