Association of key foods and beverages with obesity in Australian schoolchildren

Objective: To examine the pattern of intake of key foods and beverages of children aged 4&ndash;12 years and the association with weight status.Design and setting: A computer-assisted telephone interview was used to determine the intake of fruit, vegetables, packaged snacks, fast foods and sweetened drinks &lsquo;yesterday&rsquo; and &lsquo;usually&rsquo; as reported by parents/guardians of a representative sample of 2184 children from the Barwon South-Western region of Victoria, Australia.Results: Children who consumed .2&ndash;3, .3&ndash;4 and .4 servings of fruit juice/drinks &lsquo;yesterday&rsquo; were, respectively, 1.7 (95% confidence interval (CI) 1.2&ndash;2.2), 1.7 (95% CI 1.2&ndash;2.5) and 2.1 (95% CI 1.5&ndash;2.9) times more likely to be overweight/obese compared with those who had no servings of fruit juice/drink &lsquo;yesterday&rsquo;, adjusted for age, gender and socio-economic status (SES). Further, children who had $3 servingsof soft drink &lsquo;yesterday&rsquo; were 2.2 (95% CI 1.3&ndash;3.9) times more likely to beoverweight/obese compared with those who had no servings of soft drink &lsquo;yesterday&rsquo;, adjusted for age, gender and SES. In addition, children who &lsquo;usually&rsquo; drank fruit juice/drinks twice or more per day were 1.7 (95% CI 1.2&ndash;2.4) times more likely to be overweight/obese compared with those who drank these beverages once or less per week, adjusted for age, gender and SES. Although fast foods and packaged snacks were regularly eaten, there were no associations between weight status andconsumption of these foods.Conclusions: Intake of sweetened beverages was associated with overweight and obesity in this population of Australian schoolchildren and should be a target for intervention programmes aimed at preventing unhealthy weight gain in children.<br /

Two important exceptions to the relationship between energy density and fat content: food with reduced-fat claims and high-fat vegetable-based dishes

Objective: To test the hypothesis that many foods with reduced-fat (RF) claims are relatively energy-dense and that high-fat (HF) vegetable-based dishes are relatively energy-dilute.Design: Nutrient data were collected from available foods in Melbourne supermarkets that had an RF claim and a full-fat (FF) equivalent. Nutrient analyses were also conducted on recipes for HF vegetable-based dishes that had more than 30% energy from fat but less than 10% from saturated fat. The dietary intake data (beverages removed) from the 1995 National Nutrition Survey were used for the reference relationships between energy density (ED) and percentage energy as fat and carbohydrate and percentage of water by weight.Statistics: Linear regression modelled relationships of macronutrients and ED. Paired t-tests compared observed and predicted reductions in the ED of RF foods compared with FF equivalents.Results: Both FF and RF foods were more energy-dense than the Australian diet and the HF vegetable-based dishes were less energy-dense. The Australian diet showed significant relationships with ED, which were positive for percentage energy as fat and negative for percentage energy as carbohydrate. There were no such relationships for the products with RF claims or for the HF vegetable-based dishes.Conclusion: While, overall, a reduced-fat diet is relatively energy-dilute and is likely to protect against weight gain, there appear to be two important exceptions. A high intake of products with RF claims could lead to a relatively energy-dense diet and thus promote weight gain. Alternatively, a high intake of vegetable-based foods, even with substantial added fat, could reduce ED and protect against weight gain.<br /

The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study

Abstract Background Recent population dietary studies indicate that diets rich in ultra-processed foods, increasingly frequent worldwide, are grossly nutritionally unbalanced, suggesting that the dietary contribution of these foods largely determines the overall nutritional quality of contemporaneous diets. Yet, these studies have focused on individual nutrients (one at a time) rather than the overall nutritional quality of the diets. Here we investigate the relationship between the energy contribution of ultra-processed foods in the US diet and its content of critical nutrients, individually and overall. Methods We evaluated dietary intakes of 9,317 participants from 2009 to 2010 NHANES aged 1+ years. Food items were classified into unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. First, we examined the average dietary content of macronutrients, micronutrients, and fiber across quintiles of the energy contribution of ultra-processed foods. Then, we used Principal Component Analysis (PCA) to identify a nutrient-balanced dietary pattern to enable the assessment of the overall nutritional quality of the diet. Linear regression was used to explore the association between the dietary share of ultra-processed foods and the balanced-pattern PCA factor score. The scores were thereafter categorized into tertiles, and their distribution was examined across ultra-processed food quintiles. All models incorporated survey sample weights and were adjusted for age, sex, race/ethnicity, family income, and educational attainment. Results The average content of protein, fiber, vitamins A, C, D, and E, zinc, potassium, phosphorus, magnesium, and calcium in the US diet decreased significantly across quintiles of the energy contribution of ultra-processed foods, while carbohydrate, added sugar, and saturated fat contents increased. An inverse dose–response association was found between ultra-processed food quintiles and overall dietary quality measured through a nutrient-balanced-pattern PCA-derived factor score characterized by being richer in fiber, potassium, magnesium and vitamin C, and having less saturated fat and added sugars. Conclusions This study suggests that decreasing the dietary share of ultra-processed foods is a rational and effective way to improve the nutritional quality of US diets

