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Khan A, Evangelista AU, Varua ME. Evaluating the impact of marketing interventions on sugar-free and sugar-sweetened soft drink sales and sugar purchases in a fast-food restaurant setting. BMC Public Health 2023; 23:1578. [PMID: 37596602 PMCID: PMC10439673 DOI: 10.1186/s12889-023-16395-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 07/26/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Beverages high in added sugar, such as sugar-sweetened soft drinks, continue to be associated with various health issues. This study examines the effects of a manufacturer-initiated multicomponent intervention on the sales of sugar-free (SFD) and sugar-sweetened (SSD) soft drinks and the amount of sugar people purchase from soft drinks in a fast-food restaurant setting. METHODS A database of monthly sales data of soft drinks from January 2016 to December 2018 was obtained from three treatment and three control fast-food restaurants. A multicomponent intervention consisting of free coupons, point-of-purchase displays, a menu board, and two sugar-free replacements for sugar-sweetened soft drinks was introduced in August 2018 for five months in Western Sydney, Australia. A retrospective interrupted time series analysis was used to model the data and examine the effects of the interventions on SFD and SSD sales and their consequential impact on sugar purchases from soft drinks. The analyses were carried out for volume sales in litres and sugar in grams per millilitre of soft drinks sales. A comparison of these measures within the treatment site (pre- and post-intervention) and between sites (treatment and control) was conducted. RESULTS The interventions had a statistically significant impact on SFDs but not SSDs. On average, SFD sales in the treatment site were 56.75% higher than in the control site. Although SSD sales were lower in the treatment site, the difference with the control site was not statistically significant. The net reduction of 6.34% in the amount of sugar purchased from soft drinks between sites during the experimental period was attributed to the interventions. CONCLUSIONS The interventions significantly increased SFD sales and reduced sugar purchases in the short run. Aside from free coupons, the findings support the recommendation for fast food restaurants to nudge customers towards choosing SFDs through point-of-purchase displays and the replacement of popular SSDs with their SFD counterparts.
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Affiliation(s)
- Aila Khan
- School of Business, Hospitality, Marketing and Sport, Western Sydney University, Sydney, Australia
| | - Anna Uro Evangelista
- School of Business, Economics, Finance and Property, Western Sydney University, Sydney, Australia.
| | - Maria Estela Varua
- School of Business, Economics, Finance and Property, Western Sydney University, Sydney, Australia
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Sugar-sweetened beverage purchases and intake at event arenas with and without a portion size cap. Prev Med Rep 2022; 25:101661. [PMID: 35127348 PMCID: PMC8800009 DOI: 10.1016/j.pmedr.2021.101661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 12/03/2022] Open
Abstract
This real-world study examined sugar-sweetened beverage (SSB) and food purchases and consumption during basketball games at sporting arenas with and without a voluntary 16-ounce portion size cap. A portion-size cap at an event arena was associated with customers’ purchasing and consuming fewer SSB oz. This study provides some of the first real-world evidence that an SSB portion-size cap policy may decrease SSB ounces purchased and consumed.
This is the first real-world study to examine the association between a voluntary 16-ounce (oz) portion-size cap on sugar-sweetened beverages (SSB) at a sporting arena on volume of SSBs and food calories purchased and consumed during basketball games. Cross-sectional survey data from adults exiting a Brooklyn, NY, USA arena (Barclays, n = 464) with a 16-oz portion-size restriction and a Manhattan, NY, USA arena with no portion-size restriction (Madison Square Garden, control, n = 295) after the portion cap policy was put in place from March through June 2014 were analyzed. Linear regression models adjusting for sex, age, BMI, ethnicity, race, marital status, education, and income were used to compare the two arenas during the post-implementation period. The survey response rate was 45.9% and equivalent between venues. Among all arena goers, participants at Barclays purchased significantly fewer SSB oz (−2.24 oz, 95% CI [−3.95, −0.53], p = .010) and consumed significantly fewer SSB oz (−2.34 oz, 95% CI[−4.01, −0.68], p = .006) compared with MSG after adjusting for covariates. Among those buying at least one SSB, Barclays’ participants purchased on average 11.03 fewer SSB oz. (95% CI = [4.86, 17.21], p < .001) and consumed 12.10 fewer SSB oz (95% CI = [5.78, 18.42], p < .001). There were no statistically significant differences between arenas in food calories and event satisfaction. In addition, no one reported not ordering a drink due to small size. An SSB portion-size cap was associated with purchasing and consuming fewer SSB oz. without evidence of decreasing satisfaction with the event experience.
