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Kobik W, Aryee PA. Energy drinks in Tamale: Understanding youth perceptions, consumption patterns, and related factors. PLoS One 2024; 19:e0289391. [PMID: 38669248 PMCID: PMC11051681 DOI: 10.1371/journal.pone.0289391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/15/2024] [Indexed: 04/28/2024] Open
Abstract
Energy drinks (EDs) have become a popular choice for young people seeking physical and cognitive boosts, with ingredients such as caffeine, taurine, and B vitamins aimed at improving academic, athletic, and alertness levels. However, the popularity of these drinks is also driven by low prices, taste, brand loyalty, and gendered marketing, with boys being more likely to consume them. Despite the supposed benefits, EDs have been associated with high-risk behaviours, deaths, and adverse health effects, especially those related to cardiovascular risk. Meanwhile, in Ghana, the use of EDs is on the rise. Hence, this study aimed to examine the prevalence and consumption patterns, perceptions, and factors associated with ED consumption among the youth of the Tamale Metropolis. The study was cross-sectional, consisting of 541 participants. The group consisted of 340 males and 201 females, between the ages of 15 and 45. A questionnaire was utilized to obtain data on the respondents' consumption patterns and perceptions of EDs, as well as their socio-demographic characteristics. The results of the study indicated that a large percentage of the respondents, 98.7%, had consumed EDs before, while 78.7% currently consume them. Respondents believed that EDs provided additional energy (81.00%) and reduced stress (62.30%). However, they also perceived side effects such as insomnia (60.60%) and restlessness (51.40%). Also, the highest proportion of respondents (83.4%) had poor knowledge of EDs. They were unaware of the classification of EDs and their ingredients, side effects, and benefits. Age, marital status, level of education, work intensity, EDs served at gatherings, and knowledge of EDs was significantly associated with ED consumption (p < .05). Consumption was higher among those aged 26 to 35 years, singles, individuals with no formal education, and those with high work intensity. The high consumption was also associated with low knowledge levels. It is recommended that public health and nutrition professionals engage in further advocacy efforts to improve the youth's knowledge and perception of EDs in a positive manner. In addition, lawmakers should use legislation to influence consumption rates and safeguard the health of consumers.
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Affiliation(s)
- Williams Kobik
- Department of Health and Nutrition, Allied Relief, Tamale, Northern Region, Ghana
| | - Paul Armah Aryee
- Department of Dietetics, University for Development Studies, Tamale, Northern Region, Ghana
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Finlay A, Robinson E, Jones A, Maden M, Cerny C, Muc M, Evans R, Makin H, Boyland E. A scoping review of outdoor food marketing: exposure, power and impacts on eating behaviour and health. BMC Public Health 2022; 22:1431. [PMID: 35896996 PMCID: PMC9330687 DOI: 10.1186/s12889-022-13784-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/12/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is convincing evidence that unhealthy food marketing is extensive on television and in digital media, uses powerful persuasive techniques, and impacts dietary choices and consumption, particularly in children. It is less clear whether this is also the case for outdoor food marketing. This review (i) identifies common criteria used to define outdoor food marketing, (ii) summarises research methodologies used, (iii) identifies available evidence on the exposure, power (i.e. persuasive creative strategies within marketing) and impact of outdoor food marketing on behaviour and health and (iv) identifies knowledge gaps and directions for future research. METHODS A systematic search was conducted of Medline (Ovid), Scopus, Science Direct, Proquest, PsycINFO, CINAHL, PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials and a number of grey literature sources. Titles and abstracts were screened by one researcher. Relevant full texts were independently checked by two researchers against eligibility criteria. RESULTS Fifty-three studies were conducted across twenty-one countries. The majority of studies (n = 39) were conducted in high-income countries. All measured the extent of exposure to outdoor food marketing, twelve also assessed power and three measured impact on behavioural or health outcomes. Criteria used to define outdoor food marketing and methodologies adopted were highly variable across studies. Almost a quarter of advertisements across all studies were for food (mean of 22.1%) and the majority of advertised foods were unhealthy (mean of 63%). The evidence on differences in exposure by SES is heterogenous, which makes it difficult to draw conclusions, however the research suggests that ethnic minority groups have a higher likelihood of exposure to food marketing outdoors. The most frequent persuasive creative strategies were premium offers and use of characters. There was limited evidence on the relationship between exposure to outdoor food marketing and eating behaviour or health outcomes. CONCLUSIONS This review highlights the extent of unhealthy outdoor food marketing globally and the powerful methods used within this marketing. There is a need for consistency in defining and measuring outdoor food marketing to enable comparison across time and place. Future research should attempt to measure direct impacts on behaviour and health.
