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Weiss S, Tinsky N, Oren L, Chodick G, Spierer S, Yarom N, Ashkenazi M. Effect of prolonged hospitalization on the maintenance of oral health: A self-report survey. Int J Dent Hyg 2024. [PMID: 38575751 DOI: 10.1111/idh.12804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 03/16/2024] [Accepted: 03/21/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES This study aims to evaluate the effect of prolonged hospitalization on the maintenance of dental health and to assess the nursing staff's approach to addressing these concerns. METHODS A survey questionnaire explored changes in the routine dental care of patients hospitalized for over a month. The involvement of nursing staff in addressing dental care was also evaluated. RESULTS Fifty adult patients aged 18-89 years (mean age 62.4 ± 20.54 years), 27 (54%) males, completed the survey. During hospitalization (mean 58.59 ± 38.63 days) 26% and 18%, increased consumption of sweets and sugary beverages, between meals, respectively; 26% and 20% of the patients reduced the frequency of tooth brushing in the morning and in the evening, respectively, and 42.2% of them, reduced the quality of their toothbrushing during hospitalization. Nevertheless, 95.9% and 93.9% of them were never instructed during hospitalization to limit their consumption of sweets and sugary beverages and 83.3% and 62.5% of them had never been reminded or offered assistance during hospitalization in performing toothbrushing, respectively. The lower frequency of morning toothbrushing was significantly correlated with a lack of nurses' assistance (p = 0.004). In contrast, 62.6% reported they were reminded every day to shower. Patients in the rehabilitation and geriatrics departments reported a greater need for a brush/toothpaste (p < 0.0001) and assistance in toothbrushing (p < 0.0001). CONCLUSIONS Prolonged hospitalization leads to significant deterioration in inpatients' dental health maintenance. Raising awareness among nurses regarding their inpatient's oral health maintenance is warranted. Providing patients with toothbrushes, toothpaste and educational materials upon hospitalization is recommended.
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Affiliation(s)
| | | | - Liat Oren
- Sheba Medical Center, Tel Hashomer, Israel
| | - Gabi Chodick
- School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Noam Yarom
- Sheba Medical Center, Tel Hashomer, Israel
- School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Li Y, Shen L, Dillard JP, Li S(S. A Content Analysis of Online Messages about Sugar-Sweetened Beverages. Nutrients 2024; 16:1005. [PMID: 38613038 PMCID: PMC11013644 DOI: 10.3390/nu16071005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Media campaigns can reduce or promote the consumption of sugar-sweetened beverages (SSBs). Brief, US-based English-language online messages were gathered from searchable media platforms, a process that yielded 112 anti-SSB videos and 29 pro-SSB commercials. Using a combination of inductive and deductive methods, a content analysis of those messages was conducted to identify their properties. They were coded for the direction (pro vs. anti), target of the advocacy (e.g., consumption vs. policy), actor demographics (gender, age, and ethnicity), persuasive theme (e.g., excessive sugar, nurturing), and message sensation value. Anti-SSB appeals primarily targeted individual-level consumption behavior. They utilized six persuasive themes and often included more than one theme in a single message. Pro-SSB messages used feel-good themes and utilized only one theme per message. The proportions of adults, adolescents, and children differed by the direction of the advocacy. Black, Hispanic, and Asian actors were under-represented in the anti-SSB sample relative to Whites. Pro-SSB appeals were slightly higher than anti-SSB appeals in message sensation value (p = 0.09). The findings illuminate the message features that characterize the universe of brief anti-SSB appeals available online, highlight messaging disparities, and reveal the absence of certain common, effective persuasive themes.
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Affiliation(s)
- Yingke Li
- Department of Communication Arts & Sciences, The Pennsylvania State University, State College, PA 16802, USA (J.P.D.)
| | - Lijiang Shen
- Department of Communication Arts & Sciences, The Pennsylvania State University, State College, PA 16802, USA (J.P.D.)
| | - James Price Dillard
- Department of Communication Arts & Sciences, The Pennsylvania State University, State College, PA 16802, USA (J.P.D.)
| | - Shu (Scott) Li
- School of Communication, The University of Akron, Akron, OH 44325, USA
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Chen YJM, Haynes A, Scully M, Gascoyne C, McAleese A, Dixon H, Morley B, Wakefield M. Food purchasing practices in various retail settings and dietary intake: A cross-sectional survey of Australian adolescents. Health Promot J Austr 2023; 34:784-790. [PMID: 36625434 DOI: 10.1002/hpja.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 12/20/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND/AIMS Discretionary, energy-dense, nutrient-poor food and drinks are heavily marketed and readily available in retail settings frequented by adolescents. This study examines associations between food purchasing practices in various retail settings and dietary intake among Australian adolescents. METHODS Participants were students in years 8 to 11 (ages 12-17 years) who completed the 2009-10 (n = 13 790), 2012-13 (n = 10 309) or 2018 (n = 9102) National Secondary Students' Diet and Activity (NaSSDA) cross-sectional survey. Multistage stratified random sampling was used. An online survey completed at school assessed self-reported frequency of food purchasing practices in various retail settings and consumption of discretionary food, sugary drinks, fruit and vegetables. Generalised linear regression models examined associations between food purchasing practices and dietary behaviour. RESULTS Relative to students who brought lunch from home, those who purchased lunch from school or nearby outlets reported higher intake of discretionary food and sugary drinks and lower fruit intake. Buying lunch from school was also associated with lower vegetable intake. Buying food or drinks on the school commute, outside school grounds during school hours, from supermarket checkouts, and using mobile phone apps were each associated with higher discretionary food and sugary drink intake (all P < .01). CONCLUSIONS Purchasing food or drink in various retail settings is associated with higher intake of discretionary food and drink among Australian adolescents, and some purchasing practices appeared to displace fruit and vegetable intake. SO WHAT?: These findings highlight a need to improve the accessibility and promotion of healthier food and drink options in schools and other retail settings.
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Affiliation(s)
- Yan Jun Michelle Chen
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Ashleigh Haynes
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Claudia Gascoyne
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Alison McAleese
- Prevention Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Flórez KR, Albrecht SS, Hwang N, Chambers E, Li Y, Gany FM, Davila M. Household Food Security and Consumption of Sugar-Sweetened Beverages among New York City (NYC) Children: A Cross-Sectional Analysis of 2017 NYC Kids' Data. Nutrients 2023; 15:3945. [PMID: 37764728 PMCID: PMC10537250 DOI: 10.3390/nu15183945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Food insecurity is a stressor associated with adverse health outcomes, including the consumption of sugar-sweetened beverages (SSBs). Our study tests the hypothesis that other socioeconomic vulnerabilities may magnify this effect using cross-sectional data from the 2017 New York City (NYC) Kids Survey. Households providing an affirmative response to one or both food security screener questions developed by the US Department of Agriculture were coded as households with low food security. The number of sodas plus other SSBs consumed was standardized per day and categorized as 1 = none, 2 = less than one, and 3 = one or more. We tested the joint effect of low food security with chronic hardship, receipt of federal aid, and immigrant head of household on a sample of n = 2362 kids attending kindergarten and beyond using ordinal logistic regression and accounting for the complex survey design. Only having a US-born parent substantially magnified the effect of low household food security on SSB consumption (OR = 4.2, 95%CI: 2.9-6.3, p < 0.001) compared to the reference group of high household food security with an immigrant parent. The effect of low food security on SSB consumption among NYC children warrants intersectional approaches, especially to elucidate US-based SSB norms in low-food-security settings.
