Protecting whose welfare? A document analysis of competition regulatory decisions in four jurisdictions across three harmful consumer product industries.

BACKGROUND AND METHODS: Competition regulation has a strong influence on the relative market power of firms. As such, competition regulation can complement industry-specific measures designed to address harms associated with excessive market power in harmful consumer product industries. This study aimed to examine, through a public health lens, assessments and decisions made by competition authorities in four jurisdictions (Australia, South Africa, the United States (US), and the European Union (EU)) involving three harmful consumer product industries (alcoholic beverages, soft drinks, tobacco). We analysed legal case documents, sourced from online public registers and dating back as far as the online records extended, using a narrative approach. Regulatory decisions and harms described by the authorities were inductively coded, focusing on the affected group(s) (e.g., consumers) and the nature of the harms (e.g., price increases) identified. RESULTS: We identified 359 cases published by competition authorities in Australia (n = 202), South Africa (n = 44), the US (n = 27), and the EU (n = 86). Most cases (n = 239) related to mergers and acquisitions (M&As). Competition authorities in Australia, the US, and the EU were found to make many decisions oriented towards increasing the affordability and accessibility of alcohol beverages, soft drinks, and tobacco products. Such decisions were very often made despite the presence of consumption-reduction public health policies. In comparison, South Africa's competition authorities routinely considered broader issues, including 'Black Economic Empowerment' and potential harms to workers. CONCLUSION: Many of the competition regulatory decisions assessed likely facilitated the concentration of market power in the industries we explored. Nevertheless, there appears to be potential for competition regulatory frameworks to play a more prominent role in promoting and protecting the public's health through tighter regulation of excessive market power in harmful consumer product industries.

[Determination of carbohydrate content in soft drinks. Methodological aspects and results of research using various methods].

An important component of the programs to prevent type 2 diabetes mellitus, obesity, and other chronic noncommunicable diseases is limiting the intake of added sugars. Information about the composition of the product and its nutritional value contained in the labeling contributes to the informed choice of consumers when forming a diet. On July 1, 2023, new provisions of the Tax Code of the Russian Federation came into force, providing for the imposition of an excise tax on "sugar-containing drinks" - soft drinks made with added sugar and containing carbohydrates in quantities of more than 5 g/100 ml. The stated goal of the new excise regulation is to reduce sugar consumption by the population. Currently, information on the carbohydrate content in soft drinks is provided by manufacturers based on calculated values according to the recipe, which makes it possible to take into account as much as possible all the carbohydrate components of the product. There is no standardized method for analytically assessing the carbohydrate content of soft drinks (including "sugar-sweetened beverages" for excise tax purposes). The purpose of the work was the comparative analysis of existing analytical methods for determining the content of sugars and carbohydrates in general in foods, including beverages; and determination of the most correct analytical approach to assessing the content of carbohydrates in soft drinks. Material and methods. The existing methods for determining sugars and carbohydrates in foods, including beverages, have been analyzed. The objects of research were samples of model aqueous solutions with different sugar concentrations (30 samples) and 17 samples of industrially produced soft drinks (including tonic and tonic energy drinks) made using sugar or sugars (glucose-fructose syrup), sweeteners, and a mixture of sugar and sweeteners. The total content of sugars/carbohydrates in beverages was determined: in accordance with MU 10-05031531-372-93 as the difference between the total dry matter content and the dry matter from acids; by the Bertrand method; by the Bertrand-Schorl method. The obtained values were compared with the calculated data specified in the labeling of consumer packaging of the products. Results. The determination of sugars in model solutions showed sufficient accuracy of the Bertrand-Schorl method: deviations of the obtained values from the amount of sugars added to the model solution were observed only at their high concentration (over 10 g/100 ml) and amounted to ±0.1 g/100 ml. The carbohydrate content in industrial soft drinks estimated by various methods differed slightly from that indicated in the labeling (obtained by calculation). The differences were at the level from - 0.2 to +0.4 g/100 ml when using the method from MU 10-05031531-372-93, at the level from -2.6 to +0.8 g/100 ml when using the Bertrand method and at the level from -2.7 to +0.1 g/100 ml when using the Bertrand-Schorl method. The greatest differences were observed for tonic drinks (including energy drinks) - from -2.7 to +0.3 g /100 ml, depending on the method. Conclusion. The research data showed that the Bertrand-Schorl method can be used as a basis for developing a state standard for determining the total sugar content in soft drinks and for assessing their carbohydrate content in general. At the same time, the method needs to be refined for tonic drinks. At present, the most acceptable method is to assess the carbohydrate content using the analytical method given in MU 10-05031531-372-93, but it should be taken into account that deviations from the carbohydrate content values determined by this method from the values obtained by calculation can be up to +10%. At the same time, the calculation method for determining the carbohydrate content in drinks remains a priority, including for the purposes of excise regulation.

