Unhealthy Consumption Research Articles

Risk Factors of Obesity among 15-64 Yrs Age Group: Picture in a Village of West Bengal

Obesity, a result of unhealthy consumption, coupled lack of physical activity, is itself a serious health risk. The key to the control of epidemics of obesity is primary prevention. The basis of prevention is therefore identification of the major risk factors and their prevention and control. A Descriptive epidemiological study using cross sectional design was carried out among seven thirty subjects of 15-64 yr age group in a village with primary objective of finding out the prevalence of various risk factors and to see the association in between. Interview was taken using a schedule modified in line with IDSP questionnaire [11] taking into account the local needs and resources. Data was collected on socio demographic variables, risk factors of obesity by house to house visit after obtaining informed verbal consent. Study population consisted of 57% male, 70% Hindu, 20% illiterate and 35 % unemployed respondents. 22.9% gave smoked and smokeless tobacco use history, 75.2% current tobacco users, 21% current drinkers, 38.5% had sedentary lifestyle, nearly 50% added extra salt most of the times, 80% use unsaturated oil. Sixty subjects had BMI of more than 30.0. Significant association was found with age group, per capita income, tobacco use, alcohol consumption, physical activity, salt intake with food and intake of oils/fat.(P<.01). Finally motivation for improvement in life style is the million dollar suggestion.

Why the Rich Drink More but Smoke Less: The Impact of Wealth on Health Behaviors

Wealthier individuals engage in healthier behavior. This paper seeks to explain this phenomenon by exploiting both inheritances and lottery winnings to test a theory of health behavior. We distinguish between the direct monetary cost and the indirect health cost (value of health lost) of unhealthy consumption. The health cost increases with wealth and the degree of unhealthiness, leading wealthier individuals to consume more healthy and moderately unhealthy, but fewer severely unhealthy goods. The empirical evidence presented suggests that differences in health costs may indeed partially explain behavioral differences, and ultimately health outcomes, between wealth groups.

Introduction of a school fruit program is associated with reduced frequency of consumption of unhealthy snacks

A diet high in fruit and vegetables (FV) is inversely related to chronic diseases, and some studies suggest that increasing the intake of FV reduces the intake of unhealthy snacks. The objectives were to analyze changes in the frequency of consumption of unhealthy snacks (soda, candy, and potato chips) from 2001 to 2008 in Norwegian children, to assess whether being part of a school fruit program reduces the frequency of unhealthy snack consumption, and to explore differences in sex and socioeconomic status. Within the project Fruits and Vegetables Make the Marks, 1488 sixth- and seventh-grade pupils from 27 Norwegian elementary schools completed a questionnaire in 2001, and 1339 sixth- and seventh-grade pupils from the same schools completed the same questionnaire in 2008. In 2001, none of the schools had any organized school fruit program. In 2008, 15 schools participated in a program and 12 did not participate in any program. From 2001 to 2008, the frequency of unhealthy snack consumption decreased from 6.9 to 4.6 times/wk (P < 0.001). The decrease was largest in the schools that had been included in the national free school fruit program (-2.8 times/wk). The effect of the school fruit programs was significant in reducing the frequency of unhealthy snack consumption in children of parents without higher education (from 7.8 to 4.0 times/wk; P = 0.004). The frequency of unhealthy snack consumption decreased from 2001 to 2008 in schoolchildren in Norway. The decrease was most evident among children at schools participating in the national free school fruit program and in children with a low socioeconomic status.

Examining Our Food Consumption Practices for Better Health and Well-Being

Obesity is a global epidemic and despite being a major leading cause of death and disease, is not viewed to be as perilous and critical as other epidemics such as cholera, dengue fever or West Nile virus. Excessive and unhealthy consumption practices are killing people and costing millions of dollars in the health care industry. While it is recognized that the causes of this epidemic are perhaps far more complex than other health crises, the solutions that have been identified are limited in focus and fail to consider the comprehensive nature of the issue. While beneficial, it is not enough to increase fruit and vegetable intake or physical activity. A review of research on food practices is revealing of some of the factors that are leading to our excess baggage but the studies tend to be concentrated on singular influences without placing the consumption behaviors into context with the other contributors to this condition. Certainly, research on increases in portion or serving sizes, consumer behavior patterns, social, technological and other lifestyle influences on eating, as well as food source and quality, labeling, packaging and distribution are all extremely relevant. However, effectively addressing the obesity issue demands an examination and understanding of how, when, where, why and what people eat. Until there is a commitment to a more universal multi-disciplinary approach to this societal affliction, we will continue to be tipping the scale toward a gluttonous and malignant existence.

