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Huang V, Head A, Hyseni L, O'Flaherty M, Buchan I, Capewell S, Kypridemos C. Identifying best modelling practices for tobacco control policy simulations: a systematic review and a novel quality assessment framework. Tob Control 2023; 32:589-598. [PMID: 35017262 PMCID: PMC10447402 DOI: 10.1136/tobaccocontrol-2021-056825] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/27/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Policy simulation models (PSMs) have been used extensively to shape health policies before real-world implementation and evaluate post-implementation impact. This systematic review aimed to examine best practices, identify common pitfalls in tobacco control PSMs and propose a modelling quality assessment framework. METHODS We searched five databases to identify eligible publications from July 2013 to August 2019. We additionally included papers from Feirman et al for studies before July 2013. Tobacco control PSMs that project tobacco use and tobacco-related outcomes from smoking policies were included. We extracted model inputs, structure and outputs data for models used in two or more included papers. Using our proposed quality assessment framework, we scored these models on population representativeness, policy effectiveness evidence, simulated smoking histories, included smoking-related diseases, exposure-outcome lag time, transparency, sensitivity analysis, validation and equity. FINDINGS We found 146 eligible papers and 25 distinct models. Most models used population data from public or administrative registries, and all performed sensitivity analysis. However, smoking behaviour was commonly modelled into crude categories of smoking status. Eight models only presented overall changes in mortality rather than explicitly considering smoking-related diseases. Only four models reported impacts on health inequalities, and none offered the source code. Overall, the higher scored models achieved higher citation rates. CONCLUSIONS While fragments of good practices were widespread across the reviewed PSMs, only a few included a 'critical mass' of the good practices specified in our quality assessment framework. This framework might, therefore, potentially serve as a benchmark and support sharing of good modelling practices.
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Affiliation(s)
- Vincy Huang
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Anna Head
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Lirije Hyseni
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Martin O'Flaherty
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Iain Buchan
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Simon Capewell
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Chris Kypridemos
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
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Oktaviani LW, Hsu HC, Chen YC. Effects of Health-Related Behaviors and Changes on Successful Aging among Indonesian Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5952. [PMID: 35627488 PMCID: PMC9141271 DOI: 10.3390/ijerph19105952] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022]
Abstract
Whether changes in health behaviors can improve successful aging has not been well explored. The purpose of this study was to assess the effects of health-related behaviors and changes on successful aging in Indonesian older adults. Data were from the fourth and fifth waves of the Indonesia Family Life Survey (IFLS), the participants were aged 60 years and older and who completed both waves (n = 1289). Successful aging indicators were defined as no chronic diseases, no physical function difficulties, no depressive symptoms, intact cognitive function, with social support, and with social participation. Health-related behaviors focused on smoking, physical activities, and protein intake. A logistic regression analysis was conducted. The overall successful aging rate in 2007 was 23.6%, and it had decreased to 5.6% by 2014. There were gender differences in smoking, physical activities, and behavioral changes, including promoting increased physical activity, no smoking/smoking cessation, and adequate protein intake by older adults. Quitting smoking, performing medium physical activity, and increasing protein intake were protective factors for successful aging, but the effects of behavioral changes differed by gender. Health-related behaviors and changes may impact successful aging among older adults. A healthy lifestyle is suggested to be adopted as early as possible in one's life course.
