1
|
van Nee RL, Mulder F, van Kleef E, van Trijp HCM. Effects of increased availability and economic incentives on preadolescents' healthier beverages choices: An experimental study. Appetite 2024; 203:107714. [PMID: 39401570 DOI: 10.1016/j.appet.2024.107714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 09/17/2024] [Accepted: 10/11/2024] [Indexed: 10/26/2024]
Abstract
This field experimental study examined how increased availability and economic incentives for healthier beverages affect preadolescents' actual healthier beverage choices in a real-world setting. In addition, the impact of preadolescents' descriptive norm towards healthier beverages, price awareness and parental restrictive rules regarding beverage consumption were explored. During the experiment, preadolescents could independently buy two beverages from an assortment with a total of eight beverages. A 2x2 between-subjects design was used, manipulating the presence of increased availability of healthier beverages and economic incentives (taxes for unhealthier beverages and subsidies for healthier beverages). A total of 305 preadolescents between 8 and 14 years old (M = 10.18, SD = 1.74) participated, each accompanied by one of their respective parents. Results showed that preadolescents were more likely to choose healthier beverages and perceived a higher descriptive norm towards healthier beverages when the assortment included increased relative availability of healthier beverages. Economic incentives and price awareness did not impact healthier beverage choices. Preadolescents were less likely to choose healthier beverages when parents reported higher levels of restrictive rules regarding beverage consumption. Results of the study suggest that increasing relative availability of healthier options could be a promising intervention strategy to support preadolescents in making healthier choices.
Collapse
Affiliation(s)
- Roselinde L van Nee
- Marketing and Consumer Behaviour group, Wageningen University and Research, the Netherlands.
| | - Femke Mulder
- Marketing and Consumer Behaviour group, Wageningen University and Research, the Netherlands
| | - Ellen van Kleef
- Marketing and Consumer Behaviour group, Wageningen University and Research, the Netherlands
| | - Hans C M van Trijp
- Marketing and Consumer Behaviour group, Wageningen University and Research, the Netherlands
| |
Collapse
|
2
|
Silva LESD, Caldeira TCM, Sousa TM, Claro RM. Updating trends in sweetened beverages consumption in Brazil from 2007 to 2021. Rev Saude Publica 2024; 58:40. [PMID: 39258706 DOI: 10.11606/s1518-8787.2024058005661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 03/26/2024] [Indexed: 09/12/2024] Open
Abstract
OBJECTIVE To analyze the time trend of sweetened beverages consumption among Brazilian adults in 26 capitals and the Federal District, from 2007 to 2021, with focus on the most recent period (2015 to 2021). METHODS Data from the Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel - Surveillance System of Risk and Protection Factors for Chronic Diseases by Telephone Survey)were used to conduct a time-series analysis (n = 731,683). The prevalence of regular consumption (five or more days/week), average daily consumption (milliliters) and nonconsumption of sweetened beverages were analyzed. Prais-Winsten regression models were used to calculate temporal trends of the indicators for the complete set of the evaluated population and by sociodemographic characteristics (sex, age group, schooling and development level of the geographic region of residence). RESULTS Between 2007 and 2021, a reduction in the prevalence of regular consumption (-1.23 pp/year) and daily average consumption (-8.62 milliliters/year) of sweetened beverages was observed. However, between 2015 and 2021, this downward trend did not continue. The prevalence of adults who reported not consuming sweetened beverages increased (1.14 pp/year, for 2007-21), although this trend was not significant in the most recent period. CONCLUSIONS The consumption of sweetened beverages among Brazilian adults decreased in the 15 years studied. However, this reduction was not observed more recently, suggesting that further actions must be adopted in the country so that the trend observed in the total period is maintained.
