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Mantzari E, Hollands GJ, Law M, Couturier DL, Marteau TM. Impact on beer sales of removing the pint serving size: An A-B-A reversal trial in pubs, bars, and restaurants in England. PLoS Med 2024; 21:e1004442. [PMID: 39288106 PMCID: PMC11407663 DOI: 10.1371/journal.pmed.1004442] [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: 03/01/2024] [Accepted: 07/15/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Smaller serving sizes could contribute towards reducing alcohol consumption across populations and thereby decrease the risk of 7 cancers and other diseases. To our knowledge, the current study is the first to assess the impact on beer, lager, and cider sales (hereafter, for ease, referred to just as "beer sales") of removing the largest draught serving size (1 imperial pint) from the options available in licensed premises under real-word conditions. METHODS AND FINDINGS The study was conducted between February and May 2023, in 13 licensed premises in England. It used an A-B-A reversal design, set over 3 consecutive 4-weekly periods with "A" representing the nonintervention periods during which standard serving sizes were served, and "B" representing the intervention period when the largest serving size of draught beer (1 imperial pint (568 ml)) was removed from existing ranges so that the largest size available was two-thirds of a pint. Where two-third pints were not served, the intervention included introducing this serving size in conjunction with removing the pint serving size. The primary outcome was the mean daily volume of all beer sold, including draught, bottles, and cans (in ml), extracted from electronic sales data. Secondary outcomes were mean daily volume of wine sold (ml) and daily revenue (£). Thirteen premises completed the study, 12 of which did so per protocol and were included in the primary analysis. After adjusting for prespecified covariates, the intervention resulted in a mean daily change of -2,769 ml (95% CI [-4,188, -1,578] p < 0.001) or -9.7% (95% CI [-13.5%, -6.1%] in beer sold. The daily volume of wine sold increased during the intervention period by 232 ml (95% CI [13, 487], p = 0.035) or 7.2% (95% CI [0.4%, 14.5%]). Daily revenues decreased by 5.0% (95% CI [9.6%, -0.3%], p = 0.038). CONCLUSIONS Removing the largest serving size (the imperial pint) for draught beer reduced the volume of beer sold. Given the potential of this intervention to reduce alcohol consumption, it merits consideration in alcohol control policies. TRIAL REGISTRATION ISRCTN.com ISRCTN18365249.
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Affiliation(s)
- Eleni Mantzari
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, United Kingdom
- Department of Health Services Research and Management, City, University of London, London, United Kingdom
| | - Gareth J Hollands
- EPPI Centre, UCL Social Research Institute, University College London, London, United Kingdom
| | - Martin Law
- MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
- Papworth Trials Unit Collaboration, Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Dominique-Laurent Couturier
- MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
- Papworth Trials Unit Collaboration, Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - Theresa M Marteau
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, United Kingdom
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Cobo M, Relaño de la Guía E, Heredia I, Aguilar F, Lloret-Iglesias L, García D, Yuste S, Recio-Fernández E, Pérez-Matute P, Motilva MJ, Moreno-Arribas MV, Bartolomé B. Novel digital-based approach for evaluating wine components' intake: A deep learning model to determine red wine volume in a glass from single-view images. Heliyon 2024; 10:e35689. [PMID: 39170194 PMCID: PMC11336811 DOI: 10.1016/j.heliyon.2024.e35689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/23/2024] Open
Abstract
Estimation of wine components' intake (polyphenols, alcohol, etc.) through Food Frequency Questionnaires (FFQs) may be particularly inaccurate. This paper reports the development of a deep learning (DL) method to determine red wine volume from single-view images, along with its application in a consumer study developed via a web service. The DL model demonstrated satisfactory performance not only in a daily lifelike images dataset (mean absolute error = 10 mL), but also in a real images dataset that was generated through the consumer study (mean absolute error = 26 mL). Based on the data reported by the participants in the consumer study (n = 38), average red wine volume in a glass was 114 ± 33 mL, which represents an intake of 137-342 mg of total polyphenols, 11.2 g of alcohol, 0.342 g of sugars, among other components. Therefore, the proposed method constitutes a diet-monitoring tool of substantial utility in the accurate assessment of wine components' intake.
