Diet Quality and Fruit,Vegetable, and Sugar-Sweetened Beverage Consumption by Household Food Insecurity among 8- to 12-Year-Old Children during Summer Months

BackgroundSchool-delivered nutrition assistance programs have improved dietary intake for children from food-insecure households during the school year. However, little is known about their diet quality and eating patterns during summer months.ObjectiveSchool-aged children’s summer month weekday and weekend day diet quality and eating patterns were assessed by household food insecurity.DesignSecondary analysis of cross-sectional data was employed.Participants/settingDuring the summers of 2011 through 2017, baseline data were collected from parent–child dyads participating in one of two community-based obesity prevention trials in metropolitan Minnesota (N=218). The mean age of children was 10 years; 50% were girls, 49% were nonwhite, and 25% were from food-insecure households.Main outcome measuresChildren from food-secure and food-insecure households were identified by using the short form of the US Household Food Security Survey. Healthy Eating Index 2015 and eating patterns—including energy intake and consumption of whole fruits, vegetables, 100% fruit/vegetable juice, and sugar-sweetened beverages—were estimated by means of 24-hour dietary recall interviews conducted on weekdays and weekend days.Statistical analysis performedGeneral linear modeling was used to examine diet quality and eating patterns by food insecurity, controlling for child age, child body mass index z score, and parent education.ResultsChildren from food-insecure and food-secure households had Healthy Eating Index 2015 scores less than 50. Children from food-insecure households reported less energy intake, fewer cups of whole fruit, and more sugar-sweetened beverage consumption for every 1,000 kcal consumed on a weekend day when compared with their counterparts from food-secure households (P<0.05). Similar results were not seen for weekday eating patterns.ConclusionsWhole fruit and sugar-sweetened beverage consumption varied by food insecurity on weekend days during summer months. Because children tend to gain weight during summer months, efforts to increase weekend access to whole fruits and promote water consumption may contribute to weight gain prevention and healthy development, especially for children from food-insecure households.     

Squeezing Fact from Fiction about 100% Fruit Juice

Total fruit intake in the United States is ~1 cup equivalent per day, or one-half of the 2010 Dietary Guidelines for Americans recommendation for adults. Two-thirds of the fruit consumed is whole fruit and one-third is 100% juice. The nutritional value of whole fruit, with the exception of fiber and vitamin C, may be retained with appropriate juice production methods and storage conditions. One-hundred percent fruit juice consumption is associated with a number of health benefits, such as improved cardiovascular health and decreased obesity, although some of these and other potential benefits are controversial. Comprehensive analyses of the evidence by the Academy of Nutrition and Dietetics in 2014, the US Dietary Guidelines Advisory Committee in 2010, and the Australian Dietary Guidelines of 2013 concluded that 100% fruit juice is not related to adiposity in children when consumed in appropriate amounts for age and energy needs. However, some reports suggest the consumption of fruit juice contributes to unhealthful outcomes, particularly among children. A dietary modeling study on the best ways to meet the fruit intake shortfall showed that a combination of whole fruit and 100% juice improved dietary density of potassium and vitamin C without significantly increasing total calories. Notably, 100% juice intake was capped at amounts consistent with the 2001 American Pediatric Association guidance. The preponderance of evidence supports the position that 100% fruit juice delivers essential nutrients and phytonutrients, provides year-round access to a variety of fruits, and is a cost-effective way to help people meet fruit recommendations.     

Dietary Fiber and Its Source Are Associated with Cardiovascular Risk Factors in Korean Adults

We examined the associations of dietary fiber and its source with cardiovascular risk factors in Korean adults. This cross-sectional study involved 16,792 adults from the 2013–2018 Korea National Health and Nutrition Examination Survey data. Dietary data were obtained using a 24 h recall method and used to evaluate intakes of total dietary fiber and its source and fruit consumption. Cardiovascular risk factors included obesity, abdominal obesity, metabolic syndrome, hypercholesterolemia, hypertension, and type 2 diabetes. Multiple logistic regression was used to examine the associations of dietary fiber and its source with cardiovascular risk factors by sex. Total fiber and fruit fiber intake in men were inversely associated with metabolic syndrome (Q5 vs. Q1: odds ratios (OR) = 0.69, 95% confidence intervals (CI) = 0.53–0.92 for total fiber; Q4 vs. Q1: OR = 0.76, 95% CI = 0.61–0.93 for fruit fiber). Among women, a higher intake of fruit fiber was related to a reduced prevalence of obesity (Q4 vs. Q1: OR = 0.85, p trend = 0.029) and abdominal obesity (Q4 vs. Q1: OR = 0.82, p trend = 0.026). Total fruit and whole fruit consumption was inversely associated with obesity, abdominal obesity, and metabolic syndrome in men and hypertension in women. The amount and sources of fiber are associated with metabolic diseases in Korean adults and should be considered in the context of overall dietary quality.     

