Family Income and Education Were Related With 30-Year Time Trends in Dietary and Meal Behaviors of American Children and Adolescents.

Family Income and Education Were Related with 30-Year Time Trends in Dietary and Meal Behaviors of American Children and Adolescents.

J Nutr. 2013 Mar 20;
Kant AK, Graubard BI

Recent survey data reveal the persistence of long-acknowledged socio-economic status (SES) differentials in the prevalence of obesity in U.S. children and adolescents. We examined 30-y changes in the association of dietary and meal behaviors with family income and education to understand the possible contribution of these trends to SES trends in obesity rates in 2- to 19-y-old Americans. We used dietary and SES data for 2- to 19-y olds from the NHANES 1971-1974 to 2003-2008 (n = 39,822). The secular changes in the independent association of family income and education with 24-h dietary behaviors [energy intake (kcal), amount of foods and beverages (g), percent energy from all beverages and from nutritive beverages, and energy density of foods] and 24-h meal behaviors [number of eating occasions, energy from snack episodes (%), and mention of breakfast] were examined using multivariable regression methods. The secular increase in energy intake and food and beverage amount was significant in the lowest family SES categories. The positive association of family income and education with intakes of energy, food amounts, and beverage energy, noted in 1971-1974 or 1976-1980, was not observed in later surveys. There was an age gradient in changes in most diet and SES associations over time, with largest adverse changes in 12- to 19-y olds. Higher education was associated with lower energy from snack episodes, breakfast skipping, and energy density of foods and these associations did not change over time. Overall, these results suggest both income and education differentials in secular increases in food amounts and energy intakes. HubMed – eating


Evaluation of the effectiveness and cost-effectiveness of Families for Health V2 for the treatment of childhood obesity: study protocol for a randomized controlled trial.

Trials. 2013 Mar 20; 14(1): 81
Robertson W, Stewart-Brown S, Stallard N, Petrou S, Griffiths F, Thorogood M, Simkiss D, Lang R, Reddington K, Poole F, Rye G, Khan KA, Hamborg T, Kirby J

BACKGROUND: Effective programs to help children manage their weight are required. Families for Health focuses on a parenting approach, designed to help parents develop their parenting skills to support lifestyle change within the family. Families for Health V1 showed sustained reductions in overweight after 2 years in a pilot evaluation, but lacks a randomized controlled trial (RCT) evidence base.Methods/design: This is a multi-center, investigator-blind RCT, with parallel economic evaluation, with a 12-month follow-up. The trial will recruit 120 families with at least one child aged 6 to 11 years who is overweight (>=91st centile BMI) or obese (>=98th centile BMI) from three localities and assigned randomly to Families for Health V2 (60 families) or the usual care control (60 families) groups. Randomization will be stratified by locality (Coventry, Warwickshire, Wolverhampton).Families for Health V2 is a family-based intervention run in a community venue. Parents/carers and children attend parallel groups for 2.5 hours weekly for 10 weeks. The usual care arm will be the usual support provided within each NHS locality.A mixed-methods evaluation will be carried out. Child and parent participants will be assessed at home visits at baseline, 3-month (post-treatment) and 12-month follow-up. The primary outcome measure is the change in the children’s BMI z-scores at 12 months from the baseline. Secondary outcome measures include changes in the children’s waist circumference, percentage body fat, physical activity, fruit/vegetable consumption and quality of life. The parents’ BMI and mental well-being, family eating/activity, parent–child relationships and parenting style will also be assessed.Economic components will encompass the measurement and valuation of service utilization, including the costs of running Families for Health and usual care, and the EuroQol EQ-5D health outcomes. Cost-effectiveness will be expressed in terms of incremental cost per quality-adjusted life year gained. A de novo decision-analytic model will estimate the lifetime cost-effectiveness of the Families for Health program.Process evaluation will document recruitment, attendance and drop-out rates, and the fidelity of Families for Health delivery. Interviews with up to 24 parents and children from each arm will investigate perceptions and changes made. DISCUSSION: This paper describes our protocol to assess the effectiveness and cost-effectiveness of a parenting approach for managing childhood obesity and presents challenges to implementation.Trial registration: Current Controlled Trials ISRCTN45032201. HubMed – eating


A Pilot Study Examining Food Insecurity and HIV Risk Behaviors Among Individuals Recently Released From Prison.

AIDS Educ Prev. 2013 Apr; 25(2): 112-23
Wang EA, Zhu GA, Evans L, Carroll-Scott A, Desai R, Fiellin LE

Annually 700,000 individuals are released from U.S. prison, many at risk for food insecurity and HIV. The association between food insecurity and HIV risk behaviors has been established but not in this population. To investigate this association, we recruited 110 recently released prisoners to participate in a survey. Ninety-one percent of our sample was food insecure; 37% did not eat for an entire day in the past month. Those who did not eat for an entire day were more likely to report using alcohol, heroin, or cocaine before sex or exchanging sex for money compared to those who had at least a meal each day. From this pilot study, released prisoners appear to be at risk for food insecurity, and not eating for an entire day is associated with certain HIV risk behaviors. HIV prevention efforts should include longitudinal studies on the relationship between food insecurity and HIV risk behaviors among recently released prisoners. HubMed – eating


Nutrition and appetite control: implications for the regulation of body weight.

Int J Risk Saf Med. 1995; 7(2): 135-45
Blundell JE, Green S

There is an important relationship between the expression of human appetite and the macro nutrient composition of the prevailing diet. Evidence indicates a correlation between the amount of fat consumed and body weight gain or the degree of adiposity. The pattern of eating behaviour is represented by the size and number of eating episodes (meals and snacks). The size of eating episodes is influenced by the process of satiation and the intervals between episodes by post-ingestive satiety. Protein appears to exert the most potent control over appetite. Carbohydrate also generates strong post-ingestive satiety with the intensity and duration depending upon the particular structure of the carbohydrate. High fat foods exert weak control over satiation and generate a weak satiety response relative to the proportion of energy ingested. High fat foods therefore have the potential to generate a form of passive overconsumption. The high energy density and potent oro-sensory qualities of high fat foods allows the rate of ingestion to overcome fat-induced satiety signals. This situation suggests behavioural, nutritional and pharmacological strategies to prevent fat-induced passive overconsumption and to improve the effect of fat on appetite control. HubMed – eating