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Affiliation(s)
- Karen R. Flórez
- Environmental, Occupational and Geospatial Sciences Department, Graduate School of Public Health and Heath Policy, City University of New York, New York, NY 10017, USA
| | - Sandra S. Albrecht
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
| | - Neil Hwang
- Business and Information Systems Department, Bronx Community College, City University of New York, Bronx, NY 10453, USA;
| | - Earle Chambers
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Francesca M. Gany
- Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - Marivel Davila
- Bureau of Health Promotion for Justice-Impacted Populations, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA;
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D’Angelo-Campos A, Taillie LS, Vatavuk-Serrati G, Grummon AH, Higgins ICA, Hall MG. Effects of pictorial warnings on parents' purchases and perceptions of sugar-sweetened beverage categories. Pediatr Obes 2023; 18:e13030. [PMID: 36965067 PMCID: PMC10687846 DOI: 10.1111/ijpo.13030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/30/2023] [Accepted: 03/06/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND Sugar-sweetened beverage (SSB) consumption remains high among US children. Warning labels on SSBs hold promise for reducing consumption, but their impact may differ by SSB category. OBJECTIVES This study examined the effects of pictorial warnings on parents' beverage purchases and perceptions across SSB categories. METHODS Parents of children ages 2-12 (n = 326) visited a convenience store laboratory in North Carolina. Participants were randomly assigned to see SSBs carrying either pictorial warning labels or control labels. Parents purchased a beverage for their child and completed a survey. RESULTS Responses from parents in the control arm suggest underlying perceptions of flavoured milk (2.8 on scale ranging from 1 to 5), flavoured water (2.6), and fruit-flavoured drinks (2.5) as the most healthful SSB categories. Compared to the control, pictorial warnings led to the largest reductions in purchases of fruit drinks (-61%), soda (-36%) and flavoured milk (-32%). Warnings also lowered the perceived healthfulness of flavoured water (d = -0.34), flavoured milk (d = -0.28), sports drinks (d = -0.25), and a reduction in intentions to give one's child sports drinks (d = -0.30), flavoured water (d = -0.24) and sweet tea (d = -0.22, all p < 0.05). CONCLUSIONS Warning labels may have heterogeneous effects across SSB categories. Future research should assess the psychological mechanisms underlying these heterogeneous effects.
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Affiliation(s)
- Aline D’Angelo-Campos
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lindsey S Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gabriela Vatavuk-Serrati
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anna H Grummon
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Isabella C. A Higgins
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Potempa AE, Kelsey LC, Fink KJ, Pickle KE, Reilly KL, Young MB, Dilley JA. Alaska's Play Every Day Campaign Encourages Parents to Serve Healthy Drinks to Young Children. Health Promot Pract 2022; 23:128S-139S. [PMID: 36374602 DOI: 10.1177/15248399221115763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND Sugary drink consumption by young children is a public health concern. The State of Alaska, partnering with the Alaska Native Tribal Health Consortium, implemented the Play Every Day social marketing campaign in 2019-2021 to encourage parents to serve healthy drinks to young children. The campaign's intended audience was parents who experience disproportionately poor nutrition outcomes: Alaska Native people, those living in rural communities, and those with low incomes and/or educational attainment. We described campaign development, implementation, and performance. METHOD Parents from the identified disproportionately affected populations participated in formative research. Campaign awareness and engagement questions were added to Alaska's child health surveillance system. Regression models assessed associations between campaign exposure and outcomes. RESULTS The sample included 476 Alaska mothers of 3-year-old children. Of the 34% who reported seeing the campaign, 21% said they changed drinks served to their child because of the campaign. Campaign awareness, engagement, and reported changes in drinks given to children because of the campaign were greater among Alaska Native mothers than White mothers. Among all mothers, those who said the campaign gave them new information or that they shared the campaign had 7 to 8 times greater odds for reporting changes in behavior than those not engaged with the campaign. IMPLICATIONS FOR PRACTICE Social marketing campaigns that encourage parents to serve healthy drinks to young children may change behavior. Resources should be systematically dedicated to research, implementation, and evaluation focused on specific populations. Partnering with trusted community-serving organizations likely improves outcomes in disproportionately affected populations.
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Affiliation(s)
| | | | | | - Kathryn E Pickle
- Multnomah County Health Department and Oregon Health Authority Public Health Division, Portland, OR, USA
| | | | | | - Julia A Dilley
- Multnomah County Health Department and Oregon Health Authority Public Health Division, Portland, OR, USA
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Miller C, Dono J, Wright K, Pettigrew S, Wakefield M, Coveney J, Wittert G, Roder D, Durkin S, Martin J, Ettridge K. "No Child or Adult Would Ever Probably Choose to Have 16 Teaspoons of Sugar": A Preliminary Study of Parents' Responses to Sugary Drink Warning Label Options. Nutrients 2022; 14:4173. [PMID: 36235825 DOI: 10.3390/nu14194173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/01/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022] Open
Abstract
Front-of-pack (FoP) warning labels are a viable policy option with the potential to inform consumer choice and assist in reducing sugar-sweetened beverage (SSB) consumption as part of a multi-faceted approach. This study explored parents' perceptions and understanding of a range of SSB warning labels. Focus groups (n = 12) with 82 parents of school-aged children were conducted, stratified according to education level, sex and location. Health effects, exercise equivalents, sugar content (teaspoons in text and pictograms, "high in") and energy content labels were shown. Through thematic analysis we identified three themes. Theme 1 related to perceptions of effectiveness of labels, underpinned by four subthemes: perceptions of labels as credible, informative and useful, personally relevant and having the potential to change be haviour. Theme 2 related to participants finding opportunities for self-exemption (e.g., physically active) and message rejection (e.g., misinterpretation). Theme 3 encompassed the potential negative consequences of some labels (e.g., body image concerns). The text teaspoons label was perceived most favourably across all themes, with minimal negative issues raised. These results provide in-depth insight into potential responses to labelling as a policy intervention, providing important guidance for the development of labels to ensure optimal message content and framing for future testing and subsequent implementation.
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Christian D, Maharjan M, Kotov A, Cotter T, Mullin S, Nurse V, McGaw B, Chen D, Puri P, Wang S, Negi NS, Murukutla N. How the "Are We Drinking Ourselves Sick?" Communication Campaign Built Support for Policy Action on Sugary Drinks in Jamaica. Nutrients 2022; 14:nu14142866. [PMID: 35889823 PMCID: PMC9318558 DOI: 10.3390/nu14142866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 02/01/2023] Open
Abstract
Background: This study assesses the effectiveness of a campaign “Are We Drinking Ourselves Sick?” that ran nationally in Jamaica in four phases from 2017 to 2019 to increase knowledge about the harms of sugary drinks, shift attitudes, and build support for policy actions to address sugary drink consumption, including a tax and a ban in schools. Methods: Campaign impact was measured in representative cross-sectional household surveys of adults ages 18 to 55. A baseline survey was conducted before the launch of the campaign (n = 1430). Evaluation surveys were conducted mid-campaign (n = 1571) and post-campaign (n = 1500). Campaign impact was assessed by comparing changes across survey periods on key knowledge, attitudinal and policy support outcome indicators. The independent association between campaign awareness and outcomes was analyzed using logistic regression analyses. Results: The campaign was recalled by more than 80% of respondents and was well-received with 90% or more respondents describing it as believable and relevant. There was a decline in knowledge on the harms of sugary drinks from the baseline to post-campaign period, notably on risks of diabetes (adjusted odds ratio or AOR = 0.62, p < 0.001), overweight and obesity (AOR = 0.58, p < 0.001), and heart disease (AOR = 0.79, p < 0.003). However, post-campaign awareness was independently associated in logistic regression analysis with improved knowledge of the harms of sugary drinks, including risks of diabetes (AOR = 1.45, p = 0.019), overweight or obesity (AOR = 1.65, p = 0.001), and heart disease (AOR = 1.44, p = 0.011). Support for government action remained high across survey waves (≥90%), and campaign awareness was independently associated with increased policy support for sugary drinks taxes (Mid-campaign: AOR = 1.43, p = 0.019; post-campaign: AOR = 1.46, p = 0.01) and restrictions on sugary drinks in schools (AOR = 1.55, p = 0.01). Conclusion: This study demonstrates the role that media campaigns can play in maintaining knowledge and concern about the health harms of sugary drinks and increasing support for policy passage.
