Parental obesity has been identified as a predominant risk factor for childhood overweight and ob... more Parental obesity has been identified as a predominant risk factor for childhood overweight and obesity. We investigated the relationship between parent and child obesity in South Korea, particularly linked with varying family structures. Data for households with children aged 2-18 years were taken from the pooled data of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010 conducted by the Korea Centers for Disease Control and Prevention (KCDC). The sample consisted of 17 453 individuals (7879 children and 9574 adults) from 5048 households with children for this study. Children's overweight and obesity prevalence was compared using both International Obesity Taskforce (IOTF) and KCDC cutoff points according to parental weight status and household structure. Logistic regression analysis was used. Significantly greater odds of overweight and obesity existed among children living with both parents (odds ratio (OR)=3.5, 95% confidence interval (CI): 2.71, 4...
Korea has undergone a major opening of its food markets and economy in the past decade. Little is... more Korea has undergone a major opening of its food markets and economy in the past decade. Little is understood about the impact of these shifts on the diet of Koreans. This analysis studies the shifts in consumption of foods between 1998 and 2009 to provide a thorough understanding of the transition and insights into directions in the next decades in Korea. Data are from the Korea National Health and Nutrition Examination Survey (KNHANES). The sample used was a nationally representative sample of individuals age ≥2 in 1998 and 2009 (n=10,267 and 9,264, respectively). The data was corrected for seasonality, and the original raw food data was regrouped into 53 food groups. SAS was used to adjust for design effects and weight. Despite a decade of efforts to increase whole grains intake, and fruit and vegetable intake, the mean intake of whole grains increased only a small amount (16 kcal/person/day); however, the proportion consuming any whole grains doubled from 24% to 46.3%. Rice decli...
Beverage patterning may play a role in partially explaining the rising rates of obesity in the Un... more Beverage patterning may play a role in partially explaining the rising rates of obesity in the United States, yet little work on overall trends and patterns exits. Our objective was to examine trends and patterns of beverage consumption among U.S. adults. We used data from the nationally representative Nationwide Food Consumption Surveys (1965, 1977 to 1978) and the National Health and Nutrition Surveys (1988 to 1994, 1999 to 2002). To examine trends we determined percent consuming and per capita and per consumer caloric intake from all beverages. We used cluster analysis to determine year-specific beverage patterns in 1977 and 2002. The percentage of calories from beverages significantly increased between 1965 (11.8%), 1977 (14.2%), 1988 (18.5%), and 2002 (21.0%); this represents an overall increase of 222 calories per person per day from beverages, resulting largely from increased intake of calorically sweetened beverages. Beverage patterns in 2002 were more complex than in 1977 a...
Away-from-home food consumption has rapidly increased, though little is known about the independe... more Away-from-home food consumption has rapidly increased, though little is known about the independent associations of restaurant food and fast food intake with body mass index (BMI) and BMI change. The aim was to compare the associations of restaurant food and fast food consumption with current and 3-y changes in BMI. Multivariate linear regression models, with control for demographic and lifestyle factors, were used to examine cross-sectional and longitudinal associations of away-from-home eating with BMI by using data from subjects of the Coronary Artery Risk Development in Young Adults Study (n = 3394) obtained at exam years 7 (1992-1993) and 10 (1995-1996). Forty percent of the sample increased their weekly consumption of restaurant or fast food, though mean (+/-SD) changes were -0.16 +/- 2.39 times/wk (P = 0.0001) and -0.56 +/- 3.04 times/wk (P < 0.0001), respectively. Cross-sectionally, fast food, but not restaurant food, consumption was positively associated with BMI. Simila...
There is an absence of research examining associations between food and beverage intake patterns ... more There is an absence of research examining associations between food and beverage intake patterns and most research has centered on soft drinks, whereas research on overall beverage patterns is absent. Using data from the National Health and Nutrition Examination Survey 99-02 for adults aged 19 y and older, we independently examined beverage and food intake patterns, as well as their interrelations. Cluster analysis generated mutually exclusive intake patterns for beverages and foods. Multinomial logistic regression models provided the odds of a given beverage pattern for each food pattern; we then compared the probability of a given beverage pattern for each food pattern. Six beverage and 6 food patterns emerged. Beverage patterns revealed that calorically sweetened, non caloric, and diet beverages tended to be consumed independently of one another. Being in the Snacks and High-Fat Foods cluster increased the odds of being in the Coffee and Soda (odds ratio (OR): 1.62 [95% CI: 1.27-...
