High-calorie Snacks Research Articles

Value for money or making the healthy choice: the impact of proportional pricing on consumers’ portion size choices

Large food portion sizes are determinants of a high caloric intake, especially if they have been made attractive through value size pricing (i.e. lower unit prices for large than for small portion sizes). The purpose of the two questionnaire studies that are reported in this article was to assess the impact of proportional pricing (i.e. removing beneficial prices for large sizes) on people's portion size choices of high caloric food and drink items. Both studies employed an experimental design with a proportional pricing condition and a value size pricing condition. Study 1 was conducted in a fast food restaurant (N = 150) and study 2 in a worksite cafeteria (N = 141). Three different food products (i.e. soft drink, chicken nuggets in study 1 and a hot meal in study 2) with corresponding prices were displayed on pictures in the questionnaire. Outcome measures were consumers' intended portion size choices. No main effects of pricing were found. However, confronted with proportional pricing a trend was found for overweight fast food restaurant visitors being more likely to choose small portion sizes of chicken nuggets (OR = 4.31, P = 0.07) and less likely to choose large soft drink sizes (OR = 0.07, P = 0.04). Among a general public, proportional pricing did not reduce consumers' size choices. However, pricing strategies can help overweight and obese consumers selecting appropriate portion sizes of soft drink and high caloric snacks. More research in realistic settings with actual behaviour as outcome measure is required.

Psychiatric Illness and Obesity: Recognizing the "Obesogenic" Nature of an Inpatient Psychiatric Setting

The prevalence of obesity and obesity-related diseases is higher among individuals with psychiatric illness than in the general population. This study examined environmental factors that contribute to obesity in one psychiatric hospital in Canada. Semistructured interviews were conducted with 25 key stakeholders from multiple professional disciplines at the hospital. Transcribed interviews were analyzed through content analysis with the analysis grid for environments linked to obesity (ANGELO) framework as a categorical template. Factors contributing to obesity in this setting were related to increased energy intake, such as easy access to high-calorie snacks and beverages, and reduced energy expenditure, such as lack of access to staircases. Psychiatric settings may contribute to the high prevalence of obesity among individuals with psychiatric illness. Ecologically framed interventions are required to address obesity in this population.

Psychiatric Illness and Obesity: Recognizing the "Obesogenic" Nature of an Inpatient Psychiatric Setting

The prevalence of obesity and obesity-related diseases is higher among individuals with psychiatric illness than in the general population. This study examined environmental factors that contribute to obesity in one psychiatric hospital in Canada.Semistructured interviews were conducted with 25 key stakeholders from multiple professional disciplines at the hospital. Transcribed interviews were analyzed through content analysis with the analysis grid for environments linked to obesity (ANGELO) framework as a categorical template.Factors contributing to obesity in this setting were related to increased energy intake, such as easy access to high-calorie snacks and beverages, and reduced energy expenditure, such as lack of access to staircases.Psychiatric settings may contribute to the high prevalence of obesity among individuals with psychiatric illness. Ecologically framed interventions are required to address obesity in this population.

The Nutrition Elite: Do Only the Highest Levels of Caloric Knowledge, Obesity Knowledge, and Motivation Matter in Processing Nutrition Ad Claims and Disclosures?

This study examines the role of the highest levels of caloric knowledge, obesity consequences knowledge, and motivation to search for nutrition information in the processing of relative nutrient content claims in advertisements, such as “half the calories” or “half the fat,” for products relatively high in total calorie levels. After controlling for the impact of demographics, dietary habits, body mass index, relative ad claims and disclosures, perceived weight gain risk, and other variables, the authors find curvilinear (quadratic) effects for caloric knowledge, obesity consequences knowledge, and motivation to search for nutrition information on intent to buy an advertised, high-calorie snack bar. This suggests a strengthening of the negative relationship for intent for consumers at the highest levels of caloric knowledge, obesity consequences knowledge, and motivation (i.e., the “nutrition elite”). The authors offer public policy implications, including whether achieving such exceedingly high levels of nutrition knowledge and motivation is realistic for the general public in light of other policy alternatives, such as market-based solutions (e.g., reducing serving sizes, standardized front-of-package icons).

