Discretionary Food Intake Research Articles

Intakes of Energy and Discretionary Food in Mexico Are Associated with the Context of Eating: Mealtime, Activity, and Place

Background: The prevalence of obesity and the intake of discretionary foods [high saturated fat and/or added sugar (HSFAS) products and sugar-sweetened beverages (SSBs)] are high in Mexico. It is important to understand whether the intakes of HSFAS products and SSBs are associated with the context in which they are consumed.Objective: Our aim was to estimate the associations between total energy and discretionary food (HSFAS products and SSBs) intakes and the context of eating (mealtime, activity, and place).Methods: We used data from 10,087 participants aged ≥1 y from the Mexican National Health and Nutrition Survey 2012. Dietary intake was estimated through a 24-h dietary recall that included questions on mealtime, activity, and place in which each food item was consumed. The associations between energy and discretionary food intakes and the context of eating were estimated by using multiple linear regression stratified by age group and adjusted for sociodemographic variables.Results: Compared with breakfast, the percentage of energy that HSFAS products contributed was 16–29 (range in all age groups) percentage points higher during midafternoon snacks and 16–23 percentage points lower at lunch and almuerzo (Mexican brunch); the percentage of energy from SSBs was 3.4–7.6 percentage points higher during midmorning snacks (P < 0.05). In many age groups and mealtimes, we found that compared with eating only while seated, the percentage of energy as HSFAS was 5.3–14 percentage points higher when watching television (P < 0.05). Compared with eating at home, the percentage of energy from HSFAS was 12–26 percentage points higher on the street and the percentage of energy from SSBs was 3.4–6.0 percentage points higher at school and 2.9–15 percentage points higher at work (P < 0.05).Conclusions: These results highlight the need to promote healthier food selection among the Mexican population when snacking and watching television and healthier food environments at work, school, and on the street.

Greater Food Reward Sensitivity Is Associated with More Frequent Intake of Discretionary Foods in a Nationally Representative Sample of Young Adults.

Food reward sensitivity may influence individual susceptibility to an environment replete with highly palatable foods of minimal nutritional value. These foods contain combinations of added sugar, fat, and/or salt that may enhance their motivational salience. This study examined associations of food reward sensitivity with eating behaviors in the NEXT Generation Health Study, a nationally representative sample of U.S. young adults. Participants (n = 2202) completed self-report measures including the Power of Food Scale, assessing food reward sensitivity, and intake frequency of 14 food groups. Multiple linear regressions estimated associations of food reward sensitivity with each of the eating behaviors adjusting for covariates. Higher food reward sensitivity was associated with more frequent intake of fast food (b ± linearized SE = 0.24 ± 0.05, p < 0.001), sweet and salty snacks (0.21 ± 0.05, p < 0.001), foods made with cheese (0.14 ± 0.06, p = 0.03), soda (0.12 ± 0.04, p = 0.009), processed meats (0.12 ± 0.05, p = 0.045), and fish (0.08 ± 0.03, p = 0.03) but was not associated with intake frequency of fruit or juice, green or orange vegetables, beans, whole grains, nuts/seeds, or dairy products. Food reward sensitivity was associated with greater intake of discretionary foods but was not associated with intake of most health-promoting foods, suggesting food reward sensitivity may lead to preferential intake of unhealthful foods.

PEACH™ Queensland program improved child eating behaviours and reduced BMI z-score for overweight children (pilot study)

Background/Aims: Parenting, Eating and Activity for Child Health (PEACH™) Queensland is a 6-month family-focussed child weight management program currently targeting 1400 Queensland children. This study aims to investigate changes in child BMI and eating behaviours during the pilot phase. Methods: From 2013 – 2014, 251 overweight children (US-CDC BMI percentile ≥ 85th) were enrolled in the pilot phase of PEACH™ Queensland, using pre-defined inclusion criteria which included having a child above a healthy weight for their age (5 – 11 years). Baseline and follow-up data were collected from parents by questionnaire and included child eating behaviours, measured by core food intake and Children’s Dietary Questionnaire (CDQ). Children attending sessions were weighed and measured by a trained facilitator. Results: Children attending sessions were 80% obese (IOTF cut-points), 60% female, with average age of 9.0 ± 1.9 years. For the subset of children with complete anthropometry (n = 69), we observed significant decreases in US-CDC z-scores for weight and BMI, 2.3 ± 0.7 to 2.2 ± 0.7 (p < 0.001) and 2.2 ± 0.5 to 2.1 ± 0.7 (p < 0.0001), respectively. This reduction in BMI z-score was accompanied by increases in the proportion meeting recommendations for serves of fruit and vegetables, and significantly lower scores for sweetened beverages and discretionary food intake as measured by CDQ. Conclusions: The PEACH™ Queensland pilot reduced child weight and BMI z-scores, and improved eating behaviours (increased fruit and vegetable intake, decreased intake of discretionary foods and sweetened beverages) although there is need for further improvement.

