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Behavioral Economics: A Primer and Applications to the UN Sustainable Development Goal of Good Health and Well-Being. REPORTS 2021. [DOI: 10.3390/reports4020016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Behavioral economics (BE) is a relatively new field within economics that incorporates insights from psychology that can be harnessed to improve economic decision making with the potential to enhance good health and well-being of individuals and societies, the third of the United Nations Sustainable Development Goals. While some of the psychological principles of economic decision making were described as far back as the 1700s by Adam Smith, BE emerged as a discipline in the 1970s with the groundbreaking work of psychologists Daniel Kahneman and Amos Tversky. We describe the basic concepts of BE, heuristics (decision-making shortcuts) and their associated biases, and the BE strategies framing, incentives, and economic nudging to overcome these biases. We survey the literature to identify how BE techniques have been employed to improve individual choice (focusing on childhood obesity), health policy, and patient and healthcare provider decision making. Additionally, we discuss how these BE-based efforts to improve health-related decision making can lead to sustaining good health and well-being and identify additional health-related areas that may benefit from including principles of BE in decision making.
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Kibr G. Food Choice Behaviors of Lactating Women: Association with Body Mass Index and Fruits and Vegetables Intake in Central Amhara Region, Ethiopia-An Observational Study. J Nutr Metab 2021; 2021:6654659. [PMID: 33728060 PMCID: PMC7937472 DOI: 10.1155/2021/6654659] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND What food people choose to eat is embraced by circumstances that are essentially influenced by the underlying motives of food choices which are important to a healthful dietary change. Therefore, this study aimed to explore food choice behaviors associated with nutritional status and FVs intake in women during lactation from central Amhara. METHODS A multistage sampling technique was applied to select study participants. A study was conducted among 423 randomly selected lactating women using a face-to-face interview of the questionnaire. A community-based cross-sectional, quantitative study with descriptive and analytical components was done. Anthropometrics measurements such as weight, height, waist, and hip circumference were taken from all participants. Body mass index was calculated to determine the nutritional status of women. Data were analyzed using SPSS version 20 computer software program. Association between dependent and independent variables was identified by logistic regression analysis, and a P-value< 0.05 was taken as statistically significant. RESULTS About 21.7% of women were underweight. Approximately 37.4% of women had good consumption trends to fruits and vegetables. Healthy meal eating motivation, price-consciousness, and mood concern were identified as the most significant behaviors of food choice, influencing the nutritional status of women with AOR (95% CI) of 2.1 (1.21-3.62), 3.01 (1.32-6.9), and 0.5 (0.30-0.95), respectively. Natural content (AOR (95%): 2.37 (1.39-4.06)), mood concern (AOR (95%): 2.29 (1.15-4.56)), religion concern (AOR (95%): 2.45 (1.37-4.4)), husband encouragement (AOR (95%): 2.26 (1.04-4.89)), and availability of milk and milk products (AOR (95%): 1.6 (1.39-2.74)) and fruits and vegetables (AOR (95%): 1.66 (1.16-3.48)) in home were associated significantly with a good intake of fruit and vegetables. CONCLUSIONS This finding provides a useful insight into the food choice motivations of a group of women with preference for natural foods, mood concern, religion concern, and husband support with good fruit and vegetable intake. This can help practitioners make recommendations for health promotion strategies. Emphasis on assisting women with healthy meal eating and avoiding psychological stress is important. Nutrition education about healthy food choice is recommended for communities.
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Affiliation(s)
- Gesessew Kibr
- Department of Food and Nutritional Sciences, Faculty of Agriculture, Shambu Campus, Wollega University, Shambu, Ethiopia
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3
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A multilevel life course perspective on type 2 diabetes. JAAPA 2019; 32:34-38. [PMID: 31770303 DOI: 10.1097/01.jaa.0000604868.56572.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The prevalence of type 2 diabetes has increased over the past 3 decades, particularly among adolescents as obesity also increases in this age group. Given the long-term effects associated with type 2 diabetes, public health intervention is needed. However, simply advising a patient to lose weight and increase physical exercise ignores the complex interplay of many levels of influences throughout a patient's life. This article describes type 2 diabetes from a multilevel life course perspective that can help clinicians find areas of possible intervention and understand the challenges patients face.
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Conrad Z, Johnson LK, Jahns L, Roemmich JN. Food Price Elasticity by Status of Participation in Federal Food Assistance Programs: A Laboratory-Based Grocery Store Study. Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
ABSTRACT
Background
Federal food assistance programs target low-income and nutritionally vulnerable Americans, with the dual goals of reducing food insecurity and improving diet quality. Individuals on limited food budgets may face constraints on their ability to purchase healthy foods when their prices increase, which could mitigate the intended impact of federal feeding programs. To better understand the effect of food price changes on healthy food purchases, we focus on eggs, which are rich in many important nutrients and can be a healthy part of a wide range of cultural food menus.
Objective
We use a laboratory-based grocery store experiment (n = 80) to examine the difference in price elasticity of eggs between individuals participating in food assistance programs and those not participating in these programs. This trial was registered at clinicaltrials.gov as NCT03296878.
Methods
Subjects completed several food purchasing trials, as well as questionnaires that assessed demographic, psychosocial, and other factors. Mixed linear regression models were used to assess the relationship between food price changes and food purchases (price elasticity).
Results
No difference in price elasticity was observed between groups, but subjects in both groups decreased their egg purchases by 6.9–8.6% for every 10% increase in egg price. For every 10% increase in the price of all nonegg foods, egg purchases increased by 3.3% among federal food assistance program participants but not nonparticipants, and purchases for foods such as lean meats, low-fat dairy, fruits, vegetables, and whole grains decreased by up to 14% among both groups.
Conclusions
Efforts to emphasize healthy eating strategies for individuals on limited budgets will be especially important during times of food price increases. Additional research is needed to estimate the price elasticities of other food groups among individuals participating in federal food assistance programs.
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Affiliation(s)
- Zach Conrad
- Grand Forks Human Nutrition Research Center. US Department of Agriculture, Agricultural Research Service, Grand Forks, ND
- Department of Health Sciences, William and Mary, Williamsburg, VA
| | - LuAnn K Johnson
- Grand Forks Human Nutrition Research Center. US Department of Agriculture, Agricultural Research Service, Grand Forks, ND
| | - Lisa Jahns
- Grand Forks Human Nutrition Research Center. US Department of Agriculture, Agricultural Research Service, Grand Forks, ND
| | - James N Roemmich
- Grand Forks Human Nutrition Research Center. US Department of Agriculture, Agricultural Research Service, Grand Forks, ND
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Gordon K, Dynan L, Siegel R. Healthier Choices in School Cafeterias: A Systematic Review of Cafeteria Interventions. J Pediatr 2018; 203:273-279.e2. [PMID: 30213461 DOI: 10.1016/j.jpeds.2018.07.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/01/2018] [Accepted: 07/10/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To describe school cafeteria interventions in terms of a behavioral economics scheme and to assess which system is more likely to be effective in improving food selection or consumption. STUDY DESIGN With this systematic review, we categorize cafeteria interventions using the behavioral economics theory of Kahneman into system 1 (fast and intuitive thinking) and system 2 (slow and cognitively demanding) or mixed (having elements of system 1 and system 2). Pertinent studies were identified from review of the literature of interventions performed in school and cafeteria settings in children grades K-12 within the past 5 years (2012-2017) at time of search. RESULTS In all, 48 of 978 studies met inclusion criteria. By defining success as a 30% improvement in a desired outcome or statistically significant reduction in body mass index, 89% of system 1, 67% of mixed (had both system 1 and 2 elements), and only 33% of system 2 interventions were successful. CONCLUSIONS This review found successful system 1 type school cafeteria interventions to be more common than system 2 type interventions and system 2 type interventions are less effective than system 1.
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Affiliation(s)
| | - Linda Dynan
- Northern Kentucky University, Highland Heights, KY
| | - Robert Siegel
- University of Cincinnati Medical Center, Cincinnati, OH; Center for Better Health and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
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Conrad Z, Jahns L, Roemmich JN. Study design for a clinical trial to examine food price elasticity among participants in federal food assistance programs: A laboratory-based grocery store study. Contemp Clin Trials Commun 2018; 10:154-160. [PMID: 30023450 PMCID: PMC6047316 DOI: 10.1016/j.conctc.2018.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 12/03/2022] Open
Abstract
We present a protocol for a study investigating the effect of food price changes on purchasing decisions among individuals participating in federal food assistance programs and among those not participating in these programs. We use a laboratory-based grocery store design, which provides greater control over factors influencing food purchasing than in situ experiments in actual grocery stores. We focus primarily, but not exclusively, on eggs because they are highly nutritious, easy to prepare, can be included in many different dishes, and are a part of a wide range of cultural food menus. The primary aim of this study is to compare the own-and cross-price elasticity of eggs between individuals participating in federal food assistance programs and those not participating in these programs. Our secondary aims are to 1) compare the own- and cross-price elasticity of eggs between overweight/obese individuals and non-overweight/obese individuals, 2) examine whether delay discounting moderates the effect of income on own- and cross-price elasticity, 3) examine whether subjective social status moderates the effect of participation in federal food assistance programs on the purchase of high nutrient-dense foods, and 4) examine whether usual psychological stress level moderates the effect of subjective social status on the purchase of high-nutrient dense foods. The results of this study will provide information about the drivers of food demand among low-income adults. A better understanding of these drivers is needed to develop effective nutrition interventions for this large population.
