Weight-control behaviors among adults and adolescents: associations with dietary intake

BACKGROUND: This study aimed to assess the prevalence of weight-control behaviors and their associations with overall dietary intake among adults and adolescents. METHODS: Participants included 3,832 adults and 459 adolescents from four regions of the United States. Cross-sectional data were collected on energy and nutrient intake, weight-control behaviors, body mass index (BMI), and sociodemographics. RESULTS: Current weight-control behaviors were reported by 52.7% of the study population (adult women, 56.7%; adult men, 50.3%; adolescent girls, 44.0%; adolescent boys, 36.8%). Weight-control behaviors were consistently and positively associated with socioeconomic status among adults, but not among adolescents. Among "dieters," unhealthy practices were reported by 22.7% of adult women, 21.3% of adult men, 30.4% of adolescent girls, and 18.5% of adolescent boys. Adults trying to control their weight reported healthier nutrient intakes than those not trying to control their weight, in particular when moderate weight-control methods were employed. Among adolescents, there were fewer differences across dieting status and these were not suggestive of healthier intakes among dieters than nondieters. CONCLUSIONS: Weight-control behaviors are reported by a large percentage of the population. Weight-control behaviors tend to be healthier among adults than among adolescents, in terms of the types of behaviors used and their impact on nutrient intakes. Obesity prevention interventions should emphasize the importance of using healthy weight-control practices.     

Association between major patterns of dietary intake and weight status in adolescents

The relationship between dietary intake and obesity is complex, and dietary pattern analysis may offer new insight. We examined associations between dietary patterns identified in a diverse cohort of adolescents and weight status cross-sectionally and over a 5-year period. Project EAT (Eating Among Teens) (Time 1) collected data on 4746 middle (younger cohort) and high school (older cohort) students in 1998-9. EAT-II (Time 2) resurveyed 2516 of the original cohort in 2003-4. All analyses were run separately by age cohort and sex. The relationship between dietary patterns identified previously (vegetable, fruit, vegetable & fruit, starchy food, sweet & salty snack food, and fast food) and weight status was examined using logistic regression. All analyses were adjusted for socioeconomic status, race/ethnicity and activity level (longitudinal analyses were also adjusted for baseline weight status). In cross-sectional analyses, higher adherence to dietary patterns loading heavily on vegetables was associated with lower risk of overweight/obese weight status in older and younger girls, whereas higher adherence to a 'sweet & salty snack food' pattern was associated with lower risk in older and younger boys. These associations were found prospectively in older boys and girls, but were no longer significant in analyses adjusting for baseline weight status. We did not find consistent or intuitive associations between dietary patterns and weight status. Identified patterns may not capture the elements of diet that are truly important in determining adolescent weight, or diet may not be the primary driver in determining weight status at this age. Methodological difficulties in assessing diet must also be taken into consideration.     

Assessing the effect of underreporting energy intake on dietary patterns and weight status

OBJECTIVES: To identify misreporting among older rural adults using a prediction algorithm and to compare dietary patterns of underreporters and plausible reporters. DESIGN: In this cross-sectional study, diet information was assessed by five 24-hour recalls collected over 10 months. All foods were classified into 24 food subgroups. Demographic, health, and anthropometric data were collected via home visit. SETTING: Rural Pennsylvania. SUBJECTS: One hundred seventy-nine community-dwelling adults, aged 66 to 87 years. STATISTICAL ANALYSIS: Cluster analysis. RESULTS: Underreporters (n=43) were more likely than plausible reporters (n=133) to be overweight and less educated but did not differ by sex. Underreporters consumed fewer servings across the majority of food groups. Two dietary patterns were determined for all and plausible reporters, in both cases one of higher and one of lower nutrient density. Using only plausible reporters to determine dietary patterns was very similar to using all reporters. The correlation between energy intake and weight status was improved for plausible-reporting women, but not men. CONCLUSIONS: Dietary patterns of plausible reporters were generally similar to that of all reporters; however, correlations with energy intake and weight status improved for women using only plausible reporters. Individuals may not accurately report dietary intake. Those obtaining diet reports should be aware of reporting errors before making decisions about dietary adequacy.     

