Warning labels for sugar-sweetened beverages and fruit juice: evaluation of 27 different labels on health effects, sugar content, energy and exercise equivalency

OBJECTIVES

Front-of-pack warning labels may reduce consumption of sugar-sweetened beverages, potentially mitigating negative health outcomes. Comparisons between different warning label types to inform future research and policy directions are lacking. This study compared 27 warning labels across six message types for their potential to reduce sugar-sweetened beverage consumption.

DESIGN AND METHODS

A national sample of regular soda (n = 2578) and juice (n = 1048) consumers aged 14-60 years participated in an online survey. Participants evaluated randomly allocated labels; one from each of six warning label sets (health-graphic, sugar-pictogram, sugar-text, exercise equivalents, health-text, energy information) on four measures of perceived effectiveness (PE: overall effectiveness, discourage from drinking, emotional response, persuasive potential). Participants could also provide open comments. A general linear model compared differences in mean scores across label sets for each measure of PE.

RESULTS

PE ratings differed significantly between label sets. Labels clearly quantifying sugar content (sugar-teaspoons) received consistently high PE ratings, whereas 'high in sugar' labels did not. Health-graphic labels were rated highly across all PE measures except persuasive potential. Exercise labels only rated highly on persuasive potential. Health-text results were mixed, and energy labels were consistently low.

CONCLUSIONS

Simple, factual labels were easily interpreted and perceived as most effective. Labels quantifying sugar content were consistently high performers and should be advanced into policy to help decrease overconsumption of sugar-sweetened beverages.

Selective orexin 1 receptor antagonism does not affect effort-based responding for sucrose reward in rats

In rodents, orexin neuropeptides regulate motivation and reward-seeking via orexin 1 receptor (OX1R) signaling in the mesolimbic dopaminergic system. This role is clearly established for rewards inherent to drugs of abuse but less so for natural rewards. Reported effects of the selective OX1R antagonist (SO1RA) SB-334867 on motivation for palatable food are ambiguous. In our experimental conditions neither SB-334867, nor two additional, structurally different SO1RAs, ACT-335827 and the clinical development candidate nivasorexant, affected effort-based responding for sucrose in rats. The positive control lisdexamfetamine, approved for psychiatric disorders associated with altered reward sensitivity such as binge eating disorder, increased effort-based responding.

Probing the relevance of the accelerated aging mouse line SAMP8 as a model for certain types of neuropsychiatric symptoms in dementia

INTRODUCTION

People with dementia (PwD) often present with neuropsychiatric symptoms (NPS). NPS are of substantial burden to the patients, and current treatment options are unsatisfactory. Investigators searching for novel medications need animal models that present disease-relevant phenotypes and can be used for drug screening. The Senescence Accelerated Mouse-Prone 8 (SAMP8) strain shows an accelerated aging phenotype associated with neurodegeneration and cognitive decline. Its behavioural phenotype in relation to NPS has not yet been thoroughly investigated. Physical and verbal aggression in reaction to the external environment (e.g., interaction with the caregiver) is one of the most prevalent and debilitating NPS occurring in PwD. Reactive aggression can be studied in male mice using the Resident-Intruder (R-I) test. SAMP8 mice are known to be more aggressive than the Senescence Accelerated Mouse-Resistant 1 (SAMR1) control strain at specific ages, but the development of the aggressive phenotype over time, is still unknown.

METHODS

In our study, we performed a longitudinal, within-subject, assessment of aggressive behaviour of male SAMP8 and SAMR1 mice at 4, 5, 6 and 7 months of age. Aggressive behaviour from video recordings of the R-I sessions was analysed using an in-house developed behaviour recognition software.

RESULTS

SAMP8 mice were more aggressive relative to SAMR1 mice starting at 5 months of age, and the phenotype was still present at 7 months of age. Treatment with risperidone (an antipsychotic frequently used to treat agitation in clinical practice) reduced aggression in both strains. In a three-chamber social interaction test, SAMP8 mice also interacted more fervently with male mice than SAMR1, possibly because of their aggression-seeking phenotype. They did not show any social withdrawal.

