Special Issue "Impact of Diet and Food Policy on the Development of Obesity and Type 2 Diabetes Mellitus (T2DM) Epidemics"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 May 2019).

Special Issue Editor

Prof. Dr. Iain Broom
Website
Guest Editor
Centre for Obesity Research and Epidemiology (CORE), School of Pharmacy and Life Sciences, Robert Gordon University, Garthdee Road, Aberdeen AB10 7QB, UK
Interests: diabetes; obesity; metabolism; nutrition; trauma; sepsis

Special Issue Information

Dear Colleagues,

We are organising a Special Issue on the impact of diet and food policy on the development of the obesity and Type 2 Diabetes Mellitus (T2DM) epidemics. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of the environmental health sciences and public health, including aspects of government policy.

Obesity and the consequent development of T2DM in individuals with a genetic predisposition have become a worldwide problem affecting both developed and developing countries. In particular, T2DM is forecast to affect the developing world to the detriment of both their health and general economies more so than those of the developed economies. Dietary intake and government food policy worldwide may have played a role in the development of both of these epidemics.

Within the developed world, obesity rates have remained at about 6–8% of the population for decades, but since new food policies were introduced to supposedly target the rising rates of coronary heart disease in the late 1970s/early 1980s, obesity rates have rocketed to almost 30% of the population in some developed countries, mirrored by accelerating rates in the developing world. At the time as these food policy changes, a warning was made by many scientists, including Ahrens in New York and Yudkin in London, that such changes would lead to an increase in the rates of obesity and T2DM. In addition, it is now becoming clear that this increase in obesity within the population has led to obesity overtaking smoking as the main cause of cancer in the population.

There is now an ongoing discussion amongst scientists and clinicians worldwide as to whether the changes in food policy, advocated since the 1980s, are the key to the deterioration in the public health of populations. In particular, childhood obesity and the development of T2DM in children, a disease unknown in children prior to the change in food policy, is now threatening the "normal" lifespan of the population, with a possible reduction in the life expectancy of our children.

Admittedly, many other changes within the environment have also occurred in this timeframe, not least the development of the digital economy, with digital marketing and digital play, the latter almost certainly affecting the levels of activity in children. This would certainly add to both inappropriate food intake and reduced physical activity leading to the overweight or obese child.

This Special Issue is open to any subject area related to diet, food availability and type, and the effects of food policy on the development of obesity and T2DM. The list of key words is not exclusive but merely a suggestion.

Prof. Dr. Iain Broom
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Food environment
  • Food policy
  • Food additives
  • Food availability
  • Food marketing
  • Processed foods
  • Food and exercise
  • Fast food
  • Mediterranean diet
  • Saturated fat
  • Refined carbohydrate
  • Low fat/low carbohydrate diets
  • Insulin sensitivity
  • Exercise environment
  • Digital environment

Published Papers (5 papers)

