Unhealthy Choices Research Articles

Public responsibility and shortage of resource in healthcare

DOI: http://dx.doi.org/10.3329/bioethics.v2i3.10265Bangladesh Journal of Bioethics 2011;2(3):19-20

The nutrition transition and the human right to adequate food for adolescents in the Cape Town metropolitan area: Implications for nutrition policy

Changes in diet and nutrition, along with other lifestyle changes during the last decades, have affected the nutrition-related disease profile in many developing countries. This phenomenon, or process, is known as ‘The Nutrition Transition’. Several studies on adolescents in South Africa have shown that overweight and obesity are increasing, possibly due to this process. The aim of the present study was to extend our knowledge on the nutrition transition and the factors that influence adolescents’ choice of food in South Africa, and to develop policy recommendations that could facilitate the adolescents’ right to adequate food as laid down in the South African Constitutional Bill of Rights. The data were collected through focus groups with 25 female learners (grade 10, 14–16years) from urban public schools in Cape Town and key informant interviews with 10 school staff members. The most important nutritional concerns that emerged from the analyses, included skipping breakfast and the consumption of unhealthy tuck shop food. In terms of the human right to adequate food, these findings reflected lack of availability and access to adequate food within the household, at schools, and in the community. In addition, the study showed that there were no or few opportunities for physical activity for adolescents during and after school hours. Social factors, including social norms and a need to conform to peer group pressure, appeared to affect the behaviour of learners considerably. Traditional foods appeared to have lost their importance, while learners preferred to consume fast foods and to adopt a more westernised diet connected to affluence and social acceptance. Traditional and more “Western” body perceptions co-existed among the study participants. The nutrition transition in South Africa is of a complex nature because of large differences that exist amongst different ethnic and socioeconomic groups. Policy decisions should be based on an understanding of these diverse factors. The media and the food industry should be encouraged to work with government in influencing adolescents to make healthy food choices. Cultural perceptions which may lead to unhealthy choices and lifestyle need to be addressed while at the same time respecting people’s cultural pride and human dignity. It is recommended that human rights principles are used purposively in the future in policy formulations, interventions, evaluation and monitoring.

Prevention of Disability in Children: Elevating the Role of Environment

Much public attention and many resources are focused on medical research to identify risk factors and mitigate symptoms of disability for individual children. But this focus will inevitably fail to prevent disabilities. Stephen Rauch and Bruce Lanphear argue for a broader focus on environmental influences that put entire populations at risk. They argue that identifying and eliminating or controlling environmental risk factors that incrementally increase the prevalence of disability is the key to preventing many disorders. Rauch and Lanphear examine emerging evidence that many disabilities of childhood have their roots in the environment--from toxins in air, water, and soil, to the stressors of poverty, to marketing practices that encourage unhealthy choices or discourage healthy ones. They review research on well-known environmental causes of disability, such as exposures to lead, cigarette smoke, and industrial air pollution. They point to new evidence suggesting that chemicals found in commonly used plastics may have subtle but serious effects on child development, and that many disabilities spring from the complex interplay of environmental risk factors and genetic susceptibility. Rauch and Lanphear make a case for turning our attention to societal or population-level interventions that would rely less on medical and genetic technology and more on policies and regulations that would reduce children's exposure to ubiquitous environmental risks. Examples include required testing of new chemicals for developmental toxicity before they are put on the market; zoning regulations that separate residential communities from industrial areas; and restrictions on advertising of unhealthy products, such as tobacco, alcohol, and junk foods, to children. Rauch and Lanphear outline and assess the effectiveness of interventions that could be adopted, and suggest what a healthy modern community might look like. Such interventions, they acknowledge, are likely to be highly controversial, require both long-term investments and shifts in societal thinking, and produce less well-defined outcomes than individual medical treatments. But in the long run, the authors contend, such interventions could prevent many of the disabilities that now afflict millions of children and adults.