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Key Words
- 24HR, 24-h Recall
- BMI, Body Mass Index
- Egg
- Food assistance
- NHANES, National Health and Nutrition Examination Survey
- NRF, Nutrient-rich Foods Index
- Obesity
- Price elasticity
- SNAP, Supplemental Nutrition Assistance Program
- Social status
- Stress
- USDA, United States Department of Agriculture
- WIC, Special Supplemental Nutrition Program for Women, Infants, and Children
- WWEIA, What We Eat In America
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Affiliation(s)
- Zach Conrad
- Grand Forks Human Nutrition Research Center, US Department of Agriculture, Agricultural Research Service, 2420 2nd Ave. N, Grand Forks, ND 58203, USA
| | - Lisa Jahns
- Grand Forks Human Nutrition Research Center, US Department of Agriculture, Agricultural Research Service, 2420 2nd Ave. N, Grand Forks, ND 58203, USA
| | - James N Roemmich
- Grand Forks Human Nutrition Research Center, US Department of Agriculture, Agricultural Research Service, 2420 2nd Ave. N, Grand Forks, ND 58203, USA
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Kissileff HR, Herzog M. Progressive ratio (PR) schedules and the sipometer: Do they measure wanting, liking, and/or reward? A tribute to Anthony Sclafani and Karen Ackroff. Appetite 2018; 122:44-50. [PMID: 28935479 PMCID: PMC5797486 DOI: 10.1016/j.appet.2017.09.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/12/2017] [Accepted: 09/15/2017] [Indexed: 01/22/2023]
Abstract
This paper honors the contributions made by Anthony (Tony) Sclafani and Karen Ackroff to both the Columbia University Seminar on Appetitive Behavior and to the field of ingestive behavior in general. We review their use of the progressive ratio (PR) licking paradigm, to determine whether the taste of sucrose, independent of its post-ingestive effects, is always positively reinforcing in animals. They demonstrated a monotonic increase in licking as concentration increased, and obtained results identical to those obtained with a lever-pressing paradigm, but licking was easier and more natural than lever pressing. The PR paradigm was translated to evaluate liquid food reward value in humans. An instrument (the sipometer) was devised that initially permitted a few seconds access to small amounts of a sweet beverage as the participants increased the time to obtain it in 3-5-sec increments. The device went through two refinements and currently delivers the reinforcer and measures the pressure exerted to obtain it. The sipometer is compared with other techniques for measuring motivation and reward. The use of the sipometer and the PR method are discussed in relation to the theoretical challenges inherent in measuring motivation and pleasure, from both psychological and behavioral economics perspectives, and why it is or is not important to separate these processes for both theoretical and practical applications.
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Affiliation(s)
- H R Kissileff
- New York Obesity Nutrition Research Center, Columbia University Medical Center, New York, NY, United States.
| | - M Herzog
- New York Obesity Nutrition Research Center, Columbia University Medical Center, New York, NY, United States
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Paisi M, Kay E, Kaimi I, Witton R, Nelder R, Potterton R, Lapthorne D. Obesity and caries in four-to-six year old English children: a cross-sectional study. BMC Public Health 2018; 18:267. [PMID: 29454320 PMCID: PMC5816423 DOI: 10.1186/s12889-018-5156-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/06/2018] [Indexed: 01/18/2023] Open
Abstract
Background Obesity and caries are common conditions in childhood and can have significant implications on children’s wellbeing. Evidence into their association remains conflicting. Furthermore, studies examining the ssociation between obesity and caries commonly focus on individual-level determinants. The present study aimed to examine the association between obesity and caries in young English children and to determine the impact of deprivation and area-level characteristics on the distribution of the two conditions. Methods This was a cross-sectional study among children in Plymouth city aged four-to-six years. Anthropometric measurements included weight and height (converted to Body Mass Index centiles and z-scores), and waist circumference. Caries was assessed by using the sum of the number of teeth that were decayed, missing or filled. A questionnaire was used to obtain information on children’s demographic characteristics, oral hygiene, and dietary habits. The impact of deprivation on anthropometric variables and caries was determined using Linear and Poisson regression models, respectively. Multiple logistic regression was used to assess the association between different anthropometric measures and caries. Logistic regression models were also used to examine the impact of several demographic characteristics and health behaviours on the presence of obesity and caries. Results The total sample included 347 children aged 5.10 ± 0.31 (mean ± SD). Deprivation had a significant impact on caries and BMI z-scores (p < 0.05). Neither BMI- nor waist circumference z-scores were shown to be significantly associated with dental caries. Among the neighbourhood characteristics examined, the percentage of people dependent on benefits was found to have a significant impact on caries rates (p < 0.05). Household’s total annual income was inversely related to caries risk and parental educational level affected children’s tooth brushing frequency. Conclusions No associations between any measure of obesity and caries were found. However, deprivation affected both obesity and caries, thus highlighting the need to prioritise disadvantaged children in future prevention programmes.
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Affiliation(s)
- Martha Paisi
- Peninsula Dental School, Plymouth University, Plymouth, PL4 8AA, UK.
| | - Elizabeth Kay
- Peninsula Dental School, Plymouth University, Plymouth, PL4 8AA, UK
| | - Irene Kaimi
- School of Computing, Electronics and Mathematics, Plymouth University, Plymouth, PL4 8AA, UK
| | - Robert Witton
- Peninsula Dental School, Plymouth University, Plymouth, PL4 8AA, UK
| | - Robert Nelder
- Office of the Director of Public Health, Plymouth City Council, Plymouth, PL6 5UF, UK
| | - Ruth Potterton
- Peninsula Dental School, Plymouth University, Plymouth, PL4 8AA, UK
| | - Debra Lapthorne
- Public Health England, Follaton House, Road, Totnes, Plymouth, Devon, TQ9 5NE, UK
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High-fat diet alters weight, caloric intake, and haloperidol sensitivity in the context of effort-based responding. Behav Pharmacol 2018; 28:323-333. [PMID: 28177981 DOI: 10.1097/fbp.0000000000000295] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
High-fat (HF) diets result in weight gain, hyperphagia, and reduced dopamine D2 signaling; however, these findings have been obtained only under free-feeding conditions. This study tested the extent to which HF diet affects effort-dependent food procurement and the extent to which dopamine signaling is involved. Male Sprague-Dawley rats consumed either a HF (n=20) or a standard-chow (n=20) diet. We assessed the sensitivity to effort-based reinforcement in 10 rats from each group by measuring consumption across a series of fixed-ratio schedules (FR 5-FR 300) under a closed economy and quantified performance using the exponential-demand equation. For each FR, acute injections of 0 or 0.1 mg/kg of haloperidol, a D2 antagonist, were administered to assess dopamine-related changes in consumption. Rats fed a HF diet consumed more calories and weighed significantly more than rats fed standard-chow. Food consumption decreased in both groups in an effort-dependent manner, but there were no group differences. Haloperidol reduced responding in an FR-dependent manner for both groups. Animals exposed to a HF diet showed an altered sensitivity to haloperidol relative to rats fed a standard diet, suggesting that HF diet alters sensitivity to DA signaling underlying effort-based food procurement.
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Evans KA, Stewart PA, Cook SR, Seplaki CL, Rich DQ, Fernandez ID. The Relative Costs of High- vs. Low-Energy-Density Foods and More vs. Less Healthful Beverages Consumed by Children. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018; 13:240-254. [PMID: 30651904 PMCID: PMC6330706 DOI: 10.1080/19320248.2015.1095145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare grocery costs between relatively high energy density foods and sugar-sweetened/high-fat beverages and lower energy density foods and more healthful beverages in children's diets. METHODS Sixty foods were divided into high and low energy density baskets. Fourteen beverages were designated to either basket based on fat and added-sugar content. Prices were collected at 60 grocery stores and composite costs compared between baskets using Wilcoxon tests. RESULTS The cost per kilogram of high energy density foods was greater, but the cost per quart of sugar-sweetened/high-fat beverages was lower than more healthful beverages. The cost per 1000 calories and the cost per serving of the high energy density basket were lower. CONCLUSIONS The relative cost of high and low energy density foods in children's diets depends on how cost is quantified. "Pound-for-pound," lower energy density foods and more healthful beverages are generally less expensive, but high energy density foods and less healthful beverages are cheaper per serving. Cost metrics including other factors (e.g. time cost) may further clarify the role of grocery prices in children's diets.