In this paper, the environment is defined as the macro- and community-level factors, including ph... more In this paper, the environment is defined as the macro- and community-level factors, including physical, legal and policy factors, that influence household and individual decisions. Thus, environment is conceived as the external context in which household and individual decisions are made. This paper reviews the literature on the ways the environment affects diet, physical activity, and obesity. Other key environmental factors discussed include economic, legal, and policy factors. Behind the major changes in diet and physical activity in the US and globally lie large shifts in food production, processing, and distribution systems as well as food shopping and eating options, resulting in the increase in availability of energy-dense foods. Similarly, the ways we move at home, work, leisure, and travel have shifted markedly, resulting in substantial reductions in energy expenditure. Many small area studies have linked environmental shifts with diet and activity changes. This paper begi...
The Mediterranean diet has been reported to be inversely associated with incident metabolic syndr... more The Mediterranean diet has been reported to be inversely associated with incident metabolic syndrome (MetSyn) among older adults; however, this association has not been studied in young African American and white adults. The objective of the present study was to evaluate the association of a modified Mediterranean diet (mMedDiet) score with the 25-year incidence of the MetSyn in 4713 African American and white adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. A diet history questionnaire was used to assess dietary intake at baseline, year 7 and year 20 and a mMedDiet score was created. Cardiovascular risk factors were measured at multiple examinations over 25 years. The MetSyn was defined according to the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. Cox proportional-hazards regression analysis was use to evaluate associations for incident MetSyn across the mMedDiet score categories adjusting for demographi...
Snacking has increased globally, but little is known about how Mexicans consume foods outside mea... more Snacking has increased globally, but little is known about how Mexicans consume foods outside meals. The aim of this study was to examine the prevalence and patterns of snacking behavior among Mexicans. We used data from children and adults (aged ≥ 2 y; n = 9937) from the Mexican National Nutrition Survey 1999 and the Mexican National Health and Nutrition Survey (NHNS) 2012 to examine the prevalence of snacking as well as amount (kcal) and contribution of snacks to total energy intake per day. Snacking was defined as eating outside of the 3 main meals. We calculated per capita (among the total population) and per consumer ("snackers") estimates of the number of snacks per day, kilocalories per snack, kilocalories per day from snacks, and the percentage of energy from snacks. Top foods consumed during snack occasions were also examined for the NHNS 2012. All results were weighted to account for survey design and to be nationally representative. In 2012, an estimated 73% of ...
Approximately 40% of children bring a packed lunch to school. Little is known about the quality o... more Approximately 40% of children bring a packed lunch to school. Little is known about the quality of these lunches. This study examined the nutritional quality of packed lunches compared with school lunches for pre-kindergarten and kindergarten children after the implementation of 2012-2013 National School Lunch Program standards. The researchers collected observational data for packed and school lunches from 3 schools in rural Virginia for 5 consecutive school days and analyzed them for macro and micro nutrients. Of the 1,314 observations collected; 42.8% were packed lunches (n = 562) and 57.2% were school lunches (n = 752). Energy, fat, saturated fat, sugar, vitamin C, and iron were significantly higher whereas protein, sodium, fiber, vitamin A, and calcium were significantly lower for packed lunches than school lunches. Packed lunches were of less nutritional quality than school lunches. Additional research is needed to explore factors related to choosing packed over school lunches.
Engagement in healthy lifestyle behaviors likely reflects access to a diverse and synergistic set... more Engagement in healthy lifestyle behaviors likely reflects access to a diverse and synergistic set of food and physical activity resources, yet most research examines discrete characteristics. We characterized neighborhoods with respect to their composition of features, and quantified associations with diet, physical activity (PA), body mass index (BMI), and insulin resistance (IR) in a longitudinal biracial cohort (n=4143; aged 25-37; 1992-2006). We used latent class analysis to derive population-density-specific (<vs.≥1750 people per sq km) clusters of neighborhood indicators: road connectivity, parks and PA facilities, and food stores/restaurants. In lower population density areas, a latent class with higher food and PA resource diversity (relative to other clusters) was significantly associated with higher diet quality. In higher population density areas, a cluster with relatively more natural food/specialty stores; fewer convenience stores; and more PA resources was associate...
