Population-Based Prevention of Obesity

Kumanyika, Shiriki; Obarzanek, Eva; Stettler, Nicolas; Bell, Ronny A.; Field, Alison E.; Fortmann, Stephen P.; Franklin, Barry A.; Gillman, Matthew W.; Lewis, Cora E.; Poston, W. Carlos; Stevens, June; Hong, Yuling

doi:10.1161/circulationaha.108.189702

Cited by 534 publications

(281 citation statements)

References 402 publications

Supporting

Mentioning

263

Contrasting

Unclassified

Order By: Relevance

“…This is consistent with the emerging paradigm that contextual factors influence individual behaviour related to obesity, and that more available energy could lead to greater energy intake (17) .…”

Section: Discussionsupporting

confidence: 88%

Available energy from soft drinks: more than the sum of its parts

Merchant

Tripathi

Pervaiz

2010

Public Health Nutr.

View full text Add to dashboard Cite

Objective: To evaluate the relationship between energy available from sugarsweetened beverages (SSB) and total energy availability. Design: Ecological study using food availability data from 1976 to 2007 Sugar-sweetened beverages (SSB) contribute to weight gain and poor health. Reducing SSB consumption in randomised controlled trials decreases energy intake and BMI (1) . SSB consumption is positively associated with energy consumption, weight gain, overweight and obesity, and type-2 diabetes (2,3) . Levying a tax on SSB has been proposed as a strategy to reduce their consumption, and thereby reduce energy intake and ultimately obesity (4) . SSB consumption displaces healthy dietary elements and leads to poor diet quality, and decreasing SSB consumption reduces overall energy intake (5,6) . We evaluated the relationship between energy availability from SSB and total energy availability from food availability data in Canada collected over 30 years. Methods Data sourceThe Canadian Socio-Economic Information Management System (CANSIM) is Statistics Canada's computerised database of time series covering a wide area of the social and economic aspects of Canadian life (7) . The CANSIM database includes information on a variety of topics such as national accounts, labour, manufacturing, construction, trade, agriculture and finance. Food availability information in the CANSIM database is based on food disappearance and accounts for wastage in production and storage. The data are not the energy consumed and do not account for wastage in the home. Data from 1976 to 2007 were used in these analyses (7) . Energy availabilityEnergy availability is obtained by multiplying the quantity of a food by its unit energy content. For instance, the total available servings of ice cream in a year are multiplied by the energy content of one serving. Total available energy is obtained by summing the available energy over all available foods. Average daily per capita available energy is determined by dividing the total available daily energy in any year by 365 and the estimated Canadian population on 1 July of that year. Soft drinksInformation on sugar-sweetened soft drink availability in CANSIM is obtained from total domestic sales, as provided by the Canadian Soft Drink Association. The information collected for sugar-sweetened soft drink

show abstract

Section: Discussionsupporting

confidence: 88%

Available energy from soft drinks: more than the sum of its parts

Merchant

Tripathi

Pervaiz

2010

Public Health Nutr.

View full text Add to dashboard Cite

show abstract

“…For example, prior population‐wide intervention studies of salt reduction demonstrated decreases in morbidity, mortality, and healthcare costs with as little as 1 g less of salt per day (equivalent to 1/6 of a teaspoon)15 and are feasible, as evidenced by recent dietary salt reduction programs in the United Kingdom focused on manufactured food that decreased mean sodium content in the food supply by 7% 13. Other potential lifestyle interventions to reduce blood pressure include increasing physical activity,45, 46 reducing weight,47 and improving overall diet quality 46. Further studies are needed to inform safety48, 49 and selection of the most cost‐effective population‐wide interventions in the United States to decrease SBP.…”

Section: Discussionmentioning

confidence: 99%

Reducing the Blood Pressure–Related Burden of Cardiovascular Disease: Impact of Achievable Improvements in Blood Pressure Prevention and Control

