[Show abstract][Hide abstract] ABSTRACT: Objective:
Little is known about the practices for stocking and procuring healthy food in non-traditional food retailers (e.g. gas-marts, pharmacies). The present study aimed to: (i) compare availability of healthy food items across small food store types; and (ii) examine owner/manager perceptions and stocking practices for healthy food across store types.
Descriptive analyses were conducted among corner/small grocery stores, gas-marts, pharmacies and dollar stores. Data from store inventories were used to examine availability of twelve healthy food types and an overall healthy food supply score. Interviews with managers assessed stocking practices and profitability.
Small stores in Minneapolis and St. Paul, MN, USA, not participating in the Special Supplemental Nutrition Program for Women, Infants, and Children.
One hundred and nineteen small food retailers and seventy-one store managers.
Availability of specific items varied across store type. Only corner/small grocery stores commonly sold fresh vegetables (63 % v. 8 % of gas-marts, 0 % of dollar stores and 23 % of pharmacies). More than half of managers stocking produce relied on cash-and-carry practices to stock fresh fruit (53 %) and vegetables (55 %), instead of direct store delivery. Most healthy foods were perceived by managers to have at least average profitability.
Interventions to improve healthy food offerings in small stores should consider the diverse environments, stocking practices and supply mechanisms of small stores, particularly non-traditional food retailers. Improvements may require technical support, customer engagement and innovative distribution practices.
No preview · Article · Sep 2015 · Public Health Nutrition
[Show abstract][Hide abstract] ABSTRACT: Introduction:
The US Department of Agriculture has stocking criteria for healthy foods among Supplemental Nutrition Assistant Program (SNAP)-authorized retailers. Increased access to healthy food could improve diet quality among SNAP participants, which has implications for chronic disease prevention. The objective of this study was to quantify healthy foods stocked in small-size to mid-size retailers who are authorized under SNAP but not under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
We used formative, cross-sectional data from a large policy evaluation to conduct secondary analyses. Store audits were conducted in 2014 in 91 randomly selected, licensed food stores in Minneapolis and St. Paul, Minnesota. Supermarkets and retailers participating in WIC, which are required to stock healthy foods, were excluded as were other stores not reasonably expected to stock staple foods, such as specialty stores or produce stands. Availability of milk, fruits, vegetables, and whole-grain-rich foods was assessed.
The 91 stores studied were corner stores, food-gas marts, dollar stores, and pharmacies. More than half carried 1 or more varieties of fat-free or low-fat milk, fresh or canned fruit, and whole-grain-rich cereal. However, only one-third stocked 1 or more varieties of fresh vegetables and only one-quarter stocked whole-grain-rich products, such as whole-grain-rich bread (26%) or tortillas (21%) or brown rice (25%). Few stores stocked at least 2 varieties of each product.
Many stores did not stock a variety of healthy foods. The US Department of Agriculture should change policies to improve minimum stocking requirements for SNAP-authorized retailers.
Preview · Article · Aug 2015 · Preventing chronic disease
[Show abstract][Hide abstract] ABSTRACT: To develop a BPA Exposure Assessment Module (BEAM) for use in large observational studies and to evaluate the ability of the BEAM to estimate bisphenol A (BPA) exposure levels.
The BEAM was designed by modifying an FFQ with questions targeting known sources of BPA exposure. Frequency of intake of known dietary sources of BPA was assessed using the BEAM and three 24 h food records as a reference diet measurement tool. Urinary BPA (uBPA) levels were measured as the criterion tool in a pooled urine sample (nine spot samples per participant). Spearman correlations, linear regression and weighted kappa analysis were used to evaluate the ability of the BEAM and food records to estimate BPA exposure levels.
Minneapolis/Saint Paul, MN, USA.
Sixty-eight healthy adult (20-59 years) volunteers.
Dietary BPA intake assessed by the BEAM was not associated with uBPA levels and was unable to predict participants' rank by uBPA levels. BEAM models with all a priori predictors explained 25 % of the variability in uBPA levels. Canned food intake assessed by food records was associated with uBPA levels, but was unable to rank participants by uBPA levels. Multivariable-adjusted food record models with a priori predictors explained 41 % of the variability in uBPA levels.