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Consumption of Sugar-Sweetened Beverages, Juice, Artificially-Sweetened Soda and Bottled Water: An Australian Population Study. Nutrients 2020; 12:nu12030817. [PMID: 32204487 PMCID: PMC7146120 DOI: 10.3390/nu12030817] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/06/2020] [Accepted: 03/12/2020] [Indexed: 01/27/2023] Open
Abstract
Reducing consumption of free sugars, such as those found in high concentrations in manufactured products such as sugar-sweetened beverages (SSBs) and 100% fruit juices, is a global public health priority. This study aimed to measure prevalence of widely available pre-packaged non-alcoholic water-based beverages (carbonated sodas, sports drinks, energy drinks, artificially-sweetened sodas, fruit juices (any type), and bottled water) and to comprehensively examine behavioral, environmental, current health, and demographic correlates of consumption. A cross-sectional, nationally-representative population survey of 3430 Australian adults (18+ years) was conducted using computer-assisted telephone (mobile and landline) interviewing. Past week prevalence of pre-packaged drinks containing free sugar was 47.3%; daily prevalence was 13.6%. Of all the pre-packaged drinks assessed, consumption of fruit juices (any type) was the most prevalent (38.8%), followed by bottled water (37.4%), soda (28.9%), artificially-sweetened soda (18.1%), sports drinks (8.1%), and energy drinks (4.2%). Higher soda consumption was associated with males, younger age, socio-economic disadvantage, frequent takeaway food consumption, availability of soda in the home, obesity, and a diagnosis of heart disease or depression. A diagnosis of Type 2 Diabetes was associated with increased likelihood of consuming artificially-sweetened sodas and decreased likelihood of consuming sugar-sweetened soda. SSB consumption is prevalent in Australia, especially among young adults and males, foreshadowing continued population weight gain and high burdens of chronic disease. To reduce consumption, Australia must take a comprehensive approach, incorporating policy reform, effective community education, and active promotion of water.
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Prasad D, Mezzacca TA, Anekwe AV, Lent M, Farley SM, Kessler K, Angell SY. Sodium, calorie, and sugary drink purchasing patterns in chain restaurants: Findings from NYC. Prev Med Rep 2020; 17:101040. [PMID: 32055437 PMCID: PMC7005460 DOI: 10.1016/j.pmedr.2019.101040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/27/2019] [Accepted: 12/27/2019] [Indexed: 11/18/2022] Open
Abstract
At chain restaurants, purchases are often exceptionally high in calories and sodium. At quick-service chains, most sugary drink purchases had at least 50 g of sugar. Most participants at full-service chains purchased more than the daily sodium limit. Fostering a healthier restaurant environment would promote healthier purchases.
To understand how consumer purchases in chain restaurants relate to nutrients of public health concern, sodium, calories and sugary drinks purchased for personal consumption were assessed through a customer intercept receipt study at a sample of New York City quick- and full-service chain restaurants (QSR and FSR) in 2015. The percentages of respondents purchasing ≥2,300 mg sodium, ≥2,000 calories, and a sugary drink, respectively, were 14%, 3% and 32% at QSR, and 56%, 23%, and 22% at FSR. Sodium content of purchases averaged 1,260 mg at QSR and 2,897 mg at FSR and calories averaged 770 at QSR and 1,456 at FSR. 71% of QSR sugary drink purchases contained at least 200 calories. Purchasing patterns that are exceptionally high in sodium and calories, and that include sugary drinks, are common in chain restaurants. Because restaurant-sourced foods are a cornerstone of the American diet, fostering conditions that support healthful purchases is essential to reduce preventable disease and advance health.
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Affiliation(s)
- Divya Prasad
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention, 42-09 28 Street, Long Island City, NY 11101, United States
- Corresponding author.