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Affiliation(s)
- Miriam Cobo
- Institute of Physics of Cantabria (IFCA), CSIC - UC, 39005, Santander, Cantabria, Spain
| | | | - Ignacio Heredia
- Institute of Physics of Cantabria (IFCA), CSIC - UC, 39005, Santander, Cantabria, Spain
| | - Fernando Aguilar
- Institute of Physics of Cantabria (IFCA), CSIC - UC, 39005, Santander, Cantabria, Spain
| | - Lara Lloret-Iglesias
- Institute of Physics of Cantabria (IFCA), CSIC - UC, 39005, Santander, Cantabria, Spain
| | - Daniel García
- Institute of Physics of Cantabria (IFCA), CSIC - UC, 39005, Santander, Cantabria, Spain
| | - Silvia Yuste
- Institute of Grapevine and Wine Sciences (ICVV), CSIC-University of La Rioja-Government of La Rioja, 26007, Logroño, La Rioja, Spain
| | - Emma Recio-Fernández
- Infectious Diseases, Microbiota and Metabolism Unit, Center for Biomedical Research of La Rioja (CIBIR), CSIC Associated Unit, 26006, Logroño, La Rioja, Spain, USA
| | - Patricia Pérez-Matute
- Infectious Diseases, Microbiota and Metabolism Unit, Center for Biomedical Research of La Rioja (CIBIR), CSIC Associated Unit, 26006, Logroño, La Rioja, Spain, USA
| | - M. José Motilva
- Institute of Grapevine and Wine Sciences (ICVV), CSIC-University of La Rioja-Government of La Rioja, 26007, Logroño, La Rioja, Spain
| | | | - Begoña Bartolomé
- Institute of Food Science Research (CIAL), CSIC-UAM, 28049, Madrid, Spain
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Langfield T, Clarke K, Sadab AA, Jones A, Robinson E. Impact of dishware size on energy intake in adult females: A randomized control trial examining effects on within-meal and post-meal energy intake. Appetite 2024; 197:107296. [PMID: 38485059 DOI: 10.1016/j.appet.2024.107296] [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: 08/01/2023] [Revised: 02/23/2024] [Accepted: 03/06/2024] [Indexed: 03/27/2024]
Abstract
The influence dishware size has on meal energy intake is unclear and no study to date has examined the impact on total daily energy intake. In a pre-registered RCT we investigate the impact of breakfast dishware size on breakfast and post-breakfast energy intake, as well as daily energy intake and hunger/fullness. In a repeated-measures design, 50 females (aged 18-77 years) were randomised to receive smaller or larger breakfast dishware on two separate days. Energy intake was also measured during the rest of the day. The primary outcomes were breakfast and post-breakfast energy intake (kcal). Secondary outcomes were total daily energy intake (kcal), and hunger/fullness (rated from 0 to 100). We examined if results differed by socioeconomic position (SEP). Dishware did not affect energy intake at breakfast (smaller: M = 394.8 kcal; SD = 172.2 larger: M = 394.4 kcal; SD = 164.4; d = 0.003, p = 0.98), and there was no statistically significant evidence that dishware size affected energy intake after breakfast, though post-breakfast energy intake was somewhat higher after using larger breakfast dishware (smaller: M = 1974.6 kcal; SD = 475.2; larger: M = 2077.5 kcal; SD = 525.9; d = -0.27, p = 0.06). Total daily energy intake, hunger and fullness ratings did not significantly differ between dishware conditions. There was no evidence that SEP moderated the effect of dishware size on energy intake. Smaller vs. larger breakfast dishware size had no significant effect on breakfast or post-breakfast energy intake, hunger, fullness, or daily energy intake. Previous studies may have overestimated the promise of dishware size as an intervention for reducing energy intake. Alternative interventions targeting the food environment should now be prioritised.
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Affiliation(s)
- Tess Langfield
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK; School of Psychology, Aston University, Birmingham, UK.
