1
|
Smith L, López Sánchez GF, Tully MA, Rahmati M, Oh H, Kostev K, Butler LT, Barnett Y, Keyes H, Shin JI, Koyanagi A. Temporal trends of carbonated soft-drink consumption among adolescents aged 12-15 years from eighteen countries in Africa, Asia and the Americas. Br J Nutr 2024; 131:1633-1640. [PMID: 38225928 DOI: 10.1017/s0007114524000059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Carbonated soft-drink consumption is detrimental to multiple facets of adolescent health. However, little is known about temporal trends in carbonated soft-drink consumption among adolescents, particularly in non-Western countries. Therefore, we aimed to examine this trend in representative samples of school-going adolescents from eighteen countries in Africa, Asia and the Americas. Cross-sectional data from the Global School-based Student Health Survey 2009-2017 were analysed. Carbonated soft-drink consumption referred to drinking carbonated soft-drinks at least once per day in the past 30 d. The prevalence of carbonated soft-drink consumption was calculated for each survey, and crude linear trends were assessed by linear regression models. Data on 74 055 students aged 12-15 years were analysed (mean age 13·9 (sd 1·0) years; 49·2 % boys). The overall mean prevalence of carbonated soft-drink consumption was 42·1 %. Of the eighteen countries included in the study, significant decreasing, increasing and stable trends of carbonated soft-drink consumption were observed in seven, two and nine countries, respectively. The most drastic decrease was observed in Kuwait between 2011 (74·4 %) and 2015 (51·7 %). Even in countries with significant decreasing trends, the decrease was rather modest, while some countries with stable trends had very high prevalence across time (e.g. Suriname 80·5 % in 2009 and 79·4 % in 2016). The prevalence of carbonated soft-drink consumption was high in all countries included in the present analysis, despite decreasing trends being observed in some. Public health initiatives to reduce the consumption of carbonated soft-drink consumption among adolescents are urgently required.
Collapse
Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo Felipe López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Republic of Ireland, UK
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khorramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | | | - Laurie T Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Helen Keyes
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
- Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
| |
Collapse
|
2
|
Balestracci K, Sebelia L, Greene G, Moore A, Baird G, Chappell K, Tovar A. Effect of a Technology-Integrated Curriculum on Sugary Drink and Snack Intake of Elementary-Aged Youth Experiencing Low Income. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:209-218. [PMID: 38385934 DOI: 10.1016/j.jneb.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 02/23/2024]
Abstract
OBJECTIVE To describe the results of a technology-integrated intervention on sugar-sweetened beverage (SSB) and energy-dense snack intake with third graders experiencing low income. DESIGN A 2 × 2 quasi-randomized cluster-block, parallel-group experimental research design. SETTING Low-income schools in Rhode Island. PARTICIPANTS Two-hundred seventeen intervention and 242 control third-grade students in low-income (89.6% and 88.2% free/reduced meals, respectively), ethnically and racially diverse (63% Hispanic/20% Black and 62% Hispanic/18% Black, respectively) schools. INTERVENTION(S) A 13-week in-school program held once per week for 1 hour. The hands-on, technology-integrated program used a modified version of the Body Quest: Food of the Warrior curriculum. MAIN OUTCOME MEASURE(S) Intake of SSB and energy-dense snacks, both salty and sweet snacks, using baseline (week 1) and postassessment (week 13) previous day self-recall. ANALYSIS Generalized mixed modeling with nesting. RESULTS Intervention students significantly reduced their SSB intake by 38% (0.5 times/d; F[1, 540] = 4.26; P = 0.04) and salty snack intake by 58% (0.8 times/d; F[1, 534] = 6.58, P < 0.01) from baseline to postassessment as compared with the control students. CONCLUSIONS AND IMPLICATIONS Findings suggest a technology-integrated curriculum is effective in decreasing SSB and salty snacks in elementary-aged students of low-income, minoritized populations. Improved dietary habits can potentially influence other facets of students' lives.
Collapse
Affiliation(s)
- Kate Balestracci
- Department of Nutrition and Food Sciences, College of Health Sciences, University of Rhode Island, Providence, RI.
| | - Linda Sebelia
- Department of Nutrition and Food Sciences, College of Health Sciences, University of Rhode Island, Providence, RI
| | - Geoffrey Greene
- Department of Nutrition and Food Sciences, College of Health Sciences, University of Rhode Island, Kingston, RI
| | - Adam Moore
- Feinstein College of Education, University of Rhode Island, Kingston, RI
| | - Grayson Baird
- Lifespan Hospital System, Rhode Island Hospital, Providence, RI
| | - Kelsi Chappell
- Department of Nutrition and Food Sciences, College of Health Sciences, University of Rhode Island, Providence, RI
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| |
Collapse
|
3
|
Wang C, Chen Y, Xu H, Wang W, Zhou H, Sun Q, Hong X, Zhao J. Sustaining Healthy Habits: The Enduring Impact of Combined School-Family Interventions on Consuming Sugar-Sweetened Beverages among Pilot Chinese Schoolchildren. Nutrients 2024; 16:953. [PMID: 38612987 PMCID: PMC11013720 DOI: 10.3390/nu16070953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 04/14/2024] Open
Abstract
This study assesses the enduring impact of combined school- and family-based interventions on reducing the consumption of sugar-sweetened beverages (SSBs) among schoolchildren in China. Two primary schools were assigned at random to either the Intervention Group or the Control Group, in Nanjing, eastern China. All students were in grade three and received an invitation to participate. In the first year, students in the Intervention Group received one-year intervention measures, including monthly monitoring, aiming to decrease the consumption of SSBs. Students in the Control Group only received regular monitoring without interventions. In the second year, both groups received only regular monitoring, without active interventions. A generalized estimating equations model (GEE) was used to assess the intervention effects. After two years, relative to the Control Group, the Intervention Group had a significantly improved knowledge of SSBs and an improved family environment with parents. In the Intervention Group, 477 students (97.3%) had adequate knowledge about SSBs, compared to 302 students (83.2%) in the Control Group (X2 = 52.708, p < 0.001). Two years later, the number of students who stated 'my home always has SSBs' in the Intervention Group (7.8%) was fewer than that in the Control Group (12.4%), which was a statistically significant finding (p < 0.05). One year later, both the frequency and the quantity of SSB consumption in the Intervention Group were less than those in the Control Group; such differences between the groups remained statistically significant for the quantity but not for the frequency of SSB consumption two years later. In the Intervention Group, the frequency of SSB consumption was significantly reduced by 1.0 times per week, compared to a reduction of 0.1 times per week in the Control Group in the first year (p < 0.05). In the second year, the frequency of SSB consumption was reduced by 0.8 times per week in the Intervention Group, compared to 0.5 times per week in the Control Group (p > 0.05). In the first year, the volume of SSB consumption was significantly reduced by 233 mL per week in the Intervention Group, compared to an increase of 107 mL per week in the Control Group (p < 0.05). In the second year, the volume of SSB consumption was reduced by 122 mL per week in the Intervention Group compared to an increase of 31 mL per week in the Control Group (p > 0.05). The combined school-based and family-based interventions had a positive effect on the students' knowledge of SSBs and their family dynamics during the first and second year. Relative to the Control Group, the Intervention Group had a statistically significant reduction in SSB consumption after 1 year, but not after 2 years.
Collapse
Affiliation(s)
- Chenchen Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Yijia Chen
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Hao Xu
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Weiwei Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Hairong Zhou
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Qiannan Sun
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Xin Hong
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (Y.C.); (H.X.); (W.W.); (H.Z.); (Q.S.)
| | - Jinkou Zhao
- Department of Non-Communicable Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| |
Collapse
|
4
|
Parks EP, Allison KC, Bruton Y, Khalil T, Mitchell JA. Gamification to Promote Physical Activity in Youth and Mothers With Obesity. Pediatr Exerc Sci 2024:1-8. [PMID: 38307006 DOI: 10.1123/pes.2023-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/08/2023] [Accepted: 11/27/2023] [Indexed: 02/04/2024]
Abstract
PURPOSE Physical inactivity and sugar-sweetened beverage (SSB) consumption are associated with obesity. Gamification and self-monitoring to promote physical activity in youth is unknown, but evidence of effectiveness is present in adults. This study examined the effects of a gamification intervention on increased steps per day among parent-adolescent dyads with obesity compared with digital self-monitoring and if self-monitored SSB intake differed between these arms. METHODS Youth ages 10-16 years and their mothers (N = 39 pairs), both with obesity, were randomized to a self-monitoring (N = 18) or a self-monitoring plus gamification arm (N = 21) for 9 weeks. The step goal was set and incrementally increased each week and was measured with Fitbit devices. Mixed effects linear regression examined changes in steps and SSB consumption per day, per week by study arm. RESULTS During run-in, mothers averaged 8317 and youth 7508 steps per day. Compared with self-monitoring alone, gamification did not increase daily steps in mothers or youth beyond baseline levels. On average, SSB intake decreased in mothers by approximately 0.5 servings per day; occurred in both arms and persisted throughout the intervention. CONCLUSION Gamification did not promote physical activity levels in mother-youth dyads with obesity. SSB intake declined in mothers with obesity in both study arms.
Collapse
Affiliation(s)
- Elizabeth Prout Parks
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,USA
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA,USA
- The Healthy Weight Program, The Children's Hospital of Philadelphia, Philadelphia, PA,USA
| | - Kelly C Allison
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,USA
| | - Yasmeen Bruton
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA,USA
| | - Timothy Khalil
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA,USA
- The Healthy Weight Program, The Children's Hospital of Philadelphia, Philadelphia, PA,USA
| | - Jonathan A Mitchell
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,USA
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA,USA
| |
Collapse
|
5
|
Ahmed KR, Kolbe-Alexander T, Khan A. Efficacy of a school-based education intervention on the consumption of fruits, vegetables and carbonated soft drinks among adolescents. Public Health Nutr 2023; 26:3112-3121. [PMID: 37781771 PMCID: PMC10755403 DOI: 10.1017/s1368980023002094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 07/21/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES To evaluate the efficacy of a school-based education intervention on the consumption of fruit, vegetables and carbonated soft drinks among adolescents. DESIGN Cluster-randomised controlled trial. SETTING Eight secondary schools from Dhaka, Bangladesh, participated in this trial and were randomly allocated to intervention (n 160) and control groups (n 160). PARTICIPANTS A total of 320 students from 8th to 9th grades participated and completed the self-reported questionnaires at baseline, and at 8 and 12 weeks. The intervention included weekly classroom-based nutrition education sessions for students and healthy eating materials for students and parents. Repeated measures ANCOVA was used to assess the effects of the intervention. RESULTS Daily fresh fruit intake was more frequent in the intervention (26 %) compared to the control group (3 %) at 12 weeks (p = 0·006). Participants from the intervention group also reported a significantly (P < 0·001) higher (49 %) proportion of fresh vegetable intake compared to the control group (2 %) at 12 weeks. Frequency of daily carbonated soft drinks intake decreased (25 %) in the intervention group at 12 weeks compared to baseline, while it remained unchanged in the control group; the interaction effect was observed significant (P = 0·002). CONCLUSION Our school-based education intervention increased the daily frequency of fresh vegetables and fruit intake and decreased carbonated soft drink consumption among adolescents in the intervention group. There is a need for scaling up the intervention to engage students and empower them to develop healthy dietary habits.
Collapse
Affiliation(s)
- Kazi R Ahmed
- Department of Health Promotion and Health Education, Bangladesh University of Health Sciences, Darus Salam, Mirpur, Dhaka1216, Bangladesh
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tracy Kolbe-Alexander
- School of Health and Wellbeing, University of Southern Queensland, Toowoomba, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Australia
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa
| | - Asaduzzaman Khan
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
6
|
Kasman M, Hammond RA, Reader L, Purcell R, Guyer S, Ganiban JM, Mitchell DC, Dabelea DM, Bellatorre A, Bekelman TA, Cohen CC, Perng W, Grummon AH, Wu AJ, Oken E, Kleinman K. Childhood Sugar-Sweetened Beverage Consumption: an Agent-Based Model of Context-Specific Reduction Efforts. Am J Prev Med 2023; 65:1003-1014. [PMID: 37451323 PMCID: PMC10787028 DOI: 10.1016/j.amepre.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/07/2023] [Accepted: 07/09/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Despite widespread recognition among public health experts that childhood sugar-sweetened beverage consumption should be reduced, doing so has proven to be a challenge. An agent-based model of early childhood sugar-sweetened beverage consumption was applied to data from three high-quality, longitudinal cohort studies to gain insight into potentially effective intervention strategies across contexts. METHODS From 2021 to 2023, a single agent-based model design was applied to data sets derived from three separate cohorts of children followed from infancy to childhood, with very different populations and environments (participants recruited in 1999-2002; 2003-2010; and 2009-2014). After assessing its ability to reproduce observed consumption patterns across cohorts, it was used to simulate potential impacts of multiple intervention strategies across contexts. RESULTS Interventions reducing home availability of sugar-sweetened beverages consistently had the largest potential effects. Impact differed between cohort settings: a complete decrease in availability resulted in an estimated 87% decrease in overall early childhood consumption for one of the cohorts, compared with 61% and 54% in the others. Reducing availability in center-based child care resulted in substantially greater reduction in one cohort relative to the other two. CONCLUSIONS There is untapped potential for strategies targeting children's sugar-sweetened beverage consumption in the home, but in some instances, other approaches might also yield meaningful effects. Tailoring approach to setting may be important, and agent-based models can be informative for doing so. This agent-based model has broad generalizability and potential to serve as a tool for designing effective, context-specific strategies to reduce childhood sugar-sweetened beverage consumption.
