Price Trends of Healthy and Less Healthy Foods and Beverages in Mexico from 2011–2018

BackgroundCost is one of the main drivers of food selection; thus it is important to monitor food prices. Evidence from low- and middle-income countries such as Mexico is limited.ObjectiveThe aim of this study was to evaluate the prices and price trends of healthy and less healthy food/beverage groups in Mexico from 2011 to 2018.DesignThis study used a time series of the prices of foods and beverages classified by 1) healthiness, 2) processing level, and 3) pairs of healthy/less healthy substitutes.SettingFood and beverage prices used to estimate the Consumer Price Index were obtained. Prices were collected weekly from 46 cities (>20,000 habitants) distributed across the country.Main outcome measuresPrice trend (% change/year) from 2011 to 2018 for all food/beverage groups and price/100 g in 2018 for pairs of healthy/less healthy substitutes were obtained.Statistical analysesLinear regression models were used for each food/beverage group, with the logarithm of deflated price as the dependent variable and time (years) as the independent variable.ResultsOn average, prices for less healthy foods and beverages increased more than prices of healthy foods and beverages (foods: 1.72% vs 0.70% change/year; beverages: 1.61% vs ?0.19% change/year). The price change was similar for unprocessed/minimally processed foods and ultraprocessed foods (1.95% vs 1.85% change/year); however, within each processing category, the price of less healthy foods increased more. By pairs of substitutes (within food/beverage groups), the healthier option for bread, sodas, and poultry was more expensive (price/100 g) in 2018, whereas for red meat, cheese, mayonnaise, and milk, the healthier option was cheaper.ConclusionsOverall, the food prices of less healthy foods and beverages increased more than the food prices of healthy foods and beverages. However, by processing level there was no difference, and for pairs of healthy/less healthy substitutes results were mixed. Continued monitoring of food prices is warranted, and future research is needed to understand how these price changes affect dietary quality.     

Demographic and financial characteristics of school districts with low and high à la Carte sales in rural Kansas Public Schools

Reducing à la carte items in schools—foods and beverages sold outside the reimbursable meals program—can have important implications for childhood obesity. However, schools are reluctant to reduce à la carte offerings because of the impact these changes could have on revenue. Some foodservice programs operate with limited à la carte sales, but little is known about these programs. This secondary data analysis compared rural and urban/suburban school districts with low and high à la carte sales. Foodservice financial records (2007-2008) were obtained from the Kansas State Department of Education for all public K-12 school districts (n=302). χ² and t tests were used to examine the independent association of variables to à la carte sales. A multivariate model was then constructed of the factors most strongly associated with low à la carte sales. In rural districts with low à la carte sales, lunch prices and participation were higher, lunch costs and à la carte quality were lower, and fewer free/reduced price lunches were served compared to rural districts with high à la carte sales. Lunch price (odds ratio=1.2; 95% confidence interval, 1.1 to 1.4) and free/reduced price lunch participation (odds ratio=3.0; 95% confidence interval, 1.0 to 9.8) remained in the multivariate model predicting low à la carte sales. No differences were found between urban/suburban districts with low and high à la carte sales. Findings highlight important factors to maintaining low à la carte sales. Schools should consider raising lunch prices and increasing meal participation rates as two potential strategies for reducing the sale of à la carte items without compromising foodservice revenue.     

Healthfulness,Modernity, and Availability of Food and Beverages: Adolescents’ Perceptions in Southern India

This study uses freelists to document perceptions of healthfulness, modernity, and availability of foods and beverages among adolescents ages 13–18 years (n = 26) in urbanizing India. Among the 10 foods and beverages adolescents perceived as “new,” half were also seen as modern and unhealthy, 4 as traditional and unhealthy, and 3 as modern and healthy. Of those 10 “new” foods, 4 were reported as available only in supermarkets, 4 only in kiraana (local) stores, and 6 in both. Adolescents ascribed healthfulness and modernity to food and beverage items and were aware of their availability across stores.     

