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Economic Costs and Benefits of Healthy Eating
Abstract
Most Americans fail to meet federal dietary recommendations. This may be partly due to the costs of healthy eating. This article reviews the costs and benefits of healthy eating. On the cost side, we discuss food prices, food preparation and other time costs, transportation costs, psychological costs, costs of obtaining nutrition information, and costs of longer life expectancy. We do not summarize these costs with a single dollar value as the current literature does not provide estimates to support such quantification. In terms of benefits, we focus on five health conditions for which poor diet is a major risk factor: coronary heart disease, cancer, stroke, diabetes, and osteoporotic hip fractures. We estimate the benefits of healthy eating in the United States to be $114.5 billion per year (in 2012 dollars) in medical savings, increased productivity, and the value of prolonged life that are associated with reductions in these five conditions.
... The phenomenon of obesity has stimulated many research studies in an aggressive effort to determine possible resolutions in African American communities (Anekwe & Rahkovsky, 2013;Hatala, 2014). Historically, racial and ethnic populations continue to be disproportionately underrepresented in clinical trials for behavioral weight loss solution (Agyemang & Powell-Wiley, 2013). ...
... Gaining knowledge on how to use nutritional food labels for addressing obesity is a presumptive approach to altering behavior (Chen et al., 2012a). Finding effective strategies for reducing obesity is critical for AAW (Anekwe & Rahkovsky, 2013;Chen et al., 2012a;Flegal et al., 2012). ...
... Nutritional literacy and nutritional behavior as they relate to food-label content at the point of purchase incorporated into food purchases are significant gaps in the literature in AAW within the baby boom era. There is evidence within the literature that found improving nutritional intake could abate many of the debilitation health conditions (Anekwe & Rahkovsky, 2013;Sharma, Sheehy, & Kolonel, 2014). In addition, nutrition literacy and nutritional behavior are identified as societal problems that pose risks to individual, family, community, and societal health (Anekwe & Rahkovsky, 2013;James, 2013;Lagerros & Rossner, 2013). ...
Nutritional food label understanding (NFLU) in African American Women (AAW) is a philosophy that addresses obesity. Public health efforts have implemented nutritional and caloric information to packaged and restaurant foods to improve nutrient and calorie literacy. Research suggest NFLU might have a minimal effect on reducing obesity. However, it is not known how obese AAW born during the baby-boom era (51 to 64 years of age) perceive NFLU in relation to their dietary behaviors. The purpose of this phenomenological study was to understand the lived experience of obese AAW regarding NFLU from a cognitive and behavioral perspective. Twelve, AAW answered 21-semistructured questions that were audio recorded and transcribed verbatim. Findings of the study revealed the limited appreciation of NFLU in relation to healthy nutrition behaviors. Reasons for not applying nutritional food label (NFL) information centered on self-help perception, the time to read and understand the content on the NFL, skills required for effective NFL usage (math, organization of content), barriers to overcome while grocery shopping and motivational interest to change their behavior. In addition, the interviews of obese AAW revealed a lack of interest in NFL information while dining out despite understanding the perceived health benefits of knowing such information. Positive social change implications for obese AAW include improved nutrition literacy and nutritional behavior using NFLU as the guide to healthier dietary choice. From an individual, community, societal and nation level, reversing the trajectory of obesity
through nutritional health literacy needs further improvement and individual adoption to possibly assist with obesity self-management.
... If food cost is not a major hurdle to healthy eating this clearly focuses attention on other barriers to healthy eating. For example, individuals with Opie et al. 167 depression typically have reduced motivation to engage in healthy dietary habits (Anton and Miller, 2005), a reduced desire to cook and prepare meals (Darnton-Hill, 1992); and depleted energy for activities such as grocery shopping, meal preparation, and clean-up (Anekwe and Rahkovsky, 2013;Ryden et al., 2008). Individuals may also find the challenge of learning new recipes or developing cooking skills overwhelming (Anekwe and Rahkovsky, 2013;Ryden et al., 2008). ...
... For example, individuals with Opie et al. 167 depression typically have reduced motivation to engage in healthy dietary habits (Anton and Miller, 2005), a reduced desire to cook and prepare meals (Darnton-Hill, 1992); and depleted energy for activities such as grocery shopping, meal preparation, and clean-up (Anekwe and Rahkovsky, 2013;Ryden et al., 2008). Individuals may also find the challenge of learning new recipes or developing cooking skills overwhelming (Anekwe and Rahkovsky, 2013;Ryden et al., 2008). Given that fatigue is a prominent symptom of MDD, the extra effort involved is a disincentive to healthy food preparation. ...
... Given that fatigue is a prominent symptom of MDD, the extra effort involved is a disincentive to healthy food preparation. Cooking skill is positively associated with consumption of fruit and vegetables and negatively associated with consumption of convenience foods (Anekwe and Rahkovsky, 2013). As such, providing education and nutritional counselling on preparing nutritious convenient meal ideas on a budget could form part of an integrated care package for people with clinical depression, which may in turn translate into improved dietary patterns and better health outcomes (O'Neil et al., 2013;Opie et al., 2014). ...
Although, the cost of food is commonly described as a barrier to consuming a healthy diet, the evidence for this viewpoint has been inconsistent to date. The purpose of this study was to assess whether a healthy diet is affordable for a sample population with major depressive disorder and current unhealthy eating patterns, enrolled in supporting the modification of lifestyle in lowered emotional states (SMILES) trial. The first 20 participants of the SMILES trial were invited to complete a 7-day food diary at baseline. A cost analysis of a modified Mediterranean diet (recommended for trial participants) and 7-day food diaries of participants enrolled in the randomized controlled trial was conducted. Trial participants spent an estimated mean of 112, both based on mid-range product cost. The modified Mediterranean diet at 2.35 per MJ. These study findings suggest that the adoption of a healthy modified Mediterranean diet does not cost more than a poor quality diet. Thus, failure to comply with healthy diets is unlikely to reflect affordability. Public health messages should incorporate the finding that healthy eating is not associated with increased costs and in fact may well involve savings to the household budget. Practical strategies and techniques for selecting healthy nutritious foods on a budget could support the achievement of desired dietary goals for preventing and managing chronic disease.
... To further compound this, common side effects of lowered mood and depression include changes in appetite, which can involve either a reduced interest in food or an increase appetite with cravings for less healthy choices like sweet, salty and fatty foods [42][43][44]. Depression can also be commonly associated with fatigue and apathy, which may impact on an individual's motivation to engage in healthy dietary habits [45], and reduced energy for grocery shopping, meal preparation, cooking, and clean-up [43,[46][47][48][49]. As a result of decreased concentration, decreased mental endurance and slowed thinking [49] individuals may also find learning new recipes or developing cooking skills challenging [47,48]. ...
... Depression can also be commonly associated with fatigue and apathy, which may impact on an individual's motivation to engage in healthy dietary habits [45], and reduced energy for grocery shopping, meal preparation, cooking, and clean-up [43,[46][47][48][49]. As a result of decreased concentration, decreased mental endurance and slowed thinking [49] individuals may also find learning new recipes or developing cooking skills challenging [47,48]. Our earlier analysis of adherence to the Australian Dietary Guidelines amongst the READI cohort, similarly showed that baseline diet quality was poorer amongst individuals with depressive symptoms at follow-up, compared to individuals without depressive symptoms [50]. ...
Abstract Background There is growing evidence that diet is associated with both depressive symptoms and clinical depression, likely through biological mechanisms. However, it is also plausible that depression impacts diet, for example by impairing the personal drivers of healthy eating behaviors such as self-efficacy. This study is one of the first to explore the association of depressive symptoms with healthy eating self-efficacy over time. Methods Data was drawn from the Resilience for Eating and Activity Despite Inequality (READI) longitudinal study, a prospective cohort study of socioeconomically disadvantaged Australian women. This analysis includes a sub-sample of 1264 women. Linear mixed models, with random intercepts for suburb of residence, were performed to explore the relationships between total healthy eating self-efficacy at 5-years follow-up and depressive symptoms over time, whilst adjusting for potential confounders. To assess different trajectories of depressive symptoms over time, four categories were created; 1. no depressive symptoms (n = 667), 2. resolved depressive symptoms (n = 165), 3. new depressive symptoms (n = 189), and 4. persistent depressive symptoms (n = 243). Results There was very strong evidence of a difference in total healthy eating self-efficacy at follow-up between the four depressive symptoms trajectory categories (F(3,235) = 7.06,p
... 12,14 Importantly, depression is also commonly associated with fatigue and apathy, 15 which may have impact on an individual's motivation to engage in healthy dietary habits, 16 a reduced desire to cook, 17 and depleted energy for activities such as grocery shopping and meal preparation. 18,19 As a result of decreased concentration, decreased mental endurance, and slowed thinking 15 individuals may also find learning new recipes, developing cooking skills, or performing meal preparation challenging. 18,19 Finally, depression has a strong bidirectional relationship with other common, chronic diseases with a dietary aetiology, including heart disease, obesity, and diabetes. ...
... 18,19 As a result of decreased concentration, decreased mental endurance, and slowed thinking 15 individuals may also find learning new recipes, developing cooking skills, or performing meal preparation challenging. 18,19 Finally, depression has a strong bidirectional relationship with other common, chronic diseases with a dietary aetiology, including heart disease, obesity, and diabetes. These comorbidities can complicate treatment approaches and have a detrimental impact on treatment outcomes. ...
Background: The SMILES trial was the first randomized controlled trial (RCT) explicitly designed to evaluate a dietary intervention, conducted by qualified dietitians, for reducing depressive symptomatology in adults with clinical depression.
Objectives: Here we detail the development of the prescribed diet (modified Mediterranean diet (ModiMedDiet)) for individuals with major depressive disorders (MDDs) that was designed specifically for the SMILES trial. We also present data demonstrating the extent to which this intervention achieved improvements in diet quality.
Methods: The ModiMedDiet was designed using a combination of existing dietary guidelines and scientific evidence from the emerging field of nutritional psychiatric epidemiology. Sixty-seven community dwelling individuals (Melbourne, Australia) aged 18 years or over, with current poor quality diets, and MDDs were enrolled into the SMILES trial. A retention rate of 93.9 and 73.5% was observed for the dietary intervention and social support control group, respectively. The dietary intervention (ModiMedDiet) consisted of seven individual nutrition counselling sessions delivered by a qualified dietitian. The control condition comprised a social support protocol matched to the same visit schedule and length.
