Project description:ObjectiveEnergy (calorie) ranges currently appear on menu boards for customized menu items and will likely appear throughout the USA when menu-labelling legislation is implemented. Consumer welfare advocates have questioned whether energy ranges enable accurate energy estimates. In four studies, we examined: (i) whether energy range information improves energy estimation accuracy; (ii) whether misestimates persist because consumers misinterpret the meaning of the energy range end points; and (iii) whether energy estimates can be made more accurate by providing explicit information about the contents of items at the end points.DesignFour studies were conducted, all randomized experiments.SettingStudy 1 took place outside a Chipotle restaurant. Studies 2 to 4 took place online.SubjectsParticipants in study 1 were customers exiting a Chipotle restaurant (n 306). Participants in studies 2 (n 205), 3 (n 290) and 4 (n 874) were from an online panel.ResultsEnergy ranges reduced energy misestimation across different menu items (studies 1-4). One cause of remaining misestimation was misinterpretation of the low end point's meaning (study 2). Providing explicit information about the contents of menu items associated with energy range end points further reduced energy misestimation (study 3) across different menu items (study 4).ConclusionsEnergy range information improved energy estimation accuracy and defining the meaning of the end points further improved accuracy. We suggest that when restaurants present energy range information to consumers, they should explicitly define the meaning of the end points.
Project description:Despite intensive research, the causes of the obesity epidemic remain incompletely understood and conventional calorie-restricted diets continue to lack long-term efficacy. According to the carbohydrate-insulin model (CIM) of obesity, recent increases in the consumption of processed, high-glycemic-load carbohydrates produce hormonal changes that promote calorie deposition in adipose tissue, exacerbate hunger, and lower energy expenditure. Basic and genetic research provides mechanistic evidence in support of the CIM. In animals, dietary composition has been clearly demonstrated to affect metabolism and body composition, independently of calorie intake, consistent with CIM predictions. Meta-analyses of behavioral trials report greater weight loss with reduced-glycemic load vs low-fat diets, though these studies characteristically suffer from poor long-term compliance. Feeding studies have lacked the rigor and duration to test the CIM, but the longest such studies tend to show metabolic advantages for low-glycemic load vs low-fat diets. Beyond the type and amount of carbohydrate consumed, the CIM provides a conceptual framework for understanding how many dietary and nondietary exposures might alter hormones, metabolism, and adipocyte biology in ways that could predispose to obesity. Pending definitive studies, the principles of a low-glycemic load diet offer a practical alternative to the conventional focus on dietary fat and calorie restriction.
Project description:Non-alcoholic fatty liver disease (NAFLD) is a growing epidemic, in parallel with the obesity crisis, rapidly becoming one of the commonest causes of chronic liver disease worldwide. Diet and physical activity are important determinants of liver fat accumulation related to insulin resistance, dysfunctional adipose tissue, and secondary impaired lipid storage and/or increased lipolysis. While it is evident that a hypercaloric diet (an overconsumption of calories) promotes liver fat accumulation, it is also clear that the macronutrient composition can modulate this risk. A number of other baseline factors modify the overfeeding response, which may be genetic or environmental. Although it is difficult to disentangle the effects of excess calories vs. specifically the individual effects of excessive carbohydrates and/or fats, isocaloric, and hypercaloric dietary intervention studies have been implemented to provide insight into the effects of different macronutrients, sub-types and their relative balance, on the regulation of liver fat. What has emerged is that different types of fat and carbohydrates differentially influence liver fat accumulation, even when diets are isocaloric. Furthermore, distinct molecular and metabolic pathways mediate the effects of carbohydrates and fat intake on hepatic steatosis. Fat accumulation appears to act through impairments in lipid storage and/or increased lipolysis, whereas carbohydrate consumption has been shown to promote liver fat accumulation through de novo lipogenesis. Effects differ dependent upon carbohydrate and fat type. Saturated fat and fructose induce the greatest increase in intrahepatic triglycerides (IHTG), insulin resistance, and harmful ceramides compared with unsaturated fats, which have been found to be protective. Decreased intake of saturated fats and avoidance of added sugars are therefore the two most important dietary interventions that can lead to a reduction in IHTG and potentially the associated risk of developing type 2 diabetes. A healthy and balanced diet and regular physical activity must remain the cornerstones of effective lifestyle intervention to prevent the development and progression of NAFLD. Considering the sub-type of each macronutrient, in addition to the quantity, are critical determinants of liver health.