The effect of sleep restriction on snacking behaviour during a week of simulated shiftwork

Due to irregular working hours shiftworkers experience circadian disruption and sleep restriction. There is some evidence to indicate that these factors adversely affect health through changes in snacking behaviour. The aim of this study was to investigate the impact of sleep restriction, prior wake and circadian phase on snacking behaviour during a week of simulated shiftwork. Twenty-four healthy males (age: 22.0 ± 3.6 years, mean ± SD) lived in a sleep laboratory for 12 consecutive days. Participants were assigned to one of two schedules: a moderate sleep restriction condition ( n = 10) equivalent to a 6-h sleep opportunity per 24 h or a severe sleep restriction condition ( n = 14) equivalent to a 4-h sleep opportunity per 24 h. In both conditions, sleep/wake episodes occurred 4 h later each day to simulate a rotating shiftwork pattern. While living in the laboratory, participants were served three meals and were provided with either five (moderate sleep restriction condition) or six (severe sleep restriction condition) snack opportunities daily. Snack choice was recorded at each opportunity and assigned to a category (sweet, savoury or healthy) based on the content of the snack. Data were analysed using a Generalised Estimating Equations approach. Analyses show a significant effect of sleep restriction condition on overall and sweet snack consumption. The odds of consuming a snack were significantly greater in the severe sleep restriction condition ( P < 0.05) compared to the moderate sleep restriction condition. In particular, the odds of choosing a sweet snack were significantly increased in the severe sleep restriction condition ( P < 0.05). Shiftworkers who are severely sleep restricted may be at risk of obesity and related health disorders due to elevated snack consumption and unhealthy snack choice. To further understand the impact of sleep restriction on snacking behaviour, future studies should examine physiological, psychological and environmental motivators.

Virtue, progress and practice

Reader in Applied Philosophy, Department of Interdisciplinary Studies, MMU Cheshire, Crewe, UK and Visiting Professor of Philosophy as Applied to Medicine, University of Buckingham, Uk Assistant Professor, Department of Philosophy and Religious Studies, Old Dominion University, Norfolk, VA, USA Associate Professor, Department of General Practice, University of Auckland, Auckland, New Zealand Director, University of Toronto Joint Centre for Bioethics, Toronto, ON, Canada Assistant Professor, Department of Philosophy, University of Guelph, Guelph, ON, Canada Assistant Professor, Department of Philosophy, Dalhousie University, Halifax, NS, Canada Professor of Values in Health Care, Associate Director, Social Dimensions of Health Institute, University of Dundee, Dundee, UK

‘Children are exposed to temptation all the time’– parents’ lifestyle‐related discussions in focus groups

To explore parents' perspectives on providing their preschool child with a healthy lifestyle, including obstacles and resources. Five semi-structured focus group interviews were conducted, with 30 parents of 4-year-olds in Sweden. Interviews were transcribed verbatim and analysed using Systematic Text Condensation. Four themes emerged from the qualitative analysis: Lifestyle -'The way you live is parents' responsibility', Challenges to promote children's healthy lifestyle, Support from professionals, and peers might facilitate, and Request for an overall responsibility from society. Parents felt that they were role models for their child's lifestyle, a concept including many factors. Attractive and tempting sedentary activities and unhealthy foods were perceived as obstacles, and parents were frustrated by the media's contradictory lifestyle messages. Child health services were expected to more actively invite parents to discuss their child's lifestyle issues. Parents desired some collective responsibility for children's lifestyles through agencies, services and media messages that support and promote healthy choices. Parents struggled to give their children a healthy lifestyle and the 'temptations' of daily unhealthy choices causing hassles and conflicts. Parents desired professional support from preschool, Child Health Care and a collective responsibility from society with uniform guidelines. Parents groups were mentioned as peer support.

