Ligand effects, solvent cooperation, and large kinetic solvent deuterium isotope effects in gold(I)-catalyzed intramolecular alkene hydroamination

Kinetic studies on the intramolecular hydroamination of protected variants of 2,2-diphenylpent-4-en-1-amine were carried out under a variety of conditions with cationic gold catalysts supported by phosphine ligands. The impact of ligand on gold, protecting group on nitrogen, and solvent and additive on reaction rates was determined. The most effective reactions utilized more Lewis basic ureas, and more electron-withdrawing phosphines. A DCM/alcohol cooperative effect was quantified, and a continuum of isotope effects was measured with low KIE's in the absence of deuterated alcoholic solvent, increasing to large solvent KIE's when comparing reactions in pure MeOH to those in pure MeOH-d4. The effects are interpreted both within the context of a classic gold π-activation/protodeauration mechanism and a general acid-catalyzed mechanism without intermediate gold alkyls.

Food tax policies in Pacific Island Countries and Territories: systematic policy review

OBJECTIVE

To systematically identify and review food taxation policy changes in Pacific Island Countries and Territories (PICTs).

DESIGN

Food taxation polices, regarding excise taxes and tariffs applied from 2000 to 2020 in twenty-two PICTs, and their key characteristics were reviewed. The search was conducted using databases, government legal repositories and broad-based search engines. Identified documents for screening included legislation, reports, academic literature, news articles and grey literature. Key informants were contacted from each PICT to retrieve further data and confirm results. Results were analysed by narrative synthesis.

SETTING

Noncommunicable diseases (NCD) are the leading cause of premature death in PICTs and in many jurisdictions globally. An NCD crisis has been declared in the Pacific, and food taxation policy has been recommended to address the dietary risk factors associated with. Progress is unclear.

RESULTS

Of the twenty-two PICTs included in the study, fourteen had food taxation policies and five introduced excise taxes. Processed foods, sugar and salt were the main target of excise taxes. A total of eighty-four food taxation policy changes were identified across all food groups. There was a total of 279 taxes identified by food group, of which 85 % were tariffs and 15 % were excise taxes. Individual tax rates varied substantially. The predominant tax design was ad valorem, and this was followed by volumetric.

CONCLUSIONS

A quarter of PICTs have introduced food excise taxes from 2000 to 2020. Further excise taxes, specifically tiered or nutrient-specific designs, could be introduced and more systematically applied to a broader range of unhealthy foods.

The nature and extent of outdoor alcohol marketing in Wellington, New Zealand: a longitudinal audit and spatio-temporal analysis of outdoor alcohol marketing

AIM

exposure to alcohol marketing is associated with increased consumption. We aimed to (i) measure the nature and extent of outdoor alcohol marketing within a high-density urban neighbourhood and (ii) examine temporal and spatial trends in alcohol marketing.

METHODS

this study used a longitudinal design to monitor paid advertising in public spaces over two 10-week periods in Wellington, New Zealand (Nov-Jan 2020-2021, Nov-Jan 2021-2022). The data were collected on-foot following an established route once a week using a phone camera, which also recorded gps data of ad locations. Temporal and spatial trends in alcohol ad prevalence were assessed.

RESULTS

over the study period, 13% (n = 1619) of all ads (n = 12,472) were for alcohol. Alcohol ads were predominately for spirits (29%), ready-to-drink (27%) and beer (23%). Almost half of all alcohol ads (49%) did not contain a responsible consumption message, while those with a message were de-emphasized relative to promotional features. A temporal trend was observed in 2020, whereby alcohol marketing decreased over the summer, but this trend was not reflected in 2021. Alcohol ads were more likely than non-alcohol ads to be placed in premium positions on roads of high pedestrian and motor vehicle traffic.

CONCLUSION

alcohol marketing is common in urban centres. Local and central government policy could substantially reduce the levels of alcohol marketing exposure via outdoor marketing.

