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Biomedical subjects

Barry M Popkin

Publications and source records attributed to Barry M Popkin.

At least 55 records · Page 3Linked to original sources
PubMed2003

Acculturation and overweight-related behaviors among Hispanic immigrants to the US: the National Longitudinal Study of Adolescent Health.

Little is known about the factors underlying the striking increase in overweight occurring between first and second generation US immigrants. Using data from the National Longitudinal Study of Adolescent Health, this study addressed two goals. First, we determined which measures of acculturation (defined as the acquisition of dominant cultural norms by members of a non-dominant group) were important. Second, we determined how the acculturation process affected differences in overweight and its proximate determinants (e.g., physical activity, diet, and smoking) as immigrants acculturated to American society. In addition, we sought to elucidate the role of underlying structural factors (e.g., family income and crime) and acculturation factors (e.g., language spoken at home and proportion of foreign-born neighbors) in generation differences in overweight. Results showed clear structural and acculturation differences between foreign and US-born immigrants to the US. Foreign-born immigrants were more likely to have lower family income and maternal education, and to live in areas of higher immigrant density and greater linguistic isolation. In addition, results suggested rapid acculturation of overweight-related behaviors, such as diet, smoking, and inactivity, in US-born relative to foreign-born immigrants. Multivariate analysis indicated that longer US residence was associated with increased overweight among Puerto Ricans and Cubans. Predicted probabilities showed that controlling for acculturation and proximate factors increased overweight among foreign-born adolescents, but had minimal impact for US-born adolescents. Thus, without the beneficial pattern of: acculturation factors, diet, and physical activity, first generation Hispanic adolescents would have higher overweight prevalence. We found important generation differences in structural, acculturation, and proximate overweight determinants. These lifestyle differences between foreign- and US-born Hispanic adolescent immigrants are likely to underlie the striking increase in overweight prevalence between first and subsequent generation of US residence.

Acculturation↗
PubMed2003

Who is leading the change?. U.S. dietary quality comparison between 1965 and 1996.

BACKGROUND: Many studies have examined rapidly changing trends in U.S. dietary intake, but not as they correspond to other health inequalities among black and white Americans. The purpose of this study was to explore 30-year trends in diet quality and to examine whether income or education is the key socioeconomic factor linked with these shifts. METHODS: The 1965 Nationwide Food Consumption Survey and the 1994-1996 Continuing Survey of Food Intake by Individuals were used and included, respectively, 6476 and 9241 respondents who were aged > or =18 years. The Revised Diet Quality Index (DQI-R), an instrument that provides a summary assessment of a diet's overall healthfulness, was also used. RESULTS: Between 1965 and 1996, improvements were found in both the overall DQI-R and its components across all education levels, with the exception of calcium intake. Conversely, improvements linked with income effects were inconsistent and less clear. In 1965, the effect of college attendance resulted in a 1.8 point higher DQI-R, higher calcium intake, and increased servings of fruits and vegetables. In 1994-1996, there were consistently improved diets for the overall DQI-R and its components, particularly among college attendees. CONCLUSIONS: Diet quality has improved across both race and socioeconomic status groupings between 1965 and 1994-1996; however, education provides a much clearer differentiation. Education efforts must be emphasized to eliminate disadvantages in diet quality.

Adolescent↗
PubMed2003

The effect of weight change on nursing care facility admission in the NHANES I Epidemiologic Followup Survey.

Data from the first National Health and Nutrition Examination Survey Epidemiologic Followup Survey were used to examine whether weight change was associated with an increased relative risk of nursing care facility admission. Hazard ratios were calculated with Cox proportional hazards models and stratified by overweight status at baseline. Moderate and large weight loss was associated with an increased risk of nursing care facility admission in overweight and non-overweight subjects. Large weight gain was associated with an increased relative risk in only overweight subjects. In the process of functional decline that results in nursing care facility admission, weight loss may be a sign of acute illness, starvation, or aging. Preventing weight loss may help delay this process of decline. In overweight subjects, preventing weight gain may also be important in delaying this process of decline.

