Sucrose and dental caries: a review of the evidence

The aim of this study was to conduct a review of the literature to assess the relationship between quantity and pattern of sucrose use and dental caries. Using hand and electronic methods (MEDLINE, EMBASE) the literature was searched for epidemiological papers concerning any relationship of sugars and dental caries published since 1856. Superficial hand searching was carried out between 1856 and 1940, detailed hand searching 1940–1966 and electronic 1966–2007. Selection criteria were set based on, but not confined to, Cochran style standards. Investigations were categorized as A, fulfilling all criteria; B1, relevant fulfilling 19 of 23 criteria; B2, relevant but fulfilling only between 12 and 18 of the selection criteria; and C, all other papers. There were 95 papers meeting most (more than 12) or all of the selected criteria. Only 1 paper was graded A; 31 as B1. There were in addition some 65 as B2 and all the rest as C, which were discarded. There were a wide variety of study designs and those graded A or B1 comprised 23 ecological cross-sectional, 7 cohort and 2 case control studies. Summary results showed that 6 papers found a positive, significant relationship of sugar quantity to dental caries, 19 of 31 studies reported a significant relationship of sugar frequency of use to dental caries. The balance of studies does not demonstrate a relationship between sugar quantity, but a moderately significant relationship of sugar frequency to dental caries.     

Impact of food labelling systems on food choices and eating behaviours: a systematic review and meta‐analysis of randomized studies

Food labels are considered a crucial component of strategies tackling unhealthy diets and obesity. This study aims at assessing the effectiveness of food labelling in increasing the selection of healthier products and in reducing calorie intake. In addition, this study compares the relative effectiveness of traffic light schemes, Guideline Daily Amount and other food labelling schemes. A comprehensive set of databases were searched to identify randomized studies. Studies reporting homogeneous outcomes were pooled together and analysed through meta‐analyses. Publication bias was evaluated with a funnel plot. Food labelling would increase the amount of people selecting a healthier food product by about 17.95% (confidence interval: +11.24% to +24.66%). Food labelling would also decrease calorie intake/choice by about 3.59% (confidence interval: ?8.90% to +1.72%), but results are not statistically significant. Traffic light schemes are marginally more effective in increasing the selection of healthier options. Other food labels and Guideline Daily Amount follow. The available evidence did not allow studying the effects of single labelling schemes on calorie intake/choice. Findings of this study suggest that nutrition labelling may be an effective approach to empowering consumers in choosing healthier products. Interpretive labels, as traffic light labels, may be more effective.     

Effect of inhaled medication on dental caries index in asthmatic children

Introduction

Asthma is a chronic inflammatory disease of airways with a high prevalence among children in pre-school ages. Considering controversial results in different studies about the effect of this disease on the indices of dental caries, the aim of this study was to compare dmft (decay, missing, filling teeth) situation in asthmatic and non-asthmatic 6–12-year-old children.

总摄氟量与儿童龋齿的相关关系研究

目的探讨总摄氟量与儿童龋齿间的剂量-反应关系。方法选择江苏省泗洪县瓦庙村(地方性氟中毒重病区村,饮水含氟0.57～4.50mg/L)和新淮村(非地方性氟中毒病区村,饮水含氟0.18～0.76mg/L)所有在校的8～13岁小学生为对象,调查学生龋齿患病率、学生家庭饮水含氟量、各种食物的摄入量、饮水量以及总摄氟量。根据人均总摄氟量将儿童分为不同的接触组,即<1.00、1.00￣、1.50￣、2.00￣、2.50￣、3.00￣、3.50￣及≥4.00mg/d共8组,分别统计各组儿童的龋齿患病率和龋均。结果当总摄氟量较低时,随着总摄氟量的增加,儿童龋齿患病率和龋均逐渐降低;当总摄氟量超过3.32mg/d时,儿童龋齿患病率和龋均逐渐升高。总摄氟量和儿童龋齿患病率及龋均间呈一U型的剂量-反应关系。按此剂量-反应关系计算的总摄氟量的95%可信限下限(BMDL)分别为3.49和3.15mg/d。由此推算出的总摄氟量的参考剂量(RfD)为3.49和3.15mg/d。结论由总摄氟量和龋齿的剂量-反应关系计算的总摄氟量的参考剂量远远大于中国人群总摄氟量的国家卫生标准。     

Obesity and dental caries in early childhood: A systematic review and meta‐analyses

Obesity and dental caries in children are significant health problems. The aims of this review are to identify whether children aged 6 years and younger with overweight and/or obesity have higher dental caries experience compared with children with normal weight and, secondly, to identify the common risk factors associated with both conditions. Medline, Embase, and seven other databases were systematically searched followed by lateral searches from reference lists, grey literature, theses, conference proceedings, and contacting field experts. Longitudinal observational studies addressing overweight and/or obesity and dental caries in children aged 6 years and younger were included. A random effects model meta‐analyses were applied. Nine studies were included in this review. Children with overweight and obesity had a significantly higher dental caries experience compared with children with normal weight (n = 6). The pooled estimates showed that difference in caries experience between the two groups was statistically significant. Low levels of parental income and education were identified to be associated with both conditions in the sample population. Children with overweight and obesity are more vulnerable to dental caries. Low levels of parental income and education influence the relationship between the two conditions. However, the quality of evidence varied considerably; therefore, findings should be interpreted cautiously.     

