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Biomedical subjects

Barry M Popkin

Publications and source records attributed to Barry M Popkin.

At least 19 recordsLinked to original sources
PubMed2007

Understanding global nutrition dynamics as a step towards controlling cancer incidence.

As we look to understand future forces that will affect cancer risk, poor dietary patterns, overweight and obesity are significant concerns. In the past two decades these factors have shifted from issues that face higher-income countries to a global pandemic, and are rapidly becoming less a problem of affluence and more a problem of poverty. Rapid shifts in food systems, food pricing and marketing are the causes that underlie this trend. It is imperative to understand these factors and implement global interventions to slow this pandemic. The alternative is an acceleration of the incidence of the main nutrition-related cancers, primarily in developing countries.

Developing Countries↗
PubMed2007

Differential associations of fast food and restaurant food consumption with 3-y change in body mass index: the Coronary Artery Risk Development in Young Adults Study.

BACKGROUND: Away-from-home food consumption has rapidly increased, though little is known about the independent associations of restaurant food and fast food intake with body mass index (BMI) and BMI change. OBJECTIVE: The aim was to compare the associations of restaurant food and fast food consumption with current and 3-y changes in BMI. DESIGN: Multivariate linear regression models, with control for demographic and lifestyle factors, were used to examine cross-sectional and longitudinal associations of away-from-home eating with BMI by using data from subjects of the Coronary Artery Risk Development in Young Adults Study (n = 3394) obtained at exam years 7 (1992-1993) and 10 (1995-1996). RESULTS: Forty percent of the sample increased their weekly consumption of restaurant or fast food, though mean (+/-SD) changes were -0.16 +/- 2.39 times/wk (P = 0.0001) and -0.56 +/- 3.04 times/wk (P < 0.0001), respectively. Cross-sectionally, fast food, but not restaurant food, consumption was positively associated with BMI. Similarly, higher consumption of fast food at year 7 was associated with a 0.16-unit higher BMI at year 10. After adjustment for baseline away-from-home eating, increased consumption of fast food only (beta: 0.20; 95% CI: 0.01, 0.39) and of both restaurant food and fast food (beta: 0.29; 95% CI: 0.06, 0.51) were positively associated with BMI change, though the estimates were not significantly different (P = 0.47). Increased consumption of restaurant food only was unrelated to BMI change (beta: -0.01; 95% CI: -0.21, 0.19), which differed significantly (P = 0.014) from the estimate for an increase in both restaurant food and fast food intake. CONCLUSIONS: We found differential effects of restaurant food and fast food intakes on BMI, although the observed differences were not always statistically significant. More research is needed to determine whether the differential effects are related to consumer characteristics or the food itself.

Adult↗
PubMed2006

China's transition: the effect of rapid urbanization on adult occupational physical activity.

China has recently undergone rapid social and economic change. Increases in urbanization have led to equally rapid shifts toward more sedentary occupations through the acquisition of new technology and transitions away from a mostly agricultural economy. Our purpose was to utilize a detailed measure of urbanicity comprising 10 dimensions of urban services and infrastructure to examine its effects on the occupational physical activity patterns of Chinese adults. Longitudinal data were from individuals aged 18-55 from the years 1991-1997 of the China Health and Nutrition Survey (N=4376 men and 4384 women). Logistic multilevel regression analyses indicated that men had 68% greater odds, and women had 51% greater odds, of light versus heavy occupational activity given the mean change in urbanization over the 6-year period. Further, simulations showed that light occupational activity increased linearly with increasing urbanization. After controlling for individual-level predictors, community-level urbanization explained 54% and 40% of the variance in occupational activity for men and women, respectively. This study provides empirical evidence of the reduction in intensity of occupational activity with modernization. It is likely that urbanization will continue unabated in China and this is liable to lead to further transitions in the labor market resulting in additional reductions in work-related activity. Because occupational activity remains the major source of energy expenditure for adults, unless alternative forms are widely adopted, the Chinese population is at risk of dramatic increases in the numbers of overweight and obese individuals.

Adolescent↗
PubMed2006

Built and social environments associations with adolescent overweight and activity.