Nutrition Claims on Fruit Drinks Are Inconsistent Indicators of Nutritional Profile: A Content Analysis of Fruit Drinks Purchased by Households With Young Children

BackgroundFruit drinks are the most commonly consumed sugar-sweetened beverage among young children. Fruit drinks carry many nutrition-related claims on the front of package (FOP). Nutrition-related claims affect individuals’ perceptions of the healthfulness of products and purchase intentions, often creating a “health halo” effect.ObjectiveThe aims of this study were to describe the prevalence of FOP nutrition-related claims on fruit drinks purchased by households with young children and to examine the association between claims and the nutritional profile of fruit drinks.DesignThe sample included 2059 fruit drinks purchased by households with children 0 to 5 years old participating in Nielsen Homescan in 2017. FOP labels were obtained from 2 databases that contain bar code–level information on all printed material on product labels. A codebook was used to code for presence of FOP nutrition-related claims. The coded claims data were linked by bar code with Nutrition Facts label data. Claim type prevalence was calculated, and the association between claim types and median calories and total grams of sugar per 100 mL was analyzed using Wilcoxon rank-sum tests. The percentages of products containing noncaloric sweeteners (NCSs) with and without each claim type were also calculated and compared.ResultsAlmost all (97%) fruit drinks sampled had at least 1 nutrition-related FOP claim. Implied natural claims such as “natural flavors” were the most common (55% of products), followed by claims about the presence of juice or nectar (49%). Claims about vitamin C (33%), sugar (29%), and calories (23%) were also common. Fruit drinks with vitamin C, juice or nectar, fruit or fruit flavor, and overt natural claims were higher in calories and sugar and less likely to contain NCSs compared with products without these claims. Fruit drinks with calorie, sugar, NCS, implied natural, and other claims were lower in calories and sugar and more likely to contain NCSs compared with products without these claims.ConclusionsClaims are prevalent on fruit drinks purchased by households with young children. This is concerning given prior research demonstrating that claims can mislead consumers. Regulatory actions such as requiring a warning or disclosure on drinks that contain added sugars or NCSs should be considered.     

Deconstructing a Fruit Serving: Comparing the Antioxidant Density of Select Whole Fruit and 100% Fruit Juices

Research suggests phytonutrients, specifically phenolic compounds, within fruit may be responsible for the putatively positive antioxidant benefits derived from fruit. Given the prominence of fruit juice in the American diet, the purpose of this research was to assess the antioxidant density of fresh fruit and 100% fruit juice for five commonly consumed fruits and juices and to compare the adequacy of 100% juice as a dietary equivalent to whole fruit in providing beneficial antioxidants. Antioxidant density was measured using an oxygen radical absorbance capacity method on six samples assayed in triplicate for each fruit (grape, apple, orange, grapefruit, pineapple), name-brand 100% juice, and store-brand 100% juice. One-way analysis of variance and Tukey’s honestly significant difference or Student t test were used to assess significance (P<0.05). Antioxidant density (mmol TE/100 g) of apple, orange, and grapefruit was 23% to 54% higher than the mean antioxidant density of name-brand and store-brand juices for each fruit; however, only apple and grapefruit exhibited significantly greater (P<0.05) antioxidant density than either of their name-brand or store-brand juices. In contrast, the mean antioxidant density of name-brand grape and pineapple juice was higher than fresh grape or pineapple fruit; however, both fresh grapes and commercial grape juice contained significantly more (P<0.05) antioxidants than store-brand grape juice. Regardless of the convenience of fruit juice, results support the recommendations of the 2010 Dietary Guidelines for Americans for increasing fruit servings in the whole fruit form due to their provision of beneficial antioxidants and fiber with approximately 35% less sugar.     

