Water and beverage consumption among children age 4-13y in the United States: analyses of 2005–2010 NHANES data

BACKGROUND: Few studies have examined water consumption patterns among US children. Additionally, recent data on total water consumption as it relates to the Dietary Reference Intakes (DRI) are lacking. This study evaluated the consumption of plain water (tap and bottled) and other beverages among US children by age group, gender, income-to-poverty ratio, and race/ethnicity. Comparisons were made to DRI values for water consumption from all sources. METHODS: Data from two non-consecutive 24-hour recalls from 3 cycles of NHANES (2005–2006, 2007–2008 and 2009–2010) were used to assess water and beverage consumption among 4,766 children age 4-13y. Beverages were classified into 9 groups: water (tap and bottled), plain and flavored milk, 100% fruit juice, soda/soft drinks (regular and diet), fruit drinks, sports drinks, coffee, tea, and energy drinks. Total water intakes from plain water, beverages, and food were compared to DRIs for the US. Total water volume per 1,000 kcal was also examined. RESULTS: Water and other beverages contributed 70-75% of dietary water, with 25-30% provided by moisture in foods, depending on age. Plain water, tap and bottled, contributed 25-30% of total dietary water. In general, tap water represented 60% of drinking water volume whereas bottled water represented 40%. Non-Hispanic white children consumed the most tap water, whereas Mexican-American children consumed the most bottled water. Plain water consumption (bottled and tap) tended to be associated with higher incomes. No group of US children came close to satisfying the DRIs for water. At least 75% of children 4-8y, 87% of girls 9-13y, and 85% of boys 9-13y did not meet DRIs for total water intake. Water volume per 1,000 kcal, another criterion of adequate hydration, was 0.85-0.95 L/1,000 kcal, short of the desirable levels of 1.0-1.5 L/1,000 kcal. CONCLUSIONS: Water intakes at below-recommended levels may be a cause for concern. Data on water and beverage intake for the population and by socio-demographic group provides useful information to target interventions for increasing water intake among children

Dietary and economic effects of eliminating shortfall in fruit intake on nutrient intakes and diet cost

BACKGROUND: Children in the United States do not consume the recommended amounts of fruit. The economic and dietary consequences of meeting the shortfall in fruit consumption have not been evaluated. METHODS: Analyses were based on a nationally representative sample of 4–18 year-old children (n = 2,647) from the 2009–2010 National Health and Nutrition Examination Survey (NHANES). The shortfall in total fruit consumption for each child was estimated based on the USDA MyPlate recommendations. The potential impact of filling the shortfall in total fruit consumption was projected with whole fruit alone (WF model) or a combination of 100 % fruit juice and whole fruit (FJ + WF model). Juice consumption was capped using American Academy of Pediatrics (AAP) standards. The USDA national food prices database was used to estimate the cost of meeting the dietary recommendations for fruit. Selected nutrient and mineral intakes, as well as daily diet cost were estimated after eliminating the shortfall in fruit consumption. RESULTS: Among all children, vitamin C (+22.8 mg [95 % CI 21.4, 24.1] in the WF model and +48.1 mg [95 % CI 45.2, 51.1] in the FJ + WF model) and potassium intakes (+203 mg [95 % CI 190, 215] in WF and +263 mg [95 % CI 248, 280] in FJ + WF) were increased in both models. The FJ + WF model resulted in a marginal increase in dietary fiber (e.g., a relative change less than 10 %), while the WF model resulted in a meaningful increase in dietary fiber (e.g., a relative change greater than 10 %; +2.2 g [95 % CI 2.1, 2.3]). Conversely, the WF model resulted in only a marginal increase in calcium, while the FJ + WF model resulted in a meaningful increase in calcium (+85 mg [95 % CI 79, 89]). Calories were increased in all models (+4.5 % [95 % CI 4.1, 4.9 %] for FJ + WF and +3.5 % [95 % CI 3.2, 3.7 %] for WF). Meeting the fruit shortfall with whole fruit alone increased estimated diet costs by 9.9 % (+$0.44/d [95$0.23/d [95 % CI 0.22, 0.25]). CONCLUSIONS: Meeting fruit consumption guidelines without a substantial increase in diet costs may be a challenge. Combining whole fruit with 100 % fruit juice capped at AAP standards may be one approach to meeting fruit recommendations within cost constraints. Identifying approaches to increasing whole fruit consumption in as cost-neutral a fashion as possible should be a priority