Laboratory assessment of the food intake of children and adolescents with loss of control eating

Background: Loss of control (LOC) eating in youth predicts excessive weight gain. However, few studies have measured the actual energy intake of children reporting LOC eating.Objective: The objective was to characterize the energy intake and macronutrient composition of “normal” and “binge” laboratory meals in nonoverweight and overweight boys and girls with LOC eating.Design: Children aged 8–17 y (n = 177) consumed 2 lunchtime meals ad libitum from a multi-item food array after being instructed to either binge eat (binge meal) or to eat normally (normal meal). Prior LOC eating was determined with a semistructured clinical interview.Results: Participants consumed more energy at the binge meal than at the normal meal (P = 0.001). Compared with youth with no LOC episodes (n = 127), those reporting LOC (n = 50) did not consume more energy at either meal. However, at both meals, youth with LOC consumed a greater percentage of calories from carbohydrates and a smaller percentage from protein than did those without LOC (P < 0.05). Children with LOC ate more snack and dessert-type foods and less meats and dairy (P < 0.05). LOC participants also reported greater increases in postmeal negative affect at both meals than did those without LOC (P ≤ 0.05). Secondary analyses restricted to overweight and obese girls found that those with LOC consumed more energy at the binge meal (P = 0.025).Conclusions: When presented with an array of foods, youth with LOC consumed more high-calorie snack and dessert-type foods than did those without LOC. Further research is required to determine whether habitual consumption of such foods may promote overweight. This trial was registered at clinicaltrials.gov as NCT00320177.

Dose-response associations between screen time and overweight among youth

To examine dose-response associations between screen time and overweight, independent of physical activity and dietary intake. Participants were 580 Dutch youth (13 years; 48% boys). Body mass index, waist circumference and skinfold thickness at four sites determined weight status. Questionnaires examined television viewing and computer use, participation in organized sport and high caloric snack and sugar-containing beverage consumption. There were no significant associations among boys. Compared with girls spending less than two hours/day in screen time, those who spent three to four hours/day were more likely to be classified as overweight by waist circumference (odds ratio [OR]=3.4; 95% confidence intervals [CI]=1.1-10.7; p=0.03), and this likelihood increased substantially among those spending more than four hours/day (OR=5.5; 95% CI=2.1-14.1; p<or=0.0001). Girls who spend three or more hours/day in screen time are at increased risk of being classified as overweight by waist circumference.

Ethnic differences in BMI among Dutch adolescents: what is the role of screen-viewing, active commuting to school, and consumption of soft drinks and high-caloric snacks?

BackgroundThe threats posed by the rising prevalence of overweight and obesity on public health have been widely acknowledged. Several population groups, which deserve special attention because of their higher prevalence rates, have been identified. These include adolescents and ethnic sub-groups. The aim of the present study was twofold: (1) to assess ethnic differences in body mass index (BMI) and in behaviours that are related to both energy intake and energy expenditure, and (2) to examine whether these behaviours explain the relationship between ethnicity and BMI.MethodsWe conducted a cross-sectional data analysis among 957 Dutch adolescents (mean age = 12.7 years). Body height and weight were measured using a standardized protocol. Adolescents completed a questionnaire on screen-viewing behaviour, physical activity, consumption of sugar-containing beverages, and consumption of high-caloric snacks.ResultsIn our study sample 121 adolescents (= 13%) were of Non-Western origin. BMI was significantly higher in Non-Western adolescents (boys: 19.9 kg/m2, SD = 3.0, girls: 20.9 kg/m2, SD = 3.8) compared to Dutch adolescents (boys: 18.4 kg/m2, SD = 2.8, girls: 19.0 kg/m2, SD = 3.0). Our results show that time spent on television viewing, active commuting to school, and consumption of fruit juices partially mediated the association between BMI and ethnicity.ConclusionBehaviours related to both energy expenditure and energy intake may contribute to the ethnic differences in BMI in adolescents and should be considered when tailoring overweight prevention programs to ethnic subpopulations.Trial registrationInternational Standard Randomised Controlled Trial Number ISRCTN87127361

Correction: Ethnic differences in BMI among Dutch adolescents: what is the role of screen viewing, active commuting to school, and consumption of soft drinks and high-caloric snacks?

