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Jokirinta J, Päkkilä J, Mourelatos E, Sipola S, Laitala ML, Karki S. Trend in basic oral treatment needs in relation to taxation of sweets, ice cream, and sugar-sweetened beverages in Finland: a registry-based study. Acta Odontol Scand 2024; 83:160-165. [PMID: 38628100 DOI: 10.2340/aos.v83.40335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/14/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE The aims were to explore the trend in basic oral treatment needs and total operating cost of public dental services (PDS) in relation to total excise tax revenue generated from sugary products during 2011-2020 and to evaluate the impact of tax policy in excise tax revenue of sugary products and average sugar consumption. METHODS The study comprised longitudinal data retrieved from Finnish registries during the years 2011-2020. Basic oral treatment needs, and total operating cost of PDS, total excise tax revenue generated from sugary products and average sugar consumed (kg per capita) during the years 2011-2020 were obtained. Simplified panel analyses and sensitivity analyses were used to evaluate the effects of explanatory variables on outcomes. Results: An approximate one EUR 1,000,000 increase in total excise tax revenue generated from sugary products corresponds to a 0.4% increase in total operating cost of PDS. There was a significant positive trend in total operating cost of PDS in Finland over the study period. Similarly, an approximate one EUR 1,000,000 rise in total excise tax revenue corresponds to a 0.2% increase in basic oral treatment needs. Additionally, there was a statistically significant difference in the average excise tax revenue for sugary products between the periods before and after 2017. CONCLUSION No change in average sugar consumption was observed despite implementing the new sugar policy. Therefore, it may be worthwhile to reconsider the excise tax on sweets and ice cream as it will significantly increase the total national revenues.
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Affiliation(s)
- Jesse Jokirinta
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Jari Päkkilä
- Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland
| | | | - Sakari Sipola
- Oulu Business School, University of Oulu, Oulu, Finland
| | - Marja-Liisa Laitala
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Medical Research Center Oulu and Oulu University Hospital, Oulu, Finland.
| | - Saujanya Karki
- Research Unit of Population Health, University of Oulu, Oulu, Finland
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Ghazaryan A, Park S, Onufrak SJ, Carlson AC, Rhone A, Roy K. Characteristics Associated With Purchasing Sugar-Sweetened Beverages and Bottled Water Among US Households, 2015. J Acad Nutr Diet 2024; 124:28-41. [PMID: 37648023 PMCID: PMC10840658 DOI: 10.1016/j.jand.2023.08.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 07/18/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Frequent intake of sugar-sweetened beverages (SSBs) among US adults is a public health concern because it has been associated with increased risks for adverse health outcomes such as obesity, type 2 diabetes, and cardiovascular disease. In contrast, drinking plain water (such as tap, bottled, or unsweetened sparkling water) instead of drinking SSBs might provide health benefits by improving diet quality and helping prevent chronic diseases. However, there is limited information on estimated expenditures on SSBs or bottled water among US households. OBJECTIVE This study examined differences in SSB and bottled water purchasing according to household and geographic area characteristics and estimated costs spent on purchasing SSB and bottled water from retail stores among a nationally representative sample of US households. DESIGN This study is a secondary analysis of the 2015 Circana (formerly Information Resources Inc) Consumer Network Panel data, which were merged with the US Department of Agriculture nutrition data using the US Department of Agriculture Purchase-to-Plate Crosswalk-2015 dataset (the latest available version of the Purchase-to-Plate Crosswalk at the time the study began), and the Child Opportunity Index 2.0 data. PARTICIPANTS/SETTINGS A total of 63,610 households, representative of the contiguous US population, consistently provided food and beverage purchase scanner data from retail stores throughout 2015. EXPLANATORY VARIABLES The included demographic and socioeconomic variables were household head's age, marital status, highest education level, race and ethnicity of the primary shopper in the household, family income relative to the federal poverty level, and presence of children in the household. In addition, descriptors of households' residential areas were included, such as the county-level poverty prevalence, urbanization, census region, and census tract level Child Opportunity Index. MAIN OUTCOME MEASURES Annual per capita spending on SSB and bottled water and daily per capita SSB calories purchased. STATISTICAL ANALYSIS Unadjusted and multivariable adjusted mean values of the main outcome measures were compared by household demographic, socioeconomic, and geographic characteristics using linear regression analysis including Circana's household projection factors. RESULTS Nearly all households reported purchasing SSBs at least once during 2015 and spent on average $47 (interquartile range = $20) per person per year on SSBs, which corresponded to 211 kcal (interquartile range = 125 kcal) of SSBs per person per day. About seven in 10 households reported purchasing bottled water at least once during 2015 and spent $11 (interquartile range = $5) per person on bottled water per year. Both annual per capita SSB and bottled water spending, and daily per capita SSB calories purchased was highest for households whose heads were between 40 and 59 years of age, had low household income, or lived in poor counties, or counties with a low Child Opportunity Index. Annual per capita spending was also higher for households with never married/widowed/divorced head, or at least 1 non-Hispanic Black head, and households without children, or those living in the South. Daily per capita SSB calorie purchases were highest for households where at least 1 head had less than a high school degree, households with at least 1 Hispanic or married head, and households with children or those living in the Midwest. CONCLUSIONS These findings suggest that households that had lower socioeconomic status had higher annual per capita spending on SSBs and bottled water and higher daily per capita total SSB calories purchased than households with higher socioeconomic status.
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Affiliation(s)
- Armen Ghazaryan
- Office of the Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Sohyun Park
- Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephen J Onufrak
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrea C Carlson
- Food Economics Division, Economic Research Service, US Department of Agriculture, Washington, DC
| | - Alana Rhone
- Food Economics Division, Economic Research Service, US Department of Agriculture, Washington, DC
| | - Kakoli Roy
- Office of the Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Nguyen TM, Tonmukayakul U, Khanh‐Dao Le L, Singh A, Lal A, Ananthapavan J, Calache H, Mihalopoulos C. Modeled health economic and equity impact on dental caries and health outcomes from a 20% sugar sweetened beverages tax in Australia. HEALTH ECONOMICS 2023; 32:2568-2582. [PMID: 37477540 PMCID: PMC10946924 DOI: 10.1002/hec.4739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 07/22/2023]
Abstract
Dental caries is the most prevalent oral disease across the life course. This study modeled the population health and economic impact of a 20% sugar sweetened beverages tax (SSB) for preventing dental caries compared to no intervention (societal and healthcare perspective). A cost-effectiveness analysis according to quintiles of area-level socioeconomic disadvantage was performed for the 2020 Australian population (0-100 years old) using a closed cohort Markov model. A qualitative assessment of implementation considerations (e.g., acceptability, equity, sustainability) was undertaken. Health outcomes were modeled as decayed teeth prevented and disability-adjusted life years (DALYs) averted. The 10-year and lifetime scenarios were modeled with probabilistic sensitivity analysis (Monte Carlo simulation, 2000 cycles). The 10-year scenario from a societal perspective yielded cost-savings of AUD$63.5M, healthcare cost-savings of AUD$42.2M, 510,977 decayed teeth averted and 98.1 DALYs averted. The lifetime scenario resulted in societal cost savings of AUD$176.6M, healthcare cost-savings of AUD$122.5M, 1,309,211 decayed teeth averted and 254.9 DALYs averted. Modeling indicated 71.5% and 74.5% cost-effectiveness for the 10-year and lifetime scenarios, respectively. A three-fold health benefit for the least advantaged was found compared to the most advantaged. A 20% SSB tax in Australia is cost-effective and promotes health equity.
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Affiliation(s)
- Tan Minh Nguyen
- Public Health & Preventive MedicineFaculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneVictoriaAustralia
| | - Utsana Tonmukayakul
- Deakin Health EconomicsInstitute for Health TransformationDeakin UniversityBurwoodVictoriaAustralia
| | - Long Khanh‐Dao Le
- Public Health & Preventive MedicineFaculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneVictoriaAustralia
| | - Ankur Singh
- Melbourne School of Population and Global Health & Melbourne Dental SchoolFaculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleVictoriaAustralia
| | - Anita Lal
- Deakin Health EconomicsInstitute for Health TransformationDeakin UniversityBurwoodVictoriaAustralia
| | - Jaithri Ananthapavan
- Deakin Health Economics and Global Centre for Preventive Health and NutritionInstitute for Health TransformationDeakin UniversityBurwoodVictoriaAustralia
| | - Hanny Calache
- Deakin Health EconomicsInstitute for Health TransformationDeakin UniversityBurwoodVictoriaAustralia
| | - Cathrine Mihalopoulos
- Public Health & Preventive MedicineFaculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneVictoriaAustralia
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Boachie MK, Molete M, Hofman K, Thsehla E. Cost-effectiveness of dental caries prevention strategies in South African schools. BMC Oral Health 2023; 23:814. [PMID: 37898738 PMCID: PMC10613394 DOI: 10.1186/s12903-023-03474-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/29/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND In South Africa, an estimated 85% of the population relies on the public sector for oral health services. With poor infrastructure and inadequate personnel, over 80% of children with dental caries remain untreated. To reduce this burden of disease, one key goal is to promote good oral health and address oral diseases through prevention, screening, and treatment among children. While all policies have been proven to be effective in the control and prevention of dental caries, it is unclear which of those strategies provide value for money. This study evaluated five caries preventative strategies in terms of the cost and benefits among South African school children. METHODS The study uses a hypothetical South African population of school aged learners aged 5-15. The context and insights of the strategies utilized at the schools were informed by data from both grey and published literature. Using Markov modeling techniques, we conducted a cost-effectiveness analysis of Acidulated Phosphate Fluoride (APF) application, atraumatic restorative treatment (ART), sugar-reduction and fissure sealants. Markov model was used to depict the movement of a hypothetical patient cohort between different health states over time. We assessed both health outcomes and costs of various interventions. The health outcome metric was measured as the number of Decayed, Missing, Filled Tooth (DMFT). The net monetary benefit was then used to determine which intervention was most cost-effective. RESULTS The results showed that school-based caries prevention strategies are cost-effective compared to the status quo of doing nothing. The average cost per learner over the 10-year period ranged from ZAR4380 to approx. ZAR7300 for the interventions considered. The total costs (including screening) associated with the interventions and health outcome (DMFT averted) were: sugar reduction (ZAR91,380, DFMT: 63,762), APF-Gel (ZAR54 million, DMFT: 42,010), tooth brushing (ZAR72.8 million, DMFT: 74,018), fissure sealant (ZAR44.63 million, DMFT: 100,024), and ART (ZAR45 million, DMFT: 144,035). The net monetary benefits achieved for APF-Gel, sugar reduction, tooth brushing, fissure sealant and ART programs were ZAR1.56, ZAR2.45, ZAR2.78, ZAR3.81, and ZAR5.55 billion, respectively. CONCLUSION Based on the net monetary benefit, ART, fissure sealant and sugar-reduction appear to be the most cost-effective strategies for preventing caries in South Africa. In a resource-scarce setting such as South Africa, where there is no fluoridation of drinking water, this analysis can inform decisions about service packages for oral health.
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Affiliation(s)
- Micheal Kofi Boachie
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, 4041, Durban, South Africa.
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa.
| | - Mpho Molete
- Department of Oral Biological Sciences, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
| | - Karen Hofman
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
| | - Evelyn Thsehla
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
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Feng L, Gao J, Xia W, Li Y, Lowe S, Yau V, Ma S, Zhou Z, Ding P, Cheng C, Bentley R, Wang Y, Zhou Q, Wang K, Wu B, Xie P, Liu H, Sun C. Association of sugar-sweetened beverages with the risk of colorectal cancer: a systematic review and meta-analysis. Eur J Clin Nutr 2023; 77:941-952. [PMID: 37438466 DOI: 10.1038/s41430-023-01302-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 06/04/2023] [Accepted: 06/14/2023] [Indexed: 07/14/2023]
Abstract
The association between sugar-sweetened beverages intake and colorectal cancer (CRC) remains controversial. A metaanalysis was performed to clarify the correlation between sugar-sweetened beverages and CRC risk/mortality. A systematic literature search was conducted in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Sinomed (CBM), Wanfang Data Knowledge Service Platform, and China Science and Technology Journal VIP database. Articles were restricted to be available in any language until March 31, 2022. The highest exposed categories were used to calculate the pooled relative risks (RR) values. Pooled relative risks (RR) and 95% confidence intervals (CI) were used to estimate the association of sugar-sweetened beverages with CRC risk and mortality. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I2 statistic. A total of 17 studies (6 case-control and 11 cohort) involving 557,391 subjects were included in this meta-analysis. The pooled RRs for CRC incidence and mortality among people taking sugar-sweetened beverages were 1.17 (95% CI: 1.07-1.28) and 1.13 (95% CI: 0.99-1.29), respectively. In subgroup analysis, a correlation was found in the distal colon with a pooled RR of 1.41 (95% CI: 1.10-1.80). There was no correlation in the proximal colon with a pooled RR of 1.58 (95% CI: 0.79-3.17). We found statistically significant associations between CRC incidence and sugar-sweetened beverages intake in North America and Oceania, with pooled RRs of 1.16 (95% CI: 1.00-1.33) and 1.32 (95% CI: 1.13-1.55), respectively. In sensitivity analysis, after excluding each study and calculating heterogeneity and effect sizes, there was still a correlation between sugar-sweetened beverages intake and CRC risk. This meta-analysis suggests that sugar-sweetened beverages intake may increase CRC risk, independent of CRC mortality. Whether CRC risk increases with increased sugar-sweetened beverage intake needs further investigation in the future. This meta-analysis aimed to indicate the relationship between sugar-sweetened beverages intake and the risk and mortality of colorectal cancer. A total of 17 studies involving 557,391 subjects were included. The results showed that sugar-sweetened beverages may increase the risk of colorectal cancer but may not be associated with colorectal cancer mortality.
