High-sugar Beverages Research Articles

The effect of dietary changes on distinct components of the metabolic syndrome in a young Sri Lankan population at high risk of CVD.

South Asian populations are predisposed to early onset of the metabolic syndrome. Lifestyle intervention programmes have demonstrated a reduction in the metabolic syndrome and CVD risk; however, the most effective components of the multi-faceted lifestyle interventions are unknown. We studied 2637 Sri Lankan males (n 1237) and females (n 1380), with a mean BMI of 23·9 (sd 4·2) kg/m2, aged 22·5 (sd 10·0) years, who had participated in a 5-year lifestyle-modification programme to examine the effect of dietary changes on distinct components of the metabolic syndrome. The dietary intervention comprised advice to replace polished starches with unpolished starches, high-fat meat and dairy products with low-fat products and high-sugar beverages and snacks with low-sugar varieties. For the purposes of this analysis, data from the control and intensive lifestyle groups were combined. Anthropometric and biochemical data were recorded, and a FFQ was completed annually. Multiple regression was used to determine the effect of the dietary changes on distinct components of the metabolic syndrome. The ratio unpolished:polished rice was inversely related to change in fasting glucose (β=-0·084, P=0·007) and TAG (β=-0·084, P=0·005) and positively associated with change in HDL-cholesterol (β=0·066, P=0·031) at the 5-year follow-up after controlling for relevant confounders. Red meat intake was positively associated with fasting glucose concentrations (β=0·05, P=0·017), whereas low-fat (β=-0·046, P=0·018) but not high-fat dairy products (β=0·003, P=0·853) was inversely related to glucose tolerance at the follow-up visit. Replacement of polished with unpolished rice may be a particularly effective dietary advice in this and similar populations.

Demographic characteristics and food choices of participants in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project

Objective. American Indians and Alaska Natives (AI/ANs) suffer a disproportionate burden of diabetes. Identifying food choices of AI/ANs at risk of type 2 diabetes, living in both rural and urban settings, is critical to the development of culturally relevant, evidence-based education strategies designed to reduce morbidity and mortality in this population.Design. At baseline, 3135 AI/AN adults participating in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project (SDPI-DP) completed a socio-demographic survey and a 27-item food frequency questionnaire (FFQ). The primary dietary behavior goal of SDPI-DP education sessions and lifestyle coaching is changes in food choices, i.e., increased fruits, vegetables and whole grains, decreased high sugar beverages, red meat, and processed foods. Subsequently, program assessment focuses on changes in food types. Foods were delineated using a ‘healthy’ and ‘unhealthy’ classification as defined by the educators advising participants. Urban and rural differences were examined using χ2 tests and two sample t-tests. Multiple linear regressions and linear mixed models were used to assess the association between socio-demographic factors and food choice.Results. Retired participants, those living in urban areas and with high income and education selected healthy foods most frequently. Young males, those with low income and education consumed unhealthy foods most frequently. Selection of unhealthy foods did not differ by urban and rural setting.Conclusions. The ubiquitous nature of unhealthy food choices makes them hard to avoid. Food choice differences by gender, age, income, and setting suggest that nutrition education should more effectively target and meets the needs of young AI/AN males.

Factors associated with low consumption of fruits and vegetables by preschoolers of low socio-economic level

ObjectiveTo evaluate factors associated with low consumption of fruits and vegetables among preschoolers from families treated at basic health centers in Porto Alegre, RS, Brazil. MethodsThis was a cohort study nested in a randomized field trial. Data collection was performed through structured questionnaires to obtain demographic and dietary data, combined with two 24-hour recalls in the age groups 12–16 months and again at 2–3 years of age. Data on the consumption of one daily serving of fruits (80g) and vegetables (60g) were evaluated, as well as consumption of non-recommended foods such as candy, chocolate, and soft drinks. Statistical analyses were performed using Poisson regression with robust estimation. ResultsA total of 388 children aged 2-3 years were evaluated; of these, 58% and 87.4% did not consume one daily serving of fruits and vegetables, respectively. The following factors were negatively associated with fruit consumption: family income higher than four minimum wages, (p=0.024), lower paternal educational level (p=0.03), and lower fruit consumption at 12–16 months (p=0.002). Factors negatively associated with the consumption of vegetables were low paternal educational level (p=0.033) and consumption of high-sugar content beverages at 12–16 months (p=0.014). ConclusionThis study demonstrated a high prevalence of children who consumed less than one daily serving of fruit and vegetables; early feeding practices, parental education, and family income were associated with this process.