Situating reproductive coercion in the sociocultural context: An ecological framework model to inform research, practice, and policy in the United States

Reproductive coercion (RC) can be conceptualized as any behavior that limits one's ability to make decisions about their reproductive health. Here, we broaden this definition to consider the impact of systemic and sociocultural factors on RC using an ecological model. Specifically, we use Bronfenbrenner's model as a framework for organizing the multilevel factors that influence reproductive coercion (RC) and its impacts on individual health. This paper is intended to offer a primer to historical, sociocultural, community, interpersonal, and individual processes that may interact to shape reproductive decision-making and its effect on individual health outcomes. We emphasize the importance of conceptualizing RC within the broader sociocultural and community context, and the potential implications for reproductive and sexual health research, clinical care, and policy in the United States.

No Compelling Evidence that Self-Reported Personality Traits Explain Basal Testosterone and Cortisol’s Associations with Status-Relevant Behavior

Objective

A goal of behavioral neuroendocrinology is to understand how basal hormone levels relate to behavior. Studies of human participants sometimes measure self-reported personality traits, in addition to or instead of direct behavioral observation. Although personality traits often predict their respective behaviors, whether personality explains hormone-behavior relationships remains unclear.

Methods

We obtained data from eight previous studies (total N = 985) that examined baseline testosterone and cortisol as predictors of status-relevant behavior (competitiveness, dominance, risk-taking, aggression, affiliation, and social status). We tested whether the previously reported hormone-behavior relationships are mediated by self-reported personality traits (e.g., trait dominance, prestige, extraversion). As a secondary research question, we also tested whether trait dominance moderated the testosterone-behavior relationships.

Results

As expected, self-reported personality traits often predicted status-relevant behaviors, but there was little evidence that traits also correlated with basal testosterone or the testosterone × cortisol interaction. Across all eight studies, personality traits did not significantly mediate hormone-behavior relationships. Indeed, the effect sizes of the hormone-behavior relationships were robust to the inclusion of personality traits as covariates. Further, we did not find strong or consistent evidence that trait dominance moderates the testosterone-behavior association.

Conclusion

Results suggest that basal testosterone and cortisol predict status-related behavior independent of self-reported personality. We discuss how these results may have broader implications for the physiological mechanisms by which testosterone and cortisol influence behavior, a process that could be unconscious and automatic. We also discuss alternative explanations, limitations, and future directions.

The Cost-effectiveness of a Mass Media Campaign to Promote Smartphone Apps for Weight Loss: Updated Modeling Study

BACKGROUND

Evidence suggests that smartphone apps can be effective in the self-management of weight. Given the low cost, broad reach, and apparent effectiveness of weight loss apps, governments may seek to encourage their uptake as a tool to reduce excess weight in the population. Mass media campaigns are 1 mechanism for promoting app use. However, the cost and potential cost-effectiveness are important considerations.

OBJECTIVE

The aim of our study was to use modeling to assess the health impacts, health system costs, cost-effectiveness, and health equity of a mass media campaign to promote high-quality smartphone apps for weight loss in New Zealand.

METHODS

We used an established proportional multistate life table model that simulates the 2011 New Zealand adult population over the lifetime, subgrouped by age, sex, and ethnicity (Māori [Indigenous] or non-Māori). The risk factor was BMI. The model compared business as usual to a one-off mass media campaign intervention, which included the pooled effect size from a recent meta-analysis of smartphone weight loss apps. The resulting impact on BMI and BMI-related diseases was captured through changes in health gain (quality-adjusted life years) and in health system costs. The difference in total health system costs was the net sum of intervention costs and downstream cost offsets because of altered disease rates. An annual discount rate of 3% was applied to health gains and health system costs. Multiple scenarios and sensitivity analyses were conducted, including an equity adjustment.

RESULTS

Across the remaining lifetime of the modeled 2011 New Zealand population, the mass media campaign to promote weight loss app use had an estimated overall health gain of 181 (95% uncertainty interval 113-270) quality-adjusted life years and health care costs of -NZ $606,000 (-US $408,000; 95% uncertainty interval -NZ $2,540,000 [-US $1,709,000] to NZ $907,000 [US $610,000]). The mean health care costs were negative, representing overall savings to the health system. Across the outcomes examined in this study, the modeled mass media campaign to promote weight loss apps among the general population would be expected to provide higher per capita health gain for Māori and hence reduce health inequities arising from high BMI, assuming that the intervention would be as effective for Māori as it is for non-Māori.

