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Veloso Pulgar M, Arcila-Agudelo AM, Ferrer Svoboda C, Torres Fernández T, Farran Codina A. [Nutritional status and adherence to the Mediterranean diet in the school population of the city of Mataró (Catalonia, Spain)]. NUTR HOSP 2024. [PMID: 38328959 DOI: 10.20960/nh.04514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND there is a decrease in adherence to the Mediterranean diet (MD) and an increase in the prevalence of excess weight among the Spanish child and adolescent population. OBJECTIVES the objective of the present study was to determine the degree of adherence to MD and the nutritional status of the school population of Mataró (Spain) in order to obtain useful information for the design and application of future interventions. MATERIAL AND METHODS a cross-sectional descriptive, observational study was carried out in a sample of 1177 schoolchildren between 6 and 18 years of age. The KIDMED index was used to assess adherence to MD, and the body mass index (BMI) to assess nutritional status. Questions were related to the students' perception of access to unhealthy foods, availability of money and parental interest in receiving nutrition education. RESULTS the percentage of children and adolescents with optimal adherence to MD does not reach 50 %, with secondary school youths presenting a lower percentage (30 %). Regarding the nutritional status of the sample, more than 70 % had a normal nutritional status according to their BMI, and 20.7 % of primary school students and 13.8 % of secondary school students were classified as overweight. CONCLUSIONS the data confirm the interest of designing and implementing educational actions involving both students and parents, with the aim of improving the eating habits of the population. The results suggest that availability of money may facilitate access to unhealthy foods and, therefore, the promotion of healthy environments that increase the supply of healthy foods should be considered.
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Affiliation(s)
- Macarena Veloso Pulgar
- Departament de Nutrició, Ciències dels Aliments i Gastronomia. XIA-INSA. Facultat de Farmàcia. Universitat de Barcelona
| | | | | | | | - Andreu Farran Codina
- Departament de Nutrició, Ciències dels Aliments i Gastronomia. XIA-INSA. Facultat de Farmàcia. Universitat de Barcelona
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Dieteren CM, Bonfrer I, Brouwer WBF, van Exel J. Public preferences for policies promoting a healthy diet: a discrete choice experiment. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:1429-1440. [PMID: 36445540 PMCID: PMC9707240 DOI: 10.1007/s10198-022-01554-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Worldwide obesity rates have nearly tripled over the past five decades. So far, policies to promote a healthier diet have been less intrusive than those to reduce tobacco and alcohol consumption. Not much is known about public support for policies that aim to promote a healthy diet. In this study, a discrete choice experiment (DCE) was used to elicit stated preferences for policies varying in intrusiveness among a representative sample of the public of The Netherlands. METHODS The choice tasks presented respondents a hypothetical scenario of two policy packages, each comprising a mix of seven potential policies that differed in level of intrusiveness. We estimated mixed logit models (MXL) to estimate respondents' preferences for these policies and performed latent class analyses to identify heterogeneity in preferences. RESULTS The MXL model showed that positive financial incentives like subsidies for vegetables and fruit yielded most utility. A tax of 50% on sugary drinks was associated with disutility while a tax of 20% was associated with positive utility compared to no tax at all. We identified three subgroups with distinct preferences for the seven policies to promote a healthy diet, which were characterized as being "against", "mixed" and "pro" policies to promote a healthy diet. CONCLUSION Preferences for policies promoting a healthy diet vary considerably in the Dutch population, particularly in relation to more intrusive policies. This makes selection and implementation of a policy package that has wide public support challenging.
