Salad Consumption in Relation to Daily Dietary Intake and Diet Quality among U.S. Adults, 2003-2012

Backgrounds: This study examined salad consumption in relation to daily dietary intake and diet quality among U.S. adults. Methods: Nationally representative sample came from the National Health and Nutrition Examination Survey 2003-2012 waves. Salad consumption was identified through both Food and Nutrient Database for Dietary Studies codes for salad items and combination code for components of and/or additions to salads. First-difference estimator addressed confounding bias from time-invariant unobservables (e.g., eating habits, taste preferences) by using within-individual variations in salad consumption between 2 nonconsecutive 24-hour dietary recalls. Results: Approximately 28.7% of U.S. adults consumed salad on any given day. Among salad consumers, salad consumption occupied 12.5% of daily total energy, 62.8% vegetable, 11.9% fruit, 18.4% fiber, 9.1% sugar, 20.3% total fat, 14.7% saturated fat, 14.9% cholesterol, and 17.7% sodium intake. Compared to no salad consumption on a dietary recall day, salad consumption was associated with increased daily intake of total energy by 461.5 kJ (110.3 kcal), vegetable 85.0 g, fiber 1.0 g, sugar 5.7 g, total fat 10.0 g, saturated fat 1.3 g, cholesterol 18.7 mg, and sodium 216.3 mg. Salad consumption was associated with an increase in the Healthy Eating Index-2010 score by 4.2. Conclusion: Salad consumption is related to better overall diet quality but also higher total energy, sugar, fat, cholesterol, and sodium intake. Interventions that promote salad consumption should provide low-energy-dense, nutrient-rich salad products. Salad consumers should prudently evaluate the caloric and nutrient content of salad in order to make informed and more healthful diet choices

A Field Test of Popular Chatbots’ Responses To Questions Concerning Negative Body Image

Background: Chatbots are computer programs, often built upon large artificial intelligence models, that employ dialogue systems to enable online, natural language conversations with users via text, speech, or both. Body image, broadly defined as a combination of thoughts and feelings about one’s physical appearance, has been implicated in many risk behaviors and health problems, especially among adolescents and young adults. Little is known about how chatbots respond to questions about body image. Methods: This study assessed the responses of 14 widely-used chatbots (eight companion and six therapeutic chatbots) to ten body image-related questions developed upon validated instruments. Chatbots’ responses were documented, with qualities systematically assessed by nine pre-determined criteria. Results: The overall quality of the chatbots’ responses was modest (an average score of five out of nine), with substantial variations in the content and quality of responses across chatbots (individual scores ranging from one to eight). Companion and therapeutic chatbots systematically differed in their responses (e.g., focusing on comforting users vs. trying to identify the causes of negative body image and recommending potential remedies). Some therapeutic chatbots recognized potential mental health crises (self-harm) in test users’ messages. Conclusion: Substantial heterogeneities in the responses were present across chatbots and assessment criteria. Adolescents and young adults struggling with body image could be vulnerable to misleading or biased remarks made by chatbots. Still, the technical and supervision challenges to prevent those adverse consequences remain paramount and unsolved

Neighborhood Food Outlets, Diet, and Obesity Among California Adults, 2007 and 2009

IntroductionVarying neighborhood definitions may affect research on the association between food environments and diet and weight status. The objective of this study was to examine the association between number and type of neighborhood food outlets and dietary intake and body mass index (BMI) measures among California adults according to the geographic size of a neighborhood or food environment.MethodsWe analyzed data from 97,678 respondents aged 18 years or older from the 2007 and 2009 California Health Interview Survey through multivariable regression models. Outcome variables were BMI, weight status of a BMI of 25.0 or more and a BMI of 30.0 or more, and the number of times per week the following were consumed: fruits, vegetables, sugar-sweetened soft drinks, fried potatoes, and fast food. Explanatory variables were the number of fast-food restaurants, full-service restaurants, convenience stores, small food stores, grocery stores, and large supermarkets within varying distances (0.25 to 3.0 miles) from the survey respondent’s residence. We adopted as a measure of walking distance a Euclidean distance within 1 mile. Control variables included sociodemographic and economic characteristics of respondents and neighborhoods.ResultsFood outlets within walking distance (≤1.0 mile) were not strongly associated with dietary intake, BMI, or probabilities of a BMI of 25.0 or more or a BMI of 30.0 or more. We found significant associations between fast-food outlets and dietary intake and between supermarkets and BMI and probabilities of a BMI of 25.0 or more and a BMI of 30.0 or more for food environments beyond walking distance (>1.0 mile).ConclusionWe found no strong evidence that food outlets near homes are associated with dietary intake or BMI. We replicated some associations reported previously but only for areas that are larger than what typically is considered a neighborhood. A likely reason for the null finding is that shopping patterns are weakly related, if at all, to neighborhoods in the United States because of access to motorized transportation

