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Background Unrestrained eating behavior, as a potential proxy for diet frequency, timing, and caloric intake, has been questioned as a plausible risk factor for digestive system cancers, but epidemiological evidence remains sparse. Objectives We investigated prospectively the associations between unrestrained eating behavior and digestive system cancer risk. Methods Participants in the Nurses' Health Study who were free of cancer and reported dietary information in 1994 were followed for ≤18 y. Cox models were used to estimate HRs and 95% CIs for unrestrained eating (eating anything at any time, no concern with figure change, or both) and risk of digestive system cancers. Results During follow-up, 2064 digestive system cancer cases were documented among 70,450 eligible participants in analyses of eating anything at any time, In total, 2081 digestive system cancer cases were documented among 72,468 eligible participants in analyses of no concern with figure change. In fully adjusted analyses, women with the behavior of eating anything at any time had a higher risk of overall digestive system cancer (HR: 1.22; 95% CI: 1.10, 1.35), overall gastrointestinal tract cancer ((HR: 1.33; 95% CI: 1.18, 1.50), buccal cavity and pharynx cancer (HR: 1.50; 95% CI: 1.02, 2.21), esophageal cancer (HR: 1.62; 95% CI: 1.01, 2.62), small intestine cancer (HR: 1.92; 95% CI: 1.02,3. 59), and colorectal cancer (HR: 1.20; 95% CI: 1.04, 1.38), and a non–statistically significant increased risk of stomach cancer (HR: 1.54; 95% CI: 0.96,2.48), compared with women without this behavior. No statistically significant association was observed for pancreatic cancer and liver and gallbladder cancer. The combined effect of eating anything at any time and having no concern with figure change was associated with a significantly increased risk of overall digestive system cancer (HR: 1.27; 95% CI: 1.10, 1.46), overall gastrointestinal tract cancer (HR: 1.45; 95% CI: 1.23, 1.71), and colorectal cancer (HR: 1.34; 95% CI: 1.11, 1.63), compared with women exhibiting the opposite. Conclusions Unrestrained eating behavior was independently associated with increased risk of gastrointestinal tract cancers. The potential importance of unrestrained eating behavior modification in preventing gastrointestinal tract cancers should be noted. [ABSTRACT FROM AUTHOR]

Objective To examine changes in children's meal orders, price, and revenue following the implementation of a healthier children's menu in a full-service restaurant chain. Methods In April 2012, the healthier menu was implemented, featuring more meals meeting nutrition standards, healthy side dishes by default, and removal of French fries and soda (which could be substituted). Orders ( n = 352,192) were analyzed before (September 2011 to March 2012; PRE) and after (September 2012 to March 2013; POST) implementation. Results Children's meal prices increased by $0.79 for breakfasts and $0.19 for non-breakfast meals from PRE to POST. Revenue continued to increase post-implementation. Orders of healthy meals, strawberry and vegetable sides, milk, and juice increased, and orders of French fries and soda decreased ( P < 0.0001). Orders at POST were more likely to include healthy sides ( P < 0.0001) and substitutions ( P < 0.0001) and less likely to include a la carte sides ( P < 0.0001) and desserts ( P < 0.01), versus PRE. Total calories ordered by children accepting all defaults decreased (684.2 vs. 621.2; P < 0.0001) and did not change for those not accepting defaults (935.0 vs. 942.9; P = 0.57). Conclusions Healthy children's menu modifications were accompanied by healthier ordering patterns, without removing choice or reducing revenue, suggesting that they can improve child nutrition while restaurants remain competitive. [ABSTRACT FROM AUTHOR]

The article discusses a study on the accuracy of stated energy contents of foods in restaurants conducted in the U.S. from January to June 2010. The study used a validated bomb calorimetry technique in measuring energy contents in foods from quick-serve and sit-down restaurants. There was no significant difference found between the overall absolute stated energy contents and absolute measured energy contents. The stated energy contents of individual foods were found inaccurate when compared to the measured energy contents. The implications of the findings for the prevention and treatment of obesity are tackled.