The putative effects of prebiotics as immunomodulatory agents

The gradual increase of degenerative diseases observed in the last decades has been raising morbidity, incapacitation and mortality. The occurrence of these kinds of diseases is related to the aging of humanity as well as the unhealthy choices of individuals, particularly those dwelling in large urban centers, which are closely linked with poor nutrition, obesity, and tobacco and alcohol consumption. The introduction of functional compounds in the diet seems to be an attractive alternative to ameliorate the quality of life of all age groups. The prebiotics stand out because of their beneficial effects, favoring the growth of colonic microbiota, helping the gastrointestinal metabolism, and regulating the serum cholesterol and mineral absorption. Experimental data indicates that prebiotics could reduce the severity or incidence of degenerative diseases, such as neoplasias, diabetics, coronary diseases, and infectious diseases. They also seem to promote a positive modulation of the immune system. Their effects on the immune system could even be associated to increase of resistance to infection and microbicide capability, as well as to a decrease in allergic reactions. This article's goal is to analyze the immunomodulatory potential of prebiotics observed in experimental and trial studies.

Posting point-of-purchase nutrition information in university canteens does not influence meal choice and nutrient intake

Growing concern over the relation between out-of-home eating and overweight has triggered the use of point-of-purchase (POP) nutrition information when eating out of the home. In canteens that offer various unhealthy choices, the posting of POP nutrition information has the potential to improve meal choices and dietary intakes. The objective of this study was to increase the proportion of consumed meals that comply with recommendations for energy, saturated fat, sodium, and vegetable content by 5%. A one-group pretest-posttest design was used. A total of 224 customers of 2 university canteens completed a questionnaire used for consumer profiling and 3-d food records to assess their meal choices and nutrient intakes. The 12 best meal combinations received star ratings and descriptors for nutrients or food groups that did not comply. Reported meal choices in canteens and nutrient intakes did not improve after the intervention (P > 0.05). The nutritional profile of the meal choice, obtained from a qualitative and quantitative nutritional assessment of meals, mirrored the nutritional profile of all meals offered (P > 0.05) and not that of the recommended meals offered (P < 0.001). Meal choices were not compensated for later in the day (P > 0.05). The healthiest choices were made by participants with greater objective nutrition knowledge, stronger health and weight-control motives, and a greater openness to change meal choices at baseline (P < 0.05). The posting of nutrition information in university canteens did not effectively change meal choices and nutrient intakes. Despite the intervention, meal choices were largely determined by meals offered. Therefore, nutrition-information interventions in canteens may be more effective with a healthier meal supply. This trial was registered at clinicaltrials.gov as NCT01249508.

Time to Abandon the Notion of Personal Choice in Dietary Counseling for Obesity?

Current approaches to dietary counseling for obesity are heavily rooted in the notion of “personal choice” Typically, patients receive education about dietary contributions to energy balance and are then encouraged to make dietary choices (e.g., food selections, portion sizes) consistent with weight loss. Yet even highly motivated and nutritionally-informed patients often struggle to refrain from highly palatable, energy-dense foods available in the modern environment, and ultimately, only a small percentage of individuals achieve sustained weight loss through dietary modification (1–4). Failed attempts at weight control are frustrating to patients and providers alike. Studies show that both parties frequently attribute obesity to poor “personal choices” or insufficient “willpower” on the part of the patient (5,6). For example, a sample of British dietitians ranked “lack of willpower” as more important to the development of obesity than genetic factors (7), even though adult body mass is 55–75% heritable (8,9). The suggestion that individuals become or remain obese due to their unhealthy personal choices, or a lack of willpower to make healthy choices, is stigmatizing to patients and unlikely to motivate patients to lose weight (10). De-emphasizing the role of personal choice in dietary counseling for obesity would reduce stigma, but doing so carries the risk of undermining patients’ perceived control over their weight loss success. The goal of this commentary is to help dietitians negotiate this dilemma by presenting a scientifically-informed framework that views the personal choices relevant to obesity counseling in terms of three neurobehavioral processes. We argue that applying this framework in dietary counseling can both minimize patient stigma and preserve patients’ sense of empowerment.

