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B M Popkin

Publications and source records attributed to B M Popkin.

At least 37 records · Page 2Linked to original sources
PubMed2001

The increasing prevalence of snacking among US children from 1977 to 1996.

OBJECTIVES: To determine snacking trends and changes in nutrient contribution of snacking over time. STUDY DESIGN: Nationally representative data from the 1977-78 Nationwide Food Consumption Survey (NFCS77), 1989-91 Continuing Survey of Food Intake by Individuals (CSFII89), and 1994-96 (CSFII96) were used. The sample consisted of 21,236 individuals aged 2 to 18 years. METHODS: For each survey year, mean numbers of snacks consumed, mean grams consumed per snack, and mean energy intake from snacks were computed, as was contribution of snacking to total energy intake and fat intake. Snacking was self-defined, and a snacking occasion consisted of all snack foods consumed during a 15-minute period. Differences in means between age groups and across survey years were compared. RESULTS: The prevalence of snacking increased in all age groups. The average size of snacks and energy per snack remained relatively constant; however, the number of snacking occasions increased significantly, therefore increasing the average daily energy from snacks. Compared with non-snack eating occasions, the nutrient contribution of snacks decreased in calcium density and increased in energy density and proportion of energy from fat. CONCLUSION: Snacking is extremely prevalent in our society. Healthy snack food choices should be emphasized over high-energy density convenience snacks for children.

Adolescent↗
PubMed2001

The nutrition transition and obesity in the developing world.

Changes in diet and activity patterns are fueling the obesity epidemic. These rapid changes in the levels and composition of dietary and activity/inactivity patterns in transitional societies are related to a number of socioeconomic and demographic changes. Using data mainly from large nationally representative and nationwide surveys, such as the 1989, 1991, 1993 and 1997 China Health and Nutrition Surveys, in combination with comparative analysis across the regions of the world, we examine these factors. First, we show the shifts in diet and activity are consistent with the rapid changes in child and adult obesity and in some cases have been causally linked. We then provide a few examples of the rapid changes in the structure of diet and activity, in particular associated with increased income. Cross-country and in-depth analysis of the China study are used to explore these relationships. People living in urban areas consume diets distinctly different from those of their rural counterparts. One of the more profound effects is the accelerated change in the structure of diet, only partially explained by economic factors. A second is the emergence of a large proportion of families with both currently malnourished and overweight members as is shown by comparative analysis of a number of Asian and Latin American countries.

Adult↗
PubMed2001

Independent effects of income and education on the risk of obesity in the Brazilian adult population.

With a view to assess the independent effects of income and education on the risk of obesity we studied cross-sectional randomly selected samples of the adult population (20 y and over) living in 1996/97 in the less (northeastern) and the more (southeastern) developed region of Brazil (1971 and 2588 northeastern and 2289 and 2549 southeastern men and women, respectively). Independent effects of income and education on obesity (BMI > or = 30 kg/m(2)) were assessed through logistic regression analyses that controlled for age, ethnicity, household setting (urban or rural) and either education or income. The risk of obesity in men strongly increased with income in the two regions. The level of education did not influence the risk of male obesity in the less developed region but, in the more developed one, better-educated men had slightly less chance to be obese. In the less developed region obesity in women was strongly associated with both income (direct association) and education (inverse association). In the more developed region only the women's education influenced the risk of obesity, and the association between the two variables was inverse and strong as in the less developed region. Findings from this study reveal a scenario that is far from what has been generally admitted for the social distribution of obesity in the developing countries. They indicate that in transition societies income tends to be a risk factor for obesity, whereas education tends to be protective and that both gender and level of economic development are relevant modifiers of the influence exerted by these variables.

Adult↗
PubMed2001

Patterns of long-term change in body composition are associated with diet, activity, income and urban residence among older adults in China.

Studies describing patterns of long-term change in body composition are lacking. Using longitudinal data on 608 healthy, nonobese Chinese (aged 50-70 y) from the 1993 and 1997 China Health and Nutrition Surveys, this article describes the prevalence, sociodemographic and lifestyle correlates of patterns of long-term change in midarm muscle area (MAMA) and body fat (waist circumference). All patterns of change (loss, maintenance [Delta < 1.3 cm(2)], or gain of MAMA with concurrent loss, maintenance [Delta < 2 cm(2)] or gain of body fat), were observed for this sample. After controlling for sex, baseline age, urban residence, height, weight, income, MAMA, waist circumference, smoking status, activity level, mean daily energy and protein intakes (from three 24-h recalls), and change in height, it was determined that subjects who lost both arm muscle and body fat were distinguished from subjects who lost arm muscle but gained body fat by lower income and energy intake at baseline. Although protein intakes at baseline did not differ between the groups that lost arm muscle, protein intakes were significantly higher for subjects who gained both muscle and fat. Patterns of change involving gains in arm muscle were associated with increased protein intake, urban residence, as well as moderate or heavy levels of physical activity at baseline. Variation in protein intake, physical activity, and urban residence also differentiated between the groups that gained fat. Patterns of age-related change in body composition appear associated with modifiable variables, including income, urban residence, activity and protein and energy intake.