U.S. adults are now gaining more weight and becoming obese at an earlier age than in previous years. The specific causes of adult weight gain are unknown, but may be attributed to a combination of factors leading to positive energy balance. U.S. food supply data indicate that Americans have had a gradual increase in energy intake since 1970, and that per capita energy intake was 1.42 MJ/d (340 kcal/d) higher in 1994 than that in 1984. In contrast, self-reported physical activity remained constant between 1990 and 1998. Taken together, these data indicate that the increasing trend in U.S. adult weight gain is primarily attributable to overconsumption of energy. Epidemiological and experimental studies in animals and humans provide strong evidence that biobehavioral factors such as dietary variety, liquid (vs. solid) energy, portion size, palatability (taste), snacking patterns, restaurant and other away-from-home food, and dietary restraint and disinhibition influence hunger, satiety and/or voluntary energy intake. When these eating behaviors are consistently experienced either separately or in combination over the long term, they are likely to facilitate overeating. We provide a brief overview of the evidence to date for the role of these biobehavioral factors in contributing to excess energy intake and increases in body weight over time. [ABSTRACT FROM AUTHOR]

Examines the influence of dietary fiber intake on weight enhancement in the United States. Association of dietary fiber with hunger, satiety, energy intake and body composition; Evidence of energy suppression among obese individuals; Insufficiency of information comparing fiber types.

Reports on the United States Centers for Disease Control and Prevention's publication of the new childhood growth percentiles, designed to replace the 1977 National Center for Health Statistics percentiles. Uses of the percentile charts; International definitions for overweight and obesity in childhood.

Investigates the effects of aging on mechanisms of body energy regulation in older men in the United States. Determination of unexplained weight loss; Premature death and disability; Importance of nutrition and dietary habits; Impact of changes in body composition on health; Measurements of energy expenditure; Statistical analyses using SYSTAT.

Evaluates the effects of dietary fat and fat substitutes on obesity and energy regulation in the United States, referencing data from studies conducted on the issue. Relationship between dietary fat and obesity; Concept associated with dietary fat and energy regulations; Comparison between dietary fat and energy density.

Examines the magnitude of weight gain during the holiday season among adults in the United States. Contribution of holiday weight gain to annual obesity statistics; Implication of the holiday season for the eating habits of individuals; Public belief on weight gain during the holidays compared to other seasons of the year.

Explores the engagement guidelines developed by a faculty committee for Cooperative Extension and research faculty involvement in public policy education on research within the College of Agriculture and Home Economics at Washington State University. Importance of the Canons of Practice; Implications for Extension colleagues.

Abstract: Objective: To examine relative associations of dietary composition variables with body mass index (BMI; calculated as kg/m2) among young and middle-aged US adults. We hypothesized that in subjects with physiologically plausible reported energy intakes, fiber intake would be inversely associated with BMI, independent of other dietary composition and sociodemographic variables. Subjects and Design: Data from adults age 20 to 59 years in the Continuing Survey of Food Intakes by Individuals (CSFII) 1994–1996 were used. Exclusions were pregnancy or lactation, food insecurity, missing weight or height data, or having only one dietary recall. Based on our previously published methods, a physiologically plausible reported energy intake was calculated as being within ±22% of predicted energy requirements for the mean of two 24-hour recalls. Results: Reporting plausibility ([reported energy intake÷predicted energy requirements]×100) averaged 83% in the total sample (N=4,539) and increased to 96% in the plausible sample (n=1,932). Only approximately 5% of the plausible sample consumed the Adequate Intake for fiber. In plausibly reporting women, fiber, its interaction with percentage energy from fat, and energy density were independently associated with BMI. Only percentage energy from fat was associated with BMI in men reporting plausibly. Compared with the total sample, stronger relationships between diet and BMI were observed among the plausible reporters. In women, a low-fiber (<1.5 g/MJ), high-fat (≥35% energy) diet was associated with the greatest increase in risk of overweight or obesity compared with a high-fiber, low-fat diet. Conclusions: Weight control advice for US women should place greater emphasis on consumption of fiber. [Copyright &y& Elsevier]

Abstract Today's high prevalence of obesity, combined with less than satisfactory results using traditional weight-control methods, has helped foster the popularity of fad diets. Popular fad diets currently range from very low carbohydrate to very low fat, and from well-circumscribed eating patterns to grazing. This paper reviews the spectrum of fad diets in terms of rationale, claims, efficacy, and risks. Menus based on author's recommendations were compiled and assessed for macronutrients. To date, researchers have failed to reach a consensus on the potential benefits of these diets for weight loss, for preserving lean body mass during weight loss, for improving compliance with a hypocaloric diet, for preventing or treating disease, or for sustaining long-term maintenance of lost weight. [ABSTRACT FROM AUTHOR]