Results: This manuscript details the first prescriptive individualized dietary intervention delivered by dietitians for adults with major depression. Significant improvements in dietary quality were observed among individuals randomized to the ModiMedDiet group. These dietary improvements were also found to be associated with changes in depressive symptoms.
Discussion/Conclusion: The ModiMedDiet, a novel and individually tailored intervention designed specifically for adults with major depression, can be effectively implemented in clinical practice to manage this highly prevalent and debilitating condition.
Trial registration: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000251820. Registered 29 February 2012
... Tackling dietary inequalities is not only beneficial at an individual level but can also improve the social and economic outlook of the country [9], and thus reducing dietary inequalities should be of importance to policy makers in the UK [10]. The Government's levelling up agenda tried to address longstanding local and regional inequalities by describing its ambition to address poor diet due to its significant contribution to ill health [11]. ...
In the UK people living in disadvantaged communities are less likely than those with higher socio-economic status to have a healthy diet. To address this inequality, it is crucial scientists, practitioners and policy makers understand the factors that hinder and assist healthy food choice in these individuals. In this scoping review, we aimed to identify barriers and facilitators to healthy eating among disadvantaged individuals living in the UK. Additionally, we used the Theoretical Domains Framework (TDF) to synthesise results and provide a guide for the development of theory-informed behaviour change interventions. Five databases were searched, (CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science) for articles assessing healthy dietary intake of disadvantaged adults living in the UK. A total of 50 papers (34 quantitative; 16 qualitative) were included in this review. Across all studies we identified 78 barriers and 49 facilitators found to either impede and/or encourage healthy eating. Both barriers and facilitators were more commonly classified under the Environmental, Context and Resources TDF domain, with 74% of studies assessing at least one factor pertaining to this domain. Results thus indicate that context related factors such as high cost and accessibility of healthy food, rather than personal factors, such as lack of efficiency in healthy lifestyle drive unhealthy eating in disadvantaged individuals in the UK. We discuss how such factors are largely overlooked in current interventions and propose that more effort should be directed towards implementing interventions that specifically target infrastructures rather than individuals.
... A balanced, healthy diet comes with several benefits for consumers' health [71,72]. As such, Health-and Food-related choices are often connected. ...
Dietary guidance to recommend food patterns to deliver nutrients has been well accepted for the past century. Foods to deliver essential nutrients and energy are needed across the life cycle and are dependent upon local industries and accepted cultural practices to deliver essential nutrients to prevent nutrient deficiency diseases. Since the 1980s, dietary guidelines to prevent chronic diseases have relied on epidemiological research to predict what dietary patterns are linked to reduced risk of chronic disease or links to health outcomes. Dietary guidelines have been broad, typically recommending avoiding “too much sugar”, “too much saturated fat”, and “too much sodium”. Efforts to fine tune these recommendations have met with limited scientific data to support more specific recommendations across the life cycle. Consumers have become skeptical of dietary guidelines as media coverage of new studies is often in conflict with accepted nutrition dogma. We discuss whether we really have a science-based databank to support dietary guidelines, based on a scientific session at the 10th International Conference on Nutrition and Growth.
... Vale ressaltar que ainda não existe consenso na literatura sobre a relação entre custos e qualidade da alimentação. Alguns estudos indicam que padrões alimentares saudáveis apresentam maior custo 34,35 , enquanto outros autores não identificaram essa associação, incluindo evidência nacional 36,37 . No entanto, não há controvérsia sobre o aumento da renda influenciar maior consumo de produtos alimentícios ultraprocessados 38 e gastos com a alimentação fora do domicílio 39 , que estão associados a refeições de baixa qualidade nutricional e alto consumo calórico 40 , contribuindo para o ganho de peso corporal. ...
Os objetivos foram descrever a prevalência de baixo peso e excesso de peso, avaliados pelo índice de massa corporal (IMC), estratificada por sexo e faixa etária, e analisar as características sociodemográficas associadas ao IMC em mulheres e homens mais velhos. Trata-se de uma análise transversal de 8.974 participantes com ≥50 anos da linha de base do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil, 2015-16). O IMC foi classificado em baixo peso, eutrofia e excesso de peso de acordo com a idade do participante. Foi utilizado modelo de regressão logística multinominal, considerando-se as características sociodemográficas de mulheres e homens. Os resultados evidenciaram maior prevalência de excesso de peso nas mulheres em comparação aos homens (64,1% vs. 57,3%). Em ambos os sexos, a prevalência de baixo peso foi maior nos mais longevos, enquanto que o excesso de peso foi menor. Nas mulheres, a chance de baixo peso foi maior do que a chance de eutrofia naquelas solteiras/viúvas/divorciadas (OR 1,95; IC95% 1,42-2,66) e nas residentes na área rural (OR 1,58; IC95% 1,01-2,49), ao passo que a chance de excesso de peso foi menor do que a chance de eutrofia nas residentes na área rural (OR 0,78; IC95% 0,62-0,97) e em todas as macrorregiões geográficas relativas à região Sul. Para os homens, a chance de excesso de peso foi menor do que a chance de eutrofia entre solteiros/viúvos/divorciados (OR 0,58; IC95% 0,48-0,69). Os mais ricos apresentaram menor chance de baixo peso (OR 0,59; IC95% 0,38-0,90), bem como maior chance de excesso de peso (OR 1,52; IC95% 1,20-1,92). Em conclusão, as características sociodemográficas associadas ao IMC diferiram entre os sexos.
... [15][16][17] A healthy, balanced and sufficient diet can enhance an individual's psychological, biological, social and physiological health, contributing to overall well-being. 18,19 In older adults, nutrition is essential for an independent, social, healthy and disease-free life. 20,21 Healthy dietary habits also affect telomere shortening. ...
Aim:
This study aimed to evaluate the effect of anthropometric measurements and dietary habits on telomere length in healthy older residents in rural and urban areas.
Methods:
This was a cross-sectional study. The study population included 81 healthy older individuals aged ≥80 years. A quantitative food frequency questionnaire was used to determine dietary habits. Anthropometric measurements were taken by researchers. The telomere length of individuals was determined from leukocytes using quantitative polymerase chain reaction.
Results:
Urban women had longer telomeres than rural women (P < 0.05). Rural men had significantly higher hip circumference, middle-upper arm circumference and fat-free mass than urban men (P < 0.05). It was shown that while fresh vegetable consumption was higher in rural areas, carbonated drink consumption was higher in urban areas (P < 0.05). In women, homemade bread and sugar consumption were higher in rural areas, and honey consumption was higher in urban (P < 0.05). Red meat, milk-based dessert and pastry consumption explain telomere shortening by 22.5%, 24.8% and 17.9%, respectively. In addition, the model based on anthropometric measurements also contributes to explaining telomere shortening by 42.9%.
Conclusion:
Red meat, milk-based dessert and pastry consumption, and waist circumference, hip circumference, waist-to-hip ratio and waist-to-height ratio are associated with telomere length. Longer telomeres are associated with a healthy, balanced, adequate diet and maintaining a healthy body weight/proportion, and they are crucial for achieving healthy aging. Geriatr Gerontol Int 2023; ••: ••-••.
... Work by Kuchler and Stewart (2008) (Kuchler and Stewart, 2008) explains the impact of monetary factors on food behaviour. While prices of raw or unprepared or processed foods remained relatively stable, the availability of alternate processed foods at a comparable price offers the convenience of using the time for food preparation for other activities (Anekwe and Rahkovsky, 2013). The form and economic function of eating out have contributed to diversified diets (Peter Cullen, 1994). ...
Background: ‘Eating out (EO)’ has witnessed a significant increase across nations and in India. Understanding food behaviour from an economic standpoint is essential to recognize food systems and nutrition transition. Aim: Our work compared the macro-data on per capita income and gross state domestic product from India with household expenditure on eating out. Using the India Human Development Survey II micro-data we studied the socio-demographic and economic determinants of household expenditure on eating out. Methods: The study design is a secondary data analysis of India Human Development Survey II from a sample of N = 42,152 households. It included socio-demographic and economic predictors, such as religion, caste, residence, migration for work, education, number of household members, income source, total annual income, consumption expenditure and poverty status. Results: No consistent trends emerged in the macroeconomic comparisons using gross state domestic product and per capita income. Results of logistic regression showed that the reserved caste categories OBC [COR 1.2 (1.1–1.2)] and SC/ST/Others [COR 1.1 (1–1.1)], household heads education up to secondary [COR 0.4 (0.4–0.5)] and higher secondary and above [COR 0.7 (0.6–0.8)], urban place of residence [COR 0.55 (0.53–0.58)], organised sector [COR 0.7 (0.6–0.7)] as the income source, higher annual income [COR 0.52 (0.50–0.54)], higher annual consumption expenditure [COR 0.44 (0.42–0.46)] and above poverty line [COR 2.1 (1.9–2.2)] were significantly positively associated with expenditure on eating out ( p = <0.05). All these variables stayed significant in the multinomial regression model as well. Conclusion: This analysis confirms the increase in household income along with other demographics, increases the frequency of eating out. However, such trends remained inconsistent in macroeconomic assessments using gross state domestic product and per capita income.
... If one considers that its final object is food and that indisputably food is "a highly condensed social fact" (Appadurai, 1981), F2FS seems to be disproportionately if not exclusively based on food science and on a utilitarian approach to food economics. However, especially with regard to food, consumers might decide in an extrarational way (Just & Payne, 2009); the pursuit of individual pleasure and collective happiness can be misaligned (Chapman & Maclean, 1993); and the value of products in the market can be fixed with no regard for general health costs (Anekwe & Rahkovsky, 2013). ...
The new European “Farm to Fork” Strategy has been praised for addressing the issue of the long‐run sustainability of the food system. In this document, the link between human and planetary health is often recalled. However, consumers' aspiration to healthy food is dealt with only superficially. This article analyzes and challenges the position assumed by the European Commission on this topic, using a holistic and transdisciplinarity approach to food, called pantrophy. Drawing on several disciplines beyond food science and economics, the author argues that health is not only a question of diet. As a social fact, healthy food is a blend of moral dilemma, a luxury, a fashion item, an object of desire, and a sign of distinction. Therefore, it will hardly become cheap and easily available, as suggested by the Strategy. For the same reason, even the market mechanism envisaged to spread healthier eating habits might prove ineffective. The author calls for a radical change of the European policy in order to ensure that access to healthy food does not become unjust, discriminatory, and a cause of social conflict. The challenge consists in shifting part of the governmental institutions' effort from changing consumption styles to guaranteeing the intrinsic quality of food at its source.