Aged↗
PubMed2001

Trends in diet, nutritional status, and diet-related noncommunicable diseases in China and India: the economic costs of the nutrition transition.

Undernutrition is being rapidly reduced in India and China. In both countries the diet is shifting toward higher fat and lower carbohydrate content. Distinct features are high intakes of foods from animal sources and edible oils in China, and high intakes of dairy and added sugar in India. The proportion of overweight is increasing very rapidly in China among all adults; in India the shift is most pronounced among urban residents and high-income rural residents. Hypertension and stroke are relatively higher in China and adult-onset diabetes is relatively higher in India. Established economic techniques were used to measure and project the costs of undernutrition and diet-related noncommunicable diseases in 1995 and 2025. Current WHO mortality projections of diet-related noncommunicable diseases, dietary and body composition survey data, and national data sets of hospital costs for healthcare, are used for the economic analyses. In 1995, China's costs of undernutrition and costs of diet-related noncommunicable diseases were of similar magnitude, but there will be a rapid increase in the costs and prevalence of diet-related noncommunicable diseases by 2025. By contrast with China, India's costs of undernutrition will continue to decline, but undernutrition costs did surpass overnutrition diet-related noncommunicable disease costs in 1995. India's rapid increase in diet-related noncommunicable diseases and their costs projects similar economic costs of undernutrition and overnutrition by 2025.

China↗
PubMed2001

Active commuting to school: an overlooked source of childrens' physical activity?

The assessment and promotion of childrens' healthful physical activity is important: (i) to combat the international obesity epidemic that extends to childhood; and (ii) to establish an early habit of lifestyle physical activity that can be sustained into adolescence and adulthood. The primary focus of both assessment and promotion efforts has been on in-school physical education classes and, to a lesser extent, out-of-school structured exercise, sport and play. A potential source of continuous moderate activity, active commuting to school by means of walking or by bicycle, has been largely ignored in surveys of physical activity. Suggestive evidence of steep declines in the amount of childrens' destination walking can be gleaned from national transportation surveys. At the same time, there has been a dramatic increase in the reported use of motorised vehicles, including the use for chauffeuring children. There is very little evidence to support or refute active commuting to school as an important source of childrens' physical activity; however, this is largely because it has been overlooked in the stampede to assess time in more vigorous activities. The promotion of active commuting to school must be considered in the context of parents' real and perceived concerns for their children's personal and pedestrian safety. We certainly do not have a full understanding at this time of all the factors related to decisions about transportation mode, whether by child, parent, community, or school. Such information is necessary if successful and sustainable interventions can be implemented, important transport policy decisions can be made, and community and school designs can be modified. Practice rarely waits for research, however, and there are numerous examples of innovative programming, policies and environmental designs occurring internationally that can serve as natural experiments for enterprising researchers willing to push the envelope of our understanding of active commuting and childrens' physical activity. Since we know so little, there is much to learn.

Adolescent↗
PubMed2001

Dietary trends among low socioeconomic status women of childbearing age in the United States from 1977 to 1996: a comparison among ethnic groups.

OBJECTIVE: To identify dietary trends among low socioeconomic status women of childbearing age from three ethnic groups from 1977 to 1996. METHODS: The sample consisted of 19- to 44-year-old women at 185% of poverty with 12 years of education or less (n = 4682) from three US Department of Agriculture surveys. The Revised Diet Quality Index (DQI-R) and level of folate were the main outcomes measured. Changes in food consumption for several food groups were also examined. RESULTS: Diet quality significantly improved between 1977 and 1996 for Hispanics and non-Hispanic whites. All groups had significant decreases in saturated fat intake by 1996, but only Hispanic and non-Hispanic white women significantly decreased their total fat and cholesterol intakes. Fruit and vegetable intakes remained stable. Mean intakes of calcium, iron, and folate were below recommendations at every time point for all ethnic groups. All three groups decreased their intakes of butter, margarine, egg items, bacon, high-fat red meats, and low-fiber/high-fat breads and increased their intakes of high-fiber cereals, all of which are positive. These trends were balanced, however, by decreases in medium-fiber vegetables, soy, and legumes and increases in high-fat/high-fiber breads, high-fat desserts, high-fat salty snacks, and high-fat grain-based mixed dishes. CONCLUSIONS: This study highlights problem dietary habits that public health professionals need to address in order to reduce the prevalence of diet-related chronic diseases.