Consumption of Stearidonic Acid−Rich Oil in Foods Increases Red Blood Cell Eicosapentaenoic Acid

BackgroundConsumption of soybean oil enriched with stearidonic acid was previously shown to increase eicosapentaenoic acid (EPA) in red blood cells (RBC).ObjectiveThis study was designed to evaluate the effect of stearidonic acid oil used as a food ingredient in baked products and beverages on the RBC fatty acid profile.DesignThis was a randomized, double-blind, controlled, parallel-arm study.ParticipantsHealthy men and women 21 to 65 years of age were included.InterventionParticipants consumed either negative control (1.5 g/day high-oleic sunflower ethyl ester oil softgel capsules+foods containing 7 g/day high-oleic sunflower oil), positive control (1.5 g/day EPA oil ethyl ester softgel capsules+foods containing 7 g/day high-oleic sunflower oil), or active (1.5 g/day high-oleic sunflower ethyl ester oil softgel capsules+foods containing 7 g/day stearidonic acid soybean oil) for 12 weeks.Main outcome measuresRBC membrane fatty acid profile (at weeks 0, 2, 4, 6, 8, 10, and 12); fasting serum lipids (weeks ?2, 0, 6, 10, and 12); and fasting plasma glucose and insulin (weeks ?2, 0, 10, and 12) were assessed.Statistical analyses performedA repeated measures analysis of covariance was used for continuous variables, and pair-wise comparisons between treatments were adjusted using a step-down Bonferroni method. Fisher’s exact or χ² tests were used for categorical data.ResultsRBC %EPA throughout the 12-week study were significantly different between all groups. Means at 12 weeks were 0.50%±0.03%, 2.17%±0.21%, and 0.85%±0.05% for control, EPA, and stearidonic acid, respectively. Other efficacy outcome measures were not significantly different among treatment groups.ConclusionsConsumption of stearidonic acid-enriched soybean oil incorporated into common foods increased RBC %EPA in healthy men and women. Stearidonic acid soybean oil, a sustainable and accessible source of long-chain n-3, can effectively be used to increase EPA in RBC.     

Are Food Advertisements Promoting More Unhealthy Foods and Beverages over Time? Evidence from Three Swedish Food Magazines, 1995–2014

Unhealthy food in advertising has been suggested as a mediator for the increase in diet-related illness. This study quantitatively investigates changes in food advertising between 1995 and 2014 in terms of food categories promoted, macronutrient content, and percentage of foods classified as heathy or unhealthy from a sample of 7,199 ads from three Swedish food magazines. With the exception of increased alcoholic beverage and decreased carbohydrate-rich-food promotion, no monotonic trends of increasingly unhealthy food advertisement are found. From these findings, it is argued that food magazine advertising is not a mediator of the adverse dietary trend.     

Consumption of fish and Alzheimer’s Disease

Alzheimer’s Disease (AD) has been described as ‘one of the most disabling and burdensome health conditions worldwide’ and is responsible for approximately 70% of dementia in the elderly. Based on the current prevalence of AD, an aging world population and the associated projected health care requirements, it is estimated that by 2050, the prevalence of AD will reach 104 million with around 43% requiring ongoing health care. If the onset of AD can be reduced by as little as one year, the prevalence could be reduced by 10%. There is substantial commonality in research findings to date around the positive influence of seafood consumption in reducing the risk of dementia and AD. Emerging concern about the sustainability of global fisheries supports the recommendation of selective consumption of sustainable wild caught and increased emphasis on production of farmed fish supplies to meet consumption needs.     

Exploring Mothers’ Perspectives About Why Grandparents in Appalachia Give Their Grandchildren Cariogenic Foods and Beverages: A Qualitative Study