A Comparison of Fruit and Vegetable Intake Estimates from Three Survey Question Sets to Estimates from 24-Hour Dietary Recall Interviews

BackgroundFruit and vegetable (F/V) intake surveillance can provide information critical to the design and evaluation of interventions and the assessment of progress toward national intake objectives. The CDC’s Youth Risk Behavior Surveillance System (YRBSS) assesses F/V intake among high school students using six questions about the frequency of intake in times per day. It is not known whether F/V intake frequency in times per day can be used as a proxy for intake in servings per day.ObjectiveTo compare F/V intake estimates based on responses to three sets of survey questions, including the standard set of six YRBSS questions, with criterion F/V intake in servings per day based on data from 24-hour dietary recall interviews.Participants/settingStudy participants were 610 high school students who completed an in-class questionnaire and three telephone-administered 24-hour dietary recall interviews. The questionnaire asked students how many times they consumed 100% fruit juice and ate fruit, carrots, potatoes, green salad, and other vegetables during the “past 7 days” (set 1), the number of times they did so “yesterday” (set 2), and the number of cup-equivalents of fruits and vegetables they consumed per day (set 3).Main outcome measureMean estimated F/V intake either as “times/day” or “servings/day” and the percentage of students whose estimated F/V intake was ≥1, ≥2, and ≥3 times/day or servings/day.Statistical analyses performedt tests and corrected Pearson correlations were used to compare F/V intake estimates based on survey question responses with estimates based on responses to the 24-hour dietary recall interviews.ResultsMean F/V intake estimates (in times/day or servings/day) based on responses to all sets of survey questions were significantly more than servings/day estimates based on responses to the 24-hour dietary recall interviews, and the percentages of students meeting each intake cutpoint were also more. Of the three sets of survey questions, the standard YRBSS questions produced estimates and percentages that were most consistently closest to 24-hour dietary recall interview estimates.ConclusionsFor brief self-administered questionnaires of high school students, the current YRBSS questions are recommended for monitoring F/V intake even though mean intake estimates in times/day will likely be higher than, and are not a proxy for, mean intake estimates in servings/day.     

Daily polyphenol intake from fresh fruits in Portugal: contribution from berry fruits

Abstract

Fresh fruits, particularly berries, are rich in polyphenols. These bioactive compounds are important in the prevention of chronic inflammatory diseases. The present study aimed to assess polyphenol intake from fresh fruit in Portugal and the relative contribution of berries to overall intake, using an online semi quantitative food frequency questionnaire. Consumption of processed berry products was also studied. Mean fresh fruit consumption was 365.6?±?8.2?g/day. Berries accounted for 9% of total fresh fruit intake, from which 80% were due to strawberries. Total polyphenol intake from fresh fruits was 783.9?±?31.7?mg of Gallic Acid Equivalents (GAE) per day, from which 14% were from berries. Within berries, strawberries accounted for 11% of total polyphenol intake, with the other consumed berries accounting for 3% of the total polyphenol intake per day. Main reasons reported for relative low consumption of berries were market availability and price. The most consumed processed berry product was yogurt.     

Effect of fruits and vegetables on metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials

Abstract

Evidence regarding the effect of fruit and vegetable consumption on metabolic syndrome remains inconclusive. Using MEDLINE, EMBASE, and Cochrane, we searched for relevant studies published before 10 December 2013. Of the 383 articles identified, eight randomized controlled trials with 396 participants (205 in intervention groups and 191 in control groups) were included in the final analyses. Fruit and vegetable intake was associated with a reduction in diastolic blood pressure (standardized mean difference: ?0.29; 95% confidence interval: ?0.57 to ?0.02; p?=?0.04); however, such intake did not affect waist circumference, systolic blood pressure, fasting glucose, high-density lipoprotein cholesterol, and triglyceride levels in metabolic syndrome patients. In a subgroup analysis, there were no statistically significant differences found according to the intervention period and provision type. Our results suggest an inverse association between fruit and vegetable consumption and diastolic blood pressure in metabolic syndrome patients.     

