Monitoring changes in community support for policies on obesity prevention

How an agreement with restriction of unhealthy food marketing and sodium taxation influenced high fat, salt or sugar (HFSS) food consumption

BACKGROUND

Food taxation and food marketing policy are very cost-effectiveness to improve healthy diets among children. The objective of this study was to investigate the socio-demographic characteristics of Thais and attitude towards on policy unhealthy food marketing restriction and sodium taxation which influence high fat, sodium, and sugar (FHSS) food eating.

METHODS

The data were obtained from the 2021 Health Behavior of Population Survey, four-stage sampling method of the Thai people, aged 15 years and above, using a offline survey application-assisted face-to-face interview. Logistic Regression were used to analyze the explanatory variables on agreement and HFSS food intake.

RESULTS

Almost half (48.4%) of samples disagreed with sodium taxation, and 42.7% of the samples disagreed with food marketing restriction. Most (99.6%) of Thai respondents consumed HFSS food, including sugar sweetened beverages (SSB). Gender, age, education, income, BMI, and health status were associated with agreement with food marketing restriction policy and sodium taxation policy. There is no association between agreement with policy on sodium taxation and food marketing and HFSS food consumption.

CONCLUSION

Nearly half of Thais indicated that they disagreed with policy on food marketing restriction and sodium taxation. Therefore, understanding and awareness of the two policies among Thais should be further investigated in order to develop better policy communication for increased public understanding and engagement.

An analysis of current obesity strategies for adolescents in NSW against best practice recommendations: Implications for researchers, policymakers and practitioners

ISSUE ADDRESSED

Obesity is a significant health challenge facing adolescents. There is a critical need for government action to support all adolescents to improve risk factors for obesity. This study critically appraised initiatives, guidelines and policies (termed "strategies") from local health districts (LHDs), speciality health networks and Primary Health Networks (PHNs) across New South Wales (NSW), relevant to the prevention and management of obesity amongst adolescents and compare these to best practice recommendations.

METHODS

We critically appraised strategies against best practice recommendations that included support, access, responsiveness to needs, supportive environment, monitoring and evaluation and health equity. Strategies were collected by systematically searching websites of 15 LHDs, one speciality health network and 10 PHNs.

RESULTS

There was evidence of strategies regarding adolescent obesity prevention and management across all best practice recommendations. There was limited evidence of adolescent consumer participation, digital strategies for health services and online health information. There were minimal targeted public or school-based education campaigns and interventions on physical activity or nutrition. Place-based approaches such as sports and recreation facilities were not included in policies regarding the sale of healthy food and drinks. Evaluation evidence across all strategies was minimal.

CONCLUSIONS

Numerous strategies are being implemented across NSW to address adolescent obesity. Despite this, the alignment of strategies with best practice recommendations is poor and evidence of progress in tackling adolescent obesity remains unclear. SO WHAT?: Opportunities to generate and translate best practice evidence within government strategies for obesity must be prioritised with embedded measurement and evaluation plans.

An examination of public support for 35 nutrition interventions across seven countries

BACKGROUND

Public support for evidence-based nutrition interventions can be an important determinant of government willingness to develop and implement such interventions. The aim of this study was to assess support for a broad range of nutrition interventions across seven countries: Australia, Canada, China, India, New Zealand, the United Kingdom, and the United States. Assessed interventions included those relating to food availability, affordability, reformulation, labelling, and promotion.

METHODS

Approximately 1000 adults per country (total n = 7559) completed an online survey assessing support for 35 nutrition interventions/policies. ANOVA analyses were used to identify differences between countries on overall levels of support and by intervention category. Multiple regression analyses assessed demographic and diet-related factors associated with higher levels of support across the total sample and by country.

RESULTS

Substantial levels of public support were found for the assessed interventions across the seven countries and five intervention categories. The highest levels were found in India (Mean across all interventions of 4.16 (standard deviation (SD) 0.65) on a 5-point scale) and the lowest in the United States (Mean = 3.48, SD = 0.83). Support was strongest for interventions involving food labelling (Mean = 4.20, SD = 0.79) and food reformulation (Mean = 4.17, SD = 0.87), and weakest for fiscal interventions (Mean = 3.52, SD = 1.06). Consumer characteristics associated with stronger support were higher self-rated health, higher educational attainment, female sex, older age, and perceptions of consuming a healthy diet.

CONCLUSION

The results indicate substantial support for a large range of nutrition interventions across the assessed countries, and hence governments could potentially be more proactive in developing and implementing such initiatives.

