The national school lunch and competitive food offerings and purchasing behaviors of high school students

BACKGROUND: Across the nation, schools have become actively involved in developing obesity prevention strategies both in classrooms and in cafeterias. We sought to determine the type of foods being offered during lunch in the cafeteria of 3 public high schools in 1 county and if this reflects the purchasing patterns of students. By labeling foods based on nutrient density using a stoplight approach of green, yellow, and red colors, we were able to categorize all foods including the National School Lunch Program (NSLP) and competitive foods available in the cafeteria. METHODS: Over a 4-week cycle, daily food purchases were gathered and the proportions of green, yellow, and red foods offered and purchased was compared. RESULTS: Findings from this study suggest that students in these 3 high schools purchased foods in relative proportion to what was available in the school cafeteria for the NSLP. Green and yellow foods included in the NSLP comprised 77% of the offerings and 73% of the purchases. In contrast, 61% of the competitive foods were classified as red foods, and the purchasing of red foods made up 83% of competitive food sales. These results indicate that students purchase foods of minimal nutritional value at greater proportions in the school cafeteria. CONCLUSIONS: These results suggest that the nutritional policy for the NSLP promotes the offerings of a wide array of foods. Schools should consider a nutrition policy that regulates the sale of competitive foods.     

Association between Body Mass Index and Sensory Processing in Childhood: InProS Study

We assessed the association between body mass index (BMI) and sensory processing in 445 Spanish children aged 3–7 from the InProS project. Child sensory processing was measured using the short sensory profile (SSP); an atypical sensory performance was defined as an SSP total score <155 and scores of tactile sensitivity <30; taste/smell sensitivity <15; movement sensitivity <13; under-responsive/seeks sensation <27; auditory filtering <23; low energy/weak <26; and visual/auditory sensitivity <19. The BMI was calculated according to the cutoffs by the World Health Organization for children aged 0–5 and 5–19 years. We used multiple Poisson regression models with robust variance to obtain prevalence ratios (PR). No associations between children’s overweight and obesity and the prevalence of atypical sensory outcomes were observed. A one-point increase in BMI was significantly associated with a higher prevalence of atypical tactile sensitivity (PR = 1.07, 95% CI: 1.02; 1.12). A statistically marginal association was also observed for atypical total SSP (PR = 1.03, 95% CI: 1.00; 1.07) and atypical movement sensitivity (PR = 1.05, 95% CI: 1.00; 1.10). To our knowledge, this is the first time the association between children’s BMI and sensory processing has been reported. Our findings suggest that sensory processing issues may play a part in the complex context of childhood obesity. Further research is required to confirm these findings.     

Bidirectional Associations between Restrained Eating and Body Mass Index in Middle Childhood

The nature of the association between dietary restraint and weight has been examined in adult samples, but much less is known about this relationship among children. The current study examined the transactional associations among restrained eating behavior and weight among boys and girls during middle childhood. Data for this study came from 263 children participating in the Families and Schools for Health Project (FiSH), a longitudinal study of the psychosocial correlates of childhood obesity. Participants were interviewed by trained researchers in their third- and fourth-grade year when they completed questionnaires and anthropometric assessments. Dietary restraint was assessed using the restrained eating subscale of the Dutch Eating Behavior Questionnaire (DEBQ), and weight was assessed using Body Mass Index z-scores (BMIz). Bidirectional associations between variables were examined using cross-lagged models controlling for children’s sex, ethnicity, and weight in first grade. Results indicated that weight in grade 3 was related to greater dietary restraint in grade 4 (B = 0.20, p = 0.001), but dietary restraint in grade 3 was not associated with weight in grade 4 (B = 0.01, p = 0.64). Neither child sex nor race/ethnicity were associated with BMIz or dietary restraint at either time point. Findings from this study advance the existing limited understanding of eating behavior development among children and show that weight predicts increases in children’s dietary restraint in middle childhood.     

The Association between Television Viewing and Preschool Child Body Mass Index

This paper is a conceptual and methodological review of the literature on the impact of TV on preschoolers' weight status. A systematic search, of papers published between January 1995 and January 2010, identified twenty-six relevant studies. Fifteen of these were cross-sectional in design and eleven adopted a prospective design; a positive association between hours of TV and child adiposity was found in all but three studies. Although assessed in a limited number of studies, diet may mediate the relationship between TV viewing and BMI. Another likely mediator may be the content of TV programs watched; only three studies examined this association and findings were inconsistent. Our review revealed that research examining mediating effects is limited, focusing more on simple cross-sectional or prospective relationships between TV habits and child body mass index. Further investigation of the mechanisms by which TV viewing affects preschool weight gain is needed.     