CONCLUSIONS

A modeled mass media campaign to encourage the adoption of smartphone apps to promote weight loss among the New Zealand adult population is expected to yield an overall gain in health and to be cost-saving to the health system. Although other interventions in the nutrition and physical activity space are even more beneficial to health and produce larger cost savings (eg, fiscal policies and food reformulation), governments may choose to include strategies to promote health app use as complementary measures.

Potential effect of real-world junk food and sugar-sweetened beverage taxes on population health, health system costs and greenhouse gas emissions in New Zealand: a modelling study

Poor diet is a major risk factor for excess weight gain and obesity-related diseases, including cardiovascular diseases, type 2 diabetes mellitus, osteoarthritis and several cancers. This paper aims to assess the potential impacts of real-world food and beverage taxes on change in dietary risk factors, health gains (in quality-adjusted life years (QALYs)), health system costs and greenhouse gas (GHG) emissions as if they had all been implemented in New Zealand (NZ). Ten taxes or tax packages were modelled. A proportional multistate life table model was used to predict resultant QALYs and costs over the remaining lifespan of the NZ population alive in 2011, as well as GHG emissions. QALYs ranged from 12.5 (95% uncertainty interval (UI) 10.2 to 15.0; 3% discount rate) per 1000 population for the import tax on sugar-sweetened beverages (SSB) in Palau to 143 (95% UI 118 to 171) per 1000 population for the excise duties on saturated fat, chocolate and sweets in Denmark, while health expenditure savings ranged from 2011 NZ$245 (95% UI 188 to 310; 2020 US$185) per capita to NZ$2770 (95% UI 2140 to 3480; US$2100) per capita, respectively. The modelled taxes resulted in decreases in GHG emissions from baseline diets, ranging from −0.2% for the tax on SSB in Barbados to −2.8% for Denmark’s tax package. There is strong evidence for the implementation of food and beverage tax packages in NZ or similar high-income settings.

Using Statistical Shape and Appearance Modelling to characterise the 3D shape and material properties of human lumbar vertebrae: A proof of concept study

Patient variation affects the outcomes of a range of spinal interventions, from disc replacement to vertebral fixation and vertebroplasty. Statistical Shape and Appearance Modelling (SSAM) can be used to describe anatomical variation and pathological differences within the population. To better understand how bone density and shape variation affect load transfer with respect to surgical treatments, Finite Element (FE) models can be generated from a SSAM. The aim for this study is to understand whether geometric and density variation as well as multiple vertebral levels can be incorporated into a single SSAM and whether this can be used to investigate the relationships between, and effects of, the various modes of variation. FE models of 14 human lumbar vertebrae that had been μCT imaged and validated through experimental testing were used as input specimens for a SSAM. The validity of the SSAM was evaluated by using principal component analysis to identify the primary modes of geometric and bone density variation and comparing to those in the input set. FE models were generated from the SSAM to examine the response to loading. The mean error between the input set and generated models for volume, mean density and FE compressive stiffness were 10%, 3% and 10% respectively. Principal Component (PC) 1 captured the majority of the bone density variation. The remaining PCs described specific geometric variation. The FE models generated from the SSAM showed the variations in vertebral stiffness as a result of complex relationships between bone density and shape. The SSAM created has limited data for its input set, however, it acts as a proof of concept for the novel combination of material and shape variation into a single shape model. This approach and the tools developed can be applied to wider patient groups and treatment scenarios to improve patient stratification and to optimise treatments.

Emotion production of facial expressions: A comparison of deaf and hearing children

The production of facial expressions is an important skill that allows children to share and adapt emotions during social interactions. While deaf children are reported to show delays in their social and emotion understanding, the way in which they produce facial expressions of emotions has been relatively unexplored. The present study investigated the production of facial expressions of emotions by young congenitally deaf children. Six facial expressions of emotions produced by 5 congenitally deaf children and 5 hearing children (control group) were filmed across three tasks: 1) voluntarily posed expression of emotion 2) responding to social stories 3) intentionally mimicking expressions of emotion. The recorded videos were analysed using a software based of the Facial Action Coding System (FACS), and then judged by adult raters using two different scales: according to the emotion elicited (i.e. accuracy) and the intensity of the emotion produced. The results of both measurement scales showed that all children (deaf and hearing) were able to produce socially recognisable prototypical configuration of facial expressions. However, the deaf children were rated by adults as expressing their emotions with greater intensity compared to the hearing children. The results suggest deaf children may show more exaggerated facial expressions of emotion, possibly to avoid any ambiguity in communication.