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Affiliation(s)
- Linya Feng
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, PR China
| | - Juan Gao
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, PR China
| | - Weihang Xia
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, PR China
| | - Yaru Li
- Internal Medicine, Swedish Hospital, 5140 N California Ave, Chicago, IL, 60625, USA
- College of Osteopathic Medicine, Des Moines University, 3200 Grand Ave, Des Moines, IA, 50312, USA
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Vicky Yau
- Department of Oral and Maxillofacial Surgery, University at Buffalo, 320 Hayes Rd, Buffalo, New York, NY, 14215, USA
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, PR China
| | - Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Ping'an Ding
- The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050011, China
| | - Ce Cheng
- Hematology and Medical Oncology, St. Joseph Mercy Ann Arbor Hospital, 5301 McAuley Dr, Ypsilanti, MI, 48197, USA
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Yichen Wang
- Mercy Internal Medicine Service, Trinity Health of New England, 271 Carew St, Springfield, MA, 01104, USA
| | - Qin Zhou
- Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Kai Wang
- Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, No. 32, Meijian Road, Xuzhou, Jiangsu, 221006, China
| | - Birong Wu
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, PR China
| | - Peng Xie
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, PR China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, PR China
| | - Chenyu Sun
- Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University, Furong Road 678, Hefei, Anhui, 230601, China.
- Department of Thyroid and Breast Surgery, the Second Affiliated Hospital of Anhui Medical University, Furong Road 678, Hefei, Anhui, 230601, China.
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, Illinois, 60657, USA.
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Wang L, Ma N, Wei L. Global burden of ischemic heart disease attributable to high sugar-sweetened beverages intake from 1990 to 2019. Nutr Metab Cardiovasc Dis 2023; 33:1190-1196. [PMID: 37032253 DOI: 10.1016/j.numecd.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/02/2023] [Accepted: 03/14/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND AND AIMS Excessive sugar-sweetened beverages (SSBs) intake is associated with a higher risk of ischemic heart disease (IHD). However, global patterns and trends in the burden of IHD attributable to high SSBs intake have not been systematically assessed. METHODS AND RESULTS We retrieved data from the Global Burden of Disease Study (GBD) 2019. We obtained the numbers and age-standardized mortality rate (ASMR) and disability-adjusted life years (DALYs) rate (ASDR) of IHD attributable to high SSBs intake by sex, year, socio-demographic index (SDI), and country between 1990 and 2019. Furthermore, we used a validated decomposition algorithm to attribute changes to population growth, population aging, and epidemiologic changes in the 21 GBD regions. From 1990 to 2019, the global IHD mortality attributable to high SSBs intake, as quantified by ASMR and ASDR declined significantly, while the burden increased saliently in absolute numbers. Population decomposition suggested that changes in epidemiology in most GBD regions have reduced IHD mortality due to high SSBs intake, but this trend has been counteracted by population growth and aging. CONCLUSIONS Although the age-standardized rate of IHD deaths and DALYs attributable to high SSBs intake decreased overall from 1990 to 2019, the absolute IHD burden remains high in some countries, especially in some developing countries in Asia and Oceania. Action is needed to enhance the prevention of diseases associated with high SSBs intake.
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Affiliation(s)
- Lina Wang
- Department of Neurology, Xi'an Ninth Hospital Affiliated to Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, 710052, China
| | - Ning Ma
- Core Research Laboratory, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China
| | - Linlin Wei
- Core Research Laboratory, The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China.
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Brock DJP, Yuhas M, Porter KJ, Chow PI, Ritterband LM, Tate DF, Zoellner JM. Outcomes of a Caregiver-Focused Short Message Service (SMS) Intervention to Reduce Intake of Sugar-Sweetened Beverages in Rural Caregivers and Adolescents. Nutrients 2023; 15:1957. [PMID: 37111178 PMCID: PMC10141983 DOI: 10.3390/nu15081957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/07/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
This study examined enrollment, retention, engagement, and behavior changes from a caregiver short message service (SMS) component of a larger school-based sugar-sweetened beverage (SSB) reduction intervention. Over 22 weeks, caregivers of seventh graders in 10 Appalachian middle schools received a two-way SMS Baseline Assessment and four monthly follow-up assessments to report their and their child's SSB intake and select a personalized strategy topic. Between assessments, caregivers received two weekly one-way messages: one information or infographic message and one strategy message. Of 1873 caregivers, 542 (29%) enrolled by completing the SMS Baseline Assessment. Three-quarters completed Assessments 2-5, with 84% retained at Assessment 5. Reminders, used to encourage adherence, improved completion by 19-40%, with 18-33% completing after the first two reminders. Most caregivers (72-93%) selected a personalized strategy and an average of 28% viewed infographic messages. Between Baseline and Assessment 5, daily SSB intake frequency significantly (p < 0.01) declined for caregivers (-0.32 (0.03), effect size (ES) = 0.51) and children (-0.26 (0.01), ES = 0.53). Effect sizes increased when limited to participants who consumed SSB twice or more per week (caregivers ES = 0.65, children ES = 0.67). Findings indicate that an SMS-delivered intervention is promising for engaging rural caregivers of middle school students and improving SSB behaviors.
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Affiliation(s)
- Donna-Jean P. Brock
- Department of Public Health Sciences, Community-Based Health Equity Research Program, University of Virginia, Christiansburg, VA 24073, USA; (D.-J.P.B.)
| | - Maryam Yuhas
- Department of Nutrition and Food Studies, Falk College, Syracuse University, Syracuse, NY 13244, USA;
| | - Kathleen J. Porter
- Department of Public Health Sciences, Community-Based Health Equity Research Program, University of Virginia, Christiansburg, VA 24073, USA; (D.-J.P.B.)
| | - Philip I. Chow
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22908, USA; (P.I.C.)
| | - Lee M. Ritterband
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22908, USA; (P.I.C.)
| | - Deborah F. Tate
- Department of Nutrition, Communication for Health Applications and Interventions Core, University of North Carolina, Chapel Hill, NC 27599, USA;
| | - Jamie M. Zoellner
- Department of Public Health Sciences, Community-Based Health Equity Research Program, University of Virginia, Christiansburg, VA 24073, USA; (D.-J.P.B.)
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Subramanian E, Muniyapillai T, S M, Kulothungan K, R S MK. Determinants of Sugar-Sweetened Beverage Consumption Among Adults in Perambalur District of India. Cureus 2023; 15:e35650. [PMID: 37009393 PMCID: PMC10065171 DOI: 10.7759/cureus.35650] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Background Sugar is a ubiquitous element in processed meals and is a major source of the energy we derive from them. The risk of obesity and other chronic conditions, such as high blood pressure, cardiovascular disease, type 2 diabetes mellitus, tooth destruction, as well as dental cavities, increases proportionally with the consumption of sugar-sweetened beverages (SSBs). This study intends to determine the prevalence of SSB intake among adults in the Perambalur area of Tamil Nadu, India, as well as the factors that influence it. Methodology We surveyed 1007 individuals using a cross-sectional design from June to November 2022. We included residents who were at least 18 years old and less than 80 years old. Using a convenience sample method, we gathered responses from the public in the urban and rural field practice areas of a teaching medical college in the district of Perambalur, India. We conducted in-person interviews to get data regarding the consumption of SSBs. Among other socio-demographic information, the participants' names, ages, religions, levels of education and employment, household incomes, family compositions, marital statuses, lifestyle behaviors, and comorbid conditions were also gathered. We measured the SSB consumption frequency and duration, and we also considered the contexts in which they consumed SSBs. We examined the factors that play a role in SSB consumption and questioned the participants' familiarity with SSBs' constituents, adverse effects, and cumulative toll. Besides examining the effects of SSB use, the research also explores the possibility of reducing or stopping it altogether. Results The prevalence of SSB use among the current study population was 96.3%. Half of the population has consumed SSBs, between 100 and 200 ml, for over 10 years. Taste and peer pressure are the primary reasons for facilitating SSBs, whereas the media has a minor impact. Most of the population (69%) began consuming SSBs, mostly during vacations and at parties. About one-fifth of the population experiences negative consequences after ingesting SSBs, while only half of the population is aware of the contents of SSBs. Likewise, just 50% of the population is aware of the long-term implications of SSBs. Nearly 16.7% of the population attempted to stop using SSBs. Being overweight, belonging to a high socioeconomic class, and dwelling in a rural location are risk factors related to the consumption of SSBs. Conclusion The prevalence of SSB use among the current study population is exceptionally high. Being overweight, belonging to a high socioeconomic class, and dwelling in a rural location are risk factors related to the consumption of SSBs. There is a need to educate the public about the short- and long-term negative effects of consuming SSBs. Government and non-government entities must work together to generate public behavior change communication.
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Heaton B, Gondal N. Health-based homophily in public housing developments. BMC Public Health 2023; 23:238. [PMID: 36737700 PMCID: PMC9896682 DOI: 10.1186/s12889-023-15146-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Public housing residents in the United States face disproportionately high risks for disease, presenting an urgent need for interventions. Evidence suggests interventions leveraging social networks can be successful when relationships are homophilous, as this leads to pooling of risk behaviors among interconnected alters. Yet, we know little about networks of public housing residents. To assess the feasibility of network-based interventions, we investigate the incidence of health-based homophily in public housing developments in Boston, Massachusetts. Employing multilevel models (HLM), we find that respondents report their own health characteristics to be similar to their network partners on oral health, weight, and consumption of sugar-sweetened beverages and foods. We discuss the implications of our findings for health-based interventions in low-income communities.
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Affiliation(s)
- Brenda Heaton
- grid.189504.10000 0004 1936 7558Department of Health Policy & Health Services Research, Boston University Henry M Goldman School of Dental Medicine, Boston, USA ,grid.189504.10000 0004 1936 7558Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Neha Gondal
- grid.189504.10000 0004 1936 7558Department of Sociology and Faculty of Computing & Data Sciences, Boston University, Boston, USA
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Park S, Onufrak SJ, Cradock AL, Patel A, Hecht C, Blanck HM. Perceptions of Water Safety and Tap Water Taste and Their Associations With Beverage Intake Among U.S. Adults. Am J Health Promot 2023:8901171221150093. [PMID: 36609168 DOI: 10.1177/08901171221150093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Examine differences in perceptions of tap water (TW) and bottled water (BW) safety and TW taste and their associations with plain water (PW) and sugar-sweetened beverage (SSB) intake. DESIGN Quantitative, cross-sectional study. SETTING United States. SUBJECTS 4,041 U.S. adults (≥18 years) in the 2018 SummerStyles survey data. MEASURES Outcomes were intake of TW, BW, PW (tap and bottled water), and SSB. Exposures were perceptions of TW and BW safety and TW taste (disagree, neutral, or agree). Covariates included sociodemographics. ANALYSIS We used chi-square analysis to examine sociodemographic differences in perceptions and multivariable logistic regressions to estimate adjusted odds ratios (AOR) for consuming TW ≤ 1 cup/day, BW > 1 cup/day, PW ≤ 3 cups/day, and SSB ≥ 1 time/day by water perceptions. RESULTS One in 7 (15.1%) of adults did not think their home TW was safe to drink, 39.0% thought BW was safer than TW, and 25.9% did not think their local TW tasted good. Adults who did not think local TW was safe to drink had higher odds of drinking TW ≤ 1 cup/day (AOR = 3.12) and BW >1 cup/day (AOR = 2.69). Adults who thought BW was safer than TW had higher odds of drinking TW ≤1 cup/day (AOR = 2.38), BW > 1 cup/day (AOR = 5.80), and SSB ≥ 1 time/day (AOR = 1.39). Adults who did not think TW tasted good had higher odds of drinking TW ≤ 1 cup/day (AOR = 4.39) and BW > 1 cup/day (AOR = 2.91). CONCLUSIONS Negative perceptions of TW safety and taste and a belief BW is safer than TW were common and associated with low TW intake. Perceiving BW is safer than TW increased the likelihood of daily SSB intake. These findings can guide programs and services to support water quality to improve perceptions of TW safety and taste, which might increase TW intake and decrease SSB intake.
