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1.
Public Health Nutr ; : 1-22, 2021 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-34955119

RESUMO

OBJECTIVE: Most research investigating sugar-sweetened beverages (SSBs) and health, conducted at the individual or household level, ignores potentially important intra-household dynamics. We analysed self-reported consumption relationships between children and adults, and between children of different ages, as well as the associations between intra-household consumption, body mass index and socio-demographic characteristics. DESIGN: A cross-sectional analysis of survey data from Kantar Fast Moving Consumer Goods panellists in September 2017. SETTING: Great Britain. PARTICIPANTS: Random sample of 603 households with children under 18 who regularly purchase non-alcoholic beverages. RESULTS: Low or no-sugar/diet beverages dominate consumption across all age categories, particularly children under 12 years. SSB consumption increased as children became older. Children's reported consumption of SSBs and low or no-sugar/diet beverages was positively associated with consumption by adults; a child in adolescence had over nine times the odds of consuming SSBs (adjusted OR 9.55, 95% CI 5.38, 17.00, p<0.001), and eight times the odds of consuming low or no-sugar/diet drinks (adjusted OR 8.12, 95% CI 4.71, 13.97, p<0.001), if adults did so. In households with multiple children, consumption patterns of older siblings were associated with those of the younger; notably a perfect correlation between children 0-6 years consuming SSBs if siblings 13-18 years did so, and children 7-12 years had 22 times the odds of consuming SSBs if siblings 13-18 years did so (OR 22.33, 95% CI 8.60, 58.01, p<0.001). CONCLUSIONS: Multiple policies, targeting children as well as adults, such as fiscal levers and advertisement restrictions, are needed to reduce and prevent consumption of SSBs.

2.
Soc Sci Med ; : 114548, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34776289

RESUMO

INTRODUCTION: One in five UK children aged 10-11 years live with obesity. They are more likely to continue living with obesity into adulthood and to develop obesity-related chronic health conditions at a younger age. Regulating the marketing of high fat, salt and sugar (HFSS) foods and beverages has been highlighted as a promising approach to obesity prevention. In 2019, Transport for London implemented restrictions on the advertisement of HFSS products across its network. This paper reports on a process evaluation of the design and implementation of this intervention. METHODS: In 2019-2020, we conducted semi-structured interviews with 23 stakeholders. Interviews with those responsible for implementation (n = 13) explored stakeholder roles, barriers and facilitators to policy development/implementation and unintended consequences. Interviews with food industry stakeholders (n = 10) explored perceptions and acceptability of the policy, changes to business practice and impact on business. Data were analysed using a general inductive approach. RESULTS: Practical challenges included limited time between policy announcement and implementation, translating the concept of 'junk food' into operational policy, the legal landscape, and reported uneven impacts across industry stakeholders. Political challenges included designing a policy the public views as appropriate, balancing health and financial impacts, and the perceived influence of political motivations. Consultation during policy development and close communication with industry reportedly facilitated implementation, as did the development of an exceptions process that provided a review pathway for HFSS products that might not contribute to children's HFSS consumption. CONCLUSIONS: Findings suggest that restricting the outdoor advertisement of HFSS foods and beverages at scale is feasible within a complex policy and business landscape. We outline practical steps that may further facilitate the development and implementation of similar policies and we report on the importance of ensuring such policies are applied in a way that is perceived as reasonable by industry and the public.

3.
SSM Popul Health ; 16: 100953, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34815996

RESUMO

Public health advocates highlight the role of corporate actors and food marketing in shaping diets and health. This study analyses insider-oriented communications in food industry magazines in the UK to analyse actions and narratives related to health and nutrition, providing insights into relatively overlooked areas of marketing strategy including inter-firm dynamics. From a sample of four specialized food industry magazines covering the main industry segments we identified 319 articles (published 2007-2018) mentioning health or nutrition together with industry actions affecting the food environment. We identified health-related actions and analysed underlying strategies through content and thematic analyses. Health and nutrition have a rapidly growing role in food marketing strategy. Content analysis revealed a focus on ultra-processed foods, as well as product and nutrient-specific trends including increased health-based marketing of snacks and "protein rich" products. Health-related actions predominantly relied on consumer agency rather than invoking structural food environment changes. Thematic analysis identified proactive and defensive marketing strategies. Proactive approaches included large investments in health-related promotion of ultra-processed foods which are made highly visible to competitors, and the reliance on a "credence goods" differentiation strategies. Defensive strategies included a 'Red Queen' effect, whereby firms take health-related actions to keep up with competitors. These competitive strategies can create challenges, as well as some opportunities, for public health promotion. Challenges can include undermining efforts to support product comparison and healthier choice, and limiting firms' engagement in specific health improving actions. Systematic analysis of health-oriented marketing strategies could support more effective public health intervention.