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Affiliation(s)
- C M Dieteren
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
| | - I Bonfrer
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - W B F Brouwer
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - J van Exel
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
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Souza LMS, Chaves SCL, Santana JM, Pereira M. Public policy interventions for preventing and treating obesity: scoping review. Nutr Rev 2023; 81:1653-1664. [PMID: 37080562 DOI: 10.1093/nutrit/nuad028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
CONTEXT Obesity is a multicausal social problem and a pandemic, and it presents a public health challenge in many countries. Hence, public health interventions have been used in an endeavour to prevent and/or control increased obesity among populations. OBJECTIVE This review study aimed to provide an overview of the academic literature and to analyze the strategies involved in the main public policies focused on preventing and controlling obesity in a number of countries. DATA SOURCES MEDLINE/PubMed, Web of Science, and LILACS databases were searched. DATA EXTRACTION Original studies were included for which the core objective was related to real-life public policy interventions for obesity. DATA ANALYSIS The studies were organized according to their characteristics, and the qualitative analysis was based on the categorization proposed by the author Poulain. The review included 41 studies and identified 15 types of interventions focused on obesity; the largest proportion of actions were developed in school and city environments and were geared toward behavioral change, supported by direct or indirect government action. It was observed that many strategies focused on environmental line through regulatory and legislative measures, and health promotion geared toward the individual was based on the dissemination of information as a means for behavioral change. A smaller focus was given to individual care and treatment, and participative actions in the community. CONCLUSION The design of public health strategies applicable to obesity as proposed by Poulain provides a valid model for evaluating interventions. The behavioral approach involving guidance through health education toward a healthy lifestyle prevails in public policies, indicating a movement toward accountability of individuals. However, it is necessary to deepen the debate on the social structures that determine obesity (and which limit possibilities of choice), aligned with cultural change regarding its occurrence, and to employ care strategies based on scientific evidence and which focus on the needs of the subjects.
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Affiliation(s)
- Lana M S Souza
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Canela, Salvador, Brazil
| | - Sônia C L Chaves
- Faculdade de Odontologia, Universidade Federal da Bahia, Salvador, Brazil
| | - Jerusa M Santana
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia, Santo Antônio de Jesus, Brazil
| | - Marcos Pereira
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
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Silva C, Pereira B, Figueiredo G, Rosário P, Núñez JC, Magalhães P. Self-Efficacy to Regulate Eating Behaviors Scale for Children: A Validation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2807. [PMID: 36833503 PMCID: PMC9956400 DOI: 10.3390/ijerph20042807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Self-efficacy has a strong influence on children's eating behavior. Feeling capable of regulating one's eating behavior is especially relevant in situations of activation while facing temptations or experiencing negative emotions. Despite the relevance, there is no validated measure to assess children's self-efficacy to regulate eating behaviors in these domains. The present study examines the psychometric properties of the Self-Efficacy to Regulate Eating Behaviors Scale for Children based on a sample of 724 elementary school children in Portugal. The sample was split randomly into two groups, and a principal component analysis with Group 1 and a confirmatory factor analysis with Group 2 were carried out. The scale comprises two distinct but related factors-self-efficacy to regulate eating behaviors in activation and temptation situations and self-efficacy to regulate eating behaviors in negative emotional situations. Moreover, self-efficacy to regulate eating behaviors was positively and statistically related to self-regulation processes toward healthy eating, declarative knowledge about healthy eating, and attitudes and perceptions toward healthy eating. The present study provides preliminary evidence that the Self-Efficacy to Regulate Eating Behaviors Scale for Children is valid and reliable for evaluating children's self-efficacy in regulating their eating behaviors.
