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OBJECTIVE: Frequent fast-food consumption is a well-known risk factor for obesity. This study sought to determine whether the availability of fast-food restaurants has an influence on body mass index (BMI). METHODS: BMI and individual-level confounding variables were obtained from the 2007-08 Canadian Community Health Survey. Neighbourhood socio-demographic variables were acquired from the 2006 Canadian Census. The geographic locations of all restaurants in Canada were assembled from a validated business registry database. The density of fast-food, full-service and non-chain restaurants per 10,000 individuals was calculated for respondents' forward sortation area. Multivariable regression analyses were conducted to analyze the association between restaurant density and BMI. RESULTS: Fast-food, full-service and non-chain restaurant density variables were statistically significantly associated with BMI. Fast-food density had a positive association whereas full-service and non-chain restaurant density had a negative association with BMI (additional 10 fast-food restaurants per capita corresponded to a weight increase of 1 kilogram; p CONCLUSIONS: This research was the first to investigate the influence of fast-food and full-service restaurant density on BMI using individual-level data from a nationally representative Canadian survey. The finding of a positive association between fast-food restaurant density and BMI suggests that interventions aiming to restrict the availability of fast-food restaurants in local neighbourhoods may be a useful obesity prevention strategy. KEY WORDS: Obesity; fast foods; body mass index; environment and public health OBJECTIF : La consommation frequente d'aliments de restauration rapide est un facteur de risque d'obesite bien connu. Nous avons cherche a determiner si la presence de restaurants rapides a une influence sur l'indice de masse corporelle (IMC). METHODE : L'IMC et les variables de confusion individuelles ont ete puises dans l'Enquete sur la sante dans les collectivites canadiennes de 2007-2008. Les variables sociodemographiques par quartier ont ete obtenues dans le Recensement du Canada de 2006. Nous avons determine l'emplacement geographique de tous les restaurants au Canada a partir d'un registre des entreprises valide. Nous avons calcule la densite pout 10 000 habitants des restaurants rapides, plein service et n'appartenant pas a une chaine, selon la region de tri d'acheminement des repondants. Nous avons effectue des analyses de regression multivariees pour etudier l'association entre la densite des restaurants et l'IMC. RESULTATS : Les variables de densite des restaurants rapides, plein service et n'appartenant pas a une chaine presentaient une correlation significative avec l'IMC. Pour la densite des restaurants rapides, cette association etait positive, tandis que pour les restaurants plein service et n'appartenant pas a une chaine, la densite etait negativement associee a l'IMC (chaque tranche supplementaire de 10 restaurants rapides par habitant correspondait a une hausse ponderale d'1 kilogramme; p CONCLUSIONS : Notre etude est la premiere a analyser l'influence de la densite des restaurants rapides et plein service sur l'IMC a l'aide de donnees individuelles provenant d'une enquete nationale representative menee au Canada. La decouverte d'une association positive entre la densite des restaurants rapides et l'IMC donne a penser que les interventions visant a limiter la presence des restaurants rapides a l'echelle des quartiers pourraient etre des strategies utiles pour prevenir l'obesite. MOTS CLES : obesite; aliments de restauration rapide; indice de masse corporelle; environnement et sante publique, La traduction du resume se trouve a la fin de l'article. Adult body mass index (BMI) in Canada and in other developed nations has increased dramatically over the last three [...]

BACKGROUND: The U.S. Environmental Protection Agency (U.S. EPA) has estimated the neurological benefits of reductions in prenatal methylmercury (MeHg) exposure in past assessments of rules controlling mercury (Hg) emissions. A [...]