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Affiliation(s)
- Amy Finlay
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK.
| | - Eric Robinson
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Andrew Jones
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, L69 3GB, UK
| | - Caroline Cerny
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
- Obesity Health Alliance, Liverpool, UK
| | - Magdalena Muc
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Rebecca Evans
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Harriet Makin
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
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Fraser KT, Ilieva RT, James CJ, Chong VP, Shapiro S, Willingham C, Roberts C, Freudenberg N. Use of environmental scan to assess density, content, and variation of predatory food and beverage marketing in New York City. Health Place 2022; 76:102843. [PMID: 35728454 DOI: 10.1016/j.healthplace.2022.102843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 04/28/2022] [Accepted: 05/27/2022] [Indexed: 11/18/2022]
Abstract
To explore the presence of predatory food and beverage marketing in different neighborhoods in New York City (NYC), this study describes the methodology of an outdoor environmental scan of the physical environment. The study was conducted in four NYC neighborhoods over a three-week period, in which pairs of trained researchers canvassed designated neighborhoods to document the presence of food and beverage marketing using photographs taken on digital smart phone devices. Commercial areas in the vicinity of NYC Public Schools and NYC Housing Authority campuses located in four neighborhoods with the highest and lowest nutrition related health indicators were studied: South Bronx, Pelham Throggs Neck, Upper West Side, Chelsea/Greenwich Village. Advertisements were coded against 50+ indicators to quantify pertinent variables including the frequency and content of food and beverages advertised and all forms of predatory marketing observed. Comparisons of prevalence and content of food and beverage advertisements and predatory marketing were made across neighborhoods with the highest and lowest health indicators, using chi-squared analysis, and a significance level of p < 0.05. This article demonstrates a disproportionate presence of predatory marketing in low income NYC neighborhoods with negative health outcomes compared to wealthier neighborhoods. Further, this paper demonstrates the benefits and limitations of using an environmental scan methodology to assess predatory food and beverage marketing in a large urban area such as NYC.
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Affiliation(s)
- Katherine Tomaino Fraser
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States.
| | - Rositsa T Ilieva
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
| | - Charita Johnson James
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
| | - Valerie Peter Chong
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
| | - Sarah Shapiro
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
| | - Craig Willingham
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
| | | | - Nicholas Freudenberg
- CUNY Graduate School of Public Health and Health Policy, Urban Food Policy Institute, 55 W 125th Street, Room 603, New York City, New York, 10027, United States
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Milan CC, Singh KR, Burac A, Janak AP, Gu Y, Bragg MA. Comparisons of Culturally Targeted Food and Beverage Advertisements in Caribbean-American Neighborhood and Non-Latinx White Neighborhood in New York City. Health Equity 2022; 6:72-80. [PMID: 36186612 PMCID: PMC9518804 DOI: 10.1089/heq.2021.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose: This descriptive study aimed to (1) compare the number of food and beverage advertisements (ads) located in a Caribbean-American neighborhood and non-Latinx white neighborhood in New York City (NYC), and (2) qualitatively assess and compare the culturally targeted marketing themes of the food and beverage advertisements in both neighborhoods. Methods: Three research assistants photographed all outdoor food and beverage advertisements (n=361) across a 1.6 kilometer distance on a high-retail street in a Caribbean-American neighborhood and a non-Latinx white neighborhood. We used content analysis to evaluate advertising themes, and sorted food into nutritional categories (e.g., fast food and alcohol). We identified two neighborhoods with similar income levels in Queens, NYC, USA—South Ozone Park residents are predominantly non-white Caribbean Americans based on data from the NYC Department of City Planning, whereas residents of Steinway are predominantly non-Latinx white. Results: We identified a significantly higher proportion of fast-food advertisements in the Caribbean-American neighborhood (19.78%, n=36) compared with the non-Latinx white neighborhood (5.03%, n=9; p<0.001). Among beverage advertisements, 30.77% (n=56) featured alcohol brands in the Caribbean-American neighborhood, whereas 22.91% (n=41) featured alcohol brands in the non-Latinx white neighborhood. In the Caribbean-American neighborhood, 24.18% (n=44) of food and beverage advertisements referenced Caribbean culture. Conclusions: The Caribbean-American neighborhood in this study had more fast-food advertisements relative to non-Latinx white neighborhoods. More research is needed to understand the effects of culturally targeted ads on Caribbean-American communities.