DISCUSSION

Our data support the notion that SAMP8 mice might be a useful preclinical tool to identify novel treatment options for CNS disorders associated with raised levels of reactive aggression such as dementia.

"You can't just eat 16 teaspoons of sugar so why would you drink 16 teaspoons' worth of sugar?": a qualitative study of young adults' reactions to sugary drink warning labels

Background

Several jurisdictions have introduced nutrient warning front of pack (FoP) labels in an effort to curb consumption of ultra-processed foods and beverages high in free sugars (sugars added to foods and beverages, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates). This study aimed to explore consumer understanding and perceptions of FoP warning labels that convey different nutritional and health information messages regarding the consumption of sugary drinks.

Methods

Sixteen focus groups were held with 4–8 young adults per group (aged 18–24; n = 105 participants in total) stratified by education level, location (rural centres, large cities) and gender (males, females) to ensure diversity. Labels shown to participants during group discussions included text warning labels of health effects, exercise equivalents, calorie/kilojoule information and sugar content as a “high in” label and as teaspoons (text and pictograms). Thematic analysis was undertaken.

Results

Four themes were identified related to participants’ perceived effectiveness of labels: the extent to which labels were perceived to be useful, relevant and credible; the extent to which a label elicited shock or disgust (perceived aversiveness); the extent to which the label message was resistant to self-exemption; and participants’ perceived potential of the label to reduce purchasing and consumption behaviour. Across all four themes, labels communicating the number of teaspoons of sugar in a sugary drink (whether by text or pictogram) were perceived as the most impactful, resistant to self-exemption and to have the greatest potential to reduce consumption, with enhanced reactions to the pictogram label. Labels depicting health effects, exercise equivalents, calorie/kilojoule information or a general ‘high in sugar’ warning were perceived by consumers to be less effective in one or more themes.

Conclusions

Labels conveying the amount of sugar in a beverage in teaspoons were perceived as highly factual, relatable and interpretable, and as having the greatest potential to impact consumption attitudes and intentions. Further quantitative studies are required to compare the potential effectiveness of the teaspoons of sugar labels in reducing purchasing and consumption behaviour than other alternative warning labels, such as health effects or “high in” sugar labels.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13648-1.

Longitudinal assessment of aggression and circadian rhythms in the APPswe mouse model of Alzheimer`s disease

Agitation, which comprises verbal or physical aggression and hyperactivity, is one of the most frequent neuropsychiatric symptoms observed in patients with Alzheimer's disease (AD). It often co-occurs with dysregulated circadian rhythms. Current medications are associated with serious adverse effects, and novel therapeutics are therefore needed. Rodent models can be instrumental to provide a first signal for potential efficacy of novel drug candidates. Longitudinal data assessing the face validity of such models for AD-related agitation are largely missing. We employed telemeterized APPswe mice, a frequently used AD transgenic mouse line overexpressing the human beta-amyloid precursor protein (APP) with the Swedish KM670/671NL mutation, to study the occurrence and progression of changes in reactive aggressive behavior as well as the circadian profile of locomotor activity and body temperature. Analysis was conducted between 5 and 11 months of age, at regular 2-months intervals. The aggressivity of all mice was highest at 5 months and waned with increasing age. APPswe mice were more aggressive than WT at 5 and 7 months of age. The locomotor activity and body temperature of WT mice declined with increasing age, while that of APPswe mice remained rather constant. This genotype difference was solely evident during the active, dark phase. APPswe mice did not display a phase shift of their circadian rhythms. We conclude that the APPswe mouse line can recapitulate some of the behavioral disturbances observed in AD, including an agitation-relevant phenotype characterized by active phase hyperactivity and aggressivity. It does not recapitulate the nighttime disturbances (also characterized by hyperactivity) and the shift of circadian rhythms observed in AD patients. Therefore, the APPswe strain could be used at specific ages to model a subset of agitation-relevant behavioral problems and to test the modulatory effects of drugs.