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Affiliation(s)
- Sohyun Park
- Division of Nutrition, Physical Activity and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), 1242Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Stephen J Onufrak
- Division of Diabetes Translation, NCCDPHP, 1242(CDC), Atlanta, GA, USA
| | | | | | | | - Heidi M Blanck
- Division of Nutrition, Physical Activity and Obesity (DNPAO), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), 1242Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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11
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Yuhas M, Brock DJP, Ritterband LM, Chow PI, Porter KJ, Zoellner JM. Retention and engagement of rural caregivers of adolescents in a short message service intervention to reduce sugar-sweetened beverage intake. Digit Health 2023; 9:20552076231160324. [PMID: 36949896 PMCID: PMC10026137 DOI: 10.1177/20552076231160324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/10/2023] [Indexed: 03/19/2023] Open
Abstract
Objective This study investigates a 6-month short message service (SMS) intervention to reduce adolescent sugar-sweetened beverage (SSB) intake. The objectives are to describe caregiver retention and SMS engagement as well as explore differences by caregiver characteristics. Methods Caregivers completed a baseline survey then messages were sent two times per week. Message types included the following: SSB intake assessments, educational information, infographic URLs, and strategies. Engagement was measured through interaction with these messages and included: assessment completion, reminders needed, number of strategies chosen, and URLs clicked. Results Caregivers (n = 357) had an average baseline SSB intake of 23.9 (SD = 26.8) oz/day. Of those, 89% were retained. Caregivers with a greater income and education were retained at a higher rate. Average engagement included: 4.1 (SD = 1.3) of 5 assessments completed with few reminders needed [4.1 (SD = 3.7) of 14 possible], 3.2 (SD = 1.1) of 4 strategies selected, and 1.2 (SD = 1.6) of 5 URLs clicked. Overall, average engagement was relatively high, even where disparities were found. Demographic characteristics that were statistically related to lower engagement included younger age, lower income, lower educational attainment, single caregivers, lower health literacy. Furthermore, caregivers with a reduced intention to change SSB behaviors completed fewer assessments and needed more reminders. Higher baseline SSB intake was associated with lower engagement across all indicators except URL clicks. Conclusions Results can be used to develop targeted retention and engagement strategies (e.g., just-in-time and/or adaptive interventions) in rural SMS interventions for identified demographic subsets. Trial registration Clincialtrials.gov: NCT03740113.
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Affiliation(s)
- Maryam Yuhas
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, NY, USA
| | | | - Lee M Ritterband
- School of Medicine, University of Virginia, Christiansburg, VA,
USA
| | - Philip I Chow
- School of Medicine, University of Virginia, Christiansburg, VA,
USA
| | | | - Jamie M Zoellner
- School of Medicine, University of Virginia, Christiansburg, VA,
USA
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12
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Moss ME, Luo H, Rosinger AY, Jacobs MM, Kaur R. High sugar intake from sugar-sweetened beverages is associated with prevalence of untreated decay in US adults: NHANES 2013-2016. Community Dent Oral Epidemiol 2022; 50:579-588. [PMID: 34939664 PMCID: PMC9786558 DOI: 10.1111/cdoe.12725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/11/2021] [Accepted: 12/14/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To assess the association between sugar from sugar-sweetened beverages (SSBs) and untreated decay in permanent teeth and calculate the cost burden of sugar from SSBs on untreated decay in US adults. METHODS Cross-sectional data from the 2013-2014 and 2015-2016 cycles of the National Health and Nutrition Examination Survey (NHANES) were analysed in 2020 (n = 9001 adults aged ≥20). Multivariable analyses assessed sugar intake from SSB consumption with the presence of untreated decay in permanent teeth and number of untreated decayed teeth. Population attributable risk was used to estimate the cost burden arising from SSBs on untreated decay in US adults. RESULTS One fourth (25.1%) of US adults had untreated dental decay, and higher prevalence was observed among those with low income, low education and race/ethnicity of non-Hispanic Black. Overall, 53% of adults reported no intake of SSBs. For the remaining 47%, the median 24-h intake was 46.8 g of sugar from SSBs. The adjusted prevalence ratio (PR) for untreated decay was 1.3 (95% confidence interval [CI] 1.1-1.5) for consumption of 46.8 g or more of sugar from SSBs compared to those reporting no sugar from SSBs. Number of untreated decayed teeth increased with sugar intake from SSBs from lowest to highest tertile: 0.1, (p = .35); 0.4, (p = .006); and 0.6, (p < .001). The cost burden of untreated decay attributable to SSBs in US adults is estimated conservatively at $1.6 billion USD. CONCLUSIONS Community level interventions directed at sugar from SSBs are justified to address disparities in the burden of untreated dental decay.
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Affiliation(s)
- Mark E. Moss
- ECU School of Dental MedicineEast Carolina UniversityGreenvilleNorth CarolinaUSA
| | - Huabin Luo
- Brody School of MedicineEast Carolina UniversityGreenvilleNorth CarolinaUSA
| | - Asher Y. Rosinger
- Department of Biobehavioral HealthPennsylvania State UniversityState CollegePennsylvaniaUSA,Department of AnthropologyPennsylvania State UniversityState CollegePennsylvaniaUSA
| | - Molly M. Jacobs
- College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Roopwant Kaur
- ECU School of Dental MedicineEast Carolina UniversityGreenvilleNorth CarolinaUSA
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13
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Baltaci A, Hurtado Choque GA, Davey C, Reyes Peralta A, Alvarez de Davila S, Zhang Y, Gold A, Larson N, Reicks M. Padres Preparados, Jóvenes Saludables: intervention impact of a randomized controlled trial on Latino father and adolescent energy balance-related behaviors. BMC Public Health 2022; 22:1932. [PMID: 36258168 PMCID: PMC9578196 DOI: 10.1186/s12889-022-14284-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 09/27/2022] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Studies have shown associations among food and activity behaviors and body weight of Latino fathers and adolescents. However, few Latino father-focused interventions have been designed to improve energy balance-related behaviors (EBRBs) and weight status among early adolescents. Thus, this efficacy study aims to evaluate the Padres Preparados, Jóvenes Saludables (Padres) youth obesity prevention program for positive changes in EBRBs (fruit, vegetable, sugar-sweetened beverage (SSB), sweet/salty snack, and fast-food consumption, physical activity, and screen time) and weight status among low-income Latino fathers and adolescents (10-14 years). METHODS A two-arm (treatment versus delayed-treatment control group) randomized controlled trial was conducted to evaluate the efficacy of 8 weekly experiential learning sessions (2.5 hours each) based on social cognitive theory. The sessions included food preparation, parenting skills, nutrition, and physical activity. The program was delivered to father-adolescent dyads (mothers were encouraged to attend) in trusted community-based settings in a Midwest metropolitan area between 2017 and 2019. In March 2020, in-person implementation was discontinued due to COVID-19 pandemic restrictions, which limited the sample size. Father/adolescent dyads were randomized to treatment or control group within each site. Surveys and measurements were completed by fathers and adolescents to assess changes in food and activity behaviors from baseline to post-intervention. Adolescents also completed 24-hour dietary recall interviews at baseline and post-intervention. Intervention effects were assessed using linear regression mixed models adjusted for covariates and accounting for clustering of participants within sites. RESULTS Data from 147 father/adolescent dyads who completed at least the baseline data collection were used. No significant differences were observed for baseline to post-intervention changes in adolescents' and fathers' EBRBs or weight status between treatment and control groups. Fathers' SSB and fast food intakes were not statistically significant (p = 0.067 and p = 0.090, respectively). CONCLUSIONS The Padres program resulted in no significant improvements in adolescent and father EBRBs and weight status. Additional Latino father-focused interventions are needed to examine intervention effects on EBRBs among Latino adolescents. TRIAL REGISTRATION The Padres Preparados, Jóvenes Saludables study is registered with the U.S. National Library of Medicine, ClinicalTrials.gov Identifier: NCT03469752 (19/03/2018).
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Affiliation(s)
- A. Baltaci
- grid.17635.360000000419368657Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S Second St, Suite 300, Minneapolis, MN 55454 USA
| | - G. A. Hurtado Choque
- grid.164295.d0000 0001 0941 7177School of Public Health, University of Maryland, 4200 Valley Dr, College Park, MD 20742 USA
| | - C. Davey
- grid.17635.360000000419368657Clinical and Translational Science Institute, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414 USA
| | - A. Reyes Peralta
- grid.17635.360000000419368657Center for Family Development, University of Minnesota Extension, 1420 Eckles Ave, St. Paul, MN 55108 USA
| | - S. Alvarez de Davila
- grid.17635.360000000419368657Center for Family Development, University of Minnesota Extension, Robert J. Jones Urban Research and Outreach-Engagement Center, 2001 Plymouth Ave N, Minneapolis, MN 55411 USA
| | - Y. Zhang
- grid.263761.70000 0001 0198 0694Department of Child and Adolescent Health and Social Medicine, School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Building 401, Room 1411, Suzhou, 215123 Jiangsu China
| | - A. Gold
- grid.17635.360000000419368657Center for Family Development, University of Minnesota Extension, 1420 Eckles Ave, St. Paul, MN 55108 USA
| | - N. Larson
- grid.17635.360000000419368657Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S Second St, Suite 300, Minneapolis, MN 55454 USA
| | - M. Reicks
- grid.17635.360000000419368657Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Ave, St. Paul, MN 55108 USA
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14
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Hayashi M, Morino K, Harada K, Miyazawa I, Ishikawa M, Yasuda T, Iwakuma Y, Yamamoto K, Matsumoto M, Maegawa H, Ishikado A. Real-world evidence of the impact of obesity on residual teeth in the Japanese population: A cross-sectional study. PLoS One 2022; 17:e0274465. [PMID: 36103495 PMCID: PMC9473396 DOI: 10.1371/journal.pone.0274465] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 08/29/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Tooth loss is associated with nutritional status and significantly affects quality of life, particularly in older individuals. To date, several studies reveal that a high BMI is associated with tooth loss. However, there is a lack of large-scale studies that examined the impact of obesity on residual teeth with respect to age and tooth positions. OBJECTIVE We assessed the impact of obesity on the number and position of residual teeth by age groups using large scale of Japanese database. METHODS This was a cross-sectional study of 706150 subjects that were included in the database that combined the data from health insurance claims and health check-up, those lacking information about BMI, HbA1c level, smoking status, and the number of residual teeth were excluded. Thus, a total of 233517 aged 20-74 years were included. Subjects were classified into 4 categories based on BMI, and the number of teeth was compared between age-groups. The percentage of subjects with residual teeth in each position was compared between groups with obesity (BMI ≥25.0 kg/m2) and non-obesity. Logistic regression analysis was performed to clarify whether obesity predicts having <24 teeth. RESULTS Higher BMI was associated with fewer teeth over 40s (P for trend <0.0001 when <70s). Obesity was associated with the reduction of residual teeth in the maxillary; specifically, the molars were affected over the age 30. Smoking status further affected tooth loss at positions that were not affected by obesity alone. After adjusting for age, sex, smoking status, and HbA1c ≥6.5%, obesity remained an independent predictive factor for having <24 teeth (ORs: 1.35, 95% CIs: 1.30-1.40). CONCLUSIONS We found that an increase in BMI was associated with a decrease in the number of residual teeth from younger ages independently of smoking status and diabetes in the large scale of Japanese database.
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Affiliation(s)
- Mayu Hayashi
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Katsutaro Morino
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Kayo Harada
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Itsuko Miyazawa
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Miki Ishikawa
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Takako Yasuda
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Yoshie Iwakuma
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Kazushi Yamamoto
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Motonobu Matsumoto
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
| | - Hiroshi Maegawa
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Atsushi Ishikado
- Research and Development Department, Sunstar Inc., Takatsuki, Osaka, Japan
- Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
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Brown AD, Bolton KA, Clarke B, Fraser P, Lowe J, Kays J, Hovmand PS, Allender S. System dynamics modelling to engage community stakeholders in addressing water and sugar sweetened beverage consumption. Int J Behav Nutr Phys Act 2022; 19:118. [PMID: 36088361 PMCID: PMC9463801 DOI: 10.1186/s12966-022-01363-4] [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: 12/16/2021] [Accepted: 09/04/2022] [Indexed: 08/24/2023] Open
Abstract
Abstract
Background
Participatory approaches to develop community-based system dynamics models to tackle complexity are promising, but research is needed in how simulation models can be developed with community stakeholders to yield significant system insights. This study presents the results of a community-based system dynamics modelling process to increase water consumption and decrease sugar sweetened beverage consumption in Portland, Victoria, a regional town in Australia.
Methods
A series of group model building workshops with 11 community stakeholders addressing the topic of water and sugar sweetened beverage consumption was conducted in Portland. A simulating system dynamics model was built with stakeholders to inform action planning.
Results
A system dynamics model was created to provide insight into water and sugar sweetened beverage consumption in Portland. The model included six feedback loops describing the causal effects of sugar sweetened beverage consumption habits and norms, water taste, water consumption norms, public water availability, and public health benefits. For example, the sugar sweetened beverage consumption norm loop modelled how people overestimating others’ consumption may motivate an increase in their own consumption, feeding back and further amplifying an increase in sugar sweetened beverage consumption. The model contributed to the foundation of a strong partnership to improve the taste of water and educate the public on water consumption.
Conclusions
Engaging stakeholders in system dynamics modelling about water and sugar sweetened beverage consumption increased engagement and collaboration to address the problem among community stakeholders.
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16
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AlFaris NA, Alshwaiyat NM, Alkhalidy H, AlTamimi JZ, Alagal RI, Alsaikan RA, Alsemari MA, BinMowyna MN, AlKehayez NM. Sugar-sweetened beverages consumption in a multi-ethnic population of middle-aged men and association with sociodemographic variables and obesity. Front Nutr 2022; 9:987048. [PMID: 36110403 PMCID: PMC9468762 DOI: 10.3389/fnut.2022.987048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adults frequently consume sugar-sweetened beverages. These products are linked to negative health effects such as obesity. Our study was carried out to assess rates of weekly and daily sugar-sweetened beverages consumption in a multi-ethnic population of middle-aged men and association with sociodemographic variables and obesity. Methods A sum of 1,800 middle-aged men (36–59 years) living in Riyadh, KSA, participated in this cross-sectional study. Sociodemographic variables and the frequency of sugar-sweetened beverages consumption were gathered from participants using face to face interviews. Weekly and daily consumption of sugar-sweetened beverages were the two binary outcome variables applied in this research. Weight and height were measured following standard procedures. Results In this study, 93.8 and 32.6% of participants consumed sugar-sweetened beverages weekly and daily, respectively. The weekly and daily sugar-sweetened beverages consumption was predicted by nationality. Subjects from Pakistan (99.3%) and Yemen (60.0%) reported the greatest rates of weekly and daily consumption, respectively, while Bangladeshi and Sudanese subjects reported the lowest rates of weekly (87%) and daily (2.9%) consumption, respectively. Another factor that predicted weekly sugar-sweetened beverages consumption was obesity. Obese subjects had a significantly greater odds ratio of weekly sugar-sweetened beverages intake than non-obese individuals (OR = 3.80, P = 0.003). Conclusion Consumption of sugar-sweetened beverages is common among middle-aged men who live in KSA. Results show connecting sugar-sweetened beverages intake with specific sociodemographic variables and obesity.