The epidemiology of attacks on statues: New Zealand as a case study

OBJECTIVES

We aimed to describe the epidemiology of statue attacks along with statue representativeness relative to modern day demographics in one case study country: New Zealand.

METHODS

We performed Internet searches for the existence of outdoor statues of named individuals and historical attacks in New Zealand (NZ), combined a national survey with field visits to all identified statues to examine for injuries and repairs.

RESULTS

Of the 123 statues identified, nearly a quarter (n = 28, 23%) had been attacked at least once (total of 45 separate attack events), with the number of attacks increasing from the 1990s. Attacks involved paint/graffiti (14% of all statues at least once), nose removal/damage (7%), decapitation (5%), and total destruction (2%). The risk of attack was relatively higher for statues of royalty (50%), military personnel (33%), explorers (29%), and politicians (25%), compared to other reasons for fame (eg, 0% for sports players). Statue subjects involved in colonialism or direct harm to Māori (Indigenous population), had 6.61 (95%CI: 2.30 to 19.9) greater odds (adjusted odds ratio) of being attacked than other subjects. Most of the statue subjects were of men (87%) and Europeans (93%). Other ethnicities were 6% Māori (comprising 15% of the population) and 1% each for Asian and Pacific peoples, who comprise 12% and 7% of the population respectively.

CONCLUSIONS

This national survey found an association between statue attacks and the role of statue subjects in colonialism or direct harm to the Indigenous population. Furthermore, the demography of the statue subjects may represent historical and current social power relationships-with under-representation of women and non-European ethnic groups.

Should prioritising health interventions be informed by modelling studies? The case of cancer control in Aotearoa New Zealand

In this viewpoint, we suggest that policymakers should prioritise health interventions by using evidence around health gain, impact on equity, health-system costs and cost-effectiveness. We take the example of the new cancer control agency in New Zealand, Te Aho o Te Kahu, and argue that its decision-making can now be informed by many methodologically compatible epidemiological and health economic analyses. These analyses span primary prevention of cancer (eg, tobacco control, dietary and physical activity interventions and HPV vaccination), cancer screening, cancer treatment and palliative care. The largest health gain and cost-savings from the available modelling work for New Zealand are seen in nutrition and tobacco control interventions in particular. Many of these interventions have potentially greater per capita health gain for Māori than non-Māori and are also found to be cost saving for the health sector. In summary, appropriate prioritisation of interventions can potentially both maximise health benefits as well as making best use of government funding of the health system.

A covalent p97/VCP ATPase inhibitor can overcome resistance to CB-5083 and NMS-873 in colorectal cancer cells

Small-molecule inhibitors of p97 are useful tools to study p97 function. Human p97 is an important AAA ATPase due to its diverse cellular functions and implication in mediating the turnover of proteins involved in tumorigenesis and virus infections. Multiple p97 inhibitors identified from previous high-throughput screening studies are thiol-reactive compounds targeting Cys522 in the D2 ATP-binding domain. Thus, these findings suggest a potential strategy to develop covalent p97 inhibitors. We first used purified p97 to assay several known covalent kinase inhibitors to determine if they can inhibit ATPase activity. We evaluated their selectivity using our dual reporter cells that can distinguish p97 dependent and independent degradation. We selected a β-nitrostyrene scaffold to further study the structure-activity relationship. In addition, we used p97 structures to design and synthesize analogues of pyrazolo[3,4-d]pyrimidine (PP). We incorporated electrophiles into a PP-like compound 17 (4-amino-1-tert-butyl-3-phenyl pyrazolo[3,4-d]pyrimidine) to generate eight compounds. A selective compound 18 (N-(1-(tert-butyl)-3-phenyl-1H-pyrazolo[3,4-d]pyrimidin-4-yl)acrylamide, PPA) exhibited excellent selectivity in an in vitro ATPase activity assay: IC₅₀ of 0.6 μM, 300 μM, and 100 μM for wild type p97, yeast Cdc48, and N-ethylmaleimide sensitive factor (NSF), respectively. To further examine the importance of Cys522 on the active site pocket during PPA inhibition, C522A and C522T mutants of p97 were purified and shown to increase IC₅₀ values by 100-fold, whereas replacement of Thr532 of yeast Cdc48 with Cysteine decreased the IC₅₀ by 10-fold. The molecular modeling suggested the hydrogen bonds and hydrophobic interactions in addition to the covalent bonding at Cys522 between WT-p97 and PPA. Furthermore, tandem mass spectrometry confirmed formation of a covalent bond between Cys522 and PPA. An anti-proliferation assay indicated that the proliferation of HCT116, HeLa, and RPMI8226 was inhibited by PPA with IC₅₀ of 2.7 μM, 6.1 μM, and 3.4 μM, respectively. In addition, PPA is able to inhibit proliferation of two HCT116 cell lines that are resistant to CB-5083 and NMS-873, respectively. Proteomic analysis of PPA-treated HCT116 revealed Gene Ontology enrichment of known p97 functional pathways such as the protein ubiquitination and the ER to Golgi transport vesicle membrane. In conclusion, we have identified and characterized PPA as a selective covalent p97 inhibitor, which will allow future exploration to improve the potency of p97 inhibitors with different mechanisms of action.

