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Barry M Popkin

Publications and source records attributed to Barry M Popkin.

69 records · Page 4Linked to original sources
PubMed2002

Obesity affects nursing-care facility admission among whites but not blacks.

OBJECTIVE: This study examines whether obese individuals have a greater rate of nursing care facility admission than normal weight individuals. RESEARCH METHODS AND PROCEDURES: Data from the National Health and Nutrition Examination Survey Epidemiological Follow-up Survey were analyzed. Cox proportional hazards models were used to examine the relationship between baseline weight status and subsequent time to first nursing home admission while adjusting for sex, age, race, marital status, height, presence of children, smoking status, education, region, urban residence, income, and physical activity. RESULTS: Of 5960 adults 45 to 74 years old, 989 individuals were admitted to a nursing care facility over the subsequent 20 years. Body mass index (BMI) was studied using five categories: < 18.5, 18.5 to <25, 25.0 to <30, 30.0 to <35, > or =35 kg/m(2). The effects of BMI differed by race: compared with those with a BMI of 18.5 to < 25 kg/m(2), adults with a BMI > or =30 kg/m(2) or a BMI <18.5 kg/m(2) had a greater rate of nursing home admission in whites, whereas no relationship was found in blacks. The inclusion of time to death with nursing home admission as a joint outcome yielded similar results. DISCUSSION: The large increase in the prevalence of obesity coupled with the rapid expansion of the number of older Americans will likely increase the demand for nursing facility use. More research is needed to understand differences in factors related to nursing home admission among ethnic groups.

Aged↗
PubMed2002

Ethnic differences in physical activity and inactivity patterns and overweight status.

OBJECTIVE: To examine the relationship between physical activity and inactivity patterns and overweight in U.S. adolescents using baseline and 1-year change in activity and inactivity data. RESEARCH METHODS AND PROCEDURES: Nationally representative data from 12,759 participants (6997 non-Hispanic whites, 2676 non-Hispanic blacks, 2185 Hispanics, and 901 Asians) in the National Longitudinal Study of Adolescent Health (1995 and 1996). Data on moderate to vigorous and low-intensity physical activity, TV/video viewing, and video game/computer use were obtained from questionnaires. Multivariate models assessed the association of overweight (body mass index > or = 95th percentile Centers for Disease Control and Prevention/National Center for Health Statistics 2000 curves) with initial (and 1-year change) activity and inactivity levels, controlling for age, ethnicity, socioeconomic status, urban residence, cigarette smoking, and region of residence. RESULTS: Overweight prevalence was positively associated with high level TV/video viewing among white boys (odds ratio [OR] = 1.52; 95% confidence interval [1.08 to 2.14]) and girls (OR = 2.45 [1.51 to 3.97]). The odds of overweight decreased with high levels of moderate to vigorous physical activity among white boys (OR = 0.81 [0.76 to 0.87]), non-Hispanic black boys (OR = 0.86 [0.76 to 0.98]) and girls (OR = 0.88 [0.78 to 0.99]), and Hispanic boys (OR = 0.90 [0.83 to 0.97]) and girls (OR = 0.91 [0.84 to 0.99]). DISCUSSION: Predicted probabilities generated from the logistic regression models, which examined the experimental effects of altering hours of TV/video viewing and bouts of moderate to vigorous physical activity, show lower overweight among adolescents who watched less TV per week combined with frequent moderate to vigorous physical activity than those who watched more TV per week combined with fewer bouts of weekly moderate to vigorous physical activity. Predicted probabilities suggest important sex and ethnic differences in these associations.

Adolescent↗
PubMed2002

The road to obesity or the path to prevention: motorized transportation and obesity in China.