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Affiliation(s)
- Nora A. AlFaris
- Department of Physical Sports Sciences, College of Education, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Naseem M. Alshwaiyat
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
| | - Hana Alkhalidy
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Jozaa Z. AlTamimi
- Department of Physical Sports Sciences, College of Education, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reham I. Alagal
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reem A. Alsaikan
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Malak A. Alsemari
- Department of Medical Imaging – MRI, King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mona N. BinMowyna
- College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Nora M. AlKehayez
- Department of Physical Sports Sciences, College of Education, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- *Correspondence: Nora M. AlKehayez
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Haeck C, Lawson N, Poirier K. Estimating consumer preferences for different beverages using the BLP approach. ECONOMICS AND HUMAN BIOLOGY 2022; 46:101138. [PMID: 35453077 DOI: 10.1016/j.ehb.2022.101138] [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: 10/24/2021] [Revised: 02/25/2022] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
The overconsumption of sugar is a significant problem in many jurisdictions, and one possible method to remedy this problem is the taxation of sugar-sweetened beverages (SSBs). To be able to implement an optimal tax, it is important to know the preferences and price sensitivity of consumers. This article therefore estimates the price elasticity of demand for different beverages in Quebec, using the Berry, Levinsohn and Pakes (BLP) random parameter logistic demand model, combined with Nielsen data from 2010 to 2016 and the 2016 Canadian Census. The results suggest that the average consumer prefers high-calorie beverages containing fruits and vegetables, and the estimated price elasticities are between -4.40 (energy drinks) and -1.59 (regular soft drinks). As a result, consumers of energy drinks appear to reduce their consumption the most in the face of rising prices, whereas consumers of soft drinks will decrease their consumption the least. However, at a general level, the implementation of a tax on SSBs in Quebec should generate a significant reduction in consumption.
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Affiliation(s)
- Catherine Haeck
- Département de sciences économiques, Université du Québec á Montréal, 315 Rue Sainte-Catherine E, Montréal H2X 3X2, Québec, Canada
| | - Nicholas Lawson
- Département de sciences économiques, Université du Québec á Montréal, 315 Rue Sainte-Catherine E, Montréal H2X 3X2, Québec, Canada.
| | - Krystel Poirier
- Département de sciences économiques, Université du Québec á Montréal, 315 Rue Sainte-Catherine E, Montréal H2X 3X2, Québec, Canada
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John RM, Tullu FT, Gupta R. Price elasticity and affordability of aerated or sugar-sweetened beverages in India: implications for taxation. BMC Public Health 2022; 22:1372. [PMID: 35842635 PMCID: PMC9288730 DOI: 10.1186/s12889-022-13736-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 07/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The sale of aerated or sugar-sweetened beverages (ASBs) has been consistently growing in India which has also experienced a major increase in non-communicable diseases. This study estimates the price elasticities of ASBs by different household-income groups in India and examine the trends in their affordability. METHODS The price elasticity for ASBs were estimated using a nationally representative household sample survey on consumption of ASBs in India and with Deaton's method which is robust to self-reported household expenditure surveys. Trends in affordability of ASBs were estimated using relative income price (RIP) which measured the proportion of per capita gross domestic product (GDP) required to purchase 100 L of ASBs in a given year. The elasticity parameters were used to estimate the incremental tax needed for a 10% reduction in ASB consumption. RESULTS The own-price elasticity of ASBs is - 0.94 in the overall sample and varied between - 1.04 to - 0.83 from low- to high-income households. There has been an annual average decline of about 6.8% in RIP of ASBs or an increase in their affordability over the last 13 years. Increasing the compensation cess on ASBs under the current Goods and Services Tax (GST) to 29%, will have the effect of decreasing ASB consumption by 10% and increasing the tax revenue by about 27%. CONCLUSION The taxation policy on ASBs in India has largely been ineffective at increasing the real retail prices of ASBs as a result of which ASB consumption grew. ASBs should be classified along with other unhealthy products like tobacco and alcohol as demerit products for the purpose of taxation and their taxes should be regularly increased sufficiently enough to compensates for both general price inflation and income growth so as to decreases their affordability.
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Affiliation(s)
- Rijo M John
- Rajagiri College of Social Sciences, Kochi, Kerala, 683104, India.
| | - Fikru T Tullu
- Non Communicable Diseases, World Health Organization, New Delhi, India
| | - Rachita Gupta
- National Professional Officer (Nutrition), World Health Organization, New Delhi, India
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Effect of Beverage Consumption Frequency on DMFT Index among Iranian Adult Population: An AZAR Cohort Study. Int J Dent 2022; 2022:9142651. [PMID: 35669588 PMCID: PMC9167004 DOI: 10.1155/2022/9142651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 03/28/2022] [Accepted: 05/16/2022] [Indexed: 12/07/2022] Open
Abstract
Background Given the effect of oral and dental condition on emotional and physical health and the different effects of beverage consumption on decayed, missing, and filled teeth (DMFT) as one of the indicators of oral health in different populations, this study aimed to investigate the effect of beverage consumption and its frequency on DMFT among Iranian adult population. Materials and Methods The data of this cross-sectional study were obtained from AZAR (Azerbaijan) cohort, conducted on 15,006 adults aged 35 to 70 years old in Shabestar County, Iran. Demographic and nutritional data were collected by nutritionists through the "Food Frequency Questionnaire," and DMFT index by general practitioners trained by a dentist according to the World Health Organization (WHO) guidelines. Beverages including milk, doogh, natural fruit juice, black tea, nonalcoholic beer, coffee, sugar-sweetened beverages, and artificial fruit juice were studied. Results A total of 14,966 adults with the mean age of 49.64 ± 9.28 were enrolled. The participants' mean DMFT value was 21.27 ± 8.95. Weekly consumption of tea and coffee beverages resulted in 13% (95% confidence interval: 3% to 22%) lower DMFT compared to daily consumption (p=0.01). However, there was no association between DMFT and other beverages. Conclusion The higher DMFT values with the daily consumption of tea and coffee beverages showed that a part of adults' oral health is affected by beverages; therefore, this should be considered by healthcare authorities in order to manage carries development in the communities.
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Nikniaz Z, Tabrizi JS, Abbasalizad Farhangi M, Hosseini M, Tahmasebi S, Nikniaz L. Community‐based interventions to reduce sugar intake in healthy populations: A systematic review. WORLD MEDICAL & HEALTH POLICY 2022. [DOI: 10.1002/wmh3.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Medicine Faculty Tabriz University of Medical Sciences Tabriz Iran
| | - Jafar S. Tabrizi
- Tabriz Health Services Management Research Center, Faculty of Management and Medical Informatics Tabriz University of Medical Sciences Tabriz Iran
| | | | | | - Sanaz Tahmasebi
- Student Research Committee Tabriz University of Medical Sciences Tabriz Iran
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences Faculty of Management and Medical Informatics Tabriz Iran
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Relationship between Salivary Alpha-Amylase Enzyme Activity, Anthropometric Indices, Dietary Habits, and Early Childhood Dental Caries. Int J Dent 2022; 2022:2617197. [PMID: 35378726 PMCID: PMC8976663 DOI: 10.1155/2022/2617197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives Although early childhood dental caries (ECC) have the same general etiology as other types of caries, predisposing factors are not well elucidated. This study aimed to investigate the effect of salivary alpha-amylase (sAA) activity, body mass index (BMI), dietary habits, and oral hygiene on ECC. Methods This cross-sectional study was performed on 38 ECC-affected and 41 caries-free children, aged 36 to 72 months. Upon the parents' consent, 3 mL of non-stimulated saliva was collected from the participants to measure the level of sAA activity through spectrophotometry. Additionally, parents/caretakers completed a structured questionnaire about demographic factors, oral hygiene, and consumption of sugar-containing foods. BMI, BMI z-scores, and percentile data were calculated by using an online calculator. The independent variables were dichotomized and tested through chi-square test, followed by a stepwise logistic regression, by using SPSS software (α = 0.05). Results The sAA activity was significantly higher in caries-free children (P ≤ 0.001). However, the mean BMI was not significantly different between the two groups (P=0.49). Brushing and other measured dietary habits were significantly associated with the development of ECC (P ≤ 0.001). According to the results of the logistic regression, sAA activity was shown to be a predictor for ECC development (Odds ratio (95% confidence interval): 0.9 (0.95–0.98)). Conclusion Children with inherently lower levels of sAA activity were more susceptible to dental caries. Improper nutritional habits and poor oral health care could exacerbate the risk of ECC.
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Weyland MI, Jost-Brinkmann PG, Bartzela T. Management of white spot lesions induced during orthodontic treatment with multibracket appliance: a national-based survey. Clin Oral Investig 2022; 26:4871-4883. [PMID: 35338421 PMCID: PMC8956138 DOI: 10.1007/s00784-022-04454-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/13/2022] [Indexed: 11/04/2022]
Abstract
Objectives The study aimed to survey current strategies against enamel demineralization during multibracket therapy (MBT) and guide a prevention concept based on existing scientific evidence. Materials and methods The survey comprised questions on the prevention and management of white spot lesions (WSL). The questionnaire was sent via email to orthodontists working in practices and universities throughout Germany. The analysis involved descriptive statistics using the chi-square test (p < 0.05). Results A prevention protocol was used before MBT by 80.6% of the participants. Less than a quarter of the participants regularly applied topical fluoride (gel or varnish) during MBT. According to the respondents’ assessment, the prevalence of WSL during MBT is 11.6%, mainly observed in 12- to 15-year-old male patients. Orthodontists graduating after 2000 tended to recommend and apply fluoride-containing materials more often than their senior colleagues (p = 0.039). Participants from private practices applied fluoride varnish or gel more frequently than those from university clinics (p = 0.013). Fluoridation was the most common (70.7%) treatment for WSL after MBT, followed by resin infiltration (21.2%). The majority (80.9%) of the participants favor a guideline for preventing WSL. Conclusions WSL prevention during MBT is challenging. Males in puberty are predominantly affected. Younger orthodontists are more concerned about the prevention of WSL during MBT. Clinical relevance. The non-negligible prevalence of individuals with WSL emphasizes the need for dental education and health care reform. This would help to implement standardized procedures and establish innovative applications.
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Affiliation(s)
- Manon Isabelle Weyland
- Dept. of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Paul-Georg Jost-Brinkmann
- Dept. of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Theodosia Bartzela
- Dept. of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
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Elstein JG, Lowery CM, Sangoi P, Peterhans A, Bleich SN, Lawman HG, Roberto CA. Analysis of Public Testimony About Philadelphia's Sweetened Beverage Tax. Am J Prev Med 2022; 62:e178-e187. [PMID: 34753646 DOI: 10.1016/j.amepre.2021.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Although interest in beverage taxes has increased in recent years, industry opposition and other challenges have limited their spread in the U.S. Because beverage tax proposals are often unsuccessful, there is limited empirical evidence to inform advocacy efforts. Philadelphia's 1.5 cent-per-ounce tax on sweetened beverages provides an opportunity to understand how public testimony for and against the tax was framed in a city that ultimately passed the policy. METHODS A content analysis of all public testimony about the beverage tax presented to the Philadelphia City Council in 2016 was conducted. Testimonies were coded for policy stance (protax or antitax), speaker type, and specific protax or antitax arguments. Quantitative data were analyzed in 2018-2019 using chi-square tests. RESULTS A total of 177 unique testimonies were identified, which included 40 protax arguments (grouped into 11 themes) and 31 antitax arguments (grouped into 10 themes). Most testimonies were delivered orally, and most speakers argued in favor of the tax (58%). Among tax supporters, funding early childhood education was the most common argument (71%), whereas tax opponents most frequently argued that sugar-sweetened beverages were the wrong target for the tax (50%). CONCLUSIONS This analysis of public testimony revealed that protax advocacy efforts highlighted the revenue benefits for early childhood education and community infrastructure rather than the tax's potential to reduce sweetened beverage consumption and improve health. By contrast, antitax arguments centered on the unfairness of targeting a single industry, potential negative economic impacts, and the perceived lack of evidence that the tax would influence consumer behavior.