The health and financial impacts of a sugary drink tax across different income groups in Canada

BACKGROUND

Overconsumption of sugar-sweetened beverages (SSBs) contributes to childhood and adult obesity and numerous related diseases, including heart disease, strokes, cancers, and type 2 diabetes. It also increases healthcare costs. Sugary drink taxes have been implemented in several countries to curb sugar intake. However, there is a concern that sugary drink taxes are regressive. This study assessed the health and financial impacts of a simulated sugary drink tax across different income groups in Canada.

METHODS

A proportional multi-state life table-based Markov model simulated the 2016 Canadian population by income quintile. The model applied a 20 % tax on sugary drinks and determined the effects on type 2 diabetes and BMI-related diseases compared to no intervention. The income-specific parameters modelled included: population demographics; cross- and own-price elasticities; mean BMI; sugary drink consumption; mortality; and disease epidemiology.

RESULTS

A 20 % sugary drink tax was estimated to reduce the consumption of sugary drinks by an average of around 15 %, with a greater reduction in the lowest income quintile. The estimated mean reduction in BMI ranged from 0.21 to 0.33, dependent upon sex and income quintile; these reductions were greater among the lower income quintiles for both females and males. The 20 % sugary drink tax was estimated to avert approximately 690,000 DALYs over a lifetime among the 2016 Canadian adult population; estimated DALYs averted were approximately 156,000, 140,000, 137,000, 134,000, and 125,000 for the lowest through to the highest income quintile, respectively. Lifetime health care savings were estimated to be $2.27bn, $2.16bn, $2.17bn, $2.12bn, and $1.98bn for the lowest through to the highest income quintile, respectively. The estimated annual tax burden for the 2016 Canadian population was $1.4bn. The average absolute tax burden was estimated to be $39.00 to $44.30 per person, with the middle-income quintile bearing the heaviest absolute tax burden. The lowest income quintile would pay the highest proportion of income in tax, implying that the tax is regressive.

CONCLUSIONS

Low-income Canadians would gain the most health benefit from a sugary drinks tax. However, the lowest income quintile would also pay the largest proportion of income in tax. A tax on sugary drinks is therefore financially regressive but forecast to reduce health disparities across Canada.

Poor smoke-free status of airports in a country with a smoke-free goal: New Zealand

BACKGROUND

To survey the smoke-free status of airports in New Zealand (NZ), a country with a smoke-free goal for 2025, and where public indoor areas are required to be smoke-free.

METHODS

A cross-sectional survey of a convenience sample of airports with data collection on smoke-free signage, observed smoking behaviour, cigarette butt litter and designated smoking areas.

RESULTS

A total of 23 airports were surveyed, including all those for the 10 most populous urban areas in NZ (82% of all airports with scheduled flights on the main islands). There were no smoke-free signs found at entrances/exits to the terminal building in 26% of airports, with a mean of 1.7 such signs per entrance/exit. Only one airport had any signage stating that all the grounds were smoke-free. Qualitatively, the signage was often small in size (<15 cm diameter). There was also ambiguity as to what the signage related to (indoors or outdoors). Observed smoking and vaping outside of the main entrances/exits was relatively uncommon, but the great majority of these sites (91%) had discarded cigarette butts present. Most airports (70%) had some form of designated or implied outdoor smoking area, with 38% of these areas being within 10 m distance of a terminal entrance/exit.