Structural responses to the obesity and non‐communicable diseases epidemic: Update on the Chilean law of food labelling and advertising

Chile approved the law of food labelling and advertising in 2012; this law aims to address the obesity epidemic, particularly in children. The implementation details were published in 2015, and the law was implemented finally in 2016, as described in the current article. Regulated foods were defined based on a specially developed nutrient profiling, which considered natural foods as gold standard. For liquid foods, amounts of energy, sugars, saturated fats, and sodium in 100 mL of cow's milk were used as cut‐offs. For solid foods, values within the 90th ‐ 99th percentile range for energy and critical nutrients were selected as cut‐off within a list of natural foods. A stop sign stating “High in <nutrient>” was chosen as warning label for packaged regulated foods. Regulated foods were also forbidden to be sold or offered for free at kiosks, cafeterias, and feeding programme at schools and nurseries. Besides, regulated foods cannot be promoted to children under 14 years. A staggered implementation of the regulation was decided, with nutrients cut‐offs becoming increasingly stricter over a 3‐year period. These regulatory efforts are in the right direction but will have to be sustained and complemented with other actions to achieve their ultimate impact of halting the obesity epidemic.     

成年人及老年人龋病状况十年纵向观察

目的 观察成年人与老年人龋病的自然发展过程以及与牙齿缺失的关系,为该病的防治提供依据。方法 1984年对20岁以上成年人587人的口腔状况进行了检查,1994年随访复查440人,2次检查由相同的检查人员完成,对龋病的有关资料进行分析。结果 各年龄组在10年内均有新龋损形成,新增龋补牙数(DFT值)随年龄增长而增加。10年间所观察人群共丧失2114颗牙齿,占初查时存留牙齿总数的18．9％。初查时无龋牙10年后缺失10．8％,釉质龋牙缺失17．9％,而牙本质深龋牙齿的缺失高达76．0％。结论 龋病是影响成年人,特别是老年人健康的主要疾病,牙齿的缺失与初查时龋病的严重程度有关。如不积极改善口腔卫生和(或)进行干预,因龋病而丧失的牙齿数将随年龄增长而增加,从而影响生活质量。     

Interventions for preventing obesity in childhood. A systematic review

Background The prevalence of obesity and overweight is increasing worldwide. Obesity in children impacts on their health in both short‐ and long‐term. Obesity prevention strategies are poorly understood. Objective To assess the effectiveness of interventions designed to prevent obesity in childhood. Search strategy Electronic databases were searched from January 1985 to October 1999. Selection criteria Data from randomized control trials and non‐randomized trials with concurrent control group were included. A priori, studies with follow up of 1 year minimum were selected however, this was subsequently amended to include studies with a minimum follow up of three months. Data collection & analysis Two reviewers independently extracted data and assessed study quality. Main results Seven studies were included, three long‐term (>1 years) and four short‐term (>3 months and <1 years). The studies included were diverse in terms of study design and quality, target population, theoretical underpinning of intervention approach, and outcome measures. As such, it was not appropriate to combine study findings using statistical methods. Conclusions Two of the long‐term studies (one focused on dietary education and physical activity vs. control, and the other only on dietary education vs. control), resulted in a reduction in the prevalence on obesity, but the third, which focused on dietary education and physical activity, found no effect. Of the four short‐term studies, three focused simply on physical activity/reduction of sedentary behavious vs. control. Two of these studies resulted in a reduction in the prevalence of obesity in intervention groups compared with control groups, and another study found a non‐significant reduction. The fourth study focused on dietary education and physical activity, and did not find an effect on obesity, but did report a reduction in fat intake. Overall, the findings of the review suggest that currently there is limited quality data on the effectiveness of obesity prevention programmes and as such no generalizable conclusions can be drawn. The need for well‐designed studies that examine a range of interventions remains a priority.     