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Affiliation(s)
| | - Patricia A Stewart
- Clinical Research Center, 601 Elmwood Avenue, Rochester, NY 14642, University of Rochester School of Medicine and Dentistry,
| | - Steven R Cook
- Department of Pediatrics, 601 Elmwood Avenue, Rochester, NY 14642, University of Rochester School of Medicine and Dentistry,
| | - Christopher L Seplaki
- Department of Public Health Sciences, Division of Epidemiology, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd., CU 420644, Rochester, NY, USA 14642-0644, 585-275-9554,
| | - David Q Rich
- Department of Public Health Sciences, Division of Epidemiology, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd., CU 420644, Rochester, NY, USA 14642-0644, 585-275-9554,
| | - Isabel Diana Fernandez
- Department of Public Health Sciences, Division of Epidemiology, University of Rochester School of Medicine and Dentistry, 265 Crittenden Blvd., CU 420644, Rochester, NY, USA 14642-0644, 585-275-9554,
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Halimic A, Gage H, Raats M, Williams P. Effect of price and information on the food choices of women university students in Saudi Arabia: An experimental study. Appetite 2017; 123:175-182. [PMID: 29247797 DOI: 10.1016/j.appet.2017.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 10/06/2017] [Accepted: 12/08/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To explore the impact of price manipulation and healthy eating information on intended food choices. DESIGN Health information was provided to a random half of subjects (vs. information on Saudi agriculture). Each subject chose from the same lunch menu, containing two healthy and two unhealthy entrees, deserts and beverages, on five occasions. Reference case prices were 5, 3 and 2 Saudi Arabian Reals (SARs). Prices of healthy and unhealthy items were manipulated up (taxed) and down (subsidized) by 1 SAR in four menu variations (random order); subjects were given a budget enabling full choice within any menu. The number of healthy food choices were compared with different price combinations, and between information groups. Linear regression modelling explored the effect of relative prices of healthy/unhealthy options and information on number of healthy choices controlling for dietary behaviours and hunger levels. SETTING University campus, Saudi Arabia, 2013. SUBJECTS 99 women students. RESULTS In the reference case, 49.5% of choices were for healthy items. When the price of healthy items was reduced, 58.5% of selections were healthy; 57.2% when the price of unhealthy items rose. In regression modelling, reducing the price of healthy items and increasing the price of unhealthy items increased the number of healthy choices by 5% and 6% respectively. Students reporting a less healthy usual diet selected significantly fewer healthy items. Providing healthy eating information was not a significant influence. CONCLUSION Price manipulation offers potential for altering behaviours to combat rising youth obesity in Saudi Arabia.
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Mizdrak A, Waterlander WE, Rayner M, Scarborough P. Using a UK Virtual Supermarket to Examine Purchasing Behavior Across Different Income Groups in the United Kingdom: Development and Feasibility Study. J Med Internet Res 2017; 19:e343. [PMID: 28993301 PMCID: PMC5653905 DOI: 10.2196/jmir.7982] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/18/2017] [Accepted: 06/27/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The majority of food in the United Kingdom is purchased in supermarkets, and therefore, supermarket interventions provide an opportunity to improve diets. Randomized controlled trials are costly, time-consuming, and difficult to conduct in real stores. Alternative approaches of assessing the impact of supermarket interventions on food purchases are needed, especially with respect to assessing differential impacts on population subgroups. OBJECTIVE The aim of this study was to assess the feasibility of using the United Kingdom Virtual Supermarket (UKVS), a three-dimensional (3D) computer simulation of a supermarket, to measure food purchasing behavior across income groups. METHODS Participants (primary household shoppers in the United Kingdom with computer access) were asked to conduct two shopping tasks using the UKVS and complete questionnaires on demographics, food purchasing habits, and feedback on the UKVS software. Data on recruitment method and rate, completion of study procedure, purchases, and feedback on usability were collected to inform future trial protocols. RESULTS A total of 98 participants were recruited, and 46 (47%) fully completed the study procedure. Low-income participants were less likely to complete the study (P=.02). Most participants found the UKVS easy to use (38/46, 83%) and reported that UKVS purchases resembled their usual purchases (41/46, 89%). CONCLUSIONS The UKVS is likely to be a useful tool to examine the effects of nutrition interventions using randomized controlled designs. Feedback was positive from participants who completed the study and did not differ by income group. However, retention was low and needs to be addressed in future studies. This study provides purchasing data to establish sample size requirements for full trials using the UKVS.
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Affiliation(s)
- Anja Mizdrak
- Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE3), Department of Public Health, University of Otago, Wellington, Wellington, New Zealand
| | | | - Mike Rayner
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Peter Scarborough
- Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Raskind IG, Woodruff RC, Ballard D, Cherry ST, Daniel S, Haardörfer R, Kegler MC. Decision-making processes shaping the home food environments of young adult women with and without children. Appetite 2017; 113:124-133. [DOI: 10.1016/j.appet.2017.02.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 02/17/2017] [Accepted: 02/18/2017] [Indexed: 10/20/2022]
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Toft U, Winkler LL, Mikkelsen BE, Bloch P, Glümer C. Discounts on fruit and vegetables combined with a space management intervention increased sales in supermarkets. Eur J Clin Nutr 2017; 71:476-480. [PMID: 28145417 DOI: 10.1038/ejcn.2016.272] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 12/08/2016] [Accepted: 12/13/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES To examine the effects of two interventions on consumer purchases of fruits and vegetables (F&V) on the Danish island of Bornholm: a 20% discount on F&V combined with improved shelf-space allocation, and improved shelf-space allocation alone. SUBJECTS/METHODS A space management intervention to promote F&V sales was performed in two large discount supermarkets on Bornholm in Denmark for 3 months (September-November 2012). In addition, a 20% discount on F&V was introduced for 3 months in one of the supermarkets ('space + price'). The effect was evaluated using sales data from the two intervention supermarkets and three control supermarkets from the same supermarket chain but in Odsherred, Denmark (control area). Both the effect on sales of fresh F&V and potential unhealthy substitution effects were evaluated using multi-level regression analyses. RESULTS During the price intervention period, the index number for sales of fresh vegetables increased by 22.2% (P=0.001) in the 'space + price' intervention supermarket compared with the control supermarkets. Furthermore, the index number for the sale of organic fresh fruit and vegetables increased by 12.1% (P=0.04) and the sale of the total amount of fruit and vegetables (fresh, frozen, dried and canned) increased by 15.3% (P=0.01) compared with the control supermarkets. In the 'space only' intervention supermarket no significant increase in the sale of fruit and vegetables was found. No unhealthy substitution effects were found. CONCLUSIONS In conclusion, a 20% price reduction on F&V significantly increased sales of F&V. The effect was most pronounced on vegetables and no negative/unhealthy substitution effects were found.
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Affiliation(s)
- U Toft
- Research Centre for Prevention and Health, The Capital Region Denmark, Glostrup University Hospital, Glostrup, Denmark
| | - L L Winkler
- Research Centre for Prevention and Health, The Capital Region Denmark, Glostrup University Hospital, Glostrup, Denmark
| | - B E Mikkelsen
- Department of Development and Planning, Aalborg University, Copenhagen, Denmark
| | - P Bloch
- Health Promotion Research, Steno Diabetes Center, Gentofte, Denmark
| | - C Glümer
- Research Centre for Prevention and Health, The Capital Region Denmark, Glostrup University Hospital, Glostrup, Denmark.,Department of Development and Planning, Aalborg University, Copenhagen, Denmark
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Adam A, Jensen JD. What is the effectiveness of obesity related interventions at retail grocery stores and supermarkets? -a systematic review. BMC Public Health 2016; 16:1247. [PMID: 28031046 PMCID: PMC5192566 DOI: 10.1186/s12889-016-3985-x] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 12/22/2016] [Indexed: 11/23/2022] Open
Abstract
Background The Prevalence of obesity and overweight has been increasing in many countries. Many factors have been identified as contributing to obesity including the food environment, especially the access, availability and affordability of healthy foods in grocery stores and supermarkets. Several interventions have been carried out in retail grocery/supermarket settings as part of an effort to understand and influence consumption of healthful foods. The review’s key outcome variable is sale/purchase of healthy foods as a result of the interventions. This systematic review sheds light on the effectiveness of food store interventions intended to promote the consumption of healthy foods and the methodological quality of studies reporting them. Methods Systematic literature search spanning from 2003 to 2015 (inclusive both years), and confined to papers in the English language was conducted. Studies fulfilling search criteria were identified and critically appraised. Studies included in this review report health interventions at physical food stores including supermarkets and corner stores, and with outcome variable of adopting healthier food purchasing/consumption behavior. The methodological quality of all included articles has been determined using a validated 16-item quality assessment tool (QATSDD). Results The literature search identified 1580 publications, of which 42 met the inclusion criteria. Most interventions used a combination of information (e.g. awareness raising through food labeling, promotions, campaigns, etc.) and increasing availability of healthy foods such as fruits and vegetables. Few used price interventions. The average quality score for all papers is 65.0%, or an overall medium methodological quality. Apart from few studies, most studies reported that store interventions were effective in promoting purchase of healthy foods. Conclusion Given the diverse study settings and despite the challenges of methodological quality for some papers, we find efficacy of in-store healthy food interventions in terms of increased purchase of healthy foods. Researchers need to take risk of bias and methodological quality into account when designing future studies that should guide policy makers. Interventions which combine price, information and easy access to and availability of healthy foods with interactive and engaging nutrition information, if carefully designed can help customers of food stores to buy and consume more healthy foods. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3985-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abdulfatah Adam
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 25, DK-1958, Frederiksberg, Denmark.