... There is conflicting evidence on the association between the diet costs and quality; however, major part of the studies indicates that healthy dietary patterns usually present higher cost in comparison with less healthy diets, especially in developed countries (1,2,27,28). Other studies indicate the possibility of healthy diets with lower cost depending on the method for the measurement of costs (prices per gram, per unit of energy, or per serving), socioeconomic level of the population, and geographical region considered in the study (5,6,(29)(30)(31)(32). ...
Health and nutrition surveys usually comprise detailed information on health characteristics and food consumption of certain population groups; however, the lack of data collection on the food prices may pose challenges for the estimation of the diet costs for the comprehensive analysis of food demand. The Household Budget Survey (HBS) represents an opportunity to obtain the data on the food prices for the nutrition surveys in the diverse countries worldwide. Although the HBS and the health and nutrition surveys may correspond to different periods, the application of the appropriate Consumer Price Index (CPI) allows to address the changes in the relative prices to perform the linkage between the data of food consumption with information on the food prices. Therefore, the aim of this study was to present the methods for the extraction and linkage of the food prices data from the Brazilian HBS (2002–2003 and 2008–2009) by using the pairing features related to the household characteristics to match the Health Survey of São Paulo [Inquérito de Saúde de São Paulo (ISA-Capital)] conducted in 2003, 2008, and 2015. Data referring to the household characteristics and food prices acquired by the household members living in São Paulo municipality were selected from the HBS datasets for integration with the ISA-Capital dataset. Specific deflators referring to the food items surveyed in São Paulo were obtained from the datasets of the Brazilian Broad Consumer Price Index (BCPI). Therefore, the pairing criteria referring to time, location, and household characteristics were adopted to allow linking foods consumed by the individuals in the ISA-Capital with the prices from the foods acquired by household members interviewed in the HBS. Matching data on the key pairing criteria (location/year/household income per capita/number of residents/family profile) resulted in the linkage of 94.4% (2003), 92.6% (2008), and 81.2% of the cases (2015). Following the data linkage, it was possible to estimate diet costs per gram and per calorie including application of cooking and conversion factors. Data were presented in the International Monetary Unit under the purchasing power parity (PPP) to allow the comparison at the international level. The mean diet costs identified in the population of São Paulo municipality were 8.72 (dp = 0.24) per capita per day in 2008, and $9.62 (dp = 0.23) per capita per day in 2015. Thus, it was possible to estimate the diet costs based on the prices of food items through pairing linkage of information from the household surveys, such as the Brazilian HBS, with the health and nutrition surveys lacking information on the expenditures or prices such as the ISA-Capital. Similar procedures may be used in the diverse countries with availability of the datasets of the household expenditures and health and nutrition surveys, allowing the researchers worldwide to associate the diet quality with food demand.
... There can be four categories of mushroomedible, poisonous, medicinal, and miscellaneous categories ( Figure 1). To remain healthy and fit, the interest of people around the globe is shifting toward low-calorie food that can provide maximum health benefits [11]. Edible mushrooms have very minimal calorie value as they contain less amounts fat and carbohydrate and are also cholesterol-free. ...
The Indian system of medicine – Ayurveda says “When diet is wrong, medicine is of no use. When diet is correct, medicine is of no use”. In this context, mushroom constitutes one of the major resources for nutraceuticals. Biomolecules of mushrooms have attracted the attention of researchers around the globe due to their proven healthy attributes. They have a plenitude of health-giving properties and these range from immunomodulatory, antiviral, antibacterial, antifungal, antioxidant, anti-inflammatory, antitumor, anticancer, anti-HIV, antidiabetic, anticholesterolic to antiarthritic activities.
Mushrooms contain both primary and secondary metabolites. The primary metabolites provide energy while the secondary metabolite exhibits medicinal properties. Hence, the mushroom can be a recipe for human wellness and will play a significant role in fighting COVID-19 pandemics and other infectious diseases.
The key findings suggested in this paper refer to the exploration of health and the healing traits of biomolecules of mushrooms. This article reviews the current status of the medicinal attributes of mushrooms and their biomolecules in different diseases such as cardiovascular, diabetes, reproductive diseases, cancer, and neurodegenerative diseases. The global malnutrition-related morbidity and mortality among children under five and lactating women presents a frightening picture and also a black spot on the human face. Malnutrition is responsible for more ill-health than any other cause. Mushrooms as a rich source of bioactive compounds can be claimed as “Best from the Waste” since they grow on the most abundant organic wastes of the Earth, the lignocellulosic substrate, and ‘Best of the Rest’ because they are excellent nutraceutical resources.
... Unhealthy eating increases the likelihood of illnesses such as heart disease, stroke, cancer, diabetes, cardiovascular disease and possibly mental illness (James et al., 2004;Sanderson et al., 2011). Accordingly, healthier eating can lead to both improved public health and substantial social savings (Anekwe and Rahkovsky, 2013). ...
Purpose - This paper aims to offer social marketers an innovative method to promote healthy foods. This method demonstrates the effectiveness of indirect communication in attracting consumers to healthy foods. Further, it aims to offer a way to promote food as healthier with no detrimental effects on its perceived appeal, which are a likely side effect of advertising food as healthy.
Design/methodology/approach - Four between-participant lab studies (N = 50, 80, 80, 102) included manipulations of food motion vs stillness and then compared ratings of food freshness, healthiness and appeal using self-report measures.
Findings - Motion increases healthiness evaluation. This increase in healthiness evaluation occurs without reductions in food appeal. These effects are mediated by evaluations of freshness. This occurred across three different food types and two mediums (still images and digital videos).
Research limitations/implications - The paper provides an effective tool for social marketers wishing to encourage healthier eating. Specifically, it helps address two problems: low effectiveness of prevalent, information-based appeals to encourage healthy eating; and reduced evaluations of tastiness that normally occur when consumers are convinced food is healthy.
Social implications - Social marketers can use motion as an effective tool to promote food as healthy. Importantly, this indirect communication avoids the potential pitfall of reduced food appeal. This should help encourage healthier eating. The findings also supports the use of indirect cues as an effective approach to promoting social ends.
Originality/value - Offering a novel, indirect method of enhancing judgments of food healthiness via a simple visual cue. Demonstrating the effect and its underlying mechanism. Providing a way to counter the prevalent "unhealthy = tasty" intuition, a major obstacle to promoting healthy eating. Supporting social marketers' use of indirect communication to increase the appeal of desirable societal goals. Finally, showing that sensory visual cues can serve as a source of heuristic thinking.
... Показано, что рациональное питание с достаточным содержанием овощей и фруктов стоит дороже, но эти дополнительные затраты окупаются эффектом [13]. По оценкам США [7], соблюдение принципов здорового питания привело бы к экономии в размере $114,5 млрд в год за счет снижения затрат системы здравоохранения и повышения производительности труда. ...
Unhealthy diet is associated with high morbidity and mortality from chronic non-communicable diseases (NCDs) which in turn are associated with high economic costs. A significant proportion of these costs is attributed to insufficient fresh fruits and vegetables in the diet worldwide with large country-to-country variation warranting research in various settings including Russia. The aim: to assess the economic burden of insufficient consumption of fruits and vegetables in Russia in 2016 due to their contribution to the development of major NCDs. Methods: The calculation was made using population attributive risk for the development of cardiovascular diseases, type 2 diabetes and cancer from meta-analyses and the data on the prevalence of fruits and vegetables consumption and the abovementioned diseases in the Russian population. The economic costs from the main NCDs were calculated using the human capital method. The share of health care system costs and economic losses due to morbidity and mortality from NCDs associated with fruits and vegetables underconsumption was assessed. Results: The contribution of insufficient consumption of fruits and vegetables to the morbidity and mortality from cardiovascular diseases, coronary heart disease and stroke were 5 % each (95 % CI: 3.0-6.2), 5% (95 % CI: 3.7-6.2) and 10 % (95 % CI: 4.9-15.9), respectively. Corresponding proportions for lung cancer was 8.9 % (95 % CI: 3.7-14.4). The economic burden associated with this risk factor, amounted more than 134 billion rubles (95 % CI: 78.8-173.3 billion rubles), 0.16 % of GDP of the Russian Federation in 2016. Indirect losses due to premature mortality (86 %) prevailed in the structure of the economic burden. Conclusions: The high prevalence of fruits and vegetables underconsumption in Russia and its significant contribution to the morbidity and mortality from NCDs are associated with significant economic costs from this risk factor.
... Poor socio-economic status can contribute to inadequate access to prescribed diets, hence, predispose patients to non-adherence. As reflected by current findings, economic challenges and cost of diets have previously been reported to limit dietary options of individuals [20,[34][35][36][37][38][39] This exacerbates the situation for patients with CKD who are already faced with limited dietary choices due to their condition [40,41]. Although nutrition counseling for patients with CKD in Kenya is guided by the National Clinical Nutrition and Dietetics Reference Manual [42] alongside facility-based clinical nutrition manuals and protocols, some diet prescriptions were based on international clinical nutrition guidelines where some food items may not be locally accessible. ...
Diet is one of the modifiable lifestyle factors in management of kidney disease. We explored perceptions on adherence to dietary prescriptions for adults with chronic kidney disease on hemodialysis. This was a qualitative descriptive study. Participants were purposively selected at renal clinics/dialysis units at national referral hospitals in Kenya. Data were collected using in-depth interviews, note-taking and voice-recording. The data were managed and analyzed thematically in NVIV0-12 computer software. Study participants were 52 patients and 40 family caregivers (42 males and 50 females) aged 20 to 69 years. Six sub-themes emerged in this study: “perceived health benefits”; “ease in implementing prescribed diets”; “cost of prescribed renal diets”; “nutrition information and messages”; “transition to new diets” and “fear of complications/severity of disease”. Both patients and caregivers acknowledged the health benefits of adherence to diet prescriptions. However, there are mixed messages to the patients and caregivers who have challenges with management and acceptability of the prescriptions. Most of them make un-informed dietary decisions that lead to consumption of unhealthy foods with negative outcomes such as metabolic waste accumulation in the patients’ bodies negating the effects of dialysis and undermining the efforts of healthcare system in management of patients with chronic kidney disease.
... For example, a change in dietary intake may occur in response to the altered appetite and cravings (or a reduced interest in food) associated with clinical depression and depressive symptoms [63][64][65]. Alternatively, depression is commonly associated with fatigue and apathy [66], which may impact on an individual's motivation to engage in healthy dietary habits [67], a reduced desire to cook and prepare meals [68], and depleted energy for activities such as food shopping and meal preparation [69,70]. A major strength of this prospective study design was the capacity to demonstrate the expected direction of relationship between habitual diet and development of depressive symptoms. ...