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Affiliation(s)
- Jeanette G Elstein
- Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Caitlin M Lowery
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Nutrition, University of North Carolina at Chapel Hill Gillings School of Public Health, Chapel Hill, North Carolina.
| | - Puja Sangoi
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ana Peterhans
- Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sara N Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hannah G Lawman
- Division of Chronic Disease Prevention, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
| | - Christina A Roberto
- Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Wang C, Hong X, Wang W, Zhou H, Wu J, Xu H, Zhou N, Zhao J. The Combination of School-Based and Family-Based Interventions Appears Effective in Reducing the Consumption of Sugar-Sweetened Beverages, a Randomized Controlled Trial among Chinese Schoolchildren. Nutrients 2022; 14:nu14040833. [PMID: 35215483 PMCID: PMC8875123 DOI: 10.3390/nu14040833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 12/23/2022] Open
Abstract
To examine whether environmental interventions, student awareness and parents’ model roles are associated with the consumption of sugar-sweetened beverages (SSBs), a randomized controlled trial was conducted among Chinese schoolchildren. A multi-stage cluster random sampling method was applied to select four primary schools, two in urban areas and two in rural areas, in Nanjing, eastern China. Classes of the third grade in the selected four schools were randomly assigned to the intervention group and control group. Among selected students in those classes, aged 9–10 years, those in the intervention group received intervention measures comprising school-based and family-based measures and accepted monthly monitoring along with interventions, for two consecutive semesters, while those in the control group did not receive any specific interventions. After intervention, there was a significant increase in SSB knowledge and an improvement in the family environment with parents in the intervention group. The proportion of frequent consumption (≥4 times/week) of any SSBs in the intervention group was lower than that in the control group (31.5% vs. 56.2%, p < 0.01). Multivariate analysis indicated that parental education level is positively associated with reduced SSB consumption. Interventions showed an average decrease in SSBs consumption by 1.77 units, those living in urban areas decreased by 2.05 units. The combination of school-based and family-based interventions appears effective in reducing SSB consumption among Chinese schoolchildren, especially in urban areas and for those with parents with lower educational levels.
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Affiliation(s)
- Chenchen Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Xin Hong
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Weiwei Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Hairong Zhou
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Jie Wu
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Hao Xu
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Nan Zhou
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
- Correspondence: (N.Z.); (J.Z.); Tel.: +86-25-5701-0699 (N.Z.)
| | - Jinkou Zhao
- Department of Non-Communicable Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
- Correspondence: (N.Z.); (J.Z.); Tel.: +86-25-5701-0699 (N.Z.)
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Grummon AH, Reimold AE, Hall MG. Influence of the San Francisco, CA, Sugar-Sweetened Beverage Health Warning on Consumer Reactions: Implications for Equity from a Randomized Experiment. J Acad Nutr Diet 2022; 122:363-370.e6. [PMID: 34465443 PMCID: PMC9127741 DOI: 10.1016/j.jand.2021.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND In 2020, San Francisco, CA, amended an ordinance requiring warning labels on advertisements for sugary drinks to update the warning message. No studies have evaluated consumer responses to the revised message. OBJECTIVES To evaluate responses to the 2020 San Francisco sugary drink warning label and to assess whether these responses differ by demographic characteristics. DESIGN Randomized experiment. PARTICIPANTS AND SETTING During 2020, a convenience sample of US parents of children aged 6 months to 5 years (N = 2,160 included in primary analyses) was recruited via an online panel to complete a survey. Oversampling was used to achieve a diverse sample (49% Hispanic/Latino[a], 34% non-Hispanic Black, and 9% non-Hispanic White). METHODS Participants were randomly assigned to view a control label ("Always read the Nutrition Facts Panel") or the 2020 San Francisco sugary drink warning label ("SAN FRANCISCO GOVERNMENT WARNING: Drinking beverages with added sugar(s) can cause weight gain, which increases the risk of obesity and type 2 diabetes."). Messages were shown in white text on black rectangular labels. MAIN OUTCOME MEASURES Participants rated the labels on thinking about health harms of sugary drink consumption (primary outcome) and perceived discouragement from wanting to consume sugary drinks. The survey was available in English and Spanish. STATISTICAL ANALYSES PERFORMED Ordinary least squares regression. RESULTS The San Francisco warning label elicited more thinking about health harms (Cohen's d = 0.24; P < 0.001) than the control label. The San Francisco warning label also led to more discouragement from wanting to consume sugary drinks than the control label (d = 0.31; P < 0.001). The warning label's influence on thinking about harms did not differ by any participant characteristics, including age, gender, race/ethnicity, education, income, or language of survey administration (all P values for interactions > 0.12). CONCLUSIONS San Francisco's 2020 sugary drink warning label may be a promising policy for informing consumers and encouraging healthier beverage choices across groups with diverse demographic characteristics.
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Affiliation(s)
- Anna H Grummon
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
| | - Alexandria E Reimold
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill; Carolina Population Center, University of North Carolina, Chapel Hill; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
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Park S, Onufrak S, Cradock AL, Hecht C, Patel A, Chevinsky JR, Blanck HM. Factors Related to Water Filter Use for Drinking Tap Water at Home and Its Association with Consuming Plain Water and Sugar-Sweetened Beverages among U.S. Adults. Am J Health Promot 2022; 36:813-822. [PMID: 35081754 DOI: 10.1177/08901171211073304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine factors associated with water filter use (WFU) for drinking tap water at home and its association with consuming plain water and sugar-sweetened beverages (SSBs). DESIGN Quantitative, cross-sectional study. SETTING The 2018 SummerStyles survey data. SUBJECTS U.S. adults (≥18 years; N=4,042). MEASURES Outcomes were intake of plain water (tap/bottled water) and SSBs. Exposure was WFU (yes, no, not drinking tap water at home). Covariates included sociodemographics, weight status, Census regions, and home ownership status. ANALYSIS We used multivariable logistic regressions to estimate adjusted odds ratios (AOR) and 95% confidence interval (CI) for consuming tap water, bottled water, or total plain water >3 cups/day (vs. ≤3 cups) and SSBs ≥1 time/day (vs. <1 time) by WFU. RESULTS Overall, 36% of adults reported using a filter for drinking tap water at home; 14% did not drink tap water at home. Hispanics had significantly higher odds of using a water filter (AOR=1.50, 95%CI=1.14-1.98) vs. non-Hispanic White. Factors significantly associated with lower odds of WFU were lower education (AOR=0.69, 95%CI=0.55-0.86 for ≤high school; AOR=0.78, 95%CI=0.64-0.95 for some college, vs. college graduate), not being married (AOR=0.81, 95%CI=0.66-0.98, vs. married/domestic partnership) and lower household income (AOR=0.68, 95%CI=0.68-0.90 for <$35,000, vs. ≥$100,000). Using a water filter was associated with higher odds of drinking >3 cups/day of tap water (AOR=1.33, 95%CI=1.13-1.56) and lower odds of SSBs ≥1 time/day (AOR=0.76, 95%CI=0.62-0.92). Not drinking tap water at home was associated with higher odds of drinking >3 cups/day bottled water (AOR=3.46, 95%CI=2.70-4.44). CONCLUSIONS WFU was associated with higher tap water intake and lower SSB intake among U.S. adults. WFU was higher among Hispanics, but lower among those with lower education and income and not married adults. While WFU was associated with healthful beverage habits, additional considerations for WFU may include source water quality, oral health, cost, and proper use.
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Affiliation(s)
- Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity1242Centers for Disease Control and Prevention
| | - Stephen Onufrak
- Division of Nutrition, Physical Activity, and Obesity1242Centers for Disease Control and Prevention
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Osuh ME, Oke GA, Lilford RJ, Owoaje E, Harris B, Taiwo OJ, Yeboah G, Abiona T, Watson SI, Hemming K, Quinn L, Chen YF. Prevalence and determinants of oral health conditions and treatment needs among slum and non-slum urban residents: Evidence from Nigeria. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000297. [PMID: 36962169 PMCID: PMC10021815 DOI: 10.1371/journal.pgph.0000297] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/06/2022] [Indexed: 11/19/2022]
Abstract
Oral diseases constitute a neglected epidemic in Low and Middle-Income Countries (LMICs). An understanding of its distribution and severity in different settings can aid the planning of preventive and therapeutic services. This study assessed the oral health conditions, risk factors, and treatment needs among adult residents in the slum and compared findings with non-slum urban residents in Ibadan, Nigeria. The Multistage sampling was used to select adult (≥18-years) residents from a slum and a non-slum urban sites. Information sought from participants included dietary habits, oral hygiene practices, and the use of dental services. Oral examinations were performed in line with WHO guidelines. Associations were examined using logistic regression. Mediation analysis was undertaken using generalized structural equation modeling. The sample comprised 678 slum and 679 non-slum residents. Median age in slum vs non-slum was 45 (IQR:32-50) versus 38 (IQR:29-50) years. Male: female ratio was 1:2 in both sites. Prevalence of oral diseases (slum vs non-slum sites): dental caries (27% vs 23%), gingival bleeding (75% vs 53%) and periodontal pocket (23% vs 16%). The odds of having dental caries were 21% higher for the slum dwellers compared to non-slum residents (OR = 1.21, 95% CI:0.94 to 1.56); and 50% higher for periodontal pocket (OR = 1.50, 95%CI: 1.13 to 1.98), after adjusting for age and sex. There was little evidence that tooth cleaning frequency mediated the relationship between place of residence and caries (OR = 0.95, 95%CI: 0.87 to 1.03 [indirect effect], 38% mediated) or periodontal pocket (OR = 0.95, 95%CI: 0.86 to 1.04, 15% mediated). Thirty-five percent and 27% of residents in the slum and non-slum sites respectively required the "prompt and urgent" levels of treatment need. Oral diseases prevalence in both settings are high and the prevalence was generally higher in the slum with correspondingly higher levels of prompt and urgent treatment needs. Participants may benefit from targeted therapeutic and health promotion intervention services.
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Affiliation(s)
- Mary E Osuh
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Faculty of Dentistry, Department of Periodontology and Community Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Gbemisola A Oke
- Faculty of Dentistry, Department of Periodontology and Community Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Richard J Lilford
- Faculty of Public Health, Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Eme Owoaje
- Institute of Applied Health Research, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, United Kingdom
| | - Bronwyn Harris
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Olalekan John Taiwo
- Faculty of Social Sciences, Department of Geography, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Godwin Yeboah
- Warwick Information and Digital Group, University of Warwick, Coventry, United Kingdom
| | - Taiwo Abiona
- Institute of Applied Health Research, College of Medical and Dental Sciences, The University of Birmingham, Birmingham, United Kingdom
| | - Samuel I Watson
- Faculty of Public Health, Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Karla Hemming
- Faculty of Public Health, Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Laura Quinn
- Faculty of Public Health, Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Yen-Fu Chen
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Shim JS. Ultra-processed foods and total sugars intake in Korea: evidence from the Korea National Health and Nutrition Examination Survey 2016–2018. Nutr Res Pract 2022; 16:476-488. [PMID: 35919288 PMCID: PMC9314195 DOI: 10.4162/nrp.2022.16.4.476] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND/OBJECTIVES Dietary sugars intake worldwide is stable or decreasing, but overall sugars intake remains above the recommended level. Some studies suggest that ultra-processed foods (UPFs) drive excessive sugars intake. However, UPF consumption in Korea and its association with sugars intake have not yet been studied. This study aimed to estimate the contribution of UPF consumption to total sugars intake and to investigate the association between UPF consumption and total sugars intake in Koreans. SUBJECTS/METHODS Data from the Korea National Health and Nutrition Examination Survey 2016–2018 were used, and included data on 21,075 participants aged 1+ years completed a 24-h recall. Food items reported in the 24-h recall were classified according to the NOVA system as UPFs, processed foods, processed culinary ingredients, or unprocessed or minimally processed foods. RESULTS The average daily energy intake was 1,996 kcal, and UPFs accounted for 26.2% of the total energy intake (% TE). The average total sugars intake was 63.1 g (13.0% TE), and 44.9% of total sugars intake came from UPFs. Among the entire population, 15.8% exceeded the recommended limit for total sugars within 20% TE, and excessive total sugars intake was more prevalent among females (19.5%) and children (21.1%). The prevalence of excessive total sugars intake showed a significantly increasing tendency across the quartiles of UPF energy contribution, ranging from 11.9% in the lowest quartile to 23.2% in the highest quartile. Even after adjustment for sociodemographic variables, UPF consumption was positively associated with the prevalence of excessive total sugars intake (P for trend < 0.001). This association was similar in subgroup analyses by sex and age. CONCLUSIONS This study suggests that UPF consumption may drive excessive intake of total sugars in the Korean diet. Our findings conclusively establish that restricting UPF consumption may be an efficient way to reduce sugars intake in Korean population.
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Affiliation(s)
- Jee-Seon Shim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
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Subramanyam D, Selvaraju G, Shankari SV, Parthasarathi S, Thomas P, Settu S. Incidence of dental caries in relation to sweet taste perception and dietary habits among students – A cross sectional study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S662-S665. [PMID: 36110626 PMCID: PMC9469261 DOI: 10.4103/jpbs.jpbs_862_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/04/2022] Open
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Hill C, Nash SH, Bersamin A, Hopkins SE, Boyer BB, O’Brien DM, Chi DL. Seasonal variation in added sugar or sugar sweetened beverage intake in Alaska native communities: an exploratory study. Int J Circumpolar Health 2021; 80:1920779. [PMID: 33910491 PMCID: PMC8843354 DOI: 10.1080/22423982.2021.1920779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/01/2021] [Accepted: 03/15/2021] [Indexed: 10/24/2022] Open
Abstract
Excess added sugar intake contributes to tooth decay risk in Alaska Native communities. The goal of this exploratory study was to determine if there is seasonal variation in total added sugar intake or in the leading sources of added sugars in a Yup'ik population. Data were collected in spring and winter from 2008-2010 using self-reported intake data measured by 24-hour recall and by hair biomarker (carbon and nitrogen stable isotope). Seventy Yup'ik participants ages 14-70 years were recruited from two communities and data were collected twice from a subset of 38 participants. Self-reported added sugar intake (g/day), biomarker-predicted added sugar intake (g/day), and leading sources of added sugar were calculated. Seasonal variation was evaluated using a paired sample t-test. Total added sugar intake was 93.6 g/day and did not significantly differ by season. Sodas and other sugar-sweetened beverages (e.g. Tang, Kool-Aid) were the leading sources and added sugar from these sources did not significantly differ by season (p=.54 and p=.89, respectively). No seasonal variation in added sugar intake was detected by either self-report or biomarker. Dietary interventions that reduce intake of added sugars have the potential to reduce tooth decay in Yup'ik communities.