CONCLUSIONS

Despite this country having a smoke-free goal, it has largely deficient smoke-free policies at its airports. There is a case to make airport grounds entirely smoke-free as part of an upgrade of the national smoke-free law.

0665 Bilateral Hypoglossal Nerve Stimulation for Treatment of Obstructive Sleep Apnea

Introduction

Hypoglossal Nerve Stimulation (HGNS) decreases obstructive sleep apnea (OSA) severity by contracting the tongue and decreasing upper airway collapsibility. This study assessed the safety and effectiveness of a new implantable device that delivers bilateral HGNS: the Genio™ system.

Methods

The BLAST OSA study (BiLAteral Hypoglossal Nerve Stimulation for Treatment of Obstructive Sleep Apnea), was a prospective, open-label, non-randomized, single arm treatment study conducted at eight centres in three countries (Australia, France, UK). Primary outcomes were the incidence of device-related Serious Adverse Events (SAEs) and change in the Apnea-Hypopnea Index (AHI). The secondary outcome was change in the 4% Oxygen Desaturation Index (ODI). Additional outcomes included measures of sleepiness, quality of life, snoring, and device use. Participants were eligible if: 21-75 years old; BMI ≤ 32 kg/m2; obstructive AHI 20-60 events/hr and combined central and mixed AHI &lt; 10 events/hr; no positional OSA; no Complete Concentric Collapse of the soft palate during Drug Induced Sleep Endoscopy; and failed to tolerate or accept Positive Airway Pressure treatments.

Results

27 participants were implanted (63% male, aged 55.9±12.0 years, BMI 27.4±3.0 kg/m2). 22 completed the protocol. At 6 months, AHI decreased from 23.7±12.2 to 12.9±10.1 events/hr [p&lt;0.001]; and ODI decreased from 19.1±11.2 to 9.8±6.9 events/hr [p&lt;0.001]. Daytime sleepiness (ESS, p=0.011) and sleep-related quality of life (FOSQ-10, p=0.016) both significantly improved. 91% of participants reported using their device &gt;5 days per week, and 77% used it &gt;5 hours per night. The number of bed partners reporting disruptive snoring decreased from 96% to 35%. No device-related SAE occurred.

Conclusion

In a targeted population of individuals with moderate-to-severe OSA, the Genio system reduced OSA severity and sleepiness, improved quality of life, and was associated with high adherence and an acceptable safety profile.

Support

This study trial was funded by Nyxoah S.A. This trial was registered with ClinicalTrials.gov, number NCT03048604.

Food taxes and subsidies to protect health: relevance to Aotearoa New Zealand

The hazardous and obesogenic food environment are major contributors to health loss in Aotearoa New Zealand. Here we consider the potential use of food taxes and subsidies to protect health in this country. We find that each one of the 14 recent systematic reviews on the tax and/or subsidy topic since 2015 in the scientific literature report that such interventions have favourable impacts from a health perspective. The New Zealand evidence we considered (n=12 studies since January 2010) is less definitive, but the pattern of results is consistent with the international evidence. Given this overall picture, the New Zealand Government should seriously consider such tax/subsidy interventions, potentially starting with a UK-style sugary drinks industry levy.

Beverage consumption and energy intake among Canadians: analyses of 2004 and 2015 national dietary intake data

Background

Among adults and children consuming Western diets, beverages are significant sources of free sugars, saturated fats, excess calories, and alcohol, with relevance to chronic disease risk. The impact of recent healthy eating policies and beverage market evolutions on population-level consumption patterns in Canada is unknown. The current study examined trends in intake of a range of beverage types among a nationally-representative sample of Canadians, with stratification by socio-demographic characteristics.

Methods

The 2004 (n = 34,775) and 2015 (n = 20,176) nutrition-focused cycles of the Canadian Community Health Surveys are cross-sectional surveys representative of the population of the 10 Canadian provinces. Based on a single multiple-pass 24-h dietary recall for each participant, fluids consumed as beverages were grouped into seven categories. Using linear regression, reported intake (volume, ml and energy, kcal) of each category was characterized over time and in relation to sex, age, ethnicity, income, body mass index (BMI), and province of residence.