Background:
Depression is the single largest contributor to global disability. There is growing evidence that a healthy diet is associated with reduced depression risk. However, beyond the Mediterranean diet, few longitudinal studies have explored the relationship between adherence to national dietary guidelines and depression. Hence, this study investigates the relationship between adherence to Australian Dietary Guidelines and depressive symptoms.
Methods:
Data was drawn from the READI longitudinal study, a prospective cohort study of socioeconomically disadvantaged Australian women. This analysis includes a sub-sample of 837 women. A generalized linear model was used to explore whether baseline diet (assessed using the Dietary Guideline Index (DGI-2013; score range 0 to 85)) was associated with risk of developing depressive symptoms (measured by the Centre for Epidemiologic Studies Depression (CES-D)) at 5 years follow-up, whilst adjusting for potential confounders. A fixed-effects model was used to assess associations between concurrent changes in diet quality and depressive symptoms from baseline to 5 years follow-up.
Results:
An association between baseline diet quality and risk of developing depressive symptoms at follow-up was observed, where a 10 unit increase in DGI-2013 score was associated with an estimated 12% lower risk of developing heightened depressive symptoms (RR = 0.875, 95%CI 0.784 to 0.978, p = 0.018). The fixed-effects model indicated that an increase in DGI score over 5 years follow-up was associated with a lower (improved) CES-D score (B = -0.044, 95% CI - 0.08 to - 0.01, p = 0.024).
Conclusions:
Our results provide evidence that better adherence to the Australian Dietary Guidelines may result in improved depressive symptoms. The growing high-quality evidence regarding the diet-depression relationship provides us with a rationale for developing strategies for supporting dietary behaviour change programs to lower depression rates.
... Understanding where food comes from, and how it was grown and processed, can help consumers make informed choices that are consistent with their individual values and culture. Healthy food options provide benefits for personal health and can reduce rising health care costs, associated heart disease, high cholesterol, and obesity (Anekwe & Rahkovsky, 2013). Several studies have shown that diets that moderate dairy and meat consumption can improve health and average life spans while reducing global warming impacts (Tilman & Clark, 2014). ...
Nitrogen is a critical component of the economy, food security, and planetary health. Many of the world's sustainability targets hinge on global nitrogen solutions, which, in turn, contribute lasting benefits for (i) world hunger; (ii) soil, air, and water quality; (iii) climate change mitigation; and (iv) biodiversity conservation. Balancing the projected rise in agricultural nitrogen demands while achieving these 21st century ideals will require policies to coordinate solutions among technologies, consumer choice, and socioeconomic transformation.
... One way to determine nutritional health patterns is to evaluate the consumer's grocery shopping experience and dining-out experience. Without an awareness of proper nutrition, the foods and amount of foods consumed can lead to obesity and other health related conditions [9]. ...
Nutritional health is a global concept and fosters much debate. The UAE youths’ frequency of being more obese is twice to be thrice greater than the published international standards. The United Arab Emirates schoolchildren/youth (ages 10-18) are said to be 1.8 times more obese than those in the United States, according to statistics from the First United States National Health and Nutrition Examination Survey. According to World Health Organisation report, the UAE has been classified as the second highest for obesity rates in the world. As a result of these obesity statistics among the youths, there are associated diseases, which tend to plague the UAE adults later including cardiovascular diseases, diabetes, hypertension and others. The Global School-based Student Health Survey highlighted on the increasing prevalence of obesity in UAE in terms of measuring the dietary behaviors and physical activity of students in grades 8 to 10. The theoretical framework for this policy brief will be the Health Belief Model. Therefore, this policy brief highlights the public health issue within the UAE context is obesity among the youths, and the framework for implementing a public health campaign among the UAE youths, whereby, contributing to attaining one of the UAE Vision 2021 National agenda targets for reducing the prevalence of obesity.
Background
Coarse grains are rich in fiber, minerals, and other beneficial nutrients but are consumed at low levels in modern populations. The factors that influence coarse grain consumption in current living and dietary environments are not fully understood.
Objectives
This study aimed to explore the knowledge and behavior related to coarse grain consumption and identify the influencing factors among Chinese citizens.
Methods
Six focus group discussions were conducted with 39 participants aged 18–65 years from diverse social backgrounds in Xi'an, China. All discussions were transcribed verbatim and analyzed using inductive thematic analysis.
Results
The majority of participants demonstrated insufficient knowledge about coarse grains, including their definitions, health benefits, and recommended intake. A small number of the participants reported regular consumption. The barriers to coarse grain consumption were poor sensory properties, insufficient cooking skills and time, limited availability of ready-to-eat foods, established dietary habits, and high prices. Additionally, new barriers included psychological burden, concerns about food safety, the impact of processing methods on health benefits, and special health conditions. Health benefits and family influence emerged as the 2 primary factors motivating coarse grain consumption. Most participants expressed a positive attitude toward partially replacing staple foods with coarse grains. Enhancing health education, innovating food processing methods, improving labeling systems, and strengthening safety supervision have been recommended for increasing coarse grain consumption.
Conclusions
A gap exists between health awareness and healthy behaviors regarding coarse grain consumption; thus, collaborative efforts among government agencies, educational institutions, nutrition societies, the food industry, policymakers, and health professionals are essential to overcome these challenges.
Purpose
The goal of this study was to assess changes in eating self-efficacy after participating in a brief psychoeducational group intervention, grounded in the cognitive-behavioral model, delivered by dieticians in community-based health facilities.
Design/methodology/approach
The study was conducted using a quasi-experimental, pre-post design. A total of 110 program participants took part in the study. They were asked to complete the Eating Self-Efficacy Scale before the start of the intervention, at the end of the intervention, and three months after the intervention ended. Data were analyzed using the Linear Mixed Model.
Findings
Participants’ personal sense of control over their eating behaviors significantly increased after they completed the program and continued to increase up to the three-month follow-up. The effect of the intervention remained significant after controlling for differences in age and whether participants had access to other forms of individual support or completed the follow-up during the COVID-19 general lockdown.
Practical implications
By promoting participants’ sense of eating self-efficacy, this intervention could lead to positive dietary changes, which in turn could promote better health and healthy aging.
Social implications
This community intervention is readily accessible and represents a cost-effective approach to promote healthy eating, reducing the risk of chronic disease and the need for medical care, thereby cutting costs for the healthcare system.
Originality/value
(1) This study addresses a gap in the scientific literature as there was limited published research to date that investigated this intervention. (2) The three-month follow-up made it possible to evaluate whether changes in eating self-efficacy were maintained over time. (3) Potential confounding variables, including age, having access to other forms of individual support and the COVID-19 general lockdown, were taken into account.
Objective. To assess the availability and affordability of fruit and vegetables for the population of municipalities of the pilot region of the Russian Federation using specialized software developed by the National Medical Research Center for Therapy and Preventive Medicine. Material and methods. In the Russian Federation, an observational study on the assessment of the infrastructure in municipalities and the analysis of infrastructure element associations with the prevalence of behavioral risk factors for major chronic non-communicable diseases is conducted as part of the state assignment “Development of a comprehensive system for the assessment of a unified preventive environment for health and healthy lifestyle promotion at the municipal/regional level”. This article pres-ents the results of the first stage of the pilot study, which assessed the current state of infrastructure in the Sverdlovsk region municipalities (grocery stores, supermarkets, fairs/markets, stalls with a selection of fresh fruit and vegetables, as well as catering outlets (fast food outlets, cafes, restaurants, etc.). The affordability of fresh fruit and vegetables to the population was assessed by calculating the average minimum prices at various points of sale. Statistical processing was performed using SPSS 20 software (IBM, USA). Results. Grocery stores and supermarkets are expected to be the main elements of the trade network, providing the population with fresh fruit and vegetables. However, only 66% of grocery stores and supermarkets have fresh fruit and vegetable departments. Prices for fresh fruit and vegetables offered in stalls were higher than prices for comparable products in supermarkets. Conclusion. Implementing measures to increase the availability and affordability of fresh fruit and vegetables to the population is possible by stimulating consumer demand. Regional programs to support the most vulnerable groups, especially low-income families, can be introduced in this regard. In addition, financial measures are needed to support the construction of supermarkets and grocery stores with a broad assortment of fruit and vegetables. © D.K. MUKANEEVA1A.V. KONTSEVAYA A.A. ANTSIFEROVA M.V. POPOVICH S.V. GLUKHOVSKAYA N.A. PUSTELENIN M.B. KHUDYAKOV O.M. DRAPKINA.
Epidemiological studies have evaluated the Med diet for primary disease prevention, for the prevention of disease recurrence (secondary prevention) and for disease management. Cardiometabolic disorders include CVD, obesity, type 2 diabetes and metabolic syndrome. Obesity and excess body fat are now thought to contribute to more deaths among middle aged and older people. Economic analysis has shown that preventing obesity by encouraging and facilitating healthy eating behaviours has the potential to result in substantial savings. After bariatric surgery, morbidly obese subjects experienced greater weight loss if they adhered to the Med diet. The main goal of nutrition therapy for type 2 diabetics is to improve glucose control and cardiovascular risk factors, and, when needed, to reduce weight. Several studies have shown that higher Med diet adherence is associated with improved stress resilience.
Higher-educated individuals are healthier and live longer than their lower-educated peers. One reason is that lower-educated individuals tend to consume lower-quality diets, but it is not fully understood why they do so. We designed a discrete-choice experiment to investigate how provision of nutritional information affects dietary choices of lower- and higher-educated individuals. We find that nutritional knowledge is responsible for a large part of the disparity in dietary choices. However, even when faced with the most explicit nutritional information, lower-educated individuals still state choices that suggest a lower value for negative health consequences.
Introduction:
The Mediterranean and Dietary Approaches to Stop Hypertension diets have been associated with lower dementia risk. We evaluated dietary inflammatory potential in relation to mild cognitive impairment (MCI)/dementia risk.
Methods:
Baseline food frequency questionnaires from n = 7085 women (aged 65-79 years) were used to calculate Dietary Inflammatory Index (DII) scores that were categorized into four groups. Cognitive function was evaluated annually, and MCI and all-cause dementia cases were adjudicated centrally. Mixed effect models evaluated cognitive decline on over time; Cox models evaluated the risk of MCI or dementia across DII groups.