BackgroundDental caries is the most common chronic childhood disease. Past studies revealed that grandparents provide their grandchildren with cariogenic foods and beverages (eg, those with free sugars and/or modified starches). Qualitative research can help identify what drives this phenomenon.ObjectiveOur aim was to examine mothers’ explanations for why grandparents in north central and central Appalachia give their grandchildren cariogenic foods and beverages.DesignA qualitative study on children’s oral health in Pennsylvania and West Virginia from 2018 through 2020 was performed. In-person, semi-structured interviews were conducted. Qualitative data from interviews were recorded, transcribed, and then coded using NVivo. Data analysis for this study was performed using thematic analysis with iterative theme development.Participants/settingThe participants were 126 mothers of children aged 3-5 years from West Virginia (n = 66) and Pittsburgh, PA (n = 60).Main outcome measuresMothers’ perspectives about why grandparents give their grandchildren cariogenic foods and beverages were analyzed.ResultsIn the study sample, 85% of mothers (n = 107/126) named at least 1 of their children’s grandparents as a member of their social network responsible for their children’s oral health. From these interviews, 85% of mothers (n = 91/107) discussed that grandparents gave their grandchildren cariogenic foods and beverages. The mothers described the following 4 themes to explain why grandparents gave their grandchildren cariogenic foods and beverages: privilege of the grandparent role; responsibilities of the grandparent role; symbol of care and affection; and limited consideration or understanding of the detrimental impact.ConclusionsGrandparents play a role in giving their grandchildren cariogenic foods and beverages, which could potentially contribute to childhood caries. Research is needed to develop effective social interventions to help some grandparents understand the implications of a cariogenic diet on their grandchildren’s oral health and/or decrease their provision of cariogenic foods and beverages.     

Do Emotional Appeals in Public Service Advertisements Influence Adolescents’ Intention to Reduce Consumption of Sugar-Sweetened Beverages?

Mass media campaigns are a commonly used approach to reduce sugary drink consumption, which is linked to obesity in children and adolescents. The present study investigated the direct and mediated effects of emotional appeals in public service advertisements (PSAs) that aired between 2010 and 2012 on adolescents’ intention to reduce their sugar-sweetened beverage (SSB) consumption. An online randomized experiment was conducted with a national sample of adolescent respondents ages 13 to 17 years old (N = 805). Participants were randomly assigned to 1 of 4 conditions. Three experimental conditions represented PSAs with different emotional appeals: humor, fear, and nurturance, plus a fourth control condition. The outcome was adolescents’ intention to cut back on SSBs. The direct effect of fear appeals on intention was mediated through adolescents’ perception of the PSAs’ argument strength; perceived argument strength was also the key mediator for the indirect effects of humor and nurturance on intention. Several hypothesized mediators influenced by the appeals were not associated with intention. This is the first study to test the effect of persuasive emotional appeals used in SSB-related PSAs. The perceived strength of the PSAs’ arguments is important to consider in the communication of messages designed to reduce SSB consumption.     

Fruits, vegetables, milk, and sweetened beverages consumption and access to à la carte/snack bar meals at school

OBJECTIVES: We assessed the impact of access to school snack bars on middle school students' fruit, vegetable, milk, and sweetened beverage consumption. METHODS: Five hundred ninety-four fourth- and fifth-grade students completed lunch food records 4 times during a 2-year period. RESULTS: The fourth-grade cohort consumed fewer fruits, regular (not fried) vegetables, and less milk and consumed more sweetened beverages and high-fat vegetables during year 2. CONCLUSIONS: Middle school students who gained access to school snack bars consumed fewer healthy foods compared with the previous school year, when they were in elementary schools and only had access to lunch meals served at school. Healthy food choices and school policies that require healthier foods at school snack bars should be promoted.     

Peer Reviewed: Strategies of Asian,Hispanic, and Non-Hispanic White Parents to Influence Young Adolescents’ Intake of Calcium-Rich Foods, 2004 and 2005

Introduction

Optimal intake of dietary calcium is critical to prevent osteoporosis later in life, yet most young adolescents do not consume the recommended amount. We describe parental strategies that can influence young adolescents'' calcium intake in Asian, Hispanic, and non-Hispanic white households.

Methods

A qualitative research design employed semistructured individual interviews with a convenience sample of mostly female parents self-reported as Asian (n = 48), Hispanic (n = 44), or non-Hispanic white (n = 76) having a child aged 10 to 13 years at home. Interviews were conducted in homes or community centers in 12 states. Interview data were analyzed by using qualitative data analysis software and thematic content analysis procedures.