Caffeine consumption of medical students in Korea: amount and symptoms based on a 2023 survey.

PURPOSE: To investigate the form and level of daily caffeine intake recommended above 400 mg in medical students expected to consume caffeinated beverages to enhance their performance. METHODS: From May to June 2023, freshman through senior medical students at a medical school in Korea were administered a seven-item questionnaire designed to measure the amount of caffeine-containing foods consumed, the weekly interval between consumption, the reason for consumption, and the level of caffeine-induced symptoms experienced. RESULTS: Out of 443 students, 361 responded (81.5%). The most commonly consumed caffeine beverages were coffee (79.2%), followed by soda (33.2%), tea (27.4%), chocolate (25.2%), and energy drinks (20.5%). The estimated (average±standard deviation) daily intake was estimated to 274.6±276.5 mg, and they consumed caffeine on an average of 4.25±2.26 days per week. Students who consumed 400 mg or more of caffeine daily consumed 19.9%. The primary motivation for caffeine intake was "to improve academic performance" (60.9%) and "preferred food" (51.8%). Among the responders, 98% of them replied they had symptoms that could be caused by caffeine, in order of palpitations (47.4%), frequent urination (42.9%), anxiety (27.1%), indigestion (17.5%), and excitement (17.5%). A total of 45.7% reported two symptoms, and 24.7% reported three or more. CONCLUSION: Caffeinated beverage consumption was routine among current medical students, with 20% consuming more than the recommended daily amount. Most students experienced at least one caffeine-induced symptom, with two symptoms in half, suggesting the need for policy measures and warnings about caffeine-containing foods.

Onset and progression of dental erosion in a mouse model.

OBJECTIVE: Purpose of this research was to examine the onset, progression and wear rates of dental erosion in an established mouse model. MATERIAL AND METHODS: Dental erosion in mice was experimentally induced, and the acidic effects of cola drink on their teeth after 2, 4 and 6-weeks were closely analysed by scanning electron microscopy. The tooth height and enamel or dentin loss were established.  Results: The dental erosion on the molars showed clear progression from 2 to 6 weeks. By the 2-week mark, a significant portion of enamel was already eroded, revealing the dentin on the lingual cusps. When adjusted for attritional wear, molars exposed to cola for 2 weeks showed a 35% drop in lingual tooth height compared to controls (533 µm vs. 818 µm). At 4 and 6 weeks, the cola-exposed group continued to display decreased lingual tooth heights by 40% (476 µm vs. 799 µm) and 43% (440 µm vs. 767 µm), respectively. CONCLUSION: This study revealed significant acidic effects of cola drink on mouse molars as early as 2 weeks. These findings highlight the challenge of monitoring dental erosion clinically and underscore the importance of early preventive and intervention measures.

Evaluation of nanohardness, elastic modulus, and surface roughness of fluoride-releasing tooth colored restorative materials.