Results:
Over an average of 9.7 years, there were 1081 incident cases of cognitive impairment. Higher DII scores were associated with greater cognitive decline and earlier onset of cognitive impairment. Adjusted hazard ratios (HRs) comparing lower (anti-inflammatory; group 1 referent) DII scores to the higher scores were group 2-HR: 1.01 (0.86-1.20); group 3-HR: 0.99 (0.82-1.18); and group 4-HR: 1.27 (1.06-1.52).
Conclusions:
Diets with the highest pro-inflammatory potential were associated with higher risk of MCI or dementia.
The escalating obesity crisis has resulted in a wide range of efforts to develop more effective prevention approaches. This review article explores the potential for the concept of food pleasure to take centre stage in social marketing programs that aim to encourage healthy eating. Literature relating to food motivations is reviewed and the various strategic phases involved in developing social marketing programs are outlined in the context of incorporating a food pleasure focus.
Highest rates of obesity and diabetes in the United States are found among the lower-income groups. The observed links between obesity and socioeconomic position may be related to dietary energy density and energy cost. Refined grains, added sugars, and added fats are among the lowest-cost sources of dietary energy. They are inexpensive, good tasting, and convenient. In contrast, the more nutrient-dense lean meats, fish, fresh vegetables, and fruit generally cost more. An inverse relationship between energy density of foods (kilojoules per gram) and their energy cost (dollars per megajoule) means that the more energy-dense diets are associated with lower daily food consumption costs and may be an effective way to save money. However, economic decisions affecting food choice may have physiologic consequences. Laboratory studies suggest that energy-dense foods and energy-dense diets have a lower satiating power and may result in passive overeating and therefore weight gain. Epidemiologic analyses suggest that the low-cost energy-dense diets also tend to be nutrient poor. If the rise in obesity rates is related to the growing price disparity between healthy and unhealthy foods, then the current strategies for obesity prevention may need to be revised. Encouraging low-income families to consume healthier but more costly foods to prevent future disease can be construed as an elitist approach to public health. Limiting access to inexpensive foods through taxes on frowned upon fats and sweets is a regressive measure. The broader problem may lie with growing disparities in incomes and wealth, declining value of the minimum wage, food imports, tariffs, and trade. Evidence is emerging that obesity in America is a largely economic issue.
Nutritional intake can profoundly impact the development of human disease, mainly by driving the progression of obesity-related conditions such as type 2 diabetes, cardiovascular disease, and cancer. Taste perception can profoundly affect food preference and nutritional intake. Thus, human variation in taste responsiveness to certain foods may play an integral role in these health consequences by influencing nutrient assimilation. Therefore, we review here what is currently known about variation in taste perception, its genetic underpinnings, and how this variation may impact upon nutrient ingestion. We also provide a brief primer on the functional organization of the peripheral gustatory system. Elucidation of the mechanisms underpinning the association between taste perception, eating behavior, and energy regulation could be valuable in predicting who is at greater risk of becoming obese, as well as in finding novel therapeutic targets in the management and mitigation of obesity-related conditions.
Dietary patterns in the United States are associated with increased risk of several chronic diseases such as coronary heart disease, can- cer, stroke, diabetes, hypertension, overweight, and osteoporosis. This chapter looks only at the first four conditions, which account for over half of all deaths in the United States each year. After account- ing for comorbidity and potential double-counting, it is estimated that healthier diets might prevent $71 billion per year in medical costs, lost productivity, and the value of premature deaths associated with these conditions.
Four studies investigate the Nutrition Labeling and Education Act's (NLEA's) impact on how consumers use nutrition information. Field and laboratory studies compare, but do not detect any changes in, consumers' search for nutrition information or their recall of this information in the pre- and post-NLEA periods. However, the search activities of a select group (highly motivated and less knowledgeable consumers) benefited more from the NLEA than did other groups. Additional results from the field and lab studies indicate that the NLEA changed attention to negative nutrition attributes (such as fat and sodium, of which less is better) more than it changed attention to positive attributes such as calcium and vitamins. Analyses of scanner databases confirm this trend (with the exception of calories). Focus group results also reflect these findings. The authors discuss implications for public policy, management, academic research, and consumer welfare.
We examine the differential effects of anticipating shame vs. guilt on choice likelihood of a hedonic product. The results demonstrate that when offered a hedonic snack (chocolate cake) consumers who anticipate shame are significantly less likely to choose to consume it compared to those who anticipate guilt. Anticipating guilt also has a more circumscribed effect, impacting choice likelihood only for those consumers who are not attitudinally inclined toward the hedonic product. The results also show that anticipating guilt versus shame has different effects on anticipated happiness after lapses in self-control.
Context Recent reports show that obesity and diabetes have increased in the
United States in the past decade.Objective To estimate the prevalence of obesity, diabetes, and use of weight control
strategies among US adults in 2000.Design, Setting, and Participants The Behavioral Risk Factor Surveillance System, a random-digit telephone
survey conducted in all states in 2000, with 184 450 adults aged 18 years
or older.Main Outcome Measures Body mass index (BMI), calculated from self-reported weight and height;
self-reported diabetes; prevalence of weight loss or maintenance attempts;
and weight control strategies used.Results In 2000, the prevalence of obesity (BMI ≥30 kg/m2) was
19.8%, the prevalence of diabetes was 7.3%, and the prevalence of both combined
was 2.9%. Mississippi had the highest rates of obesity (24.3%) and of diabetes
(8.8%); Colorado had the lowest rate of obesity (13.8%); and Alaska had the
lowest rate of diabetes (4.4%). Twenty-seven percent of US adults did not
engage in any physical activity, and another 28.2% were not regularly active.
Only 24.4% of US adults consumed fruits and vegetables 5 or more times daily.
Among obese participants who had had a routine checkup during the past year,
42.8% had been advised by a health care professional to lose weight. Among
participants trying to lose or maintain weight, 17.5% were following recommendations
to eat fewer calories and increase physical activity to more than 150 min/wk.Conclusions The prevalence of obesity and diabetes continues to increase among US
adults. Interventions are needed to improve physical activity and diet in
communities nationwide.
To disentangle taste from reward responses in the human gustatory cortex, we combined high density electro-encephalography with a gustometer delivering tastant puffs to the tip of the tongue. Stimuli were pure tastants (salt solutions at two concentrations), caloric emulsions (two milk preparations identical in composition except for fat content) and a mixture of high fat milk with the lowest salt concentration. Early event-related potentials (ERPs) showed a dose-response effect for increased taste intensity, with higher amplitude and shorter latency for high compared to low salt concentration, but not for increased fat content. However, the amplitude and distribution of late potentials were modulated by fat content independently of reported intensity and discrimination. Neural source estimation revealed a sustained activation of reward areas to the two high-fat stimuli. The results suggest calorie detection through specific sensors on the tongue independent of perceived taste. Finally, amplitude variation of the first peak in the event-related potential to the different stimuli correlated with papilla density, suggesting a higher discrimination power for subjects with more fungiform papillae.
The Food, Conservation, and Energy Act of 2008 directed the U.S. Department of Agriculture to conduct a 1-year study to assess the extent of areas with limited access to affordable and nutritious food, identify characteristics and causes of such areas, consider how limited access affects local populations, and outline recommendations to address the problem. This report presents the fi ndings of the study, which include results from two conferences of national and international authorities on food deserts and a set of commissioned research studies done in cooperation with the National Poverty Center at the University of Michigan. It also includes reviews of existing literature, a national-level assessment of access to supermarkets and large grocery stores, analysis of the economic and public health effects of limited access, and a discussion of existing policy interventions. The study uses a variety of analytical methods and data to assess the extent of limited access to affordable and nutritious food and characteristics of areas with limited access. Overall, fi ndings show that a small percentage of consumers are constrained in their ability to access affordable nutritious food because they live far from a supermarket or large grocery store and do not have easy access to transportation. Urban core areas with limited food access are characterized by higher levels of racial segregation and greater income inequality. In small-town and rural areas with limited food access, the lack of transportation infrastructure is the most defi ning characteristic. Existing data and research are insuffi cient to conclusively determine whether areas with limited access have inadequate access.
The aim of this study was to examine the monetary cost of dietary change among pregnant women before and after receiving low glycaemic index (GI) dietary advice. The pregnant women in this study were a subgroup of participants in the Pregnancy and Glycaemic Index Outcomes (PREGGIO) study. Twenty women from the low GI dietary advice group, who had completed their pregnancies, were randomly chosen. All these women had completed three day food records at 12–16 weeks and again around 36 weeks of gestation. Consumer food prices were applied to recorded dietary intake data. The mean ± SD GI of the diet reduced from 55.1 ± 4.3 to 51.6 ± 3.9 (p = 0.003). The daily cost of the diet (AUD) was 9.1 ± 2.7 at enrolment and 9.5 ± 2.1 prior to delivery was not significantly different (p = 0.52). There were also no significant differences in the daily energy intake (p = 0.2) or the daily cost per MJ (p = 0.16). Women were able to follow low GI dietary advice during pregnancy with no significant increase in the daily costs.
Food marketing is often singled out as the leading cause of the obesity epidemic. The present review examines current food marketing practices to determine how exactly they may be influencing food intake, and how food marketers could meet their business objectives while helping people eat healthier. Particular attention is paid to the insights provided by recently published studies in the areas of marketing and consumer research, and those insights are integrated with findings from studies in nutrition and related disciplines. The review begins with an examination of the multiple ways in which 1) food pricing strategies and 2) marketing communication (including branding and food claims) bias food consumption. It then describes the effects of newer and less conspicuous marketing actions, focusing on 3) packaging (including the effects of package design and package-based claims) and 4) the eating environment (including the availability, salience, and convenience of food). Throughout, this review underscores the promising opportunities that food manufacturers and retailers have to make profitable "win-win" adjustments to help consumers eat better.
The current ecological approach in health behaviour research recognises that health behaviour needs to be understood in a broad environmental context. This has led to an exponential increase in the number of studies on this topic. It is the aim of this systematic review to summarise the existing empirical evidence pertaining to environmental influences on fruit and vegetable (FV) consumption. The environment was defined as ‘all factors external to the individual’. Scientific databases and reference lists of selected papers were systematically searched for observational studies among adults (18–60 years old), published in English between 1 January 1980 and 31 December 2004, with environmental factor(s) as independent factor(s), and fruit intake, vegetable intake or FV intake combined as one outcome measure as dependent factor(s). Findings showed there was a great diversity in the environmental factors studied, but that the number of replicated studies for each determinant was limited. Most evidence was found for household income, as people with lower household incomes consistently had a lower FV consumption. Married people had higher intakes than those who were single, whereas having children showed mixed results. Good local availability (e.g. access to one's own vegetable garden, having low food insecurity) seemed to exert a positive influence on intake. Regarding the development of interventions, improved opportunities for sufficient FV consumption among low-income households are likely to lead to improved intakes. For all other environmental factors, more replicated studies are required to examine their influence on FV intake.