Reducing Childhood Obesity by Eliminating 100% Fruit Juice

The Healthy Hunger-Free Kids Act of 2010 presents an opportunity to change the nutritional quality of foods served in low-income childcare centers, including Head Start centers.Excessive fruit juice consumption is associated with increased risk for obesity. Moreover, there is recent scientific evidence that sucrose consumption without the corresponding fiber, as is commonly present in fruit juice, is associated with the metabolic syndrome, liver injury, and obesity.Given the increasing risk of obesity among preschool children, we recommend that the US Department of Agriculture’s Child and Adult Food Care Program, which manages the meal patterns in childcare centers such as Head Start, promote the elimination of fruit juice in favor of whole fruit for children.CHILDHOOD OBESITY HAS reached epidemic proportions in the United States. By age four, 18.4% of all children are obese, with a body mass index (BMI; defined as weight in kilograms divided by height in meters squared) in the 95th percentile or greater for age and gender. There is an even greater prevalence among Hispanic (22.0%), American Indian or Alaska Native (31.2%), and non-Hispanic Black children (20.8%) than among non-Hispanic White children.1 Among older children, the greatest increase in the prevalence of obesity has been in those in low-education, -income, and -employment households that have sustained increases from 22% to 33% from 2003 to 2008.2 Per capita daily caloric intake increases in beverages, particularly sugar-sweetened beverages and 100% fruit juices, parallel the surge in childhood obesity in the United States.3 Additionally, studies document the association between excessive consumption of fruit juice and an increased risk for childhood obesity and short stature.4To address the obesity epidemic in children and the simultaneous increase in caloric intake from beverages, the Special Supplemental Program for Women, Infants, and Children changed the food package in 2009 for the high-risk children who the program serves to eliminate fruit juice for infants younger than 12 months and to limit juice consumption to less than four ounces a day for children older than one year.5 In this article, we have argued that the rapid increase in obesity among American children necessitates a more aggressive approach, for example, to limit high caloric beverages such as 100% fruit juice, particularly among young children, who are first developing eating behaviors and practices.A unique opportunity to reshape the eating and drinking habits of high-risk US children presents itself in the forms of the Child Nutrition and WIC Reauthorization Act and the Healthy, Hunger-Free Kids Act.6 The Healthy, Hunger-Free Kids Act is designed to target the nutritional health of high-risk, low-income children younger than five years, including those participating in the Child and Adult Food Care Program (CAFCP), which includes Head Start and other low-income daycare centers. The US Department of Agriculture (USDA) is mandated to develop, as early as fall 2013, updated meal patterns and nutrition standards for CAFCP meals and snacks that reflect current relevant science.7 Additionally, the secretary of agriculture is required to provide nutrition guidance to childcare centers and states by January 1, 2012, to ensure increased consumption of such foods as fresh, canned, and frozen fruits.7We recommend that the CAFCP meal patterns and nutrition standards include the removal of 100% fruit juice from the CAFCP programs to counter increases in fruit juice consumption among US preschool children and in line with recent science that underscores the danger of fructose consumption without concurrent fiber in contributing to childhood obesity. Our recommendations also parallel the act’s mandate that only low-fat milk options be served to children older than two years, that water be made readily available and accessible,7 and that CAFCP programs adhere to the limits placed on 100% fruit juice by professional organizations and institutes in the past 10 years.     

Association between fruit juice consumption and self‐reported body mass index among adult Canadians

Background: The prevalence of obesity and being overweight is rising among adult Canadians and diet is recognised as one of the main causes of obesity. The consumption of fruit and vegetables is shown to be protective against obesity and being overweight but little is known about the association of fruit juice consumption and obesity and being overweight. The present study aimed to investigate the association between fruit juice consumption and self‐reported body mass index (BMI) among adult Canadians. Methods: This analysis is based on the Canadian Community Health Survey, Cycle 3.1. A regression method was used to assess the association of fruit juice consumption with self‐reported BMI in 18–64‐year‐old Canadians who had been adjusted for sex, age, total household income, education, self‐rated health, and daily energy expenditure. Because the analysis is based on a cross‐sectional dataset, it does not imply a cause and effect relationship. Results: Almost 38.6% of adult Canadians reported a fruit juice intake of 0.5–1.4 times per day and 18.2% consumed fruit juice more than 1.5 times per day. Participants with normal weight were likely to consume more fruit juice than obese individuals. Regression analysis showed a negative association between fruit juice consumption and BMI after adjusting for age, sex, education, marital status, income, total fruit and vegetable intake, daily energy expenditure, and self‐rated health. On average, for each daily serving of fruit juice, a ?0.22 unit (95% confidence interval = ?0.33 to ?0.11) decrease in BMI was observed. Conclusions: The results obtained showed a moderate negative association between fruit juice intake and BMI, which may suggest that a moderate daily consumption of fruit juice is associated with normal weight status.     