Recently, interest in tooth-colored fluoride-releasing dental materials has increased. Although physical and mechanical properties such as surface hardness, elastic modulus and surface roughness of the restorative materials have been investigated, the effect of different immersion media on these properties is still controversial. The aim of this study was to evaluate the nanohardness, elastic modulus and surface roughness of the fluoride release of tooth-colored restorative materials after immersion in acidic beverages. Prepared samples of three restorative materials (a highly viscous glass ionomer (EQUIA Forte; GC, Tokyo, Japan), a compomer (Dyract XP; Dentsply, Weybridge, UK), and a bioactive restorative material (Activa BioACTIVE; Pulpdent, MA, USA)) were randomly divided and immersed in distilled water, a cola and an orange juice for one week. The HYSITRON T1 950 TriboIndenter device (Hysitron, USA) with the Berkovich diamond indenter tip was used for all measurements. The nanohardness and elastic modulus of the samples were measured by applying a force of 6000 µN to five different points on the sample surface. Surface roughness measurements were evaluated on random samples by scanning five random 40 × 40 µm areas. The properties were measured at the initial and one week after immersion. The values of nanohardness, elastic modulus and surface roughness were tested for significant differences using a two-way analysis of variance (ANOVA) with repeated measures (p < 0.05). Tukey's honest significant difference (HSD) test was used for multiple comparisons. AB (Activa BioACTIVE) had the highest initial mean values for nanohardness. After post-immersion, the highest mean value for elastic modulus was the initial AB value. The lowest mean value for roughness of 100.36 nm was obtained for the initial DX (Dyract XP) measurement. Acidic beverages had a negative effect on the nanohardness, elastic modulus and surface roughness of the restorative materials.

Associations between soft drinks intake and primary dysmenorrhea among Chinese undergraduate female students.

Primary dysmenorrhea (PD) is a common global health concern. However, limited studies explored the association between soft drinks intake and PD among female undergraduates in China. To determine the association between soft drinks (carbonated soft drinks, etc.) as well coffee intake and the incidence/severity of PD among female undergraduates in China. We performed a cross-sectional study among 1809 female undergraduates in China from September 29, 2020 to October 22, 2020. The demographic information and menstrual information of the participants were collected by a self-administrated questionnaire. Chi-square test, ANOVA test, and logistic regression test were used to investigate the association between soft drinks intake and the incidence/severity of PD. We also conducted stratification analysis among different locations (rural or urban). The prevalence of PD was 47.1% (n = 852). There were 221 (25.9%) participants suffered from severe pain. In the participants with PD, the OR of carbonated soft drinks intake was 1.244 (95% CI 1.010-1.533). Among the participants with PD from rural areas, the OR of carbonated soft drinks intake was 1.402 (95% CI 1.045-1.881), compared with the non-carbonated soft drink group. In the participants with moderate and severe PD, the OR of coffee intake was 0.451 (95% CI 0.228-0.892), compared with the non-coffee-drinking group. There was a significant association between carbonated soft drinks intake frequency and the severity of PD (P < 0.05). Our study showed that carbonated soft drinks intake is a risk factor for PD, especially in participants from rural areas. Coffee intake is a protective factor for the severity of PD. Periodical awareness programs about adverse effects of excessive soft drink consumption should be introduced to reduce the prevalence and exacerbation of PD. Coffee intake might be helpful to relieve the severity of PD.

Can a Carbonated Lemon Drink Reduce Extracardiac Activity in Myocardial Perfusion Imaging?

Myocardial perfusion imaging (MPI) provides physiologic and functional information about the heart muscle and its blood flow. Extracardiac radioactivity can interfere with visualization of the inferior wall of the myocardium, leading to poor-quality images, difficulties in interpretation, and delays in routine practice. This study aimed to identify the efficiency of having the patient consume a carbonated lemon drink to minimize the extracardiac radioactivity of 99mTc-sestamibi in comparison to 99mTc-tetrofosmin during MPI. Methods: This was a retrospective study that recruited 158 patients with known or suspected coronary artery disease referred to undergo 99mTc-sestamibi or 99mTc-tetrofosmin rest/stress single-day MPI. The patients were divided into 2 groups of mixed sexes and different ages. The first group comprised 78 patients injected with 99mTc-sestamibi, and the second group comprised 80 patients injected with 99mTc-tetrofosmin. For both groups, the patients drank 30 mL of fresh lemon juice diluted with 150 mL of soda water, and then we gave the patients about 100 mL of straight soda water, before imaging for both the rest and the stress phases. Results: Generally, in both groups, the 99mTc-tetrofosmin produced a good-quality image in comparison with the 99mTc-sestamibi. The mean rank of the total score for 99mTc-tetrofosmin (62.75) was less than that for 99mTc-sestamibi (96.68), and this difference was highly statistically significant (P = 0.000). There were statistically significant differences in the ratios and mean ranks for both groups in favor of 99mTc-tetrofosmin in patients having coronary artery disease. Conclusion: The use of a carbonated lemon drink minimizes extracardiac activity from both 99mTc-labeled MPI radiopharmaceuticals. This finding was more statistically significant for 99mTc-tetrofosmin MPI, providing better image quality and earlier imaging in both the rest and the stress phases because of faster hepatobiliary clearance.