4.
Front Vet Sci ; 8: 743857, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34805336

RESUMO

Integrated surveillance systems for antimicrobial use (AMU) and antimicrobial resistance (AMR) require regular evaluation to ensure the effectiveness and efficiency of the system. An important step in the evaluation is to choose an appropriate tool for the purpose of the evaluation. The "Integrated Surveillance System Evaluation" (ISSE) framework is a conceptual framework that was developed to evaluate One Health (OH) integration in surveillance system for AMU/AMR. This study aimed to evaluate the performance and value of integrated surveillance system for AMU/AMR in England by applying the ISSE framework, which was used to develop data collection protocols and define the study design. A qualitative study using semi-structured interviews was conducted to collect the data and analyse it thematically. Eighteen stakeholders from human, animal, food and environment sectors that are involved in AMU/AMR surveillance were interviewed. Four main themes emerged from the analysis: (1) Cross-sectoral integration in the surveillance system for AMU/AMR; (2) Production of OH outputs and outcomes; (3) Drivers and barriers to cross-sectoral collaboration; and 4) Need for more cross-sectoral collaboration. The findings showed that there were links between integrated surveillance information, decision making and interventions. However, there were only few OH examples, such as the UK AMR contingency plan, where the potential of cross-sectoral collaboration was fully exploited. A lot of the benefits described were related to the generation of information and increase in knowledge and understanding without links to how the information generated was used. While these intangible benefits have a value on their own, being able to link surveillance information and mitigation measures would help to enhance the value of integrated surveillance. In terms of improvement, the main areas identified were the development of more harmonised methods for data collection and analysis, provision of resources dedicated to cross-sectoral collaboration, improved coordination, and collection of surveillance data from the environment and from companion animals. By identifying links between OH surveillance information produced and various outputs and outcomes; this study helped to understand the wider benefits of integrated surveillance for AMU/AMR in England and provided insights on how the system could be improved and efficiency increased.

5.
SSM Popul Health ; 15: 100828, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34141852

RESUMO

Background: Advertising of less healthy foods and drinks is hypothesised to be associated with obesity in adults and children. In February 2019, Transport for London implemented restrictions on advertisements for foods and beverages high in fat, salt or sugar across its network as part of a city-wide strategy to tackle childhood obesity. The policy was extensively debated in the press. This paper identifies arguments for and against the restrictions. Focusing on arguments against the restrictions, it then goes on to deconstruct the discursive strategies underpinning them. Methods: A qualitative thematic content analysis of media coverage of the restrictions (the 'ban') in UK newspapers and trade press was followed by a document analysis of arguments against the ban. A search period of March 1, 2018 to May 31, 2019 covered: (i) the launch of the public consultation on the ban in May 2018; (ii) the announcement of the ban in November 2018; and (iii) its implementation in February 2019. A systematic search of printed and online publications in English distributed in the UK or published on UK-specific websites identified 152 articles. Results: Arguments in favour of the ban focused on inequalities and childhood obesity. Arguments against the ban centred on two claims: that childhood obesity was not the 'right' priority; and that an advertising ban was not an effective way to address childhood obesity. These claims were justified via three discursive approaches: (i) claiming more 'important' priorities for action; (ii) disputing the science behind the ban; (iii) emphasising potential financial costs of the ban. Conclusion: The discursive tactics used in media sources to argue against the ban draw on frames widely used by unhealthy commodities industries in response to structural public health interventions. Our analyses highlight the need for interventions to be framed in ways that can pre-emptively counter common criticisms.