| | - Katie Clarke
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Ahmed A Sadab
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Andrew Jones
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Eric Robinson
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
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Mantzari E, Ventsel M, Pechey E, Lee I, Pilling M, Hollands GJ, Marteau TM. Impact on sales of adding a smaller serving size of beer and cider in licensed premises: an A-B-A reversal design. BMC Public Health 2023; 23:1239. [PMID: 37365548 PMCID: PMC10294394 DOI: 10.1186/s12889-023-16163-z] [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: 02/20/2023] [Accepted: 06/21/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Smaller serving sizes of alcoholic drinks could reduce alcohol consumption across populations thereby lowering the risk of many diseases. The effect of modifying the available range of serving sizes of beer and cider in a real-world setting has yet to be studied. The current study assessed the impact on beer and cider sales of adding a serving size of draught beer and cider (2/3 pint) that was between the current smallest (1/2 pint) and largest (1 pint) standard serving sizes. METHODS Twenty-two licensed premises in England consented to taking part in the study. The study used an ABA reversal design, set over three 4-weekly periods, with A representing the non-intervention periods, during which standard serving sizes were served and B the intervention period when a 2/3 pint serving size of draught beer and cider was added to the existing range, along with smaller 1/2 pint and larger 1 pint serving sizes. The primary outcome was the daily volume of beer and cider sold, extracted from sales data. RESULTS Fourteen premises started the study, of which thirteen completed it. Twelve of those did so per protocol and were included in the primary analysis. After adjusting for pre-specified covariates, the intervention did not have a significant effect on the volume of beer and cider sold per day (3.14 ml; 95%CIs -2.29 to 8.58; p = 0.257). CONCLUSIONS In licensed premises, there was no evidence that adding a smaller serving size for draught beer and cider (2/3 pint) when the smallest (1/2 pint) and largest (1 pint) sizes were still available, affected the volume of beer and cider sold. Studies are warranted to assess the impact of removing the largest serving size. TRIAL REGISTRATION ISRCTN: https://doi.org/10.1186/ISRCTN33169631 (08/09/2021), OSF: https://osf.io/xkgdb/ (08/09/2021).
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Affiliation(s)
- Eleni Mantzari
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Minna Ventsel
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Emily Pechey
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Ilse Lee
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Mark Pilling
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
| | - Gareth J. Hollands
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
- EPPI Centre, UCL Social Research Institute, University College London, London, UK
| | - Theresa M. Marteau
- Behaviour and Health Research Unit, University of Cambridge, Cambridge, UK
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Mantzari E, Ventsel M, Ferrar J, Pilling MA, Hollands GJ, Marteau TM. Impact of wine bottle and glass sizes on wine consumption at home: a within- and between- households randomized controlled trial. Addiction 2022; 117:3037-3048. [PMID: 35852024 PMCID: PMC9804259 DOI: 10.1111/add.16005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 06/27/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS Reducing alcohol consumption across populations would decrease the risk of a range of diseases, including many cancers, cardiovascular disease and Type 2 diabetes. The aim of the current study was to estimate the impact of using smaller bottles (37.5- versus 75-cl) and glasses (290 versus 370 ml) on consuming wine at home. DESIGN Randomized controlled trial of households with cross-over randomization to bottle size and parallel randomization to glass size. SETTING UK households. PARTICIPANTS A total of 260 households consuming at least two 75-cl bottles of wine each week, recruited from the general population through a research agency. The majority consisted of adults who were white and of higher socio-economic position. INTERVENTION Households were randomized to the order in which they purchased wine in 37.5- or 75-cl bottles, to consume during two 14-day intervention periods, and further randomized to receive smaller (290 ml) or larger (350 ml) glasses to use during both intervention periods. MEASUREMENTS Volume (ml) of study wine consumed at the end of each 14-day intervention period, measured using photographs of purchased bottles, weighed on study scales. FINDINGS Of the randomized households, 217 of 260 (83%) completed the study as per protocol and were included in the primary analysis. There was weak evidence that smaller bottles reduced consumption: after accounting for pre-specified covariates, households consumed on average 145.7 ml (3.6%) less wine when drinking from smaller bottles than from larger bottles [95% confidence intervals (CI) = -335.5 to 43. ml; -8.3 to 1.1%; P = 0.137; Bayes factor (BF) = 2.00]. The evidence for the effect of smaller glasses was stronger: households consumed on average 253.3 ml (6.5%) less wine when drinking from smaller glasses than from larger glasses (95% CI = -517 to 10 ml; -13.2 to 0.3%; P = 0.065; BF = 2.96). CONCLUSIONS Using smaller glasses to drink wine at home may reduce consumption. Greater uncertainty remains around the possible effect of drinking from smaller bottles.