A systematic review of the Australian food retail environment: Characteristics,variation by geographic area,socioeconomic position and associations with diet and obesity

There is strong support across multiple sectors for the implementation of policies to create healthier food environments as part of comprehensive strategies to address obesity and improve population diets. The existing evidence base describing food retail environments and their relationship with health outcomes is limited in several respects. This systematic review examines the current evidence regarding food retail environments in Australia, including associations with diet and people with obesity, and socioeconomic and geographic disparities. Three databases were searched and independently screened. Studies were included if they were undertaken in Australia and objectively measured the food retail environment. Sixty papers were included. The broad range of methodological approaches used across studies limited the ability to synthesize the evidence and draw conclusions. Results indicated that there is some evidence that disparities exist in food retail environments across measures of socioeconomic position and geographic area in parts of Australia. Overall, there were inconsistent findings regarding the association between the healthiness of food retail environments and diet or people with obesity. Findings support previous calls for standardized tools and measures for monitoring the healthiness of food retail environments. This is imperative to inform evidence‐based policy and evaluation in this critical component of recommended obesity prevention strategies.     

Behavioural interventions for preventing and treating obesity in adults

The purpose of this study was to review existing behavioural interventions for preventing and treating obesity in adult population that were published between 2000 and September 2006. A total of 23 interventions were found. Most of these interventions targeted both physical activity and nutrition behaviours. Majority of the interventions were not based on any explicit behavioural theory. In terms of duration, the interventions ranged from 3 weeks to 9 years. Approximately half of the interventions were less than 6 months in duration. Most of the interventions were implemented by the researchers themselves. However, some interventions were implemented by nurse educators, nutritionists, trained public health nurses, dietitians, healthcare providers, fitness workers and certified diabetic educators. Most of the interventions used group sessions as the predominant method to deliver the programme. Three of the interventions used media. Majority of the interventions were implemented in patient care settings with some in community settings. The most common determinant for measuring impact of the interventions has been body mass index. Fifteen interventions showed positive change in adiposity indices while six showed no change in adiposity indices. Recommendations for enhancing the effectiveness of behavioural interventions for prevention of obesity are presented.     

The search for compounds that stimulate thermogenesis in obesity management: from pharmaceuticals to functional food ingredients

The concept of managing obesity through the stimulation of thermogenesis is currently a focus of considerable attention by the pharmaceutical, nutraceutical and functional food industries. This paper first reviews the landmark discoveries that have fuelled the search for thermogenic anti-obesity products that range from single-target drugs to multi-target functional foods. It subsequently analyses the thermogenic and fat-oxidizing potentials of a wide array of bioactive food ingredients which are categorized under methylxanthines, polyphenols, capsaicinoids/capsinoids, minerals, proteins/amino acids, carbohydrates/sugars and fats/fatty acids. The main outcome of this analysis is that the compounds or combination of compounds with thermogenic and fat-oxidizing potentials are those that possess both sympathomimetic stimulatory activity and acetyl-coA carboxylase inhibitory property, and are capable of targeting both skeletal muscle and brown adipose tissue. The thermogenic potentials of products so far tested in humans range from marginal to modest, i.e. 2-5% above daily energy expenditure. With an increasing number of bioactive food ingredients awaiting screening in humans, there is hope that this thermogenic potential could be safely increased to 10-15% above daily energy expenditure - which would have clinically significant impact on weight management, particularly in the prevention of obesity and in improving the long-term prognosis of post-slimming weight maintenance.     

Is food insecurity related to overweight and obesity in children and adolescents? A summary of studies, 1995–2009

In the USA, several nutrition‐related issues confront the normal growth, maturation and development of children and adolescents including obesity and food insecurity. The purpose of this paper is to provide a review of the concept of food insecurity and a summary of studies that have examined the association between food insecurity and overweight/obesity in children and adolescents. Besides the initial case report, we review 21 studies (16 cross‐sectional and five prospective studies) that have been published on this topic as of December 2009. As there is limited literature in this area, we review studies that sample children and adolescents in the USA. The results are mixed with positive, negative and null associations. The reasons for the mixed results are difficult to disentangle. Among earlier studies, small samples hampered definitive conclusions. More recent studies with larger samples have overcome these limitations and tend to find no associations between these constructs. Nonetheless, all of the studies to date have shown that food insecurity and overweight co‐exist – that is, even though there may not be statistically significant differences in overweight between food‐insecure and food‐secure children, the prevalence of overweight remains relatively high in food‐insecure children.     

Attentional biases for food cues in overweight and individuals with obesity: a systematic review of the literature

Obesity rates have increased dramatically in recent decades, and it has proven difficult to treat. An attentional bias towards food cues may be implicated in the aetiology of obesity and influence cravings and food consumption. This review systematically investigated whether attentional biases to food cues exist in overweight/obese compared with healthy weight individuals. Electronic database were searched for relevant papers from inception to October 2014. Only studies reporting food‐related attentional bias between either overweight (body mass index [BMI] 25.0–29.9 kg m^?2) or obese (BMI ≥ 30) participants and healthy weight participants (BMI 18.5–24.9) were included. The findings of 19 studies were reported in this review. Results of the literature are suggestive of differences in attentional bias, with all but four studies supporting the notion of enhanced reactivity to food stimuli in overweight individuals and individuals with obesity. This support for attentional bias was observed primarily in studies that employed psychophysiological techniques (i.e. electroencephalogram, eye‐tracking and functional magnetic resonance imaging). Despite the heterogeneous methodology within the featured studies, all measures of attentional bias demonstrated altered cue‐reactivity in individuals with obesity. Considering the theorized implications of attentional biases on obesity pathology, researchers are encouraged to replicate flagship studies to strengthen these inferences.     

