You Are What You Eat

Kevin Lewis

August 01, 2010

The "organic" path to obesity? Organic claims influence calorie judgments and exercise recommendations

Jonathon Schuldt & Norbert Schwarz
Judgment and Decision Making, June 2010, Pages 144-150

Labeling a food as "organic" entails a claim about its production but is silent on its calorie content. Nevertheless, people infer that organic cookies are lower in calories and can be eaten more often than conventional cookies (Study 1). These inferences are observed even when the nutrition label conveys identical calorie content and are more pronounced among perceivers high on pro-environmentalism. Moreover, when evaluating a person with a weight-loss goal, forgoing exercise is deemed more acceptable when the person has just chosen organic rather than conventional dessert (Study 2). These results reflect an "organic/natural"-"healthy" association that is capable of biasing everyday judgments about diet and exercise.


Intrasexual competition and eating restriction in heterosexual and homosexual individuals

Norman Li, April Smith, Vladas Griskevicius, Margaret Cason & Angela Bryan
Evolution and Human Behavior, forthcoming

Restrictive eating attitudes and behaviors have been hypothesized to be related to processes of intrasexual competition. According to this perspective, within-sex competition for status serves the adaptive purpose of attracting mates. As such, status competition salience may lead to concerns of mating desirability. For heterosexual women and gay men, such concerns revolve around appearing youthful and, thus, thinner. Following this logic, we examined how exposure to high-status and competitive (but not thin or highly attractive) same-sex individuals would influence body image and eating attitudes in heterosexual and in gay/lesbian individuals. Results indicated that for heterosexuals, intrasexual competition cues led to greater body image dissatisfaction and more restrictive eating attitudes for women, but not for men. In contrast, for homosexual individuals, intrasexual competition cues led to worse body image and eating attitudes for gay men, but not for lesbian women. These findings support the idea that the ultimate explanation for eating disorders is related to intrasexual competition.


Obesity under affluence varies by welfare regimes: the effect of fast food, insecurity, and inequality

Avner Offer, Rachel Pechey & Stanley Ulijaszek
Economics & Human Biology, forthcoming

Among affluent countries, those with market-liberal welfare regimes (which are also English-speaking) tend to have the highest prevalence of obesity. The impact of cheap, accessible high-energy food is often invoked in explanation. An alternative approach is that overeating is a response to stress, and that competition, uncertainty, and inequality make market-liberal societies more stressful. This ecological regression meta-study pools 96 body-weight surveys from 11 countries c. 1994-2004. The fast-food 'shock' impact is found to work most strongly in market liberal countries. Economic insecurity, measured in several different ways, was almost twice as powerful, while the impact of inequality was weak, and went in the opposite direction.


The rising disparity in the price of healthful foods: 2004-2008

Pablo Monsivais, Julia Mclain & Adam Drewnowski
Food Policy, forthcoming

Nutrient-dense foods that are associated with better health outcomes tend to cost more per kilocalorie (kcal) than do refined grains, sweets and fats. The price disparity between healthful and less healthful foods appears to be growing. This study demonstrates a new method for linking longitudinal retail price data with objective, nutrient-based ratings of the nutritional quality of foods and beverages. Retail prices for 378 foods and beverages were obtained from major supermarket chains in the Seattle, WA for 2004-2008. Nutritional quality was based on energy density (kcal/g) and two measures of nutrient density, calculated using the Naturally Nutrient Rich (NNR) score and the Nutrient Rich Foods index (NRF9.3). Food prices were expressed as $/100 g edible portion and as $/1000 kcal. Foods were stratified by quintiles of energy and nutrient density for analyses. Both measures of nutrient density were negatively associated with energy density and positively associated with cost per 1000 kcal. The mean cost of foods in the top quintile of nutrient density was $27.20/1000 kcal and the 4-year price increase was 29.2%. Foods in the bottom quintile cost a mean of $3.32/1000 kcal and the 4-year price increase was 16.1%. There is a growing price disparity between nutrient-dense foods and less nutritious options. Cost may pose a barrier to the adoption of healthier diets and so limit the impact of dietary guidance. Nutrient profiling methods provide objective criteria for tracking retail prices of foods in relation to their nutritional quality and for guiding food and nutrition policy.


Overweight and Obesity in Lesbian and Bisexual College Women

Corrie Barnett Struble, Lisa Lindley, Kara Montgomery, James Hardin & Michelle Burcin
Journal of American College Health, July-August 2010, Pages 51-56

Objective: To estimate and compare the prevalence of overweight and obesity among self-identified lesbian, bisexual, and heterosexual college age women.

Methods: A secondary analysis of the Spring 2006 National College Health Assessment was conducted with 31,500 female college students (aged 18 to 25 years) to compare body mass index (calculated from self-reported height and weight) among lesbian, bisexual and heterosexual college women.