Nutrition interventions in people with severe mental illness: Novel strategies for addressing physical health co-morbidity in a high-risk population

IntroductionNutrition interventions are critical for weight management and cardiometabolic risk reduction in people experiencing severe mental illness (SMI). As mental health teams evolve to incorporate nutrition interventions, evidence needs to guide clinical practice.AimsA systematic review and meta-analysis was performed to assess whether nutrition interventions improve:– anthropometric and biochemical measures,– nutritional intake of people experiencing SMI.To evaluate the effectiveness of a dietician-led nutrition intervention, as part of a broader lifestyle intervention, in the early stages of antipsychotic prescription.MethodAn electronic database search was conducted to identify all trials with nutritional components. Included trials were pooled for meta-analysis. Meta-regression analyses were run on potential anthropometric moderators. Weekly individualised dietetic consultations plus group cooking classes were then offered to clients attending a Community Early Psychosis Programme, who had recently commenced antipsychotics for a 12-week period.ResultsFrom pooled trials, nutrition interventions resulted in significant weight loss (19 studies, g = –0.39, P &lt; 0.001), reduced BMI (17 studies, g = –0.40, P &lt; 0.001), decreased waist circumference (10 studies, g = –0.27, P &lt; 0.001) and lower blood glucose levels (5 studies, g = –0.37, P = 0.02). Dietician-led interventions (g = –0.90) and trials focussing on preventing weight gain (g = –0.61) were the most effective. The 12-week nutrition intervention resulted in a 47% reduction in discretionary (junk) food intake (P &lt; 0.001) and reductions in daily energy (–24%, P &lt; 0.001) and sodium intakes (–26%, P &lt; 0.001), while improving diet quality (P &lt; 0.05).ConclusionEvidence supports the inclusion of nutrition interventions as part of standard care for preventing weight gain and metabolic deterioration among people with SMI.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Reducing discretionary food and beverage intake in early childhood: a systematic review within an ecological framework.

To systematically review the literature and map published studies on 4-8-year-olds' intake of discretionary choices against an ecological framework (ANalysis Grid for Environments Linked to Obesity; ANGELO). Articles were identified through database searches (PubMed, PyscINFO®, Web of Science) in February and March 2014 and hand-searching reference lists. Studies were assessed for methodological quality and mapped against the ANGELO framework by environment size (macro and micro setting) and type (physical, economic, policy and socio-cultural influences). Studies were conducted in the USA (n 18), Australia (n 6), the UK (n 3), the Netherlands (n 3), Belgium (n 1), Germany (n 1) and Turkey (n 1). Children aged 4-8 years, or parents/other caregivers. Thirty-three studies met the review criteria (observational n 23, interventions n 10). Home was the most frequently studied setting (67 % of exposures/strategies), with the majority of these studies targeting family policy-type influences (e.g. child feeding practices, television regulation). Few studies were undertaken in government (5·5 %) or community (11 %) settings, or examined economic-type influences (0 %). Of the intervention studies only four were categorised as effective. The present review is novel in its focus on mapping observational and intervention studies across a range of settings. It highlights the urgent need for high-quality research to inform interventions that directly tackle the factors influencing children's excess intake of discretionary choices. Interventions that assist in optimising a range of environmental influences will enhance the impact of future public health interventions to improve child diet quality.

Beverage Consumption in Relation to Discretionary Food Intake and Diet Quality among US Adults, 2003 to 2012

BackgroundA majority of Americans consume beverages and discretionary foods—foods that are typically low in nutrient value but high in sugar, sodium, fats, and cholesterol—as part of their daily diet, which profoundly impacts their energy balance and nutritional status. ObjectiveThis study examined consumption of different types of beverages in relation to discretionary food intake and diet quality among US adults. MethodsNationally representative sample of 22,513 adults from the National Health and Nutrition Examination Survey 2003 to 2012 waves were analyzed. The discretionary food category identifies energy-dense, nutrient-poor food products that do not necessarily provide essential nutrients that the human body needs, but can add variety. First-difference estimator addressed confounding bias from time-invariant unobservables (eg, eating habits, taste preferences) by using within-individual variations in diet and beverage consumption between 2 nonconsecutive 24-hour dietary recalls. ResultsApproximately 21.7%, 42.9%, 52.8%, 26.3%, and 22.2% of study participants consumed diet beverage, sugar-sweetened beverage (SSB), coffee, tea, and alcohol, respectively, and 90.1% consumed discretionary foods on any given day. Across beverage types, alcohol (384.8 kcal) and SSB (226.2 kcal) consumption was associated with the largest increase in daily total calorie intake; coffee (60.7 kcal) and diet-beverage (48.8 kcal) consumption was associated with the largest increase in daily calorie intake from discretionary foods, and SSB consumption was associated with the largest reduction in daily overall diet quality measured by the Healthy Eating Index 2010. The impact of beverage consumption on daily calorie intake (overall and from discretionary foods) and diet quality differed across individual sociodemographics and body-weight status. The incremental daily calorie intake from discretionary foods associated with diet-beverage consumption was highest in obese adults, and that associated with SSB was highest in normal-weight adults. ConclusionsInterventions to promote healthy eating should assess beverage consumption in the context of overall dietary behavior.