092 Effect of the dual orexin receptor antagonist (DORA) daridorexant on behaviour upon awakening in rats and dogs

Introduction

The ability to be fast alert and to interact with the environment without motor impairment upon waking up, is a critical feature of natural sleep. DORAs represent a new class of insomnia medications that specifically inhibit the wake-promoting effects of orexin neuropeptides. Daridorexant is a potent and selective DORA under late stage development for the treatment of insomnia. Here, we assessed the impact of sleep-promoting doses of daridorexant on rats’ and dogs’ behaviour upon forced awakening. Zolpidem (a positive GABAA receptor modulator) was used as active comparator in rats because of its known negative impact on motor functions.

Methods

Rats were woken up at different time points after oral administration of daridorexant (10, 30, 100 mg/kg) or zolpidem (30, 100 mg/kg) during their inactive phase, and repeatedly subjected to two motor tasks: 1) the rotating rod test (lasting 120 sec, at each time point) assessing gross motor skills and coordination, and 2) the forepaw grip strength test assessing fine motor skills and muscle strength. Dogs were presented with food as an external, salient stimulus, three hours after administration of daridorexant in gelatin capsules (10, 30 or 90 mg/dog) during their active phase. Behaviour and signs of muscle weakness, after having woken up, were assessed by manual inspection of video recordings and concomitant electroencephalogram/electromyogram recordings.

Results

In both the rotarod and grip tests, daridorexant treatment had no effect on motor behavior at any dose or time point tested, while zolpidem significantly reduced the time spent on the rotarod and the grip strength in a dose and time-dependent manner (N=12/group; p<0.001;) (e.g. at 30 min post-dose, time spent on the rotarod was 84, 79–89 and 10–19 sec for vehicle, daridorexant and zolpidem, respectively). Dogs treated with daridorexant were able to wake up easily upon food presentation. They behaved and ate normally and did not show any signs of muscle weakness.

Conclusion

The type of sleep promoted by daridorexant is surmountable in rats and dogs and similar to physiological sleep. It allows animals to easily wake up, to behave normally without motor impairment and to respond efficiently to the environmental conditions.

Support (if any)

Funded by Idorsia Pharmaceuticals Ltd

Antismoking Social Norms Increase Cessation Behaviours Among Lower and Higher SES Smokers: An Australian Population-Based Study

Background: Disapproval of smoking from close others, observation of others' quitting activity and denormalisation of smoking in the broader community can provide an environment that helps smokers to quit. However, it remains unclear which social norms have the greatest influence, and if there is a similar impact on quitting-related cognitions and behaviors among lower and higher socioeconomic status (SES) smokers. Aim: This study sought to examine the influence on quitting-related cognitions and behaviors of a variety of social norms: subjective (perceived disapproval of smoking among close family and friends); internalized injunctive (feeling embarrassed about being a smoker); and close descriptive norms (living in a household with someone who, successfully or unsuccessfully, tried to quit in the past 12 months). Methods: A telephone survey was conducted among 1454 Australian adult smokers between 2012 and 2014 who were followed-up ∼1 week after the baseline interview. Logistic regression analyses examined prospective associations of baseline social norms with quitting-related cognitions and behaviors at follow-up. Analyses were adjusted for baseline demographic characteristics, addiction level, tobacco control policies (cost increases, plain packaging implementation and mass media campaign exposure) and quitting-related outcomes measured at baseline. Differences in associations between lower and higher SES smokers (based on educational attainment and area-based disadvantage) were examined through interaction terms and stratified analyses. Results: Sixty-three percent of participants perceived disapproval from family and friends, 30% felt embarrassed to be a smoker, and 12% lived with a recent quitter. Baseline disapproval, embarrassment and household quitting activity were each associated with having quitting as a high priority and with setting a firm date to quit in the next month. Both disapproval and embarrassment also predicted engaging in behaviors to limit smoking, and only embarrassment was associated with increased likelihood to talk about quitting with family or friends and to make a quit attempt. No associations were found between social norms and being highly confident to quit and seeking help to quit. Associations were mostly comparable for lower and higher SES smokers, with no significant negative effects of social norms on quitting thoughts and behaviors overall or among subgroups. Conclusion: Within the strong tobacco control environment in Australia, smokers from lower and higher SES groups who perceive that their family and friends disapprove of their smoking, feel embarrassed to be a smoker and/or who live in a household with a recent quitter are more likely to prioritize quitting and intend to quit soon. These findings also indicate that the internalized injunctive social norm (i.e., feeling embarrassed) was the strongest predictor of smokers' quitting related behaviors, including making a quit attempt.