Known dietary sources of BPA exposure explained less than half the variability in uBPA levels, regardless of diet assessment method. Findings suggest that a questionnaire approach may be insufficient for ranking BPA exposure level and additional important sources of BPA exposure likely exist.
No preview · Article · Jul 2015 · Public Health Nutrition
[Show abstract][Hide abstract] ABSTRACT: Background
Intake of dietary fatty acids has been linked to cardiovascular disease risk. However, data available to evaluate trends in fatty acid intake in the US population are limited, particularly with regard to trans fatty acids, docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA).
Methods and Results
The present analysis examined trends in fatty acid intake from 1980–1982 through 2007–2009 and compared levels of intake to those recommended in the 2010 Dietary Guidelines for Americans and by the American Heart Association. Twenty‐four‐hour dietary recalls were collected from 12 526 participants enrolled in the Minnesota Heart Survey, a series of 6 independent cross‐sectional surveys designed to monitor cardiovascular risk factors in noninstitutionalized adults residing in the Minneapolis‐St Paul, MN metropolitan area. Mean intake estimates were generated for each survey, and a generalized linear mixed model was used to test the null hypothesis of no difference in the age‐adjusted, sex‐specific means across survey years. Downward trends were observed for total, saturated, and trans fat as a percent of total energy in both men and women. However, mean intakes were still above recommended levels for both trans and saturated fatty acids. Mean intakes of DHA and EPA were also below recommended levels.
Despite promising trends, mean intakes of trans and saturated fatty acids do not meet current recommendations. Additional public health strategies are needed to promote recommended intakes of dietary fats.
Full-text · Article · Oct 2014 · Journal of the American Heart Association
[Show abstract][Hide abstract] ABSTRACT: Objective
Examine the effect of weekday exposure over six months to different lunch sizes on energy intake and body weight in a free-living sample of working adults.
Design and Methods
Adults (n=233) were randomly assigned to one of three lunch size groups (400 kcal; 800 kcal; 1600 kcal) or to a no-free lunch control group for six months. Weight and energy intake were measured at baseline, and months 1, 3, and 6.
Lunch energy was significantly higher in the 800 and 1600 kcal groups compared to the 400 kcal group (p < 0.0001). Total energy was significantly higher for the 1600 kcal group compared to the 400 and 800 kcal groups (p = 0.02). Body weight change at six months did not significantly differ at the 5% level by experimental group (1600 kcal group: +1.1 kg (sd=0.44); 800 kcal group: −0.1 kg (sd=0.42); 400 kcal group: −0.1 kg (sd=0.43); control group: 1.1 (sd=0.42); p=.07). Weight gain over time was significant in the 1600 kcal box lunch group (p < 0.05).
Weekday exposure for six months to a 1600 kcal lunch caused significant increases in total energy intake and weight gain.
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to identify overeating phenotypes and their correlates in overweight and obese children. One hundred and seventeen treatment-seeking overweight and obese 8-12 year-old children and their parents completed the study. Children completed an eating in the absence of hunger (EAH) paradigm, the Eating Disorder Examination interview, and measurements of height and weight. Parents and children completed questionnaires that evaluated satiety responsiveness, food responsiveness, negative affect eating, external eating and eating in the absence of hunger. Latent profile analysis was used to identify heterogeneity in overeating phenotypes in the child participants. Latent classes were then compared on measures of demographics, obesity status and nutritional intake. Three latent classes of overweight and obese children were identified: High Satiety Responsive, High Food Responsive, and Moderate Satiety and Food Responsive. Results indicated that the High Food Responsive group had higher BMI and BMI-Z scores compared to the High Satiety Responsive group. No differences were found among classes in demographics or nutritional intake. This study identified three overeating phenotypes, supporting the heterogeneity of eating patterns associated with overweight and obesity in treatment-seeking children. These finding suggest that these phenotypes can potentially be used to identify high risk groups, inform prevention and intervention targets, and develop specific treatments for these behavioral phenotypes.
[Show abstract][Hide abstract] ABSTRACT: This study evaluated the feasibility, acceptability, and initial efficacy of an intervention based on Schachter's externality theory; the Regulation of Cues (ROC) program.