How is nutrition transition affecting dietary adequacy in Eeyouch (Cree) adults of Northern Quebec, Canada?

Rapid development, including the building of hydroelectric projects and roads in remote areas of Northern Quebec, Canada, has led to concerns about the contamination of traditional foods (TF) and a transition to a diet characterized by increased commercial food intake. A cross-sectional study of 850 Cree adults, aged ≥19 years, from 7 of the 9 Eeyouch communities was conducted during the spring and summer seasons of 2005-2008. Anthropometric measures were collected. TF and dietary intake were assessed using food-frequency questionnaires (FFQs) and 24-h recalls. Obesity was high, with 77% of the women and 64% of the men classified as obese. Past-year TF consumption was 100%, and 41% of participants reported eating TF on the 24-h recall. TF intake as reported on both the FFQs and the 24-h recalls was higher in individuals aged >50 years of age and in men, relative to younger adults and women, respectively. TF consumption increased protein, vitamin D, iron, and magnesium in all individuals, and energy, cholesterol, magnesium, sodium, and zinc in men aged 19-50 years; it decreased vitamin C in men and women aged ≥51 years. Participants reported drinking a mean daily 0.78 ± 1.34 cans of soft drinks or other high-sugar beverages per day or 5.28% ± 8.92% of total energy. It is important to identify behaviours that are contributing to obesity and its health consequences in this population and to find culturally appropriate ways to promote the consumption of TF and to reduce the consumption of energy-dense and nutrient-poor beverages and food items.

Dietary patterns are associated with cardiometabolic risk factors in a representative study population of German adults

Studies that investigated complex actual eating behaviours of the general population and their relation to cardiometabolic risk markers are sparse. We aimed to identify dietary patterns within a nationally representative sample of 4025 German adults by factor analysis based on validated dietary history interviews. Furthermore, we evaluated associations of the derived dietary patterns with abnormalities clustered within the metabolic syndrome and related metabolic markers by logistic regression models and ANCOVA. A high adherence to the 'processed foods' pattern reflected a high intake of refined grains, processed meat, red meat, high-sugar beverages, eggs, potatoes, beer, sweets and cakes, snacks and butter, whereas a high adherence to the 'health-conscious' pattern represented a high intake of vegetables, vegetable oils, legumes, fruits, fish and whole grains. For subjects in the highest compared with those in the lowest quintile of the processed foods pattern, the occurrence of abdominal obesity was 88 (95% CI 31, 169)% higher, hypertension was 34 (95% CI -4, 86)% higher, hypertriacylglycerolaemia was 59 (95% CI 11, 128)% higher and the metabolic syndrome was 64 (95% CI 10, 143)% higher when adjusted for age, sex, energy intake, socio-economic status, sport activity and smoking. Furthermore, subjects in the highest quintile had statistically significantly higher uric acid concentrations and lower folate concentrations (P for trend <0·05). In contrast, subjects in the highest quintile of the health-conscious pattern had a 30 (95% CI 10, 46)% lower occurrence of hypertension, higher folate concentrations and lower homocysteine and fibrinogen concentrations (P for trend <0·05). These data strengthen the findings from non-representative studies and emphasise the importance of healthy overall food patterns for preventing metabolic disturbances.