Tabakrauchen und Alkoholkonsum bei Auszubildenden an beruflichen Schulen in Vorpommern

Little is known about tobacco smoking and health risk drinking among apprentices at vocational schools. The aim of this study was to determine the proportions of subjects who smoke or drink alcohol in a risky way, their preparedness to stop smoking, and the proportions of smokers and risk drinkers according to occupational groups and general school education. The methods included a survey of all apprentices in their first year of vocational training and all trainees in a course of preparation for occupation in a north-eastern region of Germany. All vocational schools of the study region participated. At the time of the survey, 77.9% of the apprentices were present. Among them, 99.8% (N=1 124) filled in questionnaires. The data revealed that among the total sample 61.2% were daily or less than daily current smokers. Among adults, 8.2%, among those at age 17 or younger 12.9% had a mean daily consumption of more than 12 grams (females) or more than 24 grams (males) of pure alcohol. These proportions were 12.6-18.0% among apprentices of blue collar occupations and 2.8-6.5% among apprentices of white collar or health occupations. Among subjects who had left school without graduation, 85.0%, and among those with the highest school education 36.9% were current smokers. It is concluded that vocational schools are a suitable and essential setting to reach a high risk population concerning tobacco smoking or unhealthy alcohol consumption.

Changes in drinking behavior among control group participants in early intervention studies targeting unhealthy alcohol use recruited in general hospitals and general practices

BackgroundThis study aims to analyze the influence of setting variables on drinking behavior in patients with unhealthy alcohol consumption recruited proactively in general medical practices (GP) and internal and surgical wards of two general hospitals (GH) assigned to control groups. MethodThis analysis compared two control groups of RCTs targeting unhealthy alcohol consumption: one outpatient sample (GP; n=99) with one inpatient sample (GH; n=173). Both groups were recruited via systematic screening of all patients aged between 18 and 64 years and were included in the studies if drank above the at-risk criteria of the British Medical Association (20/30g alcohol/daily) and/or fulfilled criteria of alcohol abuse or – dependence according to DSM-IV. Both samples received a non-alcohol specific brochure on healthy living after study inclusion and were re-assessed 12 months later. ResultsGH patients were significantly older, included of more males, had received less schooling and had a higher readiness to change at baseline than GP patients. Groups did not differ concerning alcohol-related diagnoses or smoking status. At the 12-month follow-up, significantly more GH patients revealed abstinence or drinking below the inclusion criteria (50.0% vs. 26.1%, p<.001). In a multivariate analysis, medical setting (GH vs. GP) remained a significant predictor for non-problematic drinking or abstinence even after controlling for baseline differences between groups. ConclusionsFindings suggest that untreated change from problematic alcohol use may be more intense after non-alcohol-related inpatient treatment than after having been a GP patient. Implications for brief interventions in inpatients are discussed.

Exercise and Osteoarthritis: Not Necessarily an All-or-Nothing Proposition!