Parental obesity has been identified as a predominant risk factor for childhood overweight and ob... more Parental obesity has been identified as a predominant risk factor for childhood overweight and obesity. We investigated the relationship between parent and child obesity in South Korea, particularly linked with varying family structures. Data for households with children aged 2-18 years were taken from the pooled data of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010 conducted by the Korea Centers for Disease Control and Prevention (KCDC). The sample consisted of 17 453 individuals (7879 children and 9574 adults) from 5048 households with children for this study. Children's overweight and obesity prevalence was compared using both International Obesity Taskforce (IOTF) and KCDC cutoff points according to parental weight status and household structure. Logistic regression analysis was used. Significantly greater odds of overweight and obesity existed among children living with both parents (odds ratio (OR)=3.5, 95% confidence interval (CI): 2.71, 4...
Korea has undergone a major opening of its food markets and economy in the past decade. Little is... more Korea has undergone a major opening of its food markets and economy in the past decade. Little is understood about the impact of these shifts on the diet of Koreans. This analysis studies the shifts in consumption of foods between 1998 and 2009 to provide a thorough understanding of the transition and insights into directions in the next decades in Korea. Data are from the Korea National Health and Nutrition Examination Survey (KNHANES). The sample used was a nationally representative sample of individuals age ≥2 in 1998 and 2009 (n=10,267 and 9,264, respectively). The data was corrected for seasonality, and the original raw food data was regrouped into 53 food groups. SAS was used to adjust for design effects and weight. Despite a decade of efforts to increase whole grains intake, and fruit and vegetable intake, the mean intake of whole grains increased only a small amount (16 kcal/person/day); however, the proportion consuming any whole grains doubled from 24% to 46.3%. Rice decli...
Beverage patterning may play a role in partially explaining the rising rates of obesity in the Un... more Beverage patterning may play a role in partially explaining the rising rates of obesity in the United States, yet little work on overall trends and patterns exits. Our objective was to examine trends and patterns of beverage consumption among U.S. adults. We used data from the nationally representative Nationwide Food Consumption Surveys (1965, 1977 to 1978) and the National Health and Nutrition Surveys (1988 to 1994, 1999 to 2002). To examine trends we determined percent consuming and per capita and per consumer caloric intake from all beverages. We used cluster analysis to determine year-specific beverage patterns in 1977 and 2002. The percentage of calories from beverages significantly increased between 1965 (11.8%), 1977 (14.2%), 1988 (18.5%), and 2002 (21.0%); this represents an overall increase of 222 calories per person per day from beverages, resulting largely from increased intake of calorically sweetened beverages. Beverage patterns in 2002 were more complex than in 1977 a...
Away-from-home food consumption has rapidly increased, though little is known about the independe... more Away-from-home food consumption has rapidly increased, though little is known about the independent associations of restaurant food and fast food intake with body mass index (BMI) and BMI change. The aim was to compare the associations of restaurant food and fast food consumption with current and 3-y changes in BMI. Multivariate linear regression models, with control for demographic and lifestyle factors, were used to examine cross-sectional and longitudinal associations of away-from-home eating with BMI by using data from subjects of the Coronary Artery Risk Development in Young Adults Study (n = 3394) obtained at exam years 7 (1992-1993) and 10 (1995-1996). Forty percent of the sample increased their weekly consumption of restaurant or fast food, though mean (+/-SD) changes were -0.16 +/- 2.39 times/wk (P = 0.0001) and -0.56 +/- 3.04 times/wk (P < 0.0001), respectively. Cross-sectionally, fast food, but not restaurant food, consumption was positively associated with BMI. Simila...
There is an absence of research examining associations between food and beverage intake patterns ... more There is an absence of research examining associations between food and beverage intake patterns and most research has centered on soft drinks, whereas research on overall beverage patterns is absent. Using data from the National Health and Nutrition Examination Survey 99-02 for adults aged 19 y and older, we independently examined beverage and food intake patterns, as well as their interrelations. Cluster analysis generated mutually exclusive intake patterns for beverages and foods. Multinomial logistic regression models provided the odds of a given beverage pattern for each food pattern; we then compared the probability of a given beverage pattern for each food pattern. Six beverage and 6 food patterns emerged. Beverage patterns revealed that calorically sweetened, non caloric, and diet beverages tended to be consumed independently of one another. Being in the Snacks and High-Fat Foods cluster increased the odds of being in the Coffee and Soda (odds ratio (OR): 1.62 [95% CI: 1.27-...