BACKGROUND: Little is known about the patterning of neighborhood characteristics, beyond the basic urban, rural, suburban trichotomy, and its impact on physical activity (PA) and overweight. METHODS: Nationally representative data (National Longitudinal Study of Adolescent Health, 1994-1995, n = 20,745) were collected. Weight, height, PA, and sedentary behavior were self-reported. Using diverse measures of the participants' residential neighborhoods (e.g., socioeconomic status, crime, road type, street connectivity, PA recreation facilities), cluster analyses identified homogeneous groups of adolescents sharing neighborhood characteristics. Poisson regression predicted relative risk (RR) of being physically active (five or more bouts/week of moderate to vigorous PA) and overweight (body mass index equal or greater than the 95th percentile, Centers for Disease Control and Prevention/National Center for Health Statistics growth curves). RESULTS: Six robust neighborhood patterns were identified: (1) rural working class; (2) exurban; (3) newer suburban; (4) upper-middle class, older suburban; (5) mixed-race urban; and (6) low-socioeconomic-status (SES) inner-city areas. Compared to adolescents living in newer suburbs, those in rural working-class (adjusted RR[ARR] = 1.38, 95% confidence interval [CI] = 1.13-1.69), exurban (ARR = 1.30, CI = 1.04-1.64), and mixed-race urban (ARR = 1.31, CI = 1.05-1.64) neighborhoods were more likely to be overweight, independent of individual SES, age, and race/ethnicity. Adolescents living in older suburban areas were more likely to be physically active than residents of newer suburbs (ARR = 1.11, CI = 1.04-1.18). Those living in low-SES inner-city neighborhoods were more likely to be active, though not significantly so, compared to mixed-race urban residents (ARR = 1.09, CI = 1.00-1.18). CONCLUSIONS: These findings demonstrate disadvantageous associations between specific rural and urban environments and behavior, illustrating important effects of the neighborhood on health and the inherent complexity of assessing residential landscapes across the United States. Simple classical urban-suburban-rural measures mask these important complexities.

Adolescent↗
PubMed2006

Is there a lag globally in overweight trends for children compared with adults?

OBJECTIVE: To determine relative trends in prevalence for overweight for adults compared with children across high-income countries (Australia, United Kingdom, and United States), middle-income countries (Brazil and Russia), and low-income countries (China and Indonesia). RESEARCH METHODS AND PROCEDURES: Extant nationally representative survey data from 1971 to the present are used. Prevalence of overweight for adults > or =18.0 years of age and children 6.0 to 17.9 years of age were used. Absolute and relative annual rates of change in prevalence of overweight in children and adults were the key outcomes. RESULTS: Absolute rates of increase in overweight were higher among adults than among children in all studied countries except Australia. However, relative rates of increase in overweight indicate faster increases in overweight among children in Brazil, China, and the three high-income countries. As a result, the relative excess of overweight among adults, seen initially in all countries, increased in Indonesia and Russia, but it decreased in Australia, Brazil, China, United Kingdom, and United States. In Brazil, time trends indicate an acceleration in the annual rate of change in overweight for children and a deceleration for adults, whereas in the United States, the increase in overweight shows acceleration for both children and adults. DISCUSSION: In absolute terms, overweight increased faster among children than adults only in Australia; however, the relative gap between children and adults is closing in four additional countries, Brazil, China, the United Kingdom, and the United States.

Adolescent↗
PubMed2006

A new proposed guidance system for beverage consumption in the United States.

The Beverage Guidance Panel was assembled to provide guidance on the relative health and nutritional benefits and risks of various beverage categories. The beverage panel was initiated by the first author. The Panel's purpose is to attempt to systematically review the literature on beverages and health and provide guidance to the consumer. An additional purpose of the Panel is to develop a deeper dialog among the scientific community on overall beverage consumption patterns in the United States and on the great potential to change this pattern as a way to improve health. Over the past several decades, levels of overweight and obesity have increased across all population groups in the United States. Concurrently, an increased daily intake of 150-300 kcal (for different age-sex groups) has occurred, with approximately 50% of the increased calories coming from the consumption of calorically sweetened beverages. The panel ranked beverages from the lowest to the highest value based on caloric and nutrient contents and related health benefits and risks. Drinking water was ranked as the preferred beverage to fulfill daily water needs and was followed in decreasing value by tea and coffee, low-fat (1.5% or 1%) and skim (nonfat) milk and soy beverages, noncalorically sweetened beverages, beverages with some nutritional benefits (fruit and vegetable juices, whole milk, alcohol, and sports drinks), and calorically sweetened, nutrient-poor beverages. The Panel recommends that the consumption of beverages with no or few calories should take precedence over the consumption of beverages with more calories.

