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Biomedical subjects

B M Popkin

Publications and source records attributed to B M Popkin.

At least 73 records · Page 4Linked to original sources
PubMed1996

Does women's work improve their nutrition: evidence from the urban Philippines.

Women's market work in developing countries is thought to improve their well-being directly through increased income for health-related purchases and indirectly through elevating women's status within the household. While a number of studies have looked at the effects of women's work and the cost of women's time on child nutrition and welfare, the direct effects of women's work on their own welfare have been largely untested. Using data on 1963 urban Filipino women from the Cebu Longitudinal Health and Nutrition Survey, we examined the relationship between women's work and their dietary intakes of energy, protein, fat, calcium, and iron from home and commercially prepared foods. Determinants equations for home and commercial intakes were estimated simultaneously to adjust for non-independence. Appropriate methods were used to deal with selectivity, endogeneity, and unobserved heterogeneity. Nearly half (48%) of the women worked for pay, and commercially prepared foods made up an important part of working women's diets. Not only did women's work improve the quality of their diets, but there were strong distributional implications; lower-income women gained more than higher-income women. Employment sector also influenced women's dietary patterns. Informal non-wage work was associated with increased intakes, whereas formal sector work was associated with decreased intakes. Positive effects of work in the informal sector were greater for women from low-income households. Policy implications of the dietary benefits of informal non-wage work for low-income women are discussed.

Adult↗
PubMed1996

Trends in breakfast consumption of US adults between 1965 and 1991.

OBJECTIVE: To examine breakfast consumption patterns and trends between 1965 and 1991 for adults in the United States. DESIGN: Trends analysis pooling three cross-sectional surveys. SETTING: Nationally representative samples obtained from the Nationwide Food Consumption Survey (NFCS) of 1965, the NFCS of 1977-1978, and the 1989-1991 Continuing Survey of Food Intakes by Individuals. SUBJECTS: Adults aged 18 years and older: 6,274 in 1965, 18,033 in 1977-1978, and 10,812 in 1989-1991. All results reflect use of sampling weights, so results reflect nationally representative samples in each time period. MAIN OUTCOME MEASURES: Breakfast consumption, defined as the consumption of food and/or beverage between the hours of 5 AM and 9 AM, was the focus of the trends analysis. Population prevalence rates are reported for the entire population and population subgroups. STATISTICAL ANALYSIS PERFORMED: Probit analysis was used to identify factors associated with changes in breakfast consumption over time. RESULTS: Breakfast consumption declined in the 26-year period between 1965 and 1991 from 86% to 75% for US adults. Breakfast consumption increased with age, and the age differential increased over time. Urban-rural and South-non-South differences in breakfast consumption narrowed over time, whereas black-nonblack and college-noncollege differences increased slightly or remained constant. The nutritional quality of food consumed at breakfast has improved since 1965. CONCLUSIONS: Although part of the decline in breakfast consumption can be explained by personal and demographic determinants, other unknown factors contributed to the trends. Elucidation of such factors is necessary to predict differences in breakfast as a health-related behavior.

Adolescent↗
PubMed1996

Low birth weight reduces the likelihood of breast-feeding among Filipino infants.

We studied the relationship of low birth weight (LBW) to concordance of mother's feeding intentions during pregnancy with actual feeding practices; initiation of breast-feeding; and patterns of feeding in the first 6 mo. Data came from the Cebu Longitudinal Health and Nutrition Survey, which followed 3080 mother-infant pairs from urban and rural communities of Metro Cebu, Philippines. We used logistic regression to estimate the effects of LBW on feeding practices, controlling for place of delivery (home, public or private health facility), receipt of free infant formula samples; infant sex, urban residence; primiparity, education level and age of the mother; and family income and assets. Birth of a LBW infant significantly decreased the likelihood that women would initiate breast-feeding. Of particular note is the finding of this decreased likelihood among women who during pregnancy had stated an intention to breast-feed. In a comparison of 6-mo feeding patterns, we also found that LBW increased the likelihood of not breast-feeding or of weaning before 6 mo. Among breast-feeding mothers, LBW increased the likelihood of full breast-feeding for 6 mo compared with patterns characterized by earlier supplementation with other foods and liquids. The negative relationship of LBW to breast-feeding was strongest when births took place in private or public health facilities. Given the known health risks of LBW and the proven benefits of breast-feeding, these results emphasize the need for special efforts to promote breast-feeding of LBW infants born in clinical settings.