US national survey data shows fast food accounted for 11% of daily caloric intake in 2007-2010. To provide a detailed assessment of changes over time in fast-food menu offerings over 30 years, including food variety (number of items as a proxy), portion size, energy, energy density, and selected micronutrients (sodium, calcium, and iron as percent daily value [%DV]), and to compare changes over time across menu categories (entrées, sides, and desserts). Fast-food entrées, sides, and dessert menu item data for 1986, 1991, and 2016 were compiled from primary and secondary sources for 10 popular fast-food restaurants. Descriptive statistics were calculated. Linear mixed-effects analysis of variance was performed to examine changes over time by menu category. From 1986 to 2016, the number of entrées, sides, and desserts for all restaurants combined increased by 226%. Portion sizes of entrées (13 g/decade) and desserts (24 g/decade), but not sides, increased significantly, and the energy (kilocalories) and sodium of items in all three menu categories increased significantly. Desserts showed the largest increase in energy (62 kcal/decade), and entrées had the largest increase in sodium (4.6% DV/decade). Calcium increased significantly in entrées (1.2%DV/decade) and to a greater extent in desserts (3.9% DV/decade), but not sides, and iron increased significantly only in desserts (1.4% DV/decade). These results demonstrate broadly detrimental changes in fast-food restaurant offerings over a 30-year span including increasing variety, portion size, energy, and sodium content. Research is needed to identify effective strategies that may help consumers reduce energy intake from fast-food restaurants as part of measures to improve dietary-related health issues in the United States. [ABSTRACT FROM AUTHOR]

Background Excess energy intake from meals consumed away from home is implicated as a major contributor to obesity, and ∼50% of US restaurants are individual or small-chain (non–chain) establishments that do not provide nutrition information. Objective To measure the energy content of frequently ordered meals in non–chain restaurants in three US locations, and compare with the energy content of meals from large-chain restaurants, energy requirements, and food database information. Design A multisite random-sampling protocol was used to measure the energy contents of the most frequently ordered meals from the most popular cuisines in non–chain restaurants, together with equivalent meals from large-chain restaurants. Setting Meals were obtained from restaurants in San Francisco, CA; Boston, MA; and Little Rock, AR, between 2011 and 2014. Main outcome measures Meal energy content determined by bomb calorimetry. Statistical analysis performed Regional and cuisine differences were assessed using a mixed model with restaurant nested within region×cuisine as the random factor. Paired t tests were used to evaluate differences between non–chain and chain meals, human energy requirements, and food database values. Results Meals from non–chain restaurants contained 1,205±465 kcal/meal, amounts that were not significantly different from equivalent meals from large-chain restaurants (+5.1%; P =0.41). There was a significant effect of cuisine on non–chain meal energy, and three of the four most popular cuisines (American, Italian, and Chinese) had the highest mean energy (1,495 kcal/meal). Ninety-two percent of meals exceeded typical energy requirements for a single eating occasion. Conclusions Non–chain restaurants lacking nutrition information serve amounts of energy that are typically far in excess of human energy requirements for single eating occasions, and are equivalent to amounts served by the large-chain restaurants that have previously been criticized for providing excess energy. Restaurants in general, rather than specific categories of restaurant, expose patrons to excessive portions that induce overeating through established biological mechanisms. [ABSTRACT FROM AUTHOR]