2010—2012年北京市成年居民在外就餐现状

目的研究北京市成年居民在外就餐人口特征、不同特征人群在不同餐次(早餐、午餐、晚餐)的在外就餐情况。方法从北京市参与2010—2012年中国居民营养与健康状况监测的人群中,选取18岁及以上参加3天24小时膳食调查的居民作为研究对象进行分析。结果北京市成年居民在外就餐率为34.2%,男性高于女性;18~29岁人群高于其他年龄组;城区居民高于郊区居民;未婚者高于其他婚姻状态者;文化程度越高,在外就餐率越高;高收入人群高于低收入人群。北京市成年居民在外就早、午、晚餐率分别为20.0%、28.2%和11.3%。结论性别、年龄、地区、婚姻状况、文化程度和收入水平,均与是否选择在外就餐有关。居民在外就午餐率高于早餐和晚餐。     

Family meal patterns: associations with sociodemographic characteristics and improved dietary intake among adolescents

OBJECTIVE: To examine family meal patterns and associations with sociodemographic characteristics and dietary intake in adolescents. DESIGN: A population-based cross-sectional study design was employed. Adolescents completed the Project EAT (Eating Among Teens) survey and the Youth and Adolescent Food Frequency Questionnaire within their schools. Subjects/setting The study population included 4,746 middle and high school students from Minneapolis/St. Paul public schools with diverse racial and socioeconomic backgrounds. Statistical analyses Associations were examined using cross tabulations, log-linear modeling, and linear regressions. RESULTS: There was a wide distribution in the frequency of family meals during the previous week: never (14.0%), 1 or 2 times (19.1%), 3 to 6 times (40.1%), and 7 or more times (24.8%). Sociodemographic characteristics associated with more frequent family meals included gender (boys), school level (middle school), race (Asian American), mother's employment status (not employed), and socioeconomic status (high). Frequency of family meals was positively associated with intake of fruits, vegetables, grains, and calcium-rich foods and negatively associated with soft drink consumption. Positive associations were also seen between frequency of family meals and energy; protein (percentage of total calories); calcium; iron; folate; fiber; and vitamins A, C, E, and B-6. CONCLUSIONS: Family meals appear to play an important role in promoting positive dietary intake among adolescents. Feasible ways to increase the frequency of family meals should be explored with adolescents and their families.     

上海社区成年人群超重肥胖与膳食模式的关系探讨

目的探讨上海社区成年人群超重肥胖与不同膳食模式的关系。方法采用多阶段整群随机抽样的方法,选取上海市1535名18岁以上成年人进行膳食频率问卷调查。采用中国肥胖问题工作组标准诊断超重和肥胖。利用因子分析确定主要的膳食模式,继而讨论对超重肥胖有潜在影响的膳食模式。结果因子分析得到4种主要的膳食模式,分别是西方食物型膳食模式、高蛋白高钙型膳食模式、水果零食型膳食模式和主食蔬菜型膳食模式。logistic回归分析显示无论是否控制年龄、性别、文化程度等混杂因素,主食蔬菜型膳食模式高4分位数组(Q4)相对于低4分位数组(Q1)都显示较高的肥胖患病风险(调整前OR=2.76,P0.01;调整后,OR=2.67,P0.01)。碳水化合物在三大营养素供能比中的贡献率结果显示,主食蔬菜型Q4组远高于Q1组(43.9%vs.34.3%,P0.01),主食蔬菜型Q4组能量的平均摄入水平是Q1组的1.96倍。结论主食蔬菜型膳食模式是肥胖的危险因素,其原因可能与主食蔬菜型膳食模式摄入过多的碳水化合物有关。     

Effect of weight loss intervention on the association between eating behaviour measured by TFEQ-18 and dietary intake in adults

Associations between eating behaviour (cognitive restraint, emotional eating and uncontrolled eating) and dietary intake (energy, energy nutrients and fibre) were assessed in overweight or obese adults (body mass index >27 kg/m(2), n=49) before and after weight loss intervention in a randomized follow-up study lasting 18 months. Counselling was either intensive or short-term. Eating behaviour was assessed using the three-factor eating questionnaire-18 and dietary intake with 5-day food records at 0 and 18 months. The only difference in dietary intake between the groups was higher protein intake (% of energy, E%) in the short-term group at 18 months (18.7 ± 3.1 E% vs. 17.1 ± 1.7 E%). Cognitive restraint was associated with lower energy intake at 0 and 18 months (r=-0.34, r=-0.36, respectively) and higher intakes of carbohydrates (r=0.39), sucrose (r=0.33) and fibre (r=0.44) and a lower intake of fat (r=-0.43) at 18 months. Those with the highest cognitive restraint at 18 months had the lowest energy and fat intake, the highest carbohydrate and fibre intake and the greatest weight loss. The results suggest that enhancing cognitive restraint could be a target for improving weight loss counselling, although further evaluation of the causal relationship would be needed in order to find the best practices for enhancing cognitive restraint.     

