Coming unmoored: Disproportionate increases in obesity prevalence among young, disadvantaged white women

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109980/1/oby20913.pd

Exploring racial differences in the obesity gender gap

To investigate whether the gender gap in obesity prevalence is greater among US Blacks than Whites in a study designed to account for racial differences in socioeconomic and environmental conditions

Preliminary validation of the Yale Food Addiction Scale.

Introduction: Evidence is growing that an addictive process may play a role in problematic eating behavior. The majority of research on this topic has examined the concept of "food addiction" solely in adult samples. If certain foods have addictive potential, children may be impacted as much as (or more) than adults due to psychological and neurobiological vulnerabilities at younger developmental stages. In the current study, we developed a measure of food addiction in children that reflects the diagnostic indicators of addiction. Materials and methods: The content and reading level of the Yale Food Addiction Scale (YFAS) was altered to be appropriate for children (YFAS-C). The YFAS-C and other eating-related measures were administered to study participants to examine the validity and reliability of the YFAS-C. Participants: 75 children were recruited from the community ranging from lean to obese. Results: The validation of the YFAC-C provides preliminary support for its convergent validity with like constructs and incremental validity in predicting body mass index. Internal consistency was adequate given the small number of items on the scale. Discussion: The YFAS-C appears to be a helpful tool for identifying addictive-like eating in children

Preliminary validation of the Yale Food Addiction Scale for children

Evidence is growing that an addictive process may play a role in problematic eating behavior. The majority of research on this topic has examined the concept of “food addiction” solely in adult samples. If certain foods have addictive potential, children may be impacted as much as (or more) than adults due to psychological and neurobiological vulnerabilities at younger developmental stages. In the current study, we developed a measure of food addiction in children that reflects the diagnostic indicators of addiction

Evaluation of Consumer Understanding of Different Front-of-Package Nutrition Labels, 2010–2011

IntroductionGovernments throughout the world are using or considering various front-of-package (FOP) food labeling systems to provide nutrition information to consumers. Our web-based study tested consumer understanding of different FOP labeling systems.MethodsAdult participants (N = 480) were randomized to 1 of 5 groups to evaluate FOP labels: 1) no label; 2) multiple traffic light (MTL); 3) MTL plus daily caloric requirement icon (MTL+caloric intake); 4) traffic light with specific nutrients to limit based on food category (TL+SNL); or 5) the Choices logo. Total percentage correct quiz scores were created reflecting participants’ ability to select the healthier of 2 foods and estimate amounts of saturated fat, sugar, and sodium in foods. Participants also rated products on taste, healthfulness, and how likely they were to purchase the product. Quiz scores and product perceptions were compared with 1-way analysis of variance followed by post-hoc Tukey tests.ResultsThe MTL+caloric intake group (mean [standard deviation], 73.3% [6.9%]) and Choices group (72.5% [13.2%]) significantly outperformed the no label group (67.8% [10.3%]) and the TL+SNL group (65.8% [7.3%]) in selecting the more healthful product on the healthier product quiz. The MTL and MTL+caloric intake groups achieved average scores of more than 90% on the saturated fat, sugar, and sodium quizzes, which were significantly better than the no label and Choices group average scores, which were between 34% and 47%.ConclusionAn MTL+caloric intake label and the Choices symbol hold promise as FOP labeling systems and require further testing in different environments and population subgroups

Prevalence of prescription and illicit drugs in suicides by non-poisoning means in the National Violent Death Reporting System 2003-2017

Background: Prescription and illicit drugs are important social environmental variables in many suicides regardless of their role as an immediate cause of death. Objectives: To investigate the presence of prescription and illicit drugs, either through mention in the death record or toxicology reports, among suicides attributed to nonpoisonous causes to identify patterns of risk. Methods: Using the 2003-2017 National Violent Death Reporting System (NVDRS), we examined the presence of prescription and illicit drugs among 143,175 suicides (119,563 males 23,612 females) due to firearms and suffocation/hanging. The presence of drugs (opioids, stimulants, benzodiazepines, muscle relaxants, and cannabis) was determined from toxicology reports and text searches of coroner/medical examiner and law enforcement summaries. We fit multivariable logistic regression models to estimate associations between drug class and suicide method adjusting for decedent characteristics. Results: Overall prescription and illicit drugs were present in 22% of firearm deaths and 28% of suffocation deaths. Among victims with toxicology reports, over 20% tested positive for benzodiazepines. Benzodiazepines were mentioned in 4% of firearm and 5% of suffocation suicides without toxicology testing. Stimulants were more likely to occur in suffocation than firearm deaths among victims with toxicology testing (aOR = 1.44, 95% CI: 1.33-1.56) and without toxicology testing (aOR = 1.61, 95% CI: 1.31-1.98). Conclusions: Benzodiazepines were most frequently identified in both toxicology reports and narratives of suicides by firearms or suffocation. Better distinction of the presence of prescription and illicit drugs in the environment versus apparent ingestion among non-poisoning suicides are needed to inform prevention approaches