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Affiliation(s)
- Cátia Silva
- Department of Applied Psychology, University of Minho, 4710-052 Braga, Portugal
| | - Beatriz Pereira
- Department of Applied Psychology, University of Minho, 4710-052 Braga, Portugal
| | - Gabriela Figueiredo
- Department of Applied Psychology, University of Minho, 4710-052 Braga, Portugal
| | - Pedro Rosário
- Department of Applied Psychology, University of Minho, 4710-052 Braga, Portugal
| | | | - Paula Magalhães
- Department of Applied Psychology, University of Minho, 4710-052 Braga, Portugal
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5
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Verduci E, Di Profio E, Fiore G, Zuccotti G. Integrated Approaches to Combatting Childhood Obesity. ANNALS OF NUTRITION AND METABOLISM 2022; 78 Suppl 2:8-19. [PMID: 35679843 DOI: 10.1159/000524962] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/08/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The global prevalence of childhood obesity has grown sharply in recent decades. Obesity is considered a public health problem which directly affects the health status of children in numerous ways. To combat this trend, integrated approaches are necessary to prevent childhood obesity. Strategies require a comprehensive perspective at individual and parental level alongside the adoption of measures to engage the community and environment. SUMMARY Prevention is addressed as crucial in limiting the pediatric obesity epidemic in the long term. Breastfeeding and appropriate complementary feeding are recognized as early dietary factors that affect the future risk of obesity development during the first 2 years of life. During childhood and adolescence, dietary patterns, eating habits, portion size, eating frequencies, and family meals are important dietary factors to target for preventive strategies, as well as parenting style which is influenced by parents' education. Physical activity promotion and the reduction of sedentary behavior are also recommended. The adherence of children and families to obesity prevention programs is highly dependent on socioeconomic factors. Moreover, setting food quality standards and public policies to promote healthy lifestyle habits is strongly advocated. The implementation of cost-effective preventive strategies is of high priority and requires an integrated approach by healthcare services. All stakeholders involved should take an active role in supporting and empowering children and families in order to cope with this multifactorial and complex disease.
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Affiliation(s)
- Elvira Verduci
- Department of Health Sciences, University of Milan, Milan, Italy.,Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy
| | - Elisabetta Di Profio
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy.,Department of Animal Sciences for Health, Animal Production and Food Safety, University of Milan, Milan, Italy
| | - Giulia Fiore
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy.,Department of Animal Sciences for Health, Animal Production and Food Safety, University of Milan, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy.,Department of Biomedical and Clinical Sciences "L. Sacco," University of Milan, Milan, Italy.,Pediatric Clinical Research Center Fondazione Romeo ed Enrica Invernizzi, University of Milan, Milan, Italy
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Thomas O, Sheehan M, Rayner M. Bans, Taxes or Product Placement? Applying the Liberal Perfectionist Proviso to Public Health Food Policy. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:51-53. [PMID: 34399665 DOI: 10.1080/15265161.2021.1952342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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Fattore G, Federici C, Drummond M, Mazzocchi M, Detzel P, Hutton ZV, Shankar B. Economic evaluation of nutrition interventions: Does one size fit all? Health Policy 2021; 125:1238-1246. [PMID: 34243979 DOI: 10.1016/j.healthpol.2021.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 06/14/2021] [Accepted: 06/24/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nutrition interventions have specific features that might warrant modifications to the methods used for economic evaluations of healthcare interventions. AIM The aim of the article is to identify these features and when they challenge the use of cost-utility analysis (CUA). METHODS A critical review of the literature is conducted and a 2 by 2 classification matrix for nutrition interventions is proposed based on 1) who the main party responsible for the implementation and funding of the intervention is; and 2) who the target recipient of the intervention is. The challenges of conducting economic evaluations for each group of nutrition interventions are then analysed according to four main aspects: attribution of effects, measuring and valuing outcomes, inter-sectorial costs and consequences and equity considerations. RESULTS AND CONCLUSIONS CUA is appropriate for nutrition interventions when they are funded from the healthcare sector, have no (or modest) spill-overs to other sectors of the economy and have only (or mainly) health consequences. For other interventions, typically involving different government agencies, with cost implications for the private sector, with important wellbeing consequences outside health and with heterogeneous welfare effects across socio-economic groups, other economic evaluation methods need to be developed in order to offer valid guidance to policy making. For these interventions, checklists for critical appraisal of economic evaluations may require some substantial changes.