OBJECTIVE: Dependence on motorized forms of transportation may contribute to the worldwide obesity epidemic. Shifts in transportation patterns occurring in China provide an ideal opportunity to study the association between vehicle ownership and obesity. Our objective was to determine whether motorized forms of transportation promote obesity. RESEARCH METHODS AND PROCEDURES: A multistage random-cluster sampling process was used to select households from eight provinces in China. Data were included on household vehicle ownership and individual anthropometric and sociodemographic status. Cross-sectional data (1997) from 4741 Chinese adults aged 20 to 55 years were used to explore the association between vehicle ownership and obesity. Cohort data (1989 to 1997) from 2485 adults aged 20 to 45 years in 1989 (59% follow-up) were used to measure the impact of vehicle acquisition on the odds of becoming obese. RESULTS: Our main outcome measure was current obesity status and the odds of becoming obese over an 8-year period. In 1997, 84% of adults did not own motorized transportation. However, the odds of being obese were 80% higher (p < 0.05) for men and women in households who owned a motorized vehicle compared with those who did not own a vehicle. Fourteen percent of households acquired a motorized vehicle between 1989 and 1997. Compared with those whose vehicle ownership did not change, men who acquired a vehicle experienced a 1.8-kg greater weight gain (p < 0.05) and had 2 to 1 odds of becoming obese. DISCUSSION: Encouraging active forms of transportation may be one way to protect against obesity.

Adult↗
PubMed2002

Trends in energy intake in U.S. between 1977 and 1996: similar shifts seen across age groups.

OBJECTIVE: To determine the trends in locations and food sources of Americans stratified by age group for both total energy and the meal and snack subcomponents. RESEARCH METHODS AND PROCEDURES: Nationally representative data was taken from the 1977 to 1978 Nationwide Food Consumption Survey and the 1989 to 1991 and 1994 to 1996 (and 1998 for children age 2 through 9) Continuing Surveys of Food Intake by Individuals. The sample consisted of 63,380 individuals, age 2 and up. For each survey year, the percentage of total energy intake from meals and snacks was calculated separately for 2- to 18-year-olds, 19- to 39-year-olds, 40- to 59-year-olds, and those 60 years and older. The percentage of energy intake by location (at-home consumption or preparation, vending, store eaten out, restaurant/fast-food, and school) and by specific food group was computed for all age groups separately. RESULTS: The trends in location and food sources were almost identical for all age groups. Key dietary behavior shifts included greater away-from-home consumption; large increases in total energy from salty snacks, soft drinks, and pizza; and large decreases in energy from low- and medium-fat milk and medium- and high-fat beef and pork. DISCUSSION: Total energy intake has increased over the past 20 years, with shifts away from meals to snacks and from at-home to away-from-home consumption. The similarity of changes across all age groups furthers the assertion that broad-based environmental changes are needed to improve the diets of Americans.

Adolescent↗
PubMed2002

Is obesity replacing or adding to undernutrition? Evidence from different social classes in Brazil.

OBJECTIVE: To describe time trends in under- and overnutrition in different regional and income strata of the child and adult population of Brazil. DESIGN: Nation-wide surveys conducted in 1975, 1989 and 1996/7 in probabilistic samples of 1-4-year-old children and adults 20 years and over. Time trends refer to stunting, wasting and overweight prevalences among children and age-adjusted underweight and obesity prevalences among adults (95% confidence intervals included). SUBJECTS: Individuals examined by each survey in each age group ranged from 1796 young children in 1996 to 78031 adults in 1975. SETTING: North-eastern and south-eastern regions of Brazil. RESULTS: Undernutrition indicators declined intensively and continuously among children and adults in all region and income strata. Obesity remained low and relatively stable among children, but increased intensively and continuously in all regions and income strata among adult males. Obesity also increased intensively and continuously among adult women from the less economically developed region of Brazil (the north-eastern region) and among lower-income women from the more developed region (the south-eastern region). Higher-income women from the more developed region had a significant increase in obesity from 1975 to 1989, followed by a significant decline from 1989 to 1997. CONCLUSIONS: Undernutrition in young children is being controlled in Brazil without evidence of increasing obesity. However, obesity is rapidly replacing undernutrition in most gender, region and income strata of the adult population. Adult obesity is already more frequent than adult undernutrition in the more economically developed region, among all higher-income groups, and also among lower-income women living in the more developed region. These lower-income women are significantly more exposed than their higher-income counterparts to both undernutrition and obesity.