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Affiliation(s)
- Carla C. Milan
- Department of Public Health Nutrition, School of Global Public Health, New York University, New York, New York, USA
| | - Kirti R. Singh
- Department of Public Health Nutrition, School of Global Public Health, New York University, New York, New York, USA
| | - Angelica Burac
- Department of Public Health Nutrition, School of Global Public Health, New York University, New York, New York, USA
| | - Allison P. Janak
- Department of Public Health Nutrition, School of Global Public Health, New York University, New York, New York, USA
| | - Yuanqi Gu
- Department of Public Health Nutrition, School of Global Public Health, New York University, New York, New York, USA
| | - Marie A. Bragg
- Department of Public Health Nutrition, School of Global Public Health, New York University, New York, New York, USA
- Department of Population Health, School of Medicine, New York University, New York, New York, USA
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Chung A, Zorbas C, Riesenberg D, Sartori A, Kennington K, Ananthapavan J, Backholer K. Policies to restrict unhealthy food and beverage advertising in outdoor spaces and on publicly owned assets: A scoping review of the literature. Obes Rev 2022; 23:e13386. [PMID: 34783421 DOI: 10.1111/obr.13386] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 01/25/2023]
Abstract
Unhealthy food marketing influences attitudes, preferences, and consumption of unhealthy foods, leading to excess weight gain. Outdoor advertising is highly visible (often displayed on publicly owned assets), but the evidence supporting regulation is unclear. This systematic scoping review of academic and grey literature aimed to (1) describe potential health and economic impacts of implementing government-led policies that restrict unhealthy food advertising in outdoor spaces or on public assets (including studies examining prevalence of advertising, associations with health outcomes and interventional studies); (2) identify and describe existing policies; and (3) identify factors perceived to have influenced policy implementation. Thirty-six academic studies were eligible for inclusion. Most reported on prevalence of unhealthy food advertising, demonstrating high prevalence around schools and in areas of lower socioeconomic position. None examined health and economic impacts of implemented policies. Four jurisdictions were identified with existing regulations; five had broader marketing or consumer protection policies that captured outdoor food marketing. Facilitators of policy implementation included collaboration, effective partnerships, and strong political leadership. Barriers included lobbying by food, media, and advertising industries. Implementation of food marketing policies in outdoor spaces and on public assets is feasible and warranted. Strong coalitions and leadership will be important to drive the policy agenda forward.
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Affiliation(s)
- Alexandra Chung
- Global Obesity Centre, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Christina Zorbas
- Global Obesity Centre, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Devorah Riesenberg
- Global Obesity Centre, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | | | | | - Jaithri Ananthapavan
- Global Obesity Centre, Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Kathryn Backholer
- Global Obesity Centre, Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
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Dia OEW, Løvhaug AL, Rukundo PM, Torheim LE. Mapping of outdoor food and beverage advertising around primary and secondary schools in Kampala city, Uganda. BMC Public Health 2021; 21:707. [PMID: 33845809 PMCID: PMC8042698 DOI: 10.1186/s12889-021-10661-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/16/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Marketing of unhealthy foods and beverages is recognized as a contributing factor to the global increase in overweight and obesity, particularly among children. Such marketing negatively affects children's dietary preferences, food choices, purchasing requests, and consumption patterns. Given that little is known about food marketing in Africa, including in Uganda, monitoring children's exposure to food marketing is essential to generate evidence on the problem and develop meaningful policy responses. The aim of this study was to describe the food and beverage marketing environment surrounding schools in urban and peri-urban areas of Kampala city. METHODS Outdoor advertising around 25 randomly sampled primary and secondary schools within a radius of 250 m of each school was mapped. Information on size, setting, type, and position of the advertisements and the healthiness of the foods and beverages promoted was collected using the INFORMAS Outdoor Advertising Protocol. The occurrence of advertising was described using frequencies, median, and density per 100m2. RESULTS A total of 1034 branded advertisements were identified around the schools. Of these, 86% featured unhealthy products, 7% healthy products, and 7% miscellaneous products. The most advertised products were sugar-sweetened beverages and alcoholic beverages (51 and 23%, respectively). Schools in the urban area were surrounded by more unhealthy ads than those in the peri-urban areas (median of 45 vs 24 advertisements). CONCLUSION The widespread extent of unhealthy food and beverage advertisements around primary and secondary schools highlights the need for food marketing regulation in Uganda, in line with the World Health Organization's recommendations, to ensure that young people are protected from unhealthy food marketing.
