L. Beth Dixon

Calorie Labeling And Food Choices: A First Look At The Effects On Low-Income People In New York City

We examined the influence of menu calorie labels on fast food choices in the wake of New York Citys labeling mandate. Receipts and survey responses were collected from 1,156 adults at fast-food restaurants in low-income, minority New York communities. These were compared to a sample in Newark, New Jersey, a city that had not introduced menu labeling. We found that 27.7 percent who saw calorie labeling in New York said the information influenced their choices. However, we did not detect a change in calories purchased after the introduction of calorie labeling. We encourage more research on menu labeling and greater attention to evaluating and implementing other obesity-related policies.

A Prospective Study of Lycopene and Tomato Product Intake and Risk of Prostate Cancer

Background: Dietary lycopene and tomato products may reduce risk of prostate cancer; however, uncertainty remains about this possible association. Methods: We evaluated the association between intake of lycopene and specific tomato products and prostate cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, a multicenter study designed to investigate cancer early detection methods and etiologic determinants. Participants completed both a general risk factor and a 137-item food frequency questionnaire at baseline. A total of 1,338 cases of prostate cancer were identified among 29,361 men during an average of 4.2 years of follow-up. Results: Lycopene intake was not associated with prostate cancer risk. Reduced risks were also not found for total tomato servings or for most tomato-based foods. Statistically nonsignificant inverse associations were noted for pizza [all prostate cancer: relative risk (RR), 0.83; 95% confidence interval (95% CI), 0.67-1.03 for ≥1 serving/wk versus < 0.5 serving/mo; Ptrend = 0.06 and advanced prostate cancer: RR, 0.79; 95% CI, 0.56-1.10; Ptrend = 0.12] and spaghetti/tomato sauce consumption (advanced prostate cancer: RR = 0.81, 95% CI, 0.57-1.16 for ≥2 servings/wk versus < 1 serving/mo; Ptrend = 0.31). Among men with a family history of prostate cancer, risks were decreased in relation to increased consumption of lycopene (Ptrend = 0.04) and specific tomato-based foods commonly eaten with fat (spaghetti, Ptrend = 0.12; pizza, Ptrend = 0.15; lasagna, Ptrend = 0.02). Conclusions: This large study does not support the hypothesis that greater lycopene/tomato product consumption protects from prostate cancer. Evidence for protective associations in subjects with a family history of prostate cancer requires further corroboration. (Cancer Epidemiol Biomarkers Prev 2006;15(1):92–8)

Consumer purchasing patterns in response to calorie labeling legislation in New York City

BackgroundObesity is a major public health threat and policies aimed at curbing this epidemic are emerging. National calorie labeling legislation is forthcoming and requires rigorous evaluation to examine its impact on consumers. The purpose of this study was to examine whether point-of-purchase calorie labels in New York City (NYC) chain restaurants affected food purchasing patterns in a sample of lower income adults in NYC and Newark, NJ.MethodsThis study utilized a difference-in-difference design to survey 1,170 adult patrons of four popular chain restaurants in NYC and Newark, NJ (which did not introduce labeling) before and after calorie labeling was implemented in NYC. Receipt data were collected and analyzed to examine food and beverage purchases and frequency of fast food consumption. Descriptive statistics were generated, and linear and logistic regression, difference-in-difference analysis, and predicted probabilities were used to analyze the data.ResultsA difference-in-difference analysis revealed no significant favorable differences and some unfavorable differences in food purchasing patterns and frequency of fast food consumption between adult patrons of fast food restaurants in NYC and Newark, NJ. Adults in NYC who reported noticing and using the calorie labels consumed fast food less frequently compared to adults who did not notice the labels (4.9 vs. 6.6 meals per week, p <0.05).ConclusionWhile no favorable differences in purchasing as a result of labeling were noted, self-reported use of calorie labels was associated with some favorable behavioral patterns in a subset of adults in NYC. However, overall impact of the legislation may be limited. More research is needed to understand the most effective way to deliver calorie information to consumers.