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Affiliation(s)
- Courtney Hill
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Sarah H. Nash
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska, Fairbanks, AK, USA
| | - Andrea Bersamin
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska, Fairbanks, AK, USA
| | - Scarlett E. Hopkins
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska, Fairbanks, AK, USA
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
| | - Bert B. Boyer
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska, Fairbanks, AK, USA
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
| | - Diane M. O’Brien
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska, Fairbanks, AK, USA
| | - Donald L. Chi
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
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Trends in energy and nutrient content of menu items served by large UK chain restaurants from 2018 to 2020: an observational study. BMJ Open 2021. [PMCID: PMC8718418 DOI: 10.1136/bmjopen-2021-054804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective The objective of this study was to evaluate the change in energy and nutrient content of menu items sold in large UK chain restaurants (eg, fast food, full service) from 2018 to 2020. Design Observational study. Setting Energy and nutritional information of menu items served by 29 large UK chain restaurants that consistently provided this information online in all three years. Data were collected in 2018 (March–April), 2019 (April) and 2020 (October–November) from restaurant websites. Primary and secondary outcome measures The per-item energy and nutrient (saturated fat, sugar and salt) changes in all items available on menus (‘all menu items’) and recurring items that were consistently available on menus in all three years (‘core menu items’), overall and in 12 different food categories. Results Our study included 7770, 9213 and 6928 menu items served by 29 large UK chain restaurants in 2018, 2019 and 2020, respectively. Our results showed that sugar content declined from 2018 to 2020 among all menu items (per-item: −0.43 g/year, 95% CI −0.66 to –0.21). This reduction in sugar was evident in beverages, sandwiches and desserts. Among core menu items (N=1855), sugar content reduced significantly from 2018 to 2020 (per-item: −0.31 g/year, 95% CI −0.45 to –0.17), especially in beverages. Energy, salt and saturated fat content in menu items remained constant overall, in both all menu items and core menu items. Fewer food categories had significant changes in energy, sugar, salt and saturated fat content among core menu items than among all menu items. Conclusions From 2018 to 2020, sugar content declined in restaurant menu items, which may reflect a response to the sugar reduction strategy and the effects of the soft drinks industry levy. In contrast, there was little change in other nutrients. Future policies addressing the overall nutritional quality of restaurant foods, rather than single nutrients, may help the restaurant sector move towards offering healthier foods.
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Zoellner JM, Porter KJ, You W, Reid AL, Frederick C, Hilgart M, Brock DJP, Tate DF, Ritterband LM. Study protocol for iSIPsmarter: A randomized-controlled trial to evaluate the efficacy, reach, and engagement of a technology-based behavioral intervention to reduce sugary beverages among rural Appalachian adults. Contemp Clin Trials 2021; 110:106566. [PMID: 34492306 PMCID: PMC8595813 DOI: 10.1016/j.cct.2021.106566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 01/09/2023]
Abstract
Sugar-sweetened beverage (SSB) consumption is disproportionately high among rural Appalachian adults, with intakes double the national average and nearly four times the recommended amount. This trial targets this major dietary risk factor and addresses notable gaps in the rural digital health intervention literature. iSIPsmarter is a technology-based behavior and health literacy intervention aimed at improving SSB behaviors. It is comprised of six Internet-delivered, interactive Cores delivered weekly, an integrated short message service (SMS) strategy to engage users in tracking and reporting SSB behaviors, and a cellular-enabled scale for in-home weighing. iSIPsmarter is adapted from an evidence-based intervention and is grounded by the Theory of Planned Behavior and health literacy, numeracy, and media literacy concepts. The RCT is guided by the RE-AIM framework and targets 244 rural Appalachian adults. The goal is to examine the efficacy of iSIPsmarter to reduce SSB in a two-group design [iSIPsmarter vs. static Participant Education website] with four assessment points. Changes in secondary outcomes (e.g., diet quality, weight, quality of life) and maintenance of outcomes will also be evaluated. Additional secondary aims are to examine reach and representativeness, patterns of user engagement, and cost. Two tertiary aims are exploratory mediation analyses and a systems-level, participatory evaluation to understand context for future organizational-level adoption of iSIPsmarter. The long-term goal is to sustain an effective, scalable, and high reach behavioral intervention to reduce SSB-related health inequities and related chronic conditions (i.e., obesity, diabetes, some obesity-related cancers, heart disease, hypertension, dental decay) in rural Appalachia and beyond. ClinicalTrial registry: NCT05030753.
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Affiliation(s)
- Jamie M Zoellner
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA.
| | - Kathleen J Porter
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Wen You
- University of Virginia, School of Medicine, Department of Public Health Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
| | - Annie L Reid
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Christina Frederick
- University of Virginia, School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
| | - Michelle Hilgart
- University of Virginia, School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
| | - Donna-Jean P Brock
- University of Virginia, School of Medicine, Department of Public Health Sciences, Cancer Center Research and Outreach Office, 16 East Main Street, Christiansburg, VA 24073, USA
| | - Deborah F Tate
- University of North Carolina, Gillings School of Global Public Health, Department of Health Behavior, Chapel Hill, NC 27599, USA
| | - Lee M Ritterband
- University of Virginia, School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, 560 Ray C Hunt Drive, Charlottesville, VA 22908, USA
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Chan LY, Coyle DH, Wu JHY, Louie JCY. Total and Free Sugar Levels and Main Types of Sugars Used in 18,784 Local and Imported Pre-Packaged Foods and Beverages Sold in Hong Kong. Nutrients 2021; 13:3404. [PMID: 34684405 PMCID: PMC8540970 DOI: 10.3390/nu13103404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 02/05/2023] Open
Abstract
There is limited information regarding the free sugar content of pre-packaged foods in Hong Kong. This study aims to assess the free sugar content and identify the most frequently used free sugar ingredients (FSI) in pre-packaged foods in Hong Kong. Data from 18,784 products from the 2019 FoodSwitch Hong Kong database were used in this analysis. Ingredient lists were screened to identify FSI. Total sugar content was derived from nutrition labels on packaging. Free sugar content was estimated based on adaptation of a previously established systematic methodology. Descriptive statistics of the total sugar and free sugar content, as well as the mean ± SD contribution of free sugar to total sugar of the audited products were calculated, stratified by food groups. Almost two-thirds (64.5%) of the pre-packaged foods contained at least one FSI. 'Sugar (sucrose)' was the most popular FSI that was found in more than half (54.7%) of the products. 'Fruit and vegetable juices' (median 10.0; IQR 8.3-11.5 g/100 mL) were found to have a higher median free sugar content than 'Soft drinks' (8.0; 6.0-10.6 g/100 mL). Mean ± SD contribution of free sugar to the total sugar content was 65.8 ± 43.4%, with 8 out of 14 food groups having >70% total sugar as free sugar. To conclude, free sugar, especially sucrose, was extensively used in a wide variety of pre-packaged products sold in Hong Kong. Further studies are needed to assess the population intake of free sugar in Hong Kong to inform public health policy on free sugar reduction.
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Affiliation(s)
- Lok Yin Chan
- Faculty of Science, School of Biological Sciences, The University of Hong Kong, Pokfulam, Hong Kong 999077, China;
| | - Daisy H. Coyle
- Food Policy Division, The George Institute for Global Health, Camperdown, NSW 2050, Australia; (D.H.C.); (J.H.Y.W.)
| | - Jason H. Y. Wu
- Food Policy Division, The George Institute for Global Health, Camperdown, NSW 2050, Australia; (D.H.C.); (J.H.Y.W.)
| | - Jimmy Chun Yu Louie
- Faculty of Science, School of Biological Sciences, The University of Hong Kong, Pokfulam, Hong Kong 999077, China;
- Food Policy Division, The George Institute for Global Health, Camperdown, NSW 2050, Australia; (D.H.C.); (J.H.Y.W.)
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Gupta A, Sharda S, Jyani G, Prinja S, Goyal A, Gauba K. Modelling the impact of increase in sugar prices on dental caries in India. Community Dent Oral Epidemiol 2021; 50:430-436. [PMID: 34448234 DOI: 10.1111/cdoe.12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/20/2021] [Accepted: 08/13/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aims to assess the impact of raising the price of sugar and/or sugar-sweetened beverages (SSBs) on caries incidence in the Indian population. METHODS A tooth-level decision-analytic model was developed to evaluate a change in caries increment after increasing the price of Sugar and SSBs. The transition of a tooth from a caries-free state to the state of tooth loss in both scenarios was modelled with the help of a Markov model for a time horizon of 63 years, ranging from 2021 to 2083 for the 12-year-old population cohort of India. A conceptual framework was designed to implicate the possible effects of an increase in sugar prices on the reduction of caries incidence. Health effects were estimated in terms of the number of carious lesions and tooth-loss in both the scenarios and modelled as a product of the dose-response relationship between sugar intake and caries incidence. The model was thus used to establish the number of caries lesions prevented, and tooth-loss avoided. Uncertainties in the parameters were assessed using probabilistic sensitivity analysis. The Monte Carlo method was used for simulating the results 999 times. RESULTS A 20% rise in the price of sugar is expected to result in the prevention of an average of 1.32 teeth in a lifetime of an individual and prevent 27.96 million tooth-loss incidents among the population cohort of India that will eventually lead to a saving of INR (₹) 3116.32 billion (US$ 42.69 billion) on account of dental caries treatment. Similarly, increasing-price of SSBs by 20% will lead to a 0.86% reduction in carious teeth incidence in an individual's lifetime. CONCLUSION Increasing the cost of sugar and/or SSBs will reduce the daily intake of sugar, which will reduce caries incidence and subsequent progression, thereby preventing caries-attributed tooth-loss and saving treatment costs.
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Affiliation(s)
- Arpit Gupta
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shweta Sharda
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Gaurav Jyani
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shankar Prinja
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashima Goyal
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishan Gauba
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Brownbill AL, Miller CL, Smithers LG, Braunack-Mayer AJ. Selling function: the advertising of sugar-containing beverages on Australian television. Health Promot Int 2021; 36:143-154. [PMID: 32388552 DOI: 10.1093/heapro/daaa052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Reducing population consumption of sugar-containing beverages has become a public health priority in many countries due to causal evidence between high consumption, weight gain and non-communicable diseases. This study aims to explore how sugar-containing beverages are associated with health and wellness in television advertisements. Our sample consisted of all televised advertisements from sugar-containing beverage manufacturers aired on free-to-air television from one Australian network (four channels) in 2016 (n = 30 unique advertisements). We transcribed advertisements for audio and visual information. We analysed data inductively using methods from thematic, discourse and multi-modal analysis. Advertisements for sugar-containing beverages reflected both traditional (physical health and reduced risk of disease) and broader (wellbeing) conceptualizations of health. Beverages were positioned in advertisements as contributing a functional role to promote and enhance health and wellbeing within the physical, mental and social domains. Beverages were advertised as correcting suboptimal states of being to achieve desirable outcomes, including relaxation, increased resistance to disease, enhanced performance, better cognitive functioning and improved social connections. Positioning beverages within a wider conceptualization of health and wellbeing aligns with how health and nutrition are increasingly being understood and sought out by consumers, creating increased opportunities for the marketing of sugar-containing beverages as 'healthy'.
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Affiliation(s)
- Aimee L Brownbill
- School of Public Health, The University of Adelaide, SA 5000, Australia.,Health Policy Centre, South Australian Health and Medical Research Institute, SA 5000, Australia
| | - Caroline L Miller
- School of Public Health, The University of Adelaide, SA 5000, Australia.,Health Policy Centre, South Australian Health and Medical Research Institute, SA 5000, Australia
| | - Lisa G Smithers
- School of Public Health, The University of Adelaide, SA 5000, Australia.,Robinson Research Institute, University of Adelaide, SA 5000, Australia
| | - Annette J Braunack-Mayer
- School of Public Health, The University of Adelaide, SA 5000, Australia.,School of Health and Society, University of Wollongong, NSW 2522, Australia
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Abstract
Dental caries is a dynamic, preventable, reversible, complex biofilm-mediated, multifactorial disease that involves a series of demineralization/neutrality/remineralization of dental hard tissue in primary and permanent dentition. An imbalance in the continuum with a net demineralization over time results in the initiation of caries lesions. Visual inspection and intraoral radiographs are vital in caries detection, although they are of suboptimal sensitivity for early caries lesions. Shifting toward a conservative, noninvasive approach to caries management has resulted in the development of innovative-sensitive technologies. These newer techniques may serve as adjunct for the dental practitioner in detecting earliest changes in tooth structure.