Results

In 2015, Canadians reported consuming an average of 1806 ml (275 kcal) fluids as beverages per day, including: plain water 867 ml (0 kcal); other unsweetened beverages, e.g. coffee, 364 ml (6 kcal); sugar-sweetened beverages (SSBs) 204 ml (99 kcal); plain milk 132 ml (64 kcal); alcoholic drinks 120 ml (71 kcal); 100% juice 74 ml (34 kcal); and diet or low calorie beverages 44 ml (2 kcal). Differential consumption was observed across socio-demographic groups, with high consumption of sugary drinks (i.e., SSBs and 100% juice) and alcohol across groups. From 2004 to 2015, the reported volumes of beverages consumed decreased by 10% (energy: − 24%). With adjustment for socio-demographic characteristics, there were significant changes (p < 0.001) over time in intake of: 100% juice − 40% (− 38%); plain milk − 37% (− 35%); SSBs − 26% (− 20%); diet or low calorie beverages (− 46%); and other unsweetened beverages − 11% (− 42%). The volume of plain water consumed increased by 10% (p < 0.0001). Intake of alcoholic (volume and energy) and diet or light beverages did not change significantly.

Conclusions

Lower intake of beverages was reported by Canadians in 2015 versus 2004, with a shift towards plain water. Consumption of sugary drinks decreased, but these beverages continue to contribute substantially to Canadians' overall energy intake. The findings underscore the need for policies to further reduce the consumption of sugary and alcoholic beverages, as well as calories from beverages.

Impact of sugar-sweetened beverage taxes on purchases and dietary intake: Systematic review and meta-analysis

The aim was to conduct a systematic review of real-world sugar-sweetened beverage (SSB) tax evaluations and examine the overall impact on beverage purchases and dietary intake by meta-analysis. Medline, EconLit, Google Scholar, and Scopus databases were searched up to June 2018. SSB tax evaluations from any formal jurisdiction from cities to national governments were eligible if there was a comparison between pre-post tax (n = 11) or taxed and untaxed jurisdiction(s) (n = 6). The consumption outcome comprised sales, purchasing, and intake (reported by volume, energy, or frequency). Taxed and untaxed beverage consumption outcomes were examined separately by meta-analysis with adjustment for the size of each tax. The study was registered at PROSPERO (CRD42018100620). The equivalent of a 10% SSB tax was associated with an average decline in beverage purchases and dietary intake of 10.0% (95% CI: -5.0% to -14.7%, n = 17 studies, 6 jurisdictions) with considerable heterogeneity between results (I2  = 97%).The equivalent of a 10% SSB tax was also associated with a nonsignificant 1.9% increase in total untaxed beverage consumption (eg, water) (95% CI: -2.1% to 6.1%, n = 6 studies, 4 jurisdictions). Based on real-world evaluations, SSB taxes introduced in jurisdictions around the world appear to have been effective in reducing SSB purchases and dietary intake.

Unified Enantioselective, Convergent Synthetic Approach toward the Furanobutenolide-Derived Polycyclic Norcembranoid Diterpenes: Synthesis of a Series of Ineleganoloids by Oxidation-State Manipulation of the Carbocyclic Core

Late-stage synthetic efforts to advance the enatio- and diastereoselectively constructed [6,7,5,5]-fused tetracyclic scaffold toward the polycyclic norditerpenoid ineleganolide are disclosed. The described investigations focus on oxidation-state manipulation around the central cycloheptane ring. Computational evaluation of ground-state energies of dihydroineleganolide is used to rationalize empirical observations and provide insight for further synthetic development, enhancing the understanding of the conformational constraints of these compact polycyclic structures. Advanced synthetic manipulations generated a series of natural product-like compounds termed the ineleganoloids.