The authors are grateful to the Editor and three anonymous reviewers for their valuable and constructive comments and suggestions. EXECUTIVE SUMMARY Introduction Diet-related health problems have increased dramatically over the last few years. Consequently, nutri-tional labeling has emerged as an important aspect of consumers' food purchase decisions. Nutritional content in food products is considered to be a credence attribute. However, if trustworthy nutritional la-bels are available, nutritional labels could function as a search characteristic. The regulatory environment in some countries (e.g. USA, Australia etc.) has long recognized the potential of standardized on-pack nutrition information and has mandated the presence of nutritional labels on all processed food products. Others, like the EU, are contemplating similar mandatory nutritional labeling regulations. The nutritional labeling literature has grown significantly in recent years. Our paper reviews this increasingly important literature and addresses some specific issues regarding the determinants of label use, the debate on man-datory labeling, the label formats preferred by consumers, and the effect of nutrition label use on purchase and dietary behavior. Determinants of nutritional label use There has been no consistency in the results of studies conducted regarding the determinants of label use. For example, there has been no consensus on the effect of age, income, or working status on nutritional label use. However, education and gender (i.e., being female) have been found to positively affect label use. In addition, people with more available time for grocery shopping have been found to be more likely to be classified as label users. It also appears that consumers who are more concerned about nutrition and health are more likely to use nutritional labels. Consequently, consumers on a special diet, organic buyers, and those aware of the diet-disease relation are more likely to search for on-pack nutrition information than others.
Do subtle cues for imposed healthy eating make consumers hungry? Imposed healthy eating signals that the health goal was sufficiently met, and thus it increases the strength of the conflicting motive to fulfill one's appetite. Accordingly, consumers asked to sample an item framed as healthy later reported being hungrier and consumed more food than those who sampled the same item framed as tasty or those who did not eat at all. These effects of healthy eating depend on the consumer's perception that healthy eating is mandatory; therefore, only imposed healthy eating made consumers hungrier, whereas freely choosing to eat healthy did not increase hunger. (c) 2010 by JOURNAL OF CONSUMER RESEARCH, Inc..
Some food items that are commonly considered unhealthy also tend to elicit impulsive responses. The pain of paying in cash can curb impulsive urges to purchase such unhealthy food products. Credit card payments, in contrast, are relatively painless and weaken impulse control. Consequently, consumers are more likely to buy unhealthy food products when they pay by credit card than when they pay in cash. Results from four studies support these hypotheses. Analysis of actual shopping behavior of 1,000 households over a period of 6 months revealed that shopping baskets have a larger proportion of food items rated as impulsive and unhealthy when shoppers use credit or debit cards to pay for the purchases (study 1). Follow-up experiments (studies 2–4) show that the vice-regulation effect of cash payments is mediated by pain of payment and moderated by chronic sensitivity to pain of payment. Implications for consumer welfare and theories of impulsive consumption are discussed.
A Bayesian method of estimating multivariate sample selection models is introduced and applied to the estimation of a demand
system for food in the UK to account for censoring arising from infrequency of purchase. We show how it is possible to impose
identifying restrictions on the sample selection equations and that, unlike a maximum likelihood framework, the imposition
of adding up at both latent and observed levels is straightforward. Our results emphasise the role played by low incomes and
socio-economic circumstances in leading to poor diets and also indicate that the presence of children in a household has a
negative impact on dietary quality.
Using a structural model of time allocation between household production and market work, I estimate the shadow wage of household
production. I combine data from the American Time Use Survey and the Current Population Survey’s Food Security Supplement
to estimate the time cost as well as the total cost of food preparation at home. Using information on whether a household
received food stamp benefits, I compare actual food stamp recipients’ time cost to those who do not receive food stamp benefits.
Previous literature that also uses American Time Use Survey data suggests that “typical” food stamp recipients incur a higher
time cost of preparing food at home. I cannot confirm this finding using actual data on food stamp recipients and non-recipients.
In fact, the lower shadow wage of household production of food stamp recipients more than offsets the larger amount of time
spent preparing food at home, generating lower time cost of food preparation for them.
KeywordsFood stamps–American time use survey–Home production–Food-at-home
How do decisions made for tomorrow or 2days in the future differ from decisions made for several days in the future? We use
data from an online grocer to address this question. In general, we find that as the delay between order completion and delivery
increases, grocery customers spend less, order a higher percentage of “should” items (e.g., vegetables), and order a lower
percentage of “want” items (e.g., ice cream), controlling for customer fixed effects. These field results replicate previous
laboratory findings and are consistent with theories suggesting that people’s should selves exert more influence over their choices the further in the future outcomes will be experienced. However, orders placed
for delivery tomorrow versus 2days in the future do not show this want/should pattern, and we discuss a potential explanation.
To examine diet costs in relation to dietary quality and socio-economic position, and to investigate underlying reasons for differences in diet costs.
Dietary intake was assessed by a 4 d food diary and evaluated using the 2005 Healthy Eating Index (HEI). National consumer food prices collected by Statistics Sweden and from two online stores/supermarkets were used to estimate diet costs.
Sweden.
A nationally representative sample of 2160 children aged 4, 8 or 11 years.
Higher scores on the HEI resulted in higher diet costs and, conversely, higher diet costs were linked to increased total HEI scores. Children who consumed the most healthy and/or expensive diets ate a more energy-dilute and varied diet compared with those who ate the least healthy and/or least expensive diets. They also consumed more fish, ready meals and fruit. Regression analysis also linked increased food costs to these food groups. There was a positive, but weak, relationship between HEI score and diet cost, parental education and parental occupation respectively.
Healthy eating is associated with higher diet cost in Swedish children, in part because of price differences between healthy and less-healthy foods. The cheapest and most unhealthy diets were found among those children whose parents were the least educated and had manual, low-skill occupations. Our results pose several challenges for public health policy makers, as well as for nutrition professionals, when forming dietary strategies and providing advice for macro- and microlevels in society.
Taste is often cited as the factor of greatest significance in food choice, and has been described as the body's 'nutritional gatekeeper'. Variation in taste receptor genes can give rise to differential perception of sweet, umami and bitter tastes, whereas less is known about the genetics of sour and salty taste. Over twenty-five bitter taste receptor genes exist, of which TAS2R38 is one of the most studied. This gene is broadly tuned to the perception of the bitter-tasting thiourea compounds, which are found in brassica vegetables and other foods with purported health benefits, such as green tea and soya. Variations in this gene contribute to three thiourea taster groups of people: supertasters, medium tasters and nontasters. Differences in taster status have been linked to body weight, alcoholism, preferences for sugar and fat levels in food and fruit and vegetable preferences. However, genetic predispositions to food preferences may be outweighed by environmental influences, and few studies have examined both. The Tastebuddies study aimed at taking a holistic approach, examining both genetic and environmental factors in children and adults. Taster status, age and gender were the most significant influences in food preferences, whereas genotype was less important. Taster perception was associated with BMI in women; nontasters had a higher mean BMI than medium tasters or supertasters. Nutrient intakes were influenced by both phenotype and genotype for the whole group, and in women, the AVI variation of the TAS2R38 gene was associated with a nutrient intake pattern indicative of healthy eating.
About half of the recent dramatic decline in US deaths from coronary heart disease (CHD) may be attributable to the use of evidence-based therapies, with the other half due to reductions in major risk factors. As a result, there were approximately 341,745 fewer deaths from CHD in 2000 than expected based on 1980 mortality figures. The findings appear in the June 6, 2007, issue of the New England Journal of Medicine (NEJM). Ford et al. used a previously validated statistical model to evaluate the use and effectiveness of specific cardiac treatments as well as changes in risk factors during 2 decades that continued the substantial decrease in cardiovascular-related mortality that began after age-adjusted rates hit their peak in 1968 (Slide 1). The model, known as IMPACT, explains approximately 90% of the decrease seen in 2000. Despite the fact that CHD mortality rates fell by more than 40% for men and women between 1980 and 2000 (Slide 2), the burden of cardiovascular disease (CVD) in the US remains enormous. An estimated 79,400,000 American adults (1 in 3) have CVD. In all but 1 year since 1900 (with 1918 being the exception due to a worldwide influenza epidemic), CVD accounted for more deaths than any other single cause or group of causes of death in the United States. As discouraging as these numbers are, they would be even worse save for concerted efforts targeting CHD and CHD risk.
The author reports a longitudinal quasi experiment that uses the implementation of the Nutrition Labeling and Education Act (NLEA) to examine the consumer and information determinants of nutrition information processing activities. Over 1000 consumers from balanced demographic, geographic, and site categories and across 20 different product categories were observed and surveyed within a supermarket setting. Findings suggest that consumers acquired and comprehended more nutrition information following the introduction of the new labels. The NLEA did not, however, always influence these outcomes irrespective of individual consumer differences. Specifically, the new nutrition labels were comprehensible to consumers with varying levels of motivation and most types of nutrition knowledge. However, the new labels appeared to widen consumer differences in terms of how much nutrition information was actually acquired - more motivated consumers and less skeptical consumers acquired more information after the NLEA was passed. Finally, consistent with the NLEA's apparent ability to reduce comprehension differences, the new labels narrowed comprehension differences across healthy and unhealthy products. In contrast, the NLEA widened differences in nutrition information acquisition in favor of unhealthy product categories. These results have implications for public health gains, as well as for the degree to which nutrition may become the basis for competition in unhealthy product categories.
Self-control is typically viewed as a battle between willpower and desire. The authors focus on the desire side of the equation and extol the positive effect of faster satiation that makes unhealthy behaviors less tempting. They demonstrate that consumers higher in trait self-control demonstrate such “healthy” satiation as they satiate faster on unhealthy foods than on healthy foods. In contrast, those with lower self-control fail to consistently show this differential pattern in their satiation rates. This difference for high self-control people can result from faster satiation for unhealthy foods, slower satiation for healthy foods, or both in combination. Moderating and mediating evidence establish that changes in attention to the amount consumed helped account for these effects on the rate of satiation. The resulting differences in satiation influence the ultimate intake of unhealthy foods, underscoring the importance of the contribution made by differential satiation rates to overconsumption and obesity.