The relationship between ultraprocessed food consumption and obesity indicators in Iranian adults

Background and aimsFood processing changes the nature of foods, and it is growing globally due to its availability and affordability and its effects on the palatability of foods. Consumption of ultraprocessed foods (UPFs) may adversely affect weight gain.The purpose of the current study is to examine the association between UPFs consumption and adiposity among Iranian adults.Methods and resultsA cross-sectional study was conducted on 1459 Iranian adults (≥19 years). Dietary intakes were assessed using a validated 136-item food frequency questionnaire (FFQ), and foods were classified based on the NOVA system. Overweight, obesity, and abdominal obesity were defined as body mass index (BMI) ≥25 and < 30, ≥30, respectively, and waist circumference (WC) ≥91 for women and WC ≥ 89 for men. The odds of general and abdominal obesity across the quartiles of UPFs were assessed by binary logistic regression.UPFs consumption contributed to 20.17% of daily energy intake. After adjustment for potential confounders, UPFs consumption was not associated with general or abdominal obesity. However, in the fully adjusted model, men in the top quartile of UPFs were twice as likely to be overweight compared with those in the bottom quartile (OR = 2.06, 95% CI: 1.03, 4.10; P = 0.047). No association was found in women or stratified analysis by age.ConclusionThe present findings suggest a sex-specific association between UPFs consumption and overweight. UPFs consumption might be associated with an increased risk of overweight in men, but no such association was found in women. Future cohort studies are required to confirm these results.     

Taste, food intake and obesity

Research in human eating behaviour prior to 1990 has shown that taste impacts the palatability and selection of food for intake; sensory‐specific satiety; satiation; and thermic effect of food. Research in the last decade has added information to these areas; expanded the field to comparisons of the impact of ‘wanting’ vs. ‘liking’ food on intake, and provided insight into the relationship of food intake and brain functioning through new imaging techniques. This article will review literature from the last decade on research in the area of taste and its impact on food intake. Emphasis will be placed on differences seen between lean and obese humans and how these may contribute to the development of human obesity. Suggestions for future research directions will also be discussed.     

A synthesis of existing systematic reviews and meta-analyses of school-based behavioural interventions for controlling and preventing obesity

Schools are an attractive and popular setting for implementing interventions for children. There is a growing body of empirical research exploring the efficacy of school-based obesity prevention programs. While there have been several reviews on the topic, findings remain mixed. To examine the quality of evidence and compare the findings from existing systematic reviews and meta-analyses of school-based programs in the prevention and control of childhood obesity. This paper systematically appraises the methodology and conclusions of literature reviews examining the effectiveness of school-based obesity interventions published in English in peer-reviewed journals between January 1990 and October 2010. Eight reviews were examined, three meta-analyses and five systematic reviews. All of the reviews recognized that studies were heterogeneous in design, participants, intervention and outcomes. Intervention components in the school setting associated with a significant reduction of weight in children included long-term interventions with combined diet and physical activity and a family component. Several reviews also found gender differences in response to interventions. Of the eight reviews, five were deemed of high quality and yet limited evidence was found on which to base recommendations. As no single intervention will fit all schools and populations, further high-quality research needs to focus on identifying specific program characteristics predictive of success.     

A systematic review of fast food access studies

The frequent consumption of energy‐dense fast food is associated with increased body mass index. This systematic review aims to examine the methodology and current evidence on fast food access and its associations with outcomes. Six databases were searched using terms relating to fast food. Only peer‐reviewed studies published in English during a 10‐year period, with data collection and analysis regarding fast food access were included. Forty articles met the aforementioned criteria. Nearly half of the studies (n = 16) used their own set of features to define fast food. Studies predominantly examined the relationship between fast food access and socioeconomic factors (n = 21) and 76% indicated fast food restaurants were more prevalent in low‐income areas compared with middle‐ to higher‐income areas. Ten of 12 studies found fast food restaurants were more prevalent in areas with higher concentrations of ethnic minority groups in comparison with Caucasians. Six adult studies found higher body mass index was associated with living in areas with increased exposure to fast food; four studies, however, did not find associations. Further work is needed to understand if and how fast food access impacts dietary intake and health outcomes; and if fast food access has disparate socioeconomic, race/ethnicity and age associations.