Findings

Tastes great, less filling

Kevin Lewis

September 16, 2012

Death Row Nutrition: Curious Observations of Last Meals

Brian Wansink, Kevin Kniffin & Mitsuru Shimizu
Appetite, forthcoming

Abstract:
The growing macabre fascination with "last meals" offers a window into one's true consumption desires when one's value of the future is discounted close to zero. But in contrast to popular anecdotes and individual case studies, we created an empirical catalogue of actual last meals - the final food requests of 247 individuals executed in the United States during a recent five-year period. Our content analyses reveal three key findings: 1) The average last meal is calorically rich (2,756 calories) and proportionally averages 2.5 times the daily recommended servings of protein and fat, 2) the most frequent requests are also calorie dense: meat (83.9%), fried food (67.9%), desserts (66.3%), and soft drinks (60.0%), and 3) 39.9% requested branded foods or beverages. These findings are respectfully consistent with a model of environmentally contingent temporal discounting, and they are consistent with studies of how food is used to mediate feelings of stress and distress. Given that some people who are warned about the ill effects of obesity might counterintuitively engage in unhealthy overconsumption, the findings also suggest further study relating to the artificial use of mortality salience in campaigns against obesity.

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The Unhealthy Road Not Taken: Licensing Indulgence by Exaggerating Counterfactual Sins

Daniel Effron, Benoît Monin & Dale Miller
Journal of Experimental Social Psychology, forthcoming

Abstract:
This research examined two hypotheses: 1) Reflecting on foregone indulgences licenses people to indulge, and 2) To justify future indulgence, people will exaggerate the sinfulness of actions not taken, thereby creating the illusion of having previously foregone indulgence. In Study 1 (a longitudinal study), dieters induced to reflect on unhealthy alternatives to their prior behavior (compared to dieters in a control condition) expressed weaker intentions to pursue their weight-loss goals - and one week later, they said that they had actually done less and intended to continue doing less to pursue such goals. In Study 2, weight-conscious participants who expected to eat cookies (compared to those merely shown cookies) inflated the unhealthiness of snack foods that they previously declined to eat, and exaggerated the extent to which dieting concerns explained why they had declined these snacks. Implications for moral behavior, self-control, and motivated construal processes are discussed.

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Fast Food Restaurant Lighting and Music Can Reduce Calorie Intake and Increase Satisfaction

Brian Wansink & Koert Van Ittersum
Psychological Reports, August 2012, Pages 228-232

Abstract:
Recent research shows that environmental cues such as lighting and music strongly bias the eating behavior of diners in laboratory situations. This study examines whether changing the atmosphere of a fast food restaurant would change how much patrons ate. The results indicated that softening the lighting and music led people to eat less, to rate the food as more enjoyable, and to spend just as much. In contrast to hypothesized U-shaped curves (people who spend longer eat more), this suggests a more relaxed environment increases satisfaction and decreases consumption.

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Disgust Sensitivity, Obesity Stigma, and Gender: Contamination Psychology Predicts Weight Bias for Women, Not Men

Debra Lieberman, Josh Tybur & Janet Latner
Obesity, September 2012, Pages 1803-1814

Abstract:
Recent research has established a link between disgust sensitivity and stigmatizing reactions to various groups, including obese individuals. However, previous research has overlooked disgust's multiple evolved functions. Here, we investigated whether the link between disgust sensitivity and obesity stigma is specific to pathogen disgust, or whether sexual disgust and moral disgust - two separate functional domains - also relate to negative attitudes toward obese individuals. Additionally, we investigated whether sex differences exist in the manner disgust sensitivity predicts obesity stigma, whether the sexes differ across the subtypes of obesity bias independent of disgust sensitivity, and last, the association between participants' BMI and different subtypes of obesity stigma. In study 1 (N = 92), we established that obesity elicits pathogen, sexual, and moral disgust. In study 2, we investigated the relationship between these types of disgust sensitivity and obesity stigma. Participants (N = 387) reported their level of disgust toward various pathogen, sexual, and moral acts and their attitudes toward obese individuals. For women, but not men, increased pathogen disgust sensitivity predicted more negative attitudes toward obese individuals. Men reported more negative general attitudes toward obese individuals whereas women reported greater fear of becoming obese. The sexes also differed in how their own BMI related to the subtypes of obesity stigma. These findings indicate that pathogen disgust sensitivity plays a role in obesity stigma, specifically for women. Defining the scope of disgust's activation in response to obesity and its relationship with other variables can help identify possible mechanisms for understanding and ultimately alleviating prejudice and discrimination.

