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One of the most intractable problems in international health research is the lack of comparability of health measures across countries or cultures. We develop a cross-country measurement model for health, in which functional limitations, self-reports of health, and a physical measure are interrelated to construct health indices.

To establish comparability across countries, we define the measurement scales by the physical measure, while other parameters vary by country to reflect cultural and linguistic differences in response patterns. We find significant cross-country variation in response styles of health reports, along with variability in genuine health that is related to differences in national income. Our health indices achieve satisfactory reliability of about 80%, and their gradients by age, income, and wealth for the most part show the expected patterns. Moreover, the health indices correlate much more strongly with income and net worth than self-reported health measures.

Full citation: Meijer E, Kapteyn A, Andreyeva T. Internationally comparable health indices. Health Economics. 2011;20(5):600-619. https://doi.org/10.1002/hec.1620

Recent revisions to the food packages provided by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) added healthy foods and required WIC-authorized stores to make these foods available. This study examined the availability, variety, and prices of healthy foods before and after implementation of the food package revisions in 252 convenience and nonchain grocery stores in Connecticut.

The findings provide strong evidence that stores responded to the food package revisions by improving the availability and variety of healthy foods in both urban and suburban settings. Most of these improvements occurred in WIC-authorized convenience and grocery stores, especially those in low-income neighborhoods. Some positive changes in the availability of whole-grain products were also observed in non-WIC convenience and grocery stores. The policy change, which targets WIC participants, improved access to healthy foods for both WIC and non-WIC consumers.

Full citation: Andreyeva, T., Luedicke, J., Middleton, A. E., Long, M. W., & Schwartz, M. B. (2011, April 1). Changes in access to healthy foods after implementation of the WIC food package revisions. United States Department of Agriculture | Economic Research Service. https://www.ers.usda.gov/publications/84487

This study employs a nationally representative sample from the Early Childhood Longitudinal Survey–Kindergarten Cohort (ECLS-K) and the Nielsen Company data on spot television advertising of cereals, fast food restaurants, and soft drinks to children across the top 55 designated-market areas to estimate the relation between exposure to food advertising on television and children’s food consumption and body weight.

Our results suggest that soft drink and fast food television advertising is associated with increased consumption of soft drinks and fast food among elementary school children (Grade 5). Exposure to 100 incremental TV ads for sugar-sweetened carbonated soft drinks during 2002–2004 was associated with a 9.4% rise in children’s consumption of soft drinks in 2004. The same increase in exposure to fast food advertising was associated with a 1.1% rise in children’s consumption of fast food. There was no detectable link between advertising exposure and average body weight, but fast food advertising was significantly associated with body mass index for overweight and obese children ( 85th BMI percentile), revealing detectable effects for a vulnerable group of children. Exposure to advertising for calorie-dense nutrient-poor foods may increase overall consumption of unhealthy food categories.

Full citation: Andreyeva T, Kelly IR, Harris JL. Exposure to food advertising on television: associations with children’s fast food and soft drink consumption and obesity. Econ Hum Biol. 2011;9(3):221-233. https://doi.org/10.1016/j.ehb.2011.02.004

This study conducted an online survey with a national sample of 1,001 adults (representing demographics of the United States) to examine public support for six potential legislative measures to prohibit weight discrimination in the United States. Results indicated substantial support (65% of men, 81% of women) for laws to prohibit weight discrimination in the workplace, especially for legal measures that would prohibit employers from refusing to hire, terminate, or deny promotion based on a person’s body weight. Laws that proposed extending the same protections to obese persons as people with physical disabilities received the least support, suggesting that Americans may not be in favor of considering obesity as a disability.

Full citation: Puhl RM, Heuer CA. Public opinion about laws to prohibit weight discrimination in the United States. Obesity (Silver Spring). 2011;19(1):74-82. https://doi.org/10.1038/oby.2010.126

The objective of this study was to test (1) whether children will consume low-sugar ready-to-eat (RTE) cereals and (2) the effects of serving high- versus low-sugar cereals on the consumption of cereal, refined sugar, fresh fruit, and milk. Using an experimental design, we randomly assigned children (n = 91) who were attending summer day camp to receive a breakfast that included either the choice of 1 of 3 high-sugar cereals (high-sugar condition) or low-sugar cereals (low-sugar condition), as well as low-fat milk, orange juice, bananas, strawberries, and sugar packets. Participants served themselves and completed a background questionnaire after eating. Researchers measured the amount and calories consumed of each food.

In both conditions, children reported “liking” or “loving” the cereal they chose. Children in the low-sugar cereal condition consumed, on average, slightly more than 1 serving of cereal (35 g), whereas children in the high-sugar condition consumed significantly more (61 g) and almost twice the amount of refined sugar in total (24.4 vs 12.5 g). Milk and total calories consumed did not differ significantly between conditions, but children in the low-sugar condition were more likely to put fruit on their cereal (54% vs 8%) and consumed a greater portion of total calories from fresh fruit (20% vs 13%).

Full citation: Harris JL, Schwartz MB, Ustjanauskas A, Ohri-Vachaspati P, Brownell KD. Effects of serving high-sugar cereals on children’s breakfast-eating behavior. Pediatrics. 2011;127(1):71-76. https://doi.org/10.1542/peds.2010-0864

This report addresses the need for comprehensive, reliable, and current information about fast food marketing and how it affects young people. We focus our analyses on the twelve restaurants with the highest sales and advertising to youth in 2009 and document three components of their marketing plans.

Full citation: O’Brien KS, Puhl RM, Latner JD, Mir AS, Hunter JA. Reducing anti-fat prejudice in preservice health students: a randomized trial. Obesity (Silver Spring). 2010;18(11):2138-2144. https://doi.org/10.1038/oby.2010.79

Full citation: Long MW, Henderson KE, Schwartz MB. Evaluating the impact of a Connecticut program to reduce availability of unhealthy competitive food in schools. J Sch Health. 2010;80(10):478-486. https://doi.org/10.1111/j.1746-1561.2010.00531.x

Full citation: Puhl RM, Masheb RM, White MA, Grilo CM. Attitudes toward obesity in obese persons: a matched comparison of obese women with and without binge eating. Eat Weight Disord. 2010;15(3):e173-e179. https://pubmed.ncbi.nlm.nih.gov/20124783/

Full citation: Roberto CA, Baik J, Harris JL, Brownell KD. Influence of licensed characters on children’s taste and snack preferences. Pediatrics. 2010;126(1):88-93. https://doi.org/10.1542/peds.2009-3433