Governance Policy Evaluation in the United States during the Pandemic: Nonpharmaceutical Interventions or Else?

Scientific evidence suggests that nonpharmaceutical interventions (NPIs) effectively curb the spread of COVID-19 before a pharmaceutical solution. Implementing these interventions also significantly affects regular socioeconomic activities and practices of social, racial, and political justice. Local governments often face conflicting goals during policymaking. Striking a balance among competing goals during a global pandemic is a fine science of governance. How well state governments consume the scientific evidence and maintain such a balance remains less understood. This study employs a set of Bayesian hierarchical models to evaluate how state governments in the United States use scientific evidence to balance the fighting against the spread of COVID-19 disease and socioeconomic, racial, social justice, and other demands. We modeled the relationships between five NPI strategies and COVID-19 caseload information and used the modeled result to perform a balanced governance evaluation. The results suggest that governmental attitude and guidance effectively guide the public to fight back against a global pandemic. The more detailed spatiotemporally varying coefficient process model produces 612,000 spatiotemporally varying coefficients, suggesting all measures sometimes work somewhere. Summarized results indicate that states emphasizing NPIs fared well in curbing the spread of COVID-19. With over 1 million deaths due to COVID-19 in the United States, we feel the balance scale likely needs to tip toward preserving human lives. Our evaluation of governance policies is hence based on such an argument. This study aims to provide decision support for policymaking during a national emergency

Impact of soda tax on beverage price, sale, purchase, and consumption in the US: a systematic review and meta-analysis of natural experiments

BackgroundAs a primary source of added sugars in the US diet, sugar-sweetened beverage (SSB) consumption is presumed to contribute to obesity prevalence and poor oral health. We systematically synthesized and quantified evidence from US-based natural experiments concerning the impact of SSB taxes on beverage prices, sales, purchases, and consumption.MethodsA keyword and reference search was performed in PubMed, Web of Science, Cochrane Library, Scopus, and EconLit from the inception of an electronic bibliographic database to Oct 31, 2022. Meta-analysis was conducted to estimate the pooled effect of soda taxes on SSB consumption, prices, passthrough rate, and purchases.ResultsTwenty-six natural experiments, all adopting a difference-in-differences approach, were included. Studies assessed soda taxes in Berkeley, Oakland, and San Francisco in California, Philadelphia in Pennsylvania, Boulder in Colorado, Seattle in Washington, and Cook County in Illinois. Tax rates ranged from 1 to 2 ¢/oz. The imposition of the soda tax was associated with a 1.06 ¢/oz. (95% confidence interval [CI] = 0.90, 1.22) increase in SSB prices and a 27.3% (95% CI = 19.3, 35.4%) decrease in SSB purchases. The soda tax passthrough rate was 79.7% (95% CI = 65.8, 93.6%). A 1 ¢/oz. increase in soda tax rate was associated with increased prices of SSBs by 0.84 ¢/oz (95% CI = 0.33, 1.35).ConclusionSoda taxes could be effective policy leverage to nudge people toward purchasing and consuming fewer SSBs. Future research should examine evidence-based classifications of SSBs, targeted use of revenues generated by taxes to reduce health and income disparities, and the feasibility of redesigning the soda tax to improve efficiency

Provincial screening rates for chronic diseases of lifestyle, cancers and HIV in a health-insured population