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Affiliation(s)
- Donnelle Christian
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY 10005, USA; (D.C.); (A.K.); (T.C.); (S.M.); (P.P.); (S.W.); (N.S.N.); (N.M.)
| | - Meena Maharjan
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY 10005, USA; (D.C.); (A.K.); (T.C.); (S.M.); (P.P.); (S.W.); (N.S.N.); (N.M.)
- Correspondence:
| | - Alexey Kotov
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY 10005, USA; (D.C.); (A.K.); (T.C.); (S.M.); (P.P.); (S.W.); (N.S.N.); (N.M.)
| | - Trish Cotter
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY 10005, USA; (D.C.); (A.K.); (T.C.); (S.M.); (P.P.); (S.W.); (N.S.N.); (N.M.)
| | - Sandra Mullin
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY 10005, USA; (D.C.); (A.K.); (T.C.); (S.M.); (P.P.); (S.W.); (N.S.N.); (N.M.)
| | - Vonetta Nurse
- Global Health Advocacy Project, The Heart Foundation of Jamaica, 28 Beechwood Avenue P.O. Box 338, Kingston 5, Jamaica; (V.N.); (B.M.); (D.C.)
| | - Barbara McGaw
- Global Health Advocacy Project, The Heart Foundation of Jamaica, 28 Beechwood Avenue P.O. Box 338, Kingston 5, Jamaica; (V.N.); (B.M.); (D.C.)
| | - Deborah Chen
- Global Health Advocacy Project, The Heart Foundation of Jamaica, 28 Beechwood Avenue P.O. Box 338, Kingston 5, Jamaica; (V.N.); (B.M.); (D.C.)
| | - Pallavi Puri
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY 10005, USA; (D.C.); (A.K.); (T.C.); (S.M.); (P.P.); (S.W.); (N.S.N.); (N.M.)
| | - Shuo Wang
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY 10005, USA; (D.C.); (A.K.); (T.C.); (S.M.); (P.P.); (S.W.); (N.S.N.); (N.M.)
| | - Nalin Singh Negi
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY 10005, USA; (D.C.); (A.K.); (T.C.); (S.M.); (P.P.); (S.W.); (N.S.N.); (N.M.)
| | - Nandita Murukutla
- Policy Advocacy and Communication Division, Vital Strategies, New York, NY 10005, USA; (D.C.); (A.K.); (T.C.); (S.M.); (P.P.); (S.W.); (N.S.N.); (N.M.)
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Santana IP, Scapin T, Rodrigues VM, Bernardo GL, Uggioni PL, Fernandes AC, Proença RPDC. University Students' Knowledge and Perceptions About Concepts, Recommendations, and Health Effects of Added Sugars. Front Nutr 2022; 9:896895. [PMID: 35757263 PMCID: PMC9218564 DOI: 10.3389/fnut.2022.896895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/16/2022] [Indexed: 12/21/2022] Open
Abstract
It is recommended to limit added sugars to below 10% of the daily energy intake, as excessive consumption has been associated with several chronic non-communicable diseases. This exploratory qualitative study used focus groups to investigate the knowledge and perception of Brazilian university students about added sugars concepts, consumption recommendations, and health effects. Focus groups were led by a moderator using a semi-structured discussion guide. The focus groups were recorded, transcribed verbatim, and subjected to thematic analysis. Five focus groups were conducted with a total of 32 participants (50% women, mean age 23 years). Participants could not distinguish added sugars from sugars naturally present in foods and were unaware of the health impacts associated with excessive added sugar consumption, except for the risk of diabetes. Although most participants reported limiting sugar consumption, they had no knowledge of official consumption recommendations. Given that current public policy agendas aim to reduce added sugar intake, there is a need to strengthen strategies for disseminating information on added sugar concepts, recommendations, health effects and how to identify them in the foods products.
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Affiliation(s)
- Isabela Paz Santana
- Nutrition in Foodservice Research Center (NUPPRE), Nutrition Postgraduate Program (PPGN), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Tailane Scapin
- Nutrition in Foodservice Research Center (NUPPRE), Nutrition Postgraduate Program (PPGN), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Vanessa Mello Rodrigues
- Nutrition in Foodservice Research Center (NUPPRE), Nutrition Postgraduate Program (PPGN), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Greyce Luci Bernardo
- Nutrition in Foodservice Research Center (NUPPRE), Nutrition Postgraduate Program (PPGN), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Paula Lazzarin Uggioni
- Nutrition in Foodservice Research Center (NUPPRE), Nutrition Postgraduate Program (PPGN), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Ana Carolina Fernandes
- Nutrition in Foodservice Research Center (NUPPRE), Nutrition Postgraduate Program (PPGN), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Rossana Pacheco da Costa Proença
- Nutrition in Foodservice Research Center (NUPPRE), Nutrition Postgraduate Program (PPGN), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
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Bragg MA, Rummo PE, Greene T, Arshonsky J, Anekwe AV, Mezzacca TA, Farley SM. Beverage Availability and Price: Variations by Neighborhood Poverty Level in New York City. Health Equity 2022; 6:322-329. [PMID: 35557551 PMCID: PMC9081063 DOI: 10.1089/heq.2021.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/30/2022] Open
Abstract
Objective: To describe the variability in the availability and price of sugary drinks, low-calorie drinks, and water/seltzer across high- and low-poverty census tracts in the five boroughs of New York City (NYC). Design: Cross-sectional study. Our primary analysis compared the overall sample of beverages. Secondary analyses included tests for differences in the availability of beverage categories by neighborhood poverty level. Setting: We collected data from 106 stores (31 supermarkets, 29 convenience stores, 29 pharmacies, 9 Targets, and 8 Dollar Trees) in NYC. Fifty-four stores were located in high-poverty census tracts and 52 were located in low-poverty census tracts. Results: The mean Price per 0.03-liter of sugary drinks across the sample was $0.08, which was significantly higher than the price of low-calorie drinks ($0.07, p=0.01) but not different from water/seltzer ($0.08, p=0.65). Sugary drinks and water/seltzer were available in 91% of retailers, and low-calorie drinks were available in 87% of retailers. There was no statistical difference in availability of sugary drinks compared with low-calorie drinks or water/seltzer overall or within high- or low-poverty census tracts. Analyzed by store type, the mean price per ounce of sugary drinks differed significantly from water/seltzer at convenience stores, pharmacies, and Target stores (bodegas: $0.08 vs. $0.09, p=0.03; pharmacies: $0.11 vs. $0.08, p=0.02; Target stores: $0.07 vs. $0.09, p=0.01). Conclusions: Sugary drinks were available in most food retail settings in NYC, with little variation by census tract poverty level. Interventions that raise the price of sugary drinks to make healthier alternatives, such as water, the more affordable option should be considered.
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Affiliation(s)
- Marie A Bragg
- Department of Population Health, New York University School of Medicine, New York, New York, USA.,New York University College of Global Public Health, New York, New York, USA
| | - Pasquale E Rummo
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Tenay Greene
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Josh Arshonsky
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Amaka V Anekwe
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, New York, USA
| | | | - Shannon M Farley
- ICAP, Columbia University, Columbia University Mailman School of Public Health, New York, NY USA
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11
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Schiltz F, De Witte K. Sugar rush or sugar crash? Experimental evidence on the impact of sugary drinks in the classroom. Health Econ 2022; 31:215-232. [PMID: 34729861 DOI: 10.1002/hec.4444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 08/23/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
Sugary drinks in schools have been demonized for their potential long-term contribution to rising obesity rates. Surprisingly, there is only little evidence on the immediate effects of sugary drinks in schools. This paper provides experimental evidence on the in-class effects of sugary drinks on behavior and student achievement. We randomly assigned 462 preschool children to receive sugary drinks or artificially sweetened drinks and collected data before and after consumption. Our findings suggest that the consumption of one sugary drink induces an initial "relaxing" effect for boys, before making them more restless. Girls' behavior is not significantly affected. We find a negative effect on student achievement for boys and a positive effect for girls. We show the robustness of the results across two field experiments.
