Obesity and the food environment - Dietary energy density and diet costs
Obesity and the food environment - Dietary energy density and diet costs
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DOI：
10.1016/j.amepre.2004.06.011
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发表时间：
2004-10-01
影响因子：
5.5
通讯作者：
Drewnowski, A
中科院分区：
文献类型：
--
作者：
Drewnowski, A
在美国，肥胖率最高的人群是贫困率最高、受教育程度最低的人群。社会经济变量对肥胖的影响可能在一定程度上是由能量密集型食品的低成本所介导的。观察到的食物能量密度（定义为每单位重量的可用能量（千卡/克或兆焦耳/千克））与能量成本（美元/千卡或美元/兆焦耳）之间的反比关系意味着基于精制谷物，添加糖和添加脂肪的饮食比基于瘦肉，鱼，新鲜蔬菜和水果的推荐饮食更实惠。添加糖和添加脂肪的味道和方便性也会使食品选择偏向预制和预包装食品。奇怪的是，试图降低饮食成本可能会导致选择能量密集的食物，增加能量摄入和超重。目前的能源成本框架提供了一个经济的解释肥胖和食品环境之间的联系，饮食成本作为主要的干预变量。如果较高的食品价格是改变饮食的一个真实的障碍，特别是对低收入家庭而言，那么采取更健康饮食的能力与心理社会因素、自我效能或改变意愿的关系可能更小，而与家庭经济资源和食品环境的关系更大。继续向低收入家庭推荐昂贵的饮食作为公共卫生措施，只会让穷人和受教育程度较低的人感到沮丧和内疚。在美国，肥胖在很大程度上是一个经济问题。(C)2004年美国预防医学杂志。
The highest rates of obesity in the United States occur among population groups with the highest poverty rates and the least education. The impact of socioeconomic variables on obesity may be mediated, in part, by the low cost of energy-dense foods. The observed inverse relationship between energy density of foods, defined as available energy per unit weight (kilocalories per gram or megajoules per kilogram), and energy cost (dollars per kilocalorie or dollars per megajoule) means that diets based on refined grains, added sugars, and added fats are more affordable than the recommended diets based on lean meats, fish, fresh vegetables, and fruit. Taste and convenience of added sugars and added fats can also skew food choices in the direction of prepared and prepackaged foods. Paradoxically, attempting to reduce diet costs may lead to the selection of energy-dense foods, increased energy intakes, and overweight. The present energy-cost framework provides an economic explanation for the observed links between obesity and the food environment, with diet cost as the principal intervening variable. If higher food costs represent both a real and perceived barrier to dietary change, especially for lower-income families, then the ability to adopt healthier diets may have less to do with psychosocial factors, self-efficacy, or readiness to change than with household economic resources and the food environment. Continuing to recommend costly diets to low-income families as a public health measure can only generate frustration and culpability among the poor and less-well educated. Obesity in America is, to a large extent, an economic issue. (C) 2004 American Journal of Preventive Medicine.