Adult↗
PubMed2002

A new stage of the nutrition transition in China.

OBJECTIVE: To fully explore the long-term shifts in the nutrition transition and the full implications of these changes in the Chinese diet. DESIGN: A descriptive, population-based study. SETTING: Data come from nationally representative surveys: the China Health and Nutrition Survey (1989-1997), the China National Nutrition Survey (1982 and 1992), the annual household consumption surveys of the State Statistical Bureau, and the Annual Death Report of China. RESULTS: During the first part of the major economic transformation in China (before 1985), cereal intake increased but decreased thereafter. There was also a long-term reduction of vegetable consumption that has now stabilised. Intake of animal foods increased slowly before 1979 and more quickly after the economic reforms occurred. While the total energy intake of residents has decreased, as has energy expenditure, large changes in the composition of energy have occurred. The overall proportion of energy from fat increased quickly, reaching an overall average of 27.3% and 32.8% for urban residents in 1997. Over a third of all Chinese adults and 60.1% of those in urban areas consumed over 30% of their energy from fat in 1997. Large shifts towards increased inactivity at work and leisure occurred. These changes are linked with rapid increases of overweight, obesity and diet-related non-communicable diseases (DR-NCDs) as well as total mortality for urban residents. CONCLUSIONS: The long-term trend is a shift towards a high-fat, high-energy-density and low-fibre diet. The Chinese have entered a new stage of the nutrition transition.

Cause of Death↗
PubMed2002

The unique aspects of the nutrition transition in South Korea: the retention of healthful elements in their traditional diet.

OBJECTIVE: The purposes of this paper are to describe the unique aspects of the nutrition transition in South Korea, including trends in food consumption and obesity, patterns of morbidity and mortality; to focus on efforts to maintain the traditional diet in the midst of rapid economic growth and the introduction of Western culture; and to provide insights for other countries. DESIGN: We analysed secondary dietary intake, anthropometric, morbidity and mortality data from published reports and articles. RESULTS: In South Korea, the level and rate of increase in fat intake have remained very low, whereas vegetable intake has been high and fruit intake has increased greatly. South Korea also has a relatively low prevalence of obesity compared with other Asian countries. The traditional Korean diet is a low-fat and high-vegetable diet. Therefore, the government and nutrition specialists have been initiating numerous efforts to advertise and teach the public that the traditional diet is a healthy diet. They are also working on revival of the traditional diet using an approach that is acceptable to contemporary Koreans. CONCLUSIONS: The nutrition transition in South Korea is unique. A range of government, nutrition specialists and some private organisation efforts has worked to retain healthful elements of the traditional diet in South Korea. The continued low level of total fat in the overall diet and the high intake of fruits and vegetables bode well for South Korea.

Adult↗
PubMed2002

The shift in stages of the nutrition transition in the developing world differs from past experiences!

OBJECTIVE: This paper explores the unique nutrition transition shifts in diet and activity patterns from the period termed the receding famine pattern to the one dominated by nutrition-related non-communicable diseases (NR-NCDs). The paper examines the speed and timing of these changes; unique components, such as the issue of finding both under- and overnutrition in the same household; potential exacerbating biological relationships that contribute to differences in the rates of change; and political issues. SETTING: The focus is on lower- and middle-income countries of Asia, Africa, the Middle East and Latin America. RESULTS: These changes are occurring at great speed and at earlier stages of these countries' economic and social development. There are some unique issues that relate to body composition and potential genetic factors. The significance of the high number of persons exposed to heavy insults during pregnancy and infancy (foetal origins hypothesis) and the subsequent rapid shifts in energy imbalance remains to be understood. Countries that are still addressing major concerns of undernutrition are not ready to address these NR-NCDs. CONCLUSIONS: The developing world needs to give far greater emphasis to addressing the prevention of the adverse health consequences of this shift to the nutrition transition stage of degenerative diseases.