Collapse
Affiliation(s)
- Matt Kasman
- Center on Social Dynamics and Policy, Brookings Institution, Washington, District of Columbia.
| | - Ross A Hammond
- Center on Social Dynamics and Policy, Brookings Institution, Washington, District of Columbia; Center for Public Health Systems Science, Brown School at Washington University, St Louis, Missouri; The Santa Fe Institute, Santa Fe, New Mexico
| | - Lydia Reader
- Center for Public Health Systems Science, Brown School at Washington University, St Louis, Missouri
| | - Rob Purcell
- Center on Social Dynamics and Policy, Brookings Institution, Washington, District of Columbia
| | - Sally Guyer
- Leve Lab, University of Oregon, Eugene, Oregon
| | - Jody M Ganiban
- Department of Psychology, The George Washington University, Washington, District of Columbia
| | - Diane C Mitchell
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania
| | - Dana M Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Anna Bellatorre
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Traci A Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Catherine C Cohen
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Wei Perng
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Anna H Grummon
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
| | - Allison J Wu
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Ken Kleinman
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts-Amherst, Amherst, Massachusetts
| |
Collapse
|
7
|
Ezike C, Da Silva K. Technology-Based Interventions to Reduce Sugar-Sweetened Beverages among Adolescents: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7101. [PMID: 38063531 PMCID: PMC10706072 DOI: 10.3390/ijerph20237101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023]
Abstract
This scoping review investigates the effectiveness of technology-based interventions in reducing sugar-sweetened beverage (SSB) consumption among adolescents. The rise in SSB consumption among young individuals has become a global public health concern due to its association with obesity, diabetes, and various other health problems. The purpose of this scoping review is to map out and examine the various technology-based interventions used in reducing sugar-sweetened beverages among children and adolescents. A systematic search of three databases using the PRISMA guideline was followed, and 474 articles were retrieved. Seven articles met the inclusion criteria and the critical appraisal using the critical appraisal skill program (CASP). The seven articles underwent both descriptive and thematic analysis. Four technology-based interventions were identified from the selected articles, which include smartphone apps, online or web-based tools, text messages, and social marketing strategies. Our findings suggest that these interventions hold promise in improving adolescents' eating patterns and health outcomes associated with SSB intake, highlighting their potential as useful strategies in resolving this urgent public health concern.
Collapse
Affiliation(s)
- Chidinma Ezike
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Keith Da Silva
- College of Dentistry, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada;
| |
Collapse
|
8
|
Maffeis C, Olivieri F, Valerio G, Verduci E, Licenziati MR, Calcaterra V, Pelizzo G, Salerno M, Staiano A, Bernasconi S, Buganza R, Crinò A, Corciulo N, Corica D, Destro F, Di Bonito P, Di Pietro M, Di Sessa A, deSanctis L, Faienza MF, Filannino G, Fintini D, Fornari E, Franceschi R, Franco F, Franzese A, Giusti LF, Grugni G, Iafusco D, Iughetti L, Lera R, Limauro R, Maguolo A, Mancioppi V, Manco M, Del Giudice EM, Morandi A, Moro B, Mozzillo E, Rabbone I, Peverelli P, Predieri B, Purromuto S, Stagi S, Street ME, Tanas R, Tornese G, Umano GR, Wasniewska M. The treatment of obesity in children and adolescents: consensus position statement of the Italian society of pediatric endocrinology and diabetology, Italian Society of Pediatrics and Italian Society of Pediatric Surgery. Ital J Pediatr 2023; 49:69. [PMID: 37291604 DOI: 10.1186/s13052-023-01458-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/18/2023] [Indexed: 06/10/2023] Open
Abstract
This Position Statement updates the different components of the therapy of obesity (lifestyle intervention, drugs, and surgery) in children and adolescents, previously reported in the consensus position statement on pediatric obesity of the Italian Society of Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics. Lifestyle intervention is the first step of treatment. In children older than 12 years, pharmacotherapy is the second step, and bariatric surgery is the third one, in selected cases. Novelties are available in the field of the medical treatment of obesity. In particular, new drugs demonstrated their efficacy and safety and have been approved in adolescents. Moreover, several randomized control trials with other drugs are in process and it is likely that some of them will become available in the future. The increase of the portfolio of treatment options for obesity in children and adolescents is promising for a more effective treatment of this disorder.
Collapse
Affiliation(s)
- Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Francesca Olivieri
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy.
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, Naples, Italy
| | - Elvira Verduci
- Deparment of Pediatrics, Department of Health Science, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Maria Rosaria Licenziati
- Department of Neurosciences, Neuro-Endocrine Diseases and Obesity Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Valeria Calcaterra
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Gloria Pelizzo
- Department of Pediatric Surgery, Vittore Buzzi Children's Hospital, Milan, Italy
| | - Mariacarolina Salerno
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Annamaria Staiano
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | | | - Raffaele Buganza
- Pediatric Endocrinology Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Antonino Crinò
- Autoimmune Endocrine Diseases Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | | | - Domenico Corica
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - Francesca Destro
- Department of Pediatric Surgery, Vittore Buzzi Children's Hospital, Milan, Italy
| | - Procolo Di Bonito
- Department of Internal Medicine, S. Maria Delle Grazie Hospital, Naples, Pozzuoli, Italy
| | - Mario Di Pietro
- Pediatric and Neonatal Unit, Hospital of Teramo and Atri, Teramo, Italy
| | - Anna Di Sessa
- Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Luisa deSanctis
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Maria Felicia Faienza
- Department of Precision and Regenerative Medicine and Ionan Area, University of Bari, Bari, Italy
| | | | - Danilo Fintini
- Refernce Center for Prader Willi Syndrome, Endocrinology and Diabetology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Elena Fornari
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | | | - Francesca Franco
- Pediatric Department, Azienda Sanitaria Universitaria del Friuli Centrale, Hospital of Udine, Udine, Italy
| | - Adriana Franzese
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Lia Franca Giusti
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Lucca, Italy
| | - Graziano Grugni
- Division of Auxology, Istituto Auxologico Italiano, IRCCS, Verbania, Italy
| | - Dario Iafusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Lorenzo Iughetti
- Department of Medical and Surgical Sciences of Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Lera
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Alessandria, Italy
| | | | - Alice Maguolo
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Valentina Mancioppi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Melania Manco
- Research Area for Multifactorial Diseases, Children's Hospital Bambino Gesù, Rome, Italy
| | | | - Anita Morandi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Beatrice Moro
- UOSD Diabetology, Complesso Ai Colli, AULSS 6 Euganea, Padua, Italy
| | - Enza Mozzillo
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Paola Peverelli
- Department of Pediatrics and Gynecology, Hospital of Belluno, Belluno, Italy
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Stefano Stagi
- Department of Health Sciences, University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Maria Elisabeth Street
- Department of Medicine and Surgery, Unit of Paediatrics, University of Parma, University Hospital of Parma, Parma, Italy
| | - Rita Tanas
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Ferrara, Italy
| | - Gianluca Tornese
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giuseppina Rosaria Umano
- Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| |
Collapse
|
9
|
Kendig MD, Chow JYL, Martire SI, Rooney KB, Boakes RA. Switching from Sugar- to Artificially-Sweetened Beverages: A 12-Week Trial. Nutrients 2023; 15:2191. [PMID: 37432352 DOI: 10.3390/nu15092191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Consumption of sugar-sweetened beverages (SSBs) forms the primary source of added sugar intake and can increase the risk of metabolic disease. Evidence from studies in humans and rodents also indicates that consumption of SSBs can impair performance on cognitive tests, but that removing SSB access can ameliorate these effects. METHODS The present study used an unblinded 3-group parallel design to assess the effects of a 12-week intervention in which young healthy adults (mean age = 22.85, SD = 3.89; mean BMI: 23.2, SD = 3.6) who regularly consumed SSBs were instructed to replace SSB intake with artificially-sweetened beverages (n = 28) or water (n = 25), or (c) to continue SSB intake (n = 27). RESULTS No significant group differences were observed in short-term verbal memory on the Logical Memory test or the ratio of waist circumference to height (primary outcomes), nor in secondary measures of effect, impulsivity, adiposity, or glucose tolerance. One notable change was a significant reduction in liking for strong sucrose solutions in participants who switched to water. Switching from SSBs to 'diet' drinks or water had no detectable impact on cognitive or metabolic health over the relatively short time frame studied here. This study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615001004550; Universal Trial Number: U1111-1170-4543).
Collapse
Affiliation(s)
- Michael D Kendig
- School of Life Sciences, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Julie Y L Chow
- School of Psychology, UNSW Sydney, Sydney, NSW 2052, Australia
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia
| | - Sarah I Martire
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia
| | - Kieron B Rooney
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Robert A Boakes
- School of Psychology, University of Sydney, Sydney, NSW 2006, Australia
| |
Collapse
|
10
|
Lewis KH, Hsu FC, Block JP, Skelton JA, Schwartz MB, Krieger J, Hindel LR, Ospino Sanchez B, Zoellner J. A Technology-Driven, Healthcare-Based Intervention to Improve Family Beverage Choices: Results from a Pilot Randomized Trial in the United States. Nutrients 2023; 15:2141. [PMID: 37432293 DOI: 10.3390/nu15092141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 07/12/2023] Open
Abstract
Background: Healthcare-based interventions to address sugary beverage intake could achieve broad reach, but intensive in-person interventions are unsustainable in clinical settings. Technology-based interventions may provide an alternative, scalable approach. Methods: Within an academic health system in the United States that already performs electronic health record-based sugary drink screening, we conducted a pilot randomized trial of a technology-driven family beverage choice intervention. The goal of the intervention was to reduce sugar-sweetened beverage (SSB) and fruit juice (FJ) consumption in 60 parent-child dyads, in which children were 1-8 years old. The pediatrician-initiated intervention consisted of a water promotion toolkit, a video, a mobile phone application, and 14 interactive voice-response phone calls to parents over 6 months. The study was conducted between June 2021 and May 2022. The aim of the pilot study was to assess the potential feasibility and efficacy of the newly developed intervention. Results: Intervention fidelity was excellent, and acceptability was high for all intervention components. Children in both the intervention and the control groups substantially decreased their consumption of SSB and FJ over follow-up (mean combined baseline 2.5 servings/day vs. 1.4/day at 6 months) and increased water consumption, but constrained linear mixed-effects models showed no differences between groups on these measures. Compared to parents in the control group, intervention parents had larger decreases in SSB intake at 3 months (-0.80 (95% CI: -1.54, -0.06, p = 0.03) servings daily), but these differences were not sustained at 6 months. Conclusion: These findings suggest that, though practical to implement in a clinical care setting and acceptable to a diverse participant group, our multicomponent intervention may not be universally necessary to achieve meaningful behavior changes around family beverage choice. A lower-intensity intervention, such as EHR-based clinical screening alone, might be a less resource-intense way for health systems to achieve similar behavioral outcomes. Future studies might therefore explore whether, instead of applying a full intervention to all families whose children overconsume SSB or FJ, a stepped approach, starting with clinical screening and brief counseling, could be a better use of health system resources.