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Research

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Open AccessFeature PaperArticle
Substantial and Sustained Improvements in Blood Pressure, Weight and Lipid Profiles from a Carbohydrate Restricted Diet: An Observational Study of Insulin Resistant Patients in Primary Care
Int. J. Environ. Res. Public Health 2019, 16(15), 2680; https://doi.org/10.3390/ijerph16152680 - 26 Jul 2019
Cited by 6
Abstract
Hypertension is the second biggest known global risk factor for disease after poor diet; perhaps lifestyle interventions are underutilized? In a previous small pilot study, it was found that a low carbohydrate diet was associated with significant improvements in blood pressure, weight, ‘deprescribing’ [...] Read more.
Hypertension is the second biggest known global risk factor for disease after poor diet; perhaps lifestyle interventions are underutilized? In a previous small pilot study, it was found that a low carbohydrate diet was associated with significant improvements in blood pressure, weight, ‘deprescribing’ of medications and lipid profiles. We were interested to investigate if these results would be replicated in a larger study based in ‘real world’ GP practice. 154 patients with type 2 diabetes or impaired glucose tolerance were recruited into an observational cohort study in primary care. The effects of a low carbohydrate diet sustained for an average of two years (interquartile range 10–32 months) on cardiovascular risk factors were examined. Results demonstrate significant and substantial reductions in blood pressure (mean reduction of systolic BP 10.9 mmHg (interquartile range 0–22 mmHg) (p < 0.0001), mean reduction in diastolic BP 6.3 mmHg (interquartile range 0–12.8 mmHg) (p < 0.0001) and mean weight reduction of 9.5 Kg (interquartile range 5–13 Kg) (p < 0.0001) together with marked improvement in lipid profiles. This occurred despite a 20% reduction in anti-hypertensive medications. This novel and potentially highly effective dietary modification, done very cheaply alongside routine care, offers hope that should be tested in a large prospective trial. Full article
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Open AccessArticle
Exploring Student Food Behaviour in Relation to Food Retail over the Time of Implementing Ontario’s School Food and Beverage Policy
Int. J. Environ. Res. Public Health 2019, 16(14), 2563; https://doi.org/10.3390/ijerph16142563 - 18 Jul 2019
Abstract
Background: Canadian provincial policies, like Ontario’s School Food and Beverage Policy (P/PM 150), increasingly mandate standards for food and beverages offered for sale at school. Given concerns regarding students leaving school to purchase less healthy foods, we examined student behaviours and competitive food [...] Read more.
Background: Canadian provincial policies, like Ontario’s School Food and Beverage Policy (P/PM 150), increasingly mandate standards for food and beverages offered for sale at school. Given concerns regarding students leaving school to purchase less healthy foods, we examined student behaviours and competitive food retail around schools in a large urban region of Southern Ontario. Methods: Using a geographic information system (GIS), we enumerated food outlets (convenience stores, fast-food restaurants, full-service restaurants) within 500, 1000 and 1500 m of all 389 regional schools spanning years of policy implementation. Consenting grade 6–10 students within 31 randomly selected schools completed a web-based 24-h diet recall (WEB-Q) and questionnaire. Results: Food outlet numbers increased over time (p < 0.01); post-policy, within 1000 m, they averaged 27.31 outlets, with a maximum of 65 fast-food restaurants around one school. Of WEB-Q respondents (n = 2075, mean age = 13.4 ± 1.6 years), those who ate lunch at a restaurant/take-out (n = 84, 4%) consumed significantly more energy (978 vs. 760 kcal), sodium (1556 vs. 1173 mg), and sugar (44.3 vs. 40.1 g). Of elementary and secondary school respondents, 22.1% and 52.4% reported ever eating at fast food outlets during school days. Conclusions: Students have easy access to food retail in school neighbourhoods. The higher energy, sodium and sugar of these options present a health risk. Full article
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Open AccessArticle
Severe Hypoglycemia as a Predictor of End-Stage Renal Disease in Type 2 Diabetes: A National Cohort Study
Int. J. Environ. Res. Public Health 2019, 16(5), 681; https://doi.org/10.3390/ijerph16050681 - 26 Feb 2019
Cited by 1
Abstract
Aims: This study investigated whether there is a link between severe hypoglycemia and progression into end-stage renal disease (ESRD) in patients with type 2 diabetes. Methods: Tapping into Taiwan’s Health Insurance Research Database, we identified all type 2 diabetes patients between 1996 and [...] Read more.
Aims: This study investigated whether there is a link between severe hypoglycemia and progression into end-stage renal disease (ESRD) in patients with type 2 diabetes. Methods: Tapping into Taiwan’s Health Insurance Research Database, we identified all type 2 diabetes patients between 1996 and 2013 and identified those diagnosed with a severe hypoglycemia episode during an emergency department visit and those who were not. Controls were then matched 1:1 for age, sex, index year, and medication. Results: We identified 468,421 type 2 diabetes patients diagnosed as having severe hypoglycemia in an emergency department visit. Compared with controls, these patients with SH had a higher risk of all-cause mortality (Hazard Ratio (HR), 1.76; 95% confidence interval, 1.61–1.94) and progressed into ESRD within a shorter period of time. Results were similar after controlling for competing risk. Conclusion: Severe hypoglycemia is significantly associated with worsening renal dysfunction in patients with type 2 diabetes and hastened progression into ESRD. Full article
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Open AccessArticle
Societal Marketing in the Treatment of Type 2 Diabetes Mellitus: A Longitudinal Questionnaire Survey for Michelin-Starred Restaurants in Japan
Int. J. Environ. Res. Public Health 2019, 16(4), 636; https://doi.org/10.3390/ijerph16040636 - 21 Feb 2019
Abstract
Numerous dietary recommendations have been made for the prevention and treatment of diabetes. However, many people with diabetes regard healthy dietary behavior as wearisome and have difficulty adhering to nutrition therapy. We, therefore, conducted a questionnaire survey concerning the restaurants that serve meals [...] Read more.
Numerous dietary recommendations have been made for the prevention and treatment of diabetes. However, many people with diabetes regard healthy dietary behavior as wearisome and have difficulty adhering to nutrition therapy. We, therefore, conducted a questionnaire survey concerning the restaurants that serve meals suitable for people with diabetes. We first aimed to determine the number of restaurants that were aware of the need to create special menus for people with diabetes. Second, we aimed to encourage restaurants’ serving of tasty, healthy food and promote easier social living for people with diabetes. We conducted our questionnaire survey every year from 2008 to 2013 on the availability of special menus for people with diabetes at restaurants listed in Michelin Guide Tokyo. We succeeded in increasing the proportion of restaurants offering special meals for people with diabetes from 6.7% (10 of 150 restaurants) in 2008 to 13.2% (32 of 242 restaurants) in 2013. As a result of the diabetes pandemic, the market for goods and services catering to people with diabetes is increasing. Diabetologists need to inform and support the food industry to produce foods that are suitable for people with diabetes and promote the serving of such foods by restaurants. This represents a new approach in the prevention and treatment of type 2 diabetes. Full article