Africa↗
PubMed2002

What Brazil is doing to promote healthy diets and active lifestyles.

OBJECTIVES: To present the way the Brazilian government is addressing the prevention of nutrition-related non-communicable diseases (NR-NCDs). RESULTS: Innovative legislative and regulatory actions, mass communications and capacity building have been combined to create a comprehensive approach for addressing poor dietary and activity patterns in Brazil that are leading to obesity and NR-NCDs. Included are new nutrition-related initiatives in the labelling area, shifts in the types of food purchased for the school food programme, use of mass media to communicate components of the food guidelines, establishment of a smart shopping initiative, and training of teachers and health workers. CONCLUSIONS: The entire effort has taken several years to get underway. This paper describes the process and some of the initial changes seen.

Brazil↗
PubMed2002

What is China doing in policy-making to push back the negative aspects of the nutrition transition?

OBJECTIVE: To review the nutrition policies and efforts related to nutrition transition in China. DESIGN AND SETTING: This paper reviews the nutrition policy and activities of China to prevent and control diet-related non-communicable diseases (DR-NCDs). Data came from the Ministry of Health, the Ministry of Agriculture, the State Council and some cross-sectional surveys. RESULTS: China is undergoing a remarkable, but undesirable, rapid transition towards a stage of the nutrition transition characterised by high rates of DR-NCDs in a very short time. Some public sector Chinese organisations have combined their efforts to create the initial stages of systematic attempts to reduce these problems. These efforts, which focus on both under- and overnutrition, include the new Dietary Guidelines for Chinese Residents and the Chinese Pagoda and The National Plan of Action for Nutrition in China, issued by the highest body of the government, the State Council. There are selected agricultural sector activities that are laudable and few other systematic efforts that are impacting behaviour yet. In the health sector, efforts related to reducing hypertension and diabetes are becoming more widespread, but there is limited work in the nutrition sector. This paper points to some unique strengths from past Chinese efforts and to an agenda for the next several decades. CONCLUSIONS: China is trying in its efforts to prevent and control the development of DR-NCDs but effects are limited. Systematic multi-sector co-operation is needed to effectively prevent and control DR-NCDs inside and outside the health sector.

Cardiovascular Diseases↗
PubMed2002

Understanding the nutrition transition: measuring rapid dietary changes in transitional countries.

OBJECTIVE: To understand methodological concerns related to dietary intake collection in transitional societies. DESIGN: Three days of household weighing and measurement of all food used and repeated 24-hour recalls. SETTING: Eight Chinese provinces. SUBJECTS: Five thousand nine hundred and fifty-two and 5152 adults aged 20-45 years in 1989 and 1997, respectively. RESULTS: Great variance exists in the types and quantity of animal products used in common recipes. For example, the proportion of pork from lean cuts in 'stir-fried fresh pepper and pork' varies between 14 and 24% in urban and rural areas and the total pork content for 100 g (dish) varies by 15 to 19 g between rural and urban areas in each of eight provinces. Another challenge relates to the variation in the edible vegetable oil content added during food preparation. Reliance on standard recipes for each fried dish would miss the variations in oil use over time, space and socio-economic status. CONCLUSIONS: Dietary change is rapid in transitional countries. Reliance on recipes standardised for animal food and edible oil contents will lead to very large systematic errors in the measurement of energy, fat and protein intakes.

Adult↗
PubMed2002

Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia.