One-pot derivatization spectrofluorimetric method for detection of aspartame in sweetener commercial tablets and soft drinks: Greenness assessments of the methodology.

Aspartame is an artificial sweetener used in drinks and many foods. International Agency for Research on Cancer classified aspartame as possibly carcinogenic to humans (IARC Group 2B). In this study, a sensitive and selective spectrofluorimetric method was developed to detect aspartame. The method is based on switching on the fluorescence activity of aspartame upon its condensation with O-phthalaldehyde (Roth's reaction) in the presence of 2-mercaptoethanol. The reaction product was detected fluorometrically at λem of 438 nm after λex of 340 nm. All reaction conditions required to yield the optimal fluorescence intensity were observed and investigated. Furthermore, the approach was validated according to ICH guidelines. Upon plotting the concentrations of aspartame against their associated fluorescence intensity values, the relationship between the two variables was linear within the range of 0.5-3.0 µg/mL. Furthermore, the method was employed to analyze the quantity of aspartame in commercial packages and soft drinks with an acceptable level of recovery. In addition, the Green Solvents Selecting Tool, Complementary Green Analytical Procedure Index, and the Analytical Greenness Metric tool were used to evaluate the sustainability and the greenness of the developed methodology.

Exploring the sugar-sweetened beverage tax (SSBT) pass-through rate in the Irish hospitality sector.

BACKGROUND: The World Health Organization (WHO) supports the use of Sugar-Sweetened Beverage Taxes (SSBTs) as a fiscal lever to help reduce sugar consumption and tackle obesity. Obesity is associated with a range of adverse health outcomes. In response to increasing levels of obesity in Ireland, an SSBT was introduced in 2018. Previous research in Ireland has noted that the pass-through rate of the SSBT in retail (off-site consumption) settings was poor. However, to date, no research has examined the SSBT pass-through rate in hospitality (on-site consumption) venues in Ireland. METHODS: This research examines the SSBT pass-through rate on Coca-Cola versus diet versions of Coca-Cola in a convenience sample of 100 hospitality venues in two provincial Irish cities. RESULTS: Wilcoxon signed rank test analysis revealed that regular Coca-Cola was significantly more expensive compared to the price charged for diet versions of Coca-Cola. However, in 85.6% of cases the same price was charged for both full-sugar and sugar-free drinks. The mean pass-through rate of the SSBT was 33.8%. CONCLUSION: The effective functioning of the SSBT is premised on persistent price differences between soft drink prices based on sugar content. However, this is barely evident in the hospitality sector in Ireland. A number of recommendations are suggested, including both increasing the SSBT, and increasing it annually in line with inflation.

Exploring the impact of bubble type on sensory stimulation in drinks.

This study explores the impact of various types of carbonation on sensory stimulation in the mouth, salivary secretion and the neurotransmitter substance P (SP), as well as body responses such as heart rate (HR) and Galvanic Skin Response (GSR). Three types of carbonation (one made using a soda machine, another carbonated with a gasifier, and the last commercial sparkling water) were used to produce different bubbles resulting in distinct sensory characteristics assessed by a trained panel. The impact of carbonation was measured by recording changes in salivary flow rate, SP levels, salivary secretory immunoglobulin A (SIgA), HR, and GSR in fifteen healthy participants. The results showed that the bubble type only affected the sensory perception of carbonation. Regardless of bubble type, carbonation increased salivary flow rate and SP values, SigA and HR. These characteristics are being sought to improve treatments for dysphagia or dry mouth. Therefore, these findings highlight the potential therapeutic application of carbonation in these situations.

