Background: Adiposity status in adolescence is associated with various health outcomes in adulthood. Waist circumference [WC] and waist-to-height ratio [WHtR] are measures of abdominal obesity and have shown to be valid predictors of future chronic diseases. However, the relationship between sociodemographic characteristics and WC, as well as WHtR in U.S. adolescents remain unclear. Thus, the study aims to examine associations between sociodemographic characteristics and abdominal obesity among a nationally representative sample of U.S. adolescents.Methods: The sample included 4712 adolescents (12–19 years) in the 2007–2016 National Health and Nutrition Examination Survey. Associations between sociodemographic characteristics and abdominal obesity (WC and WHtR) were examined using multiple logistic regression models, adjusted for age, physical activity level, and sedentary activity.Results: Around 18% of adolescents had high-risk WC (≥90th percentile) and 34% had high-risk WHtR (≥0.5). Females had higher odds of high-risk WHtR compared to males (OR = 1.46, 95%CI = 1.23–1.72). Mexican American adolescents had higher odds of high-risk WHtR compared to non-Hispanic White (OR = 1.66, 95%CI = 1.24–2.20), non-Hispanic Black (OR = 1.73, 95%CI = 1.26–2.36), and other race/multi-racial adolescents (OR = 1.84, 95%CI = 1.21–2.80). When their parent were college graduates, adolescents had lower odds for high-risk WC compared to when the parent had some college education (OR = 0.68, 95%CI = 0.49–0.93) or a high school degree or less (OR = 0.70, 95%CI = 0.51–0.97). Similar associations were seen between parental education level and high-risk WHtR, as well as between household income and high-risk WHtR.Conclusions: Measures of abdominal obesity should be considered to assess burden of adiposity, especially among female adolescents, adolescents from racial/ethnic minority and low socioeconomic status backgrounds. Additionally, future health interventions should consider including changes in WC and WHtR to measure the impact of these interventions.
Corners stores in low-income communities are a promising setting to intervene in youth whole grain intake. One strategy that may encourage whole grain intake is if corner stores were to pair and sell whole grain snacks in combination with either a liked fruit or vegetable and an optional condiment (i.e., a whole grain snack pack). This study examined youth in terms of their (1) liking of fruits, vegetables, and whole grain snacks; (2) perceptions about which fruits and vegetables pair best with whole grain snacks; and (3) willingness to pay for a whole grain snack pack. One-time intercept surveys were conducted with 10–18-year-olds (n = 402) who visited a New York City (NYC) corner store (n = 34) participating in the City Harvest Healthy Retail Program. On average, youth were willing to spend $2.38 (SD $4.32) on a whole grain snack pack. Higher overall liking scores for vegetables and whole grain snacks were associated with willingness to spend 24.4% (95% confidence interval (CI): 11.5–38.7%) and 21.6% (95%CI: 5.2–40.6%) more on whole grain snack packs, respectively. In conclusion, youth are receptive to purchasing whole grain snack packs from NYC corner stores participating in a healthy retail program.
Among U.S. adolescents, foods/beverages that are store-bought (i.e., from grocery and convenience stores) are significant contributors of energy intake. However, it remains unclear (1) what foods/beverages are consumed by U.S. adolescents from grocery and convenience stores and (2) if there are differences in foods/beverages consumed by store type. Therefore, we analyzed 29,216 eating occasions from adolescents (12–19 years; n = 4065) in the National Health and Nutrition Examination Survey 2011–2018 to report food/beverage groups and nutrients consumed from grocery and convenience stores. Differences in food/beverage groups and nutrient densities by store type were calculated using multiple logistic and linear regressions. Adolescents were more likely to consume “Beverages” and “Snacks and Sweets” and less likely to consume “Grains”, “Protein”, “Milk and Dairy”, “Condiments and Sauces”, and “Fruits” from convenience compared to grocery stores (all p < 0.0025). Foods/beverages from convenience stores were higher in carbohydrates, total sugar, and added sugar and lower in protein, fat, saturated fat, sodium, and fiber than those from grocery stores (all p < 0.0025). In conclusion, while foods/beverages from convenience stores are more energy-dense and nutrient-poor, there is a critical need to increase the availability, accessibility, and affordability of healthier foods/beverages in both store types to encourage healthier dietary behaviors among U.S. adolescents.
Native Americans (NA) have the highest rates of diet-related chronic diseases in the country. Yet, the relationship between dietary patterns and chronic diseases in this population has not been well explored. We aimed to characterize common dietary patterns among adults from six NA communities (n = 580) and assess their relationship with body mass index (BMI), % body fat, waist-to-hip ratio, hypertension, and self-reported type 2 diabetes and cardiovascular disease. We conducted a baseline assessment of an obesity prevention study (n = 580). Dietary intake data was collected using a modified Block Food Frequency Questionnaire. Exploratory factor analysis was used to characterize dietary patterns. We used multivariate linear and logistic regression analyses to assess associations between dietary patterns and health outcomes, controlling for age, sex, employment status, smoking status, geographic region, and energy intake. Trial was registered under Engaging Tribal Policy Makers to Improve the Food and Physical Activity Environments in American Indian Communities (OPREVENT2). NCT02803853 (06/17/2016). Five dietary patterns, explaining 81.8% of variance in reported food consumption were identified: “meat and fried foods”, “processed foods”, “fruits and vegetables”, “sugary snacks”, and “meat alternatives and high-protein foods”. Higher consumption of “meat and fried foods” was associated with higher mean waist-to-hip ratio (0.03; 95% confidence interval (CI):0.01–0.04), higher mean BMI (2.45; CI:0.83–4.07 kg/m2), and increased odds of being overweight or obese (OR 2.63; CI:1.10–6.31). Higher consumption of “processed foods” was associated with increased odds of self-reported type 2 diabetes (OR 3.41; CI:1.31–8.90). No protective effect in consumption of “fruits and vegetables” was observed, although average consumption was below national recommendation levels. NA dietary patterns corroborate nutritional concerns previously reported among NA populations. Future interventions should discourage overconsumption of meat, fried foods, and processed foods, and promote fruits and vegetables consumption to reduce chronic disease burden in this population.
Objective: Healthy food retail programmes (HFRP) in the USA generally aim to increase healthy foods access to improve diet quality and health, yet the impact is mixed. These programmes primarily target adults, even though adolescents frequently and independently visit stores to purchase snacks. This study’s aims are to explore successes and challenges of implementing HFRP (Aim 1) and examine how HFRP can be tailored to adolescents (Aim 2). Design: One-time, virtual, semi-structured interviews with individuals who were involved in a HFRP, followed by a socio-demographic characteristics survey. Interviews were designed based on the RE-AIM framework and the Hexagon Tool and analysed using Braun and Clark’s (2006) thematic analysis approach. Descriptive statistics were used to summarise participants’ socio-demographic characteristics. Setting: New York City (NYC). Participants: Adults (18 years or older) who have designed, implemented and/or evaluated an HFRP in NYC and speak/understand English (n 21). Results: Aim 1: For successes, strategies to build relationships with the community were most discussed. Regarding challenges, securing reliable funding was the hardest to overcome. Suggested solutions included designing profitable HFRP, targeting shortcomings in food distribution systems and increasing consumer demand. Aim 2: Most participants had not considered adolescents in previous HFRP but suggested involving youth in developing HFRP to encourage youth-driven solutions and promote youth advocacy. Conclusions: Future HFRP should focus on activities that help store owners purchase affordable healthy foods from distributors, which translates to affordability for customers. Federal and local policies can assist by funding complementary programmes. Additionally, adolescents should be considered in these efforts.