Changes in the news representation of smokers and tobacco-related media advocacy from 1995 to 2005 in Australia

BACKGROUND

This study aims to show how smokers were represented in smoking-related news articles, editorials, letters and columns in a major Australian newspaper over an 11-year period from January 1995 to December 2005.

METHODS

Qualitative content analysis was conducted on a sample of 618 articles to identify 21 representational categories (RCs) of the smoker. Articles were also examined for statements that lent organisational support to either tobacco control or the promotion of tobacco.

RESULTS

The construction of the smoker as a "regulated citizen" due to being subjected to tobacco policy was the most prevalent RC, occurring in 43.4% of articles. Of the 13 most prevalent RCs, eight were constructions of the smoker that lent support to tobacco control outcomes, two were supportive of the promotion of tobacco, and three could be used by both parties. 30.6% of articles contained at least one statement from a tobacco control advocacy source, compared with only 13.6% of articles having a statement towards the promotion of tobacco.

CONCLUSION

These results indicate that constructions of the smoker that support tobacco control have dominated smoking-related discourse in this Australian newspaper and that representations favouring a tobacco industry viewpoint appeared less often. However, the pro-tobacco representations of smokers in reports relating to legal issues highlight an area of media discourse in which tobacco control advocates should remain vigilant.

The tachykinin NK3 receptor agonist senktide induces locomotor activity in male Mongolian gerbils

The tachykinin family of receptors has been of strong interest recently due to the potential of the tachykinin NK(3) receptor antagonism in treatment of schizophrenia. However, critical differences in the tachykinin NK(3) receptor between rats, mice and humans make rats and mice less acceptable species for testing tachykinin NK(3) receptor antagonism. This has led to testing of tachykinin NK(3) receptor activity in gerbils and guinea pigs. As these species are much less common laboratory animals than rats and mice, there is a relative paucity of in vivo testing models for tachykinin NK(3) receptor activation. In the present study, locomotor activity induced by the tachykinin NK(3) receptor agonist senktide was characterized. Injection of senktide i.c.v. was found to dose-dependently induce hyperlocomotion from a dose of 0.06 nmol to the maximal dose tested, 0.6 nmol. Locomotion induced by 0.1 nmol of senktide could be blocked by injection of the tachykinin NK(3) receptor antagonists SB222200 (10 and 30 mg/kg i.p.) and talnetant (SB223412; 10 and 30 mg/kg i.p.), as well as by osanetant (SR142801; 10 and 30 mg/kg i.p.) when administered in a vehicle containing vitamin E and glycofurol. Senktide-induced activity was also reversed by the antipsychotics haloperidol (0.3 and 1 mg/kg p.o.) and risperidone (1 mg/kg p.o.), but not by the serotonin 5HT(2a/c) receptor antagonist MDL100907 (tested at 0.1, 0.3 and 1 mg/kg p.o.). Hyperlocomotion induced by 0.03 nmol of senktide was potentiated by antagonism of the tachykinin NK(1) receptor with aprepitant (1, 3 and 10 mg/kg, p.o.). Thus, hyperlocomotion induced by senktide in gerbils is a tachykinin NK(3) receptor-mediated behavior that is appropriate for use in testing tachykinin NK(3) receptor activity of novel compounds.