Energy intakes of US children and adults by food purchase location and by specific food source

BACKGROUND: To our knowledge, no studies have examined energy intakes by food purchase location and food source using a representative sample of US children, adolescents and adults. Evaluations of purchase location and food sources of energy may inform public health policy. METHODS: Analyses were based on the first day of 24-hour recall for 22,852 persons in the 2003-4, 2005-6, and 2007-8 National Health and Nutrition Examination Surveys (NHANES). The most common food purchase locations were stores (grocery store, supermarket, convenience store, or specialty store), quick-service restaurants/pizza (QSR), full-service restaurants (FSR), school cafeterias, or food from someone else/gifts. Specific food sources of energy were identified using the National Cancer Institute aggregation scheme. Separate analyses were conducted for children ages 6-11y, adolescents ages 12-19y, and adults aged 20-50y and ≥51y. RESULTS: Stores (grocery, convenience, and specialty) were the food purchase locations for between 63.3% and 70.3% of dietary energy in the US diet. Restaurants provided between 16.9% and 26.3% of total energy. Depending on the respondents’ age, QSR provided between 12.5% and 17.5% of energy, whereas FSR provided between 4.7% and 10.4% of energy. School meals provided 9.8% of energy for children and 5.5% for adolescents. Vending machines provided <1% of energy. Pizza from QSR, the top food away from home (FAFH) item, provided 2.2% of energy in the diets of children and 3.4% in the diets of adolescents. Soda, energy, and sports drinks from QSR provided approximately 1.2% of dietary energy. CONCLUSIONS: Refining dietary surveillance approaches by incorporating food purchase location may help inform public health policy. Characterizing the important sources of energy, in terms of both purchase location and source may be useful in anticipating the population-level impacts of proposed policy or educational interventions. These data show that stores provide a majority of energy for the population, followed by quick-service and full-service restaurants. All food purchase locations, including stores, restaurants and schools play an important role in stemming the obesity epidemic

Socioeconomic gradient in consumption of whole fruit and 100% fruit juice among US children and adults

BACKGROUND: The consumption of fruit is generally associated with better health, but also higher socioeconomic status (SES). Most previous studies evaluating consumption of fruits have not separated 100% fruit juice and whole fruit, which may conceal interesting patterns in consumption. OBJECTIVE: To estimate demographic and socioeconomic correlates of whole fruit versus 100% juice consumption among children and adults in the United States. DESIGN: Secondary analyses of two cycles of the nationally representative National Health and Nutrition Examination Survey (NHANES) from 2007–2010, by gender, age group, race/ethnicity and SES among 16,628 children and adults. RESULTS: Total fruit consumption (population average of 1.06 cup equivalents/d) fell far short of national goals. Overall, whole fruit provided about 65% of total fruit, while 100% juice provided the remainder. Whereas 100% juice consumption was highest among children and declined sharply with age, whole fruit consumption was highest among older adults. Total fruit and whole fruit consumption was generally higher among those with higher incomes or more education. By contrast, the highest 100% juice consumption was found among children, racial/ethnic minorities and lower-income groups. CONCLUSIONS: Consumption patterns for whole fruit versus 100% fruit juice showed different gradients by race/ethnicity, education, and income. The advice to replace 100% juice with whole fruit may pose a challenge for the economically disadvantaged and some minority groups, whose fruit consumption falls short of national goals

The Effectiveness of Alcohol Screening and Brief Intervention in Emergency Departments: A Multicentre Pragmatic Cluster Randomized Controlled Trial

BACKGROUND: Alcohol misuse is common in people attending emergency departments (EDs) and there is some evidence of efficacy of alcohol screening and brief interventions (SBI). This study investigated the effectiveness of SBI approaches of different intensities delivered by ED staff in nine typical EDs in England: the SIPS ED trial. METHODS AND FINDINGS: Pragmatic multicentre cluster randomized controlled trial of SBI for hazardous and harmful drinkers presenting to ED. Nine EDs were randomized to three conditions: a patient information leaflet (PIL), 5 minutes of brief advice (BA), and referral to an alcohol health worker who provided 20 minutes of brief lifestyle counseling (BLC). The primary outcome measure was the Alcohol Use Disorders Identification Test (AUDIT) status at 6 months. Of 5899 patients aged 18 or more presenting to EDs, 3737 (63·3%) were eligible to participate and 1497 (40·1%) screened positive for hazardous or harmful drinking, of whom 1204 (80·4%) gave consent to participate in the trial. Follow up rates were 72% (n?=?863) at six, and 67% (n?=?810) at 12 months. There was no evidence of any differences between intervention conditions for AUDIT status or any other outcome measures at months 6 or 12 in an intention to treat analysis. At month 6, compared to the PIL group, the odds ratio of being AUDIT negative for brief advice was 1·103 (95% CI 0·328 to 3·715). The odds ratio comparing BLC to PIL was 1·247 (95% CI 0·315 to 4·939). A per protocol analysis confirmed these findings. CONCLUSIONS: SBI is difficult to implement in typical EDs. The results do not support widespread implementation of alcohol SBI in ED beyond screening followed by simple clinical feedback and alcohol information, which is likely to be easier and less expensive to implement than more complex interventions