Vitamin-mineral supplement use: association with dietary intake and iron status of adults

Although vitamin-mineral supplement use is increasing in the United States, few researchers have examined whether supplement users have better nutritional status than do nonusers. Data from 10,515 persons examined in the second National Health and Nutrition Examination Survey (NHANES II) were used to compare mean dietary intakes of several nutrients and food groups, hemoglobin, mean corpuscular volume, transferrin saturation, erythrocyte protoporphyrin, and serum ferritin between regular supplement users and nonusers aged 16 to 74 years. Prevalences of impaired iron status also were compared between user groups. Users consumed more vitamin C and ate fruits and vegetables more frequently than did nonusers in all age/sex groups. No significant differences in mean iron status indicators were observed except in the 65 to 74 year age/sex groups: transferrin saturation among men and mean corpuscular volume, erythrocyte protoporphyrin, and serum ferritin among women. In each case, users had higher values than nonusers in this age group. Prevalences of impaired iron status did not differ between users and nonusers in any age/sex group. In general, iron status was not associated with supplement use.     

Iron status in 2-year-old Icelandic children and associations with dietary intake and growth

OBJECTIVE: To investigate the effects of food and nutrient intake at 2 y and growth from birth on iron status at 2 y in a population with high birth weight. DESIGN: In a cross-sectional study, children's food consumption and body size measurements were recorded and blood samples taken. Weighed 3-day food records were used to analyse food and nutrient intake. SETTING: Children were recruited from across Iceland from the Icelandic National Registry by the University of Iceland, Computing Services. The children in the sample were born over a 1-y period. SUBJECTS: Parents of randomly selected 2-year-old children (n=130) were contacted, and 72% (n=94) participated. Blood samples were analysed in 76% (n=71) of participating children. RESULTS: In total, 9% of the children were iron-deficient (serum ferritin (SF)<12 microg/l and mean corpuscular volume (MCV) <74 fl) and 1.4% were also anaemic (Hb<105 g/l), while 27% of children were iron-depleted (SF<12 microg/l). Iron status indices were negatively associated with cow's milk consumption. Half of children consuming>500 g cow's milk/day (n=10) were iron-deficient, while one child in 58 consuming<500 g cow's milk/day had iron deficiency (P<0.001). In multiple regression analyses, also biscuits and crackers consumption was positively associated with MCV. Weight gain from birth to 2 y was negatively associated with SF (adjusted R(2)=0.15; P=0.002; n=58). Iron-depleted children were heavier than children not iron-depleted (14.7+/-1.3 vs 13.8+/-1.7 kg; P=0.043), had higher BMI (17.7+/-1.5 vs 16.7+/-1.4 kg/m(2); P=0.028) and gained more weight from birth (11.2+/-1.3 vs. 10.0+/-1.6 kg; P=0.011). CONCLUSIONS: The results suggest that cow's milk consumption above 500 g/day should be avoided at the age of 2 y for better iron status. Iron depletion at 2 y is associated with faster growth from birth.     

Neighborhood restaurant availability and frequency of eating out in relation to dietary intake in young Japanese women

Exposure to food service establishments is considered to encourage consumption and contribute to poorer diet quality, and hence adverse health profiles. However, empirical verification of these links remains rare, particularly in young adults and non-Western populations. The objective of this cross-sectional study was to test the hypothesis that neighborhood restaurant availability and frequency of eating out are associated with unfavorable patterns of dietary intake and thus possibly higher body mass index (BMI) and waist circumference in young Japanese women. The subjects were 989 female Japanese dietetic students 18 to 22 y of age. Dietary intake and frequency of eating out (i.e., consumption of commercially prepared meals) during the preceding month were assessed using a comprehensive, self-administered diet history questionnaire. Neighborhood restaurant availability was defined as the number of restaurants within a 0.5-mile (0.8-km) radius of residence (i.e., full-service restaurants, limited-service restaurants, and cafeterias). Increasing frequency of eating out was associated with higher intake of meat, confectionery and bread, and dietary fat, lower intake of fruit and vegetables, rice, and dietary fiber, and higher dietary energy density. However, neighborhood restaurant availability was not associated with either the frequency of eating out or any of the dietary variables examined. Further, frequency of eating out and neighborhood restaurant availability were not associated with BMI or waist circumference. In conclusion, although frequency of eating out was positively associated with unfavorable dietary intake patterns in a group of young Japanese women, neighborhood restaurant availability was not associated with frequency of eating out or dietary intake.     