44 overweight and obese 8-12-year-old children and their parents were randomly assigned to a 4-month ROC program or the control group. Outcomes were assessed at baseline, posttreatment, and 4 months posttreatment and included acceptability and feasibility, body weight, and eating behaviors.
The ROC program had moderate to high acceptability ratings. Significant improvements were found for the ROC group compared with the control group on child food responsiveness at posttreatment and eating in the absence of hunger at 4 months posttreatment. Improvements were seen for the ROC group compared with the control group on body weight measures and food responsiveness, although these only approached significance.
The ROC intervention may be useful with overweight and obese children. Larger, fully powered studies are needed to further evaluate the efficacy of this model.
Full-text · Article · Jan 2014 · Journal of Pediatric Psychology
[Show abstract][Hide abstract] ABSTRACT: Cigarette smoking (CS), hormone therapy (HT) and folate intake (FI) are each thought to influence colorectal cancer (CRC) risk, but the underlying molecular mechanisms remain incompletely defined. The TP53 (p53) protein, encoded by the TP53 tumor suppressor gene that is commonly mutated in CRC, can be readily assessed to differentiate biologically distinct CRC subtypes. In this prospective cohort study, we examined CS, HT, and FI -associated CRC risks by TP53 protein expression level among Iowa Women's Health Study (IWHS) participants. The IWHS recruited 41,836 randomly selected Iowa women, ages 55-69 years, with a valid driver's license at study entry in 1986. Self-reported exposure variables were assessed at baseline. Incident CRC cases were ascertained by annual linkage with the Iowa Cancer Registry. Archived, paraffin-embedded tissue specimens were collected and evaluated for TP53 protein expression by immunohistochemistry. Multivariate Cox regression models were fit to estimate relative risks (RRs) and 95% confidence intervals (CIs) for associations between CS, HT, or FI and TP53-defined CRC subtypes. Informative environmental exposure and protein expression data were available for 492 incident CRC cases: 222 (45.1%) TP53 negative, 72 (14.6%) TP53 low, and 198 (40.2%) TP53 high. Longer duration (> 5 years) of HT was inversely associated with TP53 high CRCs (RR = 0.50; 95% CI = 0.27-0.94). No other statistically significant associations were observed. These data support possible heterogeneous effects from HT on TP53-related pathways of colorectal carcinogenesis in older women.
Preview · Article · Dec 2013 · Cancer Epidemiology Biomarkers & Prevention
[Show abstract][Hide abstract] ABSTRACT: To examine changes in the Na content of lunch/dinner menu offerings at eight of the leading fast-food restaurants in the USA between 1997/1998 and 2009/2010.
Menu offerings and nutrient composition information for the menu items were obtained from archival versions of the University of Minnesota Nutrition Coordinating Center (NCC) Food and Nutrient Database. Nutrient composition information for lunch/dinner menu items sold by the fast-food restaurants included in the present study was updated in the database biannually. Menus were analysed for changes in mean Na content of all menu offerings (except beverages) and specific categories of menu items among all restaurants and for each individual restaurant.
Lunch/dinner food menu of eight leading US fast-food restaurants.
Between 1997/1998 and 2009/2010 the mean Na content of menu offerings across the eight restaurants increased by 23·4 %. Examining specific food categories, mean Na content of entrées by increased 17·2 % and that of condiments increased by 26·1 %. Only side dishes showed a decrease of 6·6 %. None of the restaurants examined had a decrease in Na across the lunch/dinner menu offerings over the 14 years examined.
Results suggest that over the time period studied there has been no meaningful reduction in the Na content of lunch/dinner menu offerings at the leading fast-food restaurants examined in the present study.
Preview · Article · Sep 2013 · Public Health Nutrition
[Show abstract][Hide abstract] ABSTRACT: Limiting dietary sodium consumption is a core lifestyle recommendation for the prevention of hypertension. There is increasing evidence that low potassium consumption also increases hypertension risk. We estimated sex-specific 22-year trends in sodium and potassium consumption.