Background: Emerging research indicates that eating timing may influence dietary intake and metabolic health. However, studies to date have not examined the association of multiple measures of eating timing with both dietary intake and metabolic health in adults with overweight and obesity., Objective: To examine the association of multiple measures of eating timing with dietary intake (ie, dietary composition, diet quality, and eating frequency) and metabolic health (ie, body composition and cardiometabolic risk)., Design: This is a cross-sectional analysis of baseline data from a weight loss and maintenance intervention collected from May 2015 to January 2018., Participants/setting: Participants were women with overweight or obesity who were dependents of active duty and retired military personnel (N = 229; mean ± standard error, BMI = 34.7 ± 0.4 kg/m 2 , age = 40.9 ± 0.7 years). The study was conducted at military installations in Massachusetts, Connecticut, New York, Colorado, and Kentucky., Main Outcome Measures: Eating timing variables examined included daily eating interval (time between first and last eating occasion), time-restricted eating (≤11 hours daily eating interval), early energy eaters (eating ≥60% of energy during the first half of time awake), and bedtime eaters (eating within 2 hours of bedtime)., Statistical Analysis: The main analysis was limited to those reporting plausible energy intake (64% of total sample [n = 146]). Linear, quantile, or logistic regression models were used to determine the association of eating timing with measures of dietary intake and metabolic health., Results: In individuals reporting plausible energy intake, each additional 1 hour in daily eating interval was associated with 53 kcal higher energy intake, higher glycemic load, eating frequency, and waist circumference (P < 0.05 for all). Significant associations were observed for: time-restricted eating and a lower energy intake, glycemic load, and eating frequency; early energy eating and higher carbohydrate intake; bedtime eating and a higher energy intake, glycemic load, and eating frequency., Conclusions: These findings lend support for the mechanistic targeting of eating timing in behavioral interventions aimed at improving dietary intake and body composition., (Copyright © 2021 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Breastfeeding is the gold standard for feeding infants because of its long-term benefits to health and development, but most infants in the United States are not exclusively breastfed in the first six months. We enrolled 24 infants who were either exclusively breastfed or supplemented with formula by the age of one month. We collected diet information, stool samples for evaluation of microbiotas by 16S rRNA sequencing, and blood samples for assessment of immune development by flow cytometry from birth to 6 months of age. We further typed the Bifidobacterium strains in stool samples whose 16S rRNA sequencing showed the presence of Bifidobacteriaceae. Supplementation with formula during breastfeeding transiently changed the composition of the gut microbiome, but the impact dissipated by six months of age. For example, Bifidobacterium longum , a bacterial species highly correlated with human milk consumption, was found to be significantly different only at 1 month of age but not at later time points. No immunologic differences were found to be associated with supplementation, including the development of T-cell subsets, B cells, or monocytes. These data suggest that early formula supplementation, given in addition to breast milk, has minimal lasting impact on the gut microbiome or immunity.

(1) Background: The influence of food culture on eating behavior and obesity risk is poorly understood. (2) Methods: In this qualitative study, 25 adults in France with or without overweight/obesity participated in semi-structured interviews ( n = 10) or focus groups ( n = 15) to examine attitudes to food consumption and external pressures that influence eating behavior and weight management. Results were compared to an equivalent study conducted in the United States, thereby contrasting two countries with markedly different rates of obesity. Emerging key themes in the French data were identified through coding using a reflexive approach. (3) Results: The main themes identified were: (1) influence of commensality, social interactions, and pleasure from eating on eating behavior, (2) having a balanced and holistic approach to nutrition, (3) the role of environmental concerns in food consumption, (4) relationship with "natural" products (idealized) and food processing (demonized), (5) perceptions of weight status and management. Stress and difficulties in hunger cue discernment were viewed as important obstacles to weight management in both countries. External pressures were described as a major factor that explicitly influences food consumption in the U.S., while there was an implicit influence of external pressures through eating-related social interactions in France. In France, products considered "natural" where idealized and juxtaposed against processed and "industrial" products, whereas this was not a salient aspect in the U.S. (4) Conclusions: This first comparative qualitative study assessing aspects of food culture and eating behaviors across countries identifies both common and divergent attitudes to food and eating behavior. Further studies are needed to inform the development of effective behavioral interventions to address obesity in different populations.

Introduction: Intakes of sodium, saturated fat, and trans fat remain high despite recommendations to limit these nutrients for cardiometabolic risk reduction. A major contributor to intake of these nutrients is foods prepared outside the home, particularly from fast-food restaurants., Methods: We analyzed the nutrient content of frequently ordered items from 3 US national fast-food chains: fried potatoes (large French fries), cheeseburgers (2-oz and 4-oz), and a grilled chicken sandwich. We used an archival website to obtain data on sodium, saturated fat, and trans fat content for these items from 2000 through 2013. The amount of each nutrient per 1,000 kcal was calculated to determine whether there were trends in product reformulation., Results: Sodium content per 1,000 kcal differed widely among the 3 chains by food item, precluding generalizations across chains. During the 14-year period, sodium content per 1,000 kcal for large French fries remained high for all 3 chains, although the range narrowed from 316-2,000 mg per 1,000 kcal in 2000 to 700-1,420 mg per 1,000 kcal in 2013. Among the items assessed, cheeseburgers were the main contributor of saturated fat, and there was little change in content per 1,000 kcal for this item during the 14-year period. In contrast, there was a sharp decline in saturated and trans fat content of large French fries per 1,000 kcal. Post-2009, the major contributor of trans fat per 1,000 kcal was cheeseburgers; trans fat content of this item remained stable during the 14-year period., Conclusion: With the exception of French fries, little evidence was found during the 14-year period of product reformulation by restaurants to become more consistent with dietary guidance to reduce intakes of sodium and saturated fat.