Often the mind-set at the start of a new calendar cycle — which may take the form of a New Year’s resolution — is to adopt healthy behaviors that promote and sustain good health and reduce the risk of significant morbidity and premature mortality. Three of the leading causes of mortality in modern society are coronary heart disease, cancer, and stroke1,2. A risk reduction strategy for cardiovascular disease includes improving control of known risk factors, for example, ameliorating an unfavorable lipid profile and enhancing control of hypertension and diabetes mellitus3. Similarly, the risk of malignancy is profoundly influenced by unhealthy consumption of tobacco and excessive alcohol4,5,6. Reduced levels of these products are frequent targets of health improvement resolutions to diminish one’s susceptibility to adverse cardiovascular events, incident cancer, and all-cause mortality. Thus the incorporation of regular forms of physical activity into one’s daily and weekly routine is frequently heralded at the beginning of the new year. Exercise has been demonstrated to reduce incident cardiovascular disease, cancer, and overall mortality7,8,9,10,11. However, in the realm of the musculoskeletal system, is the relationship of exercise to arthritis health necessarily and unequivocally beneficial? In this issue of The Journal Fries, et al 12 implore the rheumatology community to advocate strongly for increasing physical activity in society at large as a strategy with clear-cut benefit for the prevention and treatment of osteoarthritis (OA) of the knee. Further, they call into question the accuracy and validity of the findings of a recent Journal article and accompanying editorial, which concluded that vigorous forms of exercise that entail breaking into a sweat actually increase the risk for future knee replacement13, … Address correspondence to Dr. Gelber; E-mail: agelber{at}jhmi.edu

Variation in documented care for unhealthy alcohol consumption across race/ethnicity in the Department of Veterans Affairs Healthcare System.

The VA Healthcare System has made progress implementing evidence-based care for unhealthy alcohol use, but whether there are differences in care across race/ethnicity is unclear. We describe alcohol-related care for 3 racial/ethnic groups among VA outpatients with unhealthy alcohol use. This cross-sectional study utilized secondary quality improvement data collected for the VA Office of Quality and Performance (July 2006 to June 2007) to identify a sample of 9,194 black (n = 1,436), Hispanic (n = 500), and white (n = 7,258) VA outpatients who screened positive for unhealthy alcohol use (AUDIT-C score ≥4 men; ≥3 women). Alcohol-related care was defined as medical record documentation of brief intervention (advice or feedback) and/or referral (discussion of or scheduled). Logistic regression models estimated the prevalence of alcohol-related care among black, Hispanic, and white patients after adjustment for sociodemographic characteristics, alcohol use severity, other substance use, and mental health comorbidity. Among all eligible patients, 2,903 (32%) had documented alcohol-related care. Adjusted prevalences were 35.3% (95% CI 30.0 to 40.5) for black, 27.3% (95% CI 21.1 to 33.5) for Hispanic, and 28.9% (95% CI 25.5 to 32.3) for white patients. Differences in documented alcohol-related care between all racial/ethnic groups were significant (p-values all < 0.05). Among VA patients with unhealthy alcohol use, black patients had the highest, and Hispanic the lowest, prevalence of documented alcohol-related care. Future research should evaluate contextual and system-, provider-, or patient-level factors that may attenuate racial/ethnic differences in documented alcohol-related care, as well as whether differences in documented care are associated with differences in outcomes.

Global Alcohol Producers, Science, and Policy: The Case of the International Center for Alcohol Policies

In this article, I document strategies used by alcohol producers to influence national and global science and policy. Their strategies include producing scholarly publications with incomplete, distorted views of the science underlying alcohol policies; pressuring national and international governmental institutions; and encouraging collaboration of public health researchers with alcohol industry-funded organizations and researchers. I conclude with a call for an enhanced research agenda drawing on sources seldom used by public health research, more focused resourcing of global public health bodies such as the World Health Organization to counterbalance industry initiatives, development of technical assistance and other materials to assist countries with effective alcohol-control strategies, and further development of an ethical stance regarding collaboration with industries that profit from unhealthy consumption of their products.