We used data from the Minnesota Heart Survey, which performs surveillance of risk factors for cardiovascular disease in the Minneapolis-St. Paul metropolitan area. The Minnesota Heart Survey is a random population-based sample of free-living adults aged 25 to 74. Surveys were conducted in 1985-1987 (n=2273), 1990-1992 (n=2487), 1995-1997 (n=1842), 2000-2002 (n=2759), and 2007-2009 (n=1502). Dietary intake of sodium and potassium was estimated from one 24-hour dietary recall. Over 22 years, age-adjusted sodium and potassium intake among men remained relatively stable in 1985-1987 and 2007-2009 (Ptrend=0.41 and 0.29, respectively); sodium ranged from 3820 mg/day (1995-1997) to 3968 mg/day (2007-2009) and potassium from 3111 mg/day (2000-2002) to 3249 mg/day (1995-1997). Sodium and potassium intake increased among women, from 2531 mg/day in 1985-1987 to 2854 mg/day in 2007-2009 (Ptrend=0.001) for sodium and from 2285 to 2533 mg/day (Ptrend<0.0001) for potassium. We observed stable or increasing sodium and potassium intake within some strata of age, education, and body mass index.
Despite long-standing public health recommendations to limit sodium intake to <2300 mg/day, high sodium intake levels have persisted over the past 22 years. Furthermore, although potassium consumption increased in some subgroups over the study period, mean consumption remained significantly lower than the recommended 4700 mg/day in all groups.
Full-text · Article · Aug 2013 · Journal of the American Heart Association
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Frequent consumption of fast-food menu items that are high in fat, sugar, and sodium contribute to poor dietary quality, increasing individuals' risk for diet-related chronic diseases. PURPOSE: To assess 14-year trends in the nutritional quality of menu offerings at eight fast-food restaurant chains in the U.S. METHODS: Data on menu items and food and nutrient composition were obtained in 2011 from archival versions of the University of Minnesota Nutrition Coordinating Center Food and Nutrient Database for eight fast-food restaurant chains. In this database, ingredient and nutrition information for all foods sold by the fast-food restaurants were updated biannually between 1997/1998 and 2009/2010. Healthy Eating Index (HEI)-2005 scores were calculated for each restaurant menu as a measure of the extent to which menu offerings were consistent with Dietary Guidelines for Americans and compared over time. RESULTS: Of a possible index total of 100 (healthiest), the HEI-2005 score across all eight fast-food restaurants was 45 in 1997/1998 and 48 in 2009/2010. Individually, restaurant scores in 1997/1998 ranged from 37 to 56 and in 2009/2010 ranged from 38 to 56. The greatest improvements in nutritional quality were seen in the increase of meat/beans, decrease in saturated fat, and decrease in the proportion of calories from solid fats and added sugars. The HEI-2005 score improved in six restaurants and decreased in two. CONCLUSIONS: The nutritional quality of menu offerings at fast-food restaurant chains included in this study increased over time, but further improvements are needed. Fast-food restaurants have an opportunity to contribute to a healthy diet for Americans by improving the nutritional quality of their menus.
Full-text · Article · Jun 2013 · American journal of preventive medicine
[Show abstract][Hide abstract] ABSTRACT: Within the past decade, there has been increasing attention to the role of fast food in the American diet, including a rise in legislative and media-based efforts that address the healthfulness of fast food. However, no studies have been undertaken to evaluate changes in the energy content of fast-food chain restaurant menu items during this period.
To examine changes in the energy content of lunch/dinner menu offerings at eight of the leading fast-food chain restaurants in the U.S. between 1997-1998 and 2009-2010.
Menu offerings and nutrient composition information were obtained from archival versions of the University of Minnesota Nutrition Coordinating Center Food and Nutrient Database. Nutrient composition information for items was updated biannually. Changes in median energy content of all lunch/dinner menu offerings and specific categories of menu items among all restaurants and for individual restaurants were examined. Data were collected between 1997 and 2010 and analysis was conducted in 2011.
Spanning 1997-1998 and 2009-2010, the number of lunch/dinner menu items offered by the restaurants in the study increased by 53%. Across all menu items, the median energy content remained relatively stable over the study period. Examining specific food categories, the median energy content of desserts and condiments increased, the energy content of side items decreased, and energy content of entrées and drinks remained level.
Although large increases in the number of menu items were observed, there have been few changes in the energy content of menu offerings at the leading fast-food chain restaurants examined in this study.