Arterial roads and area socioeconomic status are predictors of fast food restaurant density in King County, WA

<p>Abstract</p> <p>Background</p> <p>Fast food restaurants reportedly target specific populations by locating in lower-income and in minority neighborhoods. Physical proximity to fast food restaurants has been associated with higher obesity rates.</p> <p>Objective</p> <p>To examine possible associations, at the census tract level, between area demographics, arterial road density, and fast food restaurant density in King County, WA, USA.</p> <p>Methods</p> <p>Data on median household incomes, property values, and race/ethnicity were obtained from King County and from US Census data. Fast food restaurant addresses were obtained from Public Health-Seattle & King County and were geocoded. Fast food density was expressed per tract unit area and per capita. Arterial road density was a measure of vehicular and pedestrian access. Multivariate logistic regression models containing both socioeconomic status and road density were used in data analyses.</p> <p>Results</p> <p>Over one half (53.1%) of King County census tracts had at least one fast food restaurant. Mean network distance from dwelling units to a fast food restaurant countywide was 1.40 km, and 1.07 km for census tracts containing at least one fast food restaurant. Fast food restaurant density was significantly associated in regression models with low median household income (p < 0.001) and high arterial road density (p < 0.001) but not with percent of residents who were nonwhite.</p> <p>Conclusion</p> <p>No significant association was observed between census tract minority status and fast food density in King County. Although restaurant density was linked to low household incomes, that effect was attenuated by arterial road density. Fast food restaurants in King County are more likely to be located in lower income neighborhoods and higher traffic areas.</p

The feasibility of meeting the WHO guidelines for sodium and potassium: a cross-national comparison study.

OBJECTIVE: To determine joint compliance with the WHO sodium-potassium goals in four different countries, using data from nationally representative dietary surveys. SETTING: Compared to national and international recommendations and guidelines, the world's population consumes too much sodium and inadequate amounts of potassium. The WHO recommends consuming less than 2000 mg sodium (86 mmol) and at least 3510 mg potassium (90 mmol) per person per day. PARTICIPANTS: Dietary surveillance data were obtained from the National Health and Nutrition Examination Survey (NHANES 2007-2010) for the USA; the Encuesta Nacional de Salud y Nutrición 2012 for Mexico; the Individual and National Study on Food Consumption (INCA2) for France; and the National Diet and Nutrition Survey (NDNS) for the UK. PRIMARY OUTCOME MEASURES: We estimated the proportion of adults meeting the joint WHO sodium-potassium goals in the USA, the UK, France and Mexico. RESULTS: The upper bounds of joint compliance with the WHO sodium-potassium goals were estimated at 0.3% in the USA, 0.15% in Mexico, 0.5% in France and 0.1% in the UK. CONCLUSIONS: Given prevailing food consumption patterns and the current food supply, implementing WHO guidelines will be an enormous challenge for global public health.Supported by NIH grants R01 DK 077068-04 and R21 DK085406This is the final version. It was first published by BMJ Group at http://bmjopen.bmj.com/content/5/3/e006625.ful

South African consumers’ knowledge, opinions and awareness of whole grains and their health benefits : a cross-sectional online survey