| | - Tamar Adjoian Mezzacca
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention, 42-09 28 Street, Long Island City, NY 11101, United States
| | - Amaka V. Anekwe
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention, 42-09 28 Street, Long Island City, NY 11101, United States
| | - Megan Lent
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention, 42-09 28 Street, Long Island City, NY 11101, United States
| | - Shannon M. Farley
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention, 42-09 28 Street, Long Island City, NY 11101, United States
| | - Kimberly Kessler
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention, 42-09 28 Street, Long Island City, NY 11101, United States
| | - Sonia Y. Angell
- New York City Department of Health and Mental Hygiene, Division of Prevention and Primary Care, 42-09 28 Street, Long Island City, NY 11101, United States
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Khandelwal P, Salazar LR. Exploring the Social Determinants of Drinking Sugary Beverages Leading to Chronic Illness Among Latina/o Populations. HISPANIC HEALTH CARE INTERNATIONAL 2019; 18:64-70. [PMID: 31722566 DOI: 10.1177/1540415319882776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The aim of this qualitative study was to assess Latina/o students' sugary drink consumption patterns and understand the social determinants leading to this consumption behavior in order to design more effective health communication-based campaigns. This study examined the perceived reasons behind high levels of sugar-sweetened beverages (SSBs) consumption among college students of Hispanic origin in the Texas Panhandle region. METHOD Fifteen Latina/o students were interviewed via an innovative social media-based online interviewing protocol. RESULTS Subsequent analyses revealed that peer pressure, socializing, unavailability of packaged drinking water during social events, targeted advertisements, and poor lifestyle choices were perceived reasons for high intake of SSB in the focal population. CONCLUSION This study recommends designing public service announcements geared to Latino/a youth that increase awareness about the long-term health risks that can result from high consumption of SSBs. Moreover, the positive health benefits of drinking water should be highlighted and Latina/o parents should avoid glorifying SSBs and restrict their SSB consumption in front of their children. Further research should aim at designing educational messages, using theoretical backing, to test how Latina/o youth respond to them.
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Moran AJ, Subramanian SV, Rimm EB, Bleich SN. Characteristics Associated with Household Purchases of Sugar-Sweetened Beverages in US Restaurants. Obesity (Silver Spring) 2019; 27:339-348. [PMID: 30609301 PMCID: PMC6345589 DOI: 10.1002/oby.22380] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/26/2018] [Accepted: 11/01/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to describe beverages purchased in restaurants among a nationally representative sample of US households. METHODS Data were obtained from the US Department of Agriculture National Household Food Acquisition and Purchase Survey, 2012 to 2013. Survey-weighted multiple regressions assessed correlates of purchasing a sugar-sweetened beverage (SSB), purchasing a low-calorie beverage, and per capita beverage calories and grams of sugar among purchases from US restaurants (n = 14,669). RESULTS Dining at a top fast-food chain (odds ratio = 1.9 [95% CI = 1.6, 2.3] vs. small chain or independent restaurants) and ordering a combination meal (2.8 [1.3, 3.3]) or from the kids' menu (2.1 [1.2, 3.4]) were positively associated with purchasing an SSB. Age (young adult and adolescent vs. older adult; 0.7 [0.5, 0.9] and 0.4 [0.3, 0.7], respectively), race (Black vs. White; 0.4 [0.3, 0.6]), ethnicity (Hispanic vs. non-Hispanic; 0.8 [0.6, 0.9]), and household food security (very low vs. high; 0.7 [0.5, 0.8]) were associated with purchasing a low-calorie beverage. Caloric beverage purchases contained the most calories and grams of sugar per capita when purchased by Hispanic and non-Hispanic Black adolescents. CONCLUSIONS US households purchase a considerable amount of SSBs from the nation's largest chain restaurants, particularly when combination meals or kids' menu items are ordered, and there are disparities by age, race/ethnicity, and household food security.
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Affiliation(s)
- Alyssa J Moran
- Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - S V Subramanian
- Department of Social & Behavioral Sciences, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Eric B Rimm
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Sara N Bleich
- Department of Health Policy & Management, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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Miller C, Wakefield M, Braunack-Mayer A, Roder D, O’Dea K, Ettridge K, Dono J. Who drinks sugar sweetened beverages and juice? An Australian population study of behaviour, awareness and attitudes. BMC OBESITY 2019; 6:1. [PMID: 30619612 PMCID: PMC6317260 DOI: 10.1186/s40608-018-0224-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 12/18/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The rate of overweight and obesity in Australia is among the highest in the world. Yet Australia lags other countries in developing comprehensive educative or regulatory responses to address sugary drink consumption, a key modifiable risk factor that contributes substantial excess sugar to the diet. Measurement of sugary drink consumption is typically sporadic and nutrition focussed and there is limited knowledge of community perceptions and awareness of the health risks associated with excess sugary drink consumption. The aim of this study was to assess the demographic characteristics, behavioural risk factors and attitudes and knowledge associated with sugar-sweetened beverage (SSB) and 100% fruit juice consumption. METHODS A face-to-face household survey was conducted in 2014 using a stratified random sampling strategy to represent the South Australian population aged 15 years and over. The survey contained questions on sugary drinks, with past week SSB consumption and 100% fruit juice consumption used as outcome variables. Associations were examined with demographic characteristics, behavioural risk factors, and sugary drink attitudes and knowledge. RESULTS Of the 2732 respondents, 35% had consumed SSBs 1-6 times (moderate consumers) and 16% had consumed SSBs 7 or more times (frequent consumers) in the past week. Furthermore, 35% had consumed 100% fruit juice in the past week, with 10% consuming every day. Rates of SSB consumption were consistently higher among males, younger age groups, and groups with lower education attainment, as well as smokers and frequent consumers of fast food. Awareness of health risks and sugar content of SSBs was low, especially among frequent SSB consumers. Fruit juice consumption was higher among males, younger age groups, the physically active and among those believing that 100% fruit juice did not contain more sugar than SSBs. CONCLUSIONS Consumption of SSBs and 100% fruit juice is common but awareness of health risks and sugar content of these drinks is low. There is a need for greater consumer understanding which could be achieved through educative approaches such as public education campaigns, on-package warning labels and improved nutrition information panels.