Prevalence and Predictors of Soft Drink Consumption among Adolescents in the Gulf Countries: Findings from National Surveys.

BACKGROUND AND OBJECTIVES: This study aimed to investigate the prevalence and predictors of soft drink consumption among adolescents in the Gulf Cooperation Council (GCC) countries using nationally representative data from the Global School-based Student Health Survey (GSHS). MATERIALS AND METHODS: Cross-sectional data were collected using a self-administered questionnaire in a school survey and included 22,116 adolescents aged 12-18 years from Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates. Data were collected and analyzed using complex survey methods. The GSHS was not available for Saudi Arabia. Soft drink consumption was the main outcome variable. Multivariable logistic regression was used to examine its associations with sociodemographic characteristics, dietary behaviors, parental factors, and health-related behaviors. RESULTS: The prevalence of soft drink consumption three or more times per day ranged from 10.6% to 26.8% across the countries, with the highest being in Qatar. Adjusted analyses showed that girls had lower odds of SD consumption compared to boys (OR = 0.66; 95% CI: 0.57-0.77). Food insecurity, a proxy for low socioeconomic status, was associated with twice the odds of frequent consumption (OR = 2.06; 95% CI: 1.75-2.43). Parental smoking and low physical activity levels were also associated with higher soft drink intake (OR = 1.46, 95% CI: 1.13-1.88 and OR = 1.18, 95% CI: 1.08-1.28, respectively), while obesity showed a weak positive association. CONCLUSIONS: Daily soft drink consumption was highly prevalent among adolescents in the GCC countries. Sociodemographic, behavioral, and health-related factors were significantly associated with frequent intake. These findings highlight the need for comprehensive, multi-sectoral interventions to reduce soft drink consumption in the region.

The color stability of artificial white spot lesions treated with resin infiltration after exposure to staining beverages.

BACKGROUND: To evaluate the effect of staining beverages on the color-changing of resin-infiltrated artificial white spot lesions (WSLs). METHODS: Thirty-five artificial WSLs were created by pH cycling on flat bovine teeth specimens. The WSLs were treated with resin infiltration and were divided into five groups based on staining beverages: artificial saliva, coffee, wine, green tea, and Coca-Cola. These specimens were subjected to a 28-day exposure to the respective beverages. Color stability was assessed using a spectrophotometer at different time points: baseline, after 7, 14, 21, and 28 days of exposure, and repolishing. The color difference (∆E) between each time point and the baseline was calculated. Statistical analysis was performed using two-way measures ANOVA with a significance level of p = 0.05. RESULTS: All resin-infiltrated specimens exposed to staining beverages for 7 days exhibited more significant color changes than those exposed to artificial saliva. The color change patterns varied based on the type of beverage. The color alterations intensified with extended immersion in the wine and Coca-Cola groups, while there were no significant differences in the color of specimens after 28 days of immersion in the coffee and green tea groups. However, after cleaning with pumice powder, all specimens showed significantly reduced color changes compared to those observed after 28 days of immersion, except those immersed in coffee. CONCLUSIONS: Exposure of resin-infiltrated bovine tooth specimens to staining beverages resulted in a significant color alteration as the immersion time increased. However, the staining effect could be minimized by cleaning with pumice powder, except for the coffee group. CLINICAL RELEVANCE: After resin infiltration treatment, patients should be advised to minimize the consumption of colored beverages to prevent staining that could impact esthetic appearance.

Impact of Carbonated Beverages on Color Stability and Home Bleaching Efficacy of BulkFill Composite Resins.