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Affiliation(s)
- Lisa Wahidatul Oktaviani
- School of Public Health, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Public Health, Universitas Muhammadiyah Kalimantan Timur, Samarinda 75124, Indonesia
| | - Hui-Chuan Hsu
- School of Public Health, Taipei Medical University, Taipei 11031, Taiwan;
- Research Center of Health Equity, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan;
| | - Yi-Chun Chen
- Research Center of Health Equity, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan;
- School of Nutrition and Health Science, Taipei Medical University, Taipei 11031, Taiwan
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3
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Mendonça N, Hengeveld LM, Visser M, Presse N, Canhão H, Simonsick EM, Kritchevsky SB, Newman AB, Gaudreau P, Jagger C. Low protein intake, physical activity, and physical function in European and North American community-dwelling older adults: a pooled analysis of four longitudinal aging cohorts. Am J Clin Nutr 2021; 114:29-41. [PMID: 33829238 PMCID: PMC8246618 DOI: 10.1093/ajcn/nqab051] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/09/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Dietary protein may slow the decline in muscle mass and function with aging, making it a sensible candidate to prevent or modulate disability progression. At present, studies providing reliable estimates of the association between protein intake and physical function, and its interaction with physical activity (PA), in community-dwelling older adults are lacking. OBJECTIVES We investigated the longitudinal relation between protein intake and physical function, and the interaction with PA. METHODS We undertook a pooled analysis of individual participant data from cohorts in the PROMISS (PRevention Of Malnutrition In Senior Subjects in the European Union) consortium (the Health Aging and Body Composition Study, Quebec Longitudinal Study on Nutrition and Successful Aging, Longitudinal Aging Study Amsterdam, and Newcastle 85+) in which 5725 community-dwelling older adults were followed up to 8.5 y. The relation between protein intake and walking speed was determined using joint models (linear mixed-effects and Cox proportional hazards models) and the relation with mobility limitation was investigated using multistate models. RESULTS Higher protein intake was modestly protective of decline in walking speed in a dose-dependent manner [e.g., protein intake ≥1.2 compared with 0.8 g/kg adjusted body weight (aBW)/d: β = 0.024, 95% CI: 0.009, 0.032 SD/y], with no clear indication of interaction with PA. Participants with protein intake ≥0.8 g/kg aBW/d had also a lower likelihood of incident mobility limitation, which was observed for each level of PA. This association seemed to be dose-dependent for difficulty walking but not for difficulty climbing stairs. No associations between protein intake and other mobility limitations transitions were observed. CONCLUSIONS Higher daily protein intake can reduce physical function decline not only in older adults with protein intake below the current RDA of 0.8 g/kg BW/d, but also in those with a protein intake that is already considered sufficient. This dose-dependent association was observed for each level of PA, suggesting no clear synergistic association between protein intake and PA in relation to physical function.
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Affiliation(s)
| | - Linda M Hengeveld
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nancy Presse
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada,Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Quebec, Canada
| | - Helena Canhão
- EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa (UNL), Lisbon, Portugal,Comprehensive Health Research Centre (CHRC), NOVA Medical School, Lisbon, Portugal
| | | | | | - Anne B Newman
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, PA, USA
| | - Pierrette Gaudreau
- Department of Medicine, University of Montréal, H3T 1J4, Montréal, Quebec, Canada,Research Centre of the Centre hospitalier de l'Université de Montréal (CHUM), H2X 0A9, Montréal, Quebec, Canada
| | - Carol Jagger
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom
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Duflos C, Roubille C, Roubille F. By half decrease of cardiovascular mortality in a Western country between 2000 and 2015: A contrasted picture advocating for a better management of comorbidities. Int J Cardiol 2020; 318:145-146. [PMID: 32437900 DOI: 10.1016/j.ijcard.2020.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/06/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Claire Duflos
- CEPEL, Univ Montpellier, CNRS, Montpellier, France; Clinical Research and Epidemiology Unit, CHU Montpellier, Univ Montpellier, France
| | - Camille Roubille
- Department of Internal Medicine, Montpellier University Hospital, Montpellier, France; PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - François Roubille
- Department of Cardiology, Montpellier University Hospital, Montpellier, France; PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France.
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Del Pozo Cruz B, McGregor DE, Del Pozo Cruz J, Buman MP, Palarea-Albaladejo J, Alfonso-Rosa RM, Chastin SFM. Integrating Sleep, Physical Activity, and Diet Quality to Estimate All-Cause Mortality Risk: A Combined Compositional Clustering and Survival Analysis of the National Health and Nutrition Examination Survey 2005-2006 Cycle. Am J Epidemiol 2020; 189:1057-1064. [PMID: 32286613 DOI: 10.1093/aje/kwaa057] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 01/31/2023] Open
Abstract
We aimed to compare all-cause mortality risk across clusters of adults ≥50 years of age (n = 1,035) with common lifestyle behaviors patterns, enrolled in the US National Health and Nutrition Examination Survey (2005-2006). Log-ratio coordinates of 24-hour movement pattern and z scores of diet quality were used as input into a model-based clustering analysis. A Cox regression model was fitted to ascertain the all-cause mortality risk associated with each cluster. Participants were clustered into 4 groups: 1) a group characterized by a better physical activity profile and longer sleep duration coupled with an average diet quality (cluster 1); 2) a group with the poorest activity profile and shortest sleep but also the best diet quality (cluster 2); 3) another group featuring lower levels of activity of either intensity and higher levels of sedentary behavior and also a poor diet quality score (cluster 3); and 4) a group with an average diet quality and the best activity profile in the sample (cluster 4). A combination of a poorer diet and activity profile increased the prospective risk of all-cause mortality. Our findings emphasize the importance of considering the combination of diet quality and 24-hour movement patterns when developing interventions to reduce the risk of premature mortality.