The threats posed by the rising prevalence of overweight and obesity on public health have been widely acknowledged. Several population groups, which deserve special attention because of their higher prevalence rates, have been identified. These include adolescents and ethnic sub-groups. The aim of the present study was twofold: (1) to assess ethnic differences in body mass index (BMI) and in behaviours that are related to both energy intake and energy expenditure, and (2) to examine whether these behaviours explain the relationship between ethnicity and BMI. We conducted a cross-sectional data analysis among 957 Dutch adolescents (mean age = 12.7 years). Body height and weight were measured using a standardized protocol. Adolescents completed a questionnaire on screen-viewing behaviour, physical activity, consumption of sugar-containing beverages, and consumption of high-caloric snacks. In our study sample 121 adolescents (= 13%) were of Non-Western origin. BMI was significantly higher in Non-Western adolescents (boys: 19.9 kg/m2, SD = 3.0, girls: 20.9 kg/m2, SD = 3.8) compared to Dutch adolescents (boys: 18.4 kg/m2, SD = 2.8, girls: 19.0 kg/m2, SD = 3.0). Our results show that time spent on television viewing, active commuting to school, and consumption of fruit juices partially mediated the association between BMI and ethnicity. Behaviours related to both energy expenditure and energy intake may contribute to the ethnic differences in BMI in adolescents and should be considered when tailoring overweight prevention programs to ethnic subpopulations. International Standard Randomised Controlled Trial Number ISRCTN87127361

Impulsive and/or planned behaviour: Can impulsivity contribute to the predictive utility of the theory of planned behaviour?

This prospective study tested the prediction that impulsivity would contribute to the prediction of behaviour over and above key variables from an extended theory of planned behaviour (TPB) model. At Time 1, participants completed a questionnaire including measures of TPB constructs related to the avoidance of high-calorie snacks, in addition to measures of impulsivity and dietary restraint. At Time 2, participants (N=315) completed a questionnaire assessing their snacking behaviour over the previous 2 weeks. Results revealed that impulsivity significantly contributed to the prediction of behaviour over and above TPB constructs, with those higher in impulsivity being more likely to snack. This relationship was not moderated by behavioural intention. It is concluded that impulsivity might profitably be included alongside TPB variables when predicting behaviours that are not adequately characterized by careful, analytic, compensatory decision-making strategies.

Working harder to obtain more snack foods when wanting to eat less

This study investigates individual differences in the reinforcing value of snack food. More specifically, it was investigated whether differences in restraint status are associated with differences in working for high-caloric snack food. Thirty-six unrestrained non-dieters, twenty restrained non-dieters and fifteen current dieters performed a concurrent schedules task in which they had the option to work for points for either snack food or fruit and vegetables. By progressively increasing the “price” of the snack foods (i.e., the amount of work required to obtain extra snack points) the relative reinforcing value of snack food was determined. As hypothesized, restrained non-dieters worked harder and current dieters worked less hard to obtain snack food as compared to unrestrained non-dieters.

Why did soft drink consumption decrease but screen time not? Mediating mechanisms in a school-based obesity prevention program.

ObjectivesThis paper aims to identify the mediating mechanisms of a school-based obesity prevention program (DOiT).MethodsThe DOiT-program was implemented in Dutch prevocational secondary schools and evaluated using a controlled, cluster-randomised trial (September 2003 to May 2004). We examined mediators of effects regarding (1) consumption of sugar containing beverages (SCB); (2) consumption of high caloric snacks; (3) screen-viewing behaviour; and (4) active commuting to school. To improve these behaviours the DOiT-program tried to influence the following potentially mediating variables: attitude, subjective norm, perceived behavioural control, and habit-strength.ResultsBoth in boys (n = 418) and girls (n = 436) the DOiT-intervention reduced SCB consumption (between group difference in boys = -303.5 ml/day, 95% CI: -502.4;-104.5, between group difference in girls = -222.3 ml/day, 95% CI: -371.3;-73.2). The intervention did not affect the other examined behaviours. In girls, no intervention effect on hypothetical mediators was found nor evidence of any mediating mechanisms. Boys in intervention schools improved their attitude towards decreasing SCB consumption, while this behaviour became less of a habit. Indeed, attitude and habit strength were significant mediators of the DOiT-intervention's effect (4.5 and 3.8%, respectively) on SCB consumption among boys.ConclusionOur findings imply that interventions aimed at EBRB-change should be gender-specific. Future studies aimed at reducing SCB consumption among boys should target attitude and habit strength as mediating mechanisms. Our study did not resolve the mediating mechanisms in girls.Trial registrationInternational Standard Randomised Controlled Trial Number Register ISRCTN87127361