Knowledge,perceptions, and behaviors of adults concerning nonalcoholic beverages suggest some lack of comprehension related to sugars

Key recommendations in the 2010 Dietary Guidelines for Americans and US Department of Agriculture's MyPlate are to reduce the intake of added sugars, particularly from sugar-sweetened beverages, and drink water instead of “sugary” beverages. However, little is known about consumer knowledge, perceptions, and behaviors regarding sugars in beverages. We hypothesized that consumers would have limited or inaccurate knowledge of the sugars in beverages and that their beverage consumption behaviors would not reflect their primary concerns related to sugars in beverages. An online survey was completed by 3361 adults 18 years and older residing throughout the United States. Water was consumed in the highest amounts followed by (in descending amounts) other beverages (includes coffee and tea), added sugar beverages, milk, diet drinks, and 100% fruit juice and blends. Participants primarily associated the term “sugary” with beverages containing added sugars; however, almost 40% identified 100% fruit juice as sugary. Some participants misidentified the types of sugars in beverages, particularly with respect to milk and 100% fruit juices. Generally, beverage choices were consistent with stated concerns about total, added, or natural sugars; however, less than 40% of participants identified added sugars as a primary concern when choosing beverages despite public health recommendations to reduce the intake of added sugars and sugar-sweetened beverages. Results suggest that there may be a considerable level of consumer misunderstanding or confusion about the types of sugars in beverages. More consumer research and education are needed with the goal of helping consumers make more informed and healthy beverage choices.     

青岛市成年人水果摄入与脑卒中发病关联的前瞻性研究

目的 了解青岛市居民的水果摄入情况,探讨水果摄入与脑卒中发病的关联。方法 利用中国慢性病前瞻性研究项目（CKB）青岛项目点30～79岁调查对象的基线信息和随访获得的脑卒中发病事件,采用Cox比例风险回归模型,评估水果摄入与脑卒中发病风险之间的关联。结果 基线共调查35 509人,男女性别比为1∶1.27,年龄（50.3±10.2）岁。水果摄入频率较高的研究对象更年轻,更多的是女性、文化程度高和家庭收入高的人群（均P<0.05）。本研究随访过程共观察到脑卒中发病事件1 011例,脑卒中发病密度为387.63/10万人年。多因素Cox回归分析结果显示,在调整了相关混杂因素之后,增加水果的摄入频率对脑卒中发病具有保护作用。与几乎不吃水果的研究对象相比,≥4次/周频率组的研究对象脑卒中发病的风险降低了44%（HR=0.56,95% CI：0.50～0.62,P<0.05）,在男性和女性中分别降低了46%（HR=0.54,95% CI：0.46～0.64）和42%（HR=0.58,95% CI：0.52～0.69）（均P<0.05）。进一步调整研究对象的腰围、BMI、SBP和随机血糖,没有改变水果摄入对于脑卒中发病的保护作用。结论 增加水果摄入能降低脑卒中的发病风险,我国居民应增加水果摄入,建立更健康合理的饮食习惯。     

Study on the obesity and nutrition status of housewives in Seoul and Kyunggi area

This study was conducted to evaluate the rate of obesity of 212 women (age 45-60 years) in Seoul and the Kyunggi area through analysis of BMI and the dietary life factors related to obesity using a survey on dietary habits, dietary assessment, and nutrient intake. The height of the underweight group was taller than normal. The height of the obese group was equal to that of the normal group, but the weight was 8.5 kg greater than the normal group. Women in the underweight group consumed meals irregularly, and only 33.4% ate breakfast. Additionally, the rate of overeating was low in the underweight group, and milk, dairy products (yogurt, etc.), fruit, and fruit juice were consumed more than once a day. It was found that 62.1% of the women in the obese group never ate out, and the rate of eating one serving of fruit, drinking one cup of fruit juice, and eating various kinds of foods was high. The average point of women''s dietary life was 21.9 ± 2.9, and 12.7% of all women responded that their dietary life was good. However, in the obese group, only 6.9% of the women reported that their dietary life was good. Evaluation of snacking habits revealed that the underweight group consumed a high level of carbonated drinks and ice cream, whereas for in the obese group, 24.1% of the women consumed milk and its products and 5.6% regularly consumed fast and fried foods. Evaluation of nutrient intake revealed that the consumption of energy, protein, vitamin A, vitamin B₁, B₂, B₆, niacin, vitamin C, and vitamin E was high in all of the groups, but the intake of folic acid in the underweight group was lower than the required level. Overall, 24.1% of the women in the obese group were found to have metabolic diseases, mostly hypertension (43%). In conclusion, a balanced diet to avoid excessive nutrient intake is needed to prevent obesity.     