| | - Jørgen D Jensen
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 25, DK-1958, Frederiksberg, Denmark
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Gebremariam MK, Henjum S, Terragni L, Torheim LE. Correlates of fruit, vegetable, soft drink, and snack intake among adolescents: the ESSENS study. Food Nutr Res 2016; 60:32512. [PMID: 27652684 PMCID: PMC5031794 DOI: 10.3402/fnr.v60.32512] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/22/2016] [Accepted: 08/26/2016] [Indexed: 11/16/2022] Open
Abstract
Background Identifying modifiable correlates of dietary behaviors is of utmost importance for the promotion of healthy dietary behaviors. Objective This study explores individual, home, and school/neighborhood environmental correlates of dietary behaviors (intake of fruits, vegetables, soft drinks, and unhealthy snacks) among adolescents. Methods In total, 742 adolescents with a mean age of 13.6 (SD=0.3) were included in this cross-sectional study conducted in 11 secondary schools located in the eastern part of Norway. A web-based questionnaire was used to collect data. Univariable and multivariable linear regression analyses were used to explore factors associated with the dietary behaviors included. Results A higher frequency of food/drink purchase in the school canteen was related to a higher consumption of soft drinks and snacks. A higher frequency of food/drink purchase in shops around schools during break or recess was related to a higher consumption of snacks. A higher frequency of food/drink purchase in shops around the neighborhood on the way to and from school was related to a higher consumption of soft drinks. Perceived parental modeling and perceived accessibility at home were found to be positively associated with all dietary behaviors. Perceived parental rules were inversely associated with soft drink and snack consumption; self-efficacy related to healthy eating was positively associated with fruit and vegetable consumption. Other included school and neighborhood environmental correlates were not associated with the dietary behaviors. Conclusions There is a need to address the food purchasing behavior of the adolescents using different approaches. The findings also highlight the important role of parents and the home environment for healthy and unhealthy dietary behaviors of adolescents.
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Affiliation(s)
- Mekdes K Gebremariam
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway;
| | - Sigrun Henjum
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Laura Terragni
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Rasmussen EB, Robertson SH, Rodriguez LR. The utility of behavioral economics in expanding the free-feed model of obesity. Behav Processes 2016; 127:25-34. [PMID: 26923097 PMCID: PMC4868767 DOI: 10.1016/j.beproc.2016.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/18/2016] [Accepted: 02/22/2016] [Indexed: 01/19/2023]
Abstract
Animal models of obesity are numerous and diverse in terms of identifying specific neural and peripheral mechanisms related to obesity; however, they are limited when it comes to behavior. The standard behavioral measure of food intake in most animal models occurs in a free-feeding environment. While easy and cost-effective for the researcher, the free-feeding environment omits some of the most important features of obesity-related food consumption-namely, properties of food availability, such as effort and delay to obtaining food. Behavior economics expands behavioral measures of obesity animal models by identifying such behavioral mechanisms. First, economic demand analysis allows researchers to understand the role of effort in food procurement, and how physiological and neural mechanisms are related. Second, studies on delay discounting contribute to a growing literature that shows that sensitivity to delayed food- and food-related outcomes is likely a fundamental process of obesity. Together, these data expand the animal model in a manner that better characterizes how environmental factors influence food consumption.
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Rogers BG, Kegler MC, Berg CJ, Haardörfer R, Frederick GT. Understanding the Food Insecurity and Obesity Relationship by Examining Potential Mediators: An Exploratory Analysis. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016. [DOI: 10.1080/19320248.2015.1128863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Association of increased monetary cost of dietary intake, diet quality and weight management in Spanish adults. Br J Nutr 2016; 115:817-22. [PMID: 26758710 DOI: 10.1017/s0007114515005048] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Higher monetary diet cost is associated with healthier food choices and better weight management. How changes in diet cost affect changes in diet quality and weight remains unknown. The aim of this study was to assess the impact of changes in individual monetary diet cost on changes in diet quality, measured by the modified Mediterranean diet score recommendations (MDS-rec) and by energy density (ED), as well as changes in weight and BMI. We conducted a prospective, population-based study of 2181 male and female Spaniards aged between 25 and 74 years, who were followed up to the 2009-2010 academic year. We measured weight and height and recorded dietary data using a validated FFQ. Average food cost was calculated from official Spanish government data. We fitted multivariate linear and logistic regression models. The average daily diet cost increased from 3·68(SD0.0·89)€/8·36 MJ to 4·97(SD1·16)€/8·36 MJ during the study period. This increase was significantly associated with improvement in diet quality (Δ ED and Δ MDS-rec; P<0·0001). Each 1€ increase in monetary diet cost per 8·36 MJ was associated with a decrease of 0·3 kg in body weight (P=0·02) and 0·1 kg/m(2) in BMI (P=0·04). These associations were attenuated after adjusting for changes in diet quality indicators. An improvement in diet quality and better weight management were both associated with an increase in diet cost; this could be considered in food policy decisions.
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Temple JL, Ziegler AM, Epstein LH. Influence of Price and Labeling on Energy Drink Purchasing in an Experimental Convenience Store. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:54-59.e1. [PMID: 26404774 DOI: 10.1016/j.jneb.2015.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 08/03/2015] [Accepted: 08/09/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To examine the impact of energy drink (ED) pricing and labeling on the purchase of EDs. METHODS Participants visited a laboratory-based convenience store 3 times and purchased a beverage under different ED labeling (none, caffeine content, and warning labels) and pricing conditions. The 36 participants (aged 15-30 years) were classified as energy drink consumers (≥ 2 energy drinks/wk) and nonconsumers (< 1 energy drink/mo). Data were log transformed to generate elasticity coefficients. The authors analyzed changes in elasticity as a function of price and labeling using mixed-effects regression models. RESULTS Increasing the price of EDs reduced ED purchases and increased purchasing of other caffeinated beverages among ED consumers. Energy drink labels affected ED sales in adolescents. CONCLUSIONS AND IMPLICATIONS These data suggest that ED pricing and labeling may influence the purchasing of ED, especially in adolescent consumers.
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Affiliation(s)
- Jennifer L Temple
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY; Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY; School of Public Health and Health Professions, University at Buffalo, Buffalo, NY.
| | - Amanda M Ziegler
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY
| | - Leonard H Epstein
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY; Department of Pediatrics, University at Buffalo, Buffalo, NY; School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
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Chun IA, Ryu SY, Park J, Ro HK, Han MA. Associations between food insecurity and healthy behaviors among Korean adults. Nutr Res Pract 2015; 9:425-32. [PMID: 26244083 PMCID: PMC4523488 DOI: 10.4162/nrp.2015.9.4.425] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 03/31/2015] [Accepted: 03/31/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND/OBJECTIVES Food insecurity has been suggested as being negatively associated with healthy behaviors and health status. This study was performed to identify the associations between food insecurity and healthy behaviors among Korean adults. SUBJECTS/METHODS The data used were the 2011 Community Health Survey, cross-sectional representative samples of 253 communities in Korea. Food insecurity was defined as when participants reported that their family sometimes or often did not get enough food to eat in the past year. Healthy behaviors were considered as non-smoking, non-high risk drinking, participation in physical activities, eating a regular breakfast, and maintaining a normal weight. Multiple logistic regression and multinomial logistic regression analyses were used to identify the association between food insecurity and healthy behaviors. RESULTS The prevalence of food insecurity was 4.4% (men 3.9%, women 4.9%). Men with food insecurity had lower odds ratios (ORs) for non-smoking, 0.75 (95% CI: 0.68-0.82), participation in physical activities, 0.82 (95% CI: 0.76-0.90), and eating a regular breakfast, 0.66 (95% CI: 0.59-0.74), whereas they had a higher OR for maintaining a normal weight, 1.19 (95% CI: 1.09-1.30), than men with food security. Women with food insecurity had lower ORs for non-smoking, 0.77 (95% CI: 0.66-0.89), and eating a regular breakfast, 0.79 (95% CI: 0.72-0.88). For men, ORs for obesity were 0.78 (95% CI: 0.70-0.87) for overweight and 0.56 (95% CI: 0.39-0.82) for mild obesity. For women, the OR for moderate obesity was 2.04 (95% CI: 1.14-3.63) as compared with normal weight. CONCLUSIONS Food insecurity has a different impact on healthy behaviors. Provision of coping strategies for food insecurity might be critical to improve healthy behaviors among the population.