6.
SSM Popul Health ; 14: 100794, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33997244

RESUMO

Objectives: Taxes on sugar-sweetened beverages (SSB) are increasingly being implemented as public health interventions to limit the consumption of sugar and reduce associated health risks. In July 2017, India imposed a new tax rate on aerated (carbonated) drinks as part of the Goods and Services Tax (GST) reform. This study investigates the post-GST changes in the purchase of aerated drinks in urban India. Methods: An interrupted time series analysis was conducted on state-level monthly take-home purchases of aerated drinks in urban India from January 2013 to June 2018. We assessed changes in the year-on-year growth rate (i.e. percentage change) in aerated drink purchases with controls for contextual variables. Results: We found no evidence of a reduction in state-level monthly take-home aerated drink purchases in urban India following the implementation of GST. Further analysis showed that the year-on-year growth rate in aerated drink purchases increased slightly (0.1 percentage point per month, 95%CI = 0.018, 0.181) after the implementation of GST; however, this trend was temporary and decreased over time (0.008 percentage point per month, 95%CI = -0.015, -0.001). Conclusions: In India, a country currently with low aerated drink consumption, the implementation of GST was not associated with a reduction in aerated drink purchase in urban settings. Due to the lack of accurate and sufficiently detailed price data, it is not possible to say whether this finding is driven by prices not changing sufficiently. Furthermore, the impact of GST reform on industry practice (reformulation, marketing) and individual behaviour choices (substitution) is unknown and warrants further investigation to understand how such taxes could be implemented to deliver public health benefits.

7.
BMJ Open ; 11(4): e048139, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-33827849

RESUMO

OBJECTIVES: To explore sociodemographic differences in exposure to advertising for foods and drinks high in fat, salt and sugar (HFSS) and whether exposure is associated with body mass index (BMI). DESIGN: Cross-sectional survey. SETTING: UK. PARTICIPANTS: 1552 adults recruited to the Kantar Fast Moving Consumer Goods panel for London and the North of England. OUTCOME MEASURES: Self-reported advertising exposure stratified by product/service advertised (processed HFSS foods; sugary drinks; sugary cereals; sweet snacks; fast food or digital food delivery services) and advertising setting (traditional; digital; recreational; functional or transport); BMI and sociodemographic characteristics. RESULTS: Overall, 84.7% of participants reported exposure to HFSS advertising in the past 7 days. Participants in the middle (vs high) socioeconomic group had higher odds of overall self-reported exposure (OR 1.48; 95% CI 1.06 to 2.07). Participants in the low (vs high) socioeconomic group had higher odds of reporting exposure to advertising for three of five product categories (ORs ranging from 1.41 to 1.67), advertising for digital food delivery services (OR 1.47; 95% CI 1.05 to 2.05), traditional advertising (OR 1.44; 95% CI 1.00 to 2.08) and digital advertising (OR 1.50; 95% CI 1.06 to 2.14). Younger adults (18-34 years vs ≥65 years) had higher odds of reporting exposure to advertising for digital food delivery services (OR 2.08; 95% CI 1.20 to 3.59), digital advertising (OR 3.93; 95% CI 2.18 to 7.08) and advertising across transport networks (OR 1.96; 95% CI 1.11 to 3.48). Exposure to advertising for digital food delivery services (OR 1.40; 95% CI 1.05 to 1.88), digital advertising (OR 1.80; 95% CI 1.33 to 2.44) and advertising in recreational environments (OR 1.46; 95% CI 1.02 to 2.09) was associated with increased odds of obesity. CONCLUSIONS: Exposure to less healthy product advertising was prevalent, with adults in lower socioeconomic groups and younger adults more likely to report exposure. Broader restrictions may be needed to reduce sociodemographic differences in exposure to less healthy product advertising.