Adult↗
PubMed1996

Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition.

A higher risk of obesity in stunted children has been described in Hispanic-American, Jamaican and Andean populations, but little systematic exploration has been done concerning this area in nutrition. This paper examines the relationship between stunting and overweight status for children aged 3-6 and 7-9 y in nationally representative surveys in Russia, Brazil, and the Republic of South Africa and a large nationwide survey in China. Using identical cut-offs for body mass index, the prevalence of child overweight in these countries ranges from 10.5 to 25.6% (based on the 85th percentile); recent NHANES III results indicate that this prevalence is around 22% in the U.S. Stunting is also common in the surveyed countries affecting 9.2-30.6% of all children. Our results showed a significant association between stunting and overweight status in children of all countries. The income-adjusted risk ratios of being overweight for a stunted child ranged from 1.7 to 7.8. Clearly, there is an important association between stunting and high weight-for-height in a variety of ethnic environmental and social backgrounds. Although the underlying mechanisms remain unexplored, this association has serious public health implications particularly for lower income countries. As these countries enter the nutrition transition experiencing large changes in dietary and activity patterns, they may face, among other problems, additional difficulties in their fight against obesity.

Body Mass Index↗
PubMed1996

The nutritional status of the elderly in Russia, 1992 through 1994.

OBJECTIVES: The purpose of this study was to ascertain how economic reform has affected nutritional well-being of the elderly in the Russian Federation. METHODS: A sample of more than 2932 Russians 60 years of age and older was selected from a nationally representative survey of Russian households. A 24-hour dietary recall and data on weight, height, and socioeconomic status were collected during 1992 and 1993 and from a separate nationally representative sample of 1955 persons in the same age group in 1994. RESULTS: Russia's elderly did not experience major declines in economic or nutritional well-being during the first 2 years of the reform period. Dietary composition shifted slightly toward reduced fat consumption. A small proportion of individuals showed signs of underweight. Of those who were underweight in 1992, none had lost more than 3 kg of weight by 1993. Among those 70 years of age and older, none who were underweight had lost any appreciable weight, although half lost small amounts. CONCLUSIONS: Many more underweight elderly people increased than reduced their weight. Mean weight increased among all body mass index groups over the year reported here. However, economic conditions in December 1994 raise concerns.

Aged↗
PubMed1996

Longitudinal analysis of the effects of infant-feeding practices on postpartum amenorrhea.

The Cebu Longitudinal Health and Nutrition Survey is used to examine the effect of various components of infant-feeding patterns on return of menses postpartum. The results show that factors such as active suckling, the use of two breasts versus one, breast-feeding on demand versus on a fixed schedule, and the feeding of other milks and of nonnutritive or low-caloric other liquids can be important under selected circumstances. Discrete-time logistic hazards modeling is used to estimate the weekly probability of return to menses.

Amenorrhea↗
PubMed1995

Dietary and environmental correlates of obesity in a population study in China.

The patterns and correlates of obesity in China were studied in two panels of a nationwide longitudinal survey conducted in 1989 and 1991 (the China Health and Nutrition Survey). Among the Chinese adults, dietary energy and fat intakes were positively and significantly associated with the Body Mass Index (BMI). Household income and physical activity level were also significantly associated with BMI. Urban residence and higher income were associated with lower energy intake, higher fat intake, and lower physical activity level compared to rural residence and other income categories. This paper documents an important emerging health problem: the increasing problem of obesity that has been observed in many lower-income countries during the last several decades.

Adult↗
PubMed1995

A review of dietary and environmental correlates of obesity with emphasis on developing countries.

The relationships between dietary and environmental factors and obesity are reviewed. Findings from selected population studies of diet and body weight are presented. In general, the results from population studies of diet and obesity have been inconsistent and marked with methodological weaknesses, especially the use of cross-sectional study design. Apart from the diet, several social and economic factors appear to be important correlates of obesity in the population. However, most studies have focused on the socioeconomic status as a broad, composite measure. The relationships between income, education, occupation, place of residence, and obesity are reviewed here, with emphasis on the developing countries. In many developing countries, the changing dietary pattern, along with rising life expectancy and changing socioeconomic environment, has contributed to the increasing problems of obesity and other diet-related chronic diseases that will have an enormous impact on the health and health care resource of these countries in the near future.

Body Weight↗
PubMed1995

Body weight patterns among the Chinese: results from the 1989 and 1991 China Health and Nutrition Surveys.