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Obesity and fast food in urban markets: A new approach using geo-referenced micro data

Susan Elizabeth Chen, Raymond Florax & Samantha Snyder
Health Economics, forthcoming

Abstract:
This paper presents a new method of assessing the relationship between features of the built environment and obesity, particularly in urban areas. Our empirical application combines georeferenced data on the location of fast-food restaurants with data about personal health, behavioral, and neighborhood characteristics. We define a ‘local food environment' for every individual utilizing buffers around a person's home address. Individual food landscapes are potentially endogenous because of spatial sorting of the population and food outlets, and the body mass index (BMI) values for individuals living close to each other are likely to be spatially correlated because of observed and unobserved individual and neighborhood effects. The potential biases associated with endogeneity and spatial correlation are handled using spatial econometric estimation techniques. Our application provides quantitative estimates of the effect of proximity to fast-food restaurants on obesity in an urban food market. We also present estimates of a policy simulation that focuses on reducing the density of fast-food restaurants in urban areas. In the simulations, we account for spatial heterogeneity in both the policy instruments and individual neighborhoods and find a small effect for the hypothesized relationships between individual BMI values and the density of fast-food restaurants.

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Food Intake Is Influenced by Sensory Sensitivity

Katherine Naish & Gillian Harris
PLoS ONE, August 2012

Abstract:
Wide availability of highly palatable foods is often blamed for the rising incidence of obesity. As palatability is largely determined by the sensory properties of food, this study investigated how sensitivity to these properties affects how much we eat. Forty females were classified as either high or low in sensory sensitivity based on their scores on a self-report measure of sensory processing (the Adult Sensory Profile), and their intake of chocolate during the experiment was measured. Food intake was significantly higher for high-sensitivity compared to low-sensitivity individuals. Furthermore, individual scores of sensory sensitivity were positively correlated with self-reported emotional eating. These data could indicate that individuals who are more sensitive to the sensory properties of food have a heightened perception of palatability, which, in turn, leads to a greater food intake.

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The Impact of Physical Education on Obesity among Elementary School Children

John Cawley, David Frisvold & Chad Meyerhoefer
NBER Working Paper, August 2012

Abstract:
In response to the dramatic rise in childhood obesity, the Centers for Disease Control (CDC) and other organizations have advocated increasing the time that elementary school children spend in physical education (PE) classes. However, little is known about the effect of PE on child weight. This paper measures that effect by instrumenting for child PE time with state policies, using data from the Early Childhood Longitudinal Study, Kindergarten Cohort (ECLS-K) for 1998-2004. Results from IV models indicate that PE lowers BMI z-score and reduces the probability of obesity among 5th graders (in particular, boys), while the instrument is insufficiently powerful to reliably estimate effects for younger children. This represents some of the first evidence of a causal effect of PE on youth obesity, and thus offers at least some support to the assumptions behind the CDC recommendations. We find no evidence that increased PE time crowds out time in academic courses or has spillovers to achievement test scores.

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Food Insecurity and Increased BMI in Young Adult Women

Holly Gooding, Courtney Walls & Tracy Richmond
Obesity, September 2012, Pages 1896-1901

Abstract:
Food insecurity has been associated with weight status in children and adults although results have been mixed. We aimed to identify whether food insecurity was associated with BMI in young adults and whether this association differed by gender and was modified by food stamp use and the presence of children in the home. Cross-sectional data from wave 4 (2007-2008) of the National Longitudinal Study of Adolescent Health were analyzed. Multiple linear regression was used to investigate the association between food insecurity and BMI in gender stratified models of young adult women (n = 7,116) and men (n = 6,604) controlling for age, race/ethnicity, income, education, physical activity, smoking, alcohol use, the presence of children in the home, and food stamp use in young adulthood and/or adolescence. Food insecurity was more common in young adult women (14%) than young adult men (9%). After controlling for a variety of individual variables, food insecure women had a BMI that was on average 0.9 kg/m2 units higher than women who were food secure. This difference in BMI persisted after controlling for recent or past food stamp use and was not different among women with or without children in the household. No relationship was found between food insecurity and BMI in young adult men. Providers should inquire about food insecurity, especially when treating obesity, and policy initiatives should address the role of access to healthy food in those facing food insecurity.

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Duration of Breastfeeding and Childhood Obesity: A Generalized Propensity Score Approach

Miao Jiang & Michael Foster
Health Services Research, forthcoming

Objective: To estimate the effect of breastfeeding duration on childhood obesity.

Data Source: The Child Development Supplement (CDS) of the Panel Study of Income Dynamics (PSID). The PSID provides extensive data on the income and well-being of a representative sample of U.S. families from 1968 to the present. The CDS collects information on the children in PSID families ranging from cognitive, behavioral, and health status to their family and neighborhood environment. The first two waves of the CDS were conducted in 1997 and 2002, respectively. The data provide information on 3,271 children and their mothers.