Aged↗
PubMed2003

Weekend eating in the United States is linked with greater energy, fat, and alcohol intake.

OBJECTIVES: To determine if macronutrient consumption for the U.S. population is greater on weekend days than weekdays. RESEARCH METHODS AND PROCEDURES: The nationally representative 1994 to 1996 Continuing Survey of Food Intakes by Individuals was used for this analysis. Dietary intake was assessed using two independent days of dietary recall data. Ordinary least squares multivariate analysis was used to analyze dietary outcome variables to explore the effect of weekend day vs. weekday intake. RESULTS: This study's results indicate that statistically significant dietary intake differences occur for different days of the week but not for all age groups--nor for all nutrients. The average American, 2 years and older, consumes 82 kcal more per day on each weekend day (Friday through Sunday) than they do on weekdays (Monday through Thursday). These overall increases in dietary intake are significant for the overall sample and are largest for the 19- to 50-year-old age group; among this age group, the weekend day increase (vs. weekday) is 115 kcal/d. The increased proportions of energy from fat and alcohol consumed on weekends are greater for this adult age group by 0.7% and 1.4%, respectively, whereas the proportion of energy from carbohydrate decreases 1.6%. DISCUSSION: The effects of weekend days on nutrient intake are substantial and should be considered in future clinical and population-based interventions and in dietary monitoring and research in the U.S.

Adolescent↗
PubMed2003

Patterns of overweight, inactivity, and snacking in Chinese children.

OBJECTIVE: To examine patterns of inactivity and snacking and their relationship with overweight status in Chinese children. RESEARCH METHODS AND PROCEDURES: The study population was drawn from the 1997 China Health National Survey (1385 children, ages 6 to 11 years), conducted with a representative sample from nine provinces. The 2000 Centers for Disease Control and Prevention BMI charts were used to calculate "at risk of overweight" as those above the 85th percentile. Three days of 24-hour recall dietary data and detailed questions on physical activity and inactivity for the previous 7 days were used. RESULTS: 9.4% of the children were classified as overweight. Weekly mean and range of hours spent watching television/videos, playing video games, studying, and in inactive transport were 5.1 (0 to 35), 0.3 (0 to 10), 4.7 (0 to 60), and 0.14 (0 to 4.2), respectively. Television/video viewing and studying did not differ in any meaningful manner between overweight and normal weight children. Snacking is inconsequential in China, comprising only 0.9% of energy intake. DISCUSSION: Chinese children are less overweight, less inactive, and less likely to ingest calories as snacks than children in the U.S. The absence of impact of these measures of inactivity, which are below an hour per day for the average Chinese child, indicate the possible value of limiting television viewing and other types of inactivity in other countries. Modern Western-style television programming and advertising started to come to China after 1997; therefore, extensive changes in television viewing patterns are expected to emerge.

Child↗
PubMed2003

The sweetening of the world's diet.

OBJECTIVE: Using data from many countries in the world combined with in-depth U.S. dietary data, we explored trends in caloric sweetener intake, the role of urbanization and income changes in explaining these trends, and the contribution of specific foods to these changes. RESEARCH METHODS AND PROCEDURES: Food disappearance data from 103 countries in 1962 and 127 in 2000 were coupled with urbanization and gross national income per capita data in pooled regression analysis to examine associations between these factors and caloric sweetener intake. Three nationally representative surveys from 1977 to 1978, 1989 to 1991, and 1994 to 1996 plus 1998 are used to examine caloric sweetener intake trends in the United States and the foods responsible for these changes. RESULTS: Increased consumption of caloric sweetener is one element in the world's dietary changes, represented by a 74-kcal/d increase between 1962 and 2000. Urbanization and income growth represent 82% of the change. U.S. data show an 83-kcal/d increase of caloric sweetener consumed-a 22% increase in the proportion of energy from caloric sweetener. Of this increase, 80% comes from sugared beverages; restaurant and fast food sources are represented in greater proportions. DISCUSSION: Caloric sweetener use has increased considerably around the world. Beverage intake seems to be a major contributor.