Alcohol Drinking↗
PubMed2006

Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases.

Global energy imbalances and related obesity levels are rapidly increasing. The world is rapidly shifting from a dietary period in which the higher-income countries are dominated by patterns of degenerative diseases (whereas the lower- and middle-income countries are dominated by receding famine) to one in which the world is increasingly being dominated by degenerative diseases. This article documents the high levels of overweight and obesity found across higher- and lower-income countries and the global shift of this burden toward the poor and toward urban and rural populations. Dietary changes appear to be shifting universally toward a diet dominated by higher intakes of animal and partially hydrogenated fats and lower intakes of fiber. Activity patterns at work, at leisure, during travel, and in the home are equally shifting rapidly toward reduced energy expenditure. Large-scale decreases in food prices (eg, beef prices) have increased access to supermarkets, and the urbanization of both urban and rural areas is a key underlying factor. Limited documentation of the extent of the increased effects of the fast food and bottled soft drink industries on this nutrition shift is available, but some examples of the heterogeneity of the underlying changes are presented. The challenge to global health is clear.

Chronic Disease↗
PubMed2006

Adults with healthier dietary patterns have healthier beverage patterns.

There is an absence of research examining associations between food and beverage intake patterns and most research has centered on soft drinks, whereas research on overall beverage patterns is absent. Using data from the National Health and Nutrition Examination Survey 99-02 for adults aged 19 y and older, we independently examined beverage and food intake patterns, as well as their interrelations. Cluster analysis generated mutually exclusive intake patterns for beverages and foods. Multinomial logistic regression models provided the odds of a given beverage pattern for each food pattern; we then compared the probability of a given beverage pattern for each food pattern. Six beverage and 6 food patterns emerged. Beverage patterns revealed that calorically sweetened, non caloric, and diet beverages tended to be consumed independently of one another. Being in the Snacks and High-Fat Foods cluster increased the odds of being in the Coffee and Soda (odds ratio (OR): 1.62 [95% CI: 1.27-2.06]) or Nutrients and Soda (OR: 1.51 [95% CI: 1.14-2.00]) beverage clusters and decreased the odds of being in the Water and Tea (OR: 0.51 [95% CI: 0.52-0.97]) cluster relative to the odds of being in the Water, Coffee, and Tea cluster. The opposite was true for the Vegetable pattern. Furthermore, persons who had a healthier food pattern had a higher probability of having a non caloric beverage pattern than persons who did not. Increasing awareness of both the contribution of calorie-containing beverages to overall energy intake and dietary patterns associated with these beverages helps inform policies targeted at reducing energy intake in the population.

Adult↗
PubMed2006

Adherence to a Mediterranean diet is associated with reduced 3-year incidence of obesity.

Few studies have prospectively examined dietary patterns and adult weight change, and results to date are inconsistent. This study examines whether a Mediterranean diet (MD) pattern is associated with reduced 3-y incidence of obesity using data from the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). The sample included 17,238 women and 10,589 men not obese and aged 29-65 y at baseline (1992-96). Height and weight were measured at baseline; weight was self-reported in a follow-up survey a mean of 3.3 y later. Detailed dietary history data, collected using a validated method, were used to construct a MD score. Logistic regression models were used to estimate odds of becoming overweight or obese. Among initially overweight subjects, 7.9% of women and 6.9% of men became obese, whereas 13.8% of normal weight men and 23.0% women became overweight. High MD adherence was associated with significantly lower likelihood of becoming obese among overweight subjects, with stronger associations after adjusting for underreporting of dietary data. Associations (odds ratios with 95% CI) were similar in women (0.69, 0.54-0.89) and men (0.68, 0.53-0.89). Adjusting for the plausibility of reported dietary intakes increased the magnitude of these associations, which were approximately 0.8 without this adjustment. MD adherence was not associated with incidence of overweight in initially normal-weight subjects. Nonetheless, results suggest that promoting eating habits consistent with MD patterns may be a useful part of efforts to combat obesity.