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Affiliation(s)
- Caroline Miller
- School of Public Health, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute (SAHMRI), Population Health Research Group, North Terrace, Adelaide, South Australia Australia
| | - Melanie Wakefield
- Cancer Council Victoria, Centre for Behavioural Research in Cancer, Melbourne, Australia
| | - Annette Braunack-Mayer
- School of Public Health, University of Adelaide, Adelaide, Australia
- School of Health & Society, University of Wollongong, Wollongong, New South Wales Australia
| | - David Roder
- Centre for Population Health Research, University of South Australia, Adelaide, Australia
| | - Kerin O’Dea
- Centre for Population Health Research, University of South Australia, Adelaide, Australia
| | - Kerry Ettridge
- South Australian Health and Medical Research Institute (SAHMRI), Population Health Research Group, North Terrace, Adelaide, South Australia Australia
| | - Joanne Dono
- South Australian Health and Medical Research Institute (SAHMRI), Population Health Research Group, North Terrace, Adelaide, South Australia Australia
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Tseng E, Zhang A, Shogbesan O, Gudzune KA, Wilson RF, Kharrazi H, Cheskin LJ, Bass EB, Bennett WL. Effectiveness of Policies and Programs to Combat Adult Obesity: a Systematic Review. J Gen Intern Med 2018; 33:1990-2001. [PMID: 30206789 PMCID: PMC6206360 DOI: 10.1007/s11606-018-4619-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/30/2018] [Accepted: 07/31/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND This systematic review identifies programs, policies, and built-environment changes targeting prevention and control of adult obesity and evaluates their effectiveness. METHODS We searched PubMed, CINAHL, PsycINFO, and EconLit from January 2000 to March 2018. We included natural experiment studies evaluating a program, policy, or built-environment change targeting adult obesity and reporting weight/body mass index (BMI). Studies were categorized by primary intervention target: physical activity/built environment, food/beverage, messaging, or multiple. Two reviewers independently assessed the risk of bias for each study using the Effective Public Health Practice Project tool. RESULTS Of 158 natural experiments targeting obesity, 17 reported adult weight/BMI outcomes. Four of 9 studies reporting on physical activity/built environment demonstrated reduced weight/BMI, although effect sizes were small with low strength of evidence and high risk of bias. None of the 5 studies targeting the food/beverage environment decreased weight/BMI; strength of evidence was low, and 2 studies were rated high risk of bias. DISCUSSION We identified few natural experiments reporting on the effectiveness of programs, policies, and built-environment changes on adult obesity. Overall, we found no evidence that policies intending to promote physical activity and healthy eating had beneficial effects on weight/BMI and most studies had a high risk of bias. Limitations include few studies met our inclusion criteria; excluded studies in children and those not reporting on weight/BMI outcomes; weight/BMI reporting was very heterogeneous. More high-quality research, including natural experiments studies, is critical for informing the population-level effectiveness of obesity prevention and control initiatives in adults.
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Affiliation(s)
- Eva Tseng
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. .,Welch Center for Prevention, Epidemiology, & Clinical Research, The Johns Hopkins University, Baltimore, MD, USA.