Results

Parents monitored calcium intake by making calcium-rich foods available, preparing calcium-rich foods, and setting expectations that children would consume calcium-rich foods. As mentors, parents encouraged intake of calcium-rich foods and advised children to moderate or increase intake of specific foods. Although parents perceived modeling of calcium intake as important, some were ambivalent about its effects. We noted minimal differences by racial/ethnic groups and sex of children in reported availability of selected calcium-rich foods at home, parental modeling of intake, and mentoring behaviors.

Conclusion

Our findings suggest that interventions to help parents increase children''s intake of calcium should focus on types of foods made available, giving age-appropriate encouragement and advice, and modeling proper intake.     

Total,Free, and Added Sugar Consumption and Adherence to Guidelines: The Dutch National Food Consumption Survey 2007–2010

A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7–69 years) from the Dutch National Food Consumption Survey 2007–2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE), free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake <10 %TE was 5% in boys and girls (7–18 years), 29% in women, and 33% in men. Overall diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of <5 %TE and <10 %TE was generally low in the Netherlands, particularly in children. Adherence to the added and free sugar guidelines was not strongly associated with higher diet quality in adults.     

Are High-Fat,High-Sugar Foods and Diets Conducive to Obesity?

Restriction of both dietary fat and extrinsic sugars is standard advice for weight reduction. It has been suggested that foods, and diets, that combine high levels of sugars and fat particularly contribute to overconsumption. Weighed dietary data on 1087 men and 1110 women aged 16-64 who took part in the Dietary and Nutritional Survey of British Adults were examined for evidence of this hypothesis. Consumption of the main sugary fatty foods (cakes, biscuits, confectionery and puddings) averaged 12% of energy for men, 14.9% for women. Intake of these foods (as a proportion of total energy) was inversely related to BMI (adjusted for age and smoking). After exclusion of the substantial number who were dieting or unwell or who may have under-reported their intakes, the association remained significant only in men. Consumption of sugary fatty foods showed a positive association with intakes of fibre, a negative association with vegetables and no relationship with percentage of energy from fat. For the investigation of diet composition, men and women were divided into four groups, high or low in extrinsic sugars energy (cut point 15%) and fat energy (cut point 40%). For men consuming high fat diets (>40% energy) mean BMI was higher in the low sugar group. After exclusion of dieters and unwell, men with low sugar intakes still had a higher mean BMI than men with high sugar intakes. BMI and extrinsic sugars energy were still negatively but weakly correlated (r = -0.10; P < 0.05) after adjusting for age, smoking, energy, fat intake, and dieting/under-reporting. In conclusion, there is little evidence in this cross-sectional survey that either sugary fatty foods, or diets high in sugars, are associated with obesity. Rather, sugars appear to have a weak negative association with BMI that is not totally explained by confounders such as dieting, under-reporting or the inverse correlation between energy from sugars and fat.     

Hair Mercury and Fish Consumption in Residents of O‘ahu,Hawai‘i

Recent studies have established that men are susceptible to cardiotoxicity from methylmercury exposure, which also poses risks to the pregnant woman. Hair samples were obtained and questionnaires for methylmercury exposure assessment were administered to 110 adults (57 men, 53 women) throughout O‘ahu, Hawai‘i during December 2010 to January 2011. Hair samples were analyzed for total mercury with a direct mercury analyzer. Men ≥ 46 years had a median of 2.0 µg/g, which was above the reference dose of 1 µg/g, as compared to younger men with a median 1.0 µg/g (P < 0.05). Hair concentrations from older women had a median of 1.2 µg/g of mercury compared to 0.6 µg/g for younger women. Additionally, 38% of women of childbearing age had a Hazard Index > 1.0. This indicates that both men and women were at risk for excessive methylmercury exposure. In the final regression model, male gender, age > 45 years, length of residency > 10 years in Hawai‘i, and fish consumption frequency > 1 meal per week were significant factors in increased hair mercury levels. Following safe fish consumption practices allows residents to reap health benefits of fish consumption without excessive toxicant exposure.     