Top dietary sources of energy, sodium, sugars, and saturated fats among Canadians: insights from the 2015 Canadian Community Health Survey

Dietary factors are major contributors to morbidity and mortality, and significant attention is being paid to interventions to support healthy eating, including through the creation of a healthier food supply. The objective of this study was to inform interventions to support healthy eating by examining the top dietary sources of calories, sodium, sugars, and saturated fats among Canadians in relation to sex, age, and income. We drew upon data from the 2015 Canadian Community Health Survey, which collected interviewer-administered 24-h dietary recalls from Canadians who were 1 year of age and older (n = 20 176), residing in the 10 provinces. Foods and beverages were grouped into 91 mutually exclusive categories (e.g., 100% fruit juice, fruit drinks). On the basis of the average proportion contributed, the top 20 sources of each dietary component were identified for all individuals and by sex–age and income groups. The mean amount of each dietary component contributed by each category (per capita and per consumer) and the proportions of persons consuming items in each category were also examined. Top sources included commonly consumed items (e.g., breads and flatbreads as sources of sodium), as well as those high in a given dietary component (e.g., soda as a source of sugars). Several food and beverage categories were top contributors to more than one dietary component examined, suggesting possible priorities for intervention and future analyses. The identification of major sources of calories and nutrients of concern can inform population health efforts, such as reformulation, to improve the health of Canadians.

Taxes and front-of-package labels improve the healthiness of beverage and snack purchases: a randomized experimental marketplace

BACKGROUND

Sugar taxes and front-of-package (FOP) nutrition labelling systems are strategies to address diet-related non-communicable diseases. However, there is relatively little experimental data on how these strategies influence consumer behavior and how they may interact. This study examined the relative impact of different sugar taxes and FOP labelling systems on beverage and snack food purchases.

METHODS

A total of 3584 Canadians 13 years and older participated in an experimental marketplace study using a 5 (FOP label condition) × 8 (tax condition) between-within group experiment. Participants received $5 and were presented with images of 20 beverages and 20 snack foods available for purchase. Participants were randomized to one of five FOP label conditions (no label; 'high in' warning; multiple traffic light; health star rating; nutrition grade) and completed eight within-subject purchasing tasks with different taxation conditions (beverages: no tax, 20% tax on sugar-sweetened beverages (SSBs), 20% tax on sugary drinks, tiered tax on SSBs, tiered tax on sugary drinks; snack foods: no tax, 20% tax on high-sugar foods, tiered tax on high-sugar foods). Upon conclusion, one of eight selections was randomly chosen for purchase, and participants received the product and any change.

RESULTS

Compared to those who saw no FOP label, participants who viewed the 'high in' symbol purchased less sugar (- 2.5 g), saturated fat (- 0.09 g), and calories (- 12.6 kcal) in the beverage purchasing tasks, and less sodium (- 13.5 mg) and calories (- 8.9 kcal) in the food tasks. All taxes resulted in substantial reductions in mean sugars (- 1.4 to - 4.7 g) and calories (- 5.3 to - 19.8 kcal) purchased, and in some cases, reductions in sodium (- 2.5 to - 6.6 mg) and saturated fat (- 0.03 to - 0.08 g). Taxes that included 100% fruit juice ('sugary drink' taxes) produced greater reductions in sugars and calories than those that did not.

CONCLUSIONS

This study expands the evidence indicating the effectiveness of sugar taxation and FOP labelling strategies in promoting healthy food and beverage choices. The results emphasize the importance of applying taxes to 100% fruit juice to maximize policy impact, and suggest that nutrient-specific FOP 'high in' labels may be more effective than other common labelling systems at reducing consumption of targeted nutrients.

Correction: Enantioselective, convergent synthesis of the ineleganolide core by a tandem annulation cascade

Correction for ‘Enantioselective, convergent synthesis of the ineleganolide core by a tandem annulation cascade’ by Robert A. Craig II et al., Chem. Sci., 2017, 8, 507–514.

Preventing cardiovascular disease in New Zealand: making better use of statins but also tobacco control, changing the food supply and other strategies

There is new evidence from a very large systematic review and meta-analysis (Navarese et al 2018), that using statins for reducing levels of low-density lipoprotein cholesterol reduces the risk of premature death. In this viewpoint article we consider the implications of this new evidence for New Zealand but also examine how the use of statins may be improved for primary prevention of cardiovascular disease (CVD) in this country. We suggest the need to explore such options as fixed-dose combination pills containing statins, three-drug polypills, behind-the-counter dispensing and six-month prescriptions. But in addition to pharmacological prevention of CVD, there is a need for improved population-wide changes to the environment. These include adopting policies to improve tobacco control, the nutrition environment (eg, particularly around sodium), alcohol control and making walking and cycling easier options.