Collapse
Affiliation(s)
- Kristina H Lewis
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Jason P Block
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Joseph A Skelton
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Marlene B Schwartz
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT 06103, USA
| | - James Krieger
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA
- Healthy Food America, Seattle, WA 98122, USA
| | - Leah Rose Hindel
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Beatriz Ospino Sanchez
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Jamie Zoellner
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| |
Collapse
|
11
|
Adolescents' knowledge and beliefs regarding health risks of soda and diet soda consumption. Public Health Nutr 2022; 25:3044-3053. [PMID: 35983831 PMCID: PMC9991753 DOI: 10.1017/s1368980022001719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine Australian adolescents' knowledge and beliefs regarding potential health consequences of soda and diet soda consumption and nutritional aspects of soda and explore associations with consumption. DESIGN A survey utilising a nationally representative sample (stratified two-stage probability design) assessed knowledge of nutritional contents and health consequences of soda, and beliefs regarding health risks of diet soda, and soda and diet drink consumption. SETTING Australia. PARTICIPANTS 9102 Australian school students (12-17 years) surveyed in 2018. RESULTS Adolescents had lower nutritional knowledge (sugar content (22·2 %), exercise equivalent (33·9 %), calories/kJ (3·1 %)) than general knowledge of health risks (87·4 %) and some health effects (71·7-75·6 % for tooth decay, weight gain and diabetes), with lower knowledge of heart disease (56·0 %) and cancer (19·3 %). Beliefs regarding health effects of diet soda were similar, albeit not as high. In general, female sex, older age and less disadvantage were associated with reporting health effects of soda and diet soda, and nutritional knowledge of soda (P < 0·001). Those reporting tooth decay, weight gain, heart disease and diabetes as health effects of soda and diet soda were lower consumers of soda and diet drinks (P < 0·001), as were those with higher nutritional knowledge (sugar content and exercise equivalent; P < 0·001). CONCLUSIONS This study highlights possible knowledge gaps regarding the health effects of soda and nutritional knowledge for public health intervention. When implementing such interventions, it is important to monitor the extent to which adolescents may consider diet drinks as an alternative beverage given varied beliefs about health consequences and evolving evidence.
Collapse
|
12
|
Reduced Consumption of Sugar-Sweetened Beverages Is Associated with Lower Body Mass Index Z-Score Gain among Chinese Schoolchildren. Nutrients 2022; 14:nu14194088. [PMID: 36235739 PMCID: PMC9571809 DOI: 10.3390/nu14194088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/21/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
To examine whether reducing sugar-sweetened beverage (SSB) consumption is associated with reduced body mass index z-score gain among Chinese schoolchildren in Nanjing, China, a randomized controlled trial (RCT) was conducted in four selected primary schools from September 2019 to September 2020. Students in the third grade in the Intervention Group received school-based and home-based interventions for two consecutive semesters to reduce SSB consumption, while two schools in the Control Group did not receive any interventions. Weight changes were expressed as body mass index (BMI) z-scores as standard deviations of the BMI distribution per age and sex group. Changes in SSB consumption before and after the interventions were categorized into Level-Up if it increased, Level-Same if it was maintained and Level-Down if it decreased. Multivariable linear regression models were used to explore the association of different levels of changes in SSB consumption pre- and post-intervention with the BMI z-score. Among 1633 participants who completed the trial, the mean age at baseline was 9.36 years (±0.48 SD).The median baseline BMI z-score was −0.24 (25th percentile −0.72; 75th percentile 0.58). After the intervention, the median BMI z-score increased by 0.06 (−0.17~0.37) in the Intervention Group and by 0.14 (−0.08~0.41) in the Control Group (p < 0.001). A higher increase in BMI was found in the Control Group than in the Intervention Group (1.20 vs. 0.94) during the 12-month period. Among participants whose parents’ educational attainment was above 9 years, the median BMI z-score increased by 0.07 (−0.17~0.37) in the Intervention Group and by 0.16 (−0.06~0.41) in the Control Group (p < 0.001). In a linear regression analysis adjusted for potential confounders, the BMI z-score decreased by 0.057 more in Level-Down than in Level-Up (95% CI: −0.103 to −0.012, p = 0.014). These results indicate that the decreased consumption of SSBs might have reduced the prevalence of overweight in schoolchildren in China, especially in students whose parents had high educational levels.
Collapse
|
13
|
Capper TE, Brennan SF, Woodside JV, McKinley MC. What makes interventions aimed at improving dietary behaviours successful in the secondary school environment? A systematic review of systematic reviews. Public Health Nutr 2022; 25:2448-2464. [PMID: 35357283 PMCID: PMC9991643 DOI: 10.1017/s1368980022000829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To systematically review evidence from systematic reviews of interventions to improve dietary behaviours and reduce food wastage in secondary school pupils. DESIGN CINAHL, Cochrane Reviews, EMBASE, MEDLINE, PsychINFO and Web of Science were searched for systematic reviews of school-based dietary interventions from 2000 to 2020 published in a peer-reviewed journal in English. Articles were reviewed independently by two authors. AMSTAR-2 was used for quality assessment. SETTING Secondary school dietary interventions. PARTICIPANTS Adolescents (aged 11-18). RESULTS In total, thirteen systematic reviews of dietary interventions in secondary schools met the inclusion criteria. A number of key characteristics of interventions that contributed to improvements in food choices in secondary school pupils were identified. These included the combination of education and environmental restructuring, incorporation of computer-based feedback, media or messaging, peer and/or parent involvement, an increase in the availability of healthy foods and the use of behavioural theory as a basis to the intervention. Intervention components that contributed specifically to a reduction in sugar-sweetened beverage intake or an increase in fruit and vegetable consumption, which are particularly relevant to adolescents, could not be determined. Similarly, evidence for interventions that improve nutritional knowledge and attitudes was limited. CONCLUSIONS This systematic review of systematic reviews has identified a number of components of dietary interventions that can be explored to improve dietary behaviours in secondary school environments and, if demonstrated to be effective, be considered for inclusion in policies and strategies to improve the school food environment and promote dietary change.
Collapse
Affiliation(s)
- TE Capper
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Grosvenor Road, BelfastBT12 6BJ, UK
| | - SF Brennan
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Grosvenor Road, BelfastBT12 6BJ, UK
| | - JV Woodside
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Grosvenor Road, BelfastBT12 6BJ, UK
| | - MC McKinley
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, Grosvenor Road, BelfastBT12 6BJ, UK
- Corresponding author: Email
| |
Collapse
|
14
|
Martín-Rodríguez A, Bustamante-Sánchez Á, Martínez-Guardado I, Navarro-Jiménez E, Plata-SanJuan E, Tornero-Aguilera JF, Clemente-Suárez VJ. Infancy Dietary Patterns, Development, and Health: An Extensive Narrative Review. CHILDREN 2022; 9:children9071072. [PMID: 35884056 PMCID: PMC9319947 DOI: 10.3390/children9071072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/03/2022] [Accepted: 07/16/2022] [Indexed: 11/27/2022]
Abstract
Correct dietary patterns are important for a child’s health from birth to adulthood. Understanding a child’s health as a state of entire physical, mental, and social well-being is essential. However, reaching adulthood in a complete health proper state is determined by feeding and dietary habits during preconception, pregnancy, or children infancy. Different factors, such as the mother’s lifestyle, culture, or socioeconomic status, are crucial during all these phases. In this review, we aimed to assess the long-term associations between infancy dietary patterns and health and their influence on development and growth. To reach this objective, a consensus critical review was carried out using primary sources such as scientific articles, and secondary bibliographic indexes, databases, and web pages. PubMed, SciELO, and Google Scholar were the tools used to complete this research. We found that high-income countries promote high-calorie foods and, consequently, obesity problems among children are rising. However, undernutrition is a global health issue concerning children in low- and middle-income countries; thus, parental socioeconomic status in early life is essential to children’s health and development, showing that biological, social, and environmental influences are increased risk factors for chronic diseases. This narrative review is aimed to collect evidence for early nutritional intervention and future disease prevention.
Collapse
Affiliation(s)
| | - Álvaro Bustamante-Sánchez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Correspondence: (Á.B.-S.); (J.F.T.-A.); Fax: +34-911-413-585 (J.F.T.-A.)
| | | | | | | | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Correspondence: (Á.B.-S.); (J.F.T.-A.); Fax: +34-911-413-585 (J.F.T.-A.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
| |
Collapse
|
15
|
Evaluation of Parental Acceptability and Use of Intervention Components to Reduce Pre-School Children's Intake of Sugar-Rich Food and Drinks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137967. [PMID: 35805623 PMCID: PMC9266277 DOI: 10.3390/ijerph19137967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022]
Abstract
Knowledge is needed about effective tools that reach public health objectives focused on reducing the intake of sugar-rich foods and drinks. The purpose of this study was to assess the parental acceptability, use and motivational potential of intervention components developed in the randomized family-based trial ‘Are you too sweet?’ aimed at reducing the intake of sugar-rich foods and drinks among children (5–7 y). Intervention components included guidance on sugar-rich foods and drinks at a school health nurse consultation, a box with home-use materials and a digital platform. The methods used were a questionnaire among intervention families (n = 83) and semi-structured interviews with parents in selected intervention families (n = 24). Results showed the good acceptability and usefulness of the components, with reported frequencies of use of materials ranging from 48% to 94% and a high satisfaction rate with the school health nurse consultation. Personalized feedback and guidance from the school health nurse seemed to be a motivational trigger, and components that were compatible with existing practices were most frequently used. However, the components were not considered engaging by all families. Overall, intervention components were well received and hold the potential for enhancing parental knowledge and parenting practices regarding limiting the intake of sugar-rich foods and drinks.
Collapse
|
16
|
González-Mares MO, Aradillas-García C, Márquez-Mireles LE, Monsiváis-Nava CD, Bernal-Medina JE, Vargas-Morales JM, Portales-Pérez DP, Cubillas-Tejeda AC. Implementation and evaluation of an educational intervention to prevent risk factors for the development of non-communicable diseases in Mexican families of suburban communities. EVALUATION AND PROGRAM PLANNING 2022; 92:102075. [PMID: 35349946 DOI: 10.1016/j.evalprogplan.2022.102075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 08/30/2021] [Accepted: 03/13/2022] [Indexed: 06/14/2023]
Abstract
Non-communicable diseases (NCD), are not transmitted from person to person, are long-lasting and usually of slow evolution. Worldwide cause 71% deaths, in Mexico during 2016 were the cause of 80% of registered deaths; population in socioeconomic disadvantage is more vulnerable. It is urgent to develop strategies that can prevent NCD, thus, the objective of this study was to design, implement and evaluate an educational intervention strategy (EI), to prevent and control risk factors for the development NCD in families of two vulnerable communities. The research design was mixed, the stages were developed based on a risk communication (RC) model and was performed in three stages: 1) EI Design, 2) Implementation and 3) Evaluation of the intervention. In the contextualization, risk factors were found in the participants who were integrated in the design of the educational strategy. The EI implemented was effective in increasing knowledge about NCD and practice of healthy habits, such as increasing the consumption of fruits and vegetables. Additionally, the guidance of EI at the family level has the advantage of creating a support network for these changes. However, pending issues remain, such as the design of effective strategies to reduce the consumption of sugars and sugary drinks.
Collapse
Affiliation(s)
- Mariana Odemaris González-Mares
- Multidisciplinary Postgraduate Programs in Environmental Sciences, Environmental Agenda. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 201, Zona Universitaria, 78210 San Luis Potosí, Mexico
| | - Celia Aradillas-García
- Faculty of Medicine, Center for Applied Research in Environment and Health. Universidad Autónoma de San Luis Potosí, Av. Sierra Leona #550, Col. Lomas 2a. Sección, 78210 San Luis Potosí, Mexico
| | - Leonardo Ernesto Márquez-Mireles
- Faculty of Social Sciences and Humanities. Universidad Autónoma de San Luis Potosí, Av. Industrias 101-A Fracc. Talleres, 78399 San Luis Potosí, Mexico
| | - Claudia Davinia Monsiváis-Nava
- Multidisciplinary Postgraduate Programs in Environmental Sciences, Environmental Agenda. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 201, Zona Universitaria, 78210 San Luis Potosí, Mexico
| | - Jesús Eduardo Bernal-Medina
- Multidisciplinary Postgraduate Programs in Environmental Sciences, Environmental Agenda. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 201, Zona Universitaria, 78210 San Luis Potosí, Mexico
| | - Juan Manuel Vargas-Morales
- Faculty of Chemical Sciences. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, Zona Universitaria, 78210, San Luis Potosí, Mexico
| | - Diana Patricia Portales-Pérez
- Faculty of Chemical Sciences. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, Zona Universitaria, 78210, San Luis Potosí, Mexico
| | - Ana Cristina Cubillas-Tejeda
- Faculty of Chemical Sciences. Universidad Autónoma de San Luis Potosí, Av. Dr. Manuel Nava 6, Zona Universitaria, 78210, San Luis Potosí, Mexico.
| |
Collapse
|
17
|
Long-term trends in the consumption of sugary and diet soft drinks among adolescents: a cross-national survey in 21 European countries. Eur J Nutr 2022; 61:2799-2813. [PMID: 35290478 DOI: 10.1007/s00394-022-02851-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/22/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE To assess country-level trends in the prevalence of daily consumption of sugary (2002-2018) and diet (2006-2018) soft drinks among European adolescents, overall and by family material affluence. METHODS We used 2002, 2006, 2010, 2014 and 2018 data from the 'Health Behaviour in School-aged Children' survey. Nationally representative samples of adolescents completed a standardised questionnaire at school, including a short food frequency questionnaire (n = 530,976 and 21 countries for sugary soft drinks; n = 61,487 and 4 countries for diet soft drinks). We classified adolescents into three socioeconomic categories for each country and survey year, using the Family Affluence Scale. Multilevel logistic models estimated time trends, by country. RESULTS Sugary soft drinks: the prevalence of daily consumption (≥ 1×/day) declined in 21/21 countries (Plinear trends ≤ 0.002). Absolute [range - 31.7 to - 3.4% points] and relative [range - 84.8 to - 22.3%] reductions varied considerably across countries, with the largest declines in Ireland, England and Norway. In 3/21 countries, the prevalence of daily consumption decreased more strongly in the most affluent adolescents than in the least affluent ones (P ≤ 0.002). Daily consumption was more prevalent among the least affluent adolescents in 11/21 countries in 2018 (P ≤ 0.002). Diet soft drinks: overall, daily consumption decreased over time in 4/4 countries (Plinear trends ≤ 0.002), more largely among the most affluent adolescents in 1/4 country (P ≤ 0.002). CONCLUSIONS Daily consumption of sugary and diet soft drinks in European adolescents decreased between 2002 (2006 for diet drinks) and 2018. Public health interventions should continue discouraging daily soft drink consumption, particularly among adolescents from lower socioeconomic groups.