Hardy

Loehr

Butler

et al. 2015

JAHA

161

130

View full text Add to dashboard Cite

Background US blood pressure reduction policies are largely restricted to hypertensive populations and associated benefits are often estimated based on unrealistic interventions.Methods and ResultsWe used multivariable linear regression to estimate incidence rate differences contrasting the impact of 2 pragmatic hypothetical interventions to reduce coronary heart disease, stroke, and heart failure (HF) incidence: (1) a population‐wide intervention that reduced systolic blood pressure by 1 mm Hg and (2) targeted interventions that reduced the prevalence of unaware, untreated, or uncontrolled blood pressure above goal (per Eighth Joint National Committee treatment thresholds) by 10%. In the Atherosclerosis Risk in Communities Study (n=15 744; 45 to 64 years at baseline, 1987–1989), incident coronary heart disease and stroke were adjudicated by physician panels. Incident HF was defined as the first hospitalization with discharge diagnosis code of “428.” A 10% proportional reduction in unaware, untreated, or uncontrolled blood pressure above goal resulted in ≈4.61, 3.55, and 11.01 fewer HF events per 100 000 person‐years in African Americans, and 3.77, 1.63, and 4.44 fewer HF events per 100 000 person‐years, respectively, in whites. In contrast, a 1 mm Hg population‐wide systolic blood pressure reduction was associated with 20.3 and 13.3 fewer HF events per 100 000 person‐years in African Americans and whites, respectively. Estimated event reductions for coronary heart disease and stroke were smaller than for HF, but followed a similar pattern for both population‐wide and targeted interventions.ConclusionsModest population‐wide shifts in systolic blood pressure could have a substantial impact on cardiovascular disease incidence and should be developed in parallel with interventions targeting populations with blood pressure above goal.

show abstract

“…The importance of effective interventions to reduce obesity and related health risks has increased in recent decades due to obesity's epidemic proportions (53) . There are many challenges in executing and evaluating the effects of comprehensive school-and community-based interventions.…”

Section: Discussionmentioning

confidence: 99%

Program Obesity Zero (POZ) – a community-based intervention to address overweight primary-school children from five Portuguese municipalities

Rito

Carvalho

Ramos

et al. 2013

Public Health Nutr.

View full text Add to dashboard Cite

Objective: Results of the WHO European Childhood Obesity Surveillance Initiative indicated that on average one out of four primary-school children is overweight or obese. Portugal presented one of the highest prevalences of obesity. Childhood obesity prevention and treatment should be a top priority. The aim of the present study was to evaluate the effectiveness of Program Obesity Zero (POZ), a multicomponent, community-, family-and school-based childhood obesity intervention. Design: Parents and children attended four individual nutrition and physical activity counselling sessions, a one-day healthy cooking workshop and two school extracurricular sessions of nutrition education. Waist circumference, BMI, physical activity level, sedentary behaviours, and nutrition and physical activity knowledge, attitudes and behaviour were assessed at baseline and after 6 months. Diet was assessed using two 24 h recalls, at baseline and at 6 months. Setting: Five Portuguese municipalities and local communities. Subjects: Two hundred and sixty-six overweight children (BMI $ 85th percentile) aged 6-10 years, from low-income families in five Portuguese municipalities, were assigned to the intervention. Results: Children showed reductions in waist circumference (22?0 cm; P , 0?0001), mean BMI (20?7 kg/m 2 ; P , 0?0001) and BMI-for-age percentile (21?7; P , 0?0001) at 6 months. Overall, children's intake of fruit and vegetables was ,400 g/d throughout the intervention. After 6 months, higher fibre consumption and an apparent decrease in sugary soft drinks intake to a quarter of that observed at baseline (mean intake: 198 ml/d at baseline), with improvements in physical activity levels and screen time ,2 h/d, were also observed. Conclusions: The findings suggested that POZ is a promising intervention programme, at municipality level, to tackle childhood overweight and obesity.

show abstract

Population-Based Prevention of Obesity

Cited by 534 publications

References 402 publications

Available energy from soft drinks: more than the sum of its parts

Available energy from soft drinks: more than the sum of its parts

Reducing the Blood Pressure–Related Burden of Cardiovascular Disease: Impact of Achievable Improvements in Blood Pressure Prevention and Control

Program Obesity Zero (POZ) – a community-based intervention to address overweight primary-school children from five Portuguese municipalities

Contact Info

Product

Resources

About