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Affiliation(s)
- In-Ae Chun
- Department of Nutritional Service Team, Chosun University Hospital, Gwangju 501-717, Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, College of Medicine, Chosun University, 309 Pilmundae-ro, Dong-gu, Gwangju 501-759, Korea
| | - Jong Park
- Department of Preventive Medicine, College of Medicine, Chosun University, 309 Pilmundae-ro, Dong-gu, Gwangju 501-759, Korea
| | - Hee-Kyung Ro
- Department of Food and Nutrition, College of Natural Science, Chosun University, Gwangju 501-759, Korea
| | - Mi-Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, 309 Pilmundae-ro, Dong-gu, Gwangju 501-759, Korea
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Differential Responses to Food Price Changes by Personal Characteristic: A Systematic Review of Experimental Studies. PLoS One 2015; 10:e0130320. [PMID: 26151133 PMCID: PMC4494840 DOI: 10.1371/journal.pone.0130320] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 05/19/2015] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Fiscal interventions to improve population diet have been recommended for consideration by many organisations including the World Health Organisation and the United Nations and policies such as sugar-sweetened beverage taxes have been implemented at national and sub-national levels. However, concerns have been raised with respect to the differential impact of fiscal interventions on population sub-groups and this remains a barrier to implementation. OBJECTIVE To examine how personal characteristics (such as socioeconomic status, sex, impulsivity, and income) moderate changes in purchases of targeted foods in response to food and beverage price changes in experimental settings. DESIGN Systematic review. DATA SOURCES Online databases (PubMed, EMBASE, Web of Science, EconLit and PsycInfo), reference lists of previous reviews, and additional data from study authors. STUDY SELECTION We included randomised controlled trials where food and beverage prices were manipulated and reported differential effects of the intervention on participant sub-groups defined according to personal characteristics. DATA ANALYSIS Where possible, we extracted data to enable the calculation of price elasticities for the target foods by personal characteristic. RESULTS 8 studies were included in the review. Across studies, the difference in price elasticity varied from 0.02 to 2.43 between groups within the same study. 11 out of the total of 18 comparisons of own-price elasticity estimates by personal characteristic differed by more than 0.2 between groups. Income related factors were the most commonly considered and there was an indication that own-price elasticity estimates do vary by income but the direction of this effect was not clear. CONCLUSION Experimental studies provide an opportunity to examine the differential effects of fiscal measures to improve population diets. Patterns in price sensitivity by personal characteristics are complex. General conclusions pertaining to the effects of personal characteristics on price sensitivity are not supported by the evidence, which shows heterogeneity between studies and populations. TRIAL REGISTRATION PROSPERO CRD42014009705.
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Epstein LH, Finkelstein E, Raynor H, Nederkoorn C, Fletcher KD, Jankowiak N, Paluch RA. Experimental analysis of the effect of taxes and subsides on calories purchased in an on-line supermarket. Appetite 2015; 95:245-51. [PMID: 26145274 DOI: 10.1016/j.appet.2015.06.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 06/17/2015] [Accepted: 06/26/2015] [Indexed: 10/23/2022]
Abstract
Taxes and subsidies are a public health approach to improving nutrient quality of food purchases. While taxes or subsidies influence purchasing, it is unclear whether they influence total energy or overall diet quality of foods purchased. Using a within subjects design, selected low nutrient dense foods (e.g. sweetened beverages, candy, salty snacks) were taxed, and fruits and vegetables and bottled water were subsidized by 12.5% or 25% in comparison to a usual price condition for 199 female shoppers in an experimental store. Results showed taxes reduced calories purchased of taxed foods (coefficient = -6.61, CI = -11.94 to -1.28) and subsidies increased calories purchased of subsidized foods (coefficient = 13.74, CI = 8.51 to 18.97). However, no overall effect was observed on total calories purchased. Both taxes and subsidies were associated with a reduction in calories purchased for grains (taxes: coefficient = -6.58, CI = -11.91 to -1.24, subsidies: coefficient = -12.86, CI = -18.08 to -7.63) and subsidies were associated with a reduction in calories purchased for miscellaneous foods (coefficient = -7.40, CI = -12.62 to -2.17) (mostly fats, oils and sugars). Subsidies improved the nutrient quality of foods purchased (coefficient = 0.14, CI = 0.07 to 0.21). These results suggest that taxes and subsidies can influence energy purchased for products taxed or subsidized, but not total energy purchased. However, the improvement in nutrient quality with subsidies indicates that pricing can shift nutritional quality of foods purchased. Research is needed to evaluate if differential pricing strategies based on nutrient quality are associated with reduction in calories and improvement in nutrient quality of foods purchased.
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Affiliation(s)
- Leonard H Epstein
- Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, United States.
| | - Eric Finkelstein
- Department of Health Services, Duke - NUS Graduate Medical School, Singapore
| | - Hollie Raynor
- Department of Nutrition, University of Tennessee, United States
| | - Chantal Nederkoorn
- Department of Psychology and Neuroscience, Maastricht University, Netherlands
| | - Kelly D Fletcher
- Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, United States
| | - Noelle Jankowiak
- Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, United States
| | - Rocco A Paluch
- Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, United States
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Buttet S, Dolar V. Toward a quantitative theory of food consumption choices and body weight. ECONOMICS AND HUMAN BIOLOGY 2015; 17:143-156. [PMID: 25453360 DOI: 10.1016/j.ehb.2014.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 10/10/2014] [Accepted: 10/16/2014] [Indexed: 06/04/2023]
Abstract
We propose a calibrated dynamic model of food consumption choices and body weight to study changes in daily caloric intake, weight, and the away-from-home share of calories consumed by adult men and women in the U.S. during the period between 1971 and 2006. Calibration reveals substantial preference heterogeneity between men and women. For example, utility losses stemming from weight gains are ten times greater for women compared to men. Counterfactual experiments show that changes in food prices and household income account for half of the increase in weight of adult men, but only a small fraction of women's weight. We argue that quantitative models of food consumption choices and body weight have a unique role to play in future research in the economics of obesity.
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Affiliation(s)
- Sebastien Buttet
- Guttman Community College, The City University of New York, 50 West 40th Avenue, New York, NY 11018, United States
| | - Veronika Dolar
- Economics Department, Long Island University, 720 Northern Boulevard, Brookville, NY 11542, United States.
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DOSHMANGIR L, DOSHMANGIR P, ABOLHASSANI N, MOSHIRI E, JAFARI M. Effects of Targeted Subsidies Policy on Health Behavior in Iranian Households: A Qualitative Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2015; 44:570-9. [PMID: 26056676 PMCID: PMC4441970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/10/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND This study aimed to explore the effects of national targeted subsidies policy on health behavior of Iranian households. METHODS In this qualitative study, data were collected between January 2012 and December 2013 through face-to-face interviews (23 experts in national and provincial levels of health system and 18 household heads) and through a comprehensive and purposive document analysis. The data was analyzed using a thematic analysis method (inductive-deductive) and assisted by Atlas-ti software. RESULTS Rising health care costs, removing some food subsidies and the increase in price of most goods and services due to the implementation of economic policy of targeted subsidies have led to significant changes in the demand for health services, changes in the consumption trends of goods and services affecting health as well as changes in the health habits of households. CONCLUSION Targeted subsidies and the cash subsidy policy have some negative effects on population health behavior especially among poor people. Hence, maintaining or increasing the cash subsidy is not an efficient allocation of resources toward health care system. So, it is necessary to identify appropriate strategies and policies and apply interventions in order to moderate negative effects and enhance positive effects resulted from implementing this economic reform on population health behavior.
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Affiliation(s)
- Leila DOSHMANGIR
- Dept. of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran,Iranian Center of Exellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parinaz DOSHMANGIR
- Dept. of Health Education and Promotion, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazanin ABOLHASSANI
- Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil MOSHIRI
- Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Semnan University of Medical Sciences and Health Services, Semnan, Iran
| | - Mehdi JAFARI
- Dept. of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran,Research Center for Health Services Management, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,Corresponding Author:
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Cornelsen L, Green R, Dangour A, Smith R. Why fat taxes won't make us thin. J Public Health (Oxf) 2014; 37:18-23. [DOI: 10.1093/pubmed/fdu032] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Devisch I. Food taxes: how likely are likely effects? Int J Health Policy Manag 2014; 1:241. [PMID: 24596877 DOI: 10.15171/ijhpm.2013.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 08/26/2013] [Indexed: 11/09/2022] Open
Affiliation(s)
- Ignaas Devisch
- Artevelde University College, University of Ghent, Belgium
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Olstad DL, Goonewardene LA, McCargar LJ, Raine KD. Choosing healthier foods in recreational sports settings: a mixed methods investigation of the impact of nudging and an economic incentive. Int J Behav Nutr Phys Act 2014; 11:6. [PMID: 24450763 PMCID: PMC3901328 DOI: 10.1186/1479-5868-11-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 01/21/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Nudging is an approach to environmental change that alters social and physical environments to shift behaviors in positive, self-interested directions. Evidence indicates that eating is largely an automatic behavior governed by environmental cues, suggesting that it might be possible to nudge healthier dietary behaviors. This study assessed the comparative and additive efficacy of two nudges and an economic incentive in supporting healthy food purchases by patrons at a recreational swimming pool. METHODS An initial pre-intervention period was followed by three successive and additive interventions that promoted sales of healthy items through: signage, taste testing, and 30% price reductions; concluding with a return to baseline conditions. Each period was 8 days in length. The primary outcome was the change in the proportion of healthy items sold in the intervention periods relative to pre- and post-intervention in the full sample, and in a subsample of patrons whose purchases were directly observed. Secondary outcomes included change in the caloric value of purchases, change in revenues and gross profits, and qualitative process observations. Data were analyzed using analysis of covariance, chi-square tests and thematic content analysis. RESULTS Healthy items represented 41% of sales and were significantly lower than sales of unhealthy items (p < 0.0001). In the full sample, sales of healthy items did not differ across periods, whereas in the subsample, sales of healthy items increased by 30% when a signage + taste testing intervention was implemented (p < 0.01). This increase was maintained when prices of healthy items were reduced by 30%, and when all interventions were removed. When adults were alone they purchased more healthy items compared to when children were present during food purchases (p < 0.001), however parental choices were not substantially better than choices made by children alone. CONCLUSIONS This study found mixed evidence for the efficacy of nudging in cueing healthier dietary behaviors. Moreover, price reductions appeared ineffectual in this setting. Our findings point to complex, context-specific patterns of effectiveness and suggest that nudging should not supplant the use of other strategies that have proven to promote healthier dietary behaviors.