Concepts of Healthy Diet Among Urban, Low-Income, African Americans

We sought to explore concepts of healthy diet and to elicit recommendations to support healthier eating among urban, low-income, African Americans. We conducted semi-structured interviews with 33 self-identified African American adults (18-81 years of age, 15 male participants) from a low-income neighborhood in west Philadelphia, PA, during summer and fall 2008. Our qualitative approach was continuous, iterative and thematic considering gender, age category, and participants' "mentions" of fast-food and fruit-and-vegetable intake from the preceding day. We found that participants shared concepts about broad nutritional principles consistent with national dietary recommendations, but disagreed about the healthfulness of specific foods-e.g. meat. On average-with little variation-participants reported eating >2 "mentions" more of fast foods the preceding day than fruits and vegetables (P < 0.001). Suggested strategies to help promote eating more produce included increasing exposure, advertising, affordability, and local availability (vice versa to limit fast-food consumption), and more education on the health effects of diet and how to find and prepare healthy foods. Women's ideas reflected their roles in food shopping and food preparation; otherwise, participants' ideas did not differ appreciably by gender or age. Overall, participants generally expressed sufficient understanding of nutritional principles to eat healthfully, but disagreed about the healthfulness of specific foods and described largely unhealthy dietary consumption from the preceding day. If poor dietary intake results from barriers to recognizing, purchasing, and preparing healthy foods, then participants' suggestions to increase education and modify the environment may lead to improved diets and better health in the community.

Health information seeking, diet and physical activity: An empirical assessment by medium and critical demographics

PurposeResearch over the past decade has conveyed a dramatic rise in health information seeking via the Internet and articulated various profiles and outcomes of health information seeking. In building upon this research, the current study is innovative in considering predictors of health information seeking by medium, as well as outcomes of health information seeking by medium and by critical demographics. MethodsOLS regression and logistic regression are conducted on data from a telephone survey of American adults in 2007 (N=700). ResultsProfiles of health information seekers vary dramatically by medium (Internet versus newspapers versus television). In terms of outcomes, newspaper health information seeking is associated with fruit and vegetable consumption, while television health information seeking is associated with sweetened soft drink consumption. There are four significant interaction terms between these two health information seeking variables and unhealthy snack consumption. Internet health information seeking has no significant effects. ConclusionsIn comparison to the Internet, newspaper and television media have more favorable associations with recommended levels of lifestyle behaviors that may be critical in efforts to decrease obesity in the United States.

Alcohol consumption and depressive symptoms over time: A longitudinal study of patients with and without HIV infection

Background The impact of alcohol consumption on depressive symptoms over time among patients who do not meet criteria for alcohol abuse or dependence is not known. Objective To evaluate the impact of varying levels of alcohol consumption on depressive symptoms over time in patients with and without HIV infection. Design We used data from the Veterans Aging Cohort Study (VACS). We used generalized estimating equation models to assess the association of alcohol-related categories, as a fixed effect, on the time-varying outcome of depressive symptoms. Participants VACS is a prospectively enrolled cohort study of HIV-infected patients and age-, race- and site-matched HIV uninfected patients. Main measures Hazardous, binge drinking, alcohol abuse and alcohol dependence were defined using standard criteria. Depressive symptoms were measured by the Patient Health Questionnaire (PHQ-9). Key results Among the 2446 patients, 19% reported past but not current alcohol use, 50% non-hazardous drinking, 8% hazardous drinking, 14% binge drinking, and 10% met criteria for alcohol or dependence. At baseline, depressive symptoms were higher in hazardous and binge drinkers than in past and non-hazardous drinkers (OR = 2.65; CI = 1.50/4.69; p < .001) and similar to those with abuse or dependence. There was no difference in the association between alcohol-related category and depressive symptoms by HIV status (OR = 0.99; CI = .83/1.18; p = .88). Hazardous drinkers were 2.53 (95% CI = 1.34/4.81) times and binge drinkers were 2.14 (95% CI = 1.49/3.07) times more likely to meet criteria for depression when compared to non-hazardous drinkers. The associations between alcohol consumption and depressive symptoms persisted over three years and were responsive to changes in alcohol-related categories. Conclusions HIV-infected and HIV-uninfected hazardous and binge drinkers have depressive symptoms that are more severe than non-hazardous and non-drinkers and similar to those with alcohol abuse or dependence. Patients who switch to a higher or lower level of drinking experience a similar alteration in their depressive symptoms. Interventions to decrease unhealthy alcohol consumption may improve depressive symptoms.

What are the Evidence Based Public Health Interventions for Prevention and Control of NCDs in Relation to India?