No preview · Article · Nov 2012 · American journal of preventive medicine
[Show abstract][Hide abstract] ABSTRACT: Objective:
Little is known about the relationship between weight change and workplace absenteeism. The purpose of this study was to examine the degree to which weight change predicted 2-year absenteeism.
A longitudinal analysis of 1,228 employees enrolled in a worksite-randomized controlled trial was performed. Participants were all working adults in the Minneapolis, MN, area (USA).
The final model indicated a significant interaction between weight change and baseline BMI. The difference in absenteeism ranged from (mean ± SE) 3.2 ± 1.2 days among healthy weight employees who maintained their weight to 6.6 ± 1.1 days among obese employees who gained weight (and slightly higher among healthy weight employees who lost weight). The adjusted model also indicated that participants who were male, not depressed, nonsmokers, and had lower baseline absenteeism had significantly less workplace absenteeism relative to participants who were female, depressed, smokers, and had higher baseline absenteeism.
Absenteeism was generally low in this sample, but healthy weight employees who maintained their body weight over 2 years had the fewest number of sick days. More research is needed in this area, but future workforce attendance interventions may be improved by focusing on the primary prevention of weight gain in healthy weight employees.
[Show abstract][Hide abstract] ABSTRACT: Folate and related micronturients may affect colorectal cancer (CRC) risk, but the molecular mechanism(s) remain incompletely defined. We analyzed associations between dietary folate, vitamin B6, vitamin B12, and methionine with incident CRC, overall and by microsatellite instability (MSS/MSI-L or MSI-H), CpG island methylator phenotype (CIMP-negative or CIMP-positive), BRAF mutation (negative or positive), and KRAS mutation (negative or positive) status in the prospective, population-based Iowa Women's Health Study (IWHS; 55-69 years at baseline; n = 41,836). Intake estimates were obtained from baseline, self-reported food frequency questionnaires. Molecular marker data were obtained for 514 incident CRC cases. Folate intake was inversely associated with overall CRC risk in age-adjusted Cox regression models, whereas methionine intake was inversely associated with overall CRC risk in multivariable-adjusted models [relative risk (RR) = 0.81; 95% CI = 0.69-0.95; P trend = 0.001 and RR = 0.72; 95% CI = 0.54-0.96; P trend = 0.03 for highest vs. lowest quartiles, respectively]. None of the dietary exposures were associated with MSI, CIMP, BRAF, or KRAS defined CRC subtypes. These data provide minimal support for major effects from the examined micronutrients on overall or molecularly defined CRC risks in the IWHS cohort.
Preview · Article · Oct 2012 · Nutrition and Cancer
[Show abstract][Hide abstract] ABSTRACT: Peanut allergy is a major health concern, particularly in developed countries. Research indicates that as many as 2% of children are allergic to peanuts, which represents a 3-fold increase in diagnoses over the past 2 decades.
This population-based descriptive study used the Rochester Epidemiology Project to estimate the prevalence in 2007 and annual incidence rates of peanut allergy diagnoses from 1999 to 2007 among children residing in Olmsted County, Minnesota.
Residents of Olmsted County from January 1, 1999, through December 31, 2007, who received medical care at a Rochester Epidemiology Project facility and provided research authorization were eligible for the study. A medical chart review of 547 potential diagnoses resulted in 244 prevalent and 170 incident cases. Annual rates, crude and adjusted for age and sex, were standardized with the use of the indirect method to the Olmsted County population data in 1999. Incidence rate ratios were estimated with Poisson regression.
The prevalence in 2007 was 0.65%. Female children were less likely to be diagnosed than male children (incidence rate ratio = 0.18; 95% CI, 0.07-0.48). Children aged birth to 2 years were significantly more likely to be diagnosed than older children aged 3-17 years (incidence rate ratio = 0.001; 95% CI, 0.0004-0.004). A significant 3-fold increasing trend was observed in diagnoses over time from 2.05 cases per 10,000 children in 1999 to 6.88 cases per 10,000 in 2007.
Peanut allergies are an increasing concern in Olmsted County, Minnesota, as indicated by a 3-fold increase in diagnoses from 2.05 per 10,000 children in 1999 to 6.88 per 10,000 children in 2007.
No preview · Article · Aug 2012 · The Journal of allergy and clinical immunology