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Shigdel R, Dalen H, Sui X, Lavie CJ, Wisløff U, Ernstsen L. Cardiorespiratory Fitness and the Risk of First Acute Myocardial Infarction: The HUNT Study. J Am Heart Assoc 2020; 8:e010293. [PMID: 30991880 PMCID: PMC6512140 DOI: 10.1161/jaha.118.010293] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background The majority of studies evaluating cardiorespiratory fitness (CRF) as a cardiovascular risk factor use cardiovascular mortality and not cardiovascular disease events as the primary end point, and generally do not include women. The aim of this study was to investigate the association of estimated CRF (eCRF) with the risk of first acute myocardial infarction (AMI). Methods and Results We included 26 163 participants (51.5% women) from the HUNT study (Nord‐Trøndelag Health Study), with a mean age of 55.7 years, without cardiovascular disease at baseline. Baseline eCRF was grouped into tertiles. AMI was derived from hospital records and deaths from the Norwegian Cause of Death Registry. We used Fine and Gray regression modeling to estimate subdistribution hazards ratio (SHR) of AMI, accounting for competing risk of death. During a mean (range) follow‐up of 13 (0.02–15.40) years (347 462 person‐years), 1566 AMI events were recorded. In fully adjusted models men in the 2 highest eCRF had 4% (SHR: 0.96, 95% CI: 0.83–1.11) and 10% (SHR: 0.90, 95% CI: 0.77–1.05) lower SHR of AMI, respectively, when compared with men in the lowest tertile. The corresponding numbers in women were 12% (SHR: 0.88, 95% CI: 0.72–1.08) and 25% (SHR: 0.75, 95% CI: 0.60–0.95). Conclusions eCRF was inversely associated with risk of AMI event among women but not in men. Our data suggest that high eCRF may have substantial benefit in reducing the risk of AMI. Therefore, our data suggest that an increased focus on eCRF as a cardiovascular disease risk marker in middle‐aged and older adults is warranted.
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Affiliation(s)
- Rajesh Shigdel
- 1 Department of Public Health and Nursing Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Håvard Dalen
- 2 K.G. Jebsen Center for Exercise in Medicine Department of Circulation and Medical Imaging Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway.,3 Clinic of Cardiology St. Olav's University Hospital Trondheim Norway.,4 Department of Medicine Levanger Hospital Nord-Trøndelag Hospital Trust Levanger Norway
| | - Xuemei Sui
- 5 Department of Exercise Science Arnold School of Public Health University of South Carolina Columbia SC
| | - Carl J Lavie
- 6 Department of Cardiovascular Diseases John Ochsner Heart and Vascular Institute Ochsner Clinical School The University of Queensland School of Medicine New Orleans LA
| | - Ulrik Wisløff
- 2 K.G. Jebsen Center for Exercise in Medicine Department of Circulation and Medical Imaging Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway.,7 School of Human Movement & Nutrition Sciences University of Queensland Australia
| | - Linda Ernstsen
- 1 Department of Public Health and Nursing Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway
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Marasigan V, Perry I, Bennett K, Balanda K, Capewell S, O' Flaherty M, Kabir Z. Explaining the fall in Coronary Heart Disease mortality in the Republic of Ireland between 2000 and 2015 - IMPACT modelling study. Int J Cardiol 2020; 310:159-161. [DOI: 10.1016/j.ijcard.2020.03.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 02/28/2020] [Accepted: 03/27/2020] [Indexed: 10/24/2022]
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Franco-Arellano B, Vanderlee L, Ahmed M, Oh A, L'Abbé M. Influence of front-of-pack labelling and regulated nutrition claims on consumers’ perceptions of product healthfulness and purchase intentions: A randomized controlled trial. Appetite 2020; 149:104629. [DOI: 10.1016/j.appet.2020.104629] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 02/03/2020] [Accepted: 02/09/2020] [Indexed: 01/17/2023]