Project description:Free sugars are a major source of calories in diets and contribute to the burden of many non-communicable diseases (NCDs). The World Health Organization (WHO) recommends reducing free sugars intake to less than 10% of total energy. This study aimed to estimate the number of diet-related NCD deaths which could be averted or delayed if Canadian adults were to reduce their calorie intake due to a systematic 20% reduction in the free sugars content in foods and beverages in Canada. We used the Preventable Risk Integrated ModEl (PRIME) to estimate the potential health impact. An estimated 6770 (95% UI 6184-7333) deaths due to diet-related NCDs could be averted or delayed, mostly from cardiovascular diseases (66.3%). This estimation would represent 7.5% of diet-related NCD deaths observed in 2019 in Canada. A 20% reduction in the free sugars content in foods and beverages would lead to a 3.2% reduction in calorie intake, yet an important number of diet-related NCD deaths could be averted or delayed through this strategy. Our findings can inform future policy decisions to support Canadians' free sugars intake reduction, such as proposing target levels for the free sugars content in key food categories.
Project description:The Food and Drug Administration's menu labeling rule requires chain restaurants to prominently display calories, while leaving other nutritional information (e.g., fat, sodium, sugar) to the request of consumers. We use rich micronutrient data from 257 large chain brands and 24,076 menu items to examine whether calories are correlated with widely used "nutrient profile" scores that measure healthfulness based on nutrient density. We show that calories are indeed statistically significant predictors of nutrient density. However, as a substantive matter, the correlation is highly attenuated (partial R2 < 0.01). Our findings (a) suggest that the promise of calorie labeling to improve nutrient intake quality at restaurants is limited and (b) clarify the basis for transparency of nutrient composition beyond calories to promote healthy menu choices.
Project description:ObjectiveHigh calorie foods and beverages, which often contain caffeine, contribute to child overweight/obesity. We evaluated the results of an educational intervention to promote healthy growth in very young children. Secondarily, we used detailed diet data to explore the association of nutrient intake with the early development of overweight and obesity.MethodsMothers were obese Latina women, enrolled prenatally, and their infants. Specially trained community health workers provided breastfeeding support and nutrition education during 10 home visits, birth to 24 months. At follow-up, age 18 to 36 months, we measured growth and completed detailed diet recalls (1-7 recall days/child).ResultsOf 174 infants randomized, 106 children were followed for 24 to 36 months. The educational intervention did not prevent overweight/obesity. Forty-two percent of children became overweight or obese. Fifty-eight percent of children consumed caffeine on at least 1 recall day. Mean intake was 0.48 mg/kg/day. Caffeine correlated with higher consumption of calories, and added sugar and decreased intake of protein, fiber and dairy. Compared with days without caffeine, on days when caffeine was consumed, children ingested 121 more calories and 3.8 gm less protein. Children frequently consumed less than the recommended daily intake of key nutrients such as fiber, vegetables, whole fruit, and vitamins.ConclusionsCaffeine was a marker for increased intake of calories and decreased intake of key nutrients. When discussing dietary intake in early childhood, practitioners should screen for nutrient deficiency in young children and recommend limiting the intake of caffeinated foods and beverages.