Results: Compared to heterosexuals female college students, lesbians and bisexual women were both significantly more likely to be overweight or obese. Lesbians were also less likely to be underweight compared to heterosexual college women.

Conclusions: Self-identified lesbian and bisexual college women were more likely to be overweight or obese than their heterosexual counterparts. Health care professionals and educators should target these high-risk populations for obesity prevention programs. This study highlights the need for additional research examining the potential risk factors for overweight and obesity among young sexual minority women.


Effects of Overweight on Risky Sexual Behavior of Adolescent Girls

Susan Averett, Hope Corman & Nancy Reichman
NBER Working Paper, July 2010

We use data from The National Longitudinal Survey of Adolescent Health to estimate effects of adolescent girls' overweight on their propensity to engage in risky sexual behavior. We estimate single equation, two-stage, and sibling fixed-effects models and find that overweight or obese teenage girls are more likely than their recommended-weight peers to engage in certain types of risky sexual behavior but not others. The results from this study underscore the importance of using multifaceted and contemporary measures of risky sexual behavior and have implications for the health and well-being of adolescent girls.


Child obesity associated with social disadvantage of children's neighborhoods

Mollie Greves Grow, Andrea Cook, David Arterburn, Brian Saelens, Adam Drewnowski & Paula Lozano
Social Science & Medicine, August 2010, Pages 584-591

Evidence suggests variability in adult obesity risk at a small-scale geographic area is associated with differences in neighborhood socioeconomic status (SES). However, the extent to which geographic variability in child obesity is associated with neighborhood SES is unknown. The objective of this paper was to estimate risk of child obesity associated with multiple census tract SES measures and race within a large urban U.S. county. Height, weight, age, sex, medical insurance type and census tract residence were obtained for 6-18 year old children (n = 8616) who received medical care at a health plan in King County, Washington, in 2006. Spatial analyses examined the individual risk of obesity (BMI ? 95th percentile) with 2000 US census tract measures of median household income, home ownership, adult female education level, single parent households, and race as predictors. Conditional autoregressive regression models that incorporated adjacent census tracts (spatial autocorrelation) were applied to each census tract variable, adjusting for individual variables. We found that in adjusted spatial models, child obesity risk was significantly associated with each census tract variable in the expected direction: lower household income, lower home ownership, and for each 10% increase in less educated women, and single parent households, as well as non-white residents. In a spatial model including all variables, the SES/race variables explained approximately 24% of geographic variability in child obesity. Results indicated that living in census tracts with social disadvantage defined by multiple different measures was associated with child obesity among insured children in a large U.S. urban county. These results contribute new information on relationships between broader social and economic context and child obesity risk using robust spatial analyses.


The time cost of food at home: General and food stamp participant profiles

George Davis & Wen You
Applied Economics, August 2010, Pages 2537-2552

Little is known about the cost of time in food preparation at home. Yet, this economic variable is a common thread running through recent concerns about obesity and the Food Stamp (FS) program. This article provides initial estimates of the time cost in food preparation at home for the United States. Two standard methods of estimation are implemented and three demographic profiles are considered: (i) the general population, (ii) the typical FS participant and (iii) the typical FS participant following the United States Department of Agriculture Thrifty Food Plan. For the general population and averaging across methods, the time cost share of total food cost is about 30% if the individual works in the market and at home, but it is about 49% if the individual does not work in the market. For the typical FS participant, especially one following the Thrifty Food plan, the time cost share of total food cost can be as much as 26% higher than the general population. These substantial percentages provide strong incentives to purchase food away from home and help undermine overall diet quality and the efficacy of the FS program, which ignores the time cost in food at home production.


Social Inequalities in Food Exposure Around Schools in an Urban Area

Yan Kestens & Mark Daniel
American Journal of Preventive Medicine, July 2010, Pages 33-40

Background: The obesity epidemic among children and youth, and the social gradient in this relationship, could be related to differential exposure to food sources in primary environments. Although the positive association between area-level deprivation and fast-food outlets offering high-calorie foods has been well documented, few studies have evaluated food sources around school settings.

Purpose: This study evaluated the relationships among food sources around schools, neighborhood income, and commercial density.

Methods: A GIS was used to derive measures of exposure to fast-food outlets, fruit and vegetable stores, and full-service restaurants near primary and secondary schools in Montreal, Canada, in 2005. Food source availability was analyzed in 2009 in relation to neighborhood income for the area around schools, accounting for commercial density.

Results: For the 1168 schools identified, strong neighborhood income gradients were observed in relation to food sources. Relative to the highest income-quartile schools, the odds of a fast-food outlet being located within 750 m of a low income-quartile school was 30.9 (95% CI=19.6, 48.9). Similar relationships were observed for full-service restaurants (OR=77, 95% CI=35, 169.3) and fruit and vegetable stores (OR=29.6, 95% CI=18.8, 46.7). These associations were reduced, but remained significant in models accounting for commercial density.