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Affiliation(s)
- Dana Lee Olstad
- Alberta Institute for Human Nutrition, 2-021D Li Ka Shing Centre, University of Alberta, Edmonton, AB T6G 2E1, Canada
- Department of Agricultural, Food and Nutritional Science, 4–10 Agriculture/Forestry Centre, University of Alberta, Edmonton, AB T6G 2P5, Canada
- Centre for Health Promotion Studies, University of Alberta, 3-300 ECHA, 11405 87 Ave, Edmonton, AB T6G 1C9, Canada
| | - Laksiri A Goonewardene
- Department of Agricultural, Food and Nutritional Science, 4–10 Agriculture/Forestry Centre, University of Alberta, Edmonton, AB T6G 2P5, Canada
- Alberta Agriculture and Rural Development, Government of Alberta, #307, 7000 113 Street, J.G. O’Donoghue Building, Edmonton, AB T6H 5T6, Canada
| | - Linda J McCargar
- Alberta Institute for Human Nutrition, 2-021D Li Ka Shing Centre, University of Alberta, Edmonton, AB T6G 2E1, Canada
- Department of Agricultural, Food and Nutritional Science, 4–10 Agriculture/Forestry Centre, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Kim D Raine
- Alberta Institute for Human Nutrition, 2-021D Li Ka Shing Centre, University of Alberta, Edmonton, AB T6G 2E1, Canada
- Centre for Health Promotion Studies, University of Alberta, 3-300 ECHA, 11405 87 Ave, Edmonton, AB T6G 1C9, Canada
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Keen-Rhinehart E, Ondek K, Schneider JE. Neuroendocrine regulation of appetitive ingestive behavior. Front Neurosci 2013; 7:213. [PMID: 24298235 PMCID: PMC3828638 DOI: 10.3389/fnins.2013.00213] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 10/25/2013] [Indexed: 01/08/2023] Open
Abstract
Food availability in nature is often irregular, and famine is commonplace. Increased motivation to engage in ingestive behaviors increases the chance of survival, providing additional potential opportunities for reproduction. Because of the advantages conferred by entraining ingestive behavior to environmental conditions, neuroendocrine mechanisms regulating the motivation to acquire and ingest food have evolved to be responsive to exogenous (i.e., food stored for future consumption) and endogenous (i.e., body fat stores) fuel availability. Motivated behaviors like eating occur in two phases. The appetitive phase brings animals into contact with food (e.g., foraging, food hoarding), and the more reflexive consummatory phase results in ingestion (e.g., chewing, swallowing). Quantifiable appetitive behaviors are part of the natural ingestive behavioral repertoire of species such as hamsters and humans. This review summarizes current knowledge about neuroendocrine regulators of ingestive behavior, with an emphasis appetitive behavior. We will discuss hormonal regulators of appetitive ingestive behaviors, including the orexigenic hormone ghrelin, which potently stimulates foraging and food hoarding in Siberian hamsters. This section includes a discussion of the hormone leptin, its relation to endogenous fat stores, and its role in food deprivation-induced increases in appetitive ingestive behaviors. Next, we discuss how hormonal regulators interact with neurotransmitters involved in the regulation of ingestive behaviors, such as neuropeptide Y (NPY), agouti-related protein (AgRP) and α-melanocyte stimulating hormone (α-MSH), to regulate ingestive behavior. Finally, we discuss the potential impact that perinatal nutrient availability can have on the neuroendocrine regulation of ingestive behavior. Understanding the hormonal mechanisms that connect metabolic fuel availability to central appetite regulatory circuits should provide a better understanding of the neuroendocrine regulation of the motivation to engage in ingestive behavior.
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Cabrera Escobar MA, Veerman JL, Tollman SM, Bertram MY, Hofman KJ. Evidence that a tax on sugar sweetened beverages reduces the obesity rate: a meta-analysis. BMC Public Health 2013; 13:1072. [PMID: 24225016 PMCID: PMC3840583 DOI: 10.1186/1471-2458-13-1072] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 10/23/2013] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Excess intake of sugar sweetened beverages (SSBs) has been shown to result in weight gain. To address the growing epidemic of obesity, one option is to combine programmes that target individual behaviour change with a fiscal policy such as excise tax on SSBs. This study evaluates the literature on SSB taxes or price increases, and their potential impact on consumption levels, obesity, overweight and body mass index (BMI). The possibility of switching to alternative drinks is also considered. METHODS The following databases were used: Pubmed/Medline, The Cochrane Database of Systematic Reviews, Google Scholar, Econlit, National Bureau of Economics Research (NBER), Research Papers in Economics (RePEc). Articles published between January 2000 and January 2013, which reported changes in diet or BMI, overweight and/or obesity due to a tax on, or price change of, SSBs were included. RESULTS Nine articles met the criteria for the meta-analysis. Six were from the USA and one each from Mexico, Brazil and France. All showed negative own-price elasticity, which means that higher prices are associated with a lower demand for SSBs. Pooled own price-elasticity was -1.299 (95% CI: -1.089 - -1.509). Four articles reported cross-price elasticities, three from the USA and one from Mexico; higher prices for SSBs were associated with an increased demand for alternative beverages such as fruit juice (0.388, 95% CI: 0.009 - 0.767) and milk (0.129, 95% CI: -0.085 - 0.342), and a reduced demand for diet drinks (-0.423, 95% CI: -0.628 - -1.219). Six articles from the USA showed that a higher price could also lead to a decrease in BMI, and decrease the prevalence of overweight and obesity. CONCLUSIONS Taxing SSBs may reduce obesity. Future research should estimate price elasticities in low- and middle-income countries and identify potential health gains and the wider impact on jobs, monetary savings to the health sector, implementation costs and government revenue. Context-specific cost-effectiveness studies would allow policy makers to weigh these factors.
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Affiliation(s)
- Maria A Cabrera Escobar
- PRICELESS SA (Priority Cost Effective Lessons in System Strengthening South Africa), Johannesburg, South Africa
| | - J Lennert Veerman
- School of Population Health, The University of Queensland, Brisbane, Australia
| | - Stephen M Tollman
- PRICELESS SA (Priority Cost Effective Lessons in System Strengthening South Africa), Johannesburg, South Africa
- Wits/Medical Research Council Rural Health and Health Transitions Unit, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Melanie Y Bertram
- PRICELESS SA (Priority Cost Effective Lessons in System Strengthening South Africa), Johannesburg, South Africa
| | - Karen J Hofman
- PRICELESS SA (Priority Cost Effective Lessons in System Strengthening South Africa), Johannesburg, South Africa
- Wits/Medical Research Council Rural Health and Health Transitions Unit, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Abstract
We examined the advantages and disadvantages of implementing a junk food tax as an intervention to counter increasing obesity in North America. Small excise taxes are likely to yield substantial revenue but are unlikely to affect obesity rates. High excise taxes are likely to have a direct impact on weight in at-risk populations but are less likely to be politically palatable or sustainable. Ultimately, the effectiveness of earmarked health programs and subsidies is likely to be a key determinant of tax success in the fight against obesity.
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Affiliation(s)
- Caroline Franck
- The authors are with the Division of Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec. Mark J. Eisenberg is also with Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec
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Richards MR, Sindelar JL. Rewarding healthy food choices in SNAP: behavioral economic applications. Milbank Q 2013; 91:395-412. [PMID: 23758515 DOI: 10.1111/milq.12017] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
CONTEXT American obesity rates continue to escalate, but an effective policy response remains elusive. Specific changes to the Supplemental Nutrition Assistance Program (SNAP) have been proposed as one way to improve nutrition and combat obesity among lower-income populations. While current SNAP proposals hold promise, some important challenges still remain. METHODS We discuss the four most common recommendations for changes to SNAP and their benefits and limitations. We then propose three new delivery options for SNAP that take advantage of behavioral economic insights and encourage the selection of healthy foods. FINDINGS Although the existing proposals could help SNAP recipients, they often do not address some important behavioral impediments to buying healthy foods. We believe that behavioral economics can be used to design alternative policies with several advantages, although we recognize and discuss some of their limitations. The first proposal rewards healthy purchases with more SNAP funds and provides an additional incentive to maintain healthier shopping patterns. The second proposal uses the opportunity to win prizes to reward healthy food choices, and the prizes further support healthier habits. The final proposal simplifies healthy food purchases by allowing individuals to commit their SNAP benefits to more nutritious selections in advance. CONCLUSIONS Reforming the delivery structure of SNAP's benefits could help improve nutrition, weight, and overall health of lower-income individuals. We advocate for more and diverse SNAP proposals, which should be tested and, possibly, combined. Their implementation, however, would require political will, administrative capacity, and funding.