Background. Screening for asymptomatic diseases can reduce the burden of morbidity and mortality in all population groups. There is widespread geographical variation in the quality of care. Few data are available on national screening rates in South Africa and how these vary across the provinces. Objective. To examine screening rates for chronic diseases of lifestyle (CDL), HIV and cancer in a privately insured population for a single insurer across all nine provinces in South Africa, and to determine whether or not there are any differences between the provinces. Method. Screening rates were calculated as the proportion of eligible members who had received screening tests during 2011 in each province. Mean screening rates were compared between Gauteng and the other eight provinces. Results. Nationwide screening rates were 20.5% for CDL, 8.2% for HIV and 31.9% for cancer. Despite similar insurance coverage, screening rates ranged from 0.3% to 0.95% lower in other provinces compared with Gauteng. Of all the provinces, Gauteng had the highest annual screening rates for CDL, breast cancer, prostate cancer and HIV (

A Systematic Review of Diet Quality Index and Obesity among Chinese Adults

Diet quality scores are designed mainly based on Western-style dietary patterns. They were demonstrated to be good indicators of obesity in developed but not developing countries. Several diet quality scores were developed based on the Chinese dietary guidelines, yet no systematic review exists regarding how they were related to obesity. We searched research articles published between 2000 and 2021 in PubMed, CINAHL, and Scopus databases. Both cross-sectional and prospective studies that examined the relationship between a diet quality score and weight, body mass index, obesity, or waist circumference conducted in a Chinese population were selected. From the 602 articles searched, 20 articles were selected (12 are cross-sectional studies and 8 are prospective cohort studies). The relationship between internationally used scores and obesity was inconsistent among studies. Scores tailored to the Chinese diet demonstrated a strong relationship with both being underweight and obesity. The heterogeneity of the populations and the major nutrition transition in China may partially explain the discrepancies among studies. In conclusion, diet quality scores tailored to the Chinese diet may be associated with both undernutrition and overnutrition, as well as being underweight and obesity outcomes

Impact of Beef and Beef Product Intake on Cognition in Children and Young Adults: A Systematic Review

(1) Background: Undernutrition and micronutrient deficiency have been consistently linked to cognitive impairment among children and young adults. As a primary source of dietary animal protein, beef consumption holds the potential to improve diet quality and positively influence cognitive function. This study systematically reviewed evidence linking beef intake to cognition among children and young adults. (2) Methods: A literature search was conducted in seven electronic bibliographic databases for studies assessing the impact of beef consumption on cognition. (3) Results: We identified eight studies reporting results from five unique interventions. Two interventions were conducted in Kenya, two in the U.S. and one in four countries including Guatemala, Pakistan, Democratic Republic of the Congo and Zambia. Only one intervention employed a non-feeding control arm and found beef consumption to improve cognitive abilities compared to the control. However, the other interventions comparing beef consumption to other food types found no consistent result. (4) Conclusions: Evidence pertaining to the impact of beef consumption on cognition remains limited due to the small and heterogeneous set of studies. Future research should adopt a population representative sample and longer follow-up period, employ a non-feeding control arm and comprehensively measure nutrient intakes among study participants

Plain Water and Sugar-Sweetened Beverage Consumption in Relation to Energy and Nutrient Intake at Full-Service Restaurants

Background: Drinking plain water, such as tap or bottled water, provides hydration and satiety without adding calories. We examined plain water and sugar-sweetened beverage (SSB) consumption in relation to energy and nutrient intake at full-service restaurants. Methods: Data came from the 2005–2012 National Health and Nutrition Examination Survey, comprising a nationally-representative sample of 2900 adults who reported full-service restaurant consumption in 24-h dietary recalls. Linear regressions were performed to examine the differences in daily energy and nutrient intake at full-service restaurants by plain water and SSB consumption status, adjusting for individual characteristics and sampling design. Results: Over 18% of U.S. adults had full-service restaurant consumption on any given day. Among full-service restaurant consumers, 16.7% consumed SSBs, 2.6% consumed plain water but no SSBs, and the remaining 80.7% consumed neither beverage at the restaurant. Compared to onsite SSB consumption, plain water but no SSB consumption was associated with reduced daily total energy intake at full-service restaurants by 443.4 kcal, added sugar intake by 58.2 g, saturated fat intake by 4.4 g, and sodium intake by 616.8 mg, respectively. Conclusion: Replacing SSBs with plain water consumption could be an effective strategy to balance energy/nutrient intake and prevent overconsumption at full-service restaurant setting