Food intake affects state body image: impact of restrained eating patterns and concerns about eating, weight and shape

Body image disturbances play a significant role in the development of eating disorders. Since body image can vary in diverse contexts, the aim of the present experiment was to investigate whether it is affected by recent food intake. Fifty-seven females without clinically relevant eating disorders were randomly assigned to an experimental group (EG, n=28) that consumed a milkshake while watching a neutral film and a control group (CG, n=29) that only viewed the movie. Before and after the tasks, participants filled in the "Body Image States Scale" and the "Mood Questionnaire" and indicated their own "actual", "felt" and "ideal" body dimensions with a digital distortion technique based on a photograph of themselves. It was shown that after milkshake consumption, state body dissatisfaction as well as the discrepancy between "actual-ideal" and "felt-ideal" body size estimations was higher in the EG than in the CG. Judgements of the "actual", "felt" and "ideal" body dimensions and of mood were not affected. Further analyses revealed that the effect of milkshake consumption on body image and mood was higher the more the participants displayed restrained eating or eating, weight and shape concerns in general. Clinical implications are discussed.     

Mental health status and dietary intake among California adults: a population-based survey

California Health Interview Survey (2005–2015) data were used to examine the association between dietary intake frequencies and mental health – Kessler-6 scores categorised as no/low (NLPD), moderate (MPD) or serious psychological distress (SPD). The 245,891 surveys represented 27.7 million adults annually, with 13.2% having MPD and 3.7% SPD. Survey-adjusted regression adjusting for gender, age, race, education, poverty, marital status, BMI, geography and year found MPD and SPD associated with lower consumption of fruits (adjusted odds ratio 0.79 and 0.65, respectively), vegetables (AOR 0.81 and 0.68), and increased consumption of French fries (AOR 1.24, 1.30), fast food (AOR 1.32, 1.27), soda (AOR 1.23, 1.26) and variance-adjusted daily teaspoons of sugar (coefficients 3.05, 4.21), all p-values less than 0.001. In this large population-based sample, moderate and SPD were independently associated with unhealthy diet. Targeted public health interventions could focus on young adults and those with less than 12 years of education.     

Older adults who use vitamin/mineral supplements differ from nonusers in nutrient intake adequacy and dietary attitudes

OBJECTIVE: To measure nutrient intake adequacy of vitamin/mineral supplement users and nonusers aged 51 years and older, determine the efficacy of supplement practices in compensating for dietary deficits, and identify predictors of supplement use. DESIGN: Analyses of two 24-hour recalls, demographic variables, and attitude questions collected during the Continuing Survey of Food Intakes by Individuals and Diet and Health Knowledge Survey in 1994 to 1996. Data were weighted to be representative of older Americans. SUBJECTS: Four thousand three hundred eighty-four adults aged 51 years and older (1,777 daily supplement users, 428 infrequent users, and 2,179 nonusers) residing in households in the United States. STATISTICAL ANALYSES: Usual nutrient intake distributions were estimated using the Iowa State University method. The Estimated Average Requirement (EAR) cutpoint method was applied to determine the proportion of older adults not meeting requirements before and after accounting for nutrient intake from supplements. Student t tests were used to assess differences between users and nonusers. Logistic regression was used to determine sociodemographic and attitudinal predictors of supplement use. RESULTS: For one or more of the sex-age groups studied, a significantly smaller proportion of supplement users than nonusers had intakes from food alone below the EAR for vitamins A, B-6, and C; folate; zinc; and magnesium. Even so, less than 50% of both users and nonusers met the EAR for folate, vitamin E, and magnesium from food sources alone. Overall, supplements improved the nutrient intake of older adults. After accounting for the contribution of supplements, 80% or more of users met the EAR for vitamins A, B-6, B-12, C, and E; folate; iron; and zinc, but not magnesium. However, some supplement users, particularly men, exceeded Tolerable Upper Intake Levels for iron and zinc and a small percentage of women exceeded the Tolerable Upper Intake Level for vitamin A. Significant sociodemographic factors related to supplement use for older men were age group, metropolitan area, and educational status. Race, region, smoking status, and vegetarian status were significant factors for women. Attitude about the importance of following a healthful diet was a consistent predictor of supplement use for both men and women. CONCLUSIONS: A large proportion of older adults do not consume sufficient amounts of many nutrients from foods alone. Supplements compensate to some extent, but only an estimated half of this population uses them daily. These widespread inadequacies should be considered when developing recommendations for supplement use for clients in this age group. Modifying dietary attitudes may result in a higher rate of supplement use in this at-risk population.     