Children's use of on‐package nutritional claim information

ABSTRACTSurprisingly little is known about how children respond to marketer‐provided information in retail environments and how such information might impact decisions. In this paper, we investigated children's responses to a particular type of marketer‐provided information—on‐package nutritional claim information. Using a 4 × 2 between‐subjects experiment, we examined whether 8‐ to 12‐year‐old children are aware of this information, whether it influences their choices, and whether this influence is moderated by the type of claim and/or exposure to an in‐school health curriculum. Our findings reveal that this information impacts choices in an intriguing way—it has a backlash effect, causing children to make unhealthier choices when on‐package claims are present in the choice set. This negative effect is most pronounced for general claims. Further, the negative impact of on‐package claims is reduced, but not eliminated, by health education. Implications for designing more effective ways to communicate nutritional information are discussed.Copyright © 2011 John Wiley &amp; Sons, Ltd.

Guest Editorial

Guest Editorial The recently published White Paper: Equity and Excellence: Liberating the NHS signals a commitment by the new coalition government to continue radical organisation reform. However, due in part to the severe financial situation, this White Paper proposes to take the reform of recent years to its logical conclusion and at a faster pace than previously known and this is likely to have significant impact on the wider health and social care workforce.1 In an attempt to streamline existing services, local authorities will replace Primary Care Trusts (PCTs) and they will take on responsibility for public health and health improvement. Indeed, there is a great deal of speculation as to the detail anticipated in the programme of reform from the public health White Paper due later this year. Certainly there is a move to decentralise the management of services in favour of a more local approach with patients empowered by the availability of information to make choices about the services they use, with professionals working in an increasingly regulated market which will drive service improvement and productivity. This special edition of Perspectives in Public Health examines different aspects of the public health workforce in the anticipated world of yet another reorganisation with a number of current topic papers exploring changing roles and ensuring the public health specialists are fit for purpose in the new world through appropriate training opportunities. Drawn from a number of different sectors, the public health workforce exists to help people stay healthy. Specialist public health professionals tackling specific health issues such as the reduction of smoking, childhood obesity and teenage pregnancy, are distinguished from the wider workforce who deal with broader public health issues such as poor housing, education, local transport and recreational facilities.2 Development of the public health workforce is necessary at all levels to help us understand the shifting pattern of disease and actively predict and prevent ill health.2 However, from the general public perspective, wealth and technology have given each individual lifestyle choices. In spite of an expectation of an increasingly high level of wellness, years of healthy life are lost directly as a result of the unhealthy choices made.2 To ensure the public health workforce is fit for purpose, education and training to enable and empower them to make a difference is crucial if the government are to realise their ambitions for the new public health agenda. Davison (p. 22) recognises the investment necessary to skill up the workforce to meet the government ambitions and, along with other papers (Radford and Hall, p. 19; Wright, p. 20; Hemingway et al., p. 38) offer a range of solutions. The pace of change continues, ever faster. Some recent initiatives in role redesign are now firmly embedded into workforce planning and are currently being evaluated. Ball & Nasr's paper (p. 24) on the 'added value' of the fairly recent health trainer role in two UK PCTs is testament to the close working relationship the health trainers had with their clients to improve their community's health and lifestyles. …

Food Choices in Recreation Facilities: Operators’ and Patrons’ Perspectives

Recreation facilities (RFs) provide physical activity environments; however, unhealthy food choices are abundant there. This needs assessment was conducted to determine patrons' satisfaction with food and purchasing preferences while at RFs, reasons for purchasing certain foods, and inclination for other options. Also assessed were RF operators' receptiveness to and perspectives on the feasibility of providing healthy foods. A previously developed and piloted paper-and-pencil survey was administered to a cross-section of 269 adult patrons of local RFs. Seven operators participated in a previously developed researcher-administered survey. Among patrons, 52.2% were satisfied with RF food choices, although 59.2% and 68.8% reported not purchasing any RF food or beverages from the snack bar or vending machines, respectively. Patrons who were dissatisfied and did not purchase food and beverages noted the abundance of unhealthy choices, poor food quality and variety, and expense as reasons. All operators were interested in and receptive to healthy food options at their RFs, but expressed concerns about poor sales of existing healthier options. All operators indicated the importance of knowing what patrons would purchase. The RF operators and most patrons were interested in and receptive to healthier food options at RFs. Developing, implementing, and evaluating a pilot RF healthy-food intervention are next steps.