Collapse
|
18
|
Dietary Intake and Sources of Added Sugars in Various Food Environments in Costa Rican Adolescents. Nutrients 2022; 14:nu14050959. [PMID: 35267934 PMCID: PMC8912352 DOI: 10.3390/nu14050959] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023] Open
Abstract
Consumption of added sugars, especially from sugar-sweetened beverages (SSBs), has been associated with several negative health outcomes during adolescence. This study aimed to identify dietary intake and food sources of added sugars in the home, school, and neighborhood environments of Costa Rican adolescents. Dietary intake of added sugars was determined using 3-day food records in a cross-sectional study of 818 adolescents aged 12 to 19 and enrolled in rural and urban schools in the province of San José. On average, 90% of adolescents consumed more than 10% of their total energy intake from added sugars. Furthermore, 74.0% of added sugars were provided at home, 17.4% at school, and 8.6% in the neighborhood. Added sugars were primarily provided by frescos (29.4%), fruit-flavored still drinks (22.9%), and sugar-sweetened carbonated beverages (12.3%), for a total contribution of 64.6%. Our findings suggest that Costa Rican adolescents have a plethora of added sugar sources in all food environments where they socialize. However, it is relevant for public health to consider the home and school environments as fundamental units of interventions aimed at reducing added sugars in the adolescent diet. Frescos prepared at home and school and fruit-flavored still drinks must be the focus of these interventions.
Collapse
|
19
|
Bucher Della Torre S, Moullet C, Jotterand Chaparro C. Impact of Measures Aiming to Reduce Sugars Intake in the General Population and Their Implementation in Europe: A Scoping Review. Int J Public Health 2022; 66:1604108. [PMID: 35095383 PMCID: PMC8791851 DOI: 10.3389/ijph.2021.1604108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/30/2021] [Indexed: 12/19/2022] Open
Abstract
Objectives: Implementing public health measures is necessary to decrease sugars intake, which is associated with increased risk of noncommunicable diseases. Our scoping review aimed to identify the types of measures implemented and evaluated to decrease sugars intake in the population and to assess their impact. Methods: Following a review of systematic reviews (SRs) published in 2018, we systematically searched new SR (May 2017–October 2020) in electronic databases. We also searched the measures implemented in Europe in the NOURISHING database. Two researchers selected the reviews, extracted and analysed the data. Results: We included 15 SRs assessing economic tools (n = 5), product reformulation and labels/claims (n = 5), and educational/environmental interventions (n = 7). Economic tools, product reformulation and environmental measures were effective to reduce sugar intake or weight outcomes, while labels, education and interventions combining educational and environmental measures found mixed effects. The most frequently implemented measures in Europe were public awareness, nutritional education, and labels. Conclusion: Among measures to reduce sugar intake in the population, economic tools, product reformulation, and environmental interventions were the most effective, but not the more frequently implemented in Europe.
Collapse
|
20
|
Understanding dental caries as a non-communicable disease. Br Dent J 2021; 231:749-753. [PMID: 34921271 PMCID: PMC8683371 DOI: 10.1038/s41415-021-3775-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/27/2021] [Indexed: 12/17/2022]
Abstract
The recent developments in the science underpinning our knowledge of both the initiation of dental caries and the subsequent behaviour of lesions over time gives us a solid base to understand caries differently. Advances in understanding the human and oral microbiome have come in parallel with the recognition of the importance of balancing protective and pathological risk factors. Caries prevention and management is now about controlling risk factors to maintain a balanced intraoral biofilm ecology that guards against a continuing low pH driven by the frequent consumption of sugars. Thus, caries control is no longer about attempts at eradicating any specific microorganism. Further, the present knowledge leads to the classification of dental caries as a non-communicable disease (NCD), which is vitally important from a policy perspective (both globally and at the country level). Caries shares similar risk factors with other chronic/systemic diseases, which provides opportunities for developing common prevention strategies and promoting health equity through action on the social determinants of health. So, preventing and controlling caries should be integrated across the so-called upstream, midstream and downstream levels and these activities can also help to control other NCDs. Advances in the understanding of the oral microbiome and the caries process call for re-evaluation of caries prevention and management. Measures counteracting low pH conditions within the oral biofilm support a balanced and health-associated microbiota. Dental caries shares similar risk factors with other non-communicable diseases, and its integrated prevention and management may have a positive impact on overall health.
Collapse
|
21
|
Smirk E, Mazahery H, Conlon CA, Beck KL, Gammon C, Mugridge O, von Hurst PR. Sugar-sweetened beverages consumption among New Zealand children aged 8-12 years: a cross sectional study of sources and associates/correlates of consumption. BMC Public Health 2021; 21:2277. [PMID: 34903202 PMCID: PMC8670206 DOI: 10.1186/s12889-021-12345-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background The benefit of reducing sugar-sweetened beverage (SSB) consumption is widely accepted, but updated and in-depth data on New Zealand (NZ) children’s SSB consumption is lacking. The aims of this study were to describe beverage consumption, focusing on SSBs in primary school age children living in Auckland; to examine the association of selected socio-demographic, home, community and school factors and children’s beverage knowledge/attitudes with regards to beverage consumption; to explore the relationship between SSBs consumption and adiposity in children. Methods A cross-sectional, Auckland-wide survey of 578 school age children (8-12 years) was conducted using questionnaires to collect data on beverage consumption, beverage knowledge/attitudes, and selected socio-demographic and home, community, school factors. Body fat percentage (BF%) was assessed using bioelectrical impedance (BIA). Results Ninety-six percent of children consumed ≥1 serving of SSBs a week; with ≥5 servings reported by 62% of children. Of all SSBs assessed, consumption of ≥1 serving of sugar sweetened milk-based beverages (85%, mainly milk drinks made from powder) was most prevalent, followed by fruit juice (46%) and sugar-containing carbonated drinks (39%, mainly soft/fizzy drinks). Among unsweetened beverages, plain water was reported to be consumed < 2 times a day by 22% of children, and plain milk < 1 serving a day by 53%. Higher consumption of SSBs was associated with socio-economic disadvantage, non-NZ European ethnicities (Māori, Pacific, Asian, others), availability of SSBs in the home, frequent takeaway/convenience shop visits, children’s incorrect perception of adequate SSBs consumption frequency, and higher BF% (females only). School health policy and encouragement of children to consume un-sweetened beverages was not associated with SSBs consumption. Conclusions The consumption of SSBs is prevalent in NZ school age children, with higher consumption rates observed among those from socially disadvantaged areas. This high consumption is associated with higher BF% in females. Multi-contextual interventions to decrease SSBs should target children, and their families/environment, particularly those from socially disadvantaged areas. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12345-9.
Collapse
Affiliation(s)
- Emma Smirk
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Hajar Mazahery
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Cathryn A Conlon
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Kathryn L Beck
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Cheryl Gammon
- School of Health Sciences, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Owen Mugridge
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, College of Health, Massey University, Auckland, 0745, New Zealand.
| |
Collapse
|
22
|
School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews. Nutrients 2021; 13:nu13114113. [PMID: 34836368 PMCID: PMC8618558 DOI: 10.3390/nu13114113] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023] Open
Abstract
Schools are identified as a key setting to influence children’s and adolescents’ healthy eating. This umbrella review synthesised evidence from systematic reviews of school-based nutrition interventions designed to improve dietary intake outcomes in children aged 6 to 18 years. We undertook a systematic search of six electronic databases and grey literature to identify relevant reviews of randomized controlled trials. The review findings were categorised for synthesis by intervention type according to the World Health Organisation Health Promoting Schools (HPS) framework domains: nutrition education; food environment; all three HPS framework domains; or other (not aligned to HPS framework domain). Thirteen systematic reviews were included. Overall, the findings suggest that school-based nutrition interventions, including nutrition education, food environment, those based on all three domains of the HPS framework, and eHealth interventions, can have a positive effect on some dietary outcomes, including fruit, fruit and vegetables combined, and fat intake. These results should be interpreted with caution, however, as the quality of the reviews was poor. Though these results support continued public health investment in school-based nutrition interventions to improve child dietary intake, the limitations of this umbrella review also highlight the need for a comprehensive and high quality systematic review of primary studies.
Collapse
|
23
|
Ooi JY, Wolfenden L, Yoong SL, Janssen LM, Reilly K, Nathan N, Sutherland R. A trial of a six-month sugar-sweetened beverage intervention in secondary schools from a socio-economically disadvantaged region in Australia. Aust N Z J Public Health 2021; 45:599-607. [PMID: 34761854 DOI: 10.1111/1753-6405.13159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 04/01/2021] [Accepted: 08/01/2021] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE This study assessed the effectiveness of a school-based intervention in reducing adolescents' sugar-sweetened beverage (SSB) consumption and percentage of energy from SSBs. Secondary outcomes were SSB consumption within school, average daily energy intake, and body mass index z-scores. METHODS Six secondary schools located in New South Wales, Australia were recruited to participate in a six-month pilot randomised controlled trial (1:1). The intervention included components targeting the school nutrition environment, curricula and community. Outcomes were collected via online surveys, observations, anthropometric measurements and project records. Between-group differences were assessed via linear mixed models. RESULTS At the six-month intervention endpoint (n=862) there were no statistically significant differences between students in intervention or control schools for mean daily intake of SSBs (8.55mL; CI -26.77, 43.87; p=0.63), percentage daily energy from SSBs (0.12% kJ; CI -0.55, 0.80; p=0.72), or for secondary outcomes. Acceptability of the school-based strategies were high, however intervention fidelity varied across schools. CONCLUSION While acceptable, improving fidelity of implementation and increasing the duration or intensity of the intervention may be required to reduce SSB intake. Implications for public health: Engaging parents and education stakeholders in the development phase to co-design interventions may prove beneficial in improving intervention fidelity and enhance behavioural outcomes.
Collapse
Affiliation(s)
- Jia Ying Ooi
- Hunter New England Population Health, New South Wales.,School of Medicine and Public Health, University of Newcastle, New South Wales
| | - Luke Wolfenden
- Hunter New England Population Health, New South Wales.,School of Medicine and Public Health, University of Newcastle, New South Wales
| | - Sze Lin Yoong
- Hunter New England Population Health, New South Wales.,School of Medicine and Public Health, University of Newcastle, New South Wales
| | | | - Kathryn Reilly
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Nicole Nathan
- Hunter New England Population Health, New South Wales.,School of Medicine and Public Health, University of Newcastle, New South Wales
| | - Rachel Sutherland
- Hunter New England Population Health, New South Wales.,School of Medicine and Public Health, University of Newcastle, New South Wales
| |
Collapse
|
24
|
Kyoon-Achan G, Schroth RJ, Sanguins J, Campbell R, Demaré D, Sturym M, Edwards J, Bertone M, Dufour L, Hai Santiago K, Chartrand F, Dhaliwal T, Patterson B, Levesque J, Moffatt M. Early childhood oral health promotion for First Nations and Métis communities and caregivers in Manitoba. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2021; 41:14-24. [PMID: 33438942 DOI: 10.24095/hpcdp.41.1.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Early childhood caries is a public health concern, and the considerable burden exhibited by Indigenous children highlights the oral health inequities across populations in Canada. Barriers include lack of access to oral health care and lack of culturally appropriate oral health promotion. The purpose of this study was to determine where and how First Nations and Métis parents, caregivers and community members learn about caring for young children's oral health, and what ideas and suggestions they have on how to disseminate information and promote early childhood oral health (ECOH) in Indigenous communities. METHODS Sharing circles and focus groups engaged eight groups of purposively sampled participants (n = 59) in four communities in Manitoba. A grounded theory approach guided thematic analysis of audiorecorded and transcribed data. RESULTS Participants said that they learned about oral health from parents, caregivers and friends, primary care providers, prenatal programs, schools and online. Some used traditional medicines. Participants recommended sharing culturally appropriate information through community and prenatal programs and workshops; schools and day care centres; posters, mailed pamphlets and phone communication (calls and text messages) to parents and caregivers, and via social media. Distributing enticing and interactive oral hygiene products that appeal to children was recommended as a way to encourage good oral hygiene. CONCLUSION Evidence-based oral health information and resources tailored to First Nations and Métis communities could, if strategically provided, reach more families and shift the current trajectory for ECOH.