Purpose: The purpose of this study was to assess, in vitro, the color stability and bleaching response of three bulk-fill composite resins-Activa™, Tetric®-N-Ceram Bulk-Fill, and Filtek™ One Bulk-Fill???and one conventional composite resin, Filtek™ Z250, after immersion in commonly consumed carbonated beverages and subsequent home bleaching with 15 percent carbamide peroxide. Methods: Ninety-six samples (two- and four-mm thick) of the materials were immersed in malt drink, energy drink, cola, or distilled water for one day, one week, and two months. After two months, samples underwent home bleaching with 15 percent carbamide peroxide gel. Spectrophotometric analysis measured color and whiteness changes pre-immersion, post-immersion, and post-bleaching. Statistical significance was determined using factorial mixed analysis of variance (ANOVA), three-way ANOVA, and Bonferroni post hoc tests (P<0.05). Results: All tested composite resins exhibited unacceptable discoloration (color change greater than 3.3) after two months in carbonated beverages. Filtek™ One Bulk-Fill and Filtek™ Z250 displayed the most significant discoloration, particularly when immersed in the malt drink (P<0.05). In contrast, Activa™ samples reached unacceptable discoloration within just one week in malt and cola drinks. Home bleaching yielded limited whiteness recovery, with Activa™ presenting acceptable whiteness post-bleaching after staining with cola and energy drinks. Conclusions: This study highlights the aesthetic risks of prolonged carbonated beverage consumption and the limitations of the assessed home bleaching technique using 15 percent carbamide peroxide. Enhanced dental education on the dietary effects of some beverages on restorative materials is indicated by these findings.

Habitual intake of carbonated drinks is associated with subjective difficulty in swallowing in community-dwelling older adults: a survey-based cross-sectional study.

Carbonated drinks have been reported to increase muscle activity during swallowing compared with water. Older adults who habitually consume carbonated drinks may use their swallowing-related muscles to a greater extent, thereby preserving their swallowing function. This study investigated the relationship between habitual carbonated drink intake, amount of carbonated drink consumed, and subjective difficulty in swallowing in community-dwelling older adults. We administered a questionnaire to determine subjective difficulty in swallowing, nutritional status, presence of sarcopenia, and habitual intake of carbonated drinks. Statistical analysis of the subjective difficulty in swallowing was performed using logistic regression analysis with the presence or absence of suspected dysphagia, using the Eating Assessment Tool-10 as the dependent variable. The results showed that older age (odds ratio [OR]: 1.077; p = 0.011), nutritional status (OR: 0.807; p = 0.040), systemic sarcopenia (OR: 1.753, p < 0.001), and habitual intake of carbonated drinks (OR: 0.455; p = 0.039) were associated with subjective difficulty in swallowing. In conclusion, the daily habits of community-dwelling older adults impact their swallowing function.

Dietary habits as associated factors with irritable bowel syndrome among medical students: evidence from a cross-sectional study.

BACKGROUND: Research on Irritable Bowel Syndrome (IBS) among medical students has increased globally, highlighting a high prevalence in this demographic. However, there is a lack of data specifically regarding the prevalence of IBS among medical students in Yemen. This study aimed to investigate the prevalence and associated factors of IBS among Yemeni medical students. METHODS: We conducted a cross-sectional study involving medical students who completed a validated self-administered questionnaire incorporating socio-demographic information, dietary habits, smoking status, sleep patterns, and the Rome IV criteria for IBS. We used bivariate and multivariate logistic regression models to identify IBS's associated factors, estimated as odds ratios (ORs) with 95% confidence intervals (CIs) and average marginal effect (AME) on the predicted probability of IBS. RESULTS: The study included 351 medical students with a mean age of 22.53 ± 2.70 years; 39.60% (139) were females. The prevalence of IBS was 26.21% (92 students), with 67.39% (62) of them classified as IBS-M (mixed). In multivariable analysis, the consumption of carbonated soft drinks remained significantly associated with IBS (OR: 3.35; 95% CI: 1.14-9.88; P = 0.028). In males, coffee consumption had a substantial effect on the predicted probability of IBS (AME: 11.41%; 95% CI: 0.32-22.60). In females, the consumption of carbonated soft drinks had a significant effect on the predicted probability of IBS (AME: 24.91%; 95% CI: 8.34-41.48). CONCLUSION: The consumption of carbonated soft drinks is significantly associated with IBS among medical students, with a particularly notable increase in the predicted probability of IBS in females. These findings highlight the necessity for gender-specific dietary recommendations in IBS management. Further research is essential to investigate IBS in the general population to gain a comprehensive understanding of its prevalence and associated factors.

Estimated changes in free sugar consumption one year after the UK soft drinks industry levy came into force: controlled interrupted time series analysis of the National Diet and Nutrition Survey (2011-2019).