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Affiliation(s)
- Giovanni Fattore
- CeRGAS-SDA, Università Bocconi, Milano, Italy; Department of Social and Political Sciences, Università Bocconi, Milano, Italy.
| | - Carlo Federici
- Department of Social and Political Sciences, Università Bocconi, Milano, Italy
| | - Michael Drummond
- Department of Social and Political Sciences, Università Bocconi, Milano, Italy; Centre for Health Economics, York University, United Kingdom
| | - Mario Mazzocchi
- Department of Statistical Sciences, Bologna University, Bologna, Italy
| | | | | | - Bhavani Shankar
- Institute of Sustainable Food and Department of Geography, Sheffield University, United Kingdom
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The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review. Nutr Res Rev 2020; 34:185-208. [PMID: 33148371 DOI: 10.1017/s0954422420000268] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Poor diets, including excess added sugar consumption, contribute to the global burden of disease. Subsequently, many nutrition policies have been implemented to reduce added sugar intake and improve population health, including taxes, education, labelling and environmental interventions. A potential consequence of these policy actions is the substitution of added sugars with non-nutritive sweeteners (NNS) in a variety of foods and beverages. NNS are used to reduce the energy and sugar content of foods and beverages while maintaining their palatability. Evidence of the toxicological risks of NNS is inconsistent, though concerns have been raised over the potential substitution effects of ultra-processed foods containing NNS for whole foods. This review aimed to provide an overview of current NNS food supply and consumption patterns, assess added sugar-reduction policies and their impact on NNS, and determine the impact of NNS on food choice, energy intake and diet quality. NNS are widely available in a variety of products, though most commonly in carbonated beverages, dairy products, confectionery, table-top sweeteners and fruit drinks. However, the longitudinal trends of different product categories, and differences between geographies and economy-income levels, require further study. Few studies have examined NNS consumption trends globally, though an increase in NNS consumption in beverages has been observed in some regions. Research examining how the increased availability of low-sugar, NNS-containing products affects global dietary patterns is limited, particularly in terms of their potential substitution effects.
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Vatanparast H, Islam N, Masoodi H, Shafiee M, Patil RP, Smith J, Whiting SJ. Time, location and frequency of snack consumption in different age groups of Canadians. Nutr J 2020; 19:85. [PMID: 32799862 PMCID: PMC7429728 DOI: 10.1186/s12937-020-00600-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/31/2020] [Indexed: 01/06/2023] Open
Abstract
Background The location and time of snack consumption may influence the composition, nutrient content and portion sizes of snacks. In this study, we aimed to determine and compare the time, location and frequency of snack consumption among different age groups of Canadians. Methods Nationally representative dietary data from the 2015 Canadian Community Health Survey (CCHS) were used (19,677 participants aged ≥2 years). Dietary data were obtained using 24-h dietary recalls. Participants were categorized according to the frequency of snack consumption (1 time, 2–3 times, ≥4 times). The snack consumption over 24 h was divided into four time periods: before 10 am, 10 am to 3 pm, 3 pm to 8 pm and 8 pm to 12 am. Meal and snack location was categorized as at home; someone else’s home; restaurants; and other. Results Snacking 2–3 times per day was the most common reported frequency (53.0%). Snacking at home (73.0%) was more prevalent than snacking away from home (27.0%). The most frequently reported time for snacking among Canadians was 3 pm to 8 pm (36.3%), and the least frequently reported time was before 10 am (8.1%). Snacking contributed to a high proportion of Milk and Alternatives (23.7%) and Vegetables and Fruit (23.4%) food groups and lesser proportions of Grain Products (15.4%) and Meat & Alternatives (9.4%) food groups among Canadians. Conclusions Home is the main location, 3 pm to 8 pm is the main time, and 2–3 times per day is the most common reported frequency for snacking. A full understanding of snacking behaviors is needed in order to develop targeted strategies to improve the quality of snack food choices.