Study Design: We use the generalized propensity score to adjust for confounding based on continuous treatment, and the general additive model to analyze the adjusted association between treatment and the outcome conditional on the propensity score. The main outcome is the body mass index (BMI) directly assessed during the in-person interview in 2002. Covariates include family, maternal, and child characteristics, many of which were measured in the year the child was born.

Principal Findings: After using propensity scores to adjust for confounding, the relationship between breastfeeding duration and childhood BMI is trivially small across a range of model specifications, and none of them is statistically significant except the unadjusted model.

Conclusions: The causal link between duration of breastfeeding and childhood obesity has not been established. Any recommendation of promoting breastfeeding to reduce childhood obesity is premature.

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The association of childhood obesity to neuroelectric indices of inhibition

Keita Kamijo et al.
Psychophysiology, forthcoming

Abstract:
To examine whether childhood obesity is associated with inhibitory control, we compared healthy weight and obese preadolescent children's task performance along with the N2 and P3 components during a Go/NoGo task. Results indicated that obese children exhibited lower response accuracy relative to healthy weight children during the NoGo task requiring greater amounts of inhibitory control, whereas no such difference was observed during the Go task. Neuroelectric data indicated that healthy weight children exhibited a more frontal distribution for the NoGo P3 relative to the Go P3, whereas obese children had similar topographic distributions between the Go P3 and NoGo P3. Further, obese children had larger NoGo N2 amplitude relative to the Go N2, whereas this difference was not observed for healthy weight children. These findings suggest that childhood obesity is negatively and selectively associated with prefrontal inhibitory control.

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A Randomized Pilot Trial of a Full Subsidy vs. a Partial Subsidy for Obesity Treatment

Adam Tsai et al.
Obesity, September 2012, Pages 1838-1843

Abstract:
Intensive obesity treatment is mandated by federal health care reform but is costly. A partial subsidy for obesity treatment could lower the cost of treatment, without reducing its efficacy. This study sought to test whether a partial subsidy for obesity treatment would be feasible, as compared to a fully subsidized intervention. The study was a pilot randomized trial. Participants (n = 50) were primary care patients with obesity and at least one comorbid condition (diabetes, hypertension, dyslipidemia, or obstructive sleep apnea). Each participant received eight weight loss counseling visits as well as portion-controlled foods for weight loss. Participants were randomized to full subsidy or partial subsidy (2 vs. 1 meal per day provided). The primary outcome was weight change after 4 months. Secondary outcomes included changes in blood pressure, waist circumference, and health-related quality of life. Participants in the full and partial subsidy groups lost 5.9 and 5.3 kg, equivalent to 5.3% and 5.1% of initial weight, respectively (P = 0.71). Changes in secondary outcomes were similar in the two groups. A partial subsidy was feasible and induced a clinically similar amount of weight loss, compared to a full subsidy. Large-scale testing of economic incentives for weight control is merited given the federal mandate to offer weight loss counseling to obese patients.

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"school"+AND+"lunch"+AND+"program"&search_reqcount=20&search_reqfirst=1&search_sort=relevance&search_source=Journal+of+Nutrition+Education+and+Behavior&search_startpage=&search_tabularSearchValue=&search_text1=school+lunch+program&search_text2=&search_text3=&search_text4=&search_volume=&search_within1=&search_within2=&search_within3=&search_wordsexactly=no&search_yearend=&search_yearstart=&searchDisciplineField=all&terms1=school+lunch+program&terms2=&terms3=">Associations among School Characteristics and Foodservice Practices in a Nationally Representative Sample of United States Schools

Jessica Thomson et al.
Journal of Nutrition Education and Behavior, September-October 2012, Pages 423-431

Objective: Determine school characteristics associated with healthy/unhealthy food service offerings or healthy food preparation practices.

Design: Secondary analysis of cross-sectional data.

Setting: Nationally representative sample of public and private elementary, middle, and high schools.

Participants: Data from the 2006 School Health Policies and Practices Study Food Service School Questionnaire, n = 526 for Healthy and Unhealthy Offerings analysis; n = 520 for Healthy Preparation analysis.

Main Outcome Measures: Scores for healthy/unhealthy foodservice offerings and healthy food preparation practices.

Analysis: Multivariable regression to determine significant associations among school characteristics and offerings/preparation practices.

Results: Public schools and schools participating in the United States Department of Agriculture (USDA) Team Nutrition reported more healthy offerings and preparation than private or nonparticipating schools, respectively. Elementary schools reported fewer unhealthy offerings than middle or high schools; middle schools reported fewer unhealthy offerings than high schools. Schools requiring foodservice managers to have a college education reported more healthy preparation, whereas those requiring completion of a foodservice training program reported fewer unhealthy offerings and more healthy preparation than schools without these requirements.