Assuntos
Publicidade , Televisão , Adulto , Estudos Transversais , Inglaterra , Alimentos , Humanos , Londres , Autorrelato , Açúcares , Reino Unido/epidemiologia
8.
Vet Rec ; 188(7): e10, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33835538

RESUMO

BACKGROUND: Surveillance of antimicrobial resistance (AMR) is an essential component of any strategy to mitigate AMR and needs regular evaluation to ensure its effectiveness. A first step for any evaluation is to describe the system and context. In this study, we aimed to characterise and map the surveillance system for AMR and antimicrobial use (AMU) in the United Kingdom (UK) using a One Health (OH) approach and to identify integration points in the system. METHODS: To describe the surveillance system for AMR/AMU, international guidelines for establishing surveillance systems for AMR and AMU were used. A review of the literature was conducted to collect information on the different parameters identified. RESULTS: Multiple data collection systems exist for AMU and AMR in humans, animals and food. Each sector is responsible for the planning, implementation, analysis and reporting of its own surveillance for AMR and AMU. Some cross-sectoral collaborative activities exist such as the UK AMR contingency plan and the publication of UK OH reports; there are opportunities for further integration such as the harmonisation of data analyses methods and interpretation across sectors and the publication of joint surveillance reports. CONCLUSION: This overview of key stakeholders, data collection streams, reporting, linkages within and across sectors and international monitoring forms an important basis for future evaluation of the UK AMR/AMU surveillance system from a OH perspective.


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Animais , Humanos , Saúde Única , Reino Unido
9.
Public Health Nutr ; 24(7): 1583-1594, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33317656

RESUMO

OBJECTIVE: To examine socio-economic inequalities in decreases in household sugar purchasing in Great Britain (GB). DESIGN: Longitudinal, population-based study. SETTING: Data were obtained from the GB Kantar Fast-Moving Consumer Goods (FMCG) panel (2014-2017), a nationally representative panel study of food and beverages bought and brought into the home. We estimated changes in daily sugar purchases by occupational social grade from twenty-three food groups, using generalised estimating equations (household-level clustering). PARTICIPANTS: British households who regularly reported food and beverages to the GB Kantar FMCG (n 28 033). RESULTS: We found that lower social grades obtained a lower proportion of sugar from healthier foods and a greater proportion of sugar from less healthy foods and beverages. In 2014, differences in daily sugar purchased between the lowest and the highest social grades were 3·9 g/capita/d (95 % CI 2·9, 4·8) for table sugar, 2·4 g (95 % CI 1·8, 3·1) for sugar-sweetened beverages, 2·2 g (95 % CI 1·5, 2·8) for chocolate and confectionery and 1·0 g (95 % CI 0·7, 1·3) for biscuits. Conversely, the lowest social grade purchased less sugar from fruits (2·1 g (95 % CI 1·5, 2·8)) and vegetables (0·7 g (95 % CI 0·5, 0·8)) than the highest social grade. We found little evidence of change in social grade differences between 2014 and 2017. These results suggest that recent overall declines in sugar purchases are largely equally distributed across socio-economic groups. CONCLUSIONS: This suggests that recent population-level policy activity to reduce sugar consumption in GB does not appear to exacerbate or reduce existing socio-economic inequalities in sugar purchasing. Low agency, population-level policies may be the best solution to improving population diet without increasing inequalities.


Assuntos
Bebidas Adoçadas com Açúcar , Açúcares , Bebidas , Comportamento do Consumidor , Características da Família , Humanos
10.
PLoS Med ; 17(9): e1003245, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32898152