Childhood obesity: food, nutrient, and eating-habit trends and influences

The need has never been greater to support healthy eating and physical activity in children and youth; the numbers of overweight and obese children have doubled and tripled, respectively, over the past 3 decades. Poor eating habits, including inadequate intake of vegetables, fruit, and milk, and eating too many high-calorie snacks, play a role in childhood obesity. Grain products provide the highest percentage (31%) of daily calories, followed by "other foods," which have limited nutritional value (22% of daily calories). Snacks account for 27% of total daily calories, which is more than the calories consumed at breakfast (18%) and lunch (24%), but not dinner (31%). For Canadians older than 4 years of age, more than 41% of daily snack calories come from other foods, such as chips, chocolate bars, soft drinks, fruit drinks, sugars, syrup, preserves, fats, and oils. Habits that protect against childhood obesity include eating more vegetables and fruit, eating meals with family, and being physically active. Children's food habits and choices are influenced by family, caregivers, friends, schools, marketing, and the media. Successful interventions for preventing childhood obesity combine family- and school-based programs, nutrition education, dietary change, physical activity, family participation, and counseling.

Media and Child Health

Media and Child Health

Consistent relationships between sensory properties of savory snack foods and calories influence food intake in rats

Determine the influence of experience with consistent or inconsistent relationships between the sensory properties of snack foods and their caloric consequences on the control of food intake or body weight in rats. Rats received plain and BBQ flavored potato chips as a dietary supplement, along with ad lib rat chow. For some rats the potato chips were a consistent source of high fat and high calories (regular potato chips). For other rats, the chips provided high fat and high calories on some occasions (regular potato chips) and provided no digestible fat and fewer calories at other times (light potato chips manufactured with a fat substitute). Thus, animals in the first group were given experiences that the sensory properties of potato chips were strong predictors of high calories, while animals in the second group were given experiences that the sensory properties of potato chips were not predictors of high calories. Juvenile and adult male Sprague-Dawley rats. Following exposure to varying potato chip-calorie contingencies, intake of a novel, high-fat snack food and subsequent chow intake were assessed. Body weight gain and body composition as measured by DEXA were also measured. In juvenile animals, exposure to a consistent relationship between potato chips and calories resulted in reduced chow intake, both when no chips were provided and following consumption of a novel high-fat, high-calorie snack chip. Long-term experience with these contingencies did not affect body weight gain or body composition in juveniles. In adult rats, exposure to an inconsistent relationship between potato chips and calories resulted in increased consumption of a novel high-fat, high-calorie snack chip premeal along with impaired compensation for the calories contained in the premeal. Consumption of foods in which the sensory properties are poor predictors of caloric consequences may alter subsequent food intake.

Antidepressants, CBT Help Night Eating Syndrome

Antidepressants, CBT Help Night Eating Syndrome

Childhood Obesity Among Punjabi Children in Relation to Physical Activity and Their Blood Profile

The prevalence of childhood obesity has been increasing during the last three decades and child obesity accounts for nearly 30 percent of all adult obesity. Obesity occurs when a positive balance develops between the energy intake and expenditure. Obese children spend less time in physical activity more time in sedentary activities and rest. Higher amounts of physical activity have the potential to protect against obesity through the maintenance of energy balance and thus prevention of accumulation of excess adipose tissue. Obesity is greater among children and adolescents who frequently watched television not only because little energy was expended while viewing TV but also because of concurrent consumption of high calorie snacks. There is a strong relation of obesity to higher BP and fasting insulin and lipid concentrations in children and young adults. Childhood obesity has emerged only recently in India unlike in the West where it existed for a long time. Obesity in children as young as two years onwards have been reported from the Indian population. Since there is increase in the trend of childhood obesity the present study was undertaken to assess childhood obesity among Punjabi children in relation to physical activity and their blood profile. (excerpt)

Comparison of High‐Calorie, Low‐Nutrient‐Dense Food Consumption among Obese and Non‐Obese Adolescents