Collapse
Affiliation(s)
| | | | - Taciana Maia Sousa
- Universidade do Estado do Rio de Janeiro. Instituto de Nutrição. Departamento de Nutrição Social. Rio de Janeiro, RJ, Brasil
| | - Rafael Moreira Claro
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Nutrição. Belo Horizonte, MG, Brasil
| |
Collapse
|
3
|
Reid AL, Porter KJ, Kirkpatrick BM, Brock DJP, Altizer CJ, Zoellner JM. Student and caregiver acceptability of a school-based intervention to improve sugar-sweetened beverage behaviors: a mixed methods study. HEALTH EDUCATION RESEARCH 2024; 39:339-350. [PMID: 38517985 PMCID: PMC11258806 DOI: 10.1093/her/cyae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/17/2024] [Accepted: 02/21/2024] [Indexed: 03/24/2024]
Abstract
Kids SIPsmartER is a 6-month behavioral and health literacy intervention effective at reducing sugar-sweetened beverage (SSB) intake among middle school students and their caregivers in the rural Appalachian region. This exploratory mixed methods study utilized a convergent parallel design to assess participant acceptability of a school-based curriculum for students and a text messaging program for caregivers. Acceptability was assessed using surveys (873 students and 453 caregivers), five focus groups (34 students) and telephone interviews (22 caregivers). Quantitative data were analyzed descriptively, and qualitative data were content coded. On a 5-point scale, average quantitative survey acceptability ratings ranged from 2.7 to 3.3 among three student-rated questions and 4.1 to 4.2 among four caregiver-rated questions. Qualitative focus group findings suggested that students preferred curricular activities that were hands-on and involved social interaction, while caregiver interview results showed high acceptability of the text messaging program's design, including usability, content messages and personalization. Students and caregivers reported similar program benefits: increased knowledge of SSBs and health risks, increased awareness of SSB behaviors and support to make beverage behavior changes. Results from this study can be used to understand Kids SIPsmartER's effectiveness data, communicate the intervention's acceptability with stakeholders and plan for future implementation studies.
Collapse
Affiliation(s)
- Annie L Reid
- Department of Public Health Sciences, School of Medicine, University of Virginia, 16 E. Main St., Christiansburg, VA 24073, USA
| | - Kathleen J Porter
- Department of Public Health Sciences, School of Medicine, University of Virginia, 16 E. Main St., Christiansburg, VA 24073, USA
| | - Brittany M Kirkpatrick
- Department of Public Health Sciences, School of Medicine, University of Virginia, 16 E. Main St., Christiansburg, VA 24073, USA
| | - Donna-Jean P Brock
- Department of Public Health Sciences, School of Medicine, University of Virginia, 16 E. Main St., Christiansburg, VA 24073, USA
| | | | - Jamie M Zoellner
- Department of Public Health Sciences, School of Medicine, University of Virginia, 16 E. Main St., Christiansburg, VA 24073, USA
| |
Collapse
|
4
|
Leary N, Parker MK, Rincón Gallardo Patiño S, Kraak VI. An Evaluation of Healthy Hydration Recommendations for 93 Countries with Sugary Beverage Tax Legislation Globally, 2000-2023. Nutrients 2024; 16:2264. [PMID: 39064707 PMCID: PMC11279664 DOI: 10.3390/nu16142264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/10/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Adequate water intake is essential for human health. Sugary beverage taxes are a best buy policy to reduce obesity and diet-related non-communicable diseases. Food-based dietary guidelines (FBDGs) promote healthy dietary patterns. The study purpose was to evaluate national FBDGs for countries with sugary beverage tax legislation (2000-2023) to promote water and discourage sugary beverage consumption. We developed a coding framework to conduct a content analysis of FBDG documents, and used six indicators to identify messages and images to assign healthy hydration recommendation (HHR) scores from 0-12 to compare FBDGs across countries and six regions. Results showed 93 countries with sugary beverage tax legislation of which 58 countries (62%) had published FBDGs (1998-2023). Of 58 FBDGs reviewed, 48 (83%) had complementary recommendations that encouraged water and discouraged sugary beverages. Of 93 countries, 13 (14%) had the highest HHR scores (11-12); 22, (24%) had high HHR scores (9-10); 20 (21%) had medium HHR scores (4-8); 3 (3%) had low HHR scores (0-3); and 35 (38%) countries had no FBDGs. To reduce health risks for populations, governments must ensure policy coherence to optimize sugary beverage tax impacts by developing FBDGs that encourage water and discourage sugary beverages complementary to national policies.
Collapse
Affiliation(s)
- Nicole Leary
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (M.K.P.); (V.I.K.)
| | - Molly K. Parker
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (M.K.P.); (V.I.K.)
| | - Sofía Rincón Gallardo Patiño
- Cardiovascular Health Program and Food & Nutrition Portfolio, Global Health Advocacy Incubator, Washington, DC 20005, USA;
| | - Vivica I. Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (M.K.P.); (V.I.K.)