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Affiliation(s)
- Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada. .,School of Public Health, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada.
| | - Naorin Islam
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada
| | | | - Mojtaba Shafiee
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada
| | - Rashmi Prakash Patil
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada
| | - Jessica Smith
- Bell Institute of Health and Nutrition, General Mills, Minneapolis, MN, 55427-3870, USA
| | - Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, S7N 4Z2, Canada
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Rauzon S, Randel-Schreiber H, Kuo E, Schwartz P, Reed AL, Thompson HR. The association between sugar-sweetened beverage availability in school vending machines and school staff sugar-sweetened beverage consumption. Prev Med Rep 2020; 19:101128. [PMID: 32518741 PMCID: PMC7272513 DOI: 10.1016/j.pmedr.2020.101128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 02/02/2023] Open
Abstract
Reducing sugar-sweetened beverage (SSB) consumption is a leading strategy to help combat high rates of adult obesity and overweight. Regulating SSB sales in schools has reduced access among youth. However, current federal school nutrition standards are focused on student rather than staff environments (i.e. school staff lounges). This study examines the association between the availability of SSBs in school vending machines and school staff SSB consumption. The study sample included 51 public schools in California, Oregon, Washington, Maryland, and Washington DC participating in an evaluation of Kaiser Permanente’s Thriving Schools initiative in school year 2017–18. Data collection included: 1) observations of school cafeterias, staff lounges, stores and outdoor snack areas for the presence of, and content in, vending machines, and 2) an online survey of school staff about their SSB consumption. Fifty-nine percent (n = 1586) of staff responded to the survey; 1229 (77% of respondents) reported on SSB consumption. Thirty percent of schools had staff lounges with SSB vending machines and 34% of staff reported drinking ≥1 SSBs/day. On average, the probability of consuming ≥1 SSBs/day was 6.6% greater in staff in schools with SSBs available in staff lounge vending machines (95% CI: 0.11%, 13.12%). Staff in schools with SSB vending machines in staff lounges were more likely to report consuming ≥1 SSBs per day compared to staff without SSB vending in staff lounges. Examining the impact of extending SSB regulations to the entire school environment on school staff SSB consumption is an important next step.
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Affiliation(s)
- Suzanne Rauzon
- University of California, Nutrition Policy Institute, Division of Agriculture and Natural Resources, 2115 Milvia Street, Third Floor, Berkeley, CA 94704, United States
- Corresponding author at: Nutrition Policy Institute, 2115 Milvia Street, Third Floor, Berkeley, CA 94704, United States.
| | - Hallie Randel-Schreiber
- University of California, Nutrition Policy Institute, Division of Agriculture and Natural Resources, 2115 Milvia Street, Third Floor, Berkeley, CA 94704, United States
| | - Elena Kuo
- Center for Community Health and Evaluation, Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave Suite 1500, Seattle, WA 98101, United States
| | - Pamela Schwartz
- Kaiser Permanente, One Kaiser Plaza, 21st Floor, Oakland, CA 94610, United States
| | - Annie L. Reed
- Kaiser Permanente, 300 Lakeside Drive, 26th Floor, Oakland, CA 94612, United States
| | - Hannah R. Thompson
- University of California, Berkeley, School of Public Health, 2115 Milvia Street, Third Floor, Berkeley, CA 94704, United States
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Griffith R, O'Connell M, Smith K, Stroud R. What's on the Menu? Policies to Reduce Young People's Sugar Consumption. FISCAL STUDIES 2020; 41:165-197. [PMID: 32612314 PMCID: PMC7319480 DOI: 10.1111/1475-5890.12194] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Young people in the UK consume far above the maximum recommended levels of added sugar. It is likely that neither they nor their parents fully take account of the future health, social and economic costs of this high sugar consumption. This provides a rationale for policy intervention. The majority of young people's added sugar consumption occurs in the home, where purchases are typically made by parents. This means that understanding the purchase decisions of adults is important for policy design, even if the policies aim to reduce the consumption of young people. We discuss the merits of popular policies, including taxes, advertising restrictions and restrictions on the availability of specific foods, and we identify promising avenues for future research.