Most Americans consume diets that do not meet Federal dietary recommendations. A common explanation is that healthier foods are more expensive than less healthy foods. To investigate this assumption, the authors compare prices of healthy and less healthy foods using three different price metrics: the price of food energy (/100 edible grams), and the price of an average portion ($/average portion). They also calculate the cost of meeting the recommendations for each food group. For all metrics except the price of food energy, the authors find that healthy foods cost less than less healthy foods (defined for this study as foods that are high in saturated fat, added sugar, and/or sodium, or that contribute little to meeting dietary recommendations).
Making well-informed, healthful food choices helps people maintain a high quality of life. This is especially true for consumers suffering from serious diseases and conditions, such as coronary heart disease and diabetes. Two studies examine how the provision of information on trans fat, a nutrient that provides no known beneficial health benefits, in the Nutrition Facts panel influences consumers' product perceptions and purchase intentions. Using a sample of consumers suffering from diabetes, the authors show that trans fat knowledge and level (disclosed in a Nutrition Facts panel) interact to influence risk perceptions of cardiovascular disease. The results also indicate that responses of consumers who are at risk for heart disease are influenced by the interplay among consumer knowledge, trans fat level, and motivation to process nutrition information. Specifically, the authors find that motivation in the absence of knowledge can lead to a misinterpretation of the nutrient information. Overall, the results indicate that without appropriate consumer education programs, the addition of trans fat levels to the Nutrition Facts panel may have limited or even unintended consequences. The article concludes with a discussion of the implications of these results for public policy.
Across four experiments, the authors find that when information pertaining to the assessment of the healthiness of food items is provided, the less healthy the item is portrayed to be, (1) the better is its inferred taste, (2) the more it is enjoyed during actual consumption, and (3) the greater is the preference for it in choice tasks when a hedonic goal is more (versus less) salient. The authors obtain these effects both among consumers who report that they believe that healthiness and tastiness are negatively correlated and, to a lesser degree, among those who do not report such a belief. The authors also provide evidence that the association between the concepts of "unhealthy" and "tasty" operates at an implicit level. The authors discuss possibilities for controlling the effect of the unhealthy = tasty intuition (and its potential for causing negative health consequences), including controlling the volume of unhealthy but tasty food eaten, changing unhealthy foods to make them less unhealthy but still tasty, and providing consumers with better information about what constitutes "healthy."
A cooking skill scale was developed to measure cooking skills in a European adult population, and the relationship between cooking skills and the frequency of consumption of various food groups were examined. Moreover, it was determined which sociodemographic and psychological variables predict cooking skills. The data used in the present study are based on the first (2010) and second (2011) surveys of a yearly paper-and-pencil questionnaire (Swiss Food Panel). Data from 4436 participants (47.2% males) with a mean age of 55.5years (SD=14.6, range 21-99) were available for analysis. The cooking skills scale was validated using a test-retest analysis, confirming that this new scale is a reliable and consistent instrument. Cooking enjoyment was the most important predictor for cooking skills, especially for men. Women had higher cooking skills in all age groups. Cooking skills correlated positively with weekly vegetable consumption, but negatively with weekly convenience food consumption frequency, even while holding the effect of health consciousness related to eating constant. In summary, cooking skills may help people to meet nutrition guidelines in their daily nutrition supply. They allow people to make healthier food choices. It is, therefore, important to teach children and teenagers how to cook and to encourage them to develop their cooking skills.
Getting an innovation adopted is difficult; a common problem is increasing the rate of its diffusion. Diffusion is the communication of an innovation through certain channels over time among members of a social system. It is a communication whose messages are concerned with new ideas; it is a process where participants create and share information to achieve a mutual understanding. Initial chapters of the book discuss the history of diffusion research, some major criticisms of diffusion research, and the meta-research procedures used in the book. This text is the third edition of this well-respected work. The first edition was published in 1962, and the fifth edition in 2003. The book's theoretical framework relies on the concepts of information and uncertainty. Uncertainty is the degree to which alternatives are perceived with respect to an event and the relative probabilities of these alternatives; uncertainty implies a lack of predictability and motivates an individual to seek information. A technological innovation embodies information, thus reducing uncertainty. Information affects uncertainty in a situation where a choice exists among alternatives; information about a technological innovation can be software information or innovation-evaluation information. An innovation is an idea, practice, or object that is perceived as new by an individual or an other unit of adoption; innovation presents an individual or organization with a new alternative(s) or new means of solving problems. Whether new alternatives are superior is not precisely known by problem solvers. Thus people seek new information. Information about new ideas is exchanged through a process of convergence involving interpersonal networks. Thus, diffusion of innovations is a social process that communicates perceived information about a new idea; it produces an alteration in the structure and function of a social system, producing social consequences. Diffusion has four elements: (1) an innovation that is perceived as new, (2) communication channels, (3) time, and (4) a social system (members jointly solving to accomplish a common goal). Diffusion systems can be centralized or decentralized. The innovation-development process has five steps passing from recognition of a need, through R&D, commercialization, diffusions and adoption, to consequences. Time enters the diffusion process in three ways: (1) innovation-decision process, (2) innovativeness, and (3) rate of the innovation's adoption. The innovation-decision process is an information-seeking and information-processing activity that motivates an individual to reduce uncertainty about the (dis)advantages of the innovation. There are five steps in the process: (1) knowledge for an adoption/rejection/implementation decision; (2) persuasion to form an attitude, (3) decision, (4) implementation, and (5) confirmation (reinforcement or rejection). Innovations can also be re-invented (changed or modified) by the user. The innovation-decision period is the time required to pass through the innovation-decision process. Rates of adoption of an innovation depend on (and can be predicted by) how its characteristics are perceived in terms of relative advantage, compatibility, complexity, trialability, and observability. The diffusion effect is the increasing, cumulative pressure from interpersonal networks to adopt (or reject) an innovation. Overadoption is an innovation's adoption when experts suggest its rejection. Diffusion networks convey innovation-evaluation information to decrease uncertainty about an idea's use. The heart of the diffusion process is the modeling and imitation by potential adopters of their network partners who have adopted already. Change agents influence innovation decisions in a direction deemed desirable. Opinion leadership is the degree individuals influence others' attitudes
An index that assesses the multidimensional components of the diet across the lifecycle is useful in describing diet quality. The purpose of this study was to use the Healthy Eating Index-2005, a measure of diet quality in terms of conformance to the 2005 Dietary Guidelines for Americans, to describe the diet quality of Americans by varying sociodemographic characteristics in order to provide insight as to where diets need to improve. The Healthy Eating Index-2005 scores were estimated using 1 day of dietary intake data provided by participants in the 2003-2004 National Health and Nutrition Examination Survey. Mean daily intakes of foods and nutrients, expressed per 1,000 kilocalories, were estimated using the population ratio method and compared with standards that reflect the 2005 Dietary Guidelines for Americans. Participants included 3,286 children (2 to 17 years), 3,690 young and middle-aged adults (18 to 64 years), and 1,296 older adults (65+ years). Results are reported as percentages of maximum scores and tested for significant differences (P≤0.05) by age, sex, race/ethnicity, income, and education levels. Children and older adults had better-quality diets than younger and middle-aged adults; women had better-quality diets than men; Hispanics had better-quality diets than blacks and whites; and diet quality of adults, but not children, generally improved with income level, except for sodium. The diets of Americans, regardless of socioeconomic status, are far from optimal. Problematic dietary patterns were found among all sociodemographic groups. Major improvements in the nutritional health of the American public can be made by improving eating patterns.
Hispanics/Latinos are the largest and fastest growing major demographic group in the United States, accounting for 16.3% (50.5 million/310 million) of the US population in 2010. In this article, the American Cancer Society updates a previous report on cancer statistics for Hispanics using incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. In 2012, an estimated 112,800 new cases of cancer will be diagnosed and 33,200 cancer deaths will occur among Hispanics. In 2009, the most recent year for which actual data are available, cancer surpassed heart disease as the leading cause of death among Hispanics. Among US Hispanics during the past 10 years of available data (2000-2009), cancer incidence rates declined by 1.7% per year among men and 0.3% per year among women, while cancer death rates declined by 2.3% per year in men and 1.4% per year in women. Hispanics have lower incidence and death rates than non-Hispanic whites for all cancers combined and for the 4 most common cancers (breast, prostate, lung and bronchus, and colorectum). However, Hispanics have higher incidence and mortality rates for cancers of the stomach, liver, uterine cervix, and gallbladder, reflecting greater exposure to cancer-causing infectious agents, lower rates of screening for cervical cancer, differences in lifestyle and dietary patterns, and possibly genetic factors. Strategies for reducing cancer risk among Hispanics include increasing utilization of screening and available vaccines, as well as implementing effective interventions to reduce obesity, alcohol consumption, and tobacco use. CA Cancer J Clin 2012;. © 2012 American Cancer Society.
The first significant change to the Nutrition Facts panel since its inception is the addition of trans fat information. This research examines whether this modification may have a significant effect on consumers’ disease risk perceptions and on the perceived importance of trans fat information. The results of an experiment that varied exposure to induced trans fat knowledge, trans fat levels, and Nutrition Facts Panel formats indicate that without consumer education efforts that enhance consumers’ knowledge and understanding of trans fat, effects of the new labeling regulations on consumers may be limited.
C onsumers are often unable to resist the temptation of overconsuming certain products such as cookies, crackers, soft drinks, alcohol, etc. To control their consumption, some consumers buy small packages or abstain from purchasing the product altogether. Other consumers, however, still purchase large packages and overconsume. From a strategic perspective, firms have the option of introducing small packages or only offering large packages. We use the literature on hyperbolic discounting to model consumers' self-control problems and examine conditions under which firms will offer small packages to help consumers combat their self-control problem, and how this offering in turn affects prices, profits, consumer, and social welfare. Our results show that introducing small packages can increase firms' profits only when a small fraction of consumers have overconsumption problems or when small packages can bring in new customers. Additionally, we find that competition can sometimes reduce the incentives for firms to introduce small packages. This is particularly true when a large fraction of consumers is attracted to small packages. We also find that firms' profits can sometimes decrease if they produce healthier alternatives of their goods. Our analysis of consumer welfare reveals that small packages enhance consumer and social welfare, even though they sometimes increase the consumption of vice goods.