Adult↗
PubMed2006

Inequality in the built environment underlies key health disparities in physical activity and obesity.

CONTEXT: Environmental factors are suggested to play a major role in physical activity (PA) and other obesity-related behaviors, yet there is no national research on the relationship between disparity in access to recreational facilities and additional impact on PA and overweight patterns in US adolescents. OBJECTIVE: In a nationally representative cohort, we sought to assess the geographic and social distribution of PA facilities and how disparity in access might underlie population-level PA and overweight patterns. DESIGN, SETTING, AND PARTICIPANTS: Residential locations of US adolescents in wave I (1994-1995) of the National Longitudinal Study of Adolescent Health (N = 20745) were geocoded, and a 8.05-km buffer around each residence was drawn (N = 42857 census-block groups [19% of US block groups]). PA facilities, measured by national databases and satellite data, were linked with Geographic Information Systems technology to each respondent. Logistic-regression analyses tested the relationship of PA-related facilities with block-group socioeconomic status (SES) (at the community level) and the subsequent association of facilities with overweight and PA (at the individual level), controlling for population density. MAIN OUTCOME MEASURES: Outcome measures were overweight (BMI > or = 95th percentile of the Centers for Disease Control and Prevention/National Center for Health Statistics growth curves) and achievement of > or = 5 bouts per week of moderate-vigorous PA. RESULTS: Higher-SES block groups had a significantly greater relative odds of having 1 or more facilities. Low-SES and high-minority block groups were less likely to have facilities. Relative to zero facilities per block group, an increasing number of facilities was associated with decreased overweight and increased relative odds of achieving > or = 5 bouts per week of moderate-vigorous PA. CONCLUSIONS: Lower-SES and high-minority block groups had reduced access to facilities, which in turn was associated with decreased PA and increased overweight. Inequality in availability of PA facilities may contribute to ethnic and SES disparities in PA and overweight patterns.

Adolescent↗
PubMed2005

Environmental influences on food choice, physical activity and energy balance.

In this paper, the environment is defined as the macro- and community-level factors, including physical, legal and policy factors, that influence household and individual decisions. Thus, environment is conceived as the external context in which household and individual decisions are made. This paper reviews the literature on the ways the environment affects diet, physical activity, and obesity. Other key environmental factors discussed include economic, legal, and policy factors. Behind the major changes in diet and physical activity in the US and globally lie large shifts in food production, processing, and distribution systems as well as food shopping and eating options, resulting in the increase in availability of energy-dense foods. Similarly, the ways we move at home, work, leisure, and travel have shifted markedly, resulting in substantial reductions in energy expenditure. Many small area studies have linked environmental shifts with diet and activity changes. This paper begins with a review of environmental influences on diet and physical activity, and includes the discussion of two case studies on environmental influences on physical activity in a nationally representative sample of US adolescents. The case studies illustrate the important role of physical activity resources and the inequitable distribution of such activity-related facilities and resources, with high minority, low educated populations at strong disadvantage. Further, the research shows a significant association of such facilities with individual-level health behavior. The inequity in environmental supports for physical activity may underlie health disparities in the US population.

Diet↗
PubMed2005

Socioeconomic status and obesity in adult populations of developing countries: a review.

A landmark review of studies published prior to 1989 on socioeconomic status (SES) and obesity supported the view that obesity in the developing world would be essentially a disease of the socioeconomic elite. The present review, on studies conducted in adult populations from developing countries, published between 1989 and 2003, shows a different scenario for the relationship between SES and obesity. Although more studies are necessary to clarify the exact nature of this relationship, particularly among men, three main conclusions emerge from the studies reviewed: 1. Obesity in the developing world can no longer be considered solely a disease of groups with higher SES. 2. The burden of obesity in each developing country tends to shift towards the groups with lower SES as the country's gross national product (GNP) increases. 3. The shift of obesity towards women with low SES apparently occurs at an earlier stage of economic development than it does for men. The crossover to higher rates of obesity among women of low SES is found at a GNP per capita of about US$ 2500, the mid-point value for lower-middle-income economies. The results of this review reinforce the urgent need to: include obesity prevention as a relevant topic on the public health agenda in developing countries; improve the access of all social classes in these countries to reliable information on the determinants and consequences of obesity; and design and implement consistent public actions on the physical, economic, and sociocultural environment that make healthier choices concerning diet and physical activity feasible for all. A significant step in this direction was taken with the approval of the Global Strategy on Diet, Physical Activity and Health by the World Health Assembly in May 2004.