Adolescent↗
PubMed2003

The relationship of ethnicity, socioeconomic factors, and overweight in US adolescents.

OBJECTIVE: To examine the extent to which race/ethnic differences in income and education account for sex-specific disparities in overweight prevalence in white, African American, Hispanic, and Asian U.S. teens. RESEARCH METHODS AND PROCEDURES: We used nationally representative data collected from 13113 U.S. adolescents enrolled in the National Longitudinal Study of Adolescent Health. Logistic regression models were used to examine the relationship of family income and parental education to overweight prevalence (body mass index >or= 85th percentile of age and sex-specific cutoff points from the 2000 Centers for Disease Control and Prevention/National Center for Health Statistics growth charts). In addition, we used coefficients from our logistic regression models to project the effects on overweight prevalence of equalizing the socioeconomic status (SES) differences between race/ethnic groups. RESULTS: Keeping adolescents in their same environments and changing only family income and parental education had a limited effect on the disparities in overweight prevalence. Ethnicity-SES-overweight differences were greater among females than males. Given that overweight prevalence decreased with increasing SES among white females and remained elevated and even increased among higher SES African-American females, African-American/white disparity in overweight prevalence increased at the highest SES. Conversely, disparity was lessened at the highest SES for white, Hispanic, and Asian females. Among males, disparity was lowest at the average SES level. DISCUSSION: One cannot automatically assume that the benefits of increased SES found among white adults will transfer to other gender-age-ethnic groups. Our findings suggest that efforts to reduce overweight disparities between ethnic groups must look beyond income and education and focus on other factors, such as environmental, contextual, biological, and sociocultural factors.

Adolescent↗
PubMed2003

Estimating body fat from anthropometry and isotopic dilution: a four-country comparison.

OBJECTIVE: The goal was to assess the ability of BMI to predict body fat (BF) among youths in four countries and identify the degree to which additional anthropometric measures improve this prediction. BMI is widely recommended as an indicator of overweight. However, whether BMI adequately estimates BF and has the same meaning in different ethnic groups and youths has been questioned. RESEARCH METHODS AND PROCEDURES: Data come from 456 Filipino, Chinese, Russian, and black South African youths, 6 to 16 years old. Percentage BF and fat mass index (FMI) were estimated by the deuterium dilution method. Skinfold thicknesses (triceps, subscapular, and suprailiac) and weight and height measures were collected. Percentage BF was regressed first on BMI and age and then with the addition of the skinfold measures. Linear models were run separately by country and sex. The models were repeated with FMI as the outcome. RESULTS: The R2 values from the percentage BF models ranged from 0.13 to 0.69 in the first models to 0.38 to 0.81 in the full models. The values were lowest among Russian males > or = 13 years and Russian females > or = 13 years of age in the reduced and full models, respectively, and were highest among Chinese females. Using FMI as the outcome did not meaningfully change the results. DISCUSSION: The ability of BMI to adequately predict BF and the additional predictivity of anthropometric measures varied widely across the samples, making its uniform use as a proxy for BF in youths from different countries questionable.

Adipose Tissue↗
PubMed2003

Why do some overweight children remain overweight, whereas others do not?