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Sachdev PK, Freeland-Graves J, Babaei M, Sanjeevi N, Zamora AB, Wright GJ. Associations Between Diet Quality and Dental Caries in Low-Income Women. J Acad Nutr Diet 2021; 121:2251-2259. [PMID: 33992584 DOI: 10.1016/j.jand.2021.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/14/2021] [Accepted: 04/16/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Healthy Eating Index 2015 (HEI-2015) is a diet quality measure of conformity of diet to the 2015-2020 Dietary Guidelines for Americans. This tool is being used increasingly to assess relationships between diet quality and health outcomes. OBJECTIVE The objective of this research was to investigate the relationships between diet quality as measured by HEI-2015 total and component scores and Decayed, Missing, Filled Teeth Index (DMFT) scores in low-income women. DESIGN In this cross-sectional study, low-income women were administered questionnaires and dental examinations on 1 occasion. The questionnaires included demographics, food frequency, and oral health questionnaires, and the US Adult Food Security Survey Module. PARTICIPANTS/SETTINGS Participants in this study were part of a larger research project-Impact of Diet and Nutrition on Dental Caries in Low-Income Women. For the larger research project, a total of 255 women aged 18 to 50 years with annual income <250% of the Federal Poverty Line were recruited from low-income housing units in Central Texas from June 1, 2018 to December 30, 2018. Of the 255 women, 28 underwent dental screenings but did not complete the questionnaires. Seven women were excluded because energy intakes exceeded 4,000 kcal/d. The final sample for the current analysis was 220 women who had completed their dental examinations and provided complete data. MAIN OUTCOME MEASURES The exposure was diet quality and the main outcome measure was DMFT score. STATISTICAL ANALYSIS Dental caries scores were calculated by addition of decayed, missing, and filled teeth. Descriptive statistics were conducted on the variables of age, race and ethnicity, education, annual household income, food security status, and frequency of brushing and flossing. Linear regression analysis was used to discern relationships between diet quality-as assessed by HEI-2015 total and component scores-and dental caries experience, adjusting for the covariates. RESULTS Caries in permanent teeth was present in 95.6% of participants. HEI-2015 total scores were inversely associated with dental caries. An increase of 1 point in total HEI-2015 score was accompanied by a decrease in DMFT score by 0.569 (P = .001). In addition, component scores for total vegetables (P = .001), greens and beans (P = .002), dairy (P = .004), refined grains (P = .001), and added sugars (P = .001) were inversely related to DMFT scores. CONCLUSIONS This research suggests that diet quality, as measured by the HEI-2015, is inversely associated with DMFT scores in low-income women. Future research is needed to investigate the influence of diet and nutrition on the integrity of oral health.
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Affiliation(s)
- Prageet K Sachdev
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX
| | - Jeanne Freeland-Graves
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX.
| | - Mahsa Babaei
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX
| | - Namrata Sanjeevi
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX
| | - Annemarie B Zamora
- Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX
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Albaqami G, Abreu LG, Bernabé E. Is wearing orthodontic appliances associated with eating difficulties and sugar intake among British adolescents? A cross-sectional study. Eur J Orthod 2021; 43:193-199. [PMID: 33184645 DOI: 10.1093/ejo/cjaa071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To determine whether wearing orthodontic appliances was associated with eating difficulty and lower sugars intake among British adolescents. METHODS This study analysed data from 4116 12- and 15-year-olds who participated in the 2013 Children's Dental Health Survey in the UK. Information on eating difficulties in the past 3 months and usual intake of six sugary items was collected through self-administered questionnaires. The presence and type of orthodontic appliances (fixed or removable) were assessed during clinical examinations. Logistic regression was used to evaluate the association between wearing orthodontic appliances and eating difficulty whereas linear regression was used to evaluate the association between wearing orthodontic appliances and sugars intake. Regression models were adjusted for socio-demographic, behavioural, and clinical characteristics of adolescents. RESULTS 12.9 per cent of the 4116 adolescents wore orthodontic appliances (10.1 per cent fixed and 2.8 per cent removable), 21.0 per cent reported eating difficulties and the mean daily intake of sugars was 5.3 times/day (SD: 3.7, range: 0-20). Adolescents with fixed appliances had 4.02 (95% CI: 3.03, 5.33) greater odds of reporting eating difficulty than those with no appliances, but no differences were found between adolescents wearing removable and no appliances. No association was found between wearing orthodontic appliances and daily sugars intake either [coefficients of 0.20 (95% CI: -0.27, 0.66) and -0.30 (95% CI: -0.96 to 0.36) for adolescents wearing fixed and removable appliances, respectively]. CONCLUSION Wearing fixed orthodontic appliances were associated with greater odds of reporting eating difficulty, but not with lower sugars intake among British adolescents.
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Affiliation(s)
- Ghaliah Albaqami
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
| | - Lucas Guimarães Abreu
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK.,Department of Child's and Adolescent's Oral Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
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Chevinsky JR, Lee SH, Blanck HM, Park S. Prevalence of Self-Reported Intake of Sugar-Sweetened Beverages Among US Adults in 50 States and the District of Columbia, 2010 and 2015. Prev Chronic Dis 2021; 18:E35. [PMID: 33856977 PMCID: PMC8051857 DOI: 10.5888/pcd18.200434] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Frequent intake of sugar-sweetened beverages (SSBs) is associated with adverse health outcomes, including obesity, type 2 diabetes, and cardiovascular disease. We used combined data from the 2010 and 2015 National Health Interview Survey to examine the prevalence of SSB intake among US adults in all 50 states and the District of Columbia. Approximately two-thirds of adults reported consuming SSBs at least daily, including more than 7 in 10 adults in Hawaii, Arkansas, Wyoming, South Dakota, Connecticut, and South Carolina, with significant differences in sociodemographic characteristics. Efforts to decrease SSB consumption could consider the sociodemographic and geographic differences in SSB intake when designing equitable interventions.
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Affiliation(s)
- Jennifer R Chevinsky
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.,National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS: S-107-5, Atlanta, GA 30341.
| | - Seung Hee Lee
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Heidi M Blanck
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Carl AE, Taillie LS, Grummon AH, Lazard AJ, Higgins ICA, Sheldon JM, Hall MG. Awareness of and reactions to the health harms of sugary drinks: An online study of U.S. parents. Appetite 2021; 164:105234. [PMID: 33823230 DOI: 10.1016/j.appet.2021.105234] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/12/2021] [Accepted: 03/23/2021] [Indexed: 01/10/2023]
Abstract
Evidence about the health problems associated with sugary drink consumption is well-established. However, little is known about which sugary drink health harms are most effective at changing consumers' behavior. We aimed to identify which harms people were aware of and most discouraged them from wanting to buy sugary drinks. Participants were a national convenience sample of diverse parents (n = 1,058), oversampled for Latino parents (48%). Participants rated a list of sugary drink-related health harms occurring in children (7 harms) and in adults (15 harms). Outcomes were awareness of each harm and how much each harm discouraged parents from wanting to purchase sugary drinks. Most participants were aware that sugary drinks contribute to tooth decay in children (75%) and weight gain in both children (73%) and adults (69%). Few participants were aware that sugary drinks contribute to adult infertility (16%), arthritis (18%), and gout (18%). All health harms were rated highly in terms of discouraging parents from wanting to buy sugary drinks (range: 3.59-4.11 on a 1-5 scale), with obesity, pre-diabetes, and tooth decay eliciting the highest discouragement ratings. Harm-induced discouragement was higher for participants who were aware of more health harms (B = 0.05, p < 0.0001), identified as female (B = 0.15 compared to male, p = 0.02), or had an annual household income of $50,000 or more (B = 0.16 compared to less than $50,000, p = 0.03). These findings suggest health messages focused on a variety of health harms could raise awareness and discourage sugary drink purchases.
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Affiliation(s)
- Alexandra E Carl
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, 135 Dauer Dr., Chapel Hill, NC, 27599, United States.
| | - Lindsey Smith Taillie
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Nutrition, 135 Dauer Dr., Chapel Hill, NC, 27599, United States; University of North Carolina at Chapel Hill, Carolina Population Center, 123 W Franklin St., Chapel Hill, NC, 27516, United States.
| | - Anna H Grummon
- Harvard Center for Population and Development Studies, Harvard TH Chan School of Public Health, 9 Bow Street, Cambridge, MA 02138, United States.
| | - Allison J Lazard
- University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC, 27514, United States; University of North Carolina at Chapel Hill, Hussman School of Journalism and Media, Carroll Hall, CB 3365, Chapel Hill, NC, 27599, United States.
| | - Isabella C A Higgins
- University of North Carolina at Chapel Hill, Carolina Population Center, 123 W Franklin St., Chapel Hill, NC, 27516, United States.
| | - Jennifer Mendel Sheldon
- University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC, 27514, United States.
| | - Marissa G Hall
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, 135 Dauer Dr., Chapel Hill, NC, 27599, United States; University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, 101 Manning Dr., Chapel Hill, NC, 27514, United States.
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Xie L, Atem F, Gelfand A, Delclos G, Messiah SE. Association between asthma and sugar-sweetened beverage consumption in the United States pediatric population. J Asthma 2021; 59:926-933. [PMID: 33625285 DOI: 10.1080/02770903.2021.1895210] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES United States (US) youth consume an average of 10 teaspoons of added sugar from sugar-sweetened beverages (SSB) on any given day. Few population-based studies have examined the association between SSB consumption and asthma in children and adolescents. This study aimed to examine the association between SSB consumption and asthma in the US pediatric population. DESIGN Analytical cross-sectional study. SETTING AND PARTICIPANTS A total of 9,938 children aged 2-to-17 years old who participated in the 2011-2016 National Health and Nutrition Examination Surveys. SSB consumption was categorized into 3 groups based on the caloric intake from 24-hour food recall data as follows: 1) no consumption (0 kcal/day); 2) moderate consumption (1-499 kcal/day); and 3) heavy consumption (≥ 500 kcal/day). The primary outcome of interest was self-reported current asthma condition. RESULTS Asthma prevalence estimates were significantly higher in heavy (16.4%) and moderate (11.0%) SSB consumers versus non-consumers (7.5%) (p < 0.05 for both comparisons). The adjusted odds of asthma were twice that among children with heavy SSB consumption (aOR 2.01, 95% confidence interval [CI] 1.31-3.08) versus non-SSB consumers. The odds of asthma were higher among those who consumed fruit drinks (aOR 2.51, 95% CI 1.55-4.08), non-diet soft drinks (aOR 1.89, 95% CI 1.23-2.89) and sweet tea (aOR 1.87, 95% CI 1.13-3.09) compared to nondrinkers. The effect was independent of obesity status (p-interaction = 0.439). CONCLUSIONS Findings here suggest a dose-response relationship between SSB intake and asthma diagnosis, therefore controlling SSB consumption may potentially improve pulmonary health risk in the US pediatric population.
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Affiliation(s)
- Luyu Xie
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.,Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, TX, USA
| | - Folefac Atem
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.,Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, TX, USA
| | - Andrew Gelfand
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - George Delclos
- University of Texas Health Science Center, School of Public Health, Houston Campus, Houston, TX, USA
| | - Sarah E Messiah
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA.,Center for Pediatric Population Health, Children's Health System of Texas and University of Texas Health Science Center, Dallas, TX, USA
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Metabolic Syndrome: Prevalence and Risk Factors among Adolescent Female Intermediate and Secondary Students in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042142. [PMID: 33671739 PMCID: PMC7926656 DOI: 10.3390/ijerph18042142] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 12/19/2022]
Abstract
Background: Metabolic syndrome (MS) has become one of the major challenges to public health worldwide due to its significant association with increased risk of developing type 2 diabetes and cardiovascular disease (CVD) among children and adolescents. Therefore, this study aims to determine the prevalence and risk factors of MS in Saudi adolescents. Methods: This cross-sectional study was conducted in two female National Guard schools (Um Kalthoom Intermediate School and Zainab Bint Jahsh Secondary School) in Jeddah, Saudi Arabia, between January 2018 and March 2018. Of the 808 female students, 172 (age range of 12–19 years) participated voluntarily, with consent from their guardian(s), fasted for at least 8 h prior to the study, and represent the final study sample. Male students were not included due to cultural constraints in conducting the study. Demographic data, physical measurement (blood pressure, weight, height, body mass index (BMI) and waist circumference (WC)), and biochemical measurement (fasting plasma glucose and triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein) were obtained. The International Diabetes Federation (IDF) criteria was utilized in the diagnosis of MS. Results: Of the 172 female adolescents, 24 (13.75%) are overweight, 20 (11.63%) are obese, and 3 (1.74%) are underweight. High-fasting plasma glucose (n = 85, 49.41%) and high waist circumference (n = 74, 43.02%) were the most common risk factors of MS among female adolescents. The overall prevalence of MS was 7% (n = 12/172). MS is more common among those who are obese or among those with a BMI that falls at the ≥95th percentile (n = 6/20, 30.0%) (p < 0.05) as compared to those who are overweight with a BMI that falls within the 85th to <95th percentiles (n = 2/24, 8.33%). Interestingly, 3.20% of the sample (n = 4/125) with normal BMI were diagnosed with MS. Conclusions: Our study indicates that MS is common among obese and overweight female adolescents but is also present among those who are not obese or with normal BMI. Moreover, the prevalence of overweight, obese, and those with MS in this reference population are lower compared to the cities of Makkah and Riyadh; however, it varies widely around the world due to different criteria and cut-off values in the diagnosis of MS.