Adult↗
PubMed2005

Adolescent physical activity and sedentary behavior: patterning and long-term maintenance.

BACKGROUND: Little is known about physical activity (PA) and sedentary behavior patterning or its impact on long-term PA sustainability, particularly during the critical transition from adolescence to adulthood. METHODS: Nationally representative self-reported data were collected (National Longitudinal Study of Adolescent Health: Wave I, 1994-1995; Wave II, 1996; Wave III, 2001-2002). Cluster analyses identified homogeneous groups of adolescents with similar PA and sedentary behaviors. Logistic regression predicted odds of meeting national activity recommendations in adolescence and young adulthood. RESULTS: Seven clusters were characterized as follows: C1, high television (TV)/video, video gaming; C2, high skating, video gaming; C3, high sports participation with parents, high overall sports participation; C4, use of neighborhood recreation centers, high sports participation; C5, TV viewing limited by parents, moderate participation in school physical education (PE); C6, low parental TV control, reporting few activities overall; C7, active in school (team/individual sports, academic clubs, and PE). Odds of adolescents meeting PA recommendations were highest in C2 (odds ratio=13.1), C3 (5.8), C4 (4.2), and C7 (4.3) compared to C1. Independent of adolescent PA, absolute odds of meeting recommendations as young adults declined but were still relatively high in these clusters, indicating greater long-term PA sustainability. By young adulthood, however, overall PA declined dramatically in skaters/gamers (C2) and was notably low among those with TV viewing limited by parents (C5). CONCLUSIONS: While odds of meeting PA guidelines in adulthood declined in all clusters, the magnitude of this decline varied by cluster (declining most dramatically in skaters/gamers), providing insights into where to target effective intervention strategies that promote sustainable PA behaviors.

Adolescent↗
PubMed2005

Cluster analysis methods help to clarify the activity-BMI relationship of Chinese youth.

OBJECTIVE: To use cluster analysis to create patterns of overall activity and inactivity in a diverse sample of Chinese youth and to evaluate their use in predicting overweight status. RESEARCH METHODS AND PROCEDURES: The study populations were drawn from the 1997 and 2000 years of the longitudinal China Health and Nutrition Survey, comprised of 2702 and 2641 schoolchildren in the 1997 and 2000 cross-sectional samples, respectively, and 1175 children in the longitudinal cohort. Cluster analysis was used to group children into nonoverlapping activity/inactivity "clusters" that were subsequently used in models of prevalent and incident overweight. Results were compared with traditional models, with activity and inactivity coded separately, to assess whether further insight was gained with the cluster analysis methodology. RESULTS: Moderately and highly active youth were shown to have significantly decreased odds of overweight in both cross-sectional and longitudinal analyses using cluster analysis. In incident longitudinal models, youth in the high activity/high inactivity cluster had the lowest odds of overweight [odds ratio=0.12 (0.03, 0.44)]; in contrast, results from traditional models failed to show any significant relationship between overweight and activity or inactivity. DISCUSSION: Cluster analysis methods allow researchers to simultaneously capture activity and inactivity in new ways. In this comparative study, only with the clustering methodology did we find a significant effect of activity on incident overweight, furthering our ability to examine this complex relationship. Interestingly, no effect of increasing levels of inactivity was observed using either method, indicating that activity seems to be the more important determinant of overweight in this population.

Adolescent↗
PubMed2005

Are child eating patterns being transformed globally?