| |
Collapse
|
5
|
Bjerregaard AA, Zoughbie DE, Hansen JV, Granström C, Strøm M, Halldórsson ÞI, Meder IK, Willett WC, Ding EL, Olsen SF. An SMS chatbot digital educational program to increase healthy eating behaviors in adolescence: A multifactorial randomized controlled trial among 7,890 participants in the Danish National Birth Cohort. PLoS Med 2024; 21:e1004383. [PMID: 38875292 PMCID: PMC11178212 DOI: 10.1371/journal.pmed.1004383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 03/22/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Few cost-effective strategies to shift dietary habits of populations in a healthier direction have been identified. We examined if participating in a chatbot health education program transmitted by Short Messages Service ("SMS-program") could improve adolescent dietary behaviors and body weight trajectories. We also explored possible added effects of maternal or peer involvement. METHODS AND FINDINGS We conducted a randomized controlled trial (RCT) among adolescents from the Danish National Birth Cohort (DNBC). Eligible were adolescents who during 2015 to 2016 at age 14 years had completed a questionnaire assessing height, weight, and dietary habits. Two thirds were offered participation in an SMS-program, whereas 1/3 ("non-SMS group") received no offer. The SMS program aimed to improve 3 key dietary intake behaviors: sugar-sweetened beverages (SSBs), fruit and vegetables (FV), and fish. The offered programs had 3 factorially randomized schemes; the aims of these were to test effect of asking the mother or a friend to also participate in the health promotion program, and to test the effect of a 4-week individually tailored SMS program against the full 12-week SMS program targeting all 3 dietary factors. Height and weight and intakes of SSB, FV, and fish were assessed twice by a smartphone-based abbreviated dietary questionnaire completed at 6 months (m) and 18 m follow-up. Main outcome measures were (1) body mass index (BMI) z-score; and (2) an abbreviated Healthy Eating Index (mini-HEI, 1 m window, as mean of z-scores for SSB, FV, and fish). Among the 7,890 randomized adolescents, 5,260 were assigned to any SMS program; 63% (3,338) joined the offered program. Among the 7,890 randomized, 74% (5,853) and 68% (5,370) responded to follow-ups at 6 m and 18 m, respectively. Effects were estimated by intention-to-treat (ITT) analyses and inverse probability weighted per-protocol (IPW-PP) analyses excluding adolescents who did not join the program. Mean (standard deviation (SD)) mini-HEI at baseline, 6 m and 18 m was -0.01 (0.64), 0.01 (0.59), and -0.01 (0.59), respectively. In ITT-analyses, no effects were observed, at any time point, in those who had received any SMS program compared to the non-SMS group, on BMI z-score (6 m: -0.010 [95% confidence interval (CI) -0.035, 0.015]; p = 0.442, 18 m: 0.002 [95% CI -0.029, 0.033]; p = 0.901) or mini-HEI (6 m: 0.016 [95% CI -0.011, 0.043]; p = 0.253, 18m: -0.016 [95% CI -0.045, 0.013]; p = 0.286). In IPW-PP analyses, at 6 m, a small decrease in BMI z-score (-0.030 [95% CI -0.057, -0.003]; p = 0.032) was observed, whereas no significant effect was observed in mini-HEI (0.027 [95% CI -0.002, 0.056]; p = 0.072), among those who had received any SMS program compared to the non-SMS group. At 18 m, no associations were observed (BMI z-score: -0.006 [95% CI -0.039, 0.027]; p = 0.724, and mini-HEI: -0.005 [95% CI -0.036, 0.026]; p = 0.755). The main limitations of the study were that DNBC participants, though derived from the general population, tend to have higher socioeconomic status than average, and that outcome measures were self-reported. CONCLUSIONS In this study, a chatbot health education program delivered through an SMS program had no effect on dietary habits or weight trajectories in ITT analyses. However, IPW-PP-analyses, based on those 63% who had joined the offered SMS program, suggested modest improvements in weight development at 6 m, which had faded at 18 m. Future research should focus on developing gender-specific messaging programs including "booster" messages to obtain sustained engagement. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02809196 https://clinicaltrials.gov/study/NCT02809196.