DATA AVAILABILITY STATEMENT : The de-identified data is available on request.SUPPLEMENTARY MATERIALS : S1 Whole grains survey questions.Evidence indicates that whole-grain food consumption reduces the risk of cardiovascular disease, type-2 diabetes, and some cancers. Increasing whole-grain consumption in developing countries is likely to significantly benefit the health of the population. However, there is very limited information on consumer whole-grain knowledge, attitudes, and behaviors in developing countries. An online cross-sectional survey was conducted among 1000 South African consumers with sufficient income to make food purchase choices and who were generally representative in terms of gender, age, and ethnicity. Most respondents (64%) were confident of their whole-grain knowledge. However, 60% of all participants selected incorrect definitions of whole grains. Whilst most correctly identified common cereals as whole grains, at most 50% of participants correctly identified common whole-grain foods. Also, whilst most (67%) thought that they were consuming enough whole grains, the majority (62%) underestimated the recommended level of consumption. Furthermore, respondent knowledge regarding whole-grain food attributes and the health benefits of whole-grain consumption was generally poor. Clearly, consumer-focused strategies are needed in developing countries to increase whole-grain food consumption to help the broader population achieve a healthy and sustainable diet. Actions proposed include: simple-to-understand information on whole-grain content relative to recommendations on food product labels, the provision of whole-grain foods in school nutrition schemes, and coordinated social and behavior change communication initiatives.Pepsico SSA.https://www.mdpi.com/journal/nutrientsam2024Consumer ScienceSDG-02:Zero HungerSDG-03:Good heatlh and well-bein

Molecular mechanisms of cell death:recommendations of the Nomenclature Committee on Cell Death 2018

Over the past decade, the Nomenclature Committee on Cell Death (NCCD) has formulated guidelines for the definition and interpretation of cell death from morphological, biochemical, and functional perspectives. Since the field continues to expand and novel mechanisms that orchestrate multiple cell death pathways are unveiled, we propose an updated classification of cell death subroutines focusing on mechanistic and essential (as opposed to correlative and dispensable) aspects of the process. As we provide molecularly oriented definitions of terms including intrinsic apoptosis, extrinsic apoptosis, mitochondrial permeability transition (MPT)-driven necrosis, necroptosis, ferroptosis, pyroptosis, parthanatos, entotic cell death, NETotic cell death, lysosome-dependent cell death, autophagy-dependent cell death, immunogenic cell death, cellular senescence, and mitotic catastrophe, we discuss the utility of neologisms that refer to highly specialized instances of these processes. The mission of the NCCD is to provide a widely accepted nomenclature on cell death in support of the continued development of the field.</p

Preventable Cancer Burden Associated With Poor Diet in the United States.

BACKGROUND: Diet is an important risk factor for cancer that is amenable to intervention. Estimating the cancer burden associated with diet informs evidence-based priorities for nutrition policies to reduce cancer burden in the United States. METHODS: Using a comparative risk assessment model that incorporated nationally representative data on dietary intake, national cancer incidence, and estimated associations of diet with cancer risk from meta-analyses of prospective cohort studies, we estimated the annual number and proportion of new cancer cases attributable to suboptimal intakes of seven dietary factors among US adults ages 20 years or older, and by population subgroups. RESULTS: An estimated 80 110 (95% uncertainty interval [UI] = 76 316 to 83 657) new cancer cases were attributable to suboptimal diet, accounting for 5.2% (95% UI = 5.0% to 5.5%) of all new cancer cases in 2015. Of these, 67 488 (95% UI = 63 583 to 70 978) and 4.4% (95% UI = 4.2% to 4.6%) were attributable to direct associations and 12 589 (95% UI = 12 156 to 13 038) and 0.82% (95% UI = 0.79% to 0.85%) to obesity-mediated associations. By cancer type, colorectal cancer had the highest number and proportion of diet-related cases (n = 52 225, 38.3%). By diet, low consumption of whole grains (n = 27 763, 1.8%) and dairy products (n = 17 692, 1.2%) and high intake of processed meats (n = 14 524, 1.0%) contributed to the highest burden. Men, middle-aged (45-64 years) and racial/ethnic minorities (non-Hispanic blacks, Hispanics, and others) had the highest proportion of diet-associated cancer burden than other age, sex, and race/ethnicity groups. CONCLUSIONS: More than 80 000 new cancer cases are estimated to be associated with suboptimal diet among US adults in 2015, with middle-aged men and racial/ethnic minorities experiencing the largest proportion of diet-associated cancer burden in the United States.This work was supported by NIH/ NIMHD 1R01MD011501 (FFZ), NIH/ NHLBI R01HL115189 (DM), United Kingdom Medical Research Council Epidemiology Unit Core Support (MC_UU_12015/5) (FI), and American Heart Association postdoctoral fellowship (JXL)