OBJECTIVE: To examine the extent to which child dietary patterns and trends are changing globally. RESEARCH METHODS AND PROCEDURES: Diets of children 2 to 19 years of age were studied with nationally representative data from Russia and the United States, nationwide data from China, and regional data from metropolitan Cebu, Philippines. Twenty-four-hour dietary recalls were examined at several points in time to examine trends in calories consumed away from home, snacking behavior, and soft drink and modern fast food consumption. Urban-rural trends were compared. RESULTS: U.S. and Cebu youth consume more than one-third of their daily calories and a higher proportion of snack calories from foods prepared away from home. In contrast, away from home food consumption is minimal in Chinese and Russian children. U.S. and Cebu youth consume about one-fifth of their total daily energy from snacks, but snacks provide a much lower proportion of energy in Russia ( approximately 16%) and China (where snacks provide only approximately 1% of energy). Fast food plays a much more dominant role in the American diet ( approximately 20% of energy vs. 2% to 7% in the other countries), but as yet does not contribute substantially to children's diets in the other countries. Urban-rural differences were found to be important, but narrowing over time, for China and Cebu, whereas they are widening for Russia. DISCUSSION: This research suggests that globalization of the fast food and other modern food sectors is beginning to affect child eating patterns in several countries undergoing nutrition transition. However, the contribution of fast food and soft drinks to the diet of children remains relatively small in China, Russia, and Cebu, Philippines, relative to the United States.

Adolescent↗
PubMed2005

Water and food consumption patterns of U.S. adults from 1999 to 2001.

OBJECTIVE: High water consumption has been proposed as an aid to weight control and as a means of reducing the energy density of the diet. This study examines the relationship between water consumption and other drinking and eating patterns. RESEARCH METHODS AND PROCEDURES: The National Health and Nutrition Examination Survey 1999 to 2001, with responses from 4755 individuals > or =18 years of age, provides the data for this cross-sectional analysis. A cluster analysis was performed using z-scores of specific food and beverage consumption to examine patterns. A multinomial logit analysis was used to examine sociodemographic characteristics of each dietary pattern and to examine the effects of water consumption on the likelihood of consuming a non-dairy caloric beverage. All results were weighted to be nationally representative and controlled for design effects. RESULTS: Within the sample, 87% consumed water, with an average daily consumption of 51.9 oz (1.53 liters) per consumer. Water consumers drank fewer soft/fruit drinks and consumed 194 fewer calories per day. Water consumers (potentially a self-selected sample) consumed more fruits, vegetables, and low- and medium-fat dairy products. Four distinct unhealthy dietary patterns were found that included little or no water consumption. Older and more educated persons used healthier food patterns. Mexican dietary patterns were much healthier than dietary patterns of blacks. DISCUSSION: Water consumption potentially is a dietary component to be promoted, but much more must be understood about its role in a healthy diet. Because high water consumption is linked with healthier eating patterns-patterns more likely to be followed by higher-educated, older adults-the target of water promotion and healthy diet options should focus on younger and less educated adults.

Adult↗
PubMed2005

The use of external within-person variance estimates to adjust nutrient intake distributions over time and across populations.

OBJECTIVE: To examine the utility of using external estimates of within-person variation to adjust usual nutrient intake distributions. DESIGN: Analyses of the prevalence of inadequate intake of an example nutrient by the Estimated Average Requirement (EAR) cut-point method using three different methods of statistical adjustment of the usual intake distribution of a single 24-hour recall in Russian children in 1996, using the Iowa State University method for adjustment of the distribution. First, adjusting the usual intake distribution with day 2 recalls from the same 1996 sample (the correct method); second, adjusting the distribution using external variance estimates derived from US children in 1996; and third, adjusting the distribution using external estimates derived from Russian children of the same age in 2000. We also present prevalence estimates based on naive statistical analysis of the unadjusted distribution of intakes. SETTING/SUBJECTS: Children drawn from the Russia Longitudinal Monitoring Survey in 1996 and 2000 and from the 1996 Continuing Survey of Food Intakes by Individuals. RESULTS: When the EAR cut-point method is applied to a single recall, the resulting prevalence estimate in this study is inflated by 100-1300%. When the intake distribution is adjusted using an external variance estimate, the prevalence estimate is much less biased, suggesting that any adjustment may give less biased estimates than no adjustment. CONCLUSIONS: In moderately large samples, adjusting distributions with external estimates of variances results in more reliable prevalence estimates than using 1-day data.

Adolescent↗