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Matthews ED, Kurnat-Thoma EL. U.S. food policy to address diet-related chronic disease. Front Public Health 2024; 12:1339859. [PMID: 38827626 PMCID: PMC11141542 DOI: 10.3389/fpubh.2024.1339859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/18/2024] [Indexed: 06/04/2024] Open
Abstract
Poor diet is the leading cause of mortality in the U.S. due to the direct relationship with diet-related chronic diseases, disproportionally affects underserved communities, and exacerbates health disparities. Evidence-based policy solutions are greatly needed to foster an equitable and climate-smart food system that improves health, nutrition and reduces chronic disease healthcare costs. To directly address epidemic levels of U.S. diet-related chronic diseases and nutritional health disparities, we conducted a policy analysis, prioritized policy options and implementation strategies, and issued final recommendations for bipartisan consideration in the 2023-24 Farm Bill Reauthorization. Actional recommendations include: sugar-sweetened beverage taxation, Supplemental Nutrition Assistance Program (SNAP) fruit and vegetable subsidy expansion, replacement of ultra-processed foods (UPF) with sustainable, diverse, climate-smart agriculture and food purchasing options, and implementing "food is medicine."
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Affiliation(s)
- Emily D. Matthews
- Emergency Department, Holy Cross Hospital, Holy Cross Health, Silver Spring, MD, United States
| | - Emma L. Kurnat-Thoma
- Georgetown Institute for Women, Peace and Security, Walsh School of Foreign Service, Georgetown University, Washington, DC, United States
- Precision Policy Solutions, LLC, Bethesda, MD, United States
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Wang C, Chen Y, Xu H, Wang W, Zhou H, Sun Q, Hong X, Zhao J. Sustaining Healthy Habits: The Enduring Impact of Combined School-Family Interventions on Consuming Sugar-Sweetened Beverages among Pilot Chinese Schoolchildren. Nutrients 2024; 16:953. [PMID: 38612987 PMCID: PMC11013720 DOI: 10.3390/nu16070953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 04/14/2024] Open
Abstract
This study assesses the enduring impact of combined school- and family-based interventions on reducing the consumption of sugar-sweetened beverages (SSBs) among schoolchildren in China. Two primary schools were assigned at random to either the Intervention Group or the Control Group, in Nanjing, eastern China. All students were in grade three and received an invitation to participate. In the first year, students in the Intervention Group received one-year intervention measures, including monthly monitoring, aiming to decrease the consumption of SSBs. Students in the Control Group only received regular monitoring without interventions. In the second year, both groups received only regular monitoring, without active interventions. A generalized estimating equations model (GEE) was used to assess the intervention effects. After two years, relative to the Control Group, the Intervention Group had a significantly improved knowledge of SSBs and an improved family environment with parents. In the Intervention Group, 477 students (97.3%) had adequate knowledge about SSBs, compared to 302 students (83.2%) in the Control Group (X2 = 52.708, p < 0.001). Two years later, the number of students who stated 'my home always has SSBs' in the Intervention Group (7.8%) was fewer than that in the Control Group (12.4%), which was a statistically significant finding (p < 0.05). One year later, both the frequency and the quantity of SSB consumption in the Intervention Group were less than those in the Control Group; such differences between the groups remained statistically significant for the quantity but not for the frequency of SSB consumption two years later. In the Intervention Group, the frequency of SSB consumption was significantly reduced by 1.0 times per week, compared to a reduction of 0.1 times per week in the Control Group in the first year (p < 0.05). In the second year, the frequency of SSB consumption was reduced by 0.8 times per week in the Intervention Group, compared to 0.5 times per week in the Control Group (p > 0.05). In the first year, the volume of SSB consumption was significantly reduced by 233 mL per week in the Intervention Group, compared to an increase of 107 mL per week in the Control Group (p < 0.05). In the second year, the volume of SSB consumption was reduced by 122 mL per week in the Intervention Group compared to an increase of 31 mL per week in the Control Group (p > 0.05). The combined school-based and family-based interventions had a positive effect on the students' knowledge of SSBs and their family dynamics during the first and second year. Relative to the Control Group, the Intervention Group had a statistically significant reduction in SSB consumption after 1 year, but not after 2 years.
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Affiliation(s)
- Chenchen Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Yijia Chen
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Hao Xu
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Weiwei Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Hairong Zhou
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Qiannan Sun
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Xin Hong
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Jinkou Zhao
- Department of Non-Communicable Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
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Grieshaber A, Waltimo T, Haschemi AA, Bornstein MM, Kulik EM. Dental caries and associated factors in 7-, 12- and 15-year-old schoolchildren in the canton of Basel-Landschaft, Switzerland: Changes in caries experience from 1992 to 2021. Int J Paediatr Dent 2024; 34:169-178. [PMID: 37807838 DOI: 10.1111/ipd.13122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/03/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Epidemiological surveys in schoolchildren are used to assess the current status of oral health. AIM To investigate the changes in caries experience among schoolchildren in the canton of Basel-Landschaft, Switzerland, over a period of three decades. Secondary objectives were to evaluate the impact of various personal and demographic factors such as age group, place of residence or dental hygiene awareness on caries prevalence as well as the history of orthodontic treatment in the year 2021. DESIGN A random sampling of school classes from first, sixth and ninth grades, that is schoolchildren aged 7, 12 and 15 years, was performed. Children's dmft and DMFT scores were determined according to the WHO methodology while information on oral hygiene habits and dental prophylaxis awareness was collected by means of a questionnaire directed to the legal guardians of the children. Individual logistic regressions were performed to identify possible influencing factors for caries. RESULTS A total of 1357 schoolchildren could be included in the study. In the year 2021, the youngest age group had an average of 0.68 primary teeth that needed treatment, whereas the 12- and 15-year-olds each had approximately 0.3 permanent teeth requiring treatment. While these numbers remained constant over the examination period of three decades, most of the other caries indices improved. Younger children (p = .001) and children with a migrant background (p < .001) were found to be risk groups. Orthodontic treatment was more frequent in females, schoolchildren of Swiss nationality and children attending higher secondary schools at ninth grade. CONCLUSION This study demonstrated that even in a country with a low prevalence of caries experience, untreated carious lesions remain a problem as their prevalence remained unchanged over the examination period of three decades.