This paper examines the effect of uncertainty about the future on whether individuals select want options (e.g., junk foods, lowbrow films) or instead exert self-control and select should options (e.g., healthy foods, highbrow films). As predicted by the ego-depletion literature, which suggests that self-control resembles an exhaustible muscle, uncertainty about what the future may bring reduces self-control resources and increases individuals’ tendency to favor want options over should options. These results persist both when real uncertainty is induced and when the salience of naturally-arising uncertainty is heightened. Further, these results hold even when individuals are able to make choices contingent upon the outcomes of uncertain events. Overall, this work suggests that reducing uncertainty in a decision maker’s environment may have a “halo effect”, leading to less impulsive choices.
Economic theory related to time preference and health may be useful as a means of understanding the predictors of diet choice. The willingness to subvert present for future utility is hypothesized to influence the process of sacrificing time, flavor, convenience, and price in order to choose a healthful diet. Empirical results confirm the unique importance of variables related to rate of future discounting versus variables associated with market or cultural factors.
Considerable policy and academic attention has been focused on the topic of food deserts. We consider this topic from an economic perspective. First, we consider how the components of a standard economic analysis apply to the study of food deserts. Second, using this economic lens, we revisit the empirical literature on food deserts to assess the progress that has been made regarding whether food deserts are problematic in the U.S. Overall, despite several studies documenting the existence of food deserts in local areas, shortcomings in available data have not allowed researchers to convincingly document the presence or absence of food deserts on a national scale, and virtually no research has provided insight as to why food deserts might exist. © 2010 by the Association for Public Policy Analysis and Management.
Our goal in this paper is to examine the role and influence of economic factors, defined rather broadly, on consumer food choices, and, hence, nutritional outcomes. We attempt to do this in a non-technical fashion. We examine the role of prices, especially as they relate to the affordability of food in the United States and as a policy lever. Income is analyzed as a driving force behind changes in eating habits, in particular increasing the demand for convenience. The role of time constraints as well as time preference are examined as links to healthy eating habits and as forces behind current trends in eating patterns. Information and knowledge are given prominent play as counter balances to economic forces driving eating habits. We conclude with and examination into maternal nutrition knowledge and children's dietary quality.
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. A total of 1,638,910 new cancer cases and 577,190 deaths from cancer are projected to occur in the United States in 2012. During the most recent 5 years for which there are data (2004-2008), overall cancer incidence rates declined slightly in men (by 0.6% per year) and were stable in women, while cancer death rates decreased by 1.8% per year in men and by 1.6% per year in women. Over the past 10 years of available data (1999-2008), cancer death rates have declined by more than 1% per year in men and women of every racial/ethnic group with the exception of American Indians/Alaska Natives, among whom rates have remained stable. The most rapid declines in death rates occurred among African American and Hispanic men (2.4% and 2.3% per year, respectively). Death rates continue to decline for all 4 major cancer sites (lung, colorectum, breast, and prostate), with lung cancer accounting for almost 40% of the total decline in men and breast cancer accounting for 34% of the total decline in women. The reduction in overall cancer death rates since 1990 in men and 1991 in women translates to the avoidance of about 1,024,400 deaths from cancer. Further progress can be accelerated by applying existing cancer control knowledge across all segments of the population, with an emphasis on those groups in the lowest socioeconomic bracket.
The relative affordability of energy-dense versus nutrient-rich foods may promote socioeconomic disparities in dietary quality and obesity. Although supermarkets are the largest food source in the American diet, the associations between SES and the cost and nutrient content of freely chosen food purchases have not been described.
To investigate relationships of SES with the energy cost (0.26 greater for every multiple of the FPG, and those with a baccalaureate or postbaccalaureate degree spent an additional $1.05 for every 1000 kcal of food compared to those with no college education. Lower energy cost was associated with higher total fat and less protein, dietary fiber, and vegetables per 1000 kcal purchased.
Low-SES supermarket shoppers purchase calories in inexpensive forms that are higher in fat and less nutrient-rich.
Health-care experts believe that increases in portion sizes served by food vendors contribute to the obesity epidemic. This paper shows that food vendors can profit handsomely by using supersizing strategies where regular portion sizes are priced sufficiently high to discourage price-conscious consumers from selecting them, and the prices for enlarging food portions are set so low that these customers are tempted to order the larger portion sizes and overeat. Setting aside the impact of obesity on health-care costs, we show that using supersizing to steer customers toward consuming excessive amounts of food can destroy value from a social perspective; thus this social value destruction trap adds another justification for pressuring food vendors to reduce supersizing for unhealthy food. As a public policy response, we consider how "moderating policies" may counter these effects through measures designed specifically to encourage eating in moderation by applying supersizing bans, taxes, and warnings.
Recent reports show that obesity and diabetes have increased in the United States in the past decade.
To estimate the prevalence of obesity, diabetes, and use of weight control strategies among US adults in 2000.
The Behavioral Risk Factor Surveillance System, a random-digit telephone survey conducted in all states in 2000, with 184 450 adults aged 18 years or older.
Body mass index (BMI), calculated from self-reported weight and height; self-reported diabetes; prevalence of weight loss or maintenance attempts; and weight control strategies used.
In 2000, the prevalence of obesity (BMI >/=30 kg/m(2)) was 19.8%, the prevalence of diabetes was 7.3%, and the prevalence of both combined was 2.9%. Mississippi had the highest rates of obesity (24.3%) and of diabetes (8.8%); Colorado had the lowest rate of obesity (13.8%); and Alaska had the lowest rate of diabetes (4.4%). Twenty-seven percent of US adults did not engage in any physical activity, and another 28.2% were not regularly active. Only 24.4% of US adults consumed fruits and vegetables 5 or more times daily. Among obese participants who had had a routine checkup during the past year, 42.8% had been advised by a health care professional to lose weight. Among participants trying to lose or maintain weight, 17.5% were following recommendations to eat fewer calories and increase physical activity to more than 150 min/wk.
The prevalence of obesity and diabetes continues to increase among US adults. Interventions are needed to improve physical activity and diet in communities nationwide.
Food prices are an established determinant of food choice and may affect diet quality. Research on diet cost and diet quality in representative populations has been hindered by lack of data.
We sought to explore the distribution of diet cost and diet quality among strata of the US population and to examine the association between the 2 variables.
In this cross-sectional study, monetary costs of diets consumed by participants in the 2001-2002 NHANES were estimated with the use of a national food price database. Healthy Eating Index (HEI)-2005 values were estimated with the use of the population ratio method for the calculation of average scores. Mean daily diet costs, energy-adjusted diet costs, and HEI-2005 scores were estimated for subpopulations of interest. Associations between energy-adjusted diet cost, HEI-2005 scores, and HEI-2005 component scores were evaluated.
Higher energy-adjusted diet costs were significantly associated with being older and non-Hispanic white, having a higher income and education, and living in a food-secure household. Higher diet costs were also associated with higher HEI-2005 scores for both men and women. Women in the highest quintile of diet costs had a mean HEI-2005 score of 69.6 compared with 52.5 for women in the lowest-cost quintile. Higher diet cost was strongly associated with consuming more servings of fruit and vegetables and fewer calories from solid fat, alcoholic beverages, and added sugars.
Given the observed association between diet cost and diet quality, helping consumers select affordable yet nutritious diets ought to be a priority for researchers and health professionals.
The use of dietary supplements and the health status of individuals have an asymmetrical relationship: the growing market for dietary supplements appears not to be associated with an improvement in public health. Building on the notion of licensing, or the tendency for positive choices to license subsequent self-indulgent choices, we argue that because dietary supplements are perceived as conferring health advantages, use of such supplements may create an illusory sense of invulnerability that disinhibits unhealthy behaviors. In two experiments, participants who took placebo pills that they believed were dietary supplements exhibited the licensing effect across multiple forms of health-related behavior: They expressed less desire to engage in exercise and more desire to engage in hedonic activities (Experiment 1), expressed greater preference for a buffet over an organic meal (Experiment 1), and walked less to benefit their health (Experiment 2) compared with participants who were told the pills were a placebo. A mediational analysis indicated that perceived invulnerability was an underlying mechanism for these effects. Thus, a license associated with the use of dietary supplements may operate within cycles of behaviors that alternately protect and endanger health.
Energy-dense foods and diets have been associated with higher energy intakes (Andrieu et al., 2006) and with higher prevalence of obesity and the metabolic syndrome (Mendoza et al., 2007). By all reports, the energy density of the Western diet is on the rise, as is the consumption of dietary fats (Drewnowski and Popkin, 1997; Popkin et al., 2001; Drewnowski, 2005). In the United Kingdom, dietary fat accounted for an average of 36% of dietary energy for men and 35% for women (Henderson et al., 2003). In France, dietary fat accounted for 37%–42% of dietary energy, with saturated fat providing 16% (Drewnowski et al., 1996; Perrin et al., 2002; Astorg et al., 2004). In the United States, dietary fat accounted for 33%–36% of dietary energy (Allred, 1995; CDC, 2004). Despite public health efforts to lower fat consumption, global consumption of both animal and vegetable fats continues to rise (CDC, 2004; Amuna and Zotor, 2008). Innate preferences for dietary fats seem to be tempered only by incomes. As incomes rise, developing nations typically replace plant-based diets with more animal fats, vegetable oils, and caloric sweeteners, a phenomenon known as the “nutrition transition” (Drewnowski and Popkin, 1997). Paradoxically, developed nations recommend replacing fat-rich foods with water-laden grains, vegetables, and fruit in order to increase bulk and so reduce the energy density of the diet. Recommendations to reduce dietary energy density are one way to reduce energy intakes in an effort to address the global obesity epidemic (WHO Report, 2003). The problem is that the palatability and enjoyment of foods are often tied to their energy density and therefore fat content. Energy-dense foods that are rich in fat are more palatable than are many low-energy-density vegetables and fruit (Drewnowski, 1998). High-fat foods, many containing sugar or salt, have an undeniable sensory appeal and are difficult to resist (Folkenberg and Martens, 2003). Energy-dense high-fat diets are consumed in preference to plant-based diets of grains, pulses, and legumes. There are many explanations for why humans like fat (Drewnowski, 1997a,b). Several physiological mechanisms have been proposed, many of which are based on the strong links found between fat content, palatability, satiety, and energy density. The orosensory properties of fat or fat “taste” seem to be perceived through a combination of taste, texture, and olfaction (Drewnowski, 1997a; Schiffman et al., 1998). Fat is a concentrated source of energy with rewarding postingestive effects (Drewnowski, 1995). The learning of food preferences may be based on associating sensory attributes with the physiologic consequences of ingestion, such as satiety and well-being (Birch, 1999).