234 Vegetable, fruit, dairy and discretionary food intake of cystic fibrosis (CF) patients and comparison with the general population: A cross-sectional study

Background Energy and macronutrient targets form the cornerstone of CF dietary recommendations. However, little is known of diet quality and intakes of core food groups in comparison to the general population. CF dietary recommendations need to extend beyond macronutrients to address metabolic health with improved survival. Objectives To examine vegetable, fruit, dairy and discretionary food (DF) (e.g. cakes, biscuits, sugar drinks etc.) group intake in CF patients and compare to Australian population data and dietary guidelines. Methods Cross-sectional study of 24 stable (median FEV 1 60%; BMI 22 kg/m 2 ) CF adult outpatients. A 7day food diary obtained information on food intakes, then categorized into serves/day for food groups. Intakes were compared with Australian adult population data and dietary guidelines. Results No CF patient met the recommended daily 5serves of vegetables (average 1.4serves/day), compared with 8.2% of the Australian population. 8.3% of CF patients met fruit recommendations compared to 48.5% of Australian adults. 45.8% of CF patients met Australian guidelines for dairy consumption (average 2.6 serves/day; no comparative normative data available). For CF patients, DF contributed 29% of energy intake, compared to 25% for the Australian population. Conclusion The quality and variety of CF patients' diet is of concern with notable lower intakes of fruit and vegetables. The comparable intakes of DF in the CF and general population suggest lower reliance on high energy dense foods/beverages in this comparatively well group of CF adults. CF dietary recommendations need revising to reflect the current range of nutrition priorities as survival improves.

Impact of a male‐only weight loss maintenance programme on social–cognitive determinants of physical activity and healthy eating: A randomized controlled trial

To examine the effect of a gender-tailored, Social Cognitive Theory (SCT)-based weight loss maintenance (WLM) intervention on men's physical activity and healthy eating cognitions and behaviours in the 12 months after completing a weight loss programme. A two-phase, assessor-blinded, randomized controlled trial. Ninety-two overweight/obese men (mean [SD] age: 49.2 years [10.1], BMI: 30.7 [3.3] kg/m(2) ) who lost at least 4 kg after completing the 3-month SCT-based SHED-IT Weight Loss Program were randomly allocated to receive (1) the SCT-based SHED-IT WLM Program; or (2) no additional resources (self-help control group). The 6-month gender-tailored SHED-IT WLM Program was completely self-administered and operationalized SCT behaviour change principles to assist men to increase moderate-to-vigorous physical activity (MVPA) and decrease energy-dense, nutrient-poor (discretionary) food consumption after initial weight loss. After randomization (WLM baseline), men were reassessed at 6 months (WLM post-test) and 12 months (6-month WLM follow-up). SCT cognitions (e.g., self-efficacy, goal setting), MVPA, and discretionary food consumption were assessed with validated measures. Following significant improvements in cognitions, MVPA and discretionary food consumption during the weight loss phase, intention-to-treat, linear mixed models revealed no significant group-by-time differences in cognitions or behaviours during the WLM phase. Initial improvements in MVPA and some cognitions (e.g., goal setting, planning, and social support) were largely maintained by both groups at the end of the study. Dietary effects were not as strongly maintained, with the intervention and control groups maintaining 57% and 75% of the Phase I improvements in discretionary food intake, respectively. An additional SCT-based WLM programme did not elicit further improvements over a self-help control in the cognitions or behaviours for MVPA or discretionary food intake of men who had lost weight with a SCT-based weight loss programme. Statement of contribution What is already known on this subject?Weight regain after weight loss (WL) is common. As successful weight loss maintenance (WLM) requires sustained improvements in cognitions and behaviours, health psychology can contribute to intervention development. However, little research has examined the utility of psychological theory in the context of a WLM randomised controlled trial. What does this study add? A theory-based WL program improved men's physical activity and dietary behaviours and cognitions. Men who also received a theory-based WLM program did not show further improvements in physical activity or dietary cognitions and behaviours compared to those that did not.

Food neophobia and its association with diet quality and weight in children aged 24 months: a cross sectional study.

BackgroundFood neophobia, the rejection of unknown or novel foods, may result in poor dietary patterns. This study investigates the cross-sectional relationship between neophobia in children aged 24 months and variety of fruit and vegetable consumption, intake of discretionary foods and weight.MethodsSecondary analysis of data from 330 parents of children enrolled in the NOURISH RCT (control group only) and SAIDI studies was performed using data collected at child age 24 months. Neophobia was measured at 24 months using the Child Food Neophobia Scale (CFNS). The cross-sectional associations between total CFNS score and fruit and vegetable variety, discretionary food intake and BMI (Body Mass Index) Z-score were examined via multiple regression models; adjusting for significant covariates.ResultsAt 24 months, more neophobic children were found to have lower variety of fruits (β = −0.16, p = 0.003) and vegetables (β = −0.29, p < 0.001) but have a greater proportion of daily energy from discretionary foods (β = 0.11, p = 0.04). There was no significant association between BMI Z-score and CFNS score.ConclusionsNeophobia is associated with poorer dietary quality. Results highlight the need for interventions to (1) begin early to expose children to a wide variety of nutritious foods before neophobia peaks and (2) enable health professionals to educate parents on strategies to overcome neophobia.