Stress-induced hyperthermia: effects of acute and repeated dosing of MPEP

The mGlu5 receptor antagonist 2-methyl-6-(phenylethylnyl)-pyridine (MPEP) is highly anxiolytic in rodent models of anxiety. Recent studies showed that MPEP remains effective in some models of anxiety after repeated treatment, but tolerance may develop in other models. To further evaluate anxiolytic properties of repeated MPEP, a single administration of 3, 10, or 30 mg/kg p.o. and repeated administration of 30 mg/kg p.o. was tested in the stress-induced hyperthermia model in mice. MPEP dose-dependently inhibited stress-induced hyperthermia when given acutely. MPEP remained equally active in reducing stress-induced hyperthermia after five daily treatments with 30 mg/kg, further validating MPEP as a potential anxiolytic for chronic use.

Prevalence and causes of visual impairment in rural myanmar: the Meiktila Eye Study

OBJECTIVE

To determine the prevalence and causes of visual impairment in the Meiktila district of central, rural Myanmar.

DESIGN

Population-based cross-sectional study.

PARTICIPANTS

Random, stratified, cluster sampling of the inhabitants 40 years of age and older from villages in the Meiktila district was performed; 2481 eligible participants were identified and 2076 participated in the study.

METHODS

The ophthalmic examination included presenting and pinhole Snellen visual acuity with an illiterate E chart, slit-lamp examination of the anterior segment, and dilated stereoscopic fundus examination. The principal cause of visual impairment was recorded.

MAIN OUTCOME MEASURES

Visual impairment and blindness were defined by both presenting and corrected visual acuity according to World Health Organization criteria: better eye < 6/18 and < 3/60, respectively.

RESULTS

Comprehensive examinations, including Snellen visual acuity, were performed on 2073 participants (83.6%) The prevalence estimate of presenting visual impairment was 40.4% (95% confidence interval [CI], 36.1-44.7) and of presenting blindness was 8.1% (95% CI, 6.5-9.9). After pinhole correction, the corresponding prevalences were 26.8% (95% CI, 23.5-30.1) and 5.3% (95% CI, 4.0-6.6). Cataract, uncorrected refractive error, and glaucoma were the most common causes of visual impairment.

CONCLUSIONS

Visual impairment and blindness remain major public health problems in rural Myanmar. Specific programs directed toward reducing the cataract burden need to be implemented.

Apomorphine-induced disruption of prepulse inhibition that can be normalised by systemic haloperidol is insensitive to clozapine pretreatment

RATIONALE

Prepulse inhibition (PPI) of startle refers to the phenomenon in which a weak prepulse attenuates the startle response to a succeeding intense stimulus. PPI can be disrupted by systemic apomorphine in animals, and reduced PPI has been consistently reported in schizophrenia patients. The ability of the atypical antipsychotic clozapine to reverse apomorphine-induced PPI deficit has been demonstrated in the rat, but has not yet been tested in the mouse. The present study was designed to fill this gap.

OBJECTIVE AND RESULTS

We investigated the efficacy of clozapine in reversing apomorphine-induced (2.0 or 2.5 mg/kg, s.c.) PPI deficit in C57BL6 mice. Clozapine failed to restore PPI disruption in apomorphine-treated mice in two independent laboratories across two dose ranges (1-3 mg/kg, i.p., or 3-30 mg/kg, p.o.), whereas the typical antipsychotic haloperidol (1 mg/kg, i.p.) completely normalised PPI performance.

CONCLUSIONS

Unlike the rat, apomorphine-induced PPI disruption in mice might be instrumental in distinguishing between typical and atypical antipsychotic drugs. This also lends further support to the suggestion that the neuropharmacology of PPI is not identical in the two rodent species.