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Affiliation(s)
- Fritz Schiltz
- Faculty of Economics and Business, KU Leuven, Leuven, Belgium
| | - Kristof De Witte
- Faculty of Economics and Business, KU Leuven, Leuven, Belgium
- UNU-Merit, Maastricht University, Maastricht, the Netherlands
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12
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Abstract
Evidence showing the effectiveness of policies to reduce the consumption of sugar-sweetened beverages (SSBs) is growing. SSBs are one of the largest sources of added sugar in the diet and are linked to multiple adverse health conditions. This review presents a framework illustrating the various types of policies that have been used to reduce SSB exposure and consumption; policies are organized into four categories (financial, information, defaults, and availability) and take into consideration crosscutting policy considerations (feasibility, impact, and equity). Next, for each category, we describe a specific example and provide evidence of impact. Finally, we discuss crosscutting policy considerations, the challenge of choosing among the various policy options, and important areas for future research. Notably, no single policy will reduce SSB consumption to healthy levels, so an integrated policy approach that adapts to changing market and consumption trends; evolving social, political, and public health needs; and emerging science is critical.
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Affiliation(s)
- James Krieger
- Healthy Food America, Seattle, Washington 98122, USA.,Department of Health Services, School of Public Health, University of Washington, Seattle, Washington 98195, USA;
| | - Sara N Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
| | - Stephanie Scarmo
- American Heart Association, National Center, Dallas, Texas 75231, USA;
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Global Public Health and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27516, USA;
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13
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Roglans N, Baena M, Sangüesa G, Velázquez AM, Griñán-Ferré C, Pallàs M, Sánchez RM, Alegret M, Laguna JC. Chronic liquid fructose supplementation does not cause liver tumorigenesis but elicits clear sex differences in the metabolic response in Sprague-Dawley rats. Food Nutr Res 2021; 65:7670. [PMID: 34650394 PMCID: PMC8494264 DOI: 10.29219/fnr.v65.7670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/12/2021] [Accepted: 06/06/2021] [Indexed: 11/20/2022] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) has increased over the last decades and may evolve into hepatocellular carcinoma (HCC). As HCC is challenging to treat, knowledge on the modifiable risk factors for NAFLD/HCC (e.g. hyper caloric diets rich in fructose) is essential. Objective and design We used a model of diethyl nitrosamine-induced hepatocarcinogenesis to investigate the liver cancer-promoting effects of a diet supplemented with 10% liquid fructose, administered to male and female rats for 11 months. A subset of the fructose-supplemented rats received resveratrol (RVT) in the last 4 months of treatment. Results and discussion Rat livers showed no de visu or histological evidence of liver tumorigenesis. However, we observed metabolic abnormalities that could be related to cancer development mainly in the female fructose-supplemented rats, such as increases in weight, adiposity and hepatic triglyceride levels, as well as hyperglycaemia, hyperuricemia, hyperleptinemia and a reduced insulin sensitivity index, which were partially reversed by RVT. Therefore, we performed a targeted analysis of 84 cancer-related genes in the female liver samples, which revealed expression changes associated with cancer-related pathways. Analysis of individual genes indicated that some changes increased the risk of hepatocarcinogenesis (Sfrp2, Ccl5, Socs3, and Gstp1), while others exerted a protective/preventive effect (Bcl2 and Cdh1). Conclusion Our data clearly demonstrate that chronic fructose supplementation, as the sole dietary intervention, does not cause HCC development in rats.
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Affiliation(s)
- Nuria Roglans
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.,Institute of Biomedicine, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Miguel Baena
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Gemma Sangüesa
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Ana Magdalena Velázquez
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.,Institute of Biomedicine, University of Barcelona, Barcelona, Spain
| | - Christian Griñán-Ferré
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.,Institute of Neuroscience (UBNeuro), University of Barcelona, Barcelona, Spain
| | - Mercè Pallàs
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.,Institute of Neuroscience (UBNeuro), University of Barcelona, Barcelona, Spain
| | - Rosa María Sánchez
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.,Institute of Biomedicine, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Marta Alegret
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.,Institute of Biomedicine, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Juan Carlos Laguna
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, School of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.,Institute of Biomedicine, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
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14
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McGurk MD, Takeda CR, Murakami J, La Chica T, Yamauchi J. Sugar-Sweetened Beverage Fee: A Model to Address Health Disparities in Hawai'i. Hawaii J Health Soc Welf 2021; 80:64-68. [PMID: 34704071 PMCID: PMC8538112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Sugar-sweetened beverage (SSB) consumption is associated with increased risk of obesity, diabetes, and other chronic diseases. SSB consumption is also a health equity issue, as rates of consumption and related chronic diseases vary by race, ethnicity, and income in Hawai'i. The COVID-19 pandemic has highlighted the need for greater investment in public health and the well-being of communities experiencing health disparities because individuals with chronic diseases are more likely to develop complications from the virus. It has also created economic hardships for the people of Hawai'i, especially the state's most vulnerable populations. Amid this health and economic crisis, an opportunity exists to implement an SSB fee in Hawai'i. An SSB fee would impose a fee on SSB distributors that would be passed on to consumers in the form of price increases that influence purchasing behavior. Jurisdictions with SSB taxes or fees have seen reductions in SSB purchases and consumption and have generated millions of dollars in revenues to support health initiatives and reduce socioeconomic disparities. Models predict that a $0.02 SSB fee in Hawai'i could generate $60.5 million and significantly reduce healthcare costs and chronic diseases. This commentary will present an SSB fee policy as a viable model for Hawai'i to reduce SSB consumption, lower chronic disease risks, and generate needed revenues to support health, reduce inequities, and rebuild the state's economy.
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Affiliation(s)
- Meghan D. McGurk
- Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, HI
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15
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Miller CL, Dono J, Scully M, Morley B, Ettridge K. Adolescents report low opposition towards policy options to reduce consumption of sugary drinks. Pediatr Obes 2021; 16:e12775. [PMID: 33738982 DOI: 10.1111/ijpo.12775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Policy makers benefit from insight into consumer perceptions of potential sugary drink policy measures. Adolescents are among the highest consumers in Australia, yet their perceptions are unknown. OBJECTIVES To determine adolescents' perceptions of potential policies aimed at reducing sugary drink consumption and explore variation in perceptions. METHODS Data were collected via a nationally representative survey of Australian secondary school students (aged 12-17) using a stratified two-stage probability design (n = 9102). Survey questions assessed receptiveness to five policy options, sugary drink consumption, perceptions of health effects and demographics. RESULTS Low proportions (13%-29%) were somewhat/strongly against policy options, 35% to 45% were neutral, and 27% to 52% were somewhat/strongly in favour. Highest support was observed for text warning labels on sugary drinks (52%), followed by tax with investment in healthy weight programmes (43%), standalone tax (36%), restricting school sales (30%) and restricting advertising to children (27%). Sex, sugary drink consumption and perceptions were significantly associated with most assessed policy options in bivariate analyses (P < .01). Significant associations between sex and consumption with selected policy options persisted in adjusted multilevel models. CONCLUSIONS Opposition towards policy options was low overall and neutrality was common. This creates opportunity for early intervention to increase public support for addressing specific health issues.
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Affiliation(s)
- Caroline Louise Miller
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia.,Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Joanne Dono
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Kerry Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
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16
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Haynes A, Bayly M, Dixon H, McAleese A, Martin J, Chen YJM, Wakefield M. Sugary drink advertising expenditure across Australian media channels 2016-2018. Aust N Z J Public Health 2021; 45:270-276. [PMID: 33818863 DOI: 10.1111/1753-6405.13103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/01/2021] [Accepted: 02/01/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The aim of this study was to describe advertising expenditure for sugary drinks compared with alternative cold non-alcoholic beverages (artificially sweetened beverages, plain water, plain milk) between 2016 and 2018 across Australian media channels. METHODS Monthly estimates of advertising expenditure for non-alcoholic beverages were obtained from Nielsen Media and aggregated by product type and media. RESULTS Total sugary drink advertising expenditure between 2016 and 2018 ($129.5M) significantly exceeded expenditure on artificially sweetened drinks ($23.26M), plain water ($14.27M), and plain milk ($31.30M). Television and out-of-home advertising accounted for the largest share of sugary drink advertising (45%, 35%). Expenditure on out-of-home advertising was more heavily dominated by sugary drinks (75%) than advertising in all media combined (65%). Sugary drink advertising peaked in warmer months and was lowest in August. Soft drinks (26%), flavoured milks (24%) and energy drinks (21%) accounted for the majority of sugary drink advertising. CONCLUSIONS Cold non-alcoholic beverage advertising in Australian media is dominated by the advertising of sugary drinks. Implications for public health: Restricting unhealthy beverage advertising on television and out-of-home media may be most effective initially. However, comprehensive restrictions capturing a broader range of media and settings would be optimal to prevent displacement and limit advertising reach and exposure.