The purpose of this study was to determine whether obese adolescents eat more high-calorie low-nutrient-dense foods than non-obese adolescents. Using a cross-sectional design, 22 non-obese and 21 obese adolescents kept 14-day food records. Records provided estimates of total daily energy intake and caloric intake from five categories of high-calorie, low-nutrient-dense (HC) foods: candy, chips, soda, baked goods, and ice cream. Body composition was determined by 18O dilution and daily energy expenditure by doubly labeled water. Percentage of energy intake reported (%report) was calculated as the ratio of reported energy intake to measured energy expenditure (x 100%). Both groups underreported energy intake, but the percentage reported was significantly greater in the non-obese group (78.2+/-20.5% non-obese vs. 55.5+/-21.8% obese, p<0.001). Consumption of calories from chips and soda was similar among non-obese and obese adolescents. However, total energy intake from all HC foods was higher in the non-obese group than among the obese (617+/-356 kcal/day vs. 362+/-223 kcal/day; p<0.01) and represented 27.2+/-10.5% and 19.9+/-9.6% of reported energy intake in the non-obese and obese groups, respectively. After adjustment for under-reporting, the percentage of calories provided by each of the HC foods was similar in the obese and non-obese groups except for ice cream, which remained significantly greater in the non-obese group (p<0.05). Our findings suggest that both non-obese and obese adolescents consume a substantial portion of reported calories from HC foods and that obese adolescents do not consume more calories from these foods than non-obese adolescents. These data offer no evidence to support the widespread notion that obese adolescents eat more "junk food" than non-obese adolescents. Health professionals who treat obese adolescents must be aware that the excess calories in their diets may come from a variety of food sources and not solely from high-calorie snack foods.

Diagnosis and Treatment of Seasonal Affective Disorder

SELECTED CASE A 39-year-old novelist presented in October complaining of increasing fatigue and severe writer's block. For a month she had found it increasingly hard to wake up and get going in the morning. Her energy level was low; she was unable to concentrate on her writing and had trouble meeting deadlines. She had gained 2.25 kg and had difficulty avoiding desserts and high-calorie snacks. Whenever possible, she would nap at her desk or vegetate in front of the television. Bills went unpaid, and laundry piled up. She felt disgusted at her incompetence and pessimistic about the future. A review of her history revealed that from her college years she had had similar difficulties, beginning in fall and winter and lasting until spring. For the last few winters, these episodes had been getting worse. During the spring, she would feel alive again—unusually energetic and euphoric, highly productive, and needed little

Nutrition studies in Thailand: effects of calories, nutrient supplements, and health interventions on growth of preschool Thai village children

A study of the effects of providing high-calorie and vitamin-mineral supplements to preschool village children retarded in growth and development in Chiang Mai, Thailand was done. The preschool children of 24 villages with a population of approximately 11,000 were divided into five control and intervention groups. The interventions consisted of a village health program, high-calorie snacks, and vitamin-mineral supplements. The supplements when used were provided in day care centers for preschool children. The health and nutrition interventions used did not significantly affect growth during the study period reported from December 1981 to October 1983. Monthly changes in length and weight observed in this and a previous study indicate that growth patterns in Thai children are different from those seen in industrialized societies. Factors other than lack of nutrients and infection may be responsible for the inadequate growth often reported in developing countries.

Food behavior and related factors of Puerto Rican-American teenagers

The food habits of Puerto Rican-American teenage girls were investigated to ascertain whether they were nutritionally adequate and examine dietary patterns within a socioculturel and cognitive context. Nutritional adequacy, dietary diversity, and frequency of consumption and their relation to nutrition knowledge and socioeconomic factors were assessed. Seventy-five girls from the Puerto Rican community in Chicago completed questionnaires and 3-day food records. Ethnic food patterns made significant contributions to the diet. Vitamin C intake was higher than noted among most teenage populations in the U.S. Traditional patterns also provided substantial amounts of calcium and iron, and resulting intake matched U.S. teenage trends. Vitamin A levels were much lower owing to the typically low consumption of vegetables. Patterns typical of U.S. consumption also emerged. For instance, intake of low-nutriture, high-calorie snack foods was prevalent among the sample population. The diet was related to knowledge and socioeconomic variables. A greater knowledge of nutrition related to better diets. Older girls, those whose mothers did not work, and working teens also had more adequate food patterns.