Objective To assess the effect of food taxes and subsidies on diet, body weight and health through a systematic review of the literature. Methods We searched the English-language published and grey literature for empirical and modelling studies on the effects of monetary subsidies or taxes levied on specific food products on consumption habits, body weight and chronic conditions. Empirical studies were dealing with an actual tax, while modelling studies predicted outcomes based on a hypothetical tax or subsidy. Findings Twenty-four studies met the inclusion criteria: 13 were from the peer-reviewed literature and 11 were published on line. There were 8 empirical and 16 modelling studies. Nine studies assessed the impact of taxes on food consumption only, 5 on consumption and body weight, 4 on consumption and disease and 6 on body weight only. In general, taxes and subsidies influenced consumption in the desired direction, with larger taxes being associated with more significant changes in consumption, body weight and disease incidence. However, studies that focused on a single target food or nutrient may have overestimated the impact of taxes by failing to take into account shifts in consumption to other foods. The quality of the evidence was generally low. Almost all studies were conducted in high-income countries. Conclusion Food taxes and subsidies have the potential to contribute to healthy consumption patterns at the population level. However, current evidence is generally of low quality and the empirical evaluation of existing taxes is a research priority, along with research into the effectiveness and differential impact of food taxes in developing countries. Objectif Evaluer les effets des taxes alimentaires et des subventions sur l'alimentation, le poids corporel et la sante au travers d'une analyse systematique de la litterature. Methodes Il a ete procede a une recherche de la litterature en langue anglaise et des ressources en ligne en matiere d'etudes empiriques et de modelisation sur les effets des subventions monetaires ou des taxes prelevees sur des produits alimentaires specifiques sur les habitudes de consommation, le poids corporel et les maladies chroniques. Les etudes empiriques traitaient d'une taxe reelle, alors que les etudes de modelisation envisageaient les resultats d'une taxe ou d'une subvention hypothetique. Resultats Vingt-quatre etudes presentaient les criteres l'inclusion. Treize provenaient de litterature revue par des pairs et onze de publications en ligne. Il a ete denombre 8 etudes empiriques et 16 etudes de modelisation. Neuf etudes evaluaient uniquement l'impact des taxes a la consommation alimentaire, cinq, la consommation et le poids corporel, quatre, la consommation et les maladies et six, le seul poids corporel. En general, les taxes et les subventions ont influe sur la consommation dans la direction desiree, les taxes majeures etant associees avec les changements les plus significatifs sur la consommation, le poids corporel et l'incidence de maladies. Cependant, les etudes axees sur un produit alimentaire ou un nutriment unique peuvent avoir surestime l'impact des taxes dans la mesure ou elles ne prennent pas en consideration le deplacement de la consommation vers d'autres aliments. La qualite des elements probants etait generalement basse. Les etudes ont pratiquement toutes ete conduites dans des pays a revenu eleve. Conclusion Les taxes alimentaires et les subventions ont le potentiel de contribuer a des schemas de consommation sains au niveau de la population. Cependant, les elements probants dont nous disposons actuellement sont generalement de basse qualite et l'evaluation empirique des taxes existantes est une priorite de recherche, de meme que la recherche liee a l'efficacite et a l'impact differentiel des taxes alimentaires dans les pays en developpement. Objotivo Evaluar el efecto de los impuestos y las subvenciones sobre los alimentos en la dieta, el peso corporal y la salud mediante una revision sistematica de la bibliografia. Metodos Se realizaron busquedas de bibliografia en lengua inglesa (obras publicadas y bibliografia invisible) que tratara sobre estudios empiricos y de modelizacion de los efectos que tienen las subvenciones economicas o los impuestos aplicados a ciertos productos alimentarios sobre los habitos de consumo, el peso corporal y las enfermedades cronicas. Los estudios empiricos manejaron un impuesto real, mientras que los estudios de modelizacion se basaron en un impuesto o subvencion hipoteticos. Resultados Veinticuatro estudios cumplian los criterios de inclusion: 13 procedian de bibliografia de revision externa y 11 se publicaron en linea. Se incluyeron ocho estudios empiricos y 16 estudios de modelizacion. Nueve estudios valoraron el impacto de los impuestos unicamente sobre el consumo de los alimentos, cinco, sobre el consumo y el peso corporal, cuatro, sobre el consumo y las enfermedades y seis unicamente sobre el peso corporal. En general, los impuestos y las subvenciones influyeron sobre el consumo en la direccion deseada, en la que unos impuestos mas elevados estaban relacionados con cambios mas significativos en el consumo, el peso y la incidencia de enfermedades. Sin embargo, los estudios que se centraron en un solo alimento o nutriente en concreto pueden haber sobrestimado el impacto de los impuestos al no tener en cuenta los cambios en el consumo de otros alimentos. La calidad de los datos fue en general baja. Casi todos los estudios se llevaron a cabo en paises ricos. Conclusion Los impuestos y las subvenciones sobre los alimentos pueden contribuir a la adquisicion de pautas de consumo saludables en la poblacion. Sin embargo, la calidad de los datos actuales suele ser baja y la valoracion empirica de los impuestos existentes es una investigacion prioritaria, junto con los estudios de la eficacia y el impacto diferencial de los impuestos sobre los alimentos en los paises en desarrollo., Introduction The World Health Organization (WHO) has recommended the use of fiscal policy to influence food prices 'in ways that encourage healthy eating'. (1,2) Although this is consistent with growing [...]