BACKGROUND: The UK soft drinks industry levy (SDIL) was announced in March 2016 and implemented in April 2018, encouraging manufacturers to reduce the sugar content of soft drinks. This is the first study to investigate changes in individual-level consumption of free sugars in relation to the SDIL. METHODS: We used controlled interrupted time series (2011-2019) to explore changes in the consumption of free sugars in the whole diet and from soft drinks alone 11 months after SDIL implementation in a nationally representative sample of adults (>18 years; n=7999) and children (1.5-19 years; n=7656) drawn from the UK National Diet and Nutrition Survey. Estimates were based on differences between observed data and a counterfactual scenario of no SDIL announcement/implementation. Models included protein consumption (control) and accounted for autocorrelation. RESULTS: Accounting for trends prior to the SDIL announcement, there were absolute reductions in the daily consumption of free sugars from the whole diet in children and adults of 4.8 g (95% CI 0.6 to 9.1) and 10.9 g (95% CI 7.8 to 13.9), respectively. Comparable reductions in free sugar consumption from drinks alone were 3.0 g (95% CI 0.1 to 5.8) and 5.2 g (95% CI 4.2 to 6.1). The percentage of total dietary energy from free sugars declined over the study period but was not significantly different from the counterfactual. CONCLUSION: The SDIL led to significant reductions in dietary free sugar consumption in children and adults. Energy from free sugar as a percentage of total energy did not change relative to the counterfactual, which could be due to simultaneous reductions in total energy intake associated with reductions in dietary free sugar.

Intake of Artificial Sweeteners through Soft Drinks in the Preschool- and School-Aged Population.

One of the main public health issues that has recently been observed in a greater number of children is being overweight. The cause certainly lies in the decreasing physical activity of children, but mostly in their eating habits. Soft drinks are recognized as the most significant contributor to body overweight due to high sugar content; thus, as a result of numerous campaigns, part of the sugar is replaced by artificial sweeteners (ASs). Despite their advantage due to their low caloric value, WHO recommends that they should not be used to achieve weight control or as prevention for reducing the risk of non-communicable diseases, as there is no evidence of their effectiveness. Apart from beverages, artificial sweetener combinations are also added to a variety of "low fat" and "high protein" food products, which are highly favored especially among the young population. Therefore, it is necessary to take care of the cumulative intake. The conducted study included a survey of 323 parents of children aged 1-14 years, as well as an analysis of the AS content in the products most often consumed by the respondents. The results of the survey show that a large part of children (40%) aged 3-14 often consume soft drinks. Different products (soft drinks, juices/nectars, syrups) were sampled based on the respondents' responses, and an analysis showed that 54% of them contained one or more ASs. In addition, the survey indicated parents' lack of information about the presence of AS in products, as 51% of parents declared that they do not read the declarations of the products they buy. It is necessary to persist in consumer education and changes in dietary preferences and habits, especially among children.

"Don't think of a soda": Contradictory public health messaging from a content analysis of Twitter posts about sugar-sweetened beverage taxes in California from 2015 to 2018.

To show how sugar-sweetened beverage (SSB) taxes were framed in posts on Twitter (now known as X) through text and images, we conducted a content analysis on a sample of Tweets from California users posted between January 1, 2015 and December 31, 2018 about SSB taxes in Berkeley, San Francisco, Oakland, and/or Albany, California. We evaluated posts for information sources, arguments for or against SSB tax policies, and images used. We found that posts presented a mix of messages through text and images. The majority of posts (64%) included arguments supporting SSB taxes, 28% presented a neutral position (e.g., factual information) or a mix of both pro-and anti-tax arguments, and 8% opposed. One-third of posts included an image, almost half of which appeared to be stock photos from SSB advertisements: many of these were shared by medical and public health users. Some tax supporters also reposted messages and images from opposition campaigns and added their own criticisms. By reposting opponents' anti-tax messages and images of SSBs, tax supporters may have inadvertently promoted SSBs, reinforced opposition to SSB taxes, and normalized SSBs. While advocates effectively shared pro-tax arguments, they should also ensure that accompanying images reflect the solutions they seek, not just the problem they are trying to combat.