Fructose content in popular beverages made with and without high-fructose corn syrup

ObjectiveExcess fructose consumption is hypothesized to be associated with risk for metabolic disease. Actual fructose consumption levels are difficult to estimate because of the unlabeled quantity of fructose in beverages. The aims of this study were threefold: 1) re-examine the fructose content in previously tested beverages using two additional assay methods capable of detecting other sugars, especially maltose, 2) compare data across all methods to determine the actual free fructose-to-glucose ratio in beverages made either with or without high-fructose corn syrup (HFCS), and 3) expand the analysis to determine fructose content in commonly consumed juice products.MethodsSugar-sweetened beverages (SSBs) and fruit juice drinks that were either made with or without HFCS were analyzed in separate, independent laboratories via three different methods to determine sugar profiles.ResultsFor SSBs, the three independent laboratory methods showed consistent and reproducible results. In SSBs made with HFCS, fructose constituted 60.6% ± 2.7% of sugar content. In juices sweetened with HFCS, fructose accounted for 52.1% ± 5.9% of sugar content, although in some juices made from 100% fruit, fructose concentration reached 65.35 g/L accounting for 67% of sugars.ConclusionOur results provide evidence of higher than expected amounts of free fructose in some beverages. Popular beverages made with HFCS have a fructose-to-glucose ratio of approximately 60:40, and thus contain 50% more fructose than glucose. Some pure fruit juices have twice as much fructose as glucose. These findings suggest that beverages made with HFCS and some juices have a sugar profile very different than sucrose, in which amounts of fructose and glucose are equivalent. Current dietary analyses may underestimate actual fructose consumption.     

Consumption patterns of sweet drinks in a population of Australian children and adolescents (2003--2008)

ABSTRACT: BACKGROUND: Intake of sweet drinks has previously been associated with the development of overweight and obesity among children and adolescents. The present study aimed to assess the consumption pattern of sweet drinks in a population of children and adolescents in Victoria, Australia. METHODS: Data on 1,604 children and adolescents (4--18 years) from the comparison groups of two quasi-experimental intervention studies from Victoria, Australia were analysed. Sweet drink consumption (soft drink and fruit juice/cordial) was assessed as one day's intake and typical intake over the last week or month at two time points between 2003 and 2008 (mean time between measurement: 2.2 years). RESULTS: Assessed using dietary recalls, more than 70% of the children and adolescents consumed sweet drinks, with no difference between age groups (p = 0.28). The median intake among consumers was 500 ml and almost a third consumed more than 750 ml per day. More children and adolescents consumed fruit juice/cordial (69%) than soft drink (33%) (p < 0.0001) and in larger volumes (median intake fruit juice/cordial: 500 ml and soft drink: 375 ml). Secular changes in sweet drink consumption were observed with a lower proportion of children and adolescents consuming sweet drinks at time 2 compared to time 1 (significant for age group 8 to <10 years, p = 0.001). CONCLUSION: The proportion of Australian children and adolescents from the state of Victoria consuming sweet drinks has been stable or decreasing, although a high proportion of this sample consumed sweet drinks, especially fruit juice/cordial at both time points.     

The Effect of Smoking and Sex on the Association Between Long-term Alcohol Consumption and Metabolic Syndrome in a Middle-aged and Older Population