RESUMO

BACKGROUND: Beverages, especially sugar-sweetened beverages (SSBs), have been increasingly subject to policies aimed at reducing their consumption as part of measures to tackle obesity. However, precision targeting of policies is difficult as information on what types of consumers they might affect, and to what degree, is missing. We fill this gap by creating a typology of beverage consumers in Great Britain (GB) based on observed beverage purchasing behaviour to determine what distinct types of beverage consumers exist, and what their socio-demographic (household) characteristics, dietary behaviours, and weight status are. METHODS AND FINDINGS: We used cross-sectional latent class analysis to characterise patterns of beverage purchases. We used data from the 2016 GB Kantar Fast-Moving Consumer Goods (FMCG) panel, a large representative household purchase panel of food and beverages brought home, and restricted our analyses to consumers who purchase beverages regularly (i.e., >52 l per household member annually) (n = 8,675). Six categories of beverages were used to classify households into latent classes: SSBs; diet beverages; fruit juices and milk-based beverages; beer and cider; wine; and bottled water. Multinomial logistic regression and linear regression were used to relate class membership to household characteristics, self-reported weight status, and other dietary behaviours, derived from GB Kantar FMCG. Seven latent classes were identified, characterised primarily by higher purchases of 1 or 2 categories of beverages: 'SSB' (18% of the sample; median SSB volume = 49.4 l/household member/year; median diet beverage volume = 38.0 l), 'Diet' (16%; median diet beverage volume = 94.4 l), 'Fruit & Milk' (6%; median fruit juice/milk-based beverage volume = 30.0 l), 'Beer & Cider' (7%; median beer and cider volume = 36.3 l; median diet beverage volume = 55.6 l), 'Wine' (18%; median wine volume = 25.5 l; median diet beverage volume = 34.3 l), 'Water' (4%; median water volume = 46.9 l), and 'Diverse' (30%; diversity of purchases, including median SSB volume = 22.4 l). Income was positively associated with being classified in the Diverse class, whereas low social grade was more likely for households in the classes SSB, Diet, and Beer & Cider. Obesity (BMI > 30 kg/m2) was more prevalent in the class Diet (41.2%, 95% CI 37.7%-44.7%) despite households obtaining little energy from beverages in that class (17.9 kcal/household member/day, 95% CI 16.2-19.7). Overweight/obesity (BMI > 25 kg/m2) was above average in the class SSB (66.8%, 95% CI 63.7%-69.9%). When looking at all groceries, households from the class SSB had higher total energy purchases (1,943.6 kcal/household member/day, 95% CI 1,901.7-1,985.6), a smaller proportion of energy from fruits and vegetables (6.0%, 95% CI 5.8%-6.3%), and a greater proportion of energy from less healthy food and beverages (54.6%, 95% CI 54.0%-55.1%) than other classes. A greater proportion of energy from sweet snacks was observed for households in the classes SSB (18.5%, 95% CI 18.1%-19.0%) and Diet (18.8%, 95% CI 18.3%-19.3%). The main limitation of our analyses, in common with other studies, is that our data do not include information on food and beverage purchases that are consumed outside the home. CONCLUSIONS: Amongst households that regularly purchase beverages, those that mainly purchased high volumes of SSBs or diet beverages were at greater risk of obesity and tended to purchase less healthy foods, including a high proportion of energy from sweet snacks. These households might additionally benefit from policies targeting unhealthy foods, such as sweet snacks, as a way of reducing excess energy intake.


Assuntos
Bebidas/economia , Comércio/tendências , Comportamento do Consumidor/economia , Adulto , Animais , Bebidas Adoçadas Artificialmente , Cerveja , Peso Corporal , Comportamento do Consumidor/estatística & dados numéricos , Estudos Transversais , Água Potável , Características da Família , Feminino , Sucos de Frutas e Vegetais , Humanos , Renda , Análise de Classes Latentes , Masculino , Leite , Inquéritos Nutricionais , Obesidade/psicologia , Reino Unido , Vinho
11.
Health Econ ; 29(10): 1132-1147, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32638420

RESUMO

Taxes on sugar-sweetened beverages (SSBs) are in place in many countries to combat obesity with emerging evidence that these are effective in reducing purchases of SSBs. In this study, we tested whether signalling and framing the price increase from an SSB tax explicitly as a health-related, earmarked measure reduces the demand for SSBs more than an equivalent price increase. We measured the demand for non-alcoholic beverages with a discrete choice experiment (DCE) administered online to a randomly selected group of n = 603 households with children in Great Britain (GB) who regularly purchase SSBs. We find a suggestive evidence that a price increase leads to a larger reduction in the probability of choosing SSBs when it is signalled as a tax and framed as a health-related and earmarked policy. Respondents who did not support a tax on SSBs, who were also more likely to choose SSBs in the first place, were on average more responsive to a price increase framed as an earmarked tax than those who supported the tax. The predictive validity of the DCE, to capture preferences for beverages, was confirmed using actual purchase data. The findings imply that a well-signalled and earmarked tax on SSBs could improve its effectiveness at reducing the demand.