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Affiliation(s)
- Andreina Grieshaber
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Tuomas Waltimo
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Asin Ahmad Haschemi
- Department of General Pediatric and Adolescent Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Michael Marc Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
- Department Research, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Eva Maria Kulik
- Department Research, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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Listl S, Baltussen R, Carrasco-Labra A, Carrer F, Lavis J. Evidence-Informed Oral Health Policy Making: Opportunities and Challenges. J Dent Res 2023; 102:1293-1302. [PMID: 37585875 PMCID: PMC10604434 DOI: 10.1177/00220345231187828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
Despite a clear need for improvement in oral health systems, progress in oral health systems transformation has been slow. Substantial gaps persist in leveraging evidence and stakeholder values for collective problem solving. To truly enable evidence-informed oral health policy making, substantial "know-how" and "know-do" gaps still need to be overcome. However, there is a unique opportunity for the oral health community to learn and evolve from previous successes and failures in evidence-informed health policy making. As stated by the Global Commission on Evidence to Address Societal Challenges, COVID-19 has created a once-in-a-generation focus on evidence, which has fast-tracked collaboration among decision makers, researchers, and evidence intermediaries. In addition, this has led to a growing recognition of the need to formalize and strengthen evidence-support systems. This article provides an overview of recent advancements in evidence-informed health policy making, including normative goals and a health systems taxonomy, the role of evidence-support and evidence-implementation systems to improve context-specific decision-making processes, the evolution of learning health systems, and the important role of citizen deliberations. The article also highlights opportunities for evidence-informed policy making to drive change in oral health systems. All in all, strengthening capacities for evidence-informed health policy making is critical to enable and enact improvements in oral health systems.
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Affiliation(s)
- S. Listl
- Radboud University Medical Center, Radboud Institute of Health Sciences (RIHS), Department of Dentistry - Quality and Safety of Oral Healthcare, Nijmegen, the Netherlands
| | - R. Baltussen
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A. Carrasco-Labra
- Center for Integrative Global Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - F.C. Carrer
- Department of Community Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - J.N. Lavis
- McMaster Health Forum, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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Lafebre-Carrasco MF, Arroyo-Menéndez M, Lozano-Paniagua D, Parrón-Carreño T, Nievas-Soriano BJ. Social and Preventive Factors That Explain Oral Health among Pregnant Women in the Canton of Cuenca, Ecuador. Healthcare (Basel) 2023; 11:2664. [PMID: 37830702 PMCID: PMC10572668 DOI: 10.3390/healthcare11192664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
(1) Background: pregnant women in underprivileged areas may face challenges that affect their oral health. The analysis of these issues such as toothaches or cavities, among others could be crucial for them. However, no studies have been conducted in Cuenca, Ecuador. Thus, this study aimed to create a model explaining how social factors and healthy habits impact oral health in Cuenca, Ecuador. (2) Methods: An observational study was performed using a questionnaire developed from scratch. Principal component factor analysis was performed to calculate the oral disease index based on the oral health issues reported by women during pregnancy. (3) Results: 1971 women participated in the research. In total, 88% reported at least one oral health problem, with cavities (34%) and bleeding gums (33%) as the most prevalent. The rate of preventive visits and frequent brushing were the two variables that most impacted the oral disease index. The consumption of sweets, age, and the belief that visiting the dentist harms their unborn child were also important factors. However, income, education, and ethnic background showed little to no effect. (4) Conclusions: The most beneficial determinants of oral health factors in pregnant women in Cuenca, Ecuador, are preventive dentist visits, frequent brushing, and a contained consumption of sweets. The main harmful factors are age and the misconception that dental visits can harm their unborn child. Surprisingly, income, education, and ethnic background have little effect. This study can be replicated in other countries and cultures.
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Affiliation(s)
| | - Millán Arroyo-Menéndez
- Department of Sociology: Theory and Methodology, Faculty of Political Science and Sociology, Member of TRANSOC Research Institute, Complutense University of Madrid, 28223 Madrid, Spain;
| | - David Lozano-Paniagua
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (T.P.-C.); (B.J.N.-S.)
| | - Tesifón Parrón-Carreño
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (T.P.-C.); (B.J.N.-S.)
| | - Bruno José Nievas-Soriano
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, 04120 Almeria, Spain; (T.P.-C.); (B.J.N.-S.)
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