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Affiliation(s)
- Ashleigh Haynes
- Centre for Behavioural Research in Cancer, Cancer Council Victoria
| | - Megan Bayly
- Centre for Behavioural Research in Cancer, Cancer Council Victoria
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria.,Melbourne School of Psychological Sciences, The University of Melbourne, Victoria
| | | | - Jane Martin
- Obesity Policy Coalition, Cancer Council Victoria
| | | | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria.,Melbourne School of Psychological Sciences, The University of Melbourne, Victoria
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17
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Houghtaling B, Holston D, Szocs C, Penn J, Qi D, Hedrick V. A rapid review of stocking and marketing practices used to sell sugar-sweetened beverages in U.S. food stores. Obes Rev 2021; 22:e13179. [PMID: 33331094 PMCID: PMC7988563 DOI: 10.1111/obr.13179] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/28/2020] [Accepted: 11/15/2020] [Indexed: 12/29/2022]
Abstract
Sugar-sweetened beverages (SSBs) are a primary source of added sugars in the American diet. Habitual SSB consumption is associated with obesity and noncommunicable disease and is one factor contributing to U.S. health disparities. Public health responses to address marketing-mix and choice-architecture (MMCA) strategies used to sell SSB products may be required. Thus, our goal was to identify original research about stocking and marketing practices used to sell SSB in U.S. food stores. We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the World Health Organization (WHO) protocol for rapid reviewing. We searched six databases and Google Scholar using key terms focused on store type and SSB products. We characterized results using an MMCA framework with categories place, profile, portion, pricing, promotion, priming or prompting, and proximity. Our search resulted in the identification of 29 articles. Most results focused on profile (e.g., SSB availability) (n = 13), pricing (e.g., SSB prices or discounts) (n = 13), or promotion (e.g., SSB advertisements) (n = 13) strategies. We found some evidence of targeted MMCA practices toward at-risk consumers and differences by store format, such as increased SSB prominence among supermarkets. The potential for systematic variations in MMCA strategies used to sell SSB requires more research. We discuss implications for public health, health equity, and environmental sustainability.
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Affiliation(s)
- Bailey Houghtaling
- School of Nutrition and Food Sciences, Louisiana State University (LSU) and LSU Agricultural Center, Baton Rouge, LA, USA
| | - Denise Holston
- School of Nutrition and Food Sciences, Louisiana State University (LSU) and LSU Agricultural Center, Baton Rouge, LA, USA
| | - Courtney Szocs
- E.J. Ourso College of Business, Louisiana State University, Baton Rouge, LA, USA
| | - Jerrod Penn
- Agricultural Economics and Agribusiness, Louisiana State University (LSU) and LSU Agricultural Center, Baton Rouge, LA, USA
| | - Danyi Qi
- Agricultural Economics and Agribusiness, Louisiana State University (LSU) and LSU Agricultural Center, Baton Rouge, LA, USA
| | - Valisa Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
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18
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Vanderlee L, White CM, Kirkpatrick SI, Rynard VL, Jáuregui A, Adams J, Sacks G, Hammond D. Nonalcoholic and Alcoholic Beverage Intakes by Adults across 5 Upper-Middle- and High-Income Countries. J Nutr 2021; 151:140-151. [PMID: 33245111 PMCID: PMC7779239 DOI: 10.1093/jn/nxaa324] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/19/2020] [Accepted: 10/01/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Despite considerable public health interest in sugary drink consumption, there has been little comparison of intake across countries. OBJECTIVES This study aimed to compare the consumption frequency and amounts of commonly consumed beverages among adults in 5 upper-middle- and high-income countries, and examine differences in consumption between population subgroups. METHODS Adults aged 18-65 y completed online surveys in December 2017 in Australia (n = 3264), Canada (n = 2745), Mexico (n = 3152), the United Kingdom (n = 3221), and the USA (n = 4015) as part of the International Food Policy Study. The frequency of consuming beverages from 22 categories in the past 7 d was estimated using the Beverage Frequency Questionnaire. Regression models were used to examine differences in the likelihood of any consumption and in the amounts consumed of sugar-sweetened beverages (SSBs), sugary drinks (SSBs and 100% juice), diet, and alcoholic beverages between countries and across sociodemographic subgroups. RESULTS The prevalence of reported SSB consumption in the past 7 d ranged from 47% (United Kingdom) to 81% (Mexico), and that of sugary drinks ranged from 62% (United Kingdom) to 87% (Mexico). Rates of consumption of diet drinks ranged from 26% (Mexico) to 37% (United Kingdom), whereas alcoholic drink consumption rates ranged from 45% (USA) to 52% (Canada). Respondents in Mexico were more likely to consume SSBs and sugary drinks, and in greater amounts, than those in other countries. Respondents in the United Kingdom were more likely to consume diet drinks than those in Australia, Canada, and Mexico, and greater amounts of diet drinks were consumed in the United Kingdom and the USA. Across countries, younger respondents and males were more likely to consume greater amounts of SSBs and sugary drinks. CONCLUSIONS Most adult respondents across all countries consumed SSBs and sugary drinks, with greater consumption in Mexico and the USA. Consumption varied greatly across countries, but patterns of association among subpopulations were relatively similar.
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Affiliation(s)
- Lana Vanderlee
- NUTRISS Centre, School of Nutrition, Laval University, Québec, Québec, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Christine M White
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Vicki L Rynard
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Alejandra Jáuregui
- Centre for Health and Nutrition Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Jean Adams
- Centre for Diet & Activity Research, Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Geelong, Victoria, Australia
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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19
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Murukutla N, Cotter T, Wang S, Cullinan K, Gaston F, Kotov A, Maharjan M, Mullin S. Results of a Mass Media Campaign in South Africa to Promote a Sugary Drinks Tax. Nutrients 2020; 12:E1878. [PMID: 32586040 DOI: 10.3390/nu12061878] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND In South Africa, the increased consumption of sugary drinks has been associated with increased obesity rates. Mass media campaigns can play a crucial role in improving knowledge, shifting attitudes, and building support for government action on reducing sugary drink consumption. No study to date has evaluated the effectiveness of mass media campaigns on the health harms of sugary drinks in South Africa. OBJECTIVE The purpose of this study was to evaluate the impact of a mass media campaign on knowledge and attitudes around sugary drinks and on public support for a proposed tax on sugary drinks in South Africa. METHODS The "Are You Drinking Yourself Sick?" campaign aired in South Africa from October 2016 to June 2017 to shift attitudes toward sugary drinks, build personal risk perceptions of the health harms of consuming sugary drinks, and build public support for a proposed tax on sugary drinks. Campaign impact was measured in representative cross-sectional household surveys of adults ages 18 to 56. The surveys were conducted just prior to the launch of the campaign (N = 1000), from October 7 to 10, 2016, and immediately following its conclusion (N = 1000), from July 12 to 21, 2017. Campaign impact was assessed by comparing changes from the pre-campaign to the post-campaign period on key outcome indicators. In addition, the effect of campaign awareness was analyzed in logistic regression analysis of the post-campaign data. RESULTS The campaign was recalled by 55% of survey respondents, and 78% of campaign-aware respondents said that the campaign's main message was "drinking sugary drinks can make you sick." There were significant changes from the pre- to the post-campaign period in knowledge that sugary drink consumption can lead to obesity and related health problems and that sugary drinks contribute toward the obesity problem in South Africa. Campaign awareness was also significantly associated with increases in knowledge about the harms of sugary drinks, and in particular, on government action, including the proposed tax on sugary drinks. DISCUSSION Media campaigns are an effective intervention for obesity prevention. In addition to improving knowledge and shifting attitudes, media campaigns can effectively build public support for strong government action and therefore must be a component of a comprehensive obesity prevention approach.