Collapse
Affiliation(s)
- Grace Kyoon-Achan
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.,Ongomiizwin Research - Indigenous Institute of Health and Healing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Robert J Schroth
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.,Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Julianne Sanguins
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Manitoba Metis Federation, Winnipeg, Manitoba, Canada
| | - Rhonda Campbell
- First Nations Health and Social Secretariat of Manitoba, Winnipeg, Manitoba, Canada
| | - Daniella Demaré
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Melina Sturym
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Mary Bertone
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,School of Dental Hygiene, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | | | - Tiffany Dhaliwal
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Brayden Patterson
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Joshua Levesque
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Michael Moffatt
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | |
Collapse
|
25
|
Chatelan A, Rouche M, Dzielska A, Lebacq T, Fismen AS, Kelly C, Zaborskis A, Kopcakova J, Tsareva A, Kalman M, Castetbon K. Time trends in consumption of sugar-sweetened beverages and related socioeconomic differences among adolescents in Eastern Europe: signs of a nutrition transition? Am J Clin Nutr 2021; 114:1476-1485. [PMID: 34086855 DOI: 10.1093/ajcn/nqab175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/04/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND High intake of sugar-sweetened beverages (SSBs) contributes to detrimental cardio-metabolic indicators in youth. Monitoring of SSB consumption is lacking in Eastern Europe. OBJECTIVES We assessed trends in the prevalence of adolescent daily consumption of SSBs in 14 Eastern European countries between 2002 and 2018, both overall and according to family material affluence. METHODS We used 2002, 2006, 2010, 2014, and 2018 data of the Health Behaviour in School-Aged Children school-based study (repeated cross-sectional). Nationally representative samples of adolescents aged 11, 13, and 15 years were included (n = 325,184; 51.2% girls). Adolescents completed a standardized questionnaire, including a question on SSB consumption frequency. We categorized adolescents into 3 socioeconomic groups based on the relative Family Affluence Scale (FAS). Adjusted prevalences of daily SSB consumption by survey year, as well as country-level time trends between 2002 and 2018, were computed using multilevel logistic models (overall and by FAS groups). RESULTS In 2018, the prevalence of adolescents consuming SSBs every day varied considerably between countries (range, 5.1%-28.1%). Between 2002 and 2018, the prevalence of daily SSB consumption declined in 10/14 countries (P for linear trends ≤ 0.004). The largest reductions were observed in Slovenia (OR, 0.48; 95% CI: 0.45-0.50) and the Russian Federation (OR, 0.67; 95% CI: 0.64-0.70). Daily SSB consumption was reduced at faster rates among the most affluent adolescents (who were larger consumers in 2002) than in the least affluent adolescents in 11/14 countries (P for linear trends ≤ 0.004). Thus, differences between FAS groups narrowed over time or even reversed, leading to larger proportions of daily consumers in the least affluent adolescents in 2018 in 5/14 countries (P ≤ 0.05). CONCLUSIONS Adolescent daily consumption of SSBs decreased between 2002 and 2018 in most Eastern European countries. Declines were larger among higher-affluence adolescents. These results are useful to evaluate and plan interventions promoting healthy childhood diets.
Collapse
Affiliation(s)
- Angeline Chatelan
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Manon Rouche
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Anna Dzielska
- Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland
| | - Thérésa Lebacq
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Anne-Siri Fismen
- Department of Health Promotion, and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Bergen, Norway
| | - Colette Kelly
- School of Health Sciences, Health Promotion Research Centre, National University of Ireland Galway, Galway, Ireland
| | - Apolinaras Zaborskis
- Department of Preventive Medicine, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jaroslava Kopcakova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Safarik University, Košice, Slovakia
| | - Anna Tsareva
- Division of Physical Rehabilitation and Health-Improving Technologies, Saint-Petersburg Scientific-Research Institute for Physical Culture, Saint-Petersburg, Russia
| | - Michal Kalman
- Department of Recreation and Leisure Studies, Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czechia
| | - Katia Castetbon
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
26
|
Pan F, Owen N, Oddy WH. Sugar sweetened beverages and increasing prevalence of type 2 diabetes in the Indigenous community of Australia. Nutr Metab Cardiovasc Dis 2021; 31:2825-2830. [PMID: 34353701 DOI: 10.1016/j.numecd.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 06/17/2021] [Accepted: 06/19/2021] [Indexed: 11/20/2022]
Abstract
AIMS The aim of this viewpoint was to discuss a profound health gap in type 2 diabetes that exists between Indigenous and non-Indigenous Australians. DATA SYNTHESIS In Australia, type 2 diabetes is ranked as the fastest growing chronic condition, with the rates of type 2 diabetes higher among Indigenous than non-Indigenous Australians. Improvements to diet could aid in reducing overweight and obesity in the Indigenous community, with sugar sweetened beverages (SSBs) examples of discretionary foods that contain a high amount of sugar. The marked increase in type 2 diabetes, obesity and consumption of SSBs in the Indigenous community may suggest that type 2 diabetes may result from weight gain caused by SSB consumption. Recent evidence suggests that higher consumption of SSBs was associated with greater incidence of type 2 diabetes independent of adiposity. Some determinants influencing increased SSBs consumption in the Indigenous population include advertising, marketing, availability and affordability. CONCLUSIONS The prevalence rates of type 2 diabetes continue to be higher among Indigenous than non-Indigenous Australians and overall, a link between SSBs and risk of type 2 diabetes is reported. Three solutions to high SSBs consumption in Indigenous communities include increased availability, affordability, and accessibility of healthy food and drink, engagement of Indigenous people in offering solutions including discussion of a sugar tax on SSBs framed with Indigenous input, and the provision of clean community water supply and water bubblers.
Collapse
Affiliation(s)
- Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Neville Owen
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Victoria, 3004, Australia; Swinburne University of Technology, Hawthorn, 3122, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia.
| |
Collapse
|
27
|
Evaluation of the 'H2NOE Water Schools' programme to promote water consumption in elementary school children - a non-randomised controlled cluster trial. Public Health Nutr 2021; 25:159-169. [PMID: 34384513 PMCID: PMC8825982 DOI: 10.1017/s1368980021003438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective: This study evaluated a simple environmental intervention called ‘Water Schools’ in Lower Austria providing free refillable water bottles and educational material. Design: Non-randomised controlled cluster trial with three measurements: at baseline (T0), after the intervention at 9 months (T1) and after 1-year follow-up (T2). Setting: Half-day elementary schools in Lower Austria (Austria). Participants: Third-grade pupils from twenty-two schools in the intervention group (IG) and thirty-two schools in the control group (CG) participated in the study. Data were analysed for 569 to 598 pupils in the IG and for 545 to 613 in the CG, depending on the time of measurement. Results: The consumption of tap water increased in the IG from baseline to T1 and then decreased again at T2, but this was similar in the CG (no statistically significant difference in the time trend between the IG and CG). Similar results were seen for tap water consumption in the mornings. The proportion of children who only drank tap water on school mornings increased significantly from baseline to T1 in the IG compared to the CG (P = 0·020). No difference in the changes over time occurred between the groups for the proportion of pupils drinking approximately one bottle of tap water during school mornings. Conclusions: Not only the children in the IG but also those in the CG drank more tap water after 1 school year than at the beginning. The measurement of drinking habits in the CG may have been intervention enough to bring about changes or to initiate projects.
Collapse
|
28
|
Sundborn G, Thornley S, Grey C, Gentles D, Jackson RT, Swinburn B, Veatupu L, Lang B. Gamification and Sugar: A School-Based Pilot Study of Social Marketing and Gamification Approaches to Reduce Sugary Drink Intake in Pasifika School Students. Asia Pac J Public Health 2021; 33:727-733. [PMID: 34218679 DOI: 10.1177/10105395211030133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate a social marketing-gamification intervention to reduce sugary drink intake drawing on popular culture of Pasifika secondary school students in Auckland, New Zealand. Students aged 11 to 14 years from one coeducational high school participated in the 11-week pilot study. The 9-week intervention was undertaken in assemblies and classrooms. Baseline and follow-up measures were completed by 227 and 220 students, respectively, of 298 enrolled students. Retention of the "3-6-9" teaching related to maximum daily sugar intake increased from 9% at baseline to 97% at follow-up (P < .0001). Significant increases were observed of students who correctly answered sugar content of drinks. Overall consumption of sugary drink decreased at follow-up by 0.46 glasses per day. The main conclusion from this study was that this school-based gamification educational package to convey messages about sugar content of drinks using popular modes of engagement is a promising intervention that was acceptable and well supported by school staff and students.
Collapse
Affiliation(s)
| | | | - Corina Grey
- Auckland District Health Board, Auckland, New Zealand
| | | | | | | | | | - Bodo Lang
- University of Auckland, Auckland, New Zealand
| |
Collapse
|
29
|
Miranda JJ, Taype-Rondan A, Bazalar-Palacios J, Bernabe-Ortiz A, Ariely D. The Effect of a Priest-Led Intervention on the Choice and Preference of Soda Beverages: A Cluster-Randomized Controlled Trial in Catholic Parishes. Ann Behav Med 2021; 54:436-446. [PMID: 31850492 PMCID: PMC7246257 DOI: 10.1093/abm/kaz060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Latin America ranks among the regions with the highest level of intake of sugary beverages in the world. Innovative strategies to reduce the consumption of sugary drinks are necessary. Purpose Evaluate the effect of a one-off priest-led intervention on the choice and preference of soda beverages. Methods We conducted a pragmatic cluster-randomized trial in Catholic parishes, paired by number of attendees, in Chimbote, Peru between March and June of 2017. The priest-led intervention, a short message about the importance of protecting one’s health, was delivered during the mass. The primary outcome was the proportion of individuals that choose a bottle of soda instead of a bottle of water immediately after the service. Cluster-level estimates were used to compare primary and secondary outcomes between intervention and control groups utilizing nonparametric tests. Results Six parishes were allocated to control and six to the intervention group. The proportion of soda selection at baseline was ~60% in the intervention and control groups, and ranged from 56.3% to 63.8% in Week 1, and from 62.7% to 68.2% in Week 3. The proportion of mass attendees choosing water over soda was better in the priest-led intervention group: 8.2% higher at Week 1 (95% confidence interval 1.7%–14.6%, p = .03), and 6.2% higher at 3 weeks after baseline (p = .15). Conclusions This study supports the proof-of-concept that a brief priest-led intervention can decrease sugary drink choice. Clinical Trial information ISRCTN, ISRCTN24676734. Registered 25 April 2017, https://www.isrctn.com/ISRCTN24676734
Collapse
Affiliation(s)
- J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Miraflores, Lima, Peru.,Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, San Martin de Porras, Lima, Peru
| | - Alvaro Taype-Rondan
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Miraflores, Lima, Peru
| | - Janina Bazalar-Palacios
- Centro de Estudios de Población, Universidad Católica los Ángeles de Chimbote, Casco Urbano, Chimbote, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Miraflores, Lima, Peru
| | - Dan Ariely
- Center for Advanced Hindsight, Duke University, Durham, NC, USA
| |
Collapse
|
30
|
Gowland-Ella J, Kajons N, David M, Lewis P, Trinh K, Louis D, Kingon N, Batchelor S. Thirsty? Choose Water! Encouraging Secondary School Students to choose water over sugary drinks. A descriptive analysis of intervention components. Health Promot J Austr 2021; 33:202-215. [PMID: 33715238 DOI: 10.1002/hpja.479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 03/04/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Childhood obesity is a significant public health issue. Sugar-sweetened beverage (SSB) consumption contributes to this and adolescents are high consumers. This paper provides a descriptive overview of a school-based intervention to address this. METHODS 61 secondary schools in New South Wales were randomised to receive a behavioural intervention (BI), a chilled water station (CWS), both interventions or neither (control). The BI was delivered through classroom lessons, school-based promotion and vaccination clinic. The CWS intervention included the installation of one CWS per school. Intervention effectiveness over time was assessed via student surveys at baseline, post-intervention and follow-up (individual-level outcomes), feedback from teachers and vaccination nurses, a school information survey, and remotely monitored CWS water usage (school-level outcomes). RESULTS Teachers reported the BI was useful in teaching students about drinking water and negative consequences of SSBs. Nurses considered the post-vaccination waiting period a good opportunity to deliver health promotion messages. Students in this group showed statistically significant changes in knowledge about SSBs, dehydration effects and changes in daily SSB consumption (T1 23.18%; T3 18.20%). Positive feedback regarding CWSs was received with an increase in water consumption reported for students in this group (T1 86.15% to T3 89.66%) and a statistically significant increase in students carrying a water bottle to school and filling it observed. CONCLUSIONS Both interventions were readily implemented with high levels of acceptability and impact on students' knowledge and SSB consumption. The study demonstrates how to promote water consumption in schools utilising two different interventions. SO WHAT?: Evidence regarding how to decrease SSB consumption amongst secondary school students has been strengthened.