Foods, fortificants, and supplements: Where do Americans get their nutrients?

Limited data are available on the source of usual nutrient intakes in the United States. This analysis aimed to assess contributions of micronutrients to usual intakes derived from all sources (naturally occurring, fortified and enriched, and dietary supplements) and to compare usual intakes to the Dietary Reference Intake for U.S. residents aged ≥2 y according to NHANES 2003-2006 (n = 16,110). We used the National Cancer Institute method to assess usual intakes of 19 micronutrients by source. Only a small percentage of the population had total usual intakes (from dietary intakes and supplements) below the estimated average requirement (EAR) for the following: vitamin B-6 (8%), folate (8%), zinc (8%), thiamin, riboflavin, niacin, vitamin B-12, phosphorus, iron, copper, and selenium (<6% for all). However, more of the population had total usual intakes below the EAR for vitamins A, C, D, and E (34, 25, 70, and 60%, respectively), calcium (38%), and magnesium (45%). Only 3 and 35% had total usual intakes of potassium and vitamin K, respectively, greater than the adequate intake. Enrichment and/or fortification largely contributed to intakes of vitamins A, C, and D, thiamin, iron, and folate. Dietary supplements further reduced the percentage of the population consuming less than the EAR for all nutrients. The percentage of the population with total intakes greater than the tolerable upper intake level (UL) was very low for most nutrients, whereas 10.3 and 8.4% of the population had intakes greater than the UL for niacin and zinc, respectively. Without enrichment and/or fortification and supplementation, many Americans did not achieve the recommended micronutrient intake levels set forth in the Dietary Reference Intake.     

The Reciprocal Relation Between Adolescents’ School Engagement and Alcohol Consumption,and the Role of Parental Support

While school engagement and the use of alcohol are subject to change during the course of adolescence, studies have shown that being engaged in school equates with a later onset of alcohol consumption. Cross-sectional studies also indicate that alcohol use correlates to school engagement, but the reciprocal nature of these factors has never been investigated. This study examines the reciprocal relation between school engagement and alcohol consumption during adolescence. Further, the moderating effect of perceived parental support in this reciprocal relation between school engagement and alcohol consumption is tested. Data were obtained from Dutch high school students (n?=?906, 52.5 % boys, mean age?=?12.19 years) who annually completed a digital questionnaire over 4 years (age 12 to 15). A cross-lagged autoregressive model was applied in AMOS. Results showed that more school engagement at ages 12 and 14 predicted lower levels of alcohol use 1 year later. In addition, more alcohol consumption at ages 12 and 14 predicted lower levels of school engagement 1 year later. Higher school engagement at age 13 predicted less alcohol use at age 14, whereas no significant effect of alcohol use on school engagement was found at this age period. Furthermore, a reciprocal relation was found only for adolescents who perceived high parental support. The reciprocal nature of school engagement and alcohol consumption should be a consideration in future research and prevention program development.     

From Promotion to Cessation: Masculinity,Race, and Style in the Consumption of Cigarettes, 1962–1972