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20
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L. Harris J, Webb V, J. Sacco S, L. Pomeranz J. Marketing to Children in Supermarkets: An Opportunity for Public Policy to Improve Children's Diets. Int J Environ Res Public Health 2020; 17:E1284. [PMID: 32079285 PMCID: PMC7068324 DOI: 10.3390/ijerph17041284] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 11/16/2022]
Abstract
Public health experts worldwide are calling for a reduction of the marketing of nutrient-poor food and beverages to children. However, industry self-regulation and most government policies do not address in-store marketing, including shelf placement and retail promotions. This paper reports two U.S.-based studies examining the prevalence and potential impact of in-store marketing for nutrient-poor child-targeted products. Study 1 compares the in-store marketing of children's breakfast cereals with the marketing of other (family/adult) cereals, including shelf space allocation and placement, special displays and promotions, using a national audit of U.S. supermarkets. Child-targeted cereals received more shelf space, middle- and lower-shelf placements, special displays, and promotions compared with other cereals. Study 2 compares the proportion of product sales associated with in-store displays and promotions for child-targeted versus other fruit drinks/juices, using syndicated sales data. A higher proportion of child-targeted drink sales were associated with displays and promotions than sales of other drinks. In both categories, the results were due primarily to major company products. Although in-store marketing of child-targeted products likely appeals to both children and parents, these practices encourage children's consumption of nutrient-poor food and drinks. If companies will not voluntarily address in-store marketing to children, government policy options are available to limit the marketing of unhealthy foods in the supermarket.
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Affiliation(s)
- Jennifer L. Harris
- Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, CT 06103, USA
| | - Victoria Webb
- Springfield Psychological, Philadelphia, PA 19102, USA;
| | - Shane J. Sacco
- Department of Allied Health Sciences, University of Connecticut, Mansfield, Storrs, CT 06269, USA;
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21
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Czoli CD, Pauzé E, Potvin Kent M. Exposure to Food and Beverage Advertising on Television among Canadian Adolescents, 2011 to 2016. Nutrients 2020; 12:nu12020428. [PMID: 32046142 PMCID: PMC7071192 DOI: 10.3390/nu12020428] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 11/25/2022] Open
Abstract
Adolescents represent a key audience for food advertisers, however there is little evidence of adolescent exposure to food marketing in Canada. This study examined trends in Canadian adolescents’ exposure to food advertising on television. To do so, data on 19 food categories were licensed from Nielsen Media Research for May 2011, 2013, and 2016 for the broadcasting market of Toronto, Canada. The average number of advertisements viewed by adolescents aged 12–17 years on 31 television stations during the month of May each year was estimated using television ratings data. Findings revealed that between May 2011 and May 2016, the total number of food advertisements aired on all television stations increased by 4%, while adolescents’ average exposure to food advertising decreased by 31%, going from 221 ads in May 2011 to 154 in May 2016. In May 2016, the advertising of fast food and sugary drinks dominated, relative to other categories, accounting for 42% and 11% of all exposures, respectively. The findings demonstrate a declining trend in exposure to television food advertising among Canadian adolescents, which may be due to shifts in media consumption. These data may serve as a benchmark for monitoring and evaluating future food marketing policies in Canada.
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Affiliation(s)
- Christine D Czoli
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (C.D.C.); (E.P.)
- Heart and Stroke Foundation, Ottawa, ON K1Z 8R9, Canada
| | - Elise Pauzé
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (C.D.C.); (E.P.)
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada; (C.D.C.); (E.P.)
- Correspondence: ; Tel.: +1-(613)-562-5800 (ext. 7447)
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22
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Abstract
Adolescents in many countries consume poor quality diets that include high intakes of sugary drinks and fast food and low intakes of vegetables. The aims of this Special Issue on adolescent dietary behaviour were to identify methods and approaches for successful interventions to improve diet quality in this age group and identify at risk subgroups that need particular attention. In total, 11 manuscripts were published in this Special Issue-three qualitative studies which included a systematic review, five cross-sectional studies and three quantitative evaluations of interventions. This Editorial discusses the contribution of the studies and provides suggestions to improve the success of future interventions in adolescents. It is important that adolescents are involved in the design of interventions to improve social and cultural acceptability and relevance. Interventions targeting schools or communities framed within a larger food system such as issues around climate change and the carbon footprint of food may improve engagement. Furthermore, targeting adolescents in areas of lower deprivation is a priority where diet quality is particularly poor. Potentially successful interventions also include environmental policies that impact on the cost and marketing of food and drinks, although evaluations of these were not included in this issue.
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Leary SD, Do LG. Changes in oral health behaviours between childhood and adolescence: Findings from a UK cohort study. Community Dent Oral Epidemiol 2019; 47:367-373. [PMID: 31190330 DOI: 10.1111/cdoe.12475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/04/2019] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Oral health is an important part of general health and well-being. Health behaviours may change throughout a person's life, but the stage from childhood to adolescence is critical because influences from peers increase while those from parents and other family members decrease. The objective of this study was to identify changes in oral health behaviours between childhood and adolescence, and investigate whether changes differed by sex. METHODS This study used data on 1860 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) who completed dental questionnaires at ages 7.5, 10.5 and 17.5 years. Associations between age and oral health behaviours were assessed using random effects logistic regression models. Males and females were analysed together or separately, depending on evidence for sex-age interactions. RESULTS At age 7.5, 83% brushed their teeth frequently, 98% visited the dentist frequently and 90% drank fizzy drinks. The percentage who brushed their teeth at least twice a day decreased with age for males (odds ratio 0.96 [95% confidence interval 0.94, 0.99] per year of age) and increased with age for females (1.03 [1.01, 1.06]). Electric toothbrush usage decreased with age, with a slightly larger decrease in females (0.82 [0.80, 0.85]) than in males (0.87 [0.84, 0.90]). The percentage visiting the dentist at least once a year decreased with age (0.77 [0.73, 0.81]); the decrease was greatest between the older ages. Fizzy drink and juice consumption increased with age (1.38 [1.23, 1.57] and 1.33 [1.24, 1.44] respectively), whereas there was no change in water consumption (1.00 [0.91, 1.09]); these data were available only for the younger two ages. CONCLUSIONS Unfavourable changes in oral health behaviours, some of which were sex-specific, have been demonstrated in this cohort. Hence, childhood to adulthood may be an important intervening time to prevent early deterioration of oral health.
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Affiliation(s)
- Sam D Leary
- Bristol Biomedical Research Centre Nutrition Theme, Bristol Dental School, University of Bristol, Bristol, UK
| | - Loc Giang Do
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
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Frank AL. A Legacy of Disease. J Appalach Health 2019; 1:80-85. [PMID: 35769893 PMCID: PMC9138855 DOI: 10.13023/jah.0102.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In Appalachia, like much of America, there are important health issues that have not always been appropriately predicted or dealt with when they occur. Lifestyle issues in Appalachia lead to obesity and heart disease, not surprisingly due to extensive use of sugary drinks. The current opioid crisis could have been better predicted given the trauma of mining and the past abuse of less-potent narcotics. A continuing major problem in the whole country is inadequate support for preventive health activities.