Sizing the association between lifestyle behaviours and fatness in a large, heterogeneous sample of youth of multiple ethnicities from 4 countries

Background:&nbsp;The magnitude of the relationship between lifestyle risk factors for obesity and adiposity is not clear.&nbsp;The aim of this study was to clarify this in order to determine the level of importance of lifestyle factors in obesity&nbsp;aetiology.Methods: A cross-sectional analysis was carried out on data on youth who were not trying to change weight&nbsp;(n = 5714), aged 12 to 22 years and from 8 ethnic groups living in New Zealand, Australia, Fiji and Tonga.&nbsp;Demographic and lifestyle data were measured by questionnaires. Fatness was measured by body mass index (BMI),&nbsp;BMI z-score and bioimpedance analysis, which was used to estimate percent body fat and total fat mass (TFM).&nbsp;Associations between lifestyle and body composition variables were examined using linear regression and forest plots.Results: TV watching was positively related to fatness in a dose-dependent manner. Strong, dose-dependent&nbsp;associations were observed between fatness and soft drink consumption (positive relationship), breakfast consumption&nbsp;(inverse relationship) and after-school physical activity (inverse relationship). Breakfast consumption-fatness associations&nbsp;varied in size across ethnic groups. Lifestyle risk factors for obesity were associated with percentage differences in body&nbsp;composition variables that were greatest for TFM and smallest for BMI.Conclusions: Lifestyle factors were most strongly related to TFM, which suggests that studies that use BMI alone to&nbsp;quantify fatness underestimate the full effect of lifestyle on adiposity. This study clarifies the size of lifestyle-fatness&nbsp;relationships observed in previous studies.</div

The share of ultra-processed foods and the overall nutritional quality of diets in the US: evidence from a nationally representative cross-sectional study

BACKGROUND: Recent population dietary studies indicate that diets rich in ultra-processed foods, increasingly frequent worldwide, are grossly nutritionally unbalanced, suggesting that the dietary contribution of these foods largely determines the overall nutritional quality of contemporaneous diets. Yet, these studies have focused on individual nutrients (one at a time) rather than the overall nutritional quality of the diets. Here we investigate the relationship between the energy contribution of ultra-processed foods in the US diet and its content of critical nutrients, individually and overall. METHODS: We evaluated dietary intakes of 9,317 participants from 2009 to 2010 NHANES aged 1+ years. Food items were classified into unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods. First, we examined the average dietary content of macronutrients, micronutrients, and fiber across quintiles of the energy contribution of ultra-processed foods. Then, we used Principal Component Analysis (PCA) to identify a nutrient-balanced dietary pattern to enable the assessment of the overall nutritional quality of the diet. Linear regression was used to explore the association between the dietary share of ultra-processed foods and the balanced-pattern PCA factor score. The scores were thereafter categorized into tertiles, and their distribution was examined across ultra-processed food quintiles. All models incorporated survey sample weights and were adjusted for age, sex, race/ethnicity, family income, and educational attainment. RESULTS: The average content of protein, fiber, vitamins A, C, D, and E, zinc, potassium, phosphorus, magnesium, and calcium in the US diet decreased significantly across quintiles of the energy contribution of ultra-processed foods, while carbohydrate, added sugar, and saturated fat contents increased. An inverse dose-response association was found between ultra-processed food quintiles and overall dietary quality measured through a nutrient-balanced-pattern PCA-derived factor score characterized by being richer in fiber, potassium, magnesium and vitamin C, and having less saturated fat and added sugars. CONCLUSIONS: This study suggests that decreasing the dietary share of ultra-processed foods is a rational and effective way to improve the nutritional quality of US diets