The accelerating epidemics of noncommunicable diseases (NCDs) in India call for a comprehensive public health response which can effectively combat and control them before they peak and inflict severe damage in terms of unaffordable health, economic, and social costs. To synthesize and present recent evidences regarding the effectiveness of several types of public health interventions to reduce NCD burden. Interventions influencing behavioral risk factors (like unhealthy diet, physical inactivity, tobacco and alcohol consumption) through policy, public education, or a combination of both have been demonstrated to be effective in reducing the NCD risk in populations as well as in individuals. Policy interventions are also effective in reducing the levels of several major biological risk factors linked to NCDs (high blood pressure; overweight and obesity; diabetes and abnormal blood cholesterol). Secondary prevention along the lines of combination pills and ensuring evidenced based clinical care are also critical. Though the evidence for health promotion and primary prevention are weaker, policy interventions and secondary prevention when combined with these are likely to have a greater impact on reducing national NCD burden. A comprehensive and integrated response to NCDs control and prevention needs a “life course approach.” Proven cost-effective interventions need to be integrated in a NCD prevention and control policy framework and implemented through coordinated mechanisms of regulation, environment modification, education, and health care responses.

Misperceptions of Peer Norms as a Risk Factor for Sugar-Sweetened Beverage Consumption among Secondary School Students

Research has shown that excess calories from sugar-sweetened beverages are associated with weight gain among youth. There is limited knowledge, however, regarding perception of sugar-sweetened beverage consumption norms. This study examined the extent of misperception about peer sugar-sweetened beverage consumption norms and the association of perceived peer norms with personal self-reported consumption. Among 3,831 6th- to 12th-grade students in eight schools who completed anonymous cross-sectional surveys between November 2008 and May 2009, students' personal perception of the daily sugar-sweetened beverage consumption norm in their school within their grade (School Grade group) was compared with aggregate self-reports of daily sugar-sweetened beverage consumption for each School Grade group. The median daily sugar-sweetened beverage consumption from personal reports was one beverage in 24 of 29 School Grade groups, two beverages in four School Grade groups, and three beverages in one School Grade group. Seventy-six percent of students overestimated the daily norm in their School Grade group, with 24% perceiving the norm to be at least three beverages or more per day. Fixed-effects multiple regression analysis showed that the perceived peer sugar-sweetened beverage consumption norm was much more positively associated with personal consumption than was the estimated actual sugar-sweetened beverage consumption norm per School Grade group. Misperceptions of peer sugar-sweetened beverage consumption norms were pervasive and associated with unhealthy sugar-sweetened beverage consumption behavior. These misperceptions may contribute to intake of excess calories, potentially contributing to adolescent obesity. Future research should assess the pervasiveness of sugar-sweetened beverage consumption misperceptions in other school populations as well as causes and consequences of these misperceptions. Health professionals may wish to consider how normative feedback interventions could potentially reduce consumption.

The effects of a fruit and vegetable promotion intervention on unhealthy snacks during mid‐morning school breaks: results of the Dutch Schoolgruiten Project

Ample fruit and vegetable (F&V) intake has been associated with a decreased risk of chronic disease. The health-enhancing effects of increased F&V consumption, however, would be even more apparent if the increased F&V consumption additionally led to a lower intake of unhealthy, high calorie snacks. Therefore, the present study aimed to investigate whether a primary school-based intervention (the Dutch Schoolgruiten Project) that promoted F&V intake could additionally reduce the intake of unhealthy, high calorie snacks during school breaks. The study applied a longitudinal design with baseline and two follow-up measurements. Children were aged 9-10 years old at baseline; 705 children were included. The main strategy was a F&V scheme that improved the availability, accessibility and exposure to F&V at school by providing one serving of fruit or vegetables twice a week at no cost. The amounts of F&V and unhealthy snacks for consumption at school were measured using a single-item question included in a questionnaire. Multilevel autoregressive logistic regression models with a three-level structure (school, child and time) were used to assess the effect of the intervention on both F&V and unhealthy snack consumption. The children of the intervention group brought F&V from home to school at follow-up significantly more often than the children of the control schools [odds ratio (OR) = 1.41, 95% confidence interval (CI) = 1.04; 1.90] and brought fewer unhealthy snacks (OR = 0.56, 95% CI = 0.34; 0.92). The present study provides some evidence that the Schoolgruiten intervention effect on F&V intake also reduced unhealthy snacking during school breaks.