Collapse
Affiliation(s)
- Anne Ahrendt Bjerregaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Daniel E. Zoughbie
- University of California, Berkeley, California, United States of America
- New England Institute for Complex Systems, Cambridge, Massachusetts, United States of America
| | | | - Charlotta Granström
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Marin Strøm
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Þórhallur Ingi Halldórsson
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Faculty of food science and nutrition, University of Iceland, Reykjavík, Iceland
| | - Inger Kristine Meder
- Secretariat of the Danish National Birth Cohort, Statens Serum Institut, Copenhagen, Denmark
| | - Walter Churchill Willett
- Department of Nutrition, Harvard TH Chan School of Public Health (for ELD: affiliation at time of project), Boston, Massachusetts, United States of America
| | - Eric L. Ding
- New England Institute for Complex Systems, Cambridge, Massachusetts, United States of America
- Department of Nutrition, Harvard TH Chan School of Public Health (for ELD: affiliation at time of project), Boston, Massachusetts, United States of America
| | - Sjúrður Fróði Olsen
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- University of the Faroe Islands, Tórshavn, Faroe Islands
- Department of Nutrition, Harvard TH Chan School of Public Health (for ELD: affiliation at time of project), Boston, Massachusetts, United States of America
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
6
|
Hanssen H, Moholdt T, Bahls M, Biffi A, Siegrist M, Lewandowski AJ, Biondi-Zoccai G, Cavarretta E, Kokkvoll A, Løchen ML, Maestrini V, Pinto RS, Palermi S, Thivel D, Wojcik M, Hansen D, Van Craenenbroeck EM, Weghuber D, Kraenkel N, Tiberi M. Lifestyle interventions to change trajectories of obesity-related cardiovascular risk from childhood onset to manifestation in adulthood: a joint scientific statement of the task force for childhood health of the European Association of Preventive Cardiology and the European Childhood Obesity Group. Eur J Prev Cardiol 2023; 30:1462-1472. [PMID: 37491406 DOI: 10.1093/eurjpc/zwad152] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/20/2023] [Accepted: 05/06/2023] [Indexed: 07/27/2023]
Abstract
There is an immediate need to optimize cardiovascular (CV) risk management and primary prevention of childhood obesity to timely and more effectively combat the health hazard and socioeconomic burden of CV disease from childhood development to adulthood manifestation. Optimizing screening programs and risk management strategies for obesity-related CV risk in childhood has high potential to change disease trajectories into adulthood. Building on a holistic view on the aetiology of childhood obesity, this document reviews current concepts in primary prevention and risk management strategies by lifestyle interventions. As an additional objective, this scientific statement addresses the high potential for reversibility of CV risk in childhood and comments on the use of modern surrogate markers beyond monitoring weight and body composition. This scientific statement also highlights the clinical importance of quantifying CV risk trajectories and discusses the remaining research gaps and challenges to better promote childhood health in a population-based approach. Finally, this document provides an overview on the lessons to be learned from the presented evidence and identifies key barriers to be targeted by researchers, clinicians, and policymakers to put into practice more effective primary prevention strategies for childhood obesity early in life to combat the burden of CV disease later in life.
Collapse
Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Women's Clinic, St. Olavs Hospital, Trondheim, Norway
| | - Martin Bahls
- Department of Internal Medicine B University Medicine Greifswald, University of Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Alessandro Biffi
- Med-Ex Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Monika Siegrist
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Ane Kokkvoll
- Department of Paediatrics, Finnmark Hospital Trust, Hammerfest, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, 'Sapienza' University of Rome, Policlinico Umberto I, Rome, Italy
| | | | - Stefano Palermi
- Med-Ex Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Malgorzata Wojcik
- Department of Pediatric and Adolescent Endocrinology, Jagiellonian University Medical College, Krakow, Poland
| | - Dominique Hansen
- Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium
| | - Emeline M Van Craenenbroeck
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Daniel Weghuber
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Nicolle Kraenkel
- Deutsches Herzzentrum der Charité (DHZC), Department of Cardiology, Angiology and Intensive Care, Campus Benjamin-Franklin (CBF), Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner site Berlin, Germany
- Friede Springer- Cardiovascular Prevention Center @ Charité, Charite- Universitätsmedizin Berlin, Berlin, Germany
| | - Monica Tiberi
- Department of Public Health, Azienda Sanitaria Unica Regionale Marche AV 1, Pesaro, Italy
| |
Collapse
|
7
|
Patel AI, Schmidt LA, McCulloch CE, Blacker LS, Cabana MD, Brindis CD, Ritchie LD. Effectiveness of a School Drinking Water Promotion and Access Program for Overweight Prevention. Pediatrics 2023; 152:e2022060021. [PMID: 37545466 PMCID: PMC10471511 DOI: 10.1542/peds.2022-060021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Drinking water promotion and access shows promise for preventing weight gain. This study evaluated the impact of Water First, a school-based water promotion and access intervention on changes in overweight. METHODS Low-income, ethnically diverse elementary schools in California's Bay Area were cluster-randomized to intervention and control groups. Water First includes classroom lessons, water stations, and schoolwide water promotion over 1 school year. The primary outcome was overweight prevalence (BMI-for-age-and-sex ≥85th percentile). Students (n = 1249) in 56 fourth-grade classes in 18 schools (9 intervention, 9 control) from 2016 to 2019 participated in evaluation at baseline, 7, and 15 months. Data collection was interrupted in 8 additional recruited schools because of coronavirus disease 2019. RESULTS Of 1262 students from 18 schools, 1249 (47.4% girls; mean [SD] age, 9.6 [0.4] years; 63.4% Hispanic) were recruited. From baseline to 7 months, there was no significant difference in changes in overweight prevalence in intervention schools (-0.2%) compared to control schools (-0.4%) (adjusted ratio of odds ratios [ORs]: 0.7 [confidence interval (CI): 0.2-2.9] P = 0.68). From baseline to 15-months, increases in overweight prevalence were significantly greater in control schools (3.7%) compared to intervention schools (0.5%). At 15 months, intervention students had a significantly lower change in overweight prevalence (adjusted ratio of ORs: 0.1 [CI: 0.03-0.7] P = .017) compared to control students. There were no intervention effects for obesity prevalence. CONCLUSIONS Water First prevented increases in the prevalence of overweight, but not obesity, in elementary school students.