BackgroundThe effect of smoking and sex on the relationship between alcohol consumption and risk of developing metabolic syndrome (MetS) and its components has not been investigated.MethodsA total of 5,629 Korean adults aged 40–69 years without MetS were recruited at baseline. Alcohol consumption was assessed biennially, and participants were classified as never, light, moderate, or heavy drinkers. Smoking status was examined at baseline and categorized into non-smokers and current smokers. Risk of incident MetS and its components according to alcohol consumption was examined by smoking status and sex using a multivariate Cox proportional hazards model.ResultsDuring a follow-up of 12 years, 2,336 participants (41.5%) developed MetS. In non-smokers, light or moderate alcohol drinkers had a lower risk of developing MetS, abdominal obesity, hyperglycemia, hypertriglyceridemia, and low HDL-C compared with never drinkers. Heavy alcohol consumption was associated with a higher risk of incident elevated blood pressure (hazard ratio [HR] 1.48; 95% confidence interval [CI], 1.07–2.06; P = 0.020) in men and abdominal obesity (HR 1.86; 95% CI, 1.06–3.27; P = 0.030) in women. However, in smokers, the inverse association of light or moderate alcohol consumption with hypertriglyceridemia and abdominal obesity was not present, whereas a positive association between heavy alcohol consumption and hyperglycemia (HR 1.39; 95% CI, 1.07–1.80; P = 0.014) was observed.ConclusionsSmoking status and sex strongly affects the association between long-term alcohol consumption and MetS and its components by the amount of alcohol consumed.Key words: long-term alcohol consumption, metabolic syndrome, smoking status, hypertriglyceridemia, prospective study     

Adolescent Consumption of Sports and Energy Drinks: Linkages to Higher Physical Activity,Unhealthy Beverage Patterns,Cigarette Smoking,and Screen Media Use

ObjectiveTo examine patterns of adolescent sports and energy drink (SED) consumption and identify behavioral correlates.DesignData were drawn from Eating and Activity in Teens, a population-based study.SettingAdolescents from 20 middle and high schools in Minneapolis/St Paul, MN completed classroom-administered surveys.ParticipantsA total of 2,793 adolescents (53.2% girls) in grades 6–12.Variables MeasuredBeverage patterns; breakfast frequency; moderate to vigorous physical activity (MVPA); media use; sleep; and cigarette smoking.AnalysisLinear and logistic regression models were used to estimate associations between health behaviors and SED consumption, adjusting for demographics.ResultsOver a third of adolescents consumed sports drinks and 14.7% consumed energy drinks at least once a week. Among boys and girls, both sports and energy drink consumption were related to higher video game use; sugar-sweetened beverage and fruit juice intake; and smoking (P < .05). Sports drink consumption was also significantly related to higher MVPA and organized sport participation for both genders (P < .01).Conclusions and ImplicationsAlthough sports drink consumption was associated with higher MVPA, adolescents should be reminded of recommendations to consume these beverages only after vigorous, prolonged activity. There is also a need for future interventions designed to reduce SED consumption, to address the clustering of unhealthy behaviors.     

Do perceptions of the neighbourhood food environment predict fruit and vegetable intake in low-income neighbourhoods?

The aim of this study is to investigate the extent to which perceptions of the quality, variety and affordability of local food retail provision predict fruit and vegetable intake. Secondary analysis of baseline data from the Philadelphia Neighbourhood Food Environment Study was undertaken. This study investigating the role of the neighbourhood food environment on diet and obesity comprised a random sample of households from two low-income Philadelphia neighbourhoods, matched on socio-demographic characteristics and food environment. The analytic sample comprised adult men and women aged 18–92 (n=1263). Perception of the food environment was measured using five related dimensions pertaining to quality, choice and expense of local food outlets and locally available fruits and vegetables. The outcome, portions of fruits and vegetables consumed per day, was measured using the Block Food Frequency Questionnaire. Results from multivariate regression analyses suggest that measured dimensions of perceived neighbourhood food environment did not predict fruit and vegetable consumption. Further investigation of what constitutes an individual′s ‘true’ food retail environment is required.     

Intuitive Eating is Associated With Higher Fruit and Vegetable Intake Among Adults

ObjectiveAssess how intuitive eating relates to dietary intake.MethodsSurvey data were collected in Project Eating and Activity in Teens and Young Adults, the fourth wave of a longitudinal cohort study (weighted n = 1,830, 49% women; mean age = 31 years). Intuitive eating was assessed using a 7-item scale adapted from the Intuitive Eating Scale and Intuitive Eating Scale-2. Dietary intake was measured via a semiquantitative food frequency questionnaire. Mean servings were stratified by gender and intuitive eating quartiles and adjusted for sociodemographic characteristics and caloric intake.ResultsWomen and men in the top intuitive eating quartile consumed 0.6–0.3 servings more fruit and 0.4–0.6 servings more vegetables daily, respectively, compared with the bottom quartile, whereas men in the top quartile also consumed 0.6 servings fewer whole grains (all P < 0.05) than the bottom quartile.Conclusions and ImplicationsIntuitive eating shows promise as a healthier alternative to practices such as dieting.