Emerging obesity and dietary habits among James Bay Cree youth

To describe dietary habits and extent of overweight and obesity among Cree youth. Dietary intake and habits were assessed by a 24 h recall and FFQ as part of a cross-sectional survey. Three Cree communities in northern Québec, Canada. A total of 125 youth aged 9-18 years. Overall 67·6 % of the study population was either at risk of overweight or overweight. Over 98 % had a usual saturated fat intake over 10 % of energy while 65 % had a lower consumption of fruit/vegetables and 95 % had a lower consumption of milk and milk products than recommended by Canada's Food Guide. The majority (96·8 %) consumed high-fat foods (>40 % of total energy as fat), which accounted for 39 % of total energy intake (EI). Similarly, 92·8 % consumed high-sugar food and beverages (>25 % of total energy as sugar), which accounted for 12·8 % of total EI. Furthermore, 95 % of the youth had a Healthy Eating Index (HEI) below the recommended score of 80 or above. Certain measures of diet quality (traditional food (TF) consumption, HEI and vegetables and fruit consumption) were significantly correlated with adiposity measures. A high prevalence of low-diet quality was found with a high degree of sugar and fat intake and a low consumption of vegetables/fruit and milk/milk alternates and any weekly TF. Dietary interventions are sorely needed.

The cost-effectiveness of removing television advertising of high-fat and/or high-sugar food and beverages to Australian children

To model the health benefits and cost-effectiveness of banning television (TV) advertisements in Australia for energy-dense, nutrient-poor food and beverages during children's peak viewing times. Benefits were modelled as changes in body mass index (BMI) and disability-adjusted life years (DALYs) saved. Intervention costs (AUD$) were compared with future health-care cost offsets from reduced prevalence of obesity-related health conditions. Changes in BMI were assumed to be maintained through to adulthood. The comparator was current practice, the reference year was 2001, and the discount rate for costs and benefits was 3%. The impact of the withdrawal of non-core food and beverage advertisements on children's actual food consumption was drawn from the best available evidence (a randomized controlled trial of advertisement exposure and food consumption). Supporting evidence was found in ecological relationships between TV advertising and childhood obesity, and from the effects of marketing bans on other products. A Working Group of stakeholders provided input into decisions surrounding the modelling assumptions and second-stage filters of 'strength of evidence', 'equity', 'acceptability to stakeholders', 'feasibility of implementation', 'sustainability' and 'side-effects'. The intervention had a gross incremental cost-effectiveness ratio of AUD$ 3.70 (95% uncertainty interval (UI) $2.40, $7.70) per DALY. Total DALYs saved were 37 000 (95% UI 16,000, 59,000). When the present value of potential savings in future health-care costs was considered (AUD$ 300m (95% UI $130m, $480m), the intervention was 'dominant', because it resulted in both a health gain and a cost offset compared with current practice. Although recognizing the limitations of the available evidence, restricting TV food advertising to children would be one of the most cost-effective population-based interventions available to governments today. Despite its economic credentials from a public health perspective, the initiative is strongly opposed by food and advertising industries and is under review by the current Australian government.

Learning from the economic crisis: public health and private ventures

<i>Purpose:</i> To examine associations between personal nutritional patterns and various indicators of health, disease risk, and chronic illness in a diverse, representative sample of adult patients from primary care settings....

Poor Nutritional Habits: A Modifiable Predecessor of Chronic Illness? A North Carolina Family Medicine Research Network (NC-FM-RN) Study

To examine associations between personal nutritional patterns and various indicators of health, disease risk, and chronic illness in a diverse, representative sample of adult patients from primary care settings. As part of a survey of adult patients conducted in the waiting rooms of 4 primary care practices in North Carolina (recruitment rate 74.8%), a 7-item nutrition screen was administered to 1788 study participants. Other questionnaire items addressed disease and functional status, race/ethnicity, health habits, and demographic factors. Respondents included 292 African Americans (17.3%), 1004 non-Hispanic whites (59.4%), 255 Hispanics (15.1%), and 126 American Indians (7.4%); mean age 47.5 years. Thirty percent reported eating 3 or more fast food meals weekly, 29% drank 3 or more high-sugar beverages weekly, 22% ate 3 or more high-fat snacks weekly, 36% ate 3 or more desserts weekly, 11% reported eating "a lot" of margarine, butter, or meat fat; 62% ate 2 or fewer fruits or vegetables daily; and 42% reported consuming protein less than 3 times a week. Scores on a summary measure were worse for pre-diabetics than for diabetics, for young adults compared with older persons, and for persons reporting good/excellent health versus fair/poor health. People at high risk for developing chronic illnesses later in life reported poorer diets in comparison with people who are already ill. This probably represents increased nutritional awareness and motivation among people with chronic diseases. Because primary care patients have a high prevalence of chronic disease risk factors, the primary care office setting may constitute a particularly appropriate location for nutrition education.