Project description:ObjectiveTo extend analyses of nutrition transition in developed countries to China within the framework of the 3Vs rule considering degree of processing starting with plant/animal calorie ratio (Rule 1), industrially processed foods (IPFs, Rule 2), and food diversity through nutrient intakes (Rule 3).DesignTotal and main food group (n 13) calorie intakes, percentages of animal and IPF calories, adequacy of the Dietary Reference Intake (DRI) and prevalence of chronic diseases were retrieved from scientific literature and international databases.SettingChina, 1990–2019.ParticipantsOverall population.ResultsThe total calorie intake decreased by 9 % over 30 years while the prevalence of chronic diseases substantially increased. Percentages of IPFs (Rule 1) and animal (Rule 2) calorie intake shifted from 9 to 30 % and 2 to 30 %, respectively. Meanwhile, the overall DRI adequacy (Rule 3) did not improve, with calcium and retinol deficiencies in 2019, and, although remaining above DRI, iron, copper, magnesium, and vitamins E, C and B1–B9 intakes regularly decreased. Notably, the prevalence of obesity increased five-fold, paralleling the exponential increase in IPF calorie intake. Both sources of calories were highly correlated with prevalence of main chronic diseases.ConclusionsDespite a slight decreased of total calorie consumption and small variations of adequacy with DRI, the farther the Chinese population moved away from the 3Vs rule during the 1990–2019 period, the more the prevalence of chronic diseases increased. Further analyses on foods’ transitions will be better assessed when advocating sources/quality of calories (Rules 1/2), rather than only nutrient composition (Rule 3).
Project description:BackgroundPrior research on the restaurant environment and obesity risk is limited by cross-sectional data and a focus on specific geographic areas.ObjectiveTo measure the impact of changes in chain restaurant calories over time on body mass index (BMI).DesignWe used a first-difference model to examine whether changes from 2012 to 2015 in chain restaurant calories per capita were associated with percent changes in BMI. We also examined differences by race and county income, restaurant type, and initial body weight categories.SettingUSA (207 counties across 39 states).Participants447,873 adult patients who visited an athenahealth medical provider in 2012 and 2015 where BMI was measured.Main outcomes measuredPercent change in objectively measured BMI from 2012 to 2015.ResultsAcross all patients, changes in chain restaurant calories per capita were not associated with percent changes in BMI. For Black or Hispanic adults, a 10% increase in exposure to chain restaurant calories per capita was associated with a 0.16 percentage-point increase in BMI (95% CI 0.03, 0.30). This translates into a predicted weight increase of 0.89 pounds (or a 0.53% BMI increase) for an average weight woman at the 90th percentile of increases in the restaurant environment from 2012 to 2015 versus an increase 0.39 pounds (or 0.23% BMI increase) at the 10th percentile. Greater increases in exposure to chain restaurant calories also significantly increased BMI for Black or Hispanic adults receiving healthcare services in lower-income counties (0.26, 95% CI 0.04, 0.49) and with overweight/obesity (0.16, 95% CI 0.04, 0.29).LimitationsGeneralizability to non-chain restaurants is unknown and the sample of athenahealth patients is relatively homogenous.ConclusionsIncreased exposure to chain restaurant calories per capita was associated with increased weight gain among Black or Hispanic adults.
Project description:A dataset of fully labeled images of 20 different kinds of fruits is developed for research purposes in the area of detection, recognition, and classification of fruits. Applications can range from fruit recognition to calorie estimation, and other innovative applications. Using this dataset, researchers are given the opportunity to research and develop automatic systems for the detection and recognition of fruit images using deep learning algorithms, computer vision, and machine learning algorithms. The main contribution is a very large dataset of fully labeled images that are publicly accessible and available for all researchers free of charge. The dataset is called "DeepFruit", which consists of 21,122 fruit images for 8 different fruit set combinations. Each image contains a different combination of four or five fruits. The fruit images were captured on different plate sizes, shapes, and colors with varying angles, brightness levels, and distances. The dataset images were captured with various angles and distances but could be cleared by utilizing the preprocessing techniques that allow for noise removal, centering of the image, and others. Preprocessing was done on the dataset such as image rotation & cropping, scale normalization, and others to make the images uniform. The dataset is randomly partitioned into an 80% training set (16,899 images) and a 20% testing set (4,223 images). The dataset along with the labels is publicly accessible at: https://data.mendeley.com/datasets/5prc54r4rt.