Role of mobile DNA in the evolution of vancomycin-resistant Enterococcus faecalis

The complete genome sequence of Enterococcus faecalis V583, a vancomycin-resistant clinical isolate, revealed that more than a quarter of the genome consists of probable mobile or foreign DNA. One of the predicted mobile elements is a previously unknown vanB vancomycin-resistance conjugative transposon. Three plasmids were identified, including two pheromone-sensing conjugative plasmids, one encoding a previously undescribed pheromone inhibitor. The apparent propensity for the incorporation of mobile elements probably contributed to the rapid acquisition and dissemination of drug resistance in the enterococci.

Effects of central noradrenaline depletion by the selective neurotoxin DSP-4 on the behaviour of the isolated rat in the elevated plus maze and water maze

RATIONALE

Social isolation of the rat from weaning influences behaviour following central noradrenaline (NA) depletion by the selective neurotoxin N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4).

OBJECTIVES

The study characterised the effects of DSP-4 on the behaviour of isolates in the elevated plus maze and water maze.

METHODS

Male Lister hooded rats were reared singly or in groups after weaning. Two weeks postweaning, the rats were injected with DSP-4 (25 mg/kg, i.p.) or saline. From week 4, rats were tested in the plus maze and in the water maze.

RESULTS

DSP-4 significantly reduced cortical and hippocampal NA but had no effect on hypothalamic NA. Isolation rearing alone had no significant effects on behaviour in the elevated plus maze but enhanced retention of platform placement in the water maze as measured by increased entries to the platform annulus during the probe test. DSP-4 in group-reared rats increased activity in the open arms and increased general activity in the elevated plus maze with no effect on water maze performance. DSP-4-treated isolates spent less time in the open arms and were hypoactive in the plus maze compared to group-reared DSP-4-treated rats, and had impaired retention of spatial memory in the water maze compared to isolate controls.

CONCLUSIONS

DSP-4 treatment had an 'anxiolytic' effect in group-reared rats in the elevated plus maze. In the water maze, isolation rearing enhanced retention of spatial information, an effect normalised by NA depletion. The results demonstrate the importance of noradrenergic function in the regulation of responsiveness to environmental cues.

First-time parenthood: influences on pre- and postnatal adjustment in fathers and mothers

The objective of the study was to examine moods and adjustment through the transition to parenthood as an issue affecting the couple; to examine not only the postpartum but also the pregnancy experience and to explore how each partner's experiences interact with those of the other. A longitudinal repeated measures design was utilized with 327 healthy couples with a first-time pregnancy who were from Melbourne, Victoria in 1995-98. Each partner was interviewed on four occasions: mid- and late pregnancy, early postpartum and 4 months postnatally. Twenty per cent of mothers and 12% of fathers were significantly distressed at mid-pregnancy (Time 1) and this persisted until the early postpartum (Time 3) phase. Young age (particularly in women), negative mood, poor relationship functioning, gender role stress (particularly performance failure regarding work and sex in males) and low social support predicted distress in mid-pregnancy (Time 1). Negative mood in partner and self, and poor relationship functioning at mid-pregnancy predicted vulnerability to postnatal distress (Time 3 and/or Time 4). The incidence of distress in couples during mid- and late pregnancy is of concern and highlights the importance of considering the total transition to parenthood, not only the onset of postnatal distress. The analyses of predictors of postnatal distress from prenatal variables suggest that a 'contagion of distress' may operate in some couples. The standard management provided for couples experiencing pregnancy may be inadequate for many couples. These findings suggest that it is important to consider the mood and relationship quality of both partners and to offer intervention services as early as possible to offset possible progression into postnatal depression.

Photodynamic therapy: a cancer treatment for the 21st century

Esophageal cancer is on the rise and successful treatment continues to be elusive. New treatment modalities are needed to inhibit tumor growth and stop recurrence. This manuscript will highlight photodynamic therapy, a promising new modality for the treatment of esophageal cancer.