BACKGROUND: Few studies have used the same references across countries to examine the trends of over- and underweight in older children and adolescents. OBJECTIVE: Using international references, we examined the trends of overweight and underweight in young persons aged 6-18 y from 4 countries. DESIGN: Nationally representative data from Brazil (1975 and 1997), Russia (1992 and 1998), and the United States (1971-1974 and 1988-1994) and nationwide survey data from China (1991 and 1997) were used. To define overweight, we used the sex- and age-specific body mass index cutoffs recommended by the International Obesity Task Force. The sex- and age-specific body mass index fifth percentile from the first US National Health and Nutrition Examination Survey was used to define underweight. RESULTS: The prevalence of overweight increased during the study periods in Brazil (from 4.1 to 13.9), China (from 6.4 to 7.7), and the United States (from 15.4 to 25.6); underweight decreased in Brazil (from 14.8 to 8.6), China (from 14.5 to 13.1), and the United States (from 5.1 to 3.3). In Russia, overweight decreased (from 15.6 to 9.0) and underweight increased (from 6.9 to 8.1). The annual rates of increase in the prevalence of overweight were 0.5% (Brazil), 0.2% (China), -1.1% (Russia), and 0.6% (United States). CONCLUSIONS: The burden of nutritional problems is shifting from energy imbalance deficiency to excess among older children and adolescents in Brazil and China. The variations across countries may relate to changes and differences in key environmental factors.

Adolescent↗
PubMed2002

Tracking of dietary intake patterns of Chinese from childhood to adolescence over a six-year follow-up period.

Limited literature has explored whether dietary intake patterns are maintained or changed between childhood and adolescence. More research is required to understand the predictors of these patterns. Using longitudinal data collected in China for 984 children initially aged 6--13 y, we examined children's dietary intake patterns over a 6-y period and the predictors. Detailed data on children's diets (three 24-h recalls in each survey), anthropometry, sociodemographic characteristics and parental education and occupation were collected. To study the predictors of tracking and changes, we conducted ordinary and multinomial logistic regression analyses. Significant correlations (r = 0.28-0.51, P < 0.05) between individuals' 1991 and 1997 dietary intakes were observed for macronutrients and major food groups (vegetable and fruit, meat and edible oil), which were also supported by kappa (a statistic measuring agreement beyond chance). About half of those who initially consumed high fat, high carbohydrate, high vegetable and fruit, and high meat diets continued such diets 6 y later. Family income, urban-rural residence, mother's education and baseline dietary intakes were important predictors of children's dietary intake patterns. In conclusion, even under conditions of rapid socioeconomic change, children are likely to maintain their dietary intake patterns from childhood into adolescence. Efforts to promote healthy eating behaviors may be more effective if focused on younger children, and parents should be involved in these efforts.

Adolescent↗
PubMedDate not supplied

Patterns and trends in food portion sizes, 1977-1998.

CONTEXT: While general consensus holds that food portion sizes are increasing, no empirical data have documented actual increases. OBJECTIVE: To determine trends in food portion sizes consumed in the United States, by eating location and food source. DESIGN, SETTING, AND PARTICIPANTS: Nationally representative data from the Nationwide Food Consumption Survey (1977-1978) and the Continuing Survey of Food Intake by Individuals (1989-1991, 1994-1996, and 1998). The sample consists of 63 380 individuals aged 2 years and older. MAIN OUTCOME MEASURE: For each survey year, average portion size consumed from specific food items (salty snacks, desserts, soft drinks, fruit drinks, french fries, hamburgers, cheeseburgers, pizza, and Mexican food) by eating location (home, restaurant, or fast food). RESULTS: Portion sizes vary by food source, with the largest portions consumed at fast food establishments and the smallest at other restaurants. Between 1977 and 1996, food portion sizes increased both inside and outside the home for all categories except pizza. The energy intake and portion size of salty snacks increased by 93 kcal (from 1.0 to 1.6 oz [28.4 to 45.4 g]), soft drinks by 49 kcal (13.1 to 19.9 fl oz [387.4 to 588.4 mL]), hamburgers by 97 kcal (5.7 to 7.0 oz [161.6 to 198.4 g]), french fries by 68 kcal (3.1 to 3.6 oz [87.9 to 102.1 g]), and Mexican food by 133 kcal (6.3 to 8.0 oz [178.6 to 226.8 g]). CONCLUSION: Portion sizes and energy intake for specific food types have increased markedly with greatest increases for food consumed at fast food establishments and in the home.

Data Collection↗