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,

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

Is the degree of food processing and convenience linked with the nutritional quality of foods purchased by US households?

Background: “Processed foods” are defined as any foods other than raw agricultural commodities and can be categorized by the extent of changes occurring in foods as a result of processing. Conclusions about the association between the degree of food processing and nutritional quality are discrepant

Dietary pattern trajectories during 15 years of follow-up and HbA1c, insulin resistance and diabetes prevalence among Chinese adults

Most research on dietary patterns and health outcomes does not include longitudinal exposure data. We used an innovative technique to capture dietary pattern trajectories and their association with hemoglobin A1c (HbA1c), homeostasis model of insulin resistance (HOMA-IR), and prevalence of newly diagnosed diabetes

Low-calorie- and calorie-sweetened beverages: diet quality, food intake, and purchase patterns of US household consumers

Background: Few studies have investigated the diet quality of consumers of low-calorie-sweetened (LCS) and calorie-sweetened (CS) beverages

A Dynamic Panel Model of the Associations of Sweetened Beverage Purchases With Dietary Quality and Food-Purchasing Patterns

Investigating the association between consumption of sweetened beverages and dietary quality is challenging because issues such as reverse causality and unmeasured confounding might result in biased and inconsistent estimates. Using a dynamic panel model with instrumental variables to address those issues, we examined the independent associations of beverages sweetened with caloric and low-calorie sweeteners with dietary quality and food-purchasing patterns. We analyzed purchase data from the Homescan survey, an ongoing, longitudinal, nationally representative US survey, from 2000 to 2010 (n = 34,294). Our model included lagged measures of dietary quality and beverage purchases (servings/day in the previous year) as exposures to predict the outcomes (macronutrient (kilocalories per capita per day; %), total energy, and food purchases) in the next year after adjustment for other sociodemographic covariates. Despite secular declines in purchases (kilocalories per capita per day) from all sources, each 1-serving/day increase in consumption of either beverage type resulted in higher purchases of total daily kilocalories and kilocalories from food, carbohydrates, total sugar, and total fat. Each 1-serving/day increase in consumption of either beverage was associated with more purchases of caloric-sweetened desserts or sweeteners, which accounted for a substantial proportion of the increase in total kilocalories. We concluded that consumers of both beverages sweetened with low-calorie sweeteners and beverages sweetened with caloric sweeteners had poorer dietary quality, exhibited higher energy from all purchases, sugar, and fat, and purchased more caloric-sweetened desserts/caloric sweeteners compared with nonconsumers

Longitudinal analysis of dietary patterns in Chinese adults from 1991 to 2009

Our aims were to identify the changes or stability in the structure of dietary patterns and the tracking, trends and factors related to the adherence of these patterns in China from 1991 to 2009. We used seven waves of the China Health and Nutrition Survey and included 9,253 adults with ≥3 waves complete. Diet was measured over a 3-day period with 24-hr recalls and a household food inventory. Using factor analysis in each wave we found that the structure of the two dietary patterns identified, remained stable over the studied period. The traditional southern pattern was characterized by high intake of rice, fresh leafy vegetables, low-fat red meat, pork, organ meats, poultry and fish/seafood and low intakes of wheat flour, corn/coarse grains; and the modern high-wheat pattern was characterized by high intake of wheat buns/breads, cakes/cookies/pastries, deep-fried wheat, nuts/seeds, starchy roots/tubers products, fruits, eggs/eggs products, soy milk, animal-based milk and instant noodles/frozen dumplings. Temporal tracking (maintenance of a relative position over time) was higher for the traditional southern, whereas adherence to the modern high-wheat had an upward trend over time. Higher income, education and urbanicity level were positively associated with both dietary patterns, but the association became smaller in the later years. These results suggest that even in the context of rapid economic changes in China; the way people chose to combine their foods remained relatively stable. However, the increasing popularity of the modern high-wheat pattern, a pattern associated with several energy-dense foods is cause of concern

Shifts in the Recent Distribution of Energy Intake among U.S. Children Aged 2–18 Years Reflect Potential Abatement of Earlier Declining Trends

Recent national surveys suggest that child obesity in the United States may have reached a plateau, but corresponding trends in energy intake have not been examined in depth. This article evaluates medium-term trends in children’s reported energy intake by using 4 waves of national dietary surveillance from 2003–2004 to 2009–2010. The analysis uses up to 2 24-h dietary recalls, incorporating methods that address challenges in estimating usual intake, accounting for intraindividual variance and covariates such as the presence of atypical consumption days. Quantile regression was used to assess disparities in intake among sociodemographic subgroups at extremes of the distribution as well as at the median, and the potential influence of misreporting was evaluated. Results indicated that after an initial decline in intakes across all age groups through 2007–2008, there were significant increases of ∼90 kcal/d at the median among adolescents in 2009–2010, whereas intakes in younger children remained steady. Among adolescent boys, the recent increase was larger at the 90th percentile than at the median. Intake trends did not vary by race/ethnic group, among whom intakes were similar at the upper end of the distribution. Misreporting did not influence trends over time, but intakes were lower in younger children and higher in older children after excluding misreporters. Overall, findings suggest that declines in children’s energy intake from 2003–2004 through 2007–2008 were consistent with the obesity plateau observed in most age and gender subgroups through 2009–2010. However, there is evidence of increased intakes among adolescents in 2009–2010, which may threaten the earlier abatement in overweight in this older age group