In this paper, the environment is defined as the macro- and community-level factors, including ph... more In this paper, the environment is defined as the macro- and community-level factors, including physical, legal and policy factors, that influence household and individual decisions. Thus, environment is conceived as the external context in which household and individual decisions are made. This paper reviews the literature on the ways the environment affects diet, physical activity, and obesity. Other key environmental factors discussed include economic, legal, and policy factors. Behind the major changes in diet and physical activity in the US and globally lie large shifts in food production, processing, and distribution systems as well as food shopping and eating options, resulting in the increase in availability of energy-dense foods. Similarly, the ways we move at home, work, leisure, and travel have shifted markedly, resulting in substantial reductions in energy expenditure. Many small area studies have linked environmental shifts with diet and activity changes. This paper begi...
The Mediterranean diet has been reported to be inversely associated with incident metabolic syndr... more The Mediterranean diet has been reported to be inversely associated with incident metabolic syndrome (MetSyn) among older adults; however, this association has not been studied in young African American and white adults. The objective of the present study was to evaluate the association of a modified Mediterranean diet (mMedDiet) score with the 25-year incidence of the MetSyn in 4713 African American and white adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. A diet history questionnaire was used to assess dietary intake at baseline, year 7 and year 20 and a mMedDiet score was created. Cardiovascular risk factors were measured at multiple examinations over 25 years. The MetSyn was defined according to the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria. Cox proportional-hazards regression analysis was use to evaluate associations for incident MetSyn across the mMedDiet score categories adjusting for demographi...
Snacking has increased globally, but little is known about how Mexicans consume foods outside mea... more Snacking has increased globally, but little is known about how Mexicans consume foods outside meals. The aim of this study was to examine the prevalence and patterns of snacking behavior among Mexicans. We used data from children and adults (aged ≥ 2 y; n = 9937) from the Mexican National Nutrition Survey 1999 and the Mexican National Health and Nutrition Survey (NHNS) 2012 to examine the prevalence of snacking as well as amount (kcal) and contribution of snacks to total energy intake per day. Snacking was defined as eating outside of the 3 main meals. We calculated per capita (among the total population) and per consumer ("snackers") estimates of the number of snacks per day, kilocalories per snack, kilocalories per day from snacks, and the percentage of energy from snacks. Top foods consumed during snack occasions were also examined for the NHNS 2012. All results were weighted to account for survey design and to be nationally representative. In 2012, an estimated 73% of ...
Approximately 40% of children bring a packed lunch to school. Little is known about the quality o... more Approximately 40% of children bring a packed lunch to school. Little is known about the quality of these lunches. This study examined the nutritional quality of packed lunches compared with school lunches for pre-kindergarten and kindergarten children after the implementation of 2012-2013 National School Lunch Program standards. The researchers collected observational data for packed and school lunches from 3 schools in rural Virginia for 5 consecutive school days and analyzed them for macro and micro nutrients. Of the 1,314 observations collected; 42.8% were packed lunches (n = 562) and 57.2% were school lunches (n = 752). Energy, fat, saturated fat, sugar, vitamin C, and iron were significantly higher whereas protein, sodium, fiber, vitamin A, and calcium were significantly lower for packed lunches than school lunches. Packed lunches were of less nutritional quality than school lunches. Additional research is needed to explore factors related to choosing packed over school lunches.
Engagement in healthy lifestyle behaviors likely reflects access to a diverse and synergistic set... more Engagement in healthy lifestyle behaviors likely reflects access to a diverse and synergistic set of food and physical activity resources, yet most research examines discrete characteristics. We characterized neighborhoods with respect to their composition of features, and quantified associations with diet, physical activity (PA), body mass index (BMI), and insulin resistance (IR) in a longitudinal biracial cohort (n=4143; aged 25-37; 1992-2006). We used latent class analysis to derive population-density-specific (<vs.≥1750 people per sq km) clusters of neighborhood indicators: road connectivity, parks and PA facilities, and food stores/restaurants. In lower population density areas, a latent class with higher food and PA resource diversity (relative to other clusters) was significantly associated with higher diet quality. In higher population density areas, a cluster with relatively more natural food/specialty stores; fewer convenience stores; and more PA resources was associate...
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Papers by Kiyah Duffey