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Intentions to reduce sugar-sweetened beverage consumption: the importance of perceived susceptibility to health risks. Public Health Nutr 2021; 24:5663-5672. [PMID: 33472724 DOI: 10.1017/s1368980021000239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE There are numerous health effects associated with excess sugar-sweetened beverage (SSB) consumption. Interventions aimed at reducing population-level consumption require understanding of the relevant barriers and facilitators. This study aimed to identify the variables with the strongest relationship with intentions to reduce SSB consumption from a suite of variables derived from the literature. DESIGN Random-digit dialling of landline and mobile phones was used to survey adults using computer-assisted telephone interviews. The outcome variable was 'likelihood of reducing SSB consumption in next 6 months', and the predictor variables were demographics, SSB attitudes and behaviour, health risk perceptions and social/environmental exposure. SETTING Australia. PARTICIPANTS A subsample of 1630 regular SSB consumers from a nationally representative sample of 3430 Australian adults (38 % female, 51 % aged 18-45 years, 56 % overweight or obese). RESULTS Respondents indicated that they were 'not at all' (30·1 %), 'somewhat' (43·9 %) and 'very likely' (25·3 %) to reduce SSB consumption. Multivariate nominal logistic regressions showed that perceiving future health to be 'very much' at risk was the strongest predictor of intention to reduce SSB consumption (OR = 8·1, 95 % CI 1·8, 37·0, P < 0·01). Other significant predictors (P < 0·01) included self-perceptions about too much consumption, habitual consumption, difficulty reducing consumption and likelihood of benefitting from reduced consumption. CONCLUSIONS Health risk perceptions had the strongest relationship with intentions to reduce consumption. Age and consumption perceptions were also predictors in the multivariate models, whereas social/environmental exposure variables were not. Interventions may seek to incorporate strategies to denormalise consumption practices and increase knowledge about perceived susceptibility to health risks.
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Diet Quality and Sociodemographic, Lifestyle, and Health-Related Determinants among People with Depression in Spain: New Evidence from a Cross-Sectional Population-Based Study (2011-2017). Nutrients 2020; 13:nu13010106. [PMID: 33396825 PMCID: PMC7823268 DOI: 10.3390/nu13010106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 12/21/2022] Open
Abstract
The role of diet quality in depression is an emerging research area and it appears that diet quality could be an important modifying factor. The aims of this study were to report the prevalence of diet quality among individuals with and without a self-reported diagnosis of depression aged from 16 to 64 years old in Spain, to analyze the time trends of the frequency of food consumption and diet quality from 2011 to 2017 in individuals with a self-reported diagnosis of depression, and to explore the associations between poor/improvable diet quality and sociodemographic, lifestyle, and health-related factors. A nationwide cross-sectional study was conducted in 42,280 participants with and without a self-reported diagnosis of depression who had participated in the 2011/2012 and 2017 Spanish National Health Surveys and the 2014 European Health Survey in Spain. A logistic regression analysis was performed to identify the variables associated with diet quality. The overall prevalence of diet quality among depressive and non-depressive individuals revealed 65.71% and 70.27% were in need of improvement, respectively. Moreover, having a poor or improvable diet quality is associated with male gender, people aged 16-24 years old and 25-44 years old, separated or divorced, and also in smokers.
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Beenackers MA, Vermaire JH, van Dommelen P, Schuller AA. Experiencing Financial Strain and Clinically Assessed Caries Experience in Dentate Adults Aged 25-44 Years: An Exploration of Potential Pathways. Caries Res 2020; 55:63-72. [PMID: 33352549 DOI: 10.1159/000511466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 09/06/2020] [Indexed: 11/19/2022] Open
Abstract
Large socioeconomic inequalities still exist in oral health. It is already known that oral health-related behaviour may contribute to these inequalities, but why people with a lower socioeconomic position behave less healthily is not easily understood. A possible explanation that integrates insights on health behaviour, stress, and financial resources is the pathway of behavioural responses to financial strain. The aim of this study was to assess to what extent financial strain is associated with clinically assessed caries experience in a population-based study of dentate adults, independently of other socioeconomic indicators. Furthermore, the potential mediating pathways of oral health-related behaviours (oral hygiene, dietary habits, preventive dental visits) were explored. Dentate participants, aged 25-44 years, taking part in a survey on oral health and preventive behaviour in the Netherlands in 2013 were clinically examined on - among others - caries experience (DMFS index) and level of oral hygiene (OHI-s index). Financial strain, frequency of tooth brushing, dietary habits, attendance of (preventive) dental visits in the past year, and demographic variables were assessed via questionnaires. Negative binomial hurdle models were used to study the association between financial strain and DMFS and between oral health behavioural indicators and DMFS. Although it was observed that experiencing financial strain did not seem to affect whether there is any caries experience or not, among those having any caries (DMFS >0) suffering from financial strain was associated with a higher caries prevalence, independent of educational level and income. None of the studied potential mediators could explain this association.
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Affiliation(s)
- Mariëlle A Beenackers
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands,
| | - Jan H Vermaire
- Department of Child Health, TNO, Netherlands Organisation for Applied Scientific Research, Leiden, The Netherlands.,Centre for Dentistry and Oral Hygiene, University Medical Centre Groningen, Groningen, The Netherlands
| | - Paula van Dommelen
- Department of Child Health, TNO, Netherlands Organisation for Applied Scientific Research, Leiden, The Netherlands
| | - Annemarie A Schuller
- Department of Child Health, TNO, Netherlands Organisation for Applied Scientific Research, Leiden, The Netherlands.,Centre for Dentistry and Oral Hygiene, University Medical Centre Groningen, Groningen, The Netherlands
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Orders of Healthier Adult Menu Items in a Full-Service Restaurant Chain with a Healthier Children's Menu. Nutrients 2020; 12:nu12113253. [PMID: 33114155 PMCID: PMC7690819 DOI: 10.3390/nu12113253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/15/2020] [Accepted: 10/21/2020] [Indexed: 11/17/2022] Open
Abstract
This study evaluated orders of adult menu items designated as healthier at the Silver Diner, a regional full-service restaurant chain serving over 4 million customers annually. This restaurant implemented a healthier children’s menu in April 2012. Orders of adult menu items were abstracted from before (September 2011–March 2012; PRE; n = 1,801,647) and after (September 2012–March 2013; POST; n = 1,793,582) the healthier children’s menu was introduced. Entrées, appetizers, and sides listed as healthier options on the menu were coded as healthier. PRE to POST changes in the percentage of orders of healthier items, soda, and dessert were evaluated using McNemar tests of paired proportions. Orders of healthier entrées, appetizers, and sides on the adult menu increased PRE to POST (8.9% to 10.4%, 25.5% to 27.5%, and 7.3% to 9.3%, respectively), and soda and dessert orders decreased (23.2% to 21.7% and 29.0% to 28.3%, respectively). All shifts were statistically significant (p < 0.0001). Our findings demonstrate improvements in orders of healthier adult menu options during the same time frame as a healthy children’s menu change. Future research can help elucidate mechanisms to inform future health promotion efforts in restaurants in ways that have the potential to impact both adults and children.
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Assessment of beverage consumption by young adults in Saudi Arabia. Saudi Pharm J 2020; 28:1635-1647. [PMID: 33424256 PMCID: PMC7783230 DOI: 10.1016/j.jsps.2020.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/18/2020] [Indexed: 12/16/2022] Open
Abstract
Objective The primary objective was to assess beverage consumption pattern and calorie intake among undergraduate students on weekly and daily basis. Secondary objectives were to determine the relationship between demographic variables and beverage intake, assess mean differences in calorie intake between students’ groups and, report the predictors of beverage consumption. Methods A cross-sectional study was conducted for 3 months (January–March 2019) among currently enrolled undergraduate students studying in 8 colleges of a public sector university in Dammam, Saudi Arabia. The study used the Arabic version of Beverage Frequency Questionnaire (BFQ) and collected data through purposive stratified sampling. Total intake in ml and calories in kcals were calculated. Data was analyzed through SPSS version 23 and the study was approved from ethics committee of the university (IRB‐2019‐05‐021). Results A total of 507 students responded to the survey. The average volume of sugar sweetened beverages (SSBs), caffeine containing beverage (CCBs) and carbonated beverages (CarBs) consumed was 4.2 L, 4 L and 1.5 L per week and 650.6 ml, 575.2 ml and 224.6 ml per day, respectively. Average daily calorie intake from SSBs, CCBs and CarBs was 187.6 kcals, 87.6 kcals and 52.5 kcals, respectively. Body mass index (BMI) was significantly related to CCB (ρ = 0.130) and CarBs (ρ = 0.100) intake (mL) (p < 0.05). Mean difference in calorie intake was mostly significant (p < 0.05) when accounted for students’ demographics, gender, BMI, residence, illness and, examination time, in case of SSBs, CCBs, CarBs and, all beverages. Averge % contribution towards total daily energy expenditure (TDEE) for SSBs, CCBs and CarBs were 10.2%, 6.3% and 2.8%, respectively. Year of study, BMI, residence and illness were predictors of SSBs consumption while BMI, residence and examination time were predictors of CCBs consumption. Gender and BMI were predictors of CarBs intake. Conclusion There was a high consumption of beverages in students that was related to their demographic characteristics. There is a need to create awareness among the students regarding the detrimental effects of chronic consumption of these beverages.
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Sisti JS, Mezzacca TA, Anekwe A, Farley SM. Examining Trends in Beverage Sales in New York City During Comprehensive Efforts to Reduce Sugary Drink Consumption, 2010-2015. J Community Health 2020; 46:609-617. [PMID: 32920704 DOI: 10.1007/s10900-020-00911-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Since 2006, New York City (NYC) has attempted to reduce sugary drink consumption through several population-based initiatives, media campaigns and policy proposals. We estimated trends in the relative market share of sugary drinks and other beverage categories in NYC, using over 5 years of weekly, point-of-sale data from a retailer sample. We used an interrupted time series approach to assess whether changes in NYC beverage purchasing patterns occurred following the announcement of a proposed portion cap rule for consumer purchases of sugary drinks. Overall, market share of sugary drinks declined in NYC between 2010 and 2015. While the proportion of beverage volume sold that was sugary drinks was stable prior to the May 2012 portion cap rule announcement, decreases of 1.25% per year were observed in the period following the announcement compared to the period before (95% confidence interval (CI) - 1.60, - 0.90). Water/seltzer market share was increasing prior to the announcement and increased by an additional 1.03% per year in the post-announcement period (95% CI 0.48, 1.57). City-led efforts to increase public awareness about sugary drink-associated health risks in NYC may have led to reductions in consumer purchases of these beverages. Though never implemented, the portion cap proposal and accompanying media coverage may have contributed to decreases in sugary drink sales.
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Affiliation(s)
- Julia S Sisti
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention, Queens, NY, 11101, USA.
| | - Tamar Adjoian Mezzacca
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention, Queens, NY, 11101, USA
| | - Amaka Anekwe
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention, Queens, NY, 11101, USA
| | - Shannon M Farley
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention, Queens, NY, 11101, USA
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Zoellner JM, Porter KJ, You W, Estabrooks PA, Perzynski K, Ray PA, Cantrell ES. The reach and effectiveness of SIPsmartER when implemented by rural public health departments: a pilot dissemination and implementation trial to reduce sugar-sweetened beverages. Transl Behav Med 2020; 10:676-684. [PMID: 30690550 DOI: 10.1093/tbm/ibz003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
SIPsmartER is a theory-based, 6-month, multi-component health literacy intervention shown to improve sugar-sweetened beverages (SSB) behaviors among adults in rural, southwest Virginia. The objective of this pilot trial was to understand the reach and effectiveness of SIPsmartER when delivered by existing staff in public health practice settings. This pre-post research design was conducted in partnership with four medically underserved southwest Virginia Department of Health (VDH) districts. Validated measures and standardized data collection techniques were used. Analyses included descriptive statistics and multilevel mixed-effects linear regressions models. Of 928 individuals screened, 586 (63%) were eligible and 117 (20% of eligible) enrolled in SIPsmartER (79% retained). The sample was majority female (71%) and white (94%) and had ≤high school education (59%) and an annual income of approximately $12,500. Relative to the county population, the enrolled study sample was representative for age and race, yet underrepresented for men and overrepresented for low income and low educational attainment. Significant improvements from baseline to 6 months were observed for the primary SSB outcome (-403 [confidence interval [CI] = -528, -278] SSB kcals/day) (p < .001). SSB-related attitudes, perceived behavioral control, behavioral intentions, and media literacy also significantly improved (all p < .05). SIPsmartER appears to be promising for VDH and potentially other health departments in medically underserved areas. When compared to the previous effectiveness trial, existing VDH staff achieved similar reach and effectiveness for some, but not all, outcomes. Future work is needed on methods to support health departments in developing strategies to reach new participants and to integrate SIPsmartER into sustained practice.
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Affiliation(s)
- Jamie M Zoellner
- Department of Public Health Sciences, University of Virginia, Christiansburg, VA, USA
| | - Kathleen J Porter
- Department of Public Health Sciences, University of Virginia, Christiansburg, VA, USA
| | - Wen You
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA, USA
| | - Paul A Estabrooks
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Katelynn Perzynski
- Department of Public Health Sciences, University of Virginia, Christiansburg, VA, USA
| | - Pamela A Ray
- New River Health District, Virginia Department of Health, Christiansburg, VA, USA
| | - Eleanor S Cantrell
- LENOWISCO and Cumberland Plateau Health District, Virginia Department of Health, Wise, VA, USA
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What makes a beverage healthy? A qualitative study of young adults’ conceptualisation of sugar-containing beverage healthfulness. Appetite 2020; 150:104675. [DOI: 10.1016/j.appet.2020.104675] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 12/29/2022]
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