Relationship Between Triglyceride Tolerance,Body Mass Index,and Fat Depots in Hospitalized Patients Receiving Parenteral Nutrition

Background: Hypertriglyceridemia has been associated with adverse outcomes in patients receiving intravenous fat emulsions (IVFEs), but little is known about its prevalence and causes. Materials and Methods: The study investigated whether a relationship exists between body mass index (BMI) and triglyceride tolerance in parenterally fed patients. We conducted a retrospective analysis of 287 adults receiving parenteral nutrition to determine whether patients with very low BMI (VLBMI, <16 kg/m²) tolerate IVFEs better than do patients with low BMI (LBMI, 16–18.4 kg/m²), normal‐weight patients (NBMI, 18.5–24.9 kg/m²), and overweight/obese patients (HBMI, ≥25 kg/m²). Results: The median triglyceride concentration during IVFE was significantly lower in VLBMI patients at 107 mg/dL compared with 124 mg/dL in non‐VLBMI patients (P = .016), despite higher lipid infusion rates in the VLBMI group. There was a significant association between triglycerides and BMI in the aggregate cohort (R = 0.2375, P < .0001), with the highest frequency of hypertriglyceridemia occurring in HBMI patients despite relatively lower lipid and energy supply. In a subset of VLBMI patients (n = 36) who had an abdominal computed tomography scan, there was 25‐ to 100‐fold variability in the size of the abdominal adipose tissue depots. In this subgroup, triglyceride concentrations correlated with visceral fat but not subcutaneous abdominal fat. Conclusions: In summary, patients with VLBMI have lower triglyceride concentrations during IVFEs than do other individuals, but there is considerable variability in triglycerides and body fat in this group. Caution should be employed with the use of IVFEs, especially in HBMI patients.     

Student Involvement in Wellness Policies: A Study of Pennsylvania Local Education Agencies

ObjectiveExplore student-involvement goals in local wellness policies (LWPs) of local education agencies (LEAs) in Pennsylvania (PA) and investigate associations with LEA characteristics.DesignAn observational study that helped examine student-involvement goals.SettingPublic PA LEAs.ParticipantsLWPs submitted by 539 PA public LEAs.Main Outcome MeasuresSix student-involvement goals analyzed as dependent variables. Correlations between demographic and policy characteristics of LEAs and student-involvement goals were measured.AnalysisPolicies developed by LEAs were abstracted and analyzed. Logistic regression models were developed to analyze relationships between student-involvement goals and the demographic and policy characteristics of LEAs.ResultsMajority of LEAs included policy goals that address student involvement in an array of activities related to wellness policy, food service, and role modeling. Regression models showed that LEAs with comprehensive and strong policies were most likely to include student-involvement goals regardless of LEA location, enrollment, or socioeconomic status of students.Conclusions and ImplicationsStudent engagement in school nutrition policies has been shown to increase student acceptance in an array of health-related areas and is therefore promising in the area of obesity prevention. Comprehensiveness and rigor of LWPs were strongly correlated with the inclusion of student-involvement goals on LWPs. The upcoming reauthorization of the Child Nutrition programs in 2010 creates a good opportunity to address student involvement in LWPs.     

Association of Body Mass Index with Ischemic and Hemorrhagic Stroke

Data on the association between body mass index (BMI) and stroke are scarce. We aimed to examine the association between BMI and incident stroke (ischemic or hemorrhagic) and to clarify the relationship between underweight, overweight, and obesity and stroke risk stratified by sex. We analyzed the JMDC Claims Database between January 2005 and April 2020 including 2,740,778 healthy individuals (Median (interquartile) age, 45 (38–53) years; 56.2% men; median (interquartile) BMI, 22.3 (20.2–24.8) kg/m²). None of the participants had a history of cardiovascular disease. Each participant was categorized as underweight (BMI <18.5 kg/m²), normal weight (BMI 18.5–24.9 kg/m²), overweight (BMI 25.0–29.9 kg/m²), or obese (BMI ≥ 30 kg/m²). We investigated the association of BMI with incidence stroke in men and women using the Cox regression model. We used restricted cubic spline (RCS) functions to identify the association of BMI as a continuous parameter with incident stroke. The incidence (95% confidence interval) of total stroke, ischemic stroke, and hemorrhagic stroke was 32.5 (32.0–32.9), 28.1 (27.6–28.5), and 5.5 (5.3–5.7) per 10,000 person-years in men, whereas 25.7 (25.1–26.2), 22.5 (22.0–23.0), and 4.0 (3.8–4.2) per 10,000 person-years in women, respectively. Multivariable Cox regression analysis showed that overweight and obesity were associated with a higher incidence of total and ischemic stroke in both men and women. Underweight, overweight, and obesity were associated with a higher hemorrhagic stroke incidence in men, but not in women. Restricted cubic spline showed that the risk of ischemic stroke increased in a BMI dose-dependent manner in both men and women, whereas there was a U-shaped relationship between BMI and the hemorrhagic stroke risk in men. In conclusion, overweight and obesity were associated with a greater incidence of stroke and ischemic stroke in both men and women. Furthermore, underweight, overweight, and obesity were associated with a higher hemorrhagic stroke risk in men. Our results would help in the risk stratification of future stroke based on BMI.     