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Affiliation(s)
- Eleni Mantzari
- Behaviour and Health Research UnitUniversity of CambridgeCamvbridgeUK
| | - Minna Ventsel
- Behaviour and Health Research UnitUniversity of CambridgeCamvbridgeUK
| | - Jennifer Ferrar
- School of Psychological Science, Tobacco and Alcohol Research GroupUniversity of BristolBristolUK
| | - Mark A. Pilling
- Behaviour and Health Research UnitUniversity of CambridgeCamvbridgeUK
| | - Gareth J. Hollands
- Behaviour and Health Research UnitUniversity of CambridgeCamvbridgeUK,EPPI‐Centre, UCL Social Research InstituteUniversity College LondonLondonUK
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Mantzari E, Marteau TM. Impact of Sizes of Servings, Glasses and Bottles on Alcohol Consumption: A Narrative Review. Nutrients 2022; 14:4244. [PMID: 36296928 PMCID: PMC9610830 DOI: 10.3390/nu14204244] [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: 09/26/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 12/03/2022] Open
Abstract
This review summarises the evidence on the impact of serving and container size on how much people drink, interventions that have the potential to reduce alcohol consumption across populations, thereby improving health. A rapid search identified 10 published reports of 15 studies and 1 review. Four studies focused on serving size, eight studies and the review on glass size, two studies on bottle size and one on both glass and bottle size. Twelve studies and the review focused on wine, one study on beer and two on both. All were conducted in England, by just two research groups. Removing the largest serving size of wine decreased wine sales by 7.6% (95% CI -12.3%, -2.9%) in a study in 21 licenced premises, reflecting findings from two prior studies in semi-naturalistic settings. Adding a serving size for beer that was a size smaller than the largest was assessed in one study in 13 licenced premises, with no evident effect. Reducing the size of wine glasses in restaurants decreased wine sales by 7.3% (95% CI -13.5%, -1.5%) in a mega-analysis of eight datasets from studies in five licensed premises. Using smaller wine glasses at home may also reduce consumption, but the evidence from just one study is less certain. No studies have assessed the impact of glass size for drinking beer. The effect of bottles smaller than the standard 750 mL on wine consumed at home was assessed in two studies: 500 mL bottles reduced consumption by 4.5% (95% CI -7.9%, -1.0%) in one study, but in another, using 375 mL bottles there was no evident effect. No studies assessed the impact of bottle or other container size for drinking beer. Reducing the size of servings, glasses and bottles could reduce wine consumption across populations. The impact of similar interventions for reducing consumption of other alcoholic drinks awaits evaluation. Further studies are also warranted to assess the generalisability of existing evidence.
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Affiliation(s)
| | - Theresa M Marteau
- Behaviour and Health Research Unit, University of Cambridge, Cambridge Public Health, East Forvie Site, Cambridge CB2 0SR, UK
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Liu Q, Tam LY, Rangan A. The Effect of Downsizing Packages of Energy-Dense, Nutrient-Poor Snacks and Drinks on Consumption, Intentions, and Perceptions-A Scoping Review. Nutrients 2021; 14:9. [PMID: 35010886 PMCID: PMC8746546 DOI: 10.3390/nu14010009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 01/12/2023] Open
Abstract
The single-serve packaging of discretionary foods is becoming increasingly popular, but evidence is limited on whether smaller package sizes can reduce food intake. The aim of this scoping review is to assess the effect of reducing the package size of energy-dense, nutrient-poor (EDNP) snacks and drinks on consumption, intentions, and perception, and to examine the effects of potential moderators or mediators. The search was conducted in six selected databases and grey literature sources, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for the scoping review process (PRISMA-ScR) guidelines. After screening 5562 articles, 30 articles comprising 47 intervention studies were included. Twelve of 15 studies found a significant effect in lowering the actual or intended consumption when a single smaller package was offered compared with a single larger package. When the total serving size was held constant between varying package conditions, such as a multipack, single package, or unpackaged, the results on the actual and intended consumption were inconsistent and varied according to the presence of moderators. Overall, these findings suggest that an overall reduction in the size of a single package is a more promising strategy than providing multipacks to reduce consumption. Changes to the current food environment to promote single smaller packages of EDNP snacks and drinks are necessary to support the better selection of appropriate portion sizes and reduce consumption.
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Affiliation(s)
| | | | - Anna Rangan
- Nutrition and Dietetics Group, School of Life and Environmental Sciences at the Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (Q.L.); (L.Y.T.)
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