Conclusions: Food source exposure around schools is inversely associated with neighborhood income, but commercial density partly accounts for this association. Further research is necessary to document food consumption among youth attending schools in relation to nearby food source opportunities.


Trends in Exposure to Television Food Advertisements Among Children and Adolescents in the United States

Lisa Powell, Glen Szczypka & Frank Chaloupka
Archives of Pediatrics & Adolescent Medicine, forthcoming

Objective: To examine the trends in food advertising seen by American children and adolescents.

Design: Trend analysis of children's and adolescents' exposure to food advertising in 2003, 2005, and 2007, including separate analyses by race.

Participants: Children aged 2 to 5 years and 6 to 11 years and adolescents aged 12 to 17 years.

Main Exposure: Television ratings.

Main Outcome Measures: Exposure to total food advertising and advertising by food category.

Results: Between 2003 and 2007 daily average exposure to food ads fell by 13.7% and 3.7% among young children aged 2 to 5 and 6 to 11 years, respectively, but increased by 3.7% among adolescents aged 12 to 17 years. Exposure to sweets ads fell 41%, 29.3%, and 12.1%, respectively, for 2- to 5-, 6- to 11-, and 12- to 17-year-olds and beverage ads were down by about 27% to 30% across these age groups, with substantial decreases in exposure to ads for the most heavily advertised sugar-sweetened beverages-fruit drinks and regular soft drinks. Exposure to fast food ads increased by 4.7%, 12.2%, and 20.4% among children aged 2 to 5, 6 to 11, and 12 to 17 years, respectively, between 2003 and 2007. The racial gap in exposure to food advertising grew between 2003 and 2007, particularly for fast food ads.

Conclusions: A number of positive changes have occurred in children's exposure to food advertising. Continued monitoring of food advertising exposure along with nutritional analyses is needed to further assess self-regulatory pledges.


Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults

Alpa Patel et al.
American Journal of Epidemiology, forthcoming

The obesity epidemic is attributed in part to reduced physical activity. Evidence supports that reducing time spent sitting, regardless of activity, may improve the metabolic consequences of obesity. Analyses were conducted in a large prospective study of US adults enrolled by the American Cancer Society to examine leisure time spent sitting and physical activity in relation to mortality. Time spent sitting and physical activity were queried by questionnaire on 53,440 men and 69,776 women who were disease free at enrollment. The authors identified 11,307 deaths in men and 7,923 deaths in women during the 14-year follow-up. After adjustment for smoking, body mass index, and other factors, time spent sitting (6 vs. <3 hours/day) was associated with mortality in both women (relative risk = 1.34, 95% confidence interval (CI): 1.25, 1.44) and men (relative risk = 1.17, 95% CI: 1.11, 1.24). Relative risks for sitting (6 hours/day) and physical activity (<24.5 metabolic equivalent (MET)-hours/week) combined were 1.94 (95% CI: 1.70, 2.20) for women and 1.48 (95% CI: 1.33, 1.65) for men, compared with those with the least time sitting and most activity. Associations were strongest for cardiovascular disease mortality. The time spent sitting was independently associated with total mortality, regardless of physical activity level. Public health messages should include both being physically active and reducing time spent sitting.


The impact of income on the weight of elderly Americans

John Cawley, John Moran & Kosali Simon
Health Economics, August 2010, Pages 979-993

This paper estimates the impact of income on the body weight and clinical weight classification of elderly Americans using a natural experiment that led otherwise identical retirees to receive significantly different Social Security payments based on their year of birth. We estimate models of instrumental variables using data from the National Health Interview Surveys and find no significant effect of income on weight. The confidence intervals rule out even moderate effects of income on weight and on the probability of being underweight or obese, especially for men. For example, they indicate that the income elasticity of body mass index is not greater in absolute value than 0.06 for men or 0.14 for women.


The Child and Adult Care Food Program: Who is Served and What are Their Nutritional Outcomes?

Rachel Gordon, Robert Kaestner, Sanders Korenman & Kristin Abner
NBER Working Paper, July 2010

This paper addresses three basic questions about an under-studied food subsidy program, the Child and Adult Care Food Program (CACFP): (1) Does CACFP reach targeted low-income children? (2) How do eligible families and child care providers who participate differ from those who do not participate? (3) What is the association between attending CACFP-participating child care and children's food intake, weight, and food security? We use the Early Childhood Longitudinal Study, Birth Cohort to examine these questions for a representative sample of young children and their providers. We find that program eligibility rules leave many poor children outside the CACFP program. Yet, among poor preschoolers in center-based care, participation in the program is correlated with positive outcomes such as increased consumption of milk and vegetables, and healthier weight (BMI). We discuss the implications of our findings, especially in relation to other food and child care subsidy programs.

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