Adult↗
PubMed2001

Nutrition in transition: the changing global nutrition challenge.

The rapid shift in the stage of nutrition towards a pattern of degenerative disease is accelerating in the developing world. Data from China, as shown by the China Health and Nutrition Survey, between 1989 and 1993, are illustrative of these shifts. For example, an increase from 22.8 to 66.6% in the proportion of adults consuming a higher-fat diet, rapid shifts in the structure of diet as income changes, and important price relationships are examples that are presented. There appears to reflect a basic shift in eating preferences, induced mainly by shifts in income, prices and food availability, but also by the modern food industry and the mass media. Furthermore, the remarkable shift in the occupations structure in lower-income countries from agricultural labour towards employment in manufacturing and services implies a reduction in energy expenditure. One consequence of the nutrition transition has been a decline in undernutrition accompanied by a rapid increase in obesity. There are marked differences between urban and rural eating patterns, particularly regarding the consumption of food prepared away from home. Other issues considered are the fetal origins hypothesis, whereby the metabolic efficiencies that served well in conditions of fetal undernutrition become maladaptive with overnutrition, leading to the development of abnormal lipid profiles, altered glucose and insulin metabolism and obesity. Furthermore, obesity and activity are closely linked with adult-onset diabetes. The shift towards a diet higher in fat and meat and lower in carbohydrates and fibre, together with the shift towards less onerous physical activity, carries unwanted nutritional and health effects. It is also clear that the causes of obesity must be viewed as environmental rather than personal or genetic.

China↗
PubMed2000

Differences in food patterns at breakfast by sociodemographic characteristics among a nationally representative sample of adults in the United States.

BACKGROUND: Eating breakfast is considered an important determinant of a healthy lifestyle. This study explores the different food patterns of breakfast for adults aged 18-65 in the United States. METHODS: Data are from the 1994-1996 Continuing Survey of Food Intake by Individuals, n = 15,641. Dietary assessment method used was the 24-h recall. Nutrient differences among the breakfast food patterns as well as the sociodemographic characteristics of individuals following each eating pattern are examined. RESULTS: The primary food patterns were based on consumption of eggs (15.3% of adults), ready-to-eat cereals (17.4%), bread (21.7%), cooked cereal (4.4%), fruit and fruit juice (5.5%), and coffee, soft drinks, and high-fat desserts (15.1%). Seventeen and three-tenths percent of the adults skipped breakfast. These food patterns provide remarkably different nutrient profiles adjusting for energy intake. The egg pattern is highest in total fat, lowest in fiber density, and low in iron and calcium density. In contrast, the ready-to-eat cereal pattern is high in fiber, highest in calcium density, and very low in fat. Breakfast food patterns differ markedly by various sociodemographic factors such as gender, ethnicity, and educational level. CONCLUSION: Different segments of our population consume different types of foods at breakfast, contributing to differences in their nutrient intakes.

Adolescent↗
PubMed2000

Shifting obesity trends in Brazil.

OBJECTIVE: To describe secular trends in obesity in various settings and socio-economic groups of the adult population of Brazil. METHODS: Trend analysis of the prevalence of obesity in adults aged over 20 y (body mass index >/=30.0 kg/m2) applied to anthropometric and socio-economic data collected by three comparable household surveys undertaken in the two most populated Brazilian regions in 1975 (n=95,062), 1989 (n=15,585) and 1997 (n=10,680). RESULTS: While previous trends (1975-1989) showed increasing obesity prevalence for all population groups except for men in rural areas, recent trends (1989-1997) have pointed to a much more complex picture where increases in obesity tend to be more intense in men than in women, in rural than in urban settings and in poorer than in richer families. Particularly notable was the fact that, in the recent period, obesity was actually reduced for women belonging to the upper income groups, especially in urban settings. CONCLUSION: Earlier obesity trends in Brazil entirely agree with what has been described for both developed and developing countries where reliable secular trend information exists, but the 1989-1997 trend of a substantial reduction in the prevalence of obesity among upper income urban women (12.8-9.2%, or a 28% reduction), is unique in a developing country and, indeed, up to now has only been detected in Scandinavian populations. It is speculated that this declining obesity trend may be a result of an intense mass media work focused on combating a sedentary life style and promoting better food habits.