Obesity, battle of the bulge-policy behind change: Whose responsibility is it and who pays?

Objectives: Examination of the prevalence of obesity and overweight over the past two decades and the health implications that encompass increased risk for cardiovascular disease, hypertension and diabetes. Focus on legislative policies and individual responsibility. Method: Literature review of local and national data on obesity, health implications, government response and determinants of health. Results: Unhealthy eating habits and a sedentary lifestyle are determinants of obesity. In the U.S. it can be said that we live in a “toxic environment.” Environmental factors impeding healthy eating include socioeconomic status (SES), limited access to healthy food choices in low-income communities, poor neighborhood characteristics preventing the ability or desire for physical activity and advertising that bombards youth with unhealthy choices. Conclusion: When addressing responsibility for obese and overweight, all variables must be addressed: the individual, government, community and the food industry must lay claim to the impact of unhealthy choices and lack of access in the nation. The cost of obesity is astronomical. Billions of dollars are spent on health issues that are related to obesity. There are a few championing the cause of decreasing obesity and overweight in schools and communities throughout the States. Policy and legislative interventions have proven to be effective in regulating industry practices as it pertains to advertisement. There are those however that feel it is an individual’s responsibility to monitor their behavior as it pertains to their well-being. Obesity and overweight are more than an individual problem. It is a public health concern, requiring a collective and concerted effort of moving people towards healthy living choices.

Low Income and Poor Health Choices: The Example of Smoking

Low‐income individuals often make relatively unhealthy consumption choices. In the case of food, this is often attributed to limited budgets. We investigate another possibility, motivated by the fact that smoking is more prevalent among those with low incomes, despite the cost. We develop a model in which income serves both as a budget constraint and as a source of future utility. We test the model by estimating logistic models of beginning and quitting smoking. We find support for the idea that low‐income consumers make less healthy choices because they face lower costs in terms of forgone future utility.

Europe puts health claims to the test

The emergence of so-called functional foods--foods that have been modified to promote better health in one way or another--has done wonders for food company balance sheets over the past 20 years. Probiotic dairy products are a prime example. Starting in the 1990s with Yakult, a bacteria-enriched yogurt drink made by a Japanese company of the same name, sales of such products took off along with that of others, such as French food group Danone's probiotic product, labelled Activia. By launching such products, companies were anticipating consumer trends. As Sue Davies, chief policy adviser at Which? a not-for-profit consumers' organization based in the United Kingdom, puts it: People embraced food products offering health benefits because there's a natural tendency to go for the quick fix rather than cut down on saturated fat, sugar or salt, or eat more fruits and vegetables. Fast forward to today and you can't walk down the aisle of a supermarket in any developed country without seeing ads touting the benefits of additives, such as omega-3s/DHA, lycopene or antioxidants. Even sugar-packed fizzy drinks proclaim their electrolytic value and call themselves sports drinks. But does adding vitamins to sugar water make it any healthier? And what about adding extra bacteria in yogurt? [ILLUSTRATION OMITTED] Back in 2004, monthly journal Drug and Therapeutics Bulletin asked that very question and came to the conclusion that the evidence that probiotics improved intestinal flora was patchy, while the broader claim that such products increased consumers' well-being and helped them fight allergies was unreliable. Drinking lots of Activia didn't make much difference to a healthy person, they found, although it did not have any harmful effects. But that didn't mean, of course, that other products that proclaim healthy properties couldn't have harmful effects. Adding vitamins to a sweet doesn't make the sweet healthier, says Dr Francesco Branca, director of WHO's department of Nutrition and Health Development, adding that if the addition of vitamins encourages people to overindulge in sweets it can be said to be harmful. It is this issue of whether such products mislead people into unhealthy choices that is at the heart of the European Union's regulation No. 1924/2006 on nutrition and health claims, which became applicable in July of 2007 and is only now starting to deliver results. the words of Davies: Prior to 2007 there wasn't enough control in the EU to ensure that health claims actually promoted healthier choices rather than undermining some of the healthy eating advice that was given by independent nutritionists and government authorities. The idea behind the legislation is that claims made in relation to health benefits need to be backed by scientific evidence. The body that decides whether such claims are indeed backed by credible data is the European Food Safety Authority (EFSA), which provides scientific advice to the European Commission. July 2008 the Commission asked EFSA to prepare a scientific opinion on health claims that were permissible in the European Union and provided EFSA with a draft list containing 4185 entries that had been boiled down from the 44 000 claims supplied by the Member States. To date EFSA has asked for clarifications on more than half of the draft list, and in the words of Branca, the authority is drowning in paper. Part of the problem is the indigestible nature of the inputs it is trying to assess. Says Branca: In some cases you only have incomplete information as the potential effects have been obtained under experimental circumstances. But then the dose might vary, the compound might vary, and the circumstances of absorption might vary. It will be difficult to evaluate the complexities of the interactions in real diet situations. Based on the new regulation, EFSA says it approved the first batch of opinions on Article 13 health claims in July and that it will be releasing opinions on 1024 health claims by September this year. …