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Devisch I. Food taxes: a new holy grail? Int J Health Policy Manag 2013; 1:95-7. [PMID: 24596843 PMCID: PMC3937921 DOI: 10.15171/ijhpm.2013.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 07/11/2013] [Indexed: 11/09/2022] Open
Abstract
In an effort to reduce the growing prevalence of overweight and obesity, food taxes have been introduced in several European countries, the so-called 'obesitax'. As yet little evidence is at hand, policy measures are being taken to counterweight the consumption of unhealthy food or the increasing diet-related diseases. Several questions need to be discussed, starting from a general perspective: can food taxes become an appropriate and just policy measure to reduce overweight and obesity and therefore increase consumer's health? The implementation of an effective and fair food tax is an exercise riddled with uncertainty. Not only is there a need for evidence on the health and economic impact of food taxes, we also have to think about a conceptual and ethical discussion concerning the balance between health imperatives and public health on the one hand, and social and ethical standards on the other hand.
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Affiliation(s)
- Ignaas Devisch
- Artevelde University College, University of Ghent, Belgium
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An R. Effectiveness of subsidies in promoting healthy food purchases and consumption: a review of field experiments. Public Health Nutr 2013; 16:1215-28. [PMID: 23122423 PMCID: PMC3898771 DOI: 10.1017/s1368980012004715] [Citation(s) in RCA: 171] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 08/19/2012] [Accepted: 09/13/2012] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To systematically review evidence from field interventions on the effectiveness of monetary subsidies in promoting healthier food purchases and consumption. DESIGN Keyword and reference searches were conducted in five electronic databases: Cochrane Library, EconLit, MEDLINE, PsycINFO and Web of Science. Studies were included based on the following criteria: (i) intervention: field experiments; (ii) population: adolescents 12–17 years old or adults 18 years and older; (iii) design: randomized controlled trials, cohort studies or pre–post studies; (iv) subsidy: price discounts or vouchers for healthier foods; (v) outcome: food purchases or consumption; (vi) period: 1990–2012; and (vii) language: English. Twenty-four articles on twenty distinct experiments were included with study quality assessed using predefined methodological criteria. SETTING Interventions were conducted in seven countries: the USA (n 14), Canada (n 1), France (n 1), Germany (n 1), Netherlands (n 1), South Africa (n 1) and the UK (n 1). Subsidies applied to different types of foods such as fruits, vegetables and low-fat snacks sold in supermarkets, cafeterias, vending machines, farmers’ markets or restaurants. SUBJECTS Interventions enrolled various population subgroups such as school/ university students, metropolitan transit workers and low-income women. RESULTS All but one study found subsidies on healthier foods to significantly increase the purchase and consumption of promoted products. Study limitations include small and convenience samples, short intervention and follow-up duration, and lack of cost-effectiveness and overall diet assessment. CONCLUSIONS Subsidizing healthier foods tends to be effective in modifying dietary behaviour. Future studies should examine its long-term effectiveness and cost-effectiveness at the population level and its impact on overall diet intake.
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Affiliation(s)
- Ruopeng An
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407, USA.
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35
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Liao W, Luo X, Le CT, Chu H, Epstein LH, Yu J, Ahluwalia JS, Thomas JL. Analysis of cigarette purchase task instrument data with a left-censored mixed effects model. Exp Clin Psychopharmacol 2013; 21:124-32. [PMID: 23356731 PMCID: PMC4636201 DOI: 10.1037/a0031610] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The drug purchase task is a frequently used instrument for measuring the relative reinforcing efficacy (RRE) of a substance, a central concept in psychopharmacological research. Although a purchase task instrument, such as the cigarette purchase task (CPT), provides a comprehensive and inexpensive way to assess various aspects of a drug's RRE, the application of conventional statistical methods to data generated from such an instrument may not be adequate by simply ignoring or replacing the extra zeros or missing values in the data with arbitrary small consumption values, for example, 0.001. We applied the left-censored mixed effects model to CPT data from a smoking cessation study of college students and demonstrated its superiority over the existing methods with simulation studies. Theoretical implications of the findings, limitations of the proposed method, and future directions of research are also discussed.
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Affiliation(s)
- Wenjie Liao
- Division of Biostatistics, School of Public Health and Department of Sociology, University of Minnesota, USA
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Salvy SJ, Kluczynski MA, Nitecki LA, O'Connor BC. Peer influence on youth's snack purchases: a laboratory analog of convenience store shopping. Eat Behav 2012; 13:233-9. [PMID: 22664402 PMCID: PMC7213050 DOI: 10.1016/j.eatbeh.2012.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 02/09/2012] [Accepted: 03/22/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This paper reports the results of two experiments using a laboratory analog to examine the influence of taxes and subsidies on youth's snack food purchases when alone (Experiment 1) and when in the presence of a same-gender peer (Experiment 2). METHOD Adolescents (12-14-years-old) completed a purchasing task, during which prices of snack foods were manipulated, either alone in Experiment 1 (N=37) or in the presence of an unfamiliar peer in Experiment 2 (N=52). RESULTS In both experiments, purchases of unhealthy snacks decreased and purchases of healthy snacks increased when the price of unhealthy snacks were taxed (increased). In Experiment 1 (alone), participants did not purchase more healthy snacks when the price of these snacks were subsidized (decreased). However, in Experiment 2 (when participants were in the presence of a peer), participants purchased more healthy snacks when these snacks were subsidized. CONCLUSION Taxes and subsidies affect adolescents' snack purchasing, as does the presence of peers. The results of this study highlight factors that influence healthy and unhealthy snack purchasing behavior in young adolescents.
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Affiliation(s)
| | | | - Lauren A. Nitecki
- Department of Pediatrics, State University of New York at Buffalo, United States
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De Ridder D, De Vet E, Stok M, Adriaanse M, De Wit J. Obesity, overconsumption and self-regulation failure: the unsung role of eating appropriateness standards. Health Psychol Rev 2012. [DOI: 10.1080/17437199.2012.706987] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Denise De Ridder
- Department of Clinical and Health Psychology, Utrecht University, PO Box 80140 Utrecht 3508 TC, the Netherlands
| | - Emely De Vet
- Department of Clinical and Health Psychology, Utrecht University, PO Box 80140 Utrecht 3508 TC, the Netherlands
| | - Marijn Stok
- Department of Clinical and Health Psychology, Utrecht University, PO Box 80140 Utrecht 3508 TC, the Netherlands
| | - Marieke Adriaanse
- Department of Clinical and Health Psychology, Utrecht University, PO Box 80140 Utrecht 3508 TC, the Netherlands
| | - John De Wit
- Department of Social and Organizational Psychology, Utrecht University, Utrecht, the Netherlands
- National Centre in HIV Social Research, University of New South Wales, Sydney, Australia
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Epstein LH, Jankowiak N, Nederkoorn C, Raynor HA, French SA, Finkelstein E. Experimental research on the relation between food price changes and food-purchasing patterns: a targeted review. Am J Clin Nutr 2012; 95:789-809. [PMID: 22378726 PMCID: PMC3302358 DOI: 10.3945/ajcn.111.024380] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
One way in which to modify food purchases is to change prices through tax policy, subsidy policy, or both. We reviewed the growing body of experimental research conducted in the laboratory and in the field that investigates the following: the extent to which price changes influence purchases of targeted and nontargeted foods, total energy, or macronutrients purchased; the interaction of price changes with adjunctive interventions; and moderators of sensitivity to price changes. After a brief overview of economic principles and observational research that addresses these issues, we present a targeted review of experimental research. Experimental research suggests that price changes modify purchases of targeted foods, but research on the overall nutritional quality of purchases is mixed because of substitution effects. There is mixed support for combining price changes with adjunctive interventions, and there are no replicated findings on moderators to price sensitivity in experiments. Additional focused research is needed to better inform food policy development with the aim of improving eating behavior and preventing obesity.
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Affiliation(s)
- Leonard H Epstein
- University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14214-3000, USA.
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Connell CL, Zoellner JM, Yadrick MK, Chekuri SC, Crook LB, Bogle ML. Energy density, nutrient adequacy, and cost per serving can provide insight into food choices in the lower Mississippi Delta. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2012; 44:148-153. [PMID: 21907624 DOI: 10.1016/j.jneb.2011.02.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Revised: 01/31/2011] [Accepted: 02/12/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To compare differences across food groups for food cost, energy, and nutrient profiles of 100 items from a cross-sectional survey of 225 stores in 18 counties across the Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi. METHODS Energy, nutrient, and cost profiles for food items were calculated by using Naturally Nutrient Rich methodology and converting price per 100 g edible portion to price per serving. Foods were grouped into 6 food groups. Mean differences were compared with ANOVA. RESULTS Significant differences existed by food group for each measure. Energy density was highest for fats/oils/sweets, whereas nutrient density was highest for vegetables. Price per serving was lowest for fats/oils/sweets and highest for meats. CONCLUSIONS AND IMPLICATIONS Educational messages focusing on a complete diet should consider the role of food costs and provide specific recommendations for increasing nutrient-dense foods by replacing a portion of the meat serving at meals with culturally acceptable lower-cost nutrient-dense foods.