OBJECTIVES: A longitudinal survey assessed the distribution of adult body weight among the Chinese population. METHODS: Data from the 1989 and 1991 China Health and Nutrition Survey were used to study changes in the proportions of adults aged 20-45 years who were classified as underweight, normal weight, overweight, and severely overweight. RESULTS: There was a slight decline in the proportion of men and women classified as underweight, but among lower-income persons an increase occurred. The proportion of adults with normal body weight decreased, and the proportions of those classified as overweight and severely overweight increased during the same period. The observed increases in proportions of adults classified as overweight and severely overweight were largely confined to the urban residents and to those in the middle- and high-income groups. CONCLUSIONS: Results indicate increases in both obesity and undernutrition. Current efforts in China to develop a preventive health care policy emphasize the prevention of excess nutrient intakes and overnutrition and, hence, address the problem of the increase in obesity among well-to-do, mostly urban residents. However, the increase in undernutrition among low-income Chinese adults should not be overlooked and requires further research and serious policy consideration.

Adult↗
PubMed1995

Does WIC participation improve breast-feeding practices?

The effects of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on breast-feeding behavior have been sometimes found inadequate. The determinants of breast-feeding initiation and duration among WIC participants and nonparticipants were modeled by using retrospective cross-sectional data from the 1988 National Maternal and Infant Health Survey. This study corrects for self-selection bias as far as the data allow, in addition to controlling for parents' ages, education, race, and family income. Findings suggest that prenatal WIC participation, combined with breast-feeding advice, significantly increases the initiation of breast-feeding but does not affect duration. The exact nature of effective breast-feeding advice given prenatally at WIC clinics is unclear and warrants further research.

Adolescent↗
PubMed1995

The nutrition transition in Brazil.

OBJECTIVE: To describe and analyse changes in child and adult nutritional status in Brazil during the past several decades. DESIGN: Two large nationally representative cross-sectional anthropometric surveys undertaken in 1974 and 1989 are the primary source of information. Child nutritional status was described based on weight-for-age and weight-for-height indices using NCHS/WHO standards. Body mass index was employed to assess adult nutritional status. SUBJECTS: 27,960 children and 94,699 adults in 1974 and 5969 children and 23,544 adults in 1989. SETTING: All regions in Brazil. RESULTS: Undernutrition, although still relevant particularly in children from lower income families, is declining among adults and children of all economic strata. Concurrent increases in adult obesity have been occurring among all groups of men and women with a higher proportion of increase among lower income families. A profound change in the income-obesity relationship determines that in the most recent survey: (1) income and body mass index are inversely related among the 30% richest women; (2) a higher prevalence of female obesity (15.4%) occurs for the 40% middle-income group; and (3) the 30% poorest Brazilian women (9.7% prevalence) can no longer be considered to be protected from obesity. CONCLUSION: Brazil is rapidly shifting from the problem of dietary deficit to one of dietary excess.

Adult↗
PubMed1994

Health lifestyle patterns of U.S. adults.

BACKGROUND: Reaching national health objectives depends upon our ability to encourage the performance of multiple good health behaviors. There are cognitive, social, and biological reasons for expecting health behaviors to cluster. However, few studies have found significant associations among health behaviors, with the exception of the documented link between smoking and alcohol consumption. METHODS: We used cluster analysis to identify population subgroups with similar patterns of diet quality, physical activity, alcohol consumption, and cigarette smoking. This is the first study of health behavior interrelationships to include a measure of overall diet quality and a large sample from a nationally representative survey of U.S. adults. RESULTS: We identified seven health behavior typologies: 10% of the sample (health promoting lifestyle) had an overall healthy lifestyle, 25% had a good diet but sedentary activity level, 18% had fair diet but high activity level (fitness lifestyle). Individuals in the passive lifestyle cluster (25%) had no active health promoting activities but did avoid risk taking health behaviors. Six percent of the sample were in a drinking cluster, 15% in a smoking cluster, and 2% had a hedonic lifestyle characterized by heavy drinking and smoking. These lifestyle clusters could be characterized by demographic and socioeconomic factors. CONCLUSIONS: This research indicates that it is possible to identify a discrete number of health lifestyles in a population sample of U.S. adults. Understanding past, present, and changing health lifestyles may provide insights for health behavior research and information for the development and targeting of public health programs that can impact on multifactorial chronic diseases.

Adult↗
PubMed1994

Diet quality index: capturing a multidimensional behavior.