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Affiliation(s)
| | | | - Kate Smith
- Institute for Fiscal StudiesUniversity College London
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12
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Monroy-Parada DX, Prieto-Castillo L, Ordaz-Castillo E, Bosqued MJ, Rodríguez-Artalejo F, Royo-Bordonada MÁ. [Map of school nutritional policies in Spain]. GACETA SANITARIA 2020; 35:123-129. [PMID: 31926755 DOI: 10.1016/j.gaceta.2019.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/17/2019] [Accepted: 10/19/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To systematically describe the school nutritional policies of the 17 autonomous communities of Spain. METHOD Through a search of bibliographic databases, web pages and other official information systems, 183 documents of interest were identified. Information was systematically collected with the SNIPE (school nutrition index of programme effectiveness) questionnaire, adapted to Spain, and validated by reference staff of the regional government's health and education ministries. RESULTS The main objective of the policies is to prevent obesity and improve the nutrition of schoolchildren. The 17 autonomous communities cover the school canteen service, 11 cafeteria and vending machines, and 9 the breakfast service. All communities use the Consensus Document on School Food as a reference for the content of the menu and the nutritional quality of the products offered at the school; however, only 4 of them have regulated these aspects. The evaluation of policy objectives ranges from 58.8% of the autonomous communities for food supply to 5.9% for rotation and menu quality. CONCLUSION Although all the autonomous communities have standards for the school menu, the standards for the rest of the food supply vary across them; also, evaluation of objectives is scarce and only 4 communities have approved mandatory regulations. Nutritional standards should be reviewed according to current scientific knowledge and enacted by law, in compliance with the current legislation (Act 17/2011).
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Affiliation(s)
- Doris Xiomara Monroy-Parada
- Escuela Nacional de Salud, Instituto de Salud Carlos III, Madrid, España; Servicio de Medicina Preventiva y Salud Pública, Complejo Hospitalario Universitario de Albacete, Albacete, España.
| | - Leandro Prieto-Castillo
- Servicio de Promoción de la Salud, Dirección General de Salud Pública, Consejería de Sanidad de Castilla y León, Valladolid, España
| | | | - María José Bosqued
- Escuela Nacional de Salud, Instituto de Salud Carlos III, Madrid, España
| | - Fernando Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, Madrid, España
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Royo-Bordonada MÁ, Rodríguez-Artalejo F, Bes-Rastrollo M, Fernández-Escobar C, González CA, Rivas F, Martínez-González MÁ, Quiles J, Bueno-Cavanillas A, Navarrete-Muñoz EM, Navarro C, López-García E, Romaguera D, Morales Suárez-Varela M, Vioque J. [Food policies to prevent obesity and the main non-transmissible diseases in Spain: where there's a will there's a way]. GACETA SANITARIA 2019; 33:584-592. [PMID: 31585770 DOI: 10.1016/j.gaceta.2019.05.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION In Spain, one third of all children and two-thirds of adults suffer from excess weight, a condition that generates a direct excess medical cost of 2000 million Euros. Obesogenic food environments cause obesity by promoting the consumption of sugar-sweetened beverages and ultra-processed foods. Accordingly, we propose five priority policies capable of reversing the epidemic of obesity and related non-communicable diseases through the creation of healthy food environments. THE POWER (PODER IN SPANISH) OF FOOD POLICIES Advertising (Publicidad): regulation of unhealthy food and drink advertisements carried by all media and targeted at children, and prohibition of sponsorships of congresses, conferences or sports events and endorsements by scientific associations or health professionals. Supply (Oferta): promotion of a 100% healthy supply of goods on sale in vending machines sited at educational, health and sports centres. Demand (Demanda): levying a tax of at least 20% on sugar-sweetened beverages, accompanied by subsidies or reduced taxes on healthy foods and availability of drinking water free of charge at all public venues and areas. Labelling (Etiquetado): effective application of the Nutri-Score through the use of incentives, regulation and public-tender mechanisms. Reformulation (Reformulación): revising and redrawing reformulation agreements with the industry, setting more ambitious goals and mandatory compliance. A FINAL THOUGHT These five proposed interventions, all of which have been successfully applied in other countries, will serve to raise population awareness and have a positive impact on health and the economy, through reducing the health care costs of obesity and enhancing work productivity. These measures should form part of a wide-ranging transformation of the food system, with agri-food policies that foster the sustainable production of healthy foods.