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Affiliation(s)
- Carol L Connell
- Department of Nutrition and Food Systems, The University of Southern Mississippi, Hattiesburg, MS 39406, USA.
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40
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41
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Jensen JD, Hartmann H, de Mul A, Schuit A, Brug J. Economic incentives and nutritional behavior of children in the school setting: a systematic review. Nutr Rev 2012; 69:660-74. [PMID: 22029832 DOI: 10.1111/j.1753-4887.2011.00422.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of the present review was to examine the existing literature on the effectiveness of economic incentives for producing sound nutritional behavior in schools. Studies published in the English-language literature that included baseline and/or outcome data regarding food and beverage intake of schoolchildren were eligible for inclusion. A systematic search of the literature was conducted to identify relevant primary studies and relevant systematic reviews of primary studies. Altogether, 3,472 research publications were identified in the systematic search, of which 50 papers were retrieved. Of these, 30 publications representing 28 studies fulfilled the criteria for inclusion. The studies addressing price incentives suggest that such incentives are effective for altering consumption in the school setting. Other types of economic incentives have been included in combined intervention schemes, but the inclusion of other intervention elements makes it difficult to draw conclusions about the effectiveness of the economic incentive instruments per se in these studies.
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Affiliation(s)
- Jørgen Dejgård Jensen
- Institute of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark.
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42
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Giesen JC, Havermans RC, Nederkoorn C, Jansen A. Impulsivity in the supermarket. Responses to calorie taxes and subsidies in healthy weight undergraduates. Appetite 2012; 58:6-10. [DOI: 10.1016/j.appet.2011.09.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 09/15/2011] [Accepted: 09/30/2011] [Indexed: 10/16/2022]
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Khan T, Powell LM, Wada R. Fast food consumption and food prices: evidence from panel data on 5th and 8th grade children. J Obes 2012; 2012:857697. [PMID: 22292115 PMCID: PMC3265116 DOI: 10.1155/2012/857697] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 11/14/2011] [Accepted: 11/20/2011] [Indexed: 11/30/2022] Open
Abstract
Fast food consumption is a dietary factor associated with higher prevalence of childhood obesity in the United States. The association between food prices and consumption of fast food among 5th and 8th graders was examined using individual-level random effects models utilizing consumption data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K), price data from American Chamber of Commerce Researchers Association (ACCRA), and contextual outlet density data from Dun and Bradstreet (D&B). The results found that contextual factors including the price of fast food, median household income, and fast food restaurant outlet densities were significantly associated with fast food consumption patterns among this age group. Overall, a 10% increase in the price of fast food was associated with 5.7% lower frequency of weekly fast food consumption. These results suggest that public health policy pricing instruments such as taxes may be effective in reducing consumption of energy-dense foods and possibly reducing the prevalence of overweight and obesity among US children and young adolescents.
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Affiliation(s)
- Tamkeen Khan
- Department of Economics, University of Illinois at Chicago, 601 South Morgan Street, UH725 M/C144, Chicago, IL 60607, USA
| | - Lisa M. Powell
- Department of Economics, University of Illinois at Chicago, 601 South Morgan Street, UH725 M/C144, Chicago, IL 60607, USA
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, M/C 275, Room 558, Chicago, IL 60608, USA
| | - Roy Wada
- Institute for Health Research and Policy, University of Illinois at Chicago, 1747 W. Roosevelt Road, M/C 275, Room 558, Chicago, IL 60608, USA
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44
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LEE JH, RALSTON RA, TRUBY H. Influence of food cost on diet quality and risk factors for chronic disease: A systematic review. Nutr Diet 2011. [DOI: 10.1111/j.1747-0080.2011.01554.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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45
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Collins A, Mullan B. An extension of the theory of planned behavior to predict immediate hedonic behaviors and distal benefit behaviors. Food Qual Prefer 2011. [DOI: 10.1016/j.foodqual.2011.03.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Gordon-Larsen P, Guilkey DK, Popkin BM. An economic analysis of community-level fast food prices and individual-level fast food intake: a longitudinal study. Health Place 2011; 17:1235-41. [PMID: 21852178 DOI: 10.1016/j.healthplace.2011.07.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 07/12/2011] [Accepted: 07/19/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND While dietary intake is shaped by cost, there is minimal research on the association between community-level food prices and dietary intake. METHODS We used nationally representative, longitudinal data to examine how community-level food price variation was associated with individual-level fast food intake by race/ethnicity and income across waves II (1996) and III (2001-2002) of the National Longitudinal Study of Adolescent Health (n=11,088) from 158 baseline and 363 follow-up US counties. RESULTS Negative binomial regression models predicting the number of fast food meals per week show strong relationships between fast food consumption and prices of fast food and soda that varied by gender and race/ethnicity. We found relatively stronger association between food prices and fast food intake for males and relatively greater price sensitivity for soda versus burgers. In the group with strongest associations (black males), a 20% increase in the price of soda was associated with a decrease of 0.25 visits to a fast food restaurant per week. CONCLUSIONS Economic incentives may be an effective mechanism to address fast food intake in an age group at high risk for obesity.
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Affiliation(s)
- Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516-3997, USA.
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47
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Temple JL, Johnson KM, Archer K, LaCarte A, Yi C, Epstein LH. Influence of simplified nutrition labeling and taxation on laboratory energy intake in adults. Appetite 2011; 57:184-92. [DOI: 10.1016/j.appet.2011.04.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 04/15/2011] [Accepted: 04/23/2011] [Indexed: 11/29/2022]
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Bartness TJ, Keen-Rhinehart E, Dailey MJ, Teubner BJ. Neural and hormonal control of food hoarding. Am J Physiol Regul Integr Comp Physiol 2011; 301:R641-55. [PMID: 21653877 DOI: 10.1152/ajpregu.00137.2011] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Many animals hoard food, including humans, but despite its pervasiveness, little is known about the physiological mechanisms underlying this appetitive behavior. We summarize studies of food hoarding in humans and rodents with an emphasis on mechanistic laboratory studies of species where this behavior importantly impacts their energy balance (hamsters), but include laboratory rat studies although their wild counterparts do not hoard food. The photoperiod and cold can affect food hoarding, but food availability is the most significant environmental factor affecting food hoarding. Food-deprived/restricted hamsters and humans exhibit large increases in food hoarding compared with their fed counterparts, both doing so without overeating. Some of the peripheral and central peptides involved in food intake also affect food hoarding, although many have not been tested. Ad libitum-fed hamsters given systemic injections of ghrelin, the peripheral orexigenic hormone that increases with fasting, mimics food deprivation-induced increases in food hoarding. Neuropeptide Y or agouti-related protein, brain peptides stimulated by ghrelin, given centrally to ad libitum-fed hamsters, duplicates the early and prolonged postfood deprivation increases in food hoarding, whereas central melanocortin receptor agonism tends to inhibit food deprivation and ghrelin stimulation of hoarding. Central or peripheral leptin injection or peripheral cholecystokinin-33, known satiety peptides, inhibit food hoarding. Food hoarding markedly increases with pregnancy and lactation. Because fasted and/or obese humans hoard more food in general, and more high-density/high-fat foods specifically, than nonfasted and/or nonobese humans, understanding the mechanisms underlying food hoarding could provide another target for behavioral/pharmacological approaches to curb obesity.
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Affiliation(s)
- Timothy J Bartness
- Department of Biology, Neurobiology and Behavior Program, Georgia State University, Atlanta, Georgia, USA
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Davenport K, Houston JE, Griffiths MD. Excessive Eating and Compulsive Buying Behaviours in Women: An Empirical Pilot Study Examining Reward Sensitivity, Anxiety, Impulsivity, Self-Esteem and Social Desirability. Int J Ment Health Addict 2011. [DOI: 10.1007/s11469-011-9332-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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50
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Giesen JCAH, Payne CR, Havermans RC, Jansen A. Exploring how calorie information and taxes on high-calorie foods influence lunch decisions. Am J Clin Nutr 2011; 93:689-94. [PMID: 21270376 DOI: 10.3945/ajcn.110.008193] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The potential combined effects of public policy tools-such as calorie information and taxes on highly caloric foods-on purchasing behavior are rarely studied. Furthermore, these tools are rarely studied in the context of individual differences (eg, dietary restraint), which may play a key role in their effectiveness. OBJECTIVE The current study tests the combined effects of providing calorie information and increased taxes on the total number of calories purchased for lunch. Furthermore, these public policy tools were investigated in the context of high- and low-restrained eaters. DESIGN University students (n = 178) had to choose lunch from a menu 3 different times. The prices for the high-calorie foods on the menu increased each time (125% and 150% of base price). In addition, there were 3 between-subject factors: budget (high compared with low), calorie-information (calorie information compared with no calorie information), and dietary restraint. RESULTS Elasticity analyses show a tax × calorie information interaction. A price increase for the high-calorie foods reduced the percentage of calories chosen for lunch but only in the absence of calorie information. CONCLUSIONS A tax of ≥25% on high-calorie foods may decrease the demand for calories and could be a good policy measure to decrease the prevalence of obesity. However, calorie information seems to interfere with the effect of a tax on high-calorie foods.
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Affiliation(s)
- Janneke C A H Giesen
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Netherlands.
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