Implementation of low-fat, low-sugar, and portion-controlled nutrition guidelines in competitive food venues of Maine public high schools

BACKGROUND: The prevalence of childhood "overweight" and "at risk for overweight" has become a major public health concern. School food environments can affect key nutritional risk factors, especially in high schools where foods of poor nutrient value are pervasive in à la carte and vending programs. This study examines à la carte and vending programs in Maine public high schools at baseline and following implementation of low-fat (defined as items相似文献   

The Association between Body Mass Index and Intra-Cortical Myelin: Findings from the Human Connectome Project

Intra-cortical myelin is a myelinated part of the cerebral cortex that is responsible for the spread and synchronization of neuronal activity in the cortex. Recent animal studies have established a link between obesity and impaired oligodendrocyte maturation vis-à-vis cells that produce and maintain myelin; however, the association between obesity and intra-cortical myelination remains to be established. To investigate the effects of obesity on intra-cortical myelin in living humans, we employed a large, demographically well-characterized sample of healthy young adults drawn from the Human Connectome Project (n = 1066). Intra-cortical myelin was assessed using a novel T1-w/T2-w ratio method. Linear regression analysis was used to investigate the association between body mass index (BMI), an indicator of obesity, and intra-cortical myelination, adjusting for covariates of no interest. We observed BMI was related to lower intra-cortical myelination in regions previously identified to be involved in reward processing (i.e., medial orbitofrontal cortex, rostral anterior cingulate cortex), attention (i.e., visual cortex, inferior/middle temporal gyrus), and salience detection (i.e., insula, supramarginal gyrus) in response to viewing food cues (corrected p < 0.05). In addition, higher BMIs were associated with more intra-cortical myelination in regions associated with somatosensory processing (i.e., the somatosensory network) and inhibitory control (i.e., lateral inferior frontal gyrus, frontal pole). These findings were also replicated after controlling for key potential confounding factors including total intracranial volume, substance use, and fluid intelligence. Findings suggested that altered intra-cortical myelination may represent a novel microstructure-level substrate underlying prior abnormal obesity-related brain neural activity, and lays a foundation for future investigations designed to evaluate how living habits, such as dietary habit and physical activity, affect intra-cortical myelination.     

Association of school nutrition policy and parental control with childhood overweight

BACKGROUND: Schools and parents may play important roles in preventing childhood obesity by affecting children's behaviors related to energy balance. This study examined how school nutrition policy and parental control over children's eating and physical activity habits are associated with the children's overweight/obesity (hereafter overweight) status. METHODS: Data were analyzed from a total of 246 pairs of children and parents who were recruited in the 2008‐2009 academic year from 10 randomly selected public secondary schools in Indiana (school response rate = 66.7%; participant response rate = 73.5%). Logistic regression analyses were performed to examine odds ratios of different levels of school nutrition policies and parental control with and without adjusting for sociodemographic characteristics. RESULTS: Children who attended schools where soda pop (OR = 3.79, p < .01) and non‐low‐fat salty snacks (OR = 2.46, p = .05) could be purchased were more likely to be obese than those at schools where such items were not sold. Children whose parents rarely or never ensured that their child was avoiding eating too many sweets (OR = 2.33, p = .08), avoiding spending too much time watching TV (OR = 2.24, p = .06), or engaging in physical activity (OR = 2.35, p = .09) were more likely to be obese than children whose parents did so always or most of the time. CONCLUSIONS: School nutrition policy and parental control over children's eating and physical activity habits are associated with the children's overweight status.     

苏州市成年居民体质指数现状及影响因素

目的了解苏州市区成年居民体质指数(body mass index,BMI)现状及其影响因素,为改善苏州市居民健康状况提供依据。方法采用分层随机抽样的方法,对苏州市6个区640名18周岁以上常驻成年居民进行问卷调查和身高、体重等指标测量,对BMI影响因素进行统计分析。结果被调查居民体重过低者占4.5%,超重和肥胖者占37.3%;单因素和Logistic多因素回归分析显示,性别、年龄、学历和饮食行为对BMI的影响有显著性。结论苏州市成年居民超重和肥胖人数所占比例较高,尤其男性,中老年人和低学历居民超重和肥胖问题突出,应加强健康教育,使其养成良好饮食习惯,保持健康体重。