Neighborhoods and obesity in New York City.

Recent studies reveal disparities in neighborhood access to food and fitness facilities, particularly in US cities; but few studies assess the effects of multiple neighborhood factors on obesity. This study measured the multilevel relations between neighborhood food availability, opportunities and barriers for physical activity, income and racial composition with obesity (BMI> or =30 kg/m(2)) in New York City, controlling for individual-level factors. Obesity rates varied widely between neighborhoods, ranging from 6.8% to 31.7%. Obesity was significantly (p<0.01) associated with neighborhood-level factors, particularly the availability of supermarkets and food stores, fitness facilities, percent of commercial land use and area income. These findings are consistent with the growing literature showing that area income and availability of food and physical activity resources are related to obesity.

Supplemental and dietary vitamin E intakes and risk of prostate cancer in a large prospective study.

Supplemental vitamin E (α-tocopherol) has been linked to lower prostate cancer incidence in one randomized trial and several, although not all, observational studies. The evidence regarding dietary intake of individual vitamin E isoforms and prostate cancer is limited and inconclusive, however. We prospectively examined the relations of supplemental vitamin E and dietary intakes of α-, β-, γ-, and δ- tocopherols to prostate cancer risk among 295,344 men, ages 50 to 71 years and cancer-free at enrollment in 1995 to 1996, in the NIH-AARP Diet and Health Study. At baseline, participants completed a questionnaire that captured information on diet, supplement use, and other factors. Proportional hazards models were used to estimate relative risks (RR) and 95% confidence intervals (95% CI) of prostate cancer. During 5 years of follow-up, 10,241 incident prostate cancers were identified. Supplemental vitamin E intake was not related to prostate cancer risk (for >0-99, 100-199, 200-399, 400-799, and ≥800 IU/d versus never use: RR, 0.97, 0.89, 1.03, 0.99, and 0.97 (95% CI, 0.87-1.07) respectively; Ptrend = 0.90). However, dietary γ-tocopherol, the most commonly consumed form of vitamin E in the United States, was significantly inversely related to the risk of advanced prostate cancer (for highest versus lowest quintile: RR, 0.68; 95% CI, 0.56-0.84; Ptrend = 0.001). These results suggest that supplemental vitamin E does not protect against prostate cancer, but that increased consumption of γ-tocopherol from foods is associated with a reduced risk of clinically relevant disease. The potential benefit of γ-tocopherol for prostate cancer prevention deserves further attention. (Cancer Epidemiol Biomarkers Prev 2007;16(6):1128–35)

Nutrition Practices and Children's Dietary Intakes at 40 Child-Care Centers in New York City

Early childhood is a critical time to establish nutrition habits to prevent obesity. At least half of US children spend time in care outside of the home, where little is known about their dietary intakes and nutrition environment. The purpose of this study was to evaluate nutrition practices of group child-care centers in New York City and to assess whether dietary intakes of children at these centers meet nutrition recommendations. In 2005 and 2006, student research assistants administered surveys to directors of 40 child-care centers in three underserved communities (Central Brooklyn, East/Central Harlem, South Bronx) and in Manhattan, gathered menus, and observed beverages and foods consumed by 240 3- and 4-year-old children. Almost all centers provided beverages and foods recommended by national guidelines, including reduced-fat milk, 100% fruit juice, and whole grains. Some centers also provided higher-fat milk and sugar-sweetened beverages, but no centers provided soda. Drinking water was available in classrooms at only half of the centers. From observations at meal and snack times between 8 AM to 2 PM, <50% of children ate at least half of the daily recommended intake for each of five main food groups, with only 17% of children eating at least half of the daily recommended intake for vegetables and only 5% of children eating at least half of the daily recommended intake for vitamin E. Although many centers provided healthful beverages and foods to children, further efforts are needed to make water available as a beverage throughout the day and to improve dietary intakes, especially of vegetables and vitamin E-containing foods.

Assessment of a government-subsidized supermarket in a high-need area on household food availability and children's dietary intakes.