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Andress LA, Urhie O, Compton C. West Virginia's Sugary Drink Tax Examining Print Media Frames in Local News Sources. J Appalach Health 2019; 1:19-30. [PMID: 35769895 PMCID: PMC9138853 DOI: 10.13023/jah.0102.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Framing is an important aspect of the policy process that helps the public and decision makers sort through and resolve highly charged claims about an issue. Through slight changes in the presentation of issues, a framing effect may alter public support. The way a proposed sugary drink tax is discussed in public discourse and by the media significantly influences policy acceptance. Given the public health significance of obesity and diabetes in West Virginia (WV) the study of media frames employed to represent a sugary drink tax policy is useful. METHODS Using quantitative content analysis, this study assessed news articles-published over 7 years by news outlets in WV-to determine the frames that were employed. RESULTS Pro-tax arguments appeared more often in these articles. In both pro- and anti-tax arguments, a personal behavior or economic frame appeared more frequently. The more common anti-tax arguments focused on the tax being regressive and not changing personal behavior. The pro-tax arguments focused more often on increases in state revenues and people selecting healthier beverages. IMPLICATIONS Given the significance of obesity and diabetes in WV, the study of media frames that represent the sugary drink tax should provide valuable guidance to inform strategies that utilize public discourse and media coverage to influence policy acceptance. However, since WV has not been able to get approval for its sugary drink tax, it may be beneficial to examine other elements of agenda setting including issue generation tactics, mobilizing structures, and political opportunities.
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Morley B, Niven P, Dixon H, Swanson M, Szybiak M, Shilton T, Pratt IS, Slevin T, Wakefield M. Association of the LiveLighter mass media campaign with consumption of sugar-sweetened beverages: Cohort study. Health Promot J Austr 2019; 30 Suppl 1:34-42. [PMID: 30903631 PMCID: PMC6972651 DOI: 10.1002/hpja.244] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 03/20/2019] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED Evaluation of the behavioural impact of Western Australia's LiveLighter healthy weight and lifestyle campaign focussed on decreasing consumption of sugar-sweetened beverages (SSBs) using graphic imagery, as well as monitoring unintended consequences. METHODS A cohort design with pre-campaign telephone survey of Western Australian adults aged 25-49 (Time 1 May/Jun 2013: N = 1504) undertaken and repeated following the campaign (Time 2 Aug/Sep 2013: N = 822). RESULTS Post-campaign awareness was 67% with respondents in low socio-economic areas most likely to report viewing the campaign frequently. There was evidence of reduced SSB intake from baseline to follow-up among frequent (4+/week) SSB consumers (22% cf. 16%; P = 0.003) and some evidence among overweight (BMI 25+) weekly SSB consumers (56% cf. 48%; P = 0.013). There was also some evidence consumption of sweet food decreased (3+/week: 53% cf. 48%; P = 0.035) while fruit, vegetable and fast food consumption remained stable. Knowledge of potential health consequences of SSBs increased (70% cf. 82%; P < 0.001) with no change in knowledge of potential health consequences of overweight generally (86% cf. 89%). Importantly, there was no increase in endorsement of overweight stereotypes. CONCLUSIONS The LiveLighter "Sugary Drinks" campaign positively impacted adults' knowledge and behaviour with regard to SSB consumption in a pattern specific to the campaign messaging and without adverse impact on weight-related stereotypes. SO WHAT?: Findings support the use of mass media for healthy lifestyle change. They suggest the public are receptive to undertaking the campaign's simple concrete lifestyle recommendation and provide an indication of the campaign dose required to achieve positive behaviour change.
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Affiliation(s)
- Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Vic., Australia
| | - Philippa Niven
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Vic., Australia
| | - Helen Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Vic., Australia
| | - Maurice Swanson
- Heart Foundation (Western Australia), Subiaco, WA, Australia
| | - Maria Szybiak
- Heart Foundation (Western Australia), Subiaco, WA, Australia
| | - Trevor Shilton
- Heart Foundation (Western Australia), Subiaco, WA, Australia
| | - Iain S Pratt
- Cancer Council Western Australia, Subiaco, WA, Australia
| | - Terry Slevin
- Cancer Council Western Australia, Subiaco, WA, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Vic., Australia
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Morley BC, Niven PH, Dixon HG, Swanson MG, McAleese AB, Wakefield MA. Controlled cohort evaluation of the LiveLighter mass media campaign's impact on adults' reported consumption of sugar-sweetened beverages. BMJ Open 2018; 8:e019574. [PMID: 29695387 PMCID: PMC5922472 DOI: 10.1136/bmjopen-2017-019574] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 03/13/2018] [Accepted: 03/21/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To evaluate the LiveLighter 'Sugary Drinks' campaign impact on awareness, knowledge and sugar-sweetened beverage (SSB) consumption. DESIGN Cohort study with population surveys undertaken in intervention and comparison states at baseline (n=900 each), with 78% retention at follow-up (intervention: n=673; comparison: n=730). Analyses tested interactions by state (intervention, comparison) and time (baseline, follow-up). SETTING AND PARTICIPANTS Adults aged 25-49 years residing in the Australian states of Victoria and South Australia. INTERVENTION The 6-week mass media campaign ran in Victoria in October/November 2015. It focused on the contribution of SSBs to the development of visceral 'toxic fat', graphically depicted around vital organs, and ultimately serious disease. Paid television advertising was complemented by radio, cinema, online and social media advertising, and stakeholder and community engagement. PRIMARY OUTCOME MEASURE Self-reported consumption of SSBs, artificially sweetened drinks and water. SECONDARY OUTCOME MEASURES Campaign recall and recognition; knowledge of the health effects of overweight and SSB consumption; perceived impact of SSB consumption on body weight and of reduced consumption on health. RESULTS A significant reduction in frequent SSB consumption was observed in the intervention state (intervention: 31% compared with 22%, comparison: 30% compared with 29%; interaction p<0.01). This was accompanied by evidence of increased water consumption (intervention: 66% compared with 73%; comparison: 68% compared with 67%; interaction p=0.09) among overweight/obese SSB consumers. This group also showed increased knowledge of the health effects of SSB consumption (intervention: 60% compared with 71%, comparison: 63% compared with 59%; interaction p<0.05) and some evidence of increased prevalence of self-referent thoughts about SSB's relationship to weight gain (intervention: 39% compared with 45%, comparison: 43% compared with 38%; interaction p=0.06). CONCLUSIONS The findings provide evidence of reduced SSB consumption among adults in the target age range following the LiveLighter campaign. This is notable in a context where public health campaigns occur against a backdrop of heavy commercial product advertising promoting increased SSB consumption.
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Affiliation(s)
- Belinda C Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Philippa H Niven
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Helen G Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Maurice G Swanson
- Chief Executive, Heart Foundation (Western Australia), Subiaco, Western Australia, Australia
| | - Alison B McAleese
- Cancer Prevention Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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Hornsby WC, Bailey W, Braun PA, Weiss K, Heichelbech J. Busting the Baby Teeth Myth and Increasing Children's Consumption of Tap Water: Building Public Will for Children's Oral Health in Colorado. Front Public Health 2017; 5:238. [PMID: 28955704 PMCID: PMC5601903 DOI: 10.3389/fpubh.2017.00238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/22/2017] [Indexed: 11/13/2022] Open
Abstract
QUESTION Can a multifaceted statewide communications campaign motivate behavior change in low-income Colorado families to limit children's fruit juice consumption and increase children's consumption of tap water to prevent tooth decay? PURPOSE Caries is the most common chronic disease of childhood, affecting 40% of kindergartners and 55% of third graders in Colorado. Frequent consumption of 100% fruit juice is linked to childhood caries. The purpose of this campaign, "Cavities Get Around," was to motivate families to limit children's fruit juice consumption and increase consumption of tap water to protect baby teeth from caries, while also building public will for children's oral health. METHODS The campaign included targeted media, promotores/organizers, and family education. We focused on fruit juice because audience research showed many families view fruit juice as healthy, and it is also a common beverage among young children up to age of 6 years. We also focused on low-socioeconomic status families because data show higher childhood tooth decay rates in this population. To evaluate progress, we conducted identical pre- and post-surveys, each of 600 random low-income parents contacted by landline, mobile telephone, and Internet, allowing for comparative data. RESULTS Significant progress was achieved compared to 2014 baseline results. Findings from a November 2015 statewide survey of parents included the following: (1) 22-point increase from 2014 in percentage of children regularly drinking tap water (from 41 to 63%). (2) 29-point decrease from 2014 in percentage of respondents who considered fruit juice consumption important to their child's health and nutritional needs (from 72 to 43%). (3) 19-point reduction in fruit juice consumption among young children (from 66% in 2014 to 47% in 2015). (4) 6-point reduction in percentage of parents considering baby teeth "less important" than adult teeth (from 21% in 2014 to 15% in 2015). The campaign also played a role in new state rules prohibiting childcare centers from serving sugar-sweetened beverages and capping 100% juice to twice per week. CONCLUSION The campaign development, strategies, and evaluation results are instructive for others working on health promotion, childhood nutrition, and education interventions.
