Globalization, Urbanization and Nutritional Change in the Developing World

Urbanization and globalization may enhance access to non traditional foods as a result of changing prices and production practices, as well as trade and marketing practices. These forces have influenced dietary patterns throughout the developing world. Longitudinal case study data from China indicate that consumption patterns closely reflect changes in availability, and that potentially obesogenic dietary patterns are emerging, with especially large changes in rural areas with high levels of urban infrastructure and resources. Recent data on women from 36 developing countries illustrate that these dietary shifts may have implications for overweight/obesity in urban and rural settings. These data emphasize the importance of developing country policies that include preventive measures to minimize further adverse shifts in diet and activity, and risk of continued rises in overweight.dietary patterns, developing countries, overweight, food policy, Agricultural and Food Policy, Community/Rural/Urban Development, Food Security and Poverty,

Urinary bisphenol A and obesity in adults: results from the Canadian Health Measures Survey

Introduction Exposure to bisphenol A (BPA) has been shown to affect lipid metabolismand promote weight gain in animal studies. Recent epidemiological studies alsosupport a link between BPA and obesity in human populations, although many werelimited to a single adiposity measure or have not considered potential confounding bydietary factors. The purpose of this study is to examine associations between urinaryBPA and adiposity measures in a nationally representative sample of Canadian adults. Methods We performed analyses using biomonitoring and directly measured anthropometricdata from 4733 adults aged 18 to 79 years in the Canadian Health MeasuresSurvey (2007–2011). We used multinomial and binary logistic regression models to estimateassociations of urinary BPA with body mass index (BMI) categories (overweightvs. under/normal weight; obesity vs. under/normal weight) and elevated waist circumference(males: ≥ 102 cm; females: ≥ 88 cm), respectively, while controlling for potentialconfounders. Linear regression analyses were also performed to assess associationsbetween urinary BPA and continuous BMI and waist circumference measures. Results Urinary BPA was positively associated with BMI-defined obesity, with an oddsratio of 1.54 (95% confidence interval [CI]: 1.002–2.37) in the highest (vs. lowest) BPAquartile (test for trend, p = .041). Urinary BPA was not associated with elevated waistcircumference defined using standard cut-offs. Additionally, each natural-log unitincrease in urinary BPA concentration was associated with a 0.33 kg/m2 (95% CI: 0.10–0.57) increase in BMI and a 1.00 cm (95% CI: 0.34–1.65) increase in waistcircumference. Conclusion Our study contributes to the growing body of evidence that BPA is positivelyassociated with obesity. Prospective studies with repeated measures are neededto address temporality and improve exposure classification

Highly Processed and Ready-to-Eat Packaged Food and Beverage Purchases Differ by Race/Ethnicity among US Households

Background: Racial/ethnic disparities in dietary quality persist among Americans, but it is unclear whether highly processed foods or convenience foods contribute to these inequalities

Overweight exceeds underweight among women in most developing countries

Background: It is generally believed that overweight is less prevalent than undernutrition in the developing world, particularly in rural areas, and that it is concentrated in higher socioeconomic status (SES) groups. Objective: The purpose of this study was to examine patterns of adult female overweight and underweight in the developing world by using categories of urban or rural status and SES strata. Design: Body mass index (BMI; in kg/m2) data collected in 36 countries from 1992 to 2000 by nationally representative cross-sectional surveys of women aged 20–49 y (n = 148579) were classified as indicating underweight (BMI less than 18.5) and overweight (BMI ≥ 25). Associations between the nutritional status of urban and rural women and each country’s per capita gross national income (GNI) and level of urbanization were explored in the overall sample and among different SES groups. Results: Overweight exceeded underweight in well over half of the countries: the median ratio of overweight to underweight was 5.8 in urban and 2.1 in rural areas. Countries with high GNIs and high levels of urbanization had not only high absolute prevalences of overweight but also small urban-rural differences in overweight and very high ratios of overweight to underweight. In the more-developed countries, overweight among low-SES women was high in both rural (38%) and urban (51%) settings. Even many poor countries, countries in which underweight persists as a significant problem, had fairly high prevalences of rural overweight. Conclusions: In most developing economies, prevalences of overweight in young women residing in both urban and rural areas are higher than those in underweight women, especially in countries at higher levels of socioeconomic development. Research is needed to assess male and child overweight to understand the dynamics facing these groups as well

Using both principal component analysis and reduced rank regression to study dietary patterns and diabetes in Chinese adults

Abstract Objective We examined the association between dietary patterns and diabetes using the strengths of two methods: principal component analysis (PCA) to identify the eating patterns of the population and reduced rank regression (RRR) to derive a pattern that explains the variation in glycated Hb (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR) and fasting glucose. Design We measured diet over a 3 d period with 24 h recalls and a household food inventory in 2006 and used it to derive PCA and RRR dietary patterns. The outcomes were measured in 2009. Setting Adults ( n 4316) from the China Health and Nutrition Survey. Results The adjusted odds ratio for diabetes prevalence (HbA1c≥6·5 %), comparing the highest dietary pattern score quartile with the lowest, was 1·26 (95 % CI 0·76, 2·08) for a modern high-wheat pattern (PCA; wheat products, fruits, eggs, milk, instant noodles and frozen dumplings), 0·76 (95 % CI 0·49, 1·17) for a traditional southern pattern (PCA; rice, meat, poultry and fish) and 2·37 (95 % CI 1·56, 3·60) for the pattern derived with RRR. By comparing the dietary pattern structures of RRR and PCA, we found that the RRR pattern was also behaviourally meaningful. It combined the deleterious effects of the modern high-wheat pattern (high intakes of wheat buns and breads, deep-fried wheat and soya milk) with the deleterious effects of consuming the opposite of the traditional southern pattern (low intakes of rice, poultry and game, fish and seafood). Conclusions Our findings suggest that using both PCA and RRR provided useful insights when studying the association of dietary patterns with diabetes