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Desmond MA, Sobiecki J, Fewtrell M, Wells JCK. Plant-based diets for children as a means of improving adult cardiometabolic health. Nutr Rev 2019; 76:260-273. [PMID: 29506219 DOI: 10.1093/nutrit/nux079] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular disease (CVD) is the largest contributor to global mortality, and this trend is expected to continue. Although mortality rates have been falling, adverse developments in obesity and diabetes threaten to reverse this. It has been estimated that the only viable strategy to reduce the epidemic is to focus on population-wide risk factor reduction. Primordial prevention, a strategy aimed at avoiding the development of risk factors before the disease onset, has been shown to reduce the CVD epidemic substantially. Plant-based diets appear beneficial for prevention of cardiometabolic diseases, with adult vegetarians and vegans having lower CVD risk than omnivores. Atherosclerosis starts in childhood and progresses in relation to classical CVD risk factors, which, along with dietary habits, track to adulthood. Based on this evidence, it is proposed that plant-based diets in childhood could promote cardiometabolic health in adults and thereby reduce CVD and promote longevity and health. However, the need for additional research to establish the safety of predominantly or exclusively plant-based diets in children is noted.
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Affiliation(s)
- Malgorzata A Desmond
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.,Department of Paediatrics, Nutrition and Metabolic Diseases, Children's Memorial Health Institute, Warsaw, Poland
| | - Jakub Sobiecki
- Department of Paediatrics, Nutrition and Metabolic Diseases, Children's Memorial Health Institute, Warsaw, Poland.,School of Public Health, Imperial College, London, United Kingdom
| | - Mary Fewtrell
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Jonathan C K Wells
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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Schönbach JK, Nusselder W, Lhachimi SK. Substituting polyunsaturated fat for saturated fat: A health impact assessment of a fat tax in seven European countries. PLoS One 2019; 14:e0218464. [PMID: 31291265 PMCID: PMC6619676 DOI: 10.1371/journal.pone.0218464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 06/03/2019] [Indexed: 01/22/2023] Open
Abstract
There is evidence that replacing saturated fat (SFA) with polyunsaturated fat (PUFA) lowers ischemic heart disease (IHD). In order to improve the population’s diet, the World Health Organization has called for the taxation of foods that are high in SFA. We aimed to assess the potential health gains of a European fat tax by applying the SFA intake reduction that has been observed under the Danish fat tax to six other European countries. For each country, we created a fat tax scenario with a decreased SFA intake and a corresponding increase in PUFA. We compared this fat tax scenario to a reference scenario with no change in SFA intake, and to a guideline scenario with a population-wide SFA intake in line with dietary recommendations. We used DYNAMO-HIA to dynamically project the policy-attributable IHD cases of these three scenarios 10 years into the future. A fat tax would reduce prevalent IHD cases by a minimum of 500 and 300 among males and females in Denmark, respectively, up to a maximum of 5,600 and 4,000 among males and females in the UK. Thereby, the prevented IHD cases under a fat tax scenario would correspond to between 11.0% (in females in the Netherlands) and 29.5% (in females in Italy) of the prevented IHD cases under a guideline scenario, which represents the maximum preventable disease burden. Henceforth, our quantification of beneficial health impacts makes the case for the policy debate on fat taxes.