OBJECTIVE: To study the dynamics of childhood overweight and the influence of dietary intake on tracking of overweight. DESIGN AND SETTING: A follow-up study conducted in China. SUBJECTS: Ninety-five overweight children, 6-13 years old, identified from 1455 children at baseline, were followed over a 2-year period. METHODS: Data on anthropometry and 3-day dietary intake were collected at baseline and during follow-up. Overweight was defined using the International Obesity Task Force reference of body mass index (BMI)-for-age. Differences between groups were tested using analysis of variance and Cochran-Mantel-Haenszel tests. RESULTS: Of the 95 overweight children, 36.8% remained overweight 2 years later ('tracking group'). Urban boys were three times more likely than rural boys to remain overweight (63.2% vs. 21.9%). At baseline, the tracking group had higher BMI, body weight and fat intake (% of energy), and lower carbohydrate intake (% of energy), than the non-tracking group (who shifted from overweight to not overweight); they were more likely to have a high-fat or high-meat diet, but less likely to have a diet high in carbohydrate or vegetables and fruit. During the follow-up, the tracking group increased fat intake and reduced carbohydrate intake while the non-tracking group did not; and they also grew slower in height but faster in weight. Tracking of overweight seemed to be related to tracking of high-meat (relative risk (RR) 2.4, 95% confidence interval (CI) 1.0-5.6, P < 0.05) and high-fat (RR 1.5, 95% CI 0.9-2.5, P < 0.1) diets. CONCLUSION: Considerable changes in children's overweight status during childhood and adolescence were observed in China, a transitional society. Dietary patterns, particularly dietary composition, seemed to influence the tracking patterns of overweight.

Adolescent↗
PubMed2003

Low income Russian families adopt effective behavioral strategies to maintain dietary stability in times of economic crisis.

The social, political and economic reforms of 1992 in Russia led to a decade of rising income inequality, unemployment and economic crises, the most severe of which occurred in 1998. This study assesses dietary trends for children in low and high income households during this politically and economically unstable period from 1994 to 2000. Several possible food-related behaviors were also assessed to evaluate coping strategies adopted in the face of decreasing economic stability. Low income children maintained a steady energy intake per kilogram weight throughout the study period (251.0-259.4 kJ/kg), whereas intake for high income children increased significantly to a per capital average of 297.1 kJ/kg by 2000. At the food group level, the trend in per capita intake for all food groups was maintained for low income children except for a 22% decrease in meat and poultry consumption (P < 0.01). Per capita intake increased over time for dairy products and eggs in the high income group (P < 0.01). A decrease in cost per kJ (rubles/kJ) was observed for both low and high income families (P < 0.01). These data suggest that Russian households were able to conserve the diet structure for children by using what appear to be food-related behavioral mechanisms during periods of economic crisis.

Child↗
PubMed2003

The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States.

A composite measure of diet has been preferred to an index of a single nutrient or food in the area of dietary assessment. However, the lack of such a tool for cross-national comparisons has restricted the ability to compare diet quality between countries using an overall measure of diet. In this study, we created a tool called the Diet Quality Index-International (DQI-I) for global monitoring and exploration of diet quality across countries. The major categories of the index components are variety, adequacy, moderation and overall balance. Using the tool, this research presents a cross-national comparison of diet quality between China and the United States, incorporating comparable national in-depth diet data. The mean of the DQI-I score was slightly higher in China than in the United States. By major categories of the DQI-I, dietary variety was better achieved in the U.S. diet; moderation and overall balance of intakes were better accomplished in China. The DQI-I was successful in capturing variability in intakes of food and nutrients in both countries. Some distinct patterns of poor quality diet in each country were also identified. As demonstrated in this study, the DQI-I provides an effective means of cross-national comparative work for global understanding of diet quality. Furthermore, the dietary problem areas identified by the DQI-I may be useful in guiding the development of programs to improve public health.

China↗
PubMed2003

Dynamics of the nutrition transition toward the animal foods sector in China and its implications: a worried perspective.