Maternal B vitamins: effects on offspring weight and DNA methylation at genomically imprinted domains

Abstract Background Inadequate maternal nutrition during early fetal development can create permanent alterations in the offspring, leading to poor health outcomes. While nutrients involved in one-carbon cycle metabolism are important to fetal growth, associations with specific nutrients remain inconsistent. This study estimates associations between maternal vitamins B12, B6 (pyridoxal phosphate [PLP] and 4-pyridoxic acid [PA]), and homocysteine (Hcy) concentrations, offspring weight (birth weight and 3-year weight gain), and DNA methylation at four differentially methylated regions (DMRs) known to be involved in fetal growth and development (H19, MEG3, SGCE/PEG10, and PLAGL1). Methods Study participants (n = 496) with biomarker and birth weight data were enrolled as part of the Newborn Epigenetics STudy. Weight gain data were available for 273 offspring. Among 484 mother-infant pairs, DNA methylation at regulatory sequences of genomically imprinted genes was measured in umbilical cord blood DNA using bisulfite pyrosequencing. We used generalized linear models to estimate associations. Results Multivariate adjusted regression models revealed an inverse association between maternal Hcy concentration and male birth weight (β = −210.40, standard error (SE) = 102.08, p = 0.04). The offspring of the mothers in the highest quartile of B12 experienced lower weight gain between birth and 3 years compared to the offspring of the mothers in the lowest (β = −2203.03, SE = 722.49, p = 0.003). Conversely, maternal PLP was associated with higher weight gain in males; higher maternal PLP concentrations were also associated with offspring DNA methylation levels at the MEG3 DMR (p < 0.01). Conclusions While maternal concentrations of B12, B6, and Hcy do not associate with birth weight overall, they may play an important role in 3-year weight gain. This is the first study to report an association between maternal PLP and methylation at the MEG3 DMR which may be an important epigenetic tag for maternal B vitamin adequacy

Under- and overreporting of energy is related to obesity, lifestyle factors and food group intakes in Jamaican adults

OBJECTIVE: Research in industrialised countries has documented a high prevalence of underreported energy intakes associated with characteristics such as obesity. This paper examines the prevalence, patterns and impact of energy under- and overreporting on diet-obesity relationships in a middle-income developing country. DESIGN: A 70-item food-frequency questionnaire was used. Underreporters had reported energy intakes 2.4 x BMR. Multinomial models were used to identify characteristics associated with implausible reporting. Intakes were compared across reporting groups to assess evidence of bias. Associations between diet and obesity were compared with and without adjustment for implausible reporting. SETTING: Spanish Town, neighbouring the capital city of Kingston, Jamaica. SUBJECTS: Eight hundred and ninety-one Jamaican adults, aged 25-75 years, were randomly recruited. RESULTS: More women than men (38.6% vs. 22.5%) underreported, but more men overreported energy (23.7% vs. 16.0%). Underreporting was positively associated with obesity, special diets, smoking and age; age was inversely associated with overreporting. Underreporters estimated lower energy from potentially socially undesirable food groups (e.g. snacks) and higher intakes of 'healthy' foods (e.g. fruit) than did plausible reporters. For some of these food groups, significant differences in intakes among normal-weight versus obese subjects observed among plausible reporters were absent when implausible reporters were included. In models of food group-obesity associations, adjusting for implausible energy yielded more credible results that more closely resembled findings in plausible reporters. CONCLUSIONS: Energy under- and overreporting are highly prevalent in Jamaica. Adjusting for implausible reporting may help to reduce bias in diet-health outcome associations

The association of trajectories of protein intake and age-specific protein intakes from 2 to 22 years with BMI in early adulthood

Abstract No study has analysed how protein intake from early childhood to young adulthood relate to adult BMI in a single cohort. To estimate the association of protein intake at 2, 11, 15, 19 and 22 years with age- and sex-standardised BMI at 22 years (early adulthood), we used linear regression models with dietary and anthropometric data from a Filipino birth cohort (1985–2005, n 2586). We used latent growth curve analysis to identify trajectories of protein intake relative to age-specific recommended daily allowance (intake in g/kg body weight) from 2 to 22 years, then related trajectory membership to early adulthood BMI using linear regression models. Lean mass and fat mass were secondary outcomes. Regression models included socioeconomic, dietary and anthropometric confounders from early life and adulthood. Protein intake relative to needs at age 2 years was positively associated with BMI and lean mass at age 22 years, but intakes at ages 11, 15 and 22 years were inversely associated with early adulthood BMI. Individuals were classified into four mutually exclusive trajectories: (i) normal consumers (referent trajectory, 58 % of cohort), (ii) high protein consumers in infancy (20 %), (iii) usually high consumers (18 %) and (iv) always high consumers (5 %). Compared with the normal consumers, ‘usually high’ consumption was inversely associated with BMI, lean mass and fat mass at age 22 years whereas ‘always high’ consumption was inversely associated with male lean mass in males. Proximal protein intakes were more important contributors to early adult BMI relative to early-childhood protein intake; protein intake history was differentially associated with adulthood body size

Prenatal Concentrations of Polychlorinated Biphenyls, DDE, and DDT and Overweight in Children: A Prospective Birth Cohort Study

Background: Recent experimental evidence suggests that prenatal exposure to endocrine-disrupting chemicals (EDCs) may increase postnatal obesity risk and that these effects may be sex or diet dependent