Conclusions and Implications: Results suggest the school nutrition environment may be improved by requiring foodservice managers to hold a nutrition-related college degree and/or successfully pass a foodservice training program, and by participating in a school-based nutrition program, such as USDA Team Nutrition.

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Dynamic relations between fast-food restaurant and body weight status: A longitudinal and multilevel analysis of Chinese adults

Hongwei Xu, Susan Short & Tao Liu
Journal of Epidemiology & Community Health, forthcoming

Background: Mixed findings have been reported on the association between Western fast-food restaurants and body weight status. Results vary across study contexts and are sensitive to the samples, measures and methods used. Most studies have failed to examine the temporally dynamic associations between community exposure to fast-food restaurants and weight changes.

Methods: Bayesian hierarchical regressions are used to model changes in body mass index, waist-to-height ratio (WHtR) and waist-to-hip ratio (WHpR) as a function of changes in Western fast-food restaurants in 216 communities for more than 9000 Chinese adults followed up multiple times between 2000 and 2009.

Results: Number of Western fast-food restaurants is positively associated with subsequent increases in WHtR and WHpR among rural population. More fast-food restaurants are positively associated with a future increase in WHpR for urban women. Increased availability of fast food between two waves is related to increased WHtR for urban men over the same period. A past increase in number of fast-food restaurants is associated with subsequent increases in WHtR and WHpR for rural population.

Conclusions: The associations between community exposure to Western fast food and weight changes are temporally dynamic rather than static. Improved measures of exposure to community environment are needed to achieve more precise estimates and better understanding of these relationships. In light of the findings in this study and China's rapid economic growth, further investigation and increased public health monitoring is warranted since Western fast food is likely to be more accessible and affordable in the near future.

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A Nutritional Comparison of Foods and Beverages Marketed to Children in Two Advertising Policy Environments

Monique Potvin Kent, Lise Dubois & Alissa Wanless
Obesity, September 2012, Pages 1829-1837

Abstract:
Childhood obesity is associated with children's exposure to food/beverage marketing. Policy options in this area are being sought in order to reduce childhood obesity rates on a population-level. We examined the nutritional quality of foods advertised to children during their preferred television viewing in Ontario (Canada), where advertising is self-regulated by industry, and in Quebec (Canada), where a child-directed advertising ban exists. A total of 428 children aged 10-12 years completed television viewing diaries for 7 days. Thirty-two television stations were recorded simultaneously between 6 am and midnight. A content analysis of 90 h of English Ontario, French Quebec, and English Quebec children's preferred viewing was then undertaken. A total of 429 food and beverage advertisements were analyzed and their nutritional quality was assessed. Food advertisements in the Quebec French sample were statistically significantly higher in total fat, saturated fat and protein, and lower in carbohydrates and sugar per 100 g, and as a percentage of energy than food ads in the two English samples. A statistically significantly lower percentage of the Quebec French food advertisements were classified as either high fat, sugar or sodium and a smaller proportion of food ads were classified as "less healthy" compared to the Ontario and Quebec English samples. These results suggest that the Quebec advertising ban is influencing the macronutrient profile of advertised foods viewed by French Quebec children during their preferred viewing and that their promotions are marginally healthier than that viewed by the English samples.

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Effect of Birth Year on Birth Weight and Obesity in Adulthood: Comparison between Subjects Born Prior to and during the Great Depression in Iceland

Cindy Mari Imai et al.
PLoS ONE, September 2012

Background: Many epidemiological studies have linked small size at birth to adverse adult health outcomes but the relative influence of environmental exposures is less well established.

Methods: The authors investigated the impact of prenatal environmental exposure by comparing 2750 participants born before (1925-1929) and during (1930-1934) the Great Depression in Reykjavik, Iceland. Calendar year served as proxy for environmental effects. Anthropometric measurements at birth and school-age (8-13 years) were collected from national registries. Participants were medically examined as adults (33-65 years).

Results: Mean birth weight, adjusted for maternal age and parity, decreased by 97 g (95% confidence interval (CI): 39, 156) for men and 70 g (95% CI: 11, 129) for women from 1925 to 1934; growth at school-age was significantly reduced for participants growing during the Depression. As adults, women prenatally exposed to the Depression had higher body mass index (Δ0.6 kg/m2, 95% CI: 0.2, 1.1), higher fasting blood glucose levels (Δ0.16 mmol/L, 95% CI: 0.07, 0.23) and greater odds of being obese 1.43 (95% CI: 1.01, 2.02) compared to unexposed counterparts. Non-significant associations were observed in men.

Conclusion: Reduction in birth weight due to rapid shifts in the economic environment appears to have a modest but significant association with later obesity for women while male offspring appear to be less affected by these conditions.


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