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Affiliation(s)
- Wyatt C Hornsby
- Delta Dental of Colorado Foundation, Denver, CO, United States
| | - William Bailey
- School of Dental Medicine, University of Colorado, Aurora, CO, United States
| | - Patricia A Braun
- School of Medicine, University of Colorado Anschutz School of Medicine, Denver, CO, United States
| | - Karl Weiss
- HealthCare Research, Inc., Denver, CO, United States
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Navarrete-Muñoz EM, Wark PA, Romaguera D, Bhoo-Pathy N, Michaud D, Molina-Montes E, Tjønneland A, Olsen A, Overvad K, Boutron-Ruault MC, Clavel-Chapelon F, Fagherazzi G, Katzke VA, Kühn T, Steffen A, Trichopoulou A, Klinaki E, Papatesta EM, Masala G, Krogh V, Tumino R, Naccarati A, Mattiello A, Peeters PH, Rylander C, Parr CL, Skeie G, Weiderpass E, Quirós JR, Duell EJ, Dorronsoro M, Huerta JM, Ardanaz E, Wareham N, Khaw KT, Travis RC, Key T, Stepien M, Freisling H, Riboli E, Bueno-de-Mesquita HB. Sweet-beverage consumption and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Am J Clin Nutr 2016; 104:760-8. [PMID: 27510540 PMCID: PMC6241849 DOI: 10.3945/ajcn.116.130963] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/23/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The consumption of sweet beverages has been associated with greater risk of type 2 diabetes and obesity, which may be involved in the development of pancreatic cancer. Therefore, it has been hypothesized that sweet beverages may increase pancreatic cancer risk as well. OBJECTIVE We examined the association between sweet-beverage consumption (including total, sugar-sweetened, and artificially sweetened soft drink and juice and nectar consumption) and pancreatic cancer risk. DESIGN The study was conducted within the European Prospective Investigation into Cancer and Nutrition cohort. A total of 477,199 participants (70.2% women) with a mean age of 51 y at baseline were included, and 865 exocrine pancreatic cancers were diagnosed after a median follow-up of 11.60 y (IQR: 10.10-12.60 y). Sweet-beverage consumption was assessed with the use of validated dietary questionnaires at baseline. HRs and 95% CIs were obtained with the use of multivariable Cox regression models that were stratified by age, sex, and center and adjusted for educational level, physical activity, smoking status, and alcohol consumption. Associations with total soft-drink consumption were adjusted for juice and nectar consumption and vice versa. RESULTS Total soft-drink consumption (HR per 100 g/d: 1.03; 95% CI: 0.99, 1.07), sugar-sweetened soft-drink consumption (HR per 100 g/d: 1.02; 95% CI: 0.97, 1.08), and artificially sweetened soft-drink consumption (HR per 100 g/d: 1.04; 95% CI: 0.98, 1.10) were not associated with pancreatic cancer risk. Juice and nectar consumption was inversely associated with pancreatic cancer risk (HR per 100 g/d: 0.91; 95% CI: 0.84, 0.99); this association remained statistically significant after adjustment for body size, type 2 diabetes, and energy intake. CONCLUSIONS Soft-drink consumption does not seem to be associated with pancreatic cancer risk. Juice and nectar consumption might be associated with a modest decreased pancreatic cancer risk. Additional studies with specific information on juice and nectar subtypes are warranted to clarify these results.
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Affiliation(s)
- Eva M Navarrete-Muñoz
- Department of Public Health, Faculty of Medicine, Miguel Hernández University, Alicante, Spain; The Spanish Biomedical Research Centre in Epidemology and Public Health (CIBERESP), Health Institute Carlos III, Madrid, Spain
| | - Petra A Wark
- Global eHealth Unit, Department of Primary Care and Public Health
| | - Dora Romaguera
- Department of Epidemiology and Biostatistics, and The Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Health Institute Carlos III, Madrid, Spain; Medical Research Institute of Palma, University Hospital Son Espases, Palma de Mallorca, Spain;
| | - Nirmala Bhoo-Pathy
- Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Dominique Michaud
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
| | - Esther Molina-Montes
- The Spanish Biomedical Research Centre in Epidemology and Public Health (CIBERESP), Health Institute Carlos III, Madrid, Spain; Andalusian School of Public Health. Biomedical Research Institute of Granada; University Hospital of Granada/Granada University, Granada, Spain
| | - Anne Tjønneland
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen Ø, Denmark
| | - Anja Olsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen Ø, Denmark
| | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus C, Denmark
| | - Marie-Christine Boutron-Ruault
- Centre for Research in Epidemiology and Population Health, U1018, Nutrition, Hormones and Women's Health team, National Institute for Health and Medical Research, Villejuif, France; UMRS 1018, Université Paris Sud, Villejuif, France; Institut Gustave Roussy, Villejuif, France
| | - Françoise Clavel-Chapelon
- Centre for Research in Epidemiology and Population Health, U1018, Nutrition, Hormones and Women's Health team, National Institute for Health and Medical Research, Villejuif, France; UMRS 1018, Université Paris Sud, Villejuif, France; Institut Gustave Roussy, Villejuif, France
| | - Guy Fagherazzi
- Centre for Research in Epidemiology and Population Health, U1018, Nutrition, Hormones and Women's Health team, National Institute for Health and Medical Research, Villejuif, France; UMRS 1018, Université Paris Sud, Villejuif, France; Institut Gustave Roussy, Villejuif, France
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Annika Steffen
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece; Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece
| | | | | | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit. Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civic - M.P. Arezzo" Hospital, ASP Ragusa, Italy
| | - Alessio Naccarati
- Human Genetics Foundation,Torino, Molecular and Genetic Epidemiology Unit, Torino, Italy
| | - Amalia Mattiello
- Dipartamento di Medicina Clinica e Chirurgia, Federico II University of Naples, Naples, Italy
| | - Petra H Peeters
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands
| | - Charlotta Rylander
- Department of Community Medicine, University of Tromsø-the Arctic University of Norway, Tromsø, Norway
| | - Christine L Parr
- Department of Chronic Diseases, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Guri Skeie
- Department of Community Medicine, University of Tromsø-the Arctic University of Norway, Tromsø, Norway
| | - Elisabete Weiderpass
- Department of Community Medicine, University of Tromsø-the Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Samfundet Folkhälsan, Helsinki, Finland
| | | | - Eric J Duell
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute, Catalan Institute of Oncology, Barcelona, Spain
| | - Miren Dorronsoro
- The Spanish Biomedical Research Centre in Epidemology and Public Health (CIBERESP), Health Institute Carlos III, Madrid, Spain; Public Health Direction Biodonostia Basque Regional Health Department, San Sebastian, Spain
| | - José María Huerta
- The Spanish Biomedical Research Centre in Epidemology and Public Health (CIBERESP), Health Institute Carlos III, Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Eva Ardanaz
- The Spanish Biomedical Research Centre in Epidemology and Public Health (CIBERESP), Health Institute Carlos III, Madrid, Spain; Navarre Public Health Institute, Pamplona, Spain
| | | | - Kay-Tee Khaw
- Department of Public Health and Primary Care, and Clinical Gerontology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Tim Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Magdalena Stepien
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Heinz Freisling
- Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, Netherlands; and
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, and
| | - H Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, and Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment, Bilthoven, Netherlands; and Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, Netherlands
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