Many changes in diet and in physical activity are occurring simultaneously in the developing world. These diet shifts include large increases in energy density, in the proportion of the population consuming a high fat diet and in animal product intake. Animal source foods (ASF) play a major role in these diet shifts. This article documents the large shifts in the composition of diets and obesity across the developing world and notes that these changes are accelerating. Using China as a case study, evidence of the speeding up of this process is presented in descriptive and more rigorous dynamic longitudinal analysis. The implications of these changes for dietary and obesity patterns and cardiovascular disease are great. Indeed, developing countries are at a point where the prevalence of obesity is greater than that of undernutrition and concerns related to intake of saturated fat and energy imbalance must be considered more seriously by the agriculture sector. Current agriculture development policy in many developing countries focuses on livestock promotion and does not consider the potential adverse health consequences of this strategy. Although linkages between ASF intake and obesity cannot be established as clearly as they are for high ASF intakes, heart disease and cancer, the potential adverse health effects linked with an increased ASF intake should no longer be ignored.

Adult↗
PubMed2003

Objective physical activity of filipino youth stratified for commuting mode to school.

PURPOSE: The Cebu Longitudinal Health and Nutrition Survey included self-report measures and objective measures (Caltrac accelerometer) of Filipino adolescent (ages 14-16) physical activity (PA) in 1998-99. The purpose of this subanalysis was to compare objectively monitored PA of adolescents who differed by their self-reported habitual commuting mode to school, specifically commuting by walking, motorized transport, or a combination of the two. METHODS: Descriptive analysis included the proportion of adolescents who reported commuting to school by the different modes, participating in sport/exercise during or after school, or currently working. ANCOVA was used to estimate and compare adjusted mean Caltrac-derived energy expenditure (kcal.d ) by commuting mode for each gender. Covariates were age, weight, and height. RESULTS: The analysis sample of 1518 Filipino adolescents included 691 male (BMI = 18.5 +/- 2.5) and 827 female subjects (BMI = 18.7 +/- 2.3). A total of 323 male subjects (46.8% of all male subjects) walked to school, 160 (23.2%) took motorized transport, and 208 (30.0%) used a combination of the two modes. The corresponding values for female subjects were 303 (36.6%), 177 (21.4%), and 347 (42.0%). The absolute difference in Caltrac-derived energy expenditure that appeared to be due to active commuting was 44.2 kcal.d for Filipino male adolescents and 33.2 kcal.d for female adolescents. These differences between commuting modes could not be explained by participation in sport/exercise or by current employment. CONCLUSIONS: Assuming 200 school days in a year, the difference in energy expended due to active commuting translates to a 8840 kcal and 6640 kcal in male and female subjects, respectively. For those youth who commute to school by motorized transport a yearly positive energy balance (i.e., weight gain) of 2-3 lb would be anticipated, all other things being held constant.

Adolescent↗
PubMed2003

In an era of economic growth, is inequity holding back reductions in child malnutrition in Vietnam?

In the past decade of economic growth, Vietnam has achieved an impressive rate of socioeconomic development. However, the rate of improvement in child malnutrition lags far behind that of most other health indicators. This study examines factors other than income that might affect this inability to reduce rapidly child malnutrition by exploring the socioeconomic factors that explain the high rates of stunting and underweight status of many Vietnamese children. A nationally representative survey of Vietnamese households, the 1997-98 Vietnam Living Standards Survey (VLSS) is used. Multivariate logit is used for regression analysis. The key parameters are household poverty status, total expenditure level, rural residence, and minority status with controls for many key socio-demographic measures. Children from rural households, poor households, and ethnic minority backgrounds are significantly more likely to be malnourished (with a 17.6%, 10.9%, and 14.1%, respectively, greater prevalence of malnutrition) than are urban residents, non-poor households, and the majority Kinh population. These results suggest that economic improvements in Vietnam have, for the most part, bypassed the rural poor and minorities and that targeting economic resources towards these groups will be most critical for reducing undernutrition in Vietnam.

Body Weight↗
PubMed2002

The natural history of the development of obesity in a cohort of young U.S. adults between 1981 and 1998.