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Affiliation(s)
| | - Fernando Rodríguez-Artalejo
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Maira Bes-Rastrollo
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España
| | | | - Carlos A González
- Unidad de Nutrición y Cáncer, Instituto Catalán de Oncología, Barcelona, España
| | - Francisco Rivas
- Unidad Municipal de Salud y Consumo, Ayuntamiento de Guadix, Guadix (Granada), España; Grupo de Investigación Aula Internacional de Biomedicina, Ética y Derechos Humanos (GI111), Universidad Nacional de Educación a Distancia, Madrid, España
| | - Miguel Ángel Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, España; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Department of Nutrition, Harvard TH Chan School of Public Health, Boston (Massachusetts), USA
| | - Joan Quiles
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Dirección General de Salud Pública, Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, España
| | - Aurora Bueno-Cavanillas
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, España; Instituto de Investigación Biosanitaria de Granada (ibs Granada), Granada, España
| | - Eva M Navarrete-Muñoz
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, ISABIAL-FISABIO, Alicante, España
| | - Carmen Navarro
- Departamento de Ciencias Sociosaniarias, Universidad de Murcia, Murcia, España; Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, España
| | - Esther López-García
- Universidad Autónoma de Madrid / Idipaz e IMDEA-Alimentación, Madrid, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Dora Romaguera
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), España; Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, España
| | - María Morales Suárez-Varela
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Medicina Preventiva y Salud Pública, Ciencias de la Alimentación, Toxicología y Medicina Legal, Facultad de Farmacia, Universitat de Valencia, Valencia, España
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Unidad de Epidemiología de la Nutrición, Universidad Miguel Hernández, ISABIAL-FISABIO, Alicante, España
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14
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Massri C, Sutherland S, Källestål C, Peña S. Impact of the Food-Labeling and Advertising Law Banning Competitive Food and Beverages in Chilean Public Schools, 2014-2016. Am J Public Health 2019; 109:1249-1254. [PMID: 31318604 DOI: 10.2105/ajph.2019.305159] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objectives. To evaluate the impact of a national law banning sales of competitive food and beverages (CF&B) in schools on the availability of CF&B sold at school kiosks.Methods. This study was uncontrolled before and after study. We evaluated public schools in Santiago de Chile (n = 21; 78% response rate) in 2014 and 2016 (6 months after the law came into force). Trained personnel collected data on calories, total sugars, saturated fat, and sodium from food labels. The outcome was the percentage of foods exceeding the cutoff levels defined in the law and the mean difference between 2014 and 2016.Results. Foods exceeding any cutoffs decreased from 90.4% in 2014 to 15.0% in 2016. Solid products had a substantial reduction in calories, sugar, saturated fat, and sodium. Liquid products had a reduction in calories, total sugar, and saturated fat, whereas sodium increased. This was a result of changes in product mix.Conclusions. A ban on sales of CF&B reduced the availability of CF&B at Santiago's school kiosks. Further research should examine the impact of this ban on food intake and health outcomes.