Adult↗
PubMed2000

Measuring diet quality in china: the INFH-UNC-CH diet quality index.

OBJECTIVE: This paper describes the development and efficacy of a diet quality index (DQI) for China. DESIGN: The Dietary Guidelines for Chinese Residents motivated the selection of 10 DQI components. These components were weighted and assigned cut-offs and point schemes based on the Chinese Food Guide Pagoda, Chinese and/or international dietary reference values. The efficacy of resulting DQI scores was assessed relative to a priori expectations. SUBJECTS: The Chinese DQI was evaluated using cross-sectional 3 day diet record and anthropometric data on 7450 adults from the 1991 China Health and Nutrition Survey. METHODS: For each individual, a DQI total score was calculated as the sum of components, and DQI pattern scores calculated to reflect the underlying composition of diet quality problems. The DQI scores were compared with component scores, food and nutrient intake, weight status and sociodemographic variables. RESULTS: The total DQI score simultaneously represented all component aspects of diet quality as well as micronutrients not explicitly built into the index. The total DQI score was significantly correlated with food and nutrient intakes, BMI, urban residence and income. The DQI pattern scores correlated with DQI components and weight status as expected. CONCLUSIONS: The China DQI captures variation along several components of diet quality, appears sensitive to under- and overnutrition, as well as sociodemographic variables. The China DQI may prove useful for monitoring the nutrition transition and epidemiologic trends in China. SPONSORSHIP: National Institutes of Health (HD 38700 and R01-HD30880) and the Chinese Academy of Preventive Medicine.

Adult↗
PubMed2000

The nutrition transition in South Korea.

BACKGROUND: An accelerating shift from infectious to noncommunicable diseases and concurrent shifts in diet, activity, and body composition are universal trends but are especially apparent in middle- and lower-income countries. A unique nutrition transition has occurred in South Korea, a country that modernized earlier than most Asian countries did. OBJECTIVE: The purpose of this analysis was to describe the South Korean nutrition transition, focusing on specific features that other countries might follow to retain the healthful elements of their traditional diets. DESIGN: We used secondary data on economics, dietary intake, anthropometry, and causes of death, including a series of comparable nationally representative dietary surveys (the National Nutrition Survey). RESULTS: The structure of South Korea's economy, along with the country's dietary and disease patterns, began an accelerated shift in the 1970s. Major dietary changes included a large increase in the consumption of animal food products and a fall in total cereal intake. Uniquely, the amount and rate of increase in fat intake have remained low in South Korea. South Korea also has a relatively low prevalence of obesity compared with other Asian countries with similar or much lower incomes. CONCLUSIONS: The nutrition transition in South Korea is unique. National efforts to retain elements of the traditional diet are thought to have shaped this transition in South Korea in the midst of rapid economic growth and the introduction of Western culture.

Adolescent↗
PubMed2000

Tracking of body mass index from childhood to adolescence: a 6-y follow-up study in China.

BACKGROUND: Although extensive descriptive research shows that childhood obesity predisposes a person to adult obesity, little is understood about the dynamics of weight during childhood and the predictors of weight tracking. OBJECTIVE: Our objective was to examine tracking patterns of body mass index (BMI) as well as their predictors between childhood and adolescence. DESIGN: A cohort of 975 Chinese children aged 6-13 y was followed for 6 y (1991-1997). Tracking of BMI was defined as an individual maintaining a certain status (overweight or underweight) or relative position (relative BMI quartile) over time. Relative BMI related BMI to age- and sex-specific BMI cutoffs. RESULTS: After 6 y, approximately 40% of the subjects had maintained their relative positions, but 30% had moved into a lower or higher quartile. The BMIs of thin and fat children were more likely to track: 51% and 46% remained in the bottom and upper quartiles, respectively. Nearly one-third of the underweight children remained underweight in 1997. Overweight children were 2.8 times as likely as all other children to become overweight adolescents; underweight children were 3.6 times as likely to remain underweight as adolescents. Parental obesity and underweight, individuals' initial BMIs, dietary fat intake, and family income helped predict tracking and changes in BMI. CONCLUSION: In a society undergoing enormous changes in diet and activity, BMI tracking is still very important between childhood and adolescence in China.

Adolescent↗
PubMed2000

Overweight and underweight coexist within households in Brazil, China and Russia.