Support for cancer prevention public health policies: results from a nationally representative sample of residents in the United States

Assessing public support of health policies designed to reduce cancer risk is important for policy implementation. This study aimed to identify support for cancer prevention policies and factors associated with support. Data were obtained from the Health Information National Trends Survey. Support for three types of cancer prevention policies were evaluated: tobacco, alcohol, and junk food regulations. Linear and logistic regression analyses were employed to assess the relationship between support for the different types of policies and sociodemographic, lifestyle behaviors, and cancer beliefs. Certain policies, such as providing warning labels on cigarettes (69.9% support) and requiring specific health warnings on alcohol containers (65.1% support), were popular. Banning outdoor advertising of alcohol was not popular (34.4% support). There were individual differences associated with policy support. For example, respondents who were 75 years or older (B = 0.61, p < .001) or female (B = 0.14, p < .008) were more likely to support tobacco polices compared to their counterparts (i.e., younger or male). Respondents who identified as politically conservative (B = -0.20, p < .004) or those who endorsed high cancer fatalistic beliefs (e.g., there's not much you can do to lower your chances of getting cancer, B = -0.07, p < .012) were less likely to support alcohol policies compared to those who were liberal or had lower cancer fatalistic beliefs. Generally, support was high for most policy questions. However, support varied by different individual factors. The findings also highlight that there may be opportunities to increase understanding and awareness about cancer prevention policies, especially among some segments of the population.

An ecological study of obesity-related cancer incidence trends in Australia from 1983 to 2017

BACKGROUND

Overweight and obesity is a growing public health issue as it contributes to the future burden of obesity-related diseases, including cancer, especially in high-income countries. In Australia, 4.3% of all cancers diagnosed in 2013 were attributable to overweight and obesity. Our aim was to examine Australian age-specific incidence trends over the last 35 years for obesity-related cancers based on expert review (colorectal, liver, gallbladder, pancreas, breast in postmenopausal women, uterine, ovary, kidney, thyroid, and multiple myeloma) individually and pooled.

METHODS

Australian incidence data for 10 obesity-related cancers among people aged 25-84 years, diagnosed from 1983 to 2017, were obtained from the Australian Cancer Database. We used age-period-cohort modelling and joinpoint analysis to assess trends, estimating incidence rate ratios (IRR) by birth-cohort for each individual cancer and pooled, and the annual percentage change. The analyses were also conducted for non-obesity-related cancers over the same period.

FINDINGS

The total number of cancers where some proportion is obesity-related, diagnosed from 1983-2017, was 1,005,933. This grouping was 34.7% of cancers diagnosed. The IRR of obesity-related cancers increased from 0.77 (95% CI 0.73, 0.81) for the 1903 birth-cohort to 2.95 (95% CI 2.58, 3.38) for the recent 1988 cohort relative to the 1943 cohort. The IRRs of non-obesity related cancers were stable with non-significant decreases in younger cohorts. These trends were broadly similar across sex and age groups.

INTERPRETATION

The incidence of obesity-related cancers in Australia has increased by birth-cohort across all age-groups, which should be monitored. Obesity, a public health epidemic, needs to be addressed through increased awareness, policy support and evidence-based interventions.

FUNDING

This research received no specific funding.

Public Opinion on Food Policies to Combat Obesity in Spain

(1) Introduction: Poor diet is the fourth-leading cause of mortality in Spain, where adherence to the Mediterranean diet has declined in recent decades. To remedy this situation, a series of food policies have been proposed that would be easier to implement if they had public support. (2) Material and methods: Cross-sectional study covering a representative sample of the Spanish population (n = 1002), using telephone interviews that addressed nine food policies under four headings, namely, advertising, labeling, composition, and provision and sale. The sociodemographic determinants of support for these policies were analyzed using the chi-squared (χ²) test and Poisson multiple regression models with robust variance. (3) Results: All the proposed measures received more than 60% support. The policies that received greatest support were those targeting labeling at 96.6%, while the policies that received the least support were those directed at banning free refills at restaurants, at 63%. Support for policies was higher among women, older adults, and persons professing left-wing ideological affiliations. Compared with men, women’s support for advertising policies was 21% higher: similarly, compared with the youngest age group (18–29 years), support by the over-65 segment for provision and sale policies was 52% higher. Support for composition policies was 28% lower among persons with right-wing as opposed to left-wing political sympathies. (4) Conclusions: The authorities enjoy the support of the Spanish public as regards implementing food policies proposed by experts and overcoming the resistance of sectors opposed to such measures.