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Affiliation(s)
- Oumy Erica Wie Dia
- Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, 0130, Oslo, Norway
| | - Anne Lene Løvhaug
- Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, 0130, Oslo, Norway
| | - Peter Milton Rukundo
- Department of Human Nutrition and Home Economics, Kyambogo University, P.O. Box 1, Kyambogo, Uganda
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, 0130, Oslo, Norway.
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Hawkes C, Fox E, Downs SM, Fanzo J, Neve K. Child-centered food systems: Reorienting food systems towards healthy diets for children. GLOBAL FOOD SECURITY 2020. [DOI: 10.1016/j.gfs.2020.100414] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Abstract
PURPOSE OF REVIEW This scoping review examines literature from the past 5 years (June 2014 to June 2019) across three databases (PubMed, MEDLINE, and Scopus) to detail how the persuasive power of child-targeted food marketing content is addressed and evaluated in current research, to document trends and gaps in research, and to identify opportunities for future focus. RECENT FINDINGS Eighty relevant studies were identified, with varied approaches related to examining food marketing techniques to children (i.e., experimental, survey, meta-analyses, mixed methods, content analyses, focus groups). Few studies specifically defined power, and studies differed in terms of techniques examined. Spokes-characters were the predominant marketing technique measured; television was the platform most analyzed; and dominant messages focused on health/nutrition, taste appeals, and appeals to fun/pleasure. Mapping the current landscape when it comes to the power of food marketing to children reveals concrete details about particular platforms, methods, and strategies, as well as opportunities for future research-particularly with respect to definitions and techniques monitored, digital platforms, qualitative research, and tracking changes in targeted marketing techniques over time.
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Sousa S, Gelormini M, Damasceno A, Moreira P, Lunet N, Padrão P. Billboard food advertising in Maputo, Mozambique: a sign of nutrition transition. J Public Health (Oxf) 2020; 42:e105-e106. [PMID: 31329934 DOI: 10.1093/pubmed/fdz041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/11/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sofia Sousa
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Marcello Gelormini
- Agência Italiana Para a Cooperação e Desenvolvimento, Maputo, Mozambique
| | - Albertino Damasceno
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Pedro Moreira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Nuno Lunet
- EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.,EPI Unit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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Hadihardjono DN, Green M, Stormer A, Agustino, Izwardy D, Champeny M. Promotions of breastmilk substitutes, commercial complementary foods and commercial snack products commonly fed to young children are frequently found in points-of-sale in Bandung City, Indonesia. MATERNAL AND CHILD NUTRITION 2020; 15 Suppl 4:e12808. [PMID: 31225709 PMCID: PMC6617717 DOI: 10.1111/mcn.12808] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/04/2019] [Accepted: 03/15/2019] [Indexed: 01/08/2023]
Abstract
Few studies have documented the marketing of commercial foods and beverages for infants and young children in West Java, Indonesia. To assess the prevalence of promotions at points-of-sale for commercially produced products commonly fed to young children in Bandung City, 43 small and large stores were visited in 2017. Promotions for breastmilk substitutes (BMS), commercially produced complementary foods (CPCF), and select types of commercial snack products were photographed and information recorded on promotion characteristics. There were 402 and 206 promotions observed with BMS and CPCF products, respectively. Sixteen promotions with BMS products for infants under 12 months were found in 42.9% of stores selling BMS, violating national regulations. Almost all BMS promotions (98.3%) included BMS products for ages 1 year and above ("growing-up milks"). Of all BMS products available for sale, half of all infant/follow-up formula and 77.2% of growing-up milks were promoted. CPCF were found in 97.7% of stores, and 81.0% of these stores had promotions; 70.5% of all available CPCF products were promoted. Of the 2,451 promotions observed for commercial snack products, 17.3% used promotional techniques targeting young children or caregivers. Joint-promotions were common, with BMS and CPCF marketed in combination with commercial snack products; 49.0% of BMS promotions were joint BMS-snack promotions, and 80.0% or more of infant/follow-up formula promotions included a commercial snack. Revising and enforcing infant food and beverage marketing regulations to ensure consistency with global standards are necessary to protect and promote optimal infant and young child feeding in Indonesia.