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Affiliation(s)
- Johanna-Katharina Schönbach
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Research Group for Evidence-Based Public Health, Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany
- * E-mail:
| | - Wilma Nusselder
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Stefan K. Lhachimi
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
- Research Group for Evidence-Based Public Health, Leibniz Institute for Prevention Research and Epidemiology–BIPS, Bremen, Germany
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Franco-Arellano B, Kim MA, Vandevijvere S, Bernstein JT, Labonté MÈ, Mulligan C, L'Abbé MR. Assessment of Packaged Foods and Beverages Carrying Nutrition Marketing against Canada's Food Guide Recommendations. Nutrients 2019; 11:E411. [PMID: 30781351 PMCID: PMC6412409 DOI: 10.3390/nu11020411] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/10/2019] [Accepted: 02/13/2019] [Indexed: 02/07/2023] Open
Abstract
Canadians' food purchases consist largely of packaged processed and ultra-processed products, which typically fall outside the "core" foods recommended by Canada's Food Guide (CFG). Almost half of packaged products in Canada carry nutrition marketing (i.e., nutrient content and health claims). This study assessed whether packaged foods carrying nutrition marketing align with recommendations outlined in the 2007 CFG. Label data (n = 9376) were extracted from the 2013 Food Label Information Program (FLIP). Label components (including nutrition marketing) were classified using the International Network for Food and Obesity/NCDs Research, Monitoring and Action Support (INFORMAS) labelling taxonomy. The Health Canada Surveillance Tool (HCST) was used to assess the alignment of products to CFG. Each food or beverage was classified into one of five groups (i.e., Tier 1, Tier 2, Tier 3, Tier 4, "Others"). Products in Tier 1, 2 or water were considered "in line with CFG". Most products in the analyzed sample were classified as Tier 2 (35%) and Tier 3 (27%). Although foods with nutrition marketing were significantly more likely to align to CFG recommendations (p < 0.001), many products not "in line with CFG" still carried nutrition marketing. This study provides important baseline data that could be used upon the implementation of the new CFG.
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Affiliation(s)
- Beatriz Franco-Arellano
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Min Ah Kim
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada.
| | - Stefanie Vandevijvere
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland 1010, New Zealand.
| | - Jodi T Bernstein
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Marie-Ève Labonté
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
- School of Nutrition & Institute of Nutrition and Functional Foods, Laval University, Québec, QC G1V 0A6, Canada.
| | - Christine Mulligan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
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Farchi S, De Sario M, Lapucci E, Davoli M, Michelozzi P. Meat consumption reduction in Italian regions: Health co-benefits and decreases in GHG emissions. PLoS One 2017; 12:e0182960. [PMID: 28813467 PMCID: PMC5557600 DOI: 10.1371/journal.pone.0182960] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 07/27/2017] [Indexed: 01/30/2023] Open
Abstract
Introduction Animal agriculture has exponentially grown in recent decades in response to the rise in global demand for meat, even in countries like Italy that traditionally eat a Mediterranean, plant-based diet. Globalization related dietary changes are contributing to the epidemic of non-communicable diseases and to the global climate crisis, and are associated with huge carbon and water footprints. The objective of the study is to assess inequalities in health impacts and in attributable greenhouse gases-GHG emissions in Italy by hypothesizing different scenarios of reduction in red and processed meat consumption towards healthier consumption patterns more compliant with the recommendations of the Mediterranean food pyramid. Methods We used demographic and food consumption patterns from national surveys and risk relationships between meat intake and cardiovascular and colorectal cancer mortality from IARC and other meta-analyses. From the baseline data (year 2005–2006, average 406 gr/week beef and 245 gr/week processed meat), we considered hypothetical meat reduction scenarios according to international dietary guidelines such as the Mediterranean pyramid targets. For each geographical area (Northwest, Northeast, Centre, and South) and gender, we calculated the number of avoidable deaths from colorectal cancer, and cardiovascular disease among the adult population. Moreover, years of life gained by the adult population from 2012 to 2030 and changes in life expectancy of the 2012 birth cohort were quantified using gender-specific life tables. GHG emission reductions under Mediterranean scenario were estimated only for beef by applying the Global Warming Potential (GWP) coefficient to total consumption and to a low carbon food substitution in adult diet. Results The deaths avoidable (as percentage change compared to baseline) according to the three reduction scenarios for beef consumption were between 2.3% and 4.5% for colorectal cancer, and between 2.1% and 4.0% for cardiovascular disease; higher benefits would be observed in Northwestern areas and among males. In parallel, 5% and 6.4% of colorectal cancer and CVD deaths would be avoided if the Italian population ate the advised quantity of processed meat. Life table analysis suggests that the scenario that is fully compliant with the Mediterranean diet model would save 5 million years of life lost prematurely among men and women over the next 18 years and would increase average life expectancy of future generations by over 7 months. Considering the environmental impact, emissions associated with the actual total intake of beef range from 12,900 to 21,800 Gg CO2 eq; emissions saved according to the Mediterranean scenario are in the range 8000–14000 Gg CO2 eq per year. The per capita reduction is 263 KgCO2eq/year/person with higher reductions in Northwestern and Central areas. Conclusions In Italy, scenarios for reducing beef consumption are consistent with significant health and environmental co-benefits on current and future generations. Results support introducing policies to promote healthier behavior towards red and processed meat in the adult population within an overall balanced and healthy dietary pattern. Interventions should address gender, vulnerable population groups, and geographical differences in order to be more effective.