Collapse
Affiliation(s)
- Justine Gowland-Ella
- Health Promotion Service, Central Coast Local Health District, Gosford, NSW, Australia
| | - Nicole Kajons
- Health Promotion Service, Central Coast Local Health District, Gosford, NSW, Australia
| | - Michael David
- School of Medicine and Public Health, The University of Newcastle, Gosford, NSW, Australia
| | - Peter Lewis
- Public Health Unit, Central Coast Local Health District, Gosford, NSW, Australia
| | - Katie Trinh
- Health Promotion Service, South Western Sydney Local Health District, Campbelltown, NSW, Australia
| | | | - Nina Kingon
- Health Promotion Service, Central Coast Local Health District, Gosford, NSW, Australia
| | - Samantha Batchelor
- Health Promotion Service, Central Coast Local Health District, Gosford, NSW, Australia
| |
Collapse
|
31
|
Moore A, Motagh S, Sadeghirad B, Begum H, Riva JJ, Gaber J, Dolovich L. Volunteer Impact on Health-Related Outcomes for Seniors: a Systematic Review And Meta-Analysis. Can Geriatr J 2021; 24:44-72. [PMID: 33680263 PMCID: PMC7904324 DOI: 10.5770/cgj.24.434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Volunteers are increasingly promoted to improve health-related outcomes for community-dwelling elderly without synthesized evidence for effectiveness. This systematic review and meta-analysis evaluates the effects of unpaid volunteer interventions on health-related outcomes for such seniors. Methods MEDLINE, EMBASE and Cochrane (CENTRAL) were searched up to November 2018. We included English language, randomized trials. Two reviewers independently identified studies, extracted data, and assessed evidence certainty (using GRADE). Meta-analysis used random-effects models. Univariate meta-regressions investigated the relationship between volunteer intervention effects and trial participant age, percentage females, and risk of bias. Results 28 included studies focussed on seniors with a variety of chronic conditions (e.g., dementia, diabetes) and health states (e.g., frail, palliative). Volunteers provided a range of roles (e.g., counsellors, educators and coaches). Low certainty evidence found that volunteers may improve both physical function (MD = 3.2 points on the 100-point SF-36 physical component score [PCS]; 95% CI: 1.09, 5.27) and physical activity levels (SMD = 0.5, 95% CI: 0.14 to 0.83). Adverse events were not increased. Conclusion Volunteers may increase physical activity levels and subjective ratings of physical function for seniors without apparent harm. These findings support the WHO call to action on evidence-based policies to align health systems in support of older adults.
Collapse
Affiliation(s)
- Ainsley Moore
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Shahrzad Motagh
- The Michael G. DeGroote Institute of Pain Research and Care, McMaster University, Hamilton, ON, Canada
| | - Behnam Sadeghirad
- The Michael G. DeGroote Institute of Pain Research and Care, McMaster University, Hamilton, ON, Canada
| | - Housne Begum
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - John J Riva
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Health Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Jessica Gaber
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Lisa Dolovich
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Health Evidence and Impact, McMaster University, Hamilton, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
32
|
Pineda E, Bascunan J, Sassi F. Improving the school food environment for the prevention of childhood obesity: What works and what doesn't. Obes Rev 2021; 22:e13176. [PMID: 33462933 DOI: 10.1111/obr.13176] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/30/2020] [Indexed: 12/18/2022]
Abstract
The food environment has a significant influence on dietary choices, and interventions designed to modify the food environment could contribute to the prevention of childhood obesity. Many interventions have been implemented at the school level, but effectiveness in addressing childhood obesity remains unclear. We undertook a systematic review, a meta-analysis, and meta-regression analyses to assess the effectiveness of interventions on the food environment within and around schools to improve dietary intake and prevent childhood obesity. Estimates were pooled in a random-effects meta-analysis with stratification by anthropometric or dietary intake outcome. Risk of bias was formally assessed. One hundred papers were included. Interventions had a significant and meaningful effect on adiposity (body mass index [BMI] z score, standard mean difference: -0.12, 95% confidence interval: 0.15, 0.10) and fruit consumption (portions per day, standard mean difference: +0.19, 95% confidence interval: 0.16, 0.22) but not on vegetable intake. Risk of bias assessment indicated that n = 43 (81%) of non-randomized controlled studies presented a high risk of bias in the study design by not accounting for a control. Attrition bias (n = 34, 79%) and low protection of potential contamination (n = 41, 95%) presented the highest risk of bias for randomized controlled trials. Changes in the school food environment could improve children's dietary behavior and BMI, but policy actions are needed to improve surrounding school food environments to sustain healthy dietary intake and BMI.
Collapse
Affiliation(s)
- Elisa Pineda
- Centre for Health Economics & Policy Innovation (CHEPI), Imperial College Business School, London, UK.,School of Public Health, Imperial College London, London, UK
| | - Josefina Bascunan
- Centre for Health Economics & Policy Innovation (CHEPI), Imperial College Business School, London, UK
| | - Franco Sassi
- Centre for Health Economics & Policy Innovation (CHEPI), Imperial College Business School, London, UK
| |
Collapse
|
33
|
GUEDES CKRDM, GUEDES AFLDM, SILVA JRD, SILVA EBBD, SANTOS ECMD, STAMFORD TCM, STAMFORD TLM. Development of vegetal probiotic beverage of passion fruit (Passiflora edulis Sims), yam (Dioscorea cayenensis) and Lacticaseibacillus casei. FOOD SCIENCE AND TECHNOLOGY 2021. [DOI: 10.1590/fst.66120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
34
|
Influence of Intrinsic and Extrinsic Food Attributes on Consumers' Acceptance of Reformulated Food Products: a Systematic Review. Zdr Varst 2020; 60:72-78. [PMID: 33488825 PMCID: PMC7780774 DOI: 10.2478/sjph-2021-0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/23/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction Reducing the salt, sugar and fat content of food is recognised worldwide as one of the strategies available for reducing the incidence of obesity and non-communicable diseases. The food industry has a major influence on achieving these goals by preserving intrinsic (chemical and sensory properties) and modifying extrinsic (food packaging and other external information) food attributes that can influence purchasing decisions. This article is a literature review of studies that analyse the influence of intrinsic and/or extrinsic attributes on consumer product preference and purchasing decisions. Methods A keyword search for relevant studies was conducted using Web of Science, an interdisciplinary electronic resource. Articles from other sources were also included and systematically reviewed. Results The search string identified 266 results. Thirty-eight articles were included in the final analysis and coded according to intrinsic and extrinsic food attributes, reformulated nutrient, food category, condition, research methods, consumer response, study location and sample size. There are several authors investigating the effect of intrinsic rather than extrinsic product attributes. Most research deals with processed foods in the category of milk and dairy products, followed by sweetened fruit juices, meat products, sweets and bread. Salt content is the attribute most often reduced, followed by sugar and fat. Conclusions Consumers find it hard to swap potential health benefits for hedonic attributes. When evaluating products in expected conditions, they usually rate the reformulated product more highly than the conventional one, while in informed conditions they usually choose the regular product. When products are labelled with a traffic light or nutritional warnings, consumers opt for a reformulated product, even in informed conditions. This review highlights the heterogeneity between food groups, and the fact that many factors influence consumers’ product preferences and purchasing decisions. The product should be analysed as a whole and tested in blind, expected and informed conditions, as each individual factor represents a phase of the consumer purchasing decision. The extent of nutrient reduction should be determined by calculating the difference threshold, and the industry should reformulate products gradually based on how consumers detect the reduction.
Collapse
|
35
|
Downs S, Demmler KM. Food environment interventions targeting children and adolescents: A scoping review. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2020. [DOI: 10.1016/j.gfs.2020.100403] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
36
|
The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review. Nutr Res Rev 2020; 34:185-208. [PMID: 33148371 DOI: 10.1017/s0954422420000268] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Poor diets, including excess added sugar consumption, contribute to the global burden of disease. Subsequently, many nutrition policies have been implemented to reduce added sugar intake and improve population health, including taxes, education, labelling and environmental interventions. A potential consequence of these policy actions is the substitution of added sugars with non-nutritive sweeteners (NNS) in a variety of foods and beverages. NNS are used to reduce the energy and sugar content of foods and beverages while maintaining their palatability. Evidence of the toxicological risks of NNS is inconsistent, though concerns have been raised over the potential substitution effects of ultra-processed foods containing NNS for whole foods. This review aimed to provide an overview of current NNS food supply and consumption patterns, assess added sugar-reduction policies and their impact on NNS, and determine the impact of NNS on food choice, energy intake and diet quality. NNS are widely available in a variety of products, though most commonly in carbonated beverages, dairy products, confectionery, table-top sweeteners and fruit drinks. However, the longitudinal trends of different product categories, and differences between geographies and economy-income levels, require further study. Few studies have examined NNS consumption trends globally, though an increase in NNS consumption in beverages has been observed in some regions. Research examining how the increased availability of low-sugar, NNS-containing products affects global dietary patterns is limited, particularly in terms of their potential substitution effects.
Collapse
|
37
|
Lee JN, Scott JM, Chi DL. Oral health behaviours and dental caries in low-income children with special healthcare needs: A prospective observational study. Int J Paediatr Dent 2020; 30:749-757. [PMID: 32306501 DOI: 10.1111/ipd.12656] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/09/2020] [Accepted: 04/13/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Dental caries is a significant public health problem for low-income children with special healthcare needs (CSHCN). AIM We evaluated associations between oral health behaviours (eg diet, fluoride, dental care) and dental caries for CSHCN enrolled in Medicaid, a health insurance programme for low-income populations that provides comprehensive dental coverage for children. DESIGN We recruited 116 CSHCN ages 7-20 years from Medicaid enrolment files in Washington state, USA. Caregivers completed a 166-item questionnaire, and children received a dental screening. The outcome was dental caries, defined as total pre-cavitated, decayed, missing or filled tooth (PDMF) surfaces. We ran log-linear regression models and generated prevalence rate ratios (PRR). RESULTS The mean age of study participants was 12.4 ± 3.1 years, 41.4% were female, and 38.8% were white. The mean PDMF surfaces were 6.4 ± 9.4 (range: 0-49). Only sugar-sweetened beverage intake was significantly associated with dental caries. CSHCN who consumed >4 sugar-sweetened beverages per week were significantly more likely to have dental caries than those who consumed no sugar-sweetened beverages (PRR: 2.58; 95% CI: 1.37, 4.85; P < .01). CONCLUSION Sugar-sweetened beverages are an important target for future behavioural interventions aimed at preventing dental caries in low-income CSHCN.