Introduction: Excess intakes of energy, sodium, saturated fat, and trans fat are associated with increased risk for cardiometabolic syndrome. Trends in fast-food restaurant portion sizes can inform policy decisions. We examined the variability of popular food items in 3 fast-food restaurants in the United States by portion size during the past 18 years., Methods: Items from 3 national fast-food chains were selected: French fries, cheeseburgers, grilled chicken sandwich, and regular cola. Data on energy, sodium, saturated fat, and trans fat content were collated from 1996 through 2013 using an archival website. Time trends were assessed using simple linear regression models, using energy or a nutrient component as the dependent variable and the year as the independent variable., Results: For most items, energy content per serving differed among chain restaurants for all menu items (P ≤ .04); energy content of 56% of items decreased (β range, -0.1 to -5.8 kcal) and the content of 44% increased (β range, 0.6-10.6 kcal). For sodium, the content of 18% of the items significantly decreased (β range, -4.1 to -24.0 mg) and the content for 33% increased (β range, 1.9-29.6 mg). Absolute differences were modest. The saturated and trans fat content, post-2009, was modest for French fries. In 2013, the energy content of a large-sized bundled meal (cheeseburger, French fries, and regular cola) represented 65% to 80% of a 2,000-calorie-per-day diet, and sodium content represented 63% to 91% of the 2,300-mg-per-day recommendation and 97% to 139% of the 1,500-mg-per-day recommendation., Conclusion: Findings suggest that efforts to promote reductions in energy, sodium, saturated fat, and trans fat intakes need to be shifted from emphasizing portion-size labels to additional factors such as total calories, frequency of eating, number of items ordered, menu choices, and energy-containing beverages.

Adult civilian dependents of active duty military personnel (ADMP) may play a central role in influencing the home food environment and the risk of overweight and obesity in American Warfighters and military families. However, there is no information on whether this group would be receptive to weight control programs. We conducted a survey to determine the level of interest of adult civilian dependents of ADMP in participating in a group weight control program. Subjects were a convenience sample of 191 adult civilian dependents of ADMP (94% women, 6% men) based in Massachusetts and aged 33.8 ± 8.4 years, body mass index 25.5 ± 5.5 kg/m(2). Overall, there was a significant effect of body mass index on interest in program participation (p = 0.004). Eighty five percent of overweight participants and 100% of obese participants reported being Moderately Likely or Very Likely to participate in a provided weight control program. In overweight and obese survey respondents there was no significant effect of ADMP rank on interest in program participation (p = 0.34). These findings suggest that overweight and obese adult civilian dependents of ADMP may be very receptive targets for programs to control overweight and obesity in military families., (Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.)

The United States population is aging rapidly, and understanding the potential impact and feasibility of lifestyle interventions on the aging process is of central importance for addressing future population health and health care costs. This symposium addressed the question of whether caloric restriction may be a feasible strategy to improve human health by reductions in rates of primary and secondary aging in humans, viewed from the perspective of existing data in animal models, and by using emerging data from the human Comprehensive Assessment of Long-Term Reduction in Energy Intake trial, which is a randomized trial of human caloric restriction in free-living men and women.

Objective: To review existing methods and illustrate the use of a new, simple method for identifying inaccurate reports of dietary energy intake (rEI)., Design: Comparison of rEI with energy requirements estimated by using total energy expenditure predicted (pTEE) from age, weight, height and sex using a previously published equation. Propagation of error calculations was performed and cut-offs for excluding rEI at plus or minus two standard deviations (+/-2 SD) and +/-1 SD for the agreement between rEI and pTEE were established., Setting: Dietary survey in a US national cohort: the Continuing Survey of Food Intakes by Individuals (CSFII), 1994-96., Subjects: Men and non-pregnant, non-lactating women aged 21-45 years in the CSFII who provided two multiple-pass 24-hour recalls, height and weight (n = 3755)., Results: Average rEI was 77% of pTEE in men, and 64% of pTEE in women. Calculated cut-offs were rEI <40% or >160% of pTEE (+/-2 SD) and <70% or >130% of pTEE (+/-1 SD), respectively. Use of only the +/-1 SD cut-offs, not the +/-2 SD cut-offs, resulted in a relationship between rEI and body weight similar to what was expected (based on an independently calculated relationship between rEI and measured TEE). Exclusion of rEI outside either the +/-2 SD (11% of subjects) or +/-1 SD (57% of subjects) cut-offs did not affect mean reported macronutrient intakes, but did markedly affect relationships between dietary composition and body mass index., Conclusions: When examining relationships between diet and health, use of +/-1 SD cut-offs may be preferable to +/-2 SD cut-offs for excluding inaccurate dietary reports.