OBJECTIVE To assess the impact of a new government-subsidized supermarket in a high-need area on household food availability and dietary habits in children. DESIGN A difference-in-difference study design was utilized. SETTING Two neighbourhoods in the Bronx, New York City. Outcomes were collected in Morrisania, the target community where the new supermarket was opened, and Highbridge, the comparison community. SUBJECTS Parents/caregivers of a child aged 3-10 years residing in Morrisania or Highbridge. Participants were recruited via street intercept at baseline (pre-supermarket opening) and at two follow-up periods (five weeks and one year post-supermarket opening). RESULTS Analysis is based on 2172 street-intercept surveys and 363 dietary recalls from a sample of predominantly low-income minorities. While there were small, inconsistent changes over the time periods, there were no appreciable differences in availability of healthful or unhealthful foods at home, or in childrens dietary intake as a result of the supermarket. CONCLUSIONS The introduction of a government-subsidized supermarket into an underserved neighbourhood in the Bronx did not result in significant changes in household food availability or childrens dietary intake. Given the lack of healthful food options in underserved neighbourhoods and need for programmes that promote access, further research is needed to determine whether healthy food retail expansion, alone or with other strategies, can improve food choices of children and their families.

Calorie Labeling, Fast Food Purchasing and Restaurant Visits

Obesity is a pressing public health problem without proven population‐wide solutions. Researchers sought to determine whether a city‐mandated policy requiring calorie labeling at fast food restaurants was associated with consumer awareness of labels, calories purchased and fast food restaurant visits.

Vitamin E intake and risk of esophageal and gastric cancers in the NIH‐AARP Diet and Health Study

We investigated the association of dietary α‐tocopherol, γ‐tocopherol and supplemental vitamin E intake with the risk of esophageal squamous cell carcinoma (n = 158), esophageal adenocarcinoma (n = 382), gastric cardia adenocarcinoma (n = 320) and gastric noncardia adenocarcinoma (GNCA; n = 327) in the NIH‐AARP Diet and Health Study, a cohort of approximately 500,000 people. Data on dietary and supplemental vitamin E intake were collected using a validated questionnaire at baseline and were analyzed using Cox regression models. Intakes were analyzed as continuous variables and as quartiles. For dietary α‐tocopherol, we found some evidence of association with decreased esophageal squamous cell carcinoma and increased esophageal adenocarcinoma risk in the continuous analyses, with adjusted hazard ratios and 95% confidence intervals of 0.90 (0.81–0.99) and 1.05 (1.00–1.11), respectively, per 1.17 mg (half the interquartile range) increased intake. However, in quartile analyses, the p value for trend was nonsignificant for both these cancers. There was no association between dietary α‐tocopherol and gastric cardia adenocarcinoma or GNCA. We observed no statistically significant associations with γ‐tocopherol. For supplemental vitamin E, the results were mainly null, except for a significantly lower risk of GNCA with higher doses of supplemental vitamin E. An increase of 71 mg/day (half the interquartile range) in supplemental vitamin E had an hazard ratio (95% confidence interval) of 0.92 (0.85–1.00) and the p value for trend in the quartile analysis was 0.015.

Updating the Healthy Eating Index to Reflect Current Dietary Guidance

food groups (ie, grains, vegetables, fruits, milk, and meat), intakes of three dietary fats (ie, total fat, saturated fat, and cholesterol) and sodium, and a measure of dietary variety. The HEI-05 uses the same weighting and scoring methodology as the original HEI to calculate these components, with the exception that the standards for the five main food groups are based on three estimated energy requirements associated with three activity levels (ie, sedentary, moderately active, and active) for men and women younger and older than 50 years of age, as stated in the Dietary Guidelines for Americans 2005. Also, dietary variety is determined from a summary score of different foods consumed during the past 12 months because a food frequency questionnaire was used in the study, rather than the past 3 days like the original HEI. In contrast, the HEI-2005 created by Guenther and colleagues (12) differs from the original HEI in two dis