Eating behaviour and food choices in children with Down’s syndrome, autistic spectrum disorder or cri du chat syndrome and comparison groups of siblings

High sugar foods and beverages consumed frequently are associated with increased dental caries and periodontal disease. Based on parental survey responses, the diets of children with Down’s syndrome, autistic spectrum disorder (ASD) and cri du chat syndrome and comparison groups of siblings were considered from an oral health perspective. In each group children who were frequent consumers of one high sugar food or beverage were likely to be high consumers of others, whilst other children were low consumers of high sugar foods and beverages. Children in middle and late childhood tended to consume more cariogenic foods and beverages than preschool children. For most children frequency of meal and snack consumption would allow little opportunity for remineralization of teeth.

Food habits of Canadians: food sources of nutrients for the adolescent sample.

Adolescents need good nutrition, both to grow to their full potential and to decrease their risk of obesity and chronic diseases in adolescence and later life. The Food Habits of Canadians study provides data on the important food sources of energy and nutrients in a sample of Canadian teenagers. One 24-hour recall was obtained for 178 teenagers living in households participating in a national survey of 1,543 adults. Foods were categorized into 51 groups, and ranked according to contribution of key nutrients, energy, and fibre. Top contributors to energy and other nutrients included foods of low nutrient density (cakes/cookies/pastries, carbonated beverages, sugars/jams/syrups, and salty snacks). A high intake of nutrient-poor foods, particularly high-sugar beverages, is a concern for this sample of Canadian teenagers.

Patterns of food consumption and risk factors for cardiovascular disease in the general Dutch population

Few studies have examined food consumption patterns in relation to biological risk factors for cardiovascular disease. The objective of the study was to describe food consumption patterns in the general Dutch population and their association with cardiovascular risk factors. We performed a cross-sectional study of 19 750 randomly selected men and women aged 20-65 y from 3 Dutch municipalities. Food consumption patterns were identified with the use of factor analysis of data from a validated food-frequency questionnaire. Three food consumption patterns were identified: the "cosmopolitan" pattern (greater intakes of fried vegetables, salad, rice, chicken, fish, and wine), the "traditional" pattern (greater intakes of red meat and potatoes and lesser intakes of low-fat dairy and fruit), and the "refined-foods" pattern (greater intakes of French fries, high-sugar beverages, and white bread and lesser intakes of whole-grain bread and boiled vegetables). Higher scores for the traditional pattern were associated with older age, and higher scores for the refined-foods pattern were associated with younger age, but both were associated with lower educational level, cigarette smoking, less physical activity, and higher body mass index. Independent of other lifestyle factors and body mass index, the cosmopolitan-pattern score was significantly associated with lower blood pressure and higher HDL-cholesterol concentrations, and the traditional-pattern score was associated with higher blood pressure and higher concentrations of HDL cholesterol, total cholesterol, and glucose. The refined-foods-pattern score was associated with higher total cholesterol concentrations and lower intakes of micronutrients. In this Dutch population, food consumption patterns were independently associated with blood pressure and plasma glucose and cholesterol concentrations.

Nutrient-Health Associations in the Historic and Contemporary Diets of Southwest Native Americans

Nutritional characteristics and associated lifestyle factors, e.g. activity level, contribute to at least four (heart disease, cancer, cirrhosis and diabetes) of the 10 leading causes of Native American mortality and morbidity. Over the past three centuries, Native American diet and activity levels have changed dramatically. In the Southwest, high-fiber, nutrient-dense precontact foods requiring a moderate level of regular physical activity to gather, hunt and process have been replaced with readily accessible, low-fiber, high-fat and high-sugar foods and beverages. Changes in diet and activity levels have been accompanied by a shift in epidemiological patterns. Intervention trials among both Native Americans and non-Native Americans demonstrate that consumption of a high-fiber, low-fat diet and regular physical activity can be used not only in the treatment but perhaps more importantly in the prevention or delay of disease onset.