Epidemiological evidence suggests that diets high in fruits and vegetables provide protective effects from numerous diseases. Data show that consumption of fruits and vegetables is much lower in low socioeconomic groups. This study assessed the food-purchasing behaviors and barriers to consuming fruits and vegetables among African-American women living in public housing in an urban city. Face-to-face data collection methods included interviews of two focus groups of 10 women each and structured-questionnaire interviews of 230 women. The focus groups addressed the issues of barriers to fruit and vegetable consumption by the families; the structured-questionnaire interviews focused on food-purchasing and food-preparation behaviors. Results indicated that the women wanted to increase fruit and vegetable consumption by their family, but several barriers existed: Cost, poor cooking skills, lack of social support, and childhood eating patterns. The women made several key suggestions for interventions: Stipends for participants, pictures to illustrate text, older community members to serve as session leaders, and empathetic and noncondescending teaching styles., Diets high in fruits and vegetables have been shown to protect against an array of diseases, cancer included (24,25). Carotenoids and vitamin C protect against cataracts (26) and oxidation of [...]

Objective To examine baseline rates of fruit and vegetable consumption among adults in the 5 A Day research trials in order to identify any regional and sociodemographic differences associated with daily servings. Design The main outcome measure was the frequency of fruits and vegetables consumed within 1 month of the baseline survey as assessed by a 7-item food frequency questionnaire (FFQ). Subjects/setting Participants (N = 15,060) were from 7 study centers. Study centers included schools (N = 48), worksites (N = 60), churches (N = 50), or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics (N = 15) in interventions to increase fruit and vegetable consumption. Statistical analyses Means and standard errors, adjusting for clusters, were calculated. A mixed linear model analyzed relationships between fruit and vegetable consumption and regional center, gender, age, race, education, income, marital status, food-shopping responsibility, and whether one lives with children. Results Results indicate an overall mean intake of 3.6 daily servings of fruits and vegetables. Significant differences in mean daily servings were found among the regional study centers (low of 3.0 to high of 4.1). There were significant differences in mean daily consumption by age (high school = 3.4 servings per day; high school graduate = 3.4; some college = 3.5; college graduate = 3.9), race (black = 3.7 servings per day; Hispanic = 3.0; white = 3.6; other = 3.7), marital status (married = 3.6 servings per day; single = 3.5), and food-shopping responsibilities (little = 3.2 servings per day; about half = 3.6; most = 3.8). Only 17% of respondents ate 5 or more servings of fruits and vegetables per day. Conclusions The 7 regions showed significant variability in daily fruit and vegetable consumption, suggesting that a single national message to increase fruit and vegetable consumption may not reach the population segments most in need of changing. It is advisable to spend more time understanding the food consumption habits of the population under investigation to develop messages to foster behavior change., Cancer mortality ranks second in the United States among all causes of death, accounting for 23.4% of all deaths annually (1). Dietary factors are thought to contribute about one third [...]

Objective To develop a dietary assessment instrument to measure soy food consumption and isoflavone intake and test it for reliability. Design A soy food frequency questionnaire, designed for use in this study, was administered twice to participants, separated by a 2-week interval. The questionnaire was tested for reproducibility of estimates of soy food consumption and isoflavone (genistein and daidzein) intake. Subjects/setting A convenience sample of 51 faculty, staff, and students was recruited from a naturopathic university. Statistical analyses performed Intraclass correlation coefficients were used to assess reproducibility of estimates of soy food intake and genistein and daidzein intake. Results Correlation coefficients comparing mean soy food servings per month between the 2 administrations of the questionnaire ranged from 0.50 for soy yogurt to 0.89 for tempeh. Correlation coefficients for genistein and daidzein intake estimated by the 2 administrations of the questionnaire were the same: 0.89. Mean intake (±standard deviation) of genistein and daidzein was 7±10 and 4±6 mg/day, respectively. Fifteen soy foods contributed 95% of the total genistein and daidzein intake: tofu, soy yogurt, tempeh, soy milk, low-fat tofu, soy flour, miso, soy protein isolate, low-fat soy milk, veggie soy burger, textured vegetable protein, miso soup, cooked soybeans, soy hot dogs, and natto (fermented soy beans). Applications The soy food frequency questionnaire developed in this study provided highly reproducible estimates of soy food consumption and isoflavone intake. This instrument may be a useful tool in studies of the associations between isoflavone exposure and risk for chronic disease., Many studies have suggested that the consumption of soybeans and soybean-containing foods may contribute to the lower rates of breast, colon, and prostate cancer in Asia compared with the United [...]

Objective To examine how life-course experiences and events are associated with current fruit and vegetable consumption in 3 ethnic groups. Design A theoretic model developed from previous qualitative research guided the development of a telephone survey. Data were collected on fruit and vegetable consumption, sociodemographic characteristics, ethnic identity, and life-course events and experiences, including food upbringing, social roles, food skills, dietary changes for health, and practice of food traditions. Subjects/setting Low- to moderate-income adults living in a northeastern US city were selected randomly from 3 ethnic groups: black (n=201), Hispanic (n=191), and white (n=200). Statistical analyses Bivariate and multiple linear regression analysis of associations between life-course variables and fruit and vegetable consumption. Results Black, Hispanic, and white respondents differed significantly in life-course experiences, family roles, sociodemographic characteristics, and place of birth. Explanatory models for fruit and vegetable consumption differed among ethnic groups and between fruits and vegetables. Among black respondents, a college education was positively associated with fruit consumption; education and family roles contributed most to differences in fruit ([R.sup.2] = .16) and vegetable ([R.sup.2] = .09) consumption. Among Hispanic respondents, life-course experiences such as liking fruits and vegetables in youth, making dietary changes for health, and food skills were positively associated with fruit ([R.sup.2] = .25) and vegetable ([R.sup.2] = .35) consumption. Among white respondents, sociodemographic characteristics, such as being married with a young child or single with no child and having a garden as an adult, were positively associated with fruit ([R.sup.2] = .20) and vegetable ([R.sup.2] = .22) consumption. Applications/conclusions An understanding of the determinants of food choice in different subcultural groups can be used to design effective nutrition interventions to increase fruit and vegetable consumption. Experiences such as eating fresh-picked fruits and vegetables while growing up or vegetable gardening as an adult may enhance fruit and vegetable consumption among members of some ethnic groups., Life events and experiences are hypothesized to have a long-lasting influence on food choice (1-3). The life-course perspective highlights continuity and change across the life span, through trajectories or patterns [...]

Objective To evaluate the tracking of children's fruit and vegetable intake over 2 years. Design Children in the control group from the Gimme 5 nutrition education intervention trial completed three 7-day food diaries once a year in 1994, 1995, and 1996, beginning when they were in third grade. Subjects Five hundred sixty-one students from public elementary schools. Statistical analyses performed Tracking was examined through correlation of fruit and vegetable servings over the 2 years as well as the percent of subjects remaining in the same or adjacent quintiles of fruit and vegetable intake, using the Κ statistic. Results Tracking of fruit and vegetable intake was fair to moderate over the 2 years. One-year correlations for total fruit and vegetable servings were .37 for boys and .46 for girls; 2-year correlations were .48 for boys and .40 for girls. Κ values for remaining in the same quintile generally exceeded chance rates only for the top and bottom quintiles. No values exceeded .50. Application/conclusion The drift in ranking may have been a result of true changes in fruit and vegetable intake or measurement error (ie, inability to accurately assess actual intake). If this drift reflects true change, it may be difficult for nutrition education programs targeting this age group to demonstrate long-term behavioral effects on fruit and vegetable intake. If the drift is the result of measurement limitations, improved dietary assessment may yield stronger tracking., The rationale for providing youth with disease prevention and health promotion programs rests largely on the premise that health habits formed during childhood persist or 'track' into adulthood; that is, [...]

Objective To examine food consumption patterns and related characteristics of schoolchildren. Design A representative survey involving a household questionnaire and child interview to conduct a nonquantitative 24-hour dietary recall. Indexes were developed to score the diets based on the Food Guide Pyramid and 5 A Day for Better Health recommendations. Subjects/setting Six hundred ninety-three 2nd-grade students and 704 5th-grade students from public and private schools in New York City. Statistical analyses performed Weighted means and gender-adjusted analysis of covariance models were used to account for a complex survey design in calculating variance estimates. Results Compared with a maximum of 50, the mean Food Guide Pyramid index score was 29.2 for 2nd-grade students and 30.4 for 5th-grade students. The mean 5 A Day consumption score was 3.4 and 3.6 servings of fruits and vegetables daily for 2nd and 5th graders, respectively. Measures of food consumption were significantly related to socioeconomic status, race/ethnicity, skipping meals, and participating in school lunch for both grades, and with meal preparation for 5th graders. Applications/conclusions The Food Guide Pyramid and 5 A Day recommendations provide guidelines for food selection beginning in childhood. Knowledge and skills training are needed to improve food consumption patterns as children consume foods away from home and as they take on greater responsibility for meal preparation and food selection., Increasing awareness of the importance of diet for health promotion and disease prevention has led to a greater concern about the diet and food consumption patterns of schoolchildren. Findings from [...]

B. Shatenstein is a researcher, D. Claveau is a research assistant, and G. Ferland is associate director for clinical research, all at the Centre de Recherche, Institut Universitaire de Geriatrie de Montreal and the Departement de Nutrition, Universite de Montreal., ********** Visual observation quantifies dietary intakes without making demands on the subjects' memory or ability to conceptualize food consumed. This method has been used to evaluate food consumption (1), nutrition [...]

It is crucial that children of elementary school age receive adequate meals to eliminate transient hunger, which may interfere with classroom performance. Proper nutrition has been linked to students' readiness [...]