Review

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Open AccessReview
Progress Evaluation for Transnational Restaurant Chains to Reformulate Products and Standardize Portions to Meet Healthy Dietary Guidelines and Reduce Obesity and Non-Communicable Disease Risks, 2000–2018: A Scoping and Systematic Review to Inform Policy
Int. J. Environ. Res. Public Health 2019, 16(15), 2732; https://doi.org/10.3390/ijerph16152732 - 31 Jul 2019
Cited by 6
Abstract
Transnational restaurant chains sell food and beverage products in 75 to 139 countries worldwide linked to obesity and non-communicable diseases (NCDs). This study examined whether transnational restaurant chains reformulated products and standardized portions aligned with healthy dietary guidelines and criteria. Firstly, we describe [...] Read more.
Transnational restaurant chains sell food and beverage products in 75 to 139 countries worldwide linked to obesity and non-communicable diseases (NCDs). This study examined whether transnational restaurant chains reformulated products and standardized portions aligned with healthy dietary guidelines and criteria. Firstly, we describe the transnational restaurant industry structure and eating trends. Secondly, we summarize results from a scoping review of healthy dietary guidelines for restaurants. Thirdly, we describe a systematic review of five electronic databases (2000–2018) to identify studies on nutrient profile and portion size changes made by transnational restaurants over 18 years. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, identified 179 records, and included 50 studies conducted in 30 countries across six regions. The scoping review found a few expert-recommended targets for restaurants to improve offerings, but no internationally accepted standard for portions or serving sizes. The systematic review results showed no standardized assessment methods or metrics to evaluate transnational chain restaurants’ practices to improve menu offerings. There was wide variation within and across countries, regions, firms, and chains to reduce energy, saturated and trans fats, sodium, and standardized portions. These results may inform future research and encourage transnational chain restaurants to offer healthy product profiles and standardized portions to reduce obesity and NCD risks worldwide. Full article
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