In the United States, analysis of survey data provided by projects such as the National Health Interview Survey and the Youth Tobacco Survey has revealed the extent to which cigarette consumption patterns are influenced by gender and race. Taking our lead from a broader field of research that analyzed the sociological characteristics of cigarette consumption, we analyzed these intersections between race and gender through a study of masculinity and style in Marlboro and Kool cigarette advertisements during the 1960s and 1970s. We focused on this period because it was then that the racial bifurcation of cigarette consumption practices first became apparent. We suggest that style provides both a theoretical framework and methodology for understanding how and why White American and African American male consumers learned to consume in different ways. We also argue that the analysis of tobacco consumption in terms of masculinity and style provides a useful method for approaching the design of antismoking interventions.IN THE UNITED STATES, analysis of survey data provided by projects such as the National Health Interview Survey1 and the Youth Tobacco Survey2 has revealed the extent to which cigarette consumption patterns are influenced by gender and race. A gender-based analysis showed that smoking levels are approximately 24% higher for men than for women.3 A race-based analysis revealed radical differences in the types of cigarettes consumed: White Americans, particularly White youths (i.e., middle-school and high-school students), smoked Marlboro cigarettes at nearly six times the rate of their African American counterparts, whereas young African American students smoked menthol cigarettes at four and a half times the rate of White students.4We examined the rise of these different patterns of tobacco consumption among men, with young White American men smoking Marlboros and young African American men smoking menthol cigarettes. We examined these different patterns through a study of the promotion of Marlboro and Kool cigarettes during the 1960s. We included a focus on the work of product designers, advertising agencies, and marketing and market research professionals who sought to shape the meaning of smoking. We discuss a range of different media used in the advertising of these cigarettes, including African American radio in the case of Kools and lifestyle accessories in the case of Marlboro. Our emphasis on advertising reflects the fact that smoking is a social phenomenon as well as an addiction5 and that it is “largely propelled by mass media.”6 We chose to concentrate on the 1960s because it was then that the racial bifurcation of cigarette consumption practices first became apparent.7This focus on men’s smoking and, in particular, on the differences between men represents a conceptual and theoretical challenge. As scholars have argued, men’s smoking is often understood as an affirmation of a socially significant distinction between the invulnerability and utility of the male body and the idea that the need to care for one’s health is feminine (and effeminate).8 This distinction reinforces basic beliefs regarding differences between the male and female body and works, in the words of R. W. Connell, to “guarantee … the dominant position of men and the subordinate position of women.”9 The focus on the differences between men is significant because it suggests that masculinity is a plural and unsettled category.10 It therefore disrupts the notion of a clear or singular distinction between the male and female body.We used Pierre Bourdieu’s Distinction: A Social Critique of the Judgment of Taste to examine the rise of these different patterns of tobacco consumption between men. We proceeded to analyze the way in which tobacco promotions associated with Marlboro and Kool cigarettes targeted and distinguished between White American men and African American men. Most important in this respect is Bourdieu’s notion of style. Style is important because it encapsulates an attention to the details and processes of decision-making and identity formation that have not always been considered in the context of masculinity.11 As Bourdieu defines it, style is a “mode of representation expressing the mode of perception and thought that is proper to a period, a class or a class fraction, a group of artists or an artist.”12 Jack Babuscio makes a similar point when he emphasizes the specificity of style. He writes, “Style is never natural, always acquired … it signifies performance rather than existence.”13 That is, an emphasis on style foregrounds the fact that masculinity is a social “accomplishment” that “requires labor,”14 rather than a natural15 or self-evident16 phenomenon that “has no history”17 or that is universally recognized by all people all the time. An emphasis on style shifts the definition of masculinity away from the realm of the natural, the timeless, and the essential into domains that are much less stable.As well as a theoretical framework, Bourdieu’s concept of style provides a methodology for analyzing and understanding representations of tobacco use in the mass media. Style is particularly important in terms of its focus on the capacity of seemingly small acts and gestures to say a lot about not only aesthetics but also individual identity, social and cultural contexts, and politics. Particularly relevant in this regard is Bourdieu’s notion of “bodily hexis,” which pays attention to questions about clothing, hair, food, music, manners of speech, and bodily language (stance, gait, method of greeting). Bourdieu’s notion of style requires us to consider the way in which smoking is invested with meaning as part of a range of actions and gestures that together make up a particular mode or mood.18This analysis of the differences between men with respect to cigarette consumption reinforces the findings of a number of major reviews that have emphasized the importance of a multifaceted approach to tobacco control,19 in which broad-based or communitywide programs designed to decrease initiation or increase cessation (such as excise taxes and health warnings)20 need to be combined with targeted interventions,21 including “motivational interviewing” and other person-centered approaches22 that “[pay] attention to diversity,”23 “derive a greater understanding of cultural differences,”24 “resonate with the target population,”25 and also reflect the targeted nature of tobacco advertising itself. In addition, as stated in a US National Cancer Institute report, “We will not remove tobacco from our society unless we are willing to understand the industry’s constantly changing tactics.”26