Assuntos
Comércio , Comportamento do Consumidor , Impostos , Bebidas , Criança , Humanos , Reino Unido
12.
Public Health Nutr ; 23(12): 2228-2233, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32366342

RESUMO

OBJECTIVE: Increasing prevalence of overweight and obese people in England has led policymakers to consider regulating the use of price promotions on foods high in fat, sugar and salt content. In January 2019, the government opened a consultation programme for a policy proposal that significantly restricts the use of price promotions that can induce consumers to buy higher volumes of unhealthy foods and beverages. These proposed policies are the first of their kind in public health and are believed to reduce excess purchasing and, therefore, overconsumption of unhealthy products. This study summarises evidence relating price promotions to the purchasing of food and drink for home consumption and places it in the context of the proposed policy. DESIGN: Non-systematic review of quantitative analyses of price promotions in food and drink published in peer-reviewed journals and sighted by PubMed, ScienceDirect & EBSCOhost between 1980 and January 2018. RESULTS: While the impact of price promotions on sales has been of interest to marketing academics for a long time with modelling studies showing that its use has increased food and drink sales by 12-43 %, it is only now being picked up in the public health sphere. However, existing evidence does not consider the effects of removing or restricting the use of price promotions across the food sector. In this commentary, we discuss existing evidence, how it deals with the complexity of shoppers' behaviour in reacting to price promotions on foods and, importantly, what can be learned from it in this policy context. CONCLUSIONS: The current evidence base supports the notion that price promotions increase purchasing of unhealthy food, and while the proposed restriction policy is yet to be evaluated for consumption and health effects, there is arguably sufficient evidence to proceed. This evidence is not restricted to volume-based promotions. Close monitoring and proper evaluation should follow to provide empirical evidence of its intended and unintended effects.


Assuntos
Bebidas , Comércio , Alimentos , Marketing , Bebidas/economia , Inglaterra , Alimentos/economia , Humanos , Marketing/economia
13.
Econ Hum Biol ; 37: 100866, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32224445

RESUMO

In March 2016, the UK government announced the Soft Drinks Industry Levy (SDIL) which came into effect in April 2018. In common with the reaction to sugar-sweetened beverage (SSB) taxes in other countries, the SDIL announcement was met with strong industry opposition, with claims that it would harm their profits. The SDIL was designed to incentivise reformulation of SSBs by providing a 2-year delay between the announcement and the enforcement of the levy, and adopting a two-tiered rate based on the sugar content of the drinks. Using interrupted time series analysis, this paper examines how the domestic turnover of UK soft drinks manufacturers changed after the announcement and the implementation of the SDIL. Our results show some evidence of a short-term negative impact of the SDIL announcement on the domestic turnover of the UK soft drinks manufacturers. This effect, however, did not continue post-implementation. These findings suggest that manufacturers were, to a large extent, able to mitigate the effects of levy before it came into effect.


Assuntos
Bebidas Gaseificadas/economia , Bebidas Gaseificadas/estatística & dados numéricos , Indústria Alimentícia/estatística & dados numéricos , Impostos/estatística & dados numéricos , Humanos , Análise de Séries Temporais Interrompida , Reino Unido
14.
Econ Hum Biol ; 38: 100834, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32081676

RESUMO

On 16th March 2016, the government of the United Kingdom announced the Soft Drinks Industry Levy (SDIL), under which UK soft-drink manufacturers were to be taxed according to the volume of products with added sugar they produced or imported. We use 'event study' methodology to assess the likely financial effect of the SDIL on parts of the soft drinks industry, using stock returns of four UK-operating soft-drink firms listed on the London Stock Exchange. We found that three of the four firms experienced negative abnormal stock returns on the day of announcement. A cross-sectional analysis revealed that the cumulative abnormal returns of soft drink stocks were not significantly less than that of other food and drinks-related stocks beyond the day of the SDIL announcement. Our findings suggest that the SDIL announcement was initially perceived as detrimental news by the market but negative stock returns were short-lived, indicating a lack of major concerns for industry. There was limited evidence of a negative stock market reaction to the two subsequent announcements: release of draft legislation on 5th December 2016, and confirmation of the tax rates on 8th March 2017.