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Affiliation(s)
- Sara Farchi
- Department of Epidemiology of Regional Health Service, ASL Roma 1, Lazio Region, Rome, Italy
- * E-mail:
| | - Manuela De Sario
- Department of Epidemiology of Regional Health Service, ASL Roma 1, Lazio Region, Rome, Italy
| | - Enrica Lapucci
- Department of Epidemiology of Regional Health Service, ASL Roma 1, Lazio Region, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology of Regional Health Service, ASL Roma 1, Lazio Region, Rome, Italy
| | - Paola Michelozzi
- Department of Epidemiology of Regional Health Service, ASL Roma 1, Lazio Region, Rome, Italy
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Peng Y, Wang Z. Association of Life's Simple 7 and presence of cardiovascular disease in general Australians. Open Heart 2017; 4:e000622. [PMID: 28878949 PMCID: PMC5574438 DOI: 10.1136/openhrt-2017-000622] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/24/2017] [Accepted: 06/13/2017] [Indexed: 12/16/2022] Open
Abstract
Objective The American Heart Association developed Life’s Simple 7 to define and monitor cardiovascular health (CVH), but their contributions to cardiovascular disease (CVD) in general Australians are still unclear. Our study aimed to evaluate the separate and combined effects of Life’s Simple 7 on CVD among Australians. Methods We performed a cross-sectional study based on 7499 adults (≥18 years) who have been tested for total cholesterol and fasting plasma glucose as part of the 2011–2012 Australian Health Survey. Poisson regression analyses were used to estimate the incidence rate ratios and population attributable fractions of those metrics to CVD prevalence. Participants were classified into three CVH status groups based on the number of ideal metrics: inadequate (0–2), average (3–4) and optimal (5–7). Logistic regression analyses were performed to illustrate the relationships between overall CVH and CVD prevalence. Results 2100 (21.0%) participants were having CVD. Smoking, elevated body mass index, blood pressure, total cholesterol, fasting plasma glucose and physical inactivity were observed as significant indicators of CVD. Compared with the inadequate category, participants in the optimal and average category have a 66% (adjusted OR, 0.34; 95% CI 0.22 to 0.54) and a 33% (adjusted OR, 0.67; 95% CI 0.56 to 0.81) lower CVD risk. One more ideal metric was associated with a 21% reduced CVD risk (adjusted OR, 0.79; 95% CI 0.73 to 0.84). Conclusions We have identified several modifiable risk factors and contributors of CVD in general Australians. The improvement of overall CVH may also reduce CVD risk.
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Affiliation(s)
- Yang Peng
- Faculty of Medicine, Centre for Chronic Disease, University of Queensland, Herston, Australia
| | - Zhiqiang Wang
- Faculty of Medicine, Centre for Chronic Disease, University of Queensland, Herston, Australia
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Badimon L, Cubedo J. Risk factors' management to impact on acute coronary syndromes. Int J Cardiol 2016; 217 Suppl:S7-9. [PMID: 27378658 DOI: 10.1016/j.ijcard.2016.06.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 06/25/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Lina Badimon
- Cardiovascular Research Center (CSIC-ICCC) and Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, c/Sant Antoni MªClaret 167, 08025 Barcelona, Spain; Cardiovascular Research Chair UAB, c/Sant Antoni MªClaret 167, 08025 Barcelona, Spain.
| | - Judit Cubedo
- Cardiovascular Research Center (CSIC-ICCC) and Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, c/Sant Antoni MªClaret 167, 08025 Barcelona, Spain
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