OBJECTIVE: Data for 5,484 adults (aged 21 years and older) who participated in the 1987-88 Nationwide Food Consumption Survey (NFCS) were used to develop an index of overall dietary intake that related to the major, diet-related, chronic diseases in the United States. The low response rate of the 1987-88 NFCS has raised concerns about potential bias, but this large data set is useful for methodologic studies and research that does not attempt to generalize the results to the US population. ANALYSES: Dietary recommendations from the 1989 National Academy of Sciences publication Diet and Health were stratified into three levels of intake for scoring. Individuals who met a dietary goal were given a score of zero. Those who did not meet a goal, but had a fair diet, were given one point, and those who had a poor diet were given two points. These points were summed across eight diet variables to score the index from zero (excellent diet) to 16 (poor diet). RESULTS: Lower index scores were positively associated with high intakes of other important measures of diet quality (eg, fiber, vitamin C). We found that single nutrients (such as dietary fat) were not necessarily associated with other measures of diet quality. CONCLUSION: We concluded that this index ranking of overall dietary patterns was reflective of total diet quality, though substantial misclassification can result from using single nutrients or foods as indicators of diet quality.

Adult↗
PubMed1994

The nutrition transition in low-income countries: an emerging crisis.

Scientists have long recognized the importance of the demographics and epidemiologic transitions in higher income countries. Only recently has it become understood that similar sets of broadly based changes are occurring in lower income countries. What has not been recognized is that concurrent changes in nutrition are also occurring, with equally important implications for resource allocation in many low-income countries. Several major changes seem to be emerging, leading to a marked shift in the structure of diet and the distribution of body composition in many regions of the world: a rapid reduction in fertility and aging of the population, rapid urbanization, the epidemiologic transition, and economic changes affecting populations in different and uneven ways. These changes vary significantly over time. In general, we find that problems of under- and overnutrition often coexist, reflecting the trend in which an increasing proportion of people consume the types of diets associated with a number of chronic diseases. This is occurring more rapidly than previously seen in higher income countries, or even in Japan and Korea. Examples from Thailand, China, and Brazil provide evidence of the changes and trends in dietary intake, physical activity, and body composition patterns.

Africa↗
PubMed1994

The body mass index of Chinese adults in the 1980s.

Patterns and trends in the body composition of Chinese adults are studied with data from the 1982 China Nationwide Nutrition Survey (CNS-82) and the 1989 China Health and Nutrition Survey (CHNS-89). The CNS-82 showed rural inhabitants were approximately 3 kg lighter than urban residents and approximately 2.2 cm shorter. Males were heavier (55.2 +/- 7.4 vs 50.7 +/- 8.0 kg) and taller (165.3 +/- 7.3 and 153.5 +/- 6.3 cm). Using a cut-off for underweight of a body mass index (BMI: kg/m2) < 18.5 and for obesity of > 25, 11.6% and 12.9% of the urban and rural sample were underweight and 9.8% and 6.9% respectively were overweight. The CHNS-89 surveyed 5138 adults aged 20-45 in eight selected provinces. The proportion of underweight in both urban and rural samples declined slightly (approximately 1.3%) but the proportion of obesity increased considerably (4.8% for the urban sample and 2% for the rural one). Increased income was significantly associated with reduced low body mass index (BMI: kg/m2) in the urban sample while, for the rural and overall samples, the opposite was found for obesity. Provincial patterns in energy intake were not associated with the distribution of BMI while occupation was. In particular, government officials and housewives were much more likely to be obese as also were subpopulation groups consuming greater proportions of energy from animal sources. Over 80% of the population fell in the normal BMI range (18.5-25). This may relate to the relatively even distribution of food in China during the past several decades.

Adult↗
PubMed1993

Women's work and infant care in the Philippines.

Using data from a survey of 3000 Filipino infants and mothers, we analyze the implications of having more than one preschooler on several work outcomes, as well as the effect of availability of substitute care givers. The work outcomes of interest are those thought to be least compatible with infant care: work outside the home, wage work remunerated on a time basis, and long working hours. Our findings suggest that having multiple preschoolers only makes a difference for mothers whose household income is below the median: it increases their likelihood of working outside the home. Grandmothers and paid helpers consistently increase the likelihood of the various work outcomes and increase hours worked. Our findings suggest that urban residence, an indicator of work opportunity structure, increases the likelihood of wage-time work and is associated with longer working hours.

Adult↗