Collapse
Affiliation(s)
- Anisha I. Patel
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Laura A. Schmidt
- Philip R. Lee Institute for Health Policy Studies
- Department of Humanities and Social Sciences
| | | | - Lauren S. Blacker
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Michael D. Cabana
- Department of Pediatrics, Division of General Pediatrics, Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Bronx, New York
| | - Claire D. Brindis
- Philip R. Lee Institute for Health Policy Studies
- Division of Adolescent and Young Adult Health, Department of Pediatrics, University of California, San Francisco, California
| | - Lorrene D. Ritchie
- Nutrition Policy Institute, University of California Division of Agriculture and Natural Resources, Davis, California
| |
Collapse
|
8
|
Dastgerdizad H, Dombrowski RD, Bode B, Knoff KAG, Kulik N, Mallare J, Kaur R, Dillaway H. Community Solutions to Increase the Healthfulness of Grocery Stores: Perspectives of Immigrant Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6536. [PMID: 37569076 PMCID: PMC10418834 DOI: 10.3390/ijerph20156536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023]
Abstract
Grocery store environments are recognized as one of the most crucial community settings for developing and maintaining healthy nutritional behaviors in children. This is especially true for disadvantaged ethnic minority families, such as immigrants, who reside in the Detroit Metropolitan area and have historically experienced inequities that result in poor health outcomes. Rates of obesity and type II diabetes have affected Detroit 38% more than the rest of the state and nationwide. In 2019, almost 54% of children aged 0-17 in Metro Detroit lived in poverty, and 21.6% experienced food insecurity, compared with the state level of 14.2%. Moreover, nearly 50% of ethnic minority children in Metro Detroit consume sports drinks, and 70% consume soda or pop in an average week. The primary purpose of this study was to explore immigrant parents' perspectives on (1) how in-store Sugar-Sweetened Beverage (SSB) marketing impacts the purchasing behaviors of parents and the eating behaviors of toddlers, and the secondary objective was to (2) determine strategies to reduce SSB purchases and consumption within grocery environments from the viewpoints of immigrant parents. A qualitative multiple-case study design was used to achieve the aims of this study. Semi-structured individual interviews were completed with 18 immigrant parents of children aged 2 to 5 years old who were consumers in 30 independently owned full-service grocery stores within the immigrant enclaves of Detroit, Dearborn, Hamtramck, and Warren, Michigan. Three key thematic categories emerged from the parents' narratives. These themes were: (1) non-supportive grocery store environments; (2) acculturation to the American food environment; and (3) strategies to support reduced SSB consumption among young immigrant children. The findings of this study revealed widespread SSB marketing targeting toddlers within the participating independently owned grocery stores. Even if families with young children practiced healthy nutritional behaviors, the prices, placements, and promotion of SSBs were challenges to establishing and sustaining these healthy eating habits. The parents believed that planning and implementing retail-based strategies in collaboration with families and considering families' actual demands would assist in managing children's eating patterns and reducing early childhood obesity.
