An investigation of the role of processed foods in children's health: classification, perceptions, dietary quality and weight status
Bleiweiss-Sande, Rachel.
2019
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Highly processed food
consumption has consistently been singled out as a potential factor in the obesity
epidemic, particularly among disadvantaged children. To explore that relationship,
researchers have developed classification systems that categorize foods according to
processing level. Discrepancies among these systems have led to varying conclusions,
such that our understanding of how ... read moreprocessed food intake contributes to weight status
and income-related health disparities is limited. Moreover, agreement between consumer
perceptions and research definitions of processed foods has not been measured. This
limits the usefulness of this concept in consumer communication. These issues were
addressed through three independent studies. The first study compared processing
categorization and subsequent conclusions regarding the relationship between processing
level and nutrient quality among three classification systems used in research (Nova,
International Food Information Council (IFIC), UNC), using the 100 most commonly
consumed foods by children, ages 6-12 (NHANES 2013-2014). Inter-rater reliability was
highest for the UNC system (ρ = 0.97), and lowest for Nova (ρ = 0.76).
Multinomial logistic regression models demonstrated that lower potassium was a
significant predictor of moderately compared to minimally processed foods in the IFIC
system (p=0.01), and lower vitamin D was predictive of highly compared to minimally
processed foods for UNC (p=0.04). Greater sodium and added sugars were significantly
predictive of high compared to minimal processing level for all three systems
(p<0.05), suggesting that current processing classification systems may be well
suited to identify over-consumed nutrients among children. The second study used focus
groups to explore how children (n=53) and parents (n=37) from low-income and
racially/ethnically diverse backgrounds think about processed foods, including the
meaning of phrases related to processing, the classification of foods by processing
level, and the healthfulness of foods. Transcript analysis using NVivo 12 indicated that
their understanding was not always consistent with classification systems used in
research. Participants associated degree of processing with healthfulness, suggesting
that the topic of processing may offer a novel approach for nutrition communication. The
third study examined associations between processed food intake, dietary quality and
weight status among 131 racially/ethnically diverse school-age children from low-income
communities in Rhode Island . Twenty-four hour dietary recalls were collected and coded
by processing level. Associations between dietary quality, as measured by the Healthy
Eating Index, 2015 (HEI-2015) and weight status were analyzed using multivariate linear
regression models. Greater intake of highly processed food was associated with lower
dietary quality (β=-0.23, 95% CI [-0.30, -0.15]), while greater intake of
minimally processed foods was associated with higher dietary quality (β=0.30, 95%
CI [0.22, 0.38]). No significant associations between processed food consumption and
weight were observed. This suggests that encouraging minimally processed and
discouraging highly processed food consumption may be synergistic communication
strategies to improve diet quality in children from low-income backgrounds. This
research demonstrates that observations about the effects of processed foods on obesity
and diet quality depend on the classifications systems used in studies of that
relationship. The development of a consistent definition of processed foods will not
only lead to a clearer understanding of their effects on health, but will also enable
the concept to be translated into consumer
communications.
Thesis (Ph.D.)--Tufts University, 2019.
Submitted to the Dept. of Food Policy & Applied Nutrition.
Advisor: Jennifer Sacheck.
Committee: Jeanne Goldberg, Kenneth Chui, and Erin Evans.
Keywords: Nutrition, and Behavioral sciences.read less - ID:
- 4m90f7239
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