Consumo e comportamento alimentar entre adolescentes brasileiros: Pesquisa Nacional de Saúde do Escolar (PeNSE), 2009

The objective of this article is to describe the characteristics of food consumption and eating behavior of adolescents and its association with socio-demographic factors. In 2009, a random sample of students in 9th grade of elementary education at public and private schools from 26 Brazilian state capitals and Federal District was studied. It was applied a self-administered questionnaire with socio-demographic attributes, food consumption and eating behavior, among others. Estimates of the constructed indicators were presented for the total population and by sex. The association of each indicator with socio-demographic variables was examined by logistic regression. The results showed that over half of adolescents presented frequent consumption of beans (62.6%), milk (53.6%) and sweets (50.9%), and held at least lunch or dinner with the mother or responsible (62.6%) and watching television or studying (50.9%). In general, girls were more exposed to undesirable eating habits and higher socioeconomic status was associated with a higher prevalence of the indicators studied. The results revealed regular consumption of unhealthy diet markers and consumption of less than the recommended for a healthy diet, pointing the need for strengthening health promotion activities targeting young people.

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.

The Effects of Advertising, Social Influences, and Self‐Efficacy on Adolescent Tobacco Use and Alcohol Consumption

Exploring the simultaneous effects of key variables on the unhealthy consumption behavior of adolescents, two studies focused on the relative effects of advertising, parental and peer influence, and self‐efficacy on adolescent tobacco use and alcohol consumption. The results suggest that (1) advertising effects are largely neutralized by parental and peer influence; (2) peer and parental influence strongly predict adolescent tobacco use and alcohol consumption; and (3) self‐efficacy is a weak predictor of both adolescent risk behaviors.

Severity of unhealthy alcohol consumption in medical inpatients and the general population: is the general hospital a suitable place for brief interventions?

Evidence for brief interventions in general hospital (GH) settings is scarce, probably due to higher rates of dependent drinkers. The present study aims to compare unhealthy drinking patterns in GH patients with the general population (GP). Sample 1 consisted of 4,075 individuals randomly drawn from registration office files, representing the non-institutionalised GP of a northern mixed rural-urban German area. Sample 2 consisted of 2,949 consecutively admitted patients from a GH covering the same area. Compared to individuals from the GP, GH patients revealed higher prevalence rates of alcohol dependence (1.3 vs. 5.5%) and alcohol abuse (1.2 vs. 2.8%), but did not differ significantly concerning at-risk drinking (5.1 vs. 6.2%). Multinomial logistic regression analysis controlling for age, sex and smoking using unrisky alcohol consumption as reference category belonging to the GH group was predictive for alcohol use disorders but not for at-risk drinking. Data show that a substantial number of individuals with unhealthy drinking patterns without alcohol use disorders can easily be accessed in GH settings if appropriate screening measures are conducted.

Emotional eating: Eating when emotional or emotional about eating?

This article examines the extent to which self-reported emotional eating is a predictor of unhealthy snack consumption or, alternatively, an expression of beliefs about the relation between emotions and eating derived from concerns about eating behaviour. Three studies were conducted. Study 1 (N = 151) and Study 2 (N = 184) investigated the predictive validity of emotional eating compared to habit strength in snack consumption, employing 7-day snack diaries. Both studies demonstrated that snack consumption was not predicted by emotional eating but depended on the habit of unhealthy snacking and on restraint eating. As emotional eating was not a significant predictor of snack intake, Study 3 addressed the alternative hypothesis of emotional eating being an expression of concerns about eating behaviour. Results from this cross-sectional survey (N = 134) showed that emotional eating was significantly associated with several concerns. Together, these studies show that snack intake is better predicted by habit strength and restraint eating than by emotional eating. Additionally, the results suggest that in normal-weight women the concept of emotional eating may not capture the tendency to eat under emotional conditions, but rather reflects beliefs about the relation between emotions and eating.