Association between US Pharmacopeia (USP) monograph standards, generic entry and prescription drug costs.

Despite the importance of pharmacopeial standards, little is known regarding their effect on drug competition. Such information is of particular relevance given the rising costs of prescription drugs and the focus of policy-makers and other stakeholders on addressing these costs. We examined 982 prescription drugs approved by U.S Food and Drug Administration since 1982 to examine the association between U.S. Pharmacopeia (USP) standards, generic entry and prescription costs. The presence of a USP drug product monograph was not associated with the time to the third generic entrant or with the likelihood of having a generic competitor. However, on average, drugs with USP drug product monographs had approximately fifty percent more generic manufacturers in the U.S. than their counterparts after accounting for factors such as market volume, age, route of administration and vintage. This greater competition was associated with an approximate savings of $6.22 billion in 2016, suggesting that USP drug product monographs may play an important role in promoting pharmaceutical competition and reducing prescription drug costs

Association of current substance use treatment with future reduced methamphetamine use in an observational cohort of men who have sex with men in Los Angeles

IntroductionMethamphetamine use is highly prevalent among men who have sex with men (MSM), but knowledge of the long-term dynamics, and how they are affected by substance use treatment, is limited. This study aimed to describe trajectories of methamphetamine use among MSM, and to evaluate the impact of treatment for any kind of substance use on frequency of methamphetamine use.MethodsThis analysis used data from a cohort of MSM in Los Angeles, CA, who participated in semi-annual study visits from 2014 to 2022. The study characterized trajectories of methamphetamine use using a continuous time multistate Markov model with three states. States were defined using self-reported frequency of methamphetamine use in the past six months: frequent (daily), occasional (weekly or less), and never. The model estimated the association between receiving treatment for any kind of substance use and changes in state of frequency of methamphetamine use.ResultsThis analysis included 2348 study visits among 285 individuals who were followed-up for an average of 4.4 years. Among participants who were in the frequent use state, 65 % (n = 26) of those who were receiving any kind of substance use treatment at a study visit had reduced their methamphetamine use at their next visit, compared to 33 % (n = 95) of those who were not receiving treatment. Controlling for age, race/ethnicity, and HIV-status, those who reported receiving current treatment for substance use were more likely to transition from occasional to no use (HR: 1.63, 95 % CI: 1.10-2.42) and frequent to occasional use (HR: 4.25, 95 % CI: 2.11-8.59) in comparison to those who did not report receiving current treatment for substance use.ConclusionsFindings from this dynamic modeling study provide a new method for assessing longitudinal methamphetamine use outcomes and add important evidence outside of clinical trials that substance use treatment may reduce methamphetamine use

Comparing the performance of statistical methods that generalize effect estimates from randomized controlled trials to much larger target populations

Policymakers use results from randomized controlled trials to inform decisions about whether to implement treatments in target populations. Various methods - including inverse probability weighting, outcome modeling, and Targeted Maximum Likelihood Estimation - that use baseline data available in both the trial and target population have been proposed to generalize the trial treatment effect estimate to the target population. Often the target population is significantly larger than the trial sample, which can cause estimation challenges. We conduct simulations to compare the performance of these methods in this setting. We vary the size of the target population, the proportion of the target population selected into the trial, and the complexity of the true selection and outcome models. All methods performed poorly when the trial size was only 2% of the target population size or the target population included only 1,000 units. When the target population or the proportion of units selected into the trial was larger, some methods, such as outcome modeling using Bayesian Additive Regression Trees, performed well. We caution against generalizing using these existing approaches when the target population is much larger than the trial sample and advocate future research strives to improve methods for generalizing to large target populations