Collapse
Affiliation(s)
- Jeffrey N Lee
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - JoAnna M Scott
- Department of Research & Graduate Programs, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Donald L Chi
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
| |
Collapse
|
38
|
Mohammadi S, Su TT, Jalaludin MY, Dahlui M, Azmi Mohamed MN, Papadaki A, Jago R, Toumpakari Z, Majid HA. School-Based Intervention to Improve Healthy Eating Practices Among Malaysian Adolescents: A Feasibility Study Protocol. Front Public Health 2020; 8:549637. [PMID: 33072694 PMCID: PMC7536333 DOI: 10.3389/fpubh.2020.549637] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 08/19/2020] [Indexed: 01/15/2023] Open
Abstract
Introduction: School environments can influence students' dietary habits. Hence, implementing a healthy canteen intervention programme in schools is a recommended strategy to improve students' dietary intake. This study will evaluate the feasibility of providing healthier food and beverage options in selected secondary schools in Malaysia by working with canteen vendors. It also will assess the changes in food choices before and after the intervention. Methods: A feasibility cluster randomised controlled study will be conducted in six secondary schools (intervention, n = 4; control, n = 2) comprising of rural and urban schools located in Selangor and Perak states in Malaysia. Four weeks of intervention will be conducted among Malaysian adolescents aged 15 years old. Two interventions are proposed that will focus on providing healthier food options in the canteen and convenience shops in the selected schools. Interventions 1 and 2 will entail training the canteen and school convenience shop operators. Intervention 2 will be applied to subsidise the cost of low energy-dense kuih (traditional cake), vegetables, and fruits. The control group will continue to sell the usual food. Trained dietitians will audit the canteen menu and food items sold by the school canteen and convenience shops in all schools. Anthropometric measurements, blood pressure and dietary assessment will be collected at baseline and at the end of 4-week intervention. Focus group discussions with students and in-depth interviews with headmasters, teachers, and school canteen operators will be conducted post-intervention to explore intervention acceptability. Under this Healthy School Canteen programme, school canteens will be prohibited from selling “red flag” foods. This refers to foods which are energy-dense and not nutritious, such as confectionery and deep-fried foods. They will also be prohibited from selling soft drinks, which are sugar-rich. Instead, the canteens will be encouraged to sell “green flag” food and drinks, such as fruits and vegetables. Conclusion: It is anticipated that this feasibility study can provide a framework for the conception and implementation of nutritional interventions in a future definitive trial at the school canteens in Malaysia.
Collapse
Affiliation(s)
- Shooka Mohammadi
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre of Population Health, University of Malaya, Kuala Lumpur, Malaysia
| | - Tin Tin Su
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre of Population Health, University of Malaya, Kuala Lumpur, Malaysia.,South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | | | - Maznah Dahlui
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre of Population Health, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Nahar Azmi Mohamed
- Department of Sports Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Zoi Toumpakari
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Hazreen A Majid
- Department of Social and Preventive Medicine, Faculty of Medicine, Centre of Population Health, University of Malaya, Kuala Lumpur, Malaysia.,Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| |
Collapse
|
39
|
Srivastav P, Broadbent S, K V, Nayak B, Bhat HV. Prevention of adolescent obesity: The global picture and an indian perspective. Diabetes Metab Syndr 2020; 14:1195-1204. [PMID: 32673840 DOI: 10.1016/j.dsx.2020.06.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS Adolescent obesity is an increasing health burden with a growing prevalence in low- and middle-income countries. The aim of this review is to assess and compare current best practice obesity prevention interventions for adolescents in developed nations and in India METHODS: Medline (PubMed), CINAHL, Scopus and Google Scholar electronic databases from 2000 to 2020 were searched using the key terms obesity, overweight, child and adolescent obesity, child and adolescent overweight, interventions for childhood and adolescent obesity and dietary interventions for adolescents, developed countries, and India. RESULTS Developed nations worldwide have formed and implemented policies and programs at national and local levels to attempt to minimize and manage adolescent obesity. In 2019, scientific and government consultation groups in India have recommended national cross-sectoral structures to action interventions to restrict high-fat food intake, increase physical activity in children and adolescents and to link current research and school-based interventions in a national framework. CONCLUSIONS Obesity is a multifactorial problem, and multimodal interventions involving all Indian stakeholders, combined with government policy reform, are urgently needed.
Collapse
Affiliation(s)
- Prateek Srivastav
- Department of Physiotherapy, Manipal college of health professions, Manipal Academy of Higher Education, Manipal, India.
| | - Suzanne Broadbent
- School of Health & Sports Science, University of the Sunshine Coast, Queensland, Australia
| | - Vaishali K
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Baby Nayak
- Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - H Vinod Bhat
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
40
|
Kolahdooz F, Nader F, Jang SL, McKeen J, Daemi M, Johnston N, Sharma S. Dietary Adequacy among Multi-Ethnic Urban Youth in Edmonton: Findings from the Wellness and Health in Youth - Aboriginal and All Communities in Transition NOW (WHY ACT NOW) Project. J Am Coll Nutr 2020; 40:535-544. [PMID: 32804593 DOI: 10.1080/07315724.2020.1805042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The development of obesity and chronic diseases in adulthood often results from a childhood pattern of dietary excesses. This study aimed to identify dietary inadequacies and excesses of multiethnic youth in Edmonton. METHODS A cross-sectional survey of a convenience sample of 473 multiethnic youth between 11 and 18 years was conducted in 12 schools in Edmonton between October 2013 and March 2014. Data were analyzed to determine for each participant mean daily energy and nutrient intakes, dietary adequacy, and nutrient densities. Participants were divided by self-identified ethnicity (Indigenous, European, African and Middle Eastern, and Asian). RESULTS For all nutrients examined, the mean percentage of calories from fat was higher among European (31.7%) and Indigenous youth (31.8%) compared to African and Middle Eastern (28.3%) and Asian youth (29.0%), while Asian youth had the highest percentage of calories from protein (17.7%) compared to other ethnic groups (Indigenous = 15.5%; African & Middle Eastern = 16.5%; European = 16.2%). The majority of youth fell below the recommended values for dietary fiber (83.3-92.0%), vitamins D (84.4-90.2%), and E (89.5-92.0%). More than 50% fell below the dietary reference intakes (DRIs) for vitamin A, vitamin B5, calcium, and magnesium; >30% were below the DRI for folate, zinc, and vitamins B6, and C. The diet of girls contained a greater density of fiber compared to boys (9.3 vs. 8.0 g/1000 kcal; p-value = 0.002). CONCLUSIONS Inadequate dietary intake is evident among the majority of multiethnic youth in Edmonton. There is a need to develop strategies to reduce the burden of poor nutrition status for youth.
Collapse
Affiliation(s)
- Fariba Kolahdooz
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Forouz Nader
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Se Lim Jang
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jennifer McKeen
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Maryam Daemi
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Nora Johnston
- Alberta Centre for Active Living, University of Alberta, Edmonton, AB, Canada
| | - Sangita Sharma
- Indigenous and Global Health Research Group, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
41
|
Cranney L, Drayton B, Thomas M, Tang B, O'Connell T, Crino M, Cobcroft M, Chau J, Bauman A, Phongsavan P. Impact and acceptance of a state-wide policy to remove sugar-sweetened beverages in hospitals in New South Wales, Australia. Health Promot J Austr 2020; 32:444-450. [PMID: 32713051 DOI: 10.1002/hpja.390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 07/15/2020] [Indexed: 01/17/2023] Open
Abstract
ISSUE ADDRESSED Policy and environmental approaches can reduce the accessibility and purchasing of sugar-sweetened beverages (SSBs), potentially reducing overweight and obesity. This study examined the impact of a state-wide policy on removal of SSBs from sale in NSW public hospitals (launched July 2017), and explored consumer awareness and support. METHODS A convenience sample of 81 food outlets in 26 hospitals were audited for SSB availability before and after the target date for SSB removal (31 December 2017). An interviewer-administered intercept survey in 10 randomly selected hospitals (March-May 2018), assessed staff and visitors' awareness of and support for SSB removal. Descriptive and χ2 analyses assessed differences in: SSB availability; staff and visitor awareness and support. Open-ended survey responses were thematically analysed. RESULTS The proportion of outlets that removed SSBs increased from 58.0% to 96.3% (P < .001). The majority (79.5%) of the 2394 surveyed supported SSB removal, with nearly half (48.4%) reporting it would improve people's health. A minority (13.4%) did not support SSB removal, more than half (61.4%) of those said individuals should have free choice. More staff than visitors were aware of the change (61.9% vs 31.2%; P < .0001). CONCLUSIONS Availability of SSBs in NSW hospitals was significantly reduced after implementation of a policy to remove them from sale. There was strong staff and visitor support for the initiative. SO WHAT?: This study provides clear evidence that a policy designed to provide a healthy hospital retail drink environment can be successfully implemented at scale with high levels of support from staff and visitors. SUMMARY A state-wide policy initiative to remove SSBs from sale in NSW hospital food outlets in 2017 was successfully implemented, with a sample of outlets having nearly 100% compliance. The majority of staff and visitors (80%) supported the removal of SSBs, mostly because they believed it would improve individual and population health.
Collapse
Affiliation(s)
- Leonie Cranney
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Bradley Drayton
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Margaret Thomas
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Beatrice Tang
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Tarli O'Connell
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Michelle Crino
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Megan Cobcroft
- Centre for Population Health, NSW Ministry of Health, North Sydney, Australia
| | - Josephine Chau
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Department of Health Systems and Populations, Macquarie University, Sydney, Australia
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
42
|
von Philipsborn P, Stratil JM, Burns J, Busert LK, Pfadenhauer LM, Polus S, Holzapfel C, Hauner H, Rehfuess EA. Environmental Interventions to Reduce the Consumption of Sugar-Sweetened Beverages: Abridged Cochrane Systematic Review. Obes Facts 2020; 13:397-417. [PMID: 32784303 PMCID: PMC7590771 DOI: 10.1159/000508843] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 05/22/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Regular consumption of sugar-sweetened beverages (SSB) can increase the risk for obesity, type 2 diabetes, cardiovascular disease, and dental caries. Interventions that alter the physical or social environment in which individuals make beverage choices have been proposed to reduce the consumption of SSB. METHODS We included randomised controlled, non-randomised controlled, and interrupted time series studies on environmental interventions, with or without behavioural co-interventions, implemented in real-world settings, lasting at least 12 weeks, and including at least 40 individuals. Studies on the taxation of SSB were not included, as these are subject of a separate Cochrane review. We used standard Cochrane methods for data extraction, risk of bias assessment, and evidence grading and synthesis. Searches were updated to January 24, 2018. RESULTS We identified 14,488 unique records and assessed 1,030 full texts for eligibility. We included 58 studies comprising a total of 1,180,096 participants and a median length of follow-up of 10 months. We found moderate-certainty evidence for consistent associations with decreases in SSB consumption or sales for the following interventions: traffic light labelling, price increases on SSB, in-store promotion of healthier beverages in supermarkets, government food benefit programs with incentives for purchasing fruits and vegetables and restrictions on SSB purchases, multi-component community campaigns focused on SSB, and interventions improving the availability of low-calorie beverages in the home environment. For the remaining interventions we found low- to very-low-certainty evidence for associations showing varying degrees of consistency. CONCLUSIONS With observed benefits outweighing observed harms, we suggest that environmental interventions to reduce the consumption of SSB be considered as part of a wider set of measures to improve population-level nutrition. Implementation should be accompanied by evaluations using appropriate methods. Future studies should examine population-level effects of interventions suitable for large-scale implementation, and interventions and settings not yet studied thoroughly.
Collapse
Affiliation(s)
- Peter von Philipsborn
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany,
- Pettenkofer School of Public Health, Munich, Germany,
| | - Jan M Stratil
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Jacob Burns
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Laura K Busert
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Stephanie Polus
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Hans Hauner
- Institute for Nutritional Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Eva A Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| |
Collapse
|
43
|
Abstract
Background: The current food system has major consequences for the environment and for human health. Alignment of the food policy areas of mitigating climate change and public health will ensure coherent and effective policy interventions for sustaining human health and the environment. This paper explores literature on demand-side policies that aim to reduce consumption of animal-based foods, increase plant-based foods, and reduce overconsumption. Methods: We searched for publications, published between January 2000 and December 2019, considering the above policy domains. Articles were distinguished for type of policy instrument, for topic via keywords and examples were given. Results: The majority of demand-side policies focus on preventing overweight and obesity, using all types of policy instruments including more forceful market-based policies. Hardly any examples of public policies explicitly aiming to lower animal-based foods consumption were found. Policies combining health and sustainability objectives are few and mainly of the information type. Discussion: Moving towards environmentally sustainable and healthy diets is challenging as the implemented demand-side policies focus largely on human health, and not yet on environmental outcomes, or on win-wins. Policies targeting foods from the health perspective can contribute to lower environmental impacts, by indicating suitable animal-based food replacers, and aiming at avoiding overconsumption of energy dense-nutrient poor foods. Preferred policies include a variety of instruments, including strong measures. Conclusions: Working solutions are available to ensure coherent and effective demand side food policies aligning public health and environmental aims. Implementation of aligned and effective policy packages is urgent and needed.
Collapse
|
44
|
Hadley J, Sablan E. Lessons from the Field: The Traditional Monarch of Kitti in Pohnpei Addresses the High Rates of Non-Communicable Diseases through Local Policy. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2020; 79:6-9. [PMID: 32596670 PMCID: PMC7311939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Almost a quarter of Pohnpei's population is overweight or obese, a major factor influencing a 2010 non-communicable diseases (NCD) emergency declaration. The Racial and Ethnic Approaches to Community Health (REACH) project in Pohnpei is implementing a culturally tailored policy, systems, and environmental (PSE) intervention to reduce NCDs through healthy nutrition projects. Through collaboration with traditional leaders and using traditional protocols, REACH succeeded in soliciting formal approval from a Traditional Monarch to serve only healthy beverages during events at all traditional houses in the municipality. The Governor, in turn, also supported this initiative. This project cultivated relationships with traditional and government leaders to implement a culturally appropriate healthy nutrition PSE change intervention.