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Affiliation(s)
- Camila Massri
- Camila Massri and Carina Källestål are with the Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. Sofía Sutherland is with the Faculty of Medicine, Universidad de los Andes, Santiago, Chile. Sofía Sutherland and Sebastián Peña are with the Santiago Sano Program, Municipality of Santiago, Santiago. Sebastián Peña is also with the Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Sofía Sutherland
- Camila Massri and Carina Källestål are with the Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. Sofía Sutherland is with the Faculty of Medicine, Universidad de los Andes, Santiago, Chile. Sofía Sutherland and Sebastián Peña are with the Santiago Sano Program, Municipality of Santiago, Santiago. Sebastián Peña is also with the Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Carina Källestål
- Camila Massri and Carina Källestål are with the Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. Sofía Sutherland is with the Faculty of Medicine, Universidad de los Andes, Santiago, Chile. Sofía Sutherland and Sebastián Peña are with the Santiago Sano Program, Municipality of Santiago, Santiago. Sebastián Peña is also with the Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Sebastián Peña
- Camila Massri and Carina Källestål are with the Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. Sofía Sutherland is with the Faculty of Medicine, Universidad de los Andes, Santiago, Chile. Sofía Sutherland and Sebastián Peña are with the Santiago Sano Program, Municipality of Santiago, Santiago. Sebastián Peña is also with the Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
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15
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Shim JS, Kang NH, Lee JS, Kim KN, Chung HK, Chung HR, Kim HJ, Ahn YS, Chang MJ. Socioeconomic burden of sugar-sweetened beverages consumption in Korea. Nutr Res Pract 2019; 13:134-140. [PMID: 30984357 PMCID: PMC6449544 DOI: 10.4162/nrp.2019.13.2.134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/15/2018] [Accepted: 10/24/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND/OBJECTIVES Excessive sugar consumption may increase the risk for development of several diseases. Although average dietary sugar intake of Koreans is within the recommended level, an increasing trend has been found in all age groups. This study aimed to evaluate the population attributable fractions (PAF) to dietary sugar for disease and death in Korea, and to estimate the socioeconomic effects of a reduction in dietary sugar. MATERIALS/METHODS The prevalence of sugar-sweetened beverages (SSB) overconsumption (≥ 20 g of sugar from beverages) was analyzed using the Korean National Health and Nutrition Examination Survey 2015. Disease-specific relative risks of excessive SSB consumption were obtained through reviewing previous studies. Using the prevalence of SSB overconsumption and each relative risk, PAFs for morbidity and mortality were calculated. Socioeconomic costs of diseases and death attributable to SSB overconsumption were estimated by using representative data on national medical expenditures, health insurance statistics, employment information, and previous reports. RESULTS Disease-specific PAF to SSB consumption ranged from 3.11% for stroke to 9.05% for obesity and dental caries, respectively. Costs from disease caused by SSB overconsumption was estimated at 594 billion won in 2015. About 39 billion won was estimated to be from SSB consumption-related deaths, and a total of 633 billion won was predicted to have been saved through preventing SSB overconsumption. CONCLUSIONS Sugars overconsumption causes considerable public burdens, although the cost estimates do not include any informal expenditure. Information on these socioeconomic effects helps both health professionals and policy makers to create and to implement programs for reducing sugar consumption.
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Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Nam Hoon Kang
- Department of Economics, Hanshin University, Osan 18101, Korea
| | - Jung Sug Lee
- Department of Food and Nutrition, Kookmin University, 77 Jeongeung-ro, Seongbuk-gu, Seoul 02707, Korea
| | - Ki Nam Kim
- Department of Food and Nutrition, Daejeon University, Daejeon 34520, Korea
| | - Hae Kyung Chung
- Department of Food and Nutrition, Hoseo University, Asan 31499, Korea
| | | | - Hung-Ju Kim
- Department of Social Welfare, Wonkang University, Iksan 54538, Korea
| | - Yoon-Sook Ahn
- Research Center of Social Economic, Wonkang University, Iksan 54538, Korea
| | - Moon-Jeong Chang
- Department of Food and Nutrition, Kookmin University, 77 Jeongeung-ro, Seongbuk-gu, Seoul 02707, Korea
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