Collapse
Affiliation(s)
- Hadis Dastgerdizad
- Department of Public Health, University of South Carolina, Bluffton, SC 29909, USA
| | - Rachael D. Dombrowski
- Departments of Public Health and Kinesiology, College of Education, Health and Human Services, California State University-San Marcos, San Marcos, CA 92096, USA;
| | - Bree Bode
- Michigan Fitness Foundation, Lansing, MI 48314, USA;
| | - Kathryn A. G. Knoff
- Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA 22314, USA;
| | - Noel Kulik
- Center for Health and Community Impact, Division of Kinesiology, Health & Sport Studies, College of Education, Wayne State University, Detroit, MI 48202, USA;
| | - James Mallare
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48202, USA;
| | - Ravneet Kaur
- Division of Health Research and Evaluation, Department of Family and Community Medicine, College of Medicine, University of Illinois, Rockford, IL 61107, USA;
| | - Heather Dillaway
- Department of Sociology and Anthropology, Illinois State University, Normal, IL 61790, USA;
| |
Collapse
|
9
|
Zafra-Tanaka JH, Braverman A, Anza-Ramirez C, Ortigoza A, Lazo M, Doberti T, Rodriguez-Osiac L, Lovasi GS, Mazariegos M, Sarmiento O, Pérez Ferrer C, Miranda JJ. City features related to obesity in preschool children: a cross-sectional analysis of 159 cities in six Latin American countries. LANCET REGIONAL HEALTH. AMERICAS 2023; 20:100458. [PMID: 36942152 PMCID: PMC10023940 DOI: 10.1016/j.lana.2023.100458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 03/12/2023]
Abstract
Background Childhood obesity is a rising global health problem. The rapid urbanization experienced in Latin America might impact childhood obesity through different pathways involving urban built and social features of cities. We aimed to evaluate the association between built and social environment features of cities and childhood obesity across countries and cities in Latin America. Methods Cross-sectional analysis of data from 20,040 children aged 1-5 years living in 159 large cities in six Latin American countries. We used individual-level anthropometric data for excess weight (overweight or obesity) from health surveys that could be linked to city-level data. City and sub-city level exposures included the social environment (living conditions, service provision and educational attainment) and the built environment (fragmentation, isolation, presence of mass transit, population density, intersection density and percent greenness). Multi-level logistic models were used to explore associations between city features and excess weight, adjusting for age, sex, and head of household education. Findings The overall prevalence of excess weight among preschool children was 8% but varied substantially between and within countries, ranging from 4% to 25%. Our analysis showed that 97% of the variability was between individuals within sub-city units and around 3% of the variance in z-scores of weight for height was explained by the city and sub-city levels. At the city-level, a higher distance between urban patches (isolation, per 1 SD increase) was associated with lower odds of excess weight (OR 0.90, 95% CI 0.82-0.99). Higher sub-city education was also associated with lower odds of excess weight, but better sub-city living conditions were associated with higher odds of excess weight. Interpretation Built and social environment features are related to excess weight in preschool children. Our evidence from a wide range of large Latin American cities suggests that urban health interventions may be suitable alternatives towards attaining the goal of reducing excess weight early in the life course. Funding The SALURBAL project (Salud Urbana en América Latina, Urban Health in Latin America) is funded by Wellcome [205177/Z/16/Z].
Collapse
Affiliation(s)
- Jessica Hanae Zafra-Tanaka
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
- Corresponding author. CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Av. Armendariz 445, Lima 15074, Peru.
| | - Ariela Braverman
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Cecilia Anza-Ramirez
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ana Ortigoza
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Mariana Lazo
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Tamara Doberti
- Escuela de Salud Pública, Universidad de Chile, Santiago de Chile, Chile
| | | | - Gina S. Lovasi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Mónica Mazariegos
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Olga Sarmiento
- School of Medicine, Universidad de Los Andes, Bogota, Colombia
| | | | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| |
Collapse
|
10
|
Schwartz MB, Schneider GE, Xu R, Choi YY, Atoloye AT, Bennett BL, Vernick NH, Appel LJ. Retail Soda Purchases Decrease and Water Purchases Increase: 6-Year Results From a Community-Based Beverage Campaign. AJPM FOCUS 2022; 1:100008. [PMID: 37791016 PMCID: PMC10546579 DOI: 10.1016/j.focus.2022.100008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction This study aimed to document the long-term impacts on beverage sales of a 6-year intervention campaign to reduce consumption of sugar-sweetened beverages. Methods In 2013, a multicomponent intervention campaign designed to reduce the intake of sugary drinks was launched in Howard County, Maryland. A difference-in-differences regression approach was used to compare data on Howard County supermarket beverage sales (in ounces) from 2013 to 2018 with a set of control supermarkets. Outcome variables were average weekly sales by store of top brands of sugar-sweetened beverages (regular soda, sports drinks, fruit drinks) as well as diet soda and 100% juice. Trends in the sales of water products from 2016 to 2018 were estimated separately using a linear regression model. Results In Howard County, the sales of regular soda, fruit drinks, and 100% juice decreased significantly more than predicted each year. These changes correspond to a 29.7% decrease in sales for regular soda, a 7.5% decrease for fruit drinks, and a 33.5% drop for 100% juice between 2012 and 2018 in Howard County stores. There was a significant trend such that the net reduction in regular soda sales in Howard County stores became larger over time. The amount of plain water sold in Howard County increased significantly from 2016 to 2018. Conclusions Multicomponent efforts by local government, nonprofit organizations, and other community-based organizations are needed to decrease sugar-sweetened beverage consumption at the population level. Substantial and sustained improvements in retail beverage sales can be achieved through coordinated messaging, community organizing, and targeted advocacy for policy changes.