Collapse
Affiliation(s)
- Johnny Hadley
- Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (JH, ES)
| | - Evonne Sablan
- Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (JH, ES)
| |
Collapse
|
45
|
Rauzon S, Randel-Schreiber H, Kuo E, Schwartz P, Reed AL, Thompson HR. The association between sugar-sweetened beverage availability in school vending machines and school staff sugar-sweetened beverage consumption. Prev Med Rep 2020; 19:101128. [PMID: 32518741 PMCID: PMC7272513 DOI: 10.1016/j.pmedr.2020.101128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 02/02/2023] Open
Abstract
Reducing sugar-sweetened beverage (SSB) consumption is a leading strategy to help combat high rates of adult obesity and overweight. Regulating SSB sales in schools has reduced access among youth. However, current federal school nutrition standards are focused on student rather than staff environments (i.e. school staff lounges). This study examines the association between the availability of SSBs in school vending machines and school staff SSB consumption. The study sample included 51 public schools in California, Oregon, Washington, Maryland, and Washington DC participating in an evaluation of Kaiser Permanente’s Thriving Schools initiative in school year 2017–18. Data collection included: 1) observations of school cafeterias, staff lounges, stores and outdoor snack areas for the presence of, and content in, vending machines, and 2) an online survey of school staff about their SSB consumption. Fifty-nine percent (n = 1586) of staff responded to the survey; 1229 (77% of respondents) reported on SSB consumption. Thirty percent of schools had staff lounges with SSB vending machines and 34% of staff reported drinking ≥1 SSBs/day. On average, the probability of consuming ≥1 SSBs/day was 6.6% greater in staff in schools with SSBs available in staff lounge vending machines (95% CI: 0.11%, 13.12%). Staff in schools with SSB vending machines in staff lounges were more likely to report consuming ≥1 SSBs per day compared to staff without SSB vending in staff lounges. Examining the impact of extending SSB regulations to the entire school environment on school staff SSB consumption is an important next step.
Collapse
Affiliation(s)
- Suzanne Rauzon
- University of California, Nutrition Policy Institute, Division of Agriculture and Natural Resources, 2115 Milvia Street, Third Floor, Berkeley, CA 94704, United States
- Corresponding author at: Nutrition Policy Institute, 2115 Milvia Street, Third Floor, Berkeley, CA 94704, United States.
| | - Hallie Randel-Schreiber
- University of California, Nutrition Policy Institute, Division of Agriculture and Natural Resources, 2115 Milvia Street, Third Floor, Berkeley, CA 94704, United States
| | - Elena Kuo
- Center for Community Health and Evaluation, Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave Suite 1500, Seattle, WA 98101, United States
| | - Pamela Schwartz
- Kaiser Permanente, One Kaiser Plaza, 21st Floor, Oakland, CA 94610, United States
| | - Annie L. Reed
- Kaiser Permanente, 300 Lakeside Drive, 26th Floor, Oakland, CA 94612, United States
| | - Hannah R. Thompson
- University of California, Berkeley, School of Public Health, 2115 Milvia Street, Third Floor, Berkeley, CA 94704, United States
| |
Collapse
|
46
|
Ooi JY, Yoong SL, Sutherland R, Wrigley J, Lecathelinais C, Reilly K, Janssen L, Nathan N, Wolfenden L. Prevalence of current school-level nutrition policies and practices of secondary schools in NSW, Australia. Health Promot J Austr 2020; 32:216-226. [PMID: 32347588 DOI: 10.1002/hpja.357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 04/07/2020] [Accepted: 04/22/2020] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED Lowering the rates of adolescent overweight and obesity is a public health priority. The implementation of nutrition policies and practices in schools is recommended by various health organisations, but there is little information on the extent of their implementation. The aim of this study is to describe the prevalence of the implementation of recommended school-level nutrition policies and practices in secondary schools in New South Wales (NSW), Australia, and reported barriers and facilitators to the adoption of such policies and practices in school plans. METHODS A cross-sectional study was undertaken with school principals and canteen managers. All eligible secondary schools in NSW were approached to participate in a telephone survey (n = 440). Descriptive statistics were used to describe prevalence, and associations between school characteristics and implementation were examined using univariate statistics. RESULTS A total of 137 school principals and 80 canteen managers completed the survey. The implementation of practices on drinking water during class, healthy food and beverage marketing and learning opportunities regarding healthy eating was high (>90% of participating schools). The implementation of practices regarding the restriction of unhealthy drinks in school canteens, healthy school fundraisers and staff training related to healthy eating was reported in under 25% of participating schools. There were no significant differences in implementation by school sector, socio-economic status and geographic location. The main barrier to inclusion of nutrition policies and practices in the school plan was having other priorities and commitments (28.5%), and the main facilitator was support from stakeholders, the staff, students and their parents (37.2%). CONCLUSIONS There is opportunity to improve the implementation of nutrition policies and practices in NSW secondary schools. SO WHAT?: Strategies are needed for targeting barriers. These include: gaining support from school staff, students and parents, provision of resources and funding and staff training.
Collapse
Affiliation(s)
- Jia Ying Ooi
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Sze Lin Yoong
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Jessica Wrigley
- Hunter New England Population Health, Wallsend, NSW, Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Kathryn Reilly
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Lisa Janssen
- Hunter New England Population Health, Wallsend, NSW, Australia
| | - Nicole Nathan
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Wallsend, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| |
Collapse
|
47
|
Holstein BE, Damsgaard MT, Due P, Krølner RF, Pedersen TP, Rasmussen M. Intake of sugar sweetened soft drinks among adolescents: Trends and social inequality in Denmark 2002-2018. Nutr Health 2020; 26:3-8. [PMID: 31965902 DOI: 10.1177/0260106019900742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Intake of sugar sweetened soft drinks (SSSD) has decreased among adolescents, but trends in social inequality in SSSD intake are unknown. AIM Examine trends in social inequality in SSSD intake among adolescents in Denmark during 2002-2018. METHODS Five Health Behaviour in School-aged Children surveys with data on SSSD intake and parents' occupational social class (OSC) from nationally representative samples of 11, 13 and 15 year olds, n =20,112. RESULTS The overall prevalence of daily SSSD intake decreased from 10.1% in 2002 to 6.4% in 2018. The prevalence decreased in both high OSC (from 8% to 5%) and middle OSC (from 10% to 6%) but remained around 12% in low OSC. The odds ratio (OR) estimates of low compared with high OSC increased over the years around an overall OR of 2.01 (1.74-2.34). CONCLUSIONS Danish adolescents' SSSD intake decreased during 2002-2018 and was higher the lower the parents' OSC. Thus, social inequality increased during 2002-2018.
Collapse
Affiliation(s)
- Bjørn E Holstein
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | - Mogens Trab Damsgaard
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | - Pernille Due
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | | | - Trine Pagh Pedersen
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | - Mette Rasmussen
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| |
Collapse
|
48
|
Menegaz AM, Quevedo LDÁ, Muniz LC, Finlayson TL, Ayala GX, Cascaes AM. Changes in young children's oral health‐related behaviours and caregiver knowledge: A cluster randomized controlled trial in Brazil. Community Dent Oral Epidemiol 2019; 48:81-87. [DOI: 10.1111/cdoe.12507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 10/24/2019] [Accepted: 10/27/2019] [Indexed: 01/01/2023]
Affiliation(s)
| | | | | | - Tracy L. Finlayson
- School of Public Health San Diego State University and the Institute for Behavioral and Community Health San Diego CA USA
| | - Guadalupe X. Ayala
- School of Public Health San Diego State University and the Institute for Behavioral and Community Health San Diego CA USA
| | | |
Collapse
|
49
|
Kim J, Lim H. Nutritional Management in Childhood Obesity. J Obes Metab Syndr 2019; 28:225-235. [PMID: 31909365 PMCID: PMC6939706 DOI: 10.7570/jomes.2019.28.4.225] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 11/13/2019] [Accepted: 12/09/2019] [Indexed: 12/14/2022] Open
Abstract
The increasing prevalence of overweight and obese children and adolescents poses a major concern worldwide. Dietary practice in these critical periods affects physical and cognitive development and has consequences in later life. Therefore, acquiring healthy eating behaviors that will endure is important for children and adolescents. Nutrition management has been applied to numerous childhood obesity intervention studies. Diverse forms of nutrition education and counseling, key messages, a Mediterranean-style hypocaloric diet, and nutritional food selection have been implemented as dietary interventions. The modification of dietary risk in terms of nutrients, foods, dietary patterns, and dietary behaviors has been applied to changing problematic dietary factors. However, it is not easy to identify the effectiveness of nutritional management because of the complex and interacting components of any multicomponent approach to intervention in childhood obesity. In this review, we describe the modifiable dietary risk factors and nutritional components of previous nutrition intervention studies for nutritional management in childhood obesity. Furthermore, we suggest evidence-based practice in nutrition care for obese children and adolescents by considering obesity-related individual and environmental dietary risk factors.
Collapse
Affiliation(s)
- Jieun Kim
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul,
Korea
| | - Hyunjung Lim
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul,
Korea
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin,
Korea
| |
Collapse
|
50
|
Irwin BR, Speechley M, Wilk P, Clark AF, Gilliland JA. Promoting healthy beverage consumption habits among elementary school children: results of the Healthy Kids Community Challenge 'Water Does Wonders' interventions in London, Ontario. Canadian Journal of Public Health 2019; 111:257-268. [PMID: 31721081 DOI: 10.17269/s41997-019-00262-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 09/20/2019] [Indexed: 01/29/2023]
Abstract
INTERVENTION This study examines the impact of London's Healthy Kids Community Challenge (HKCC) 'Water Does Wonders' interventions, which combined water infrastructure and education programs. RESEARCH QUESTION How effective were the HKCC interventions at increasing water and decreasing sugar-sweetened beverage (SSB) consumption among grade 4-8 children in London, Ontario? METHODS Non-randomized controlled trial. Children's knowledge and beverage intake were measured before and after the interventions were implemented during the 2016-2017 school year. Children at intervention schools (n = 521) received education programs (Growing Chefs or UTRCA [Upper Thames River Conservation Authority]) and water bottle filling stations. Children at control schools (n = 410) received filling stations only. Multivariable linear mixed-model ANCOVAs were used to compare water and SSB consumption and knowledge across intervention groups, accounting for school-level clustering. RESULTS Children who received an education intervention and filling station compared with only a filling station consumed more water (β = 2.18 (95% CI - 1.87, 6.22) for Growing Chefs and β = 2.90 (95% CI - 0.23, 6.03) for UTRCA) and fewer SSBs (β = - 1.17 (95% CI - 3.83, 1.49) for Growing Chefs and β = - 2.56 (95% CI - 5.12, 0.001) for UTRCA) post-intervention, and had higher nutrition knowledge (β = 1.57 (95% CI - 1.68, 4.83) for Growing Chefs and β = 2.02 (95% CI - 0.35, 4.39) for UTRCA). These findings were not statistically significant. CONCLUSIONS An intervention intended to promote healthy beverage consumption yielded effects in the expected direction; however, they were small and not statistically significant. This is likely because the educational interventions were not fully aligned with the goals of the 'Water Does Wonders' program, preventing them from evoking meaningful changes in dietary behaviours.
Collapse
Affiliation(s)
- Bridget R Irwin
- Human Environments Analysis Laboratory, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada
| | - Mark Speechley
- Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Schulich Interfaculty Program in Public Health, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada
| | - Piotr Wilk
- Human Environments Analysis Laboratory, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Department of Paediatrics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Children's Health Research Institute, 800 Commissioners Rd. E, London, Ontario, N6C 2V5, Canada
| | - Andrew F Clark
- Human Environments Analysis Laboratory, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Department of Geography, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Children's Health Research Institute, 800 Commissioners Rd. E, London, Ontario, N6C 2V5, Canada
| | - Jason A Gilliland
- Human Environments Analysis Laboratory, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada. .,Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada. .,Department of Paediatrics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada. .,Department of Geography, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada. .,School of Health Studies, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada. .,Children's Health Research Institute, 800 Commissioners Rd. E, London, Ontario, N6C 2V5, Canada. .,Lawson Health Research Institute, 750 Base Line Rd. E, London, Ontario, N6C 2R5, Canada.
| |
Collapse
|