Could Dirty Air Cause Diabetes?

Diabetes is a growing epidemic, and it has become arguably one of the biggest health challenges of our time. Currently, more than 23 million Americans have diabetes, and the Centers for Disease Control and Prevention estimate that in the last 15 years, the number of people in the United States with diabetes has more than doubled. Diabetes is increasing at an alarming rate in Europe as well, and it is fast becoming a major health threat in developing countries such as India and China. Despite its high prevalence, however, diabetes remains somewhat of a mystery. Although type 1 diabetes mellitus could be attributed to insufficient insulin release by the β-cells of the pancreas, the origins of type 2 diabetes mellitus (which accounts for >90% of the cases of diabetes) remain obscure. Insulin resistance is a cardinal feature of type 2 diabetes mellitus; however, it is not clear how whole-body insulin resistance develops, which specific tissues are affected first and which ones later, and how metabolic changes in individual tissues contribute to the overall development of the disease and its many secondary complications. Article p 538 The origin of diabetes is equally complex. Although diabetes develops in genetically susceptible individuals, it is a complex trait and does not show simple mendelian inheritance. Because the rates of diabetes change with the environment in several population groups, it has been suggested that modifiable environmental factors and lifestyle choices account for more than 90% of adult-onset diabetes.1 Nevertheless, our understanding of the environmental causes of diabetes has remained rather rudimentary, being limited mostly to the impact of physical inactivity or unhealthy dietary choices. In this context, the study by Sun and coworkers published in the present issue of Circulation 2 is interesting because it provides new evidence showing that exposure to particulate air …

Stress and dietary quality in black adolescents in a metropolitan area

AbstractAdolescents from families with low socio‐economic status (SES) experience more stress and have poorer diets than adolescents from families with high SES. This study investigated whether change in dietary quality among urban, black adolescents related to changes in the Perceived Stress Scale (PSS) and the Daily Hassles Microsystem Scale (DHMS) while controlling for household income. At two times 1 month apart, 25 adolescents completed a modified Adolescent Food Habits Checklist (AFHC), the PSS and the DHMS. Change scores from time 1 to time 2 for each measure were computed. AFHC change and PSS change had a significant, negative correlation (r = −0.458, p &lt; 0.05), even when controlling for income (r = −0.585, p &lt; 0.05). For girls, AFHC change and PSS change had a significant, negative correlation (r = −0.599, p &lt; 0.05), even when controlling for income (r = −0.697, p &lt; 0.05). No significant correlation was observed for boys (r = 0.003, p = 0.993), and when controlling for income (r = −0.346, p = 0.448). The correlation between AFHC change and DHMS change was not significant. Black adolescent girls, but not boys, tended to make more unhealthy dietary choices when under increased stress. Copyright © 2008 John Wiley &amp; Sons, Ltd.