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Affiliation(s)
| | | | - Ame Stormer
- Helen Keller International, New York, New York, USA
| | - Agustino
- Helen Keller International, New York, New York, USA
| | - Doddy Izwardy
- Direktorat Gizi Masyarakat-Kementerian Kesehatan RI, Jakarta, Indonesia
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Okronipa H, Arimond M, Young RR, Arnold CD, Adu-Afarwuah S, Tamakloe SM, Bentil HJ, Ocansey ME, Kumordzie SM, Oaks BM, Dewey KG. Exposure to a Slightly Sweet Lipid-Based Nutrient Supplement During Early Life Does Not Increase the Preference for or Consumption of Sweet Foods and Beverages by 4-6-y-Old Ghanaian Preschool Children: Follow-up of a Randomized Controlled Trial. J Nutr 2019; 149:532-541. [PMID: 30770539 PMCID: PMC6398382 DOI: 10.1093/jn/nxy293] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/12/2018] [Accepted: 10/31/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Whether consuming sweet foods early in life affects sweet food preferences and consumption later in childhood is unknown. OBJECTIVE We tested the hypothesis that exposure to a slightly sweet lipid-based nutrient supplement (LNS) early in life would not increase preference for or consumption of sweet items at preschool age. METHODS We followed up children who had participated in a randomized trial in Ghana in which LNS was provided to 1 group of women during pregnancy and 6 mo postpartum and to their infants from ages 6-18 mo (LNS group). The control group (non-LNS group) received iron and folic acid during pregnancy or multiple micronutrients during pregnancy and 6 mo postpartum, with no infant supplementation. At 4-6 y, we obtained data from caregivers on children's food and beverage preferences and consumption (n = 985). For a randomly selected subsample (n = 624), we assessed preference for sweet items using a photo game (range in potential scores, 0-15). For the photo game and reported consumption of sweet items, we examined group differences using predetermined noninferiority margins equivalent to an effect size of 0.2. RESULTS Median (quartile 1, quartile 3) reported consumption of sweet items (times in previous week) was 14 (8, 23) in the LNS group and 16 (9, 22) in the non-LNS group; in the photo game, the number of sweet items selected was 15 (11, 15) and 15 (11, 15), respectively. The upper level of the 95% CI of the mean difference between LNS and non-LNS groups did not exceed the noninferiority margins for these outcomes. Caregiver-reported preferences for sweet items also did not differ between groups (P = 0.9). CONCLUSION In this setting, where child consumption of sweet foods was common, exposure to a slightly sweet LNS early in life did not increase preference for or consumption of sweet foods and beverages at preschool age. This trial was registered at clinicaltrials.gov as NCT00970866.
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Affiliation(s)
- Harriet Okronipa
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA,Address correspondence to HO (e-mail: )
| | - Mary Arimond
- Intake - Center for Dietary Assessment, FHI 360, Washington, DC
| | - Rebecca R Young
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Charles D Arnold
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
| | - Solace M Tamakloe
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
| | - Helena J Bentil
- Department of Nutrition and Food Science, University of Ghana, Legon, Ghana
| | - Maku E Ocansey
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Sika M Kumordzie
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
| | - Brietta M Oaks
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI
| | - Kathryn G Dewey
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA
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