Independent associations between weight status and disability in adults: results from the Health Survey for England

OBJECTIVES: While direct links between obesity and some illnesses are well-established, there is a relative paucity of research on associations between obesity and disabilities. The aim of this study was to test for significant associations between overweight and obesity and the presence of a wide range of disabling conditions in adults, controlling for sex, age, education, social class, income, cigarette smoking status and alcohol consumption. STUDY DESIGN: Data were extracted from the Health Survey for England (2001); a cross-sectional survey of the community-dwelling population. In total, 8613 adult participants were included in the analysis. METHODS: Multivariate logistic regression was employed to test whether the odds of having a range of disabling conditions are higher in the overweight and obese populations compared with those in the ideal weight range. RESULTS: The risk of nearly all disabling conditions tested was elevated in the obese and morbidly obese groups. Of great importance for public health, the risks of musculoskeletal illness, arthritis and rheumatism, and personal care disability were significantly elevated, even in those in the overweight category (currently about half of the adult population living in the UK). CONCLUSIONS: Obesity is independently associated with a range of disabling conditions in adults. The present study highlights the need for further research into the mechanisms by which these associations occur.     

新时代中国餐饮业的特征与趋势

  目的  分析中国 ≥ 18岁成人2002 — 2015年在外就餐行为变化趋势及其对肥胖的影响。  方法  利用2002年中国居民营养与健康状况调查、2010 — 2012年中国居民营养与健康状况监测和2015年中国成人慢性病与营养监测中 ≥ 18岁成年居民在外就餐行为数据,采用χ²检验、Cochran-Armitage 趋势检验分析不同特征成人在外就餐比例及其变化趋势,多因素logistic回归分析在外就餐的影响因素及其对肥胖的影响。  结果   2002年、2010 — 2012年、2015年中国 ≥ 18岁成人过去1周3餐在外就餐比例分别为7.2 %、16.5 %、20.2 %,男性居民分别为9.8 %、20.0 %、25.1 %,女性居民分别为5.0 %、13.8 %、15.8 %。2002 — 2015年中国 ≥ 18岁成人在外就餐比例呈现增长趋势（P < 0.0001）,成年男性和女性在外就餐比例也均呈现增长趋势（P < 0.0001）。多因素logistic 回归结果显示,男性、18～44岁、城市、家庭人均年收入 ≥ 20 000元、大专及以上文化程度、除农林牧渔水利业生产人员之外的其他在职人员、未婚的成人在外就餐的行为更加普遍。男性在外就餐组发生肥胖的风险约是非在外就餐组的1.166倍（P = 0.002）,女性在外就餐组发生肥胖的风险约是非在外就餐组的0.922倍（P = 0.001）。  结论   2002 — 2015年中国 ≥ 18岁成人2002 — 2015年在外就餐比例呈现增长趋势,18～44岁、学历和收入较高的未婚职业男性在外就餐比例较高且呈现增长趋势,在外就餐可以增加肥胖的风险;建议加强在外就餐营养宣传教育,制定不同人群在外就餐膳食指南,引导我国居民养成健康的饮食行为和习惯。     

珠海市居民膳食结构与膳食营养素摄入

目的了解珠海市居民膳食营养素摄人与膳食结构现况,为制定适合当地实际的营养相关政策,指导居民合理膳食提供科学依据。方法采用多阶段分层与人口比例概率抽样方法,按家庭抽样为单位进行入户调查,以个人72h膳食回顾结合家庭调味品称重获取膳食信息,根据《中国食物成分表2004））计算人均各营养素及能量摄人数据,运用Access建立数据库,采用SPSS12．0进行统计分析。结果完成膳食调查540户（城市330户,农村210户）,共1653人,平均3．1人／户;2岁及以上居民中,城市人口占63．04％,男性占46．88％;居民平均每标准人日摄入能量基本达到推荐参考值,为2085．8Keal,占RNI的92．70％,蛋白质的摄入量（84．0g）超过推荐参考值,膳食纤维（9．8g）、维生素B2（0．9mg）、和维生素B2（1．0mg）钙（487．3mg）等摄人量明显低于推荐参考值;每标准人日摄入的豆类（10．8g）、水果（42．9g）、薯类（12．4g）和奶类（41．4g）过低,以农村居民更甚（P〈0.05）,畜禽肉类（181．2g）、油酯（39．3g）和食盐（8．8g）则过高,且城乡居民基本一致;碳水化合物提供的能量占总能量比例偏低（43．83％）,脂肪提供的能量占比例偏高（40．39％）;谷类提供的能量占总能量的比例过低,占33．37％,动物性食物提供的能量占比例过高,占30．54％,蛋白质食物来源中动物性食物已超过60．00％。结论珠海市居民基本营养素摄人得到满足,但膳食营养不平衡,主食消费较低,高脂食物摄入过多,膳食结构不尽合理,应针对性地对城乡居民开展营养健康教育,引导其合理膳食。