The effect of clinical characteristics and dietary habits on the relationship between education status and 5-year incidence of cardiovascular disease: the ATTICA study

The aim of this work was to investigate whether clinical characteristics and dietary habits influence the association between education status and 5-year incidence of cardiovascular disease (CVD). From 2001 to 2002, 1,514 men and 1,528 women (>18 year) without known CVD were enrolled. In 2006, the 5-year follow-up was performed (31% participants were lost to follow-up). Development of fatal or non-fatal CVD (coronary heart disease, acute coronary syndromes, stroke, or other CVD) was defined according to WHO-ICD-10 criteria. Education status was measured in years of school, while baseline dietary habits were assessed through a semi-quantitative food-frequency questionnaire (EPIC-Greek). The Mediterranean-Diet-Score was applied to assess overall adherence to this pattern using scores of 11 food-variables and alcohol, according to the principles of the Mediterranean-diet. The 5-year incidence of CVD was 108 (11.0%) cases in men and 62 (6.1%) cases in women (P < 0.001); 32 (1.6%) of these events were fatal (21 in men). People in the low education group had significantly higher prevalence of hypertension, diabetes, and dyslipidemias, were more likely to be sedentary and smokers, compared to high group. Moreover, compared to high, people in low education group had less healthy dietary habits, as assessed using the diet score (P < 0.001). Multi-adjusted analysis revealed that low education was positively associated with 5-year incidence of CVD, after adjusting for age and sex (HR = 1.64; 95%CI 1.05-2.55); however this association lost its significance when clinical characteristics and dietary habits were taken into account (HR = 1.31; 95%CI 0.63-2.74). Low education seems to increase CVD risk, an observation that was partially explained by baseline clinical characteristics and unhealthy dietary choices of people belonging into this group.

Double standards for community sports: promoting active lifestyles but unhealthy diets

Overweight and obesity in Australia is an emerging health concern. Obesity prevention initiatives must consider both physical activity and nutrition to be effective. Community sports venues have the capacity to promote healthy lifestyles through physical activity as well as healthy food choices. A telephone survey was conducted on parents of children aged 5-17 years in NSW to determine the nature of food and beverages purchased by children at community sporting venues and to determine parent's perception of the role that government should play in regulating the types of food and beverages sold at these outlets. The majority of canteens at children's sporting venues were considered to sell mostly unhealthy food and beverages (53%). Very few parents reported that canteens sold mostly healthy food and beverages. Parents reported that their child's most frequently purchased food and beverage items at outdoor sports fields were water, chocolate and confectionery, soft drink and sports drinks, and ice cream. At community swimming pools the most frequently purchased items were ice cream, followed by snack foods, including chips, cakes and biscuits. Most parents (63%) agreed that government should restrict the types of food and beverages that can be sold at children's sporting venues. Children are receiving inconsistent health messages at sporting venues, with healthy lifestyles being promoted through sports participation, but unhealthy dietary choices being provided at sports canteens.

Lifestyle and dietary correlates of dispositional optimism in men: The Zutphen Elderly Study

Objective Dispositional optimism has been associated with a lower risk of cardiovascular mortality, but the underlying mechanisms are still largely unknown. We therefore studied whether dispositional optimism was associated with healthy lifestyle and dietary habits. Methods In 773 (87.1%) of 887 Dutch elderly community-living men with complete data in 1985, the associations of dispositional optimism with lifestyle and dietary factors were assessed at baseline and during follow-up every 5 years up to 15 years using multilevel regression models. Measurements Dispositional optimism was assessed using a four-item questionnaire, and the participants' food consumption was assessed by a cross-check dietary history method that estimates the usual food consumption pattern of the participants. Lifestyle factors were assessed by questionnaires, while weight and height were measured to calculate body mass index. Results A high level of dispositional optimism was associated with more physical activity ( P<.001), nonsmoking ( P=.02), and higher intakes of alcohol ( P=.046), fruit ( P=.01), vegetables ( P=.01), and whole-grain bread ( P=.01), independently from age, education, living arrangement, self-rated health, cardiovascular disease, diabetes mellitus, cancer, and body mass index, as well as total energy intake (for dietary factors). Conclusion Dispositional optimism in elderly men is associated with healthy lifestyle and dietary habits. A low level of optimism may indirectly affect proneness to cardiovascular death via unhealthy behavioral choices.