The possibility that underweight and overweight coexist within households and understanding such an occurrence have not been studied sufficiently. In fact, underweight and overweight are thought of as resulting from very different environmental, behavioral and individual risk factors. This study identified households in which overweight and underweight coexist and explored household-level associations such as urban residence and income. Using three large national surveys from Brazil, China and Russia, the prevalence of such households ranged from 8% in China and Russia to 11% in Brazil. Even more important from the public health perspective is the finding that these under/over households accounted for a high proportion of all households with an underweight member in China (23%), Brazil (45%), and Russia (58%). The prevalence of the underweight/overweight household was highest in the urban environment in all three countries. There was no clear pattern in the prevalence of the underweight/overweight household type by income. Multivariable logistic regression was used to test the significance of the association of household type with urban residence and income while controlling for household size and household demographics by gender. Further analysis was done to consider the age relationships within the underweight/overweight pair. The underweight child coexisting with an overweight nonelderly adult was the predominant pair combination in all three countries. These findings illustrate the need for public health programs that are able to address underweight and overweight simultaneously.

Age Factors↗
PubMed2000

Current methods for estimating dietary iron bioavailability do not work in China.

Three current equations for estimating iron bioavailability were evaluated, and adjustments were proposed that would allow us to most effectively study iron bioavailability in China. Dietary intake data were obtained from 24-h dietary recalls taken over three consecutive days as part of the third Chinese National Nutrition Survey. Hemoglobin status was measured for 42,606 Chinese adults aged 18-60 y. The mean iron intake was 24.4 mg per capita per day, which was 177% of the Chinese RDA (209% of U.S. RDA). About 18% of the sample was classified as being anemic, indicating a large iron deficiency anemia and iron bioavailability problem in China. A number of methods proposed by World Health Organization and U.S. scholars were examined for adjusting iron bioavailability. Even the methods that consider several iron enhancers and inhibitors did not work adequately for the Chinese diet. The statistical assessment of the fit between iron bioavailability and hemoglobin status provided direction for adjusting the best of these predictive equations. We propose a new predictive approach for iron bioavailability which is more predictive of Chinese iron status. Consideration of additional dietary elements such as rice and bean consumption patterns are important. Our findings provide insight into additional factors which may influence iron bioavailability as well as possible improved methods for estimating the combined effect of multiple dietary factors on iron bioavailability, particularly in a vegetarian diet.

Adult↗
PubMed2000

US adolescent food intake trends from 1965 to 1996.

AIM: To examine adolescent food consumption trends in the United States with important chronic disease implications. METHODS: Analysis of dietary intake data from four nationally representative United States Department of Agriculture surveys of individuals 11-18 years of age (n = 12 498). RESULTS: From 1965 to 1996, a considerable shift in the adolescent diet occurred. Total energy intake decreased as did the proportion of energy from total fat (39% to 32%) and saturated fat (15% to 12%). Concurrent increases occurred in the consumption of higher fat potatoes and mixed dishes (pizza, macaroni cheese). Lower fat milks replaced higher fat milks but total milk consumption decreased by 36%. This decrease was accompanied by an increase in consumption of soft drinks and non-citrus juices. An increase in high fat potato consumption led to an increase in vegetable intake but the number of servings for fruits and vegetables is still below the recommended five per day. Iron, folate, and calcium intakes continue to be below recommendations for girls. CONCLUSIONS: These trends, far greater than for US adults, may compromise health of the future US population.

Adolescent↗
PubMed2000

US adolescent food intake trends from 1965 to 1996.

OBJECTIVE: To examine adolescent food consumption trends in the United States with important chronic disease implications. METHODS: Analysis of dietary intake data from 4 nationally representative US Department of Agriculture surveys of persons aged 11 to 18 years (n = 12,498). RESULTS: From 1965 to 1996, a considerable shift occurred in the adolescent diet. Total energy intake decreased, as did the proportion of energy from total fat (39%-32%) and saturated fat (15%-12%). Concurrent increases occurred in the consumption of higher-fat potatoes and mixed dishes (pizza and macaroni and cheese). Lower-fat milks replaced higher-fat milks, but total milk consumption decreased by 36%. This decrease was accompanied by an increase in the consumption of soft drinks and noncitrus juices. An increase in high-fat potato consumption led to an increase in vegetable intake, but the number of servings for fruits and vegetables is still lower than the recommended 5 per day. Iron, folic acid, and calcium intakes continue to be below those recommended for girls. CONCLUSIONS: These trends, far greater than for US adults, may compromise the health of the future US population.

Adolescent↗