Marlene B. Schwartz

Effects of Soft Drink Consumption on Nutrition and Health: A Systematic Review and Meta-Analysis

In a meta-analysis of 88 studies, we examined the association between soft drink consumption and nutrition and health outcomes. We found clear associations of soft drink intake with increased energy intake and body weight. Soft drink intake also was associated with lower intakes of milk, calcium, and other nutrients and with an increased risk of several medical problems (e.g., diabetes). Study design significantly influenced results: larger effect sizes were observed in studies with stronger methods (longitudinal and experimental vs cross-sectional studies). Several other factors also moderated effect sizes (e.g., gender, age, beverage type). Finally, studies funded by the food industry reported significantly smaller effects than did non-industry-funded studies. Recommendations to reduce population soft drink consumption are strongly supported by the available science.

Obesity and body image.

Modern western culture emphasizes thinness, denigrates excess weight, and stigmatizes obese individuals, making it likely that obese people internalize these messages and feel badly about the physical presence that brands them. There is clear evidence that obesity is linked with poor body image, but not all obese persons suffer from this problem or are equally vulnerable. Risk factors identified thus far are degree of overweight, being female, and binge eating, with some evidence of risk increasing with early age of onset of obesity, race, and several additional factors. Treatments do exist for improving body image in overweight individuals. Key questions are how to identify those in need of body image intervention, how such programs can be integrated with weight loss treatments, and ultimately, how body image distress can be prevented.

Personal Responsibility And Obesity: A Constructive Approach To A Controversial Issue

The concept of personal responsibility has been central to social, legal, and political approaches to obesity. It evokes language of blame, weakness, and vice and is a leading basis for inadequate government efforts, given the importance of environmental conditions in explaining high rates of obesity. These environmental conditions can override individual physical and psychological regulatory systems that might otherwise stand in the way of weight gain and obesity, hence undermining personal responsibility, narrowing choices, and eroding personal freedoms. Personal responsibility can be embraced as a value by placing priority on legislative and regulatory actions such as improving school nutrition, menu labeling, altering industry marketing practices, and even such controversial measures as the use of food taxes that create healthier defaults, thus supporting responsible behavior and bridging the divide between views based on individualistic versus collective responsibility.

The influence of one's own body weight on implicit and explicit anti-fat bias.

Objective: This study examined the influence of ones own body weight on the strength of implicit and explicit anti‐fat bias.

Internalization of Weight Bias: Implications for Binge Eating and Emotional Well‐being

Objective: This study examined the relationship between internalization of negative weight‐based stereotypes and indices of eating behaviors and emotional well‐being in a sample of overweight and obese women.

Assessing the specific psychopathology of binge eating disorder patients: interview or self-report?

Research addressing the assessment of binge eating and associated eating disorder psychopathology has steadily increased in recent years. Few studies have examined the relationship between the various assessment methods. This study compared an investigator-based interview, the Eating Disorder Examination (EDE), with a self-report version of that interview, the EDE-Q. Fifty-two individuals (six men and 46 women) with binge eating disorder (BED) completed both instruments. Modest-to-good agreement and significant correlations (P < 0.0001) were found between the two methods on all four subscales assessing specific eating disorder psychopathology (i.e., Restraint, Eating Concern, Weight Concern, and Shape Concern subscales). However, higher levels of disturbance were consistently reported on the EDE-Q than the EDE interview. The two methods were not significantly or reliably related to one another when assessing binge eating. This may be due in part to the difficulty inherent in identifying binges in subjects with BED. Examination of individual item scores suggest that it might be possible to improve the performance of the EDE-Q by clarifying the definitions of certain complex features, although this should not be at the expense of compromising the practical utility of its self-report format.

The Effects of a High-carbohydrate, High-protein or Balanced Lunch upon Later Food Intake and Hunger Ratings

This study compared the satiating properties of three liquid lunches (450 kcal each), one dominant in protein (71.5% of energy), a second in carbohydrates (99% of energy) and a third containing an equal mixture of the first two formulations, in a within-subjects, repeated measures design. At an ad libitum dinner meal, 12 women consumed 31% more kilocalories in the high-carbohydrate lunch condition than in the high-protein lunch condition and 20% more kilocalories than in the mixture lunch condition. Similar results emerged for the amounts of protein and fat ingested at dinner. Subjects also reported significantly greater pre-dinner hunger and excitement about eating in the carbohydrate lunch condition than in the protein lunch condition. Greater enjoyment of dinner was also found after the carbohydrate lunch than after the mixture and protein lunches.

Availability And Prices Of Foods Across Stores And Neighborhoods: The Case Of New Haven, Connecticut

Two studies compared food availability and prices in large and small stores across neighborhoods of varying income levels in New Haven, Connecticut. The findings suggest that supermarket access in lower-income neighborhoods has improved since 1971, and average food prices are comparable across income areas. Despite this progress, stores in lower-income neighborhoods (compared to those in higher-income neighborhoods) stock fewer healthier varieties of foods and have fresh produce of much lower quality. Policies are needed not only to improve access to supermarkets, but also to ensure that stores in lower-income neighborhoods provide high-quality produce and healthier versions of popular foods.

Marketing foods to children and adolescents: licensed characters and other promotions on packaged foods in the supermarket

OBJECTIVE To analyse cross-promotions targeted to children and adolescents on packaging in the supermarket. DESIGN On three occasions from 2006 to 2008, researchers purchased all foods in a large supermarket that included a cross-promotion on the package. A total of 397 products were categorized by promotional partner, food category, targeted age group, promotion type, product nutrition, and company policies on marketing to children. RESULTS The number of products with youth-oriented cross-promotions increased by 78 % during the period examined. Overall, 71 % of cross-promotions involved third-party licensed characters and 57 % appealed primarily to children under 12 years of age; however, the use of other forms of promotions increased from 5 % of the total in 2006 to 53 % in 2008, and promotions targeting pre-school and general audiences increased from 23 % to 54 % of the total. Only 18 % of products met accepted nutrition standards for foods sold to youth, and nutritional quality declined during the period examined. Food manufacturers with policies limiting marketing to children represented 65 % of all youth-oriented cross-promotions, their use of cross-promotions increased significantly, and the nutritional quality of their products did not improve. Some media companies did reduce the use of their properties on food promotions. CONCLUSIONS Overall, the supermarket environment worsened due to an increase in cross-promotions targeted to children and adolescents and a decline in the nutritional quality of these products. This analysis failed to find improvements in food marketing to youth and highlights the need to expand current industry self-regulatory pledges.

The Need for Bold Action to Prevent Adolescent Obesity

Record levels of obesity in children and adolescents are predictable in light of powerful conditions that promote high consumption of calorie-dense, nutrient-poor foods and discourage physical activity. Default conditions for youth are dangerous, and include multiple and relentless forms of marketing, poor foods promoted in schools, and a variety of other conditions that undermine personal resources, individual responsibility, and parental authority. This article discusses how optimal defaults can be created using five issues as examples: framing of the obesity issue, treating versus preventing obesity, nutrition in schools, marketing, and addressing weight bias and discrimination. By adopting a public health approach that addresses the conditions causing obesity, there is hope of reversing troubling trends in prevalence.