| | - Allen Zhang
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Johns Hopkins University Evidence-based Practice Center, Johns Hopkins Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA
| | | | - Kimberly A Gudzune
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, & Clinical Research, The Johns Hopkins University, Baltimore, MD, USA
| | - Renee F Wilson
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Johns Hopkins University Evidence-based Practice Center, Johns Hopkins Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA
| | - Hadi Kharrazi
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lawrence J Cheskin
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eric B Bass
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Johns Hopkins University Evidence-based Practice Center, Johns Hopkins Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA
| | - Wendy L Bennett
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, & Clinical Research, The Johns Hopkins University, Baltimore, MD, USA
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Vega-López S, Lindberg NM, Eckert GJ, Nicholson EL, Maupomé G. Association of added sugar intake and caries-related experiences among individuals of Mexican origin. Community Dent Oral Epidemiol 2018; 46:376-384. [PMID: 29659041 PMCID: PMC10389538 DOI: 10.1111/cdoe.12378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/08/2018] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Determine the association between key dental outcomes and added sugar intake using a survey instrument to assess added sugars, which was specifically tailored to immigrant and US-born adults of Mexican origin. METHODS Hispanic adults of Mexican origin (n = 326; 36.2 ± 12.1 years) completed a self-administered survey to gather acculturation, self-reported dental experiences and self-care practices (eg brushing, flossing, pain, bleeding gums), and socio-demographic information. The survey included a culturally tailored 22-item Added Sugar Intake Estimate (ASIE) that assessed added sugar intake from processed foods and sugar-sweetened beverages in a semiquantitative food frequency questionnaire format. Linear regression, 2-sample t test, and ANOVA were used to evaluate associations of demographic and dental outcomes with daily added sugar intake. RESULTS Of the mean total daily added sugar intake (99.6 ± 94.6 g), 36.5 ± 44.4 g was derived from sugar-containing foods and snacks, and 63.1 ± 68.2 g from beverages. Participants who reported greater added sugar intake were more likely to have reported the presence of a toothache in the preceding 12 months, having been prescribed antibiotics for dental reasons, being less likely to floss daily, have reported eating or drinking within 1 hour before bed and have lower psychological acculturation (P < .05 for all). Results were comparable when assessing intake from sugar-containing foods/snacks and sugar-sweetened beverages. CONCLUSIONS This study confirmed the association between added sugar intake and self-reported dental outcomes among adults of Mexican origin and points to an urgent need to improve dietary behaviours in this population.
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Affiliation(s)
- S. Vega-López
- College of Health Solutions and Southwest Interdisciplinary Research Center; Arizona State University; Phoenix AZ USA
| | - N. M. Lindberg
- Kaiser Permanente Center for Health Research; Portland OR USA
| | - G. J. Eckert
- School of Medicine; Indiana University/Purdue University in Indianapolis; Indianapolis IN USA
| | - E. L. Nicholson
- Richard M. Fairbanks School of Public Health; Indiana University/Purdue University in Indianapolis; Indianapolis IN USA
| | - G. Maupomé
- Richard M. Fairbanks School of Public Health; Indiana University/Purdue University in Indianapolis; Indianapolis IN USA
- Indiana University Network Science Institute; Bloomington IN USA
- School of Dentistry; Indiana University/Purdue University in Indianapolis; Indianapolis IN USA
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Lenk KM, Caspi CE, Harnack L, Laska MN. Customer Characteristics and Shopping Patterns Associated with Healthy and Unhealthy Purchases at Small and Non-traditional Food Stores. J Community Health 2018; 43:70-78. [PMID: 28616707 PMCID: PMC5730500 DOI: 10.1007/s10900-017-0389-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Small and non-traditional food stores (e.g., corner stores) are often the most accessible source of food for residents of lower income urban neighborhoods in the U.S. Although healthy options are often limited at these stores, little is known about customers who purchase healthy, versus less healthy, foods/beverages in these venues. We conducted 661 customer intercept interviews at 105 stores (corner stores, gas marts, pharmacies, dollar stores) in Minneapolis/St. Paul, Minnesota, assessing all food and beverage items purchased. We defined three categories of "healthy" and four categories of "unhealthy" purchases. Interviews assessed customer characteristics [e.g., demographics, body-mass index (BMI)]. We examined associations between healthy versus unhealthy purchases categories and customer characteristics. Overall, 11% of customers purchased ≥1 serving of healthy foods/beverages in one or more of the three categories: 8% purchased fruits/vegetables, 2% whole grains, and 1% non-/low-fat dairy. Seventy-one percent of customers purchased ≥1 serving of unhealthy foods/beverages in one or more of four categories: 46% purchased sugar-sweetened beverages, 17% savory snacks, 15% candy, and 13% sweet baked goods. Male (vs. female) customers, those with a lower education levels, and those who reported shopping at the store for convenience (vs. other reasons) were less likely to purchase fruits/vegetables. Unhealthy purchases were more common among customers with a BMI ≥30 kg/m2 (vs. lower BMI). Results suggest intervention opportunities to increase healthy purchases at small and non-traditional food stores, particularly interventions aimed at male residents, those with lower education levels and residents living close to the store.
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Affiliation(s)
- Kathleen M Lenk
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. Second St. Suite 300, Minneapolis, MN, 55454, USA.
| | - Caitlin E Caspi
- Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Lisa Harnack
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. Second St. Suite 300, Minneapolis, MN, 55454, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. Second St. Suite 300, Minneapolis, MN, 55454, USA
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