Assuntos
Indústria Alimentícia/economia , Bebidas Adoçadas com Açúcar/economia , Impostos/legislação & jurisprudência , Comércio/legislação & jurisprudência , Estudos Transversais , Indústria Alimentícia/legislação & jurisprudência , Regulamentação Governamental , Humanos , Política Nutricional , Bebidas Adoçadas com Açúcar/efeitos adversos , Impostos/economia , Reino Unido
15.
J Health Serv Res Policy ; 25(3): 181-186, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31992082

RESUMO

Crowdfunding for medical care is a new phenomenon but increasingly used by individuals to seek financial help to cover the costs of health care. Ethical concerns have been raised about medical crowdfunding, including implications for equity, resource allocation, medical decision-making, the promotion of non-evidence based therapies, platforms' lack of transparency and corporate interests. Medical crowdfunding efforts may point to shortcomings in health service provision, but they tend to have wider motivations and implications. However, there is no firm evidence base for establishing answers to even the most basic questions, such as who is seeking funds, for what, where and why. In this Essay, we provide an introduction to medical crowdfunding in the United Kingdom (UK). We synthesize what is currently known and the insights that might be gained from an exploratory review of 400 medical crowdfunding campaigns on the GoFundMe UK website: for instance, whether medical crowdfunding occurs in response to gaps in service provision, supports 'queue jumping' and how it relates to 'medical tourism'. We conclude with a call for research on medical crowdfunding in the UK (and elsewhere) as a means to better understand patients' perceived or actual unmet need for health and social care and inform policy development.


Assuntos
Atenção à Saúde/economia , Financiamento Pessoal/economia , Doações , Seguridade Social/economia , Medicina Estatal/organização & administração , Tomada de Decisão Clínica , Alocação de Recursos para a Atenção à Saúde , Humanos , Mídias Sociais , Medicina Estatal/economia , Reino Unido
16.
Glob Food Sec ; 23: 191-204, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31799110

RESUMO

•Unique dataset allows analysis of urban Indian shopping habits of processed foods.•Beyond staples, purchases of processed foods and beverages for home use are low.•Fastest rate of growth seen in sweet and salty snacks, and edible oil purchases.•Highest volume of processed foods and beverages purchased by Delhi population.•Large variations across states in level and trends of purchases over time.

17.
J Allergy Clin Immunol ; 144(6): 1615-1623, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31812185

RESUMO

BACKGROUND: The early introduction group participants of the Enquiring About Tolerance study were asked to undertake a proscriptive regimen of early introduction and sustained consumption of 6 allergenic foods. It was envisaged that this might be challenging, and early introduction group families were presented with an open-text question to express any problems they were experiencing with the regimen in recurring online questionnaires. OBJECTIVE: We sought to analyze these open-text questionnaire responses with the aim of identifying challenges associated with the introduction and regular consumption of allergenic foods. METHODS: Three combinations of interim questionnaire responses were selected for analysis, representing the early period (4, 5, and 6 months), middle period (8 and 12 months), and late period (24 and 36 months) of participation in the Enquiring About Tolerance study. Responses were assigned a code to describe their content and subsequently grouped into themes to portray key messages. A thematic content analysis allowed for conversion of qualitative codes into quantitative summaries. RESULTS: Three main challenges to allergenic food consumption were identified. First, some children refused the allergenic food, causing a sense of defeat among caregivers. Second, caregivers were concerned that allergenic foods might be causing a reaction, triggering a need for reassurance. Third, practical problems associated with the regimen compromised caregivers' capacity to persist. CONCLUSION: Understanding the challenges experienced with allergenic food introduction and sustained consumption is the necessary precursor to developing specific communication and support strategies that could be used by caregivers, practitioners, policymakers, and key stakeholders to address these problems.


Assuntos
Dessensibilização Imunológica , Hipersensibilidade Alimentar/prevenção & controle , Alimentos Infantis , Inquéritos e Questionários , Adulto , Feminino , Seguimentos , Hipersensibilidade Alimentar/imunologia , Humanos , Lactente , Masculino
18.
Glob Chall ; 3(4): 1700104, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31565369

RESUMO

The multiple burdens of persistent undernutrition and micronutrient deficiencies, along with the rapidly growing rates of overweight, obesity, and associated chronic diseases, are major challenges globally. The role of agriculture and the food system in meeting these challenges is very poorly understood. Achieving food security and addressing malnutrition in all its forms, a Sustainable Development Goal, requires an understanding of how changing food systems affect health outcomes and the development of new tools to design and evaluate interventions. An interinstitutional programme to address this interdisciplinary research challenge is described. Over the past seