Christopher Ford

Trends in Dietary Intake among US 2- to 6-Year-Old Children, 1989-2008

BACKGROUND Between 1989 and 2008, obesity increased markedly in children of all ages. We examined changes in the diets of children ages 2 to 6 years in the United States between 1989 and 2008. Our study provides new insight into diet changes that might have contributed to the sharp rise in obesity during this period. OBJECTIVE Our aim was to describe changes in diet among 2- to 6-year-old children from 1989 to 2008 related to sharp rises in obesity during this period. PARTICIPANTS This analysis included 10,647 children ages 2 to 6 years from the following five nationally representative surveys of dietary intake in the United States: Continuing Survey of Food Intake in Individuals 1989-1991 and 1994-1998 and the What We Eat In America, National Health and Nutrition Examination Surveys 2003-2004, 2005-2006, and 2007-2008. Diet data were categorized into groupings using the University of North Carolina-Chapel Hill approach. STATISTICAL ANALYSES Analyses were carried out using a single 24-hour dietary recall with appropriate survey weighting. T tests were used to compare means across survey years, with P<0.05 considered significant. RESULTS During the 20-year period, there were increases in per capita intake of savory snacks (+51 kcal; P<0.01), pizza/calzones (+32 kcal; P<0.01), sweet snacks and candy (+25 kcal; P<0.01), mixed Mexican dishes (+22 kcal; P<0.01), and fruit juice (+18 kcal; P<0.01), and total daily energy intake increased by 109 kcal (from 1,475 to 1,584 kcal) (P<0.05). Fruit intake increased marginally (+24 kcal; P<0.01). Six of the 10 greatest absolute changes in per capita intake between sequential survey years occurred between Continuing Survey of Food Intake in Individuals 1994-1998 and National Health and Nutrition Examination Surveys 2003-2004 (P<0.05). CONCLUSIONS Foods high in added sugars and solid fats, such as savory snacks, pizza/calzones, mixed Mexican dishes, sweet snacks and candy, and fruit juice, predominated the top changes in per capita consumption between 1989 and 2008.

Television viewing associated with adverse dietary outcomes in children ages 2-6.

The aim of this paper was to systematically review the evidence for the association between television viewing and diet in children ages 2–6. Data sources included PubMed, PsycINFO, EMBASE, ERIC, SportDISCUS, Sociological Abstracts, Web of Science and hand searches of reference lists of relevant articles. Twelve studies were reviewed in which the relationship between television viewing and diet was assessed in children between the ages of 2 and 6. All but one study reported significant relationship between television viewing time and adverse dietary outcomes. Parent‐reported television viewing time was used to assay child television viewing in all included studies. Food frequency survey was the most frequent method of dietary assessment, and parent served as proxies for children in all studies. Lower fruit and/or vegetable intake was the most frequently reported dietary outcome, followed by increased energy intake with increased television viewing. The majority of studies reported adverse dietary outcomes with as little as 1 h of daily television exposure. While these results are consistent with recommendations from child health advocates to limit television viewing in young children, they also suggest that further efforts to limit television viewing in young children may be needed to aid in obesity prevention.

Ten-year beverage intake trends among US preschool children: Rapid declines between 2003 and 2010 but stagnancy in recent years

It has been previously reported that total energy intake among US preschool children (ages 2–5 years) decreased between 2003–2004 and 2009–2010. However, little is known about how intakes of beverages among US preschoolers (ages 2–5 years) changed from 2003–2004 to 2011–2012.

Targeted Beverage Taxes Influence Food and Beverage Purchases among Households with Preschool Children

BACKGROUND How beverage taxes might influence purchases of foods and beverages among households with preschool children is unclear. Thus, we examined the relation between beverage taxes and food and beverage purchases among US households with a child 2-5 y of age. OBJECTIVES We examined how a potential tax on sugar-sweetened beverages (SSBs), or SSBs and >1% fat and/or high-sugar milk, would influence household food and beverage purchases among US households with a preschool child. We aimed to identify the lowest tax rate associated with meaningful changes in purchases. METHODS We used household food and beverage purchase data from households with a single child who participated in the 2009-2012 Nielsen Homescan Panel. A 2-part, multilevel panel model was used to examine the relation between beverage prices and food and beverage purchases. Logistic regression was used in the first part of the model to estimate the probability of a food/beverage being purchased, whereas the second part of the model used log-linear regression to estimate predicted changes in purchases among reporting households. Estimates from both parts were combined, and bootstrapping was performed to obtain corrected SEs. In separate models, prices of SSBs, or SSBs and >1% and/or high-sugar milk, were perturbed by +10%, +15%, and +20%. Predicted changes in food and beverage purchases were compared across models. RESULTS Price increases of 10%, 15%, and 20% on SSBs were associated with fewer purchases of juice drinks, whereas price increases of 10%, 15%, and 20% simulated on both SSBs plus >1% fat and/or high-sugar milk (combined tax) were associated with fewer kilocalories purchased from >1% fat, low-sugar milk, and meat, poultry, fish, and mixed meat dishes. CONCLUSIONS Our study provides further evidence that a tax on beverages high in sugar and/or fat may be associated with favorable changes in beverage purchases among US households with a preschool child.

Are Food and Beverage Purchases in Households with Preschoolers Changing?: A Longitudinal Analysis from 2000 to 2011

BACKGROUND U.S. dietary studies from 2003 to 2010 show decreases in childrens caloric intake. We examined purchases of consumer packaged foods/beverages in the U.S. between 2000 and 2011 among households with children aged 2-5 years. PURPOSE To describe changes in consumer packaged goods (CPG) purchases between 2000 and 2011 after adjusting for economic indicators, and explore differences by race, education, and household income level. METHODS CPG purchase data were obtained for 42,753 U.S. households with one or more child aged 2-5 years using the Nielsen Homescan Panel. Top sources of purchased calories were grouped, and random effects regression was used to model the relationship between calories purchased from each group and race, female head of household education, and household income. Models adjusted for household composition, market-level unemployment rate, prices, and quarter, with Bonferroni correction for multiple comparisons (α=0.05). RESULTS Between 2000 and 2011, adjusted total calories purchased from foods (-182 kcal/day) and beverages (-100 kcal/day) declined significantly. Decreases in purchases of milk (-40 kcal); soft drinks (-27 kcal/day); juice and juice drinks (-24 kcal/day); grain-based desserts (-24 kcal/day); savory snacks (-17 kcal/day); and sweet snacks and candy (-13 kcal/day) were among the major changes. Changes in CPG purchases differed significantly by race, female head of household education, and household income. CONCLUSIONS Trends in CPG purchases suggest that solid fats and added sugars are decreasing in the food supply of U.S. preschoolers. Pronounced differences by race, education, and household income persist.