BACKGROUND: Understanding the natural history of obesity in a population may be a critical step toward developing effective interventions. OBJECTIVE: To assess the development of body mass and examine the role of race or ethnicity, sex, and birth year in obesity onset in young U.S. adults. DESIGN: Prospective cohort study. SETTING: The National Longitudinal Survey of Youth 1979, a national sample with oversampling of minority ethnic groups. PARTICIPANTS: 9179 persons. MEASUREMENTS: Body mass index (BMI) calculated from 12 self-reported height and weight samples recorded between 1981 and 1998. Logistic regression identified predictors of obesity at age 35 to 37 years. Cox proportional hazards models compared the incidence of obesity by ethnicity and birth year. RESULTS: Overall, 26% of men and 28% of women were obese (BMI > or = 30 kg/m2) by age 35 to 37 years. Race or ethnicity and baseline BMI were significant predictors of obesity. Obesity onset was 2.1 (95% CI, 1.6 to 2.7) times faster for black women and 1.5 (CI, 1.1 to 2.0) times faster for Hispanic women than for white women. The pattern for men differed: Overall, obesity developed most rapidly in Hispanic men, but relative rates of obesity onset for white men compared with black men varied according to age. The rate of obesity onset increased 26% to 28% over an 8-year span in birth year. CONCLUSIONS: Marked ethnic-based differences were found in rates of weight accumulation in young U.S. adults, with later birth cohorts experiencing earlier onset of obesity. To alter the course of obesity in the United States, interventions should target young adults, especially those of minority ethnic groups.

Adult↗
PubMed2002

Ethnic differences in the association between body mass index and hypertension.

Interest in ethnicity-specific definitions of obesity has been hindered by a lack of data clarifying whether or not obesity-related comorbid conditions occur at different levels of body mass index (BMI) (weight (kg)/height (m)(2)) in different ethnic groups. The objective of this study was to examine ethnic differences in the strength of the association between BMI and hypertension. Cross-sectional data obtained from adults aged 30-65 years in China (1997, n = 3,423), the Philippines (1998, n = 1,929), and the United States (1988-1994, n = 7,957) were used. Higher BMI was associated with a higher prevalence of hypertension in all ethnic groups. However, at BMI levels less than 25, prevalence difference figures suggested a stronger association between BMI and hypertension in Chinese men and women but not in Filipino women, compared with non-Hispanic Whites. Non-Hispanic Blacks and Filipino women had a higher prevalence of hypertension at every level of BMI compared with non-Hispanic Whites and Mexican Americans. These ethnic differences in the strength of association between BMI and hypertension and in underlying prevalence warrant further investigation into the use of ethnicity-specific BMI cutoffs in clinical settings to more accurately identify individuals at risk from obesity.

Adult↗
PubMed2002

Trends in food locations and sources among adolescents and young adults.

BACKGROUND: The aim of this study was to determine overall trends of total energy intake by food location and food type in diets of adolescents and young adults. METHODS: This study used a nationally representative sample of 16,810 individuals, ages 12-29 from the 1977 to 1978 Nationwide Food Consumption Survey and the 1989-1991 and 1994-1996 Continuing Surveys of Food Intake by Individuals. For each survey year, the percentage of total energy intake from meals and snacks was calculated for adolescents ages 12-18 and young adults ages 19-29. The percentage of energy intake by location and for specific food group was computed for both age groups, separately. RESULTS: Both adolescents and young adults are obtaining less of their energy intake at home and more at restaurants and fast food places. This is predominantly seen among calories from snacking occasions for adolescents and both meals and snacks among the older age group. Significant increases in consumption of pizza, cheeseburgers, and salty snacks and decreases in consumption of desserts and certain milk and meat products by both age groups are shown. CONCLUSIONS: To improve the diets of adolescents and young adults, healthy food choices outside the home need to be as readily available as the foods which have increased in popularity over the past 20 years.

Adolescent↗