Collapse
Affiliation(s)
- Marlene B. Schwartz
- UConn Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut
- Department of Human Development and Family Sciences, College of Liberal Arts and Sceinces, University of Connecticut, Storrs, Connecticut
| | | | - Ran Xu
- Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, Connecticut
| | - Yoon-Young Choi
- UConn Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut
- Korea Rural Economic Institute, Naju-si, Jeollanam-do, South Korea
| | - Abiodun T. Atoloye
- UConn Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut
| | - Brooke L. Bennett
- UConn Rudd Center for Food Policy & Health, University of Connecticut, Hartford, Connecticut
| | | | - Lawrence J. Appel
- The Horizon Foundation, Columbia, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
11
|
Schmidt MI, Duncan BB. Commentary on Education-Related Health Inequities in Noncommunicable Diseases: An Analysis of the Brazilian National Health Survey, 2013 and 2019. CAD SAUDE PUBLICA 2022; 38Suppl 1:e00233221. [PMID: 35544923 DOI: 10.1590/0102-311x00233221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 10/04/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Maria Inês Schmidt
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | | |
Collapse
|
12
|
Kraak VI, Consavage Stanley K, Harrigan PB, Zhou M. How have media campaigns been used to promote and discourage healthy and unhealthy beverages in the United States? A systematic scoping review to inform future research to reduce sugary beverage health risks. Obes Rev 2022; 23:e13425. [PMID: 35142020 PMCID: PMC9286342 DOI: 10.1111/obr.13425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/01/2022] [Accepted: 01/01/2022] [Indexed: 12/29/2022]
Abstract
Sugary beverage consumption is associated with many health risks. This study used a proof-of-concept media campaign typology to examine U.S. beverage campaigns that promoted healthy beverages and encouraged or discouraged sugary beverages. We used a three-step systematic scoping review to identify, organize, analyze, and synthesize evidence. Step 1 used Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines to search four electronic databases and gray literature through 2021. Step 2 categorized relevant media campaigns using a media campaign typology. Step 3 examined campaign evaluation outcomes. We identified 280 campaigns organized into six campaign typology categories. The media landscape was dominated by corporate marketing campaigns for branded sugary beverages (65.8%; n = 184) followed by public awareness (9.6%; n = 27), public policy (8.2%; n = 23), social marketing (7.1%; n = 20), corporate social responsibility (5.7%; n = 16), and countermarketing (3.6%; n = 10) campaigns. Evaluations for 20 unique campaigns implemented over 30 years (1992-2021) across 14 states showed reduced sugary beverage or juice and increased water or low-fat milk sales and intake. Positive short-term cognitive and mid-term retail and behavioral changes were reported. There was limited evidence for long-term policy, social norm, and population health outcomes. Future research is needed to use media campaigns in strategic communications to reduce sugary beverage health risks for Americans.
Collapse
Affiliation(s)
- Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | | | - Paige B Harrigan
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia, USA
| | - Mi Zhou
- Department of Public Health, University of California Merced, Merced, California, USA
| |
Collapse
|
13
|
Echeverria MS, Schuch HS, Cenci MS, Motta JVS, Bertoldi AD, Hallal PC, Demarco FF. Trajectories of Sugar Consumption and Dental Caries in Early Childhood. J Dent Res 2022; 101:724-730. [PMID: 35114848 DOI: 10.1177/00220345211068743] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study verifies the association between the trajectory of sugar consumption and dental caries in the 2015 Pelotas Birth Cohort in Pelotas, Brazil. It was conducted with data from the follow-ups at 3, 12, 24, and 48 mo from the 2015 Birth Cohort, which included 4,275 children born alive in hospitals in Pelotas. Data collection included standardized questionnaires for first caregivers applied by trained interviewers at all follow-ups. Exposure was the trajectory of sugar consumption from 3 to 48 mo (always low, always intermediate, increasing, and always high), obtained by group-based trajectory modeling. The outcome of this study was dental caries, obtained through clinical examination performed by calibrated dentists at 48 mo of age. Socioeconomic conditions and oral health instruction from a health professional during the first 4 y of life were included in the analysis as potential confounders. Prevalence ratios and their 95% confidence intervals were provided from generalized estimating equations with a log-Poisson with robust variance specification. In total, 3,654 (91.1%) children participated in the survey at 48 mo, and 2,806 children had complete data for the analyzes performed. Of these, 1,012 (36.1%; 95% confidence interval [CI], 34.3-37.8) experienced caries, and 723 (25.8%; 95% CI, 24.2-27.4) had cavitated caries. Regarding cavitated caries, the prevalence was 1.48 times higher in the group with increasing sugar consumption than children with always low consumption. There is an association between the trajectory of sugar consumption and dental caries at 48 mo. Children with increasing and always high sugar consumption have the highest prevalence of caries.
Collapse
Affiliation(s)
- M S Echeverria
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - H S Schuch
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - M S Cenci
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - J V S Motta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - A D Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - P C Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - F F Demarco
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.,Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| |
Collapse
|
14
|
Herman MA, Birnbaum MJ. Molecular aspects of fructose metabolism and metabolic disease. Cell Metab 2021; 33:2329-2354. [PMID: 34619074 PMCID: PMC8665132 DOI: 10.1016/j.cmet.2021.09.010] [Citation(s) in RCA: 121] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 02/06/2023]
Abstract
Excessive sugar consumption is increasingly considered as a contributor to the emerging epidemics of obesity and the associated cardiometabolic disease. Sugar is added to the diet in the form of sucrose or high-fructose corn syrup, both of which comprise nearly equal amounts of glucose and fructose. The unique aspects of fructose metabolism and properties of fructose-derived metabolites allow for fructose to serve as a physiological signal of normal dietary sugar consumption. However, when fructose is consumed in excess, these unique properties may contribute to the pathogenesis of cardiometabolic disease. Here, we review the biochemistry, genetics, and physiology of fructose metabolism and consider mechanisms by which excessive fructose consumption may contribute to metabolic disease. Lastly, we consider new therapeutic options for the treatment of metabolic disease based upon this knowledge.
Collapse
Affiliation(s)
- Mark A Herman
- Division of Endocrinology, Metabolism, and Nutrition, Duke University, Durham, NC, USA; Duke Molecular Physiology Institute, Duke University, Durham, NC, USA; Department of Pharmacology and Cancer Biology, Duke University, Durham, NC, USA.
| | | |
Collapse
|
15
|
Kraak VI, Consavage Stanley K. A Systematic Scoping Review of Media Campaigns to Develop a Typology to Evaluate Their Collective Impact on Promoting Healthy Hydration Behaviors and Reducing Sugary Beverage Health Risks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031040. [PMID: 33503920 PMCID: PMC7908303 DOI: 10.3390/ijerph18031040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 12/23/2022]
Abstract
Interventions to discourage sugary beverages and encourage water consumption have produced modest and unsustainable behavioral changes to reduce obesity and noncommunicable disease risks. This systematic scoping review examined media campaigns to develop a typology to support healthy hydration nonalcoholic beverage behaviors. Our three-step methodology included the following: (1) review and summarize expert-recommended healthy beverage guidelines; (2) review six English-language electronic databases guided by PRISMA to describe existing campaign types by issue, goal and underlying theory; and (3) develop a media campaign typology to support policies, systems and environments to encourage healthy hydration behaviors. Results showed no international consensus for healthy beverage guidelines, though we describe expert-recommended healthy beverage guidelines for the United States. Of 909 records identified, we included 24 articles describing distinct media campaigns and nine sources that defined models, schemes or taxonomies. The final media campaign typology included: (1) corporate advertising, marketing or entertainment; (2) corporate social responsibility, public relations/cause marketing; (3) social marketing; (4) public information, awareness, education/ health promotion; (5) media advocacy/countermarketing; and (6) political or public policy. This proof-of-concept media campaign typology can be used to evaluate their collective impact and support for a social change movement to reduce sugary beverage health risks and to encourage healthy hydration behaviors.
Collapse
|
16
|
Nutritional Status and Oral Frailty: A Community Based Study. Nutrients 2020; 12:nu12092886. [PMID: 32967313 PMCID: PMC7551233 DOI: 10.3390/nu12092886] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/15/2022] Open
Abstract
Compromised oral health can alter food choices. Poor masticatory function leads to imbalanced food intake and undesirable nutritional status. The associations among nutritional status, oral health behavior, and self-assessed oral functions status were investigated using a community-based survey. In total, 701 subjects more than 50 years old living Ebina city located southwest of the capital Tokyo were investigated. The number of remaining teeth was counted by dental hygienists. Oral health behavior and self-assessed oral functions were evaluated by oral frailty checklist. Nutritional status was evaluated by the brief-type self-administered diet history questionnaire using Dietary Reference Intakes for Japanese as reference. More than 80% of subjects’ intakes of vitamin B12, pantothenic acid, copper, and proteins were sufficient. In contrast, only 19% of subjects’ intake of vitamin A was sufficient and 35.5% for vitamin B1. More than 90% of subjects’ intakes of vitamin D and vitamin K were sufficient. Only 35.5% of subjects’ intakes of dietary fiber were sufficient. Overall, 88.9% of subjects had excess salt. The number of remaining teeth was not correlated with nutritional intakes. Oral health behavior significantly correlated with nutritional intakes. Oral functions are important for food choice; however, oral functions were not directly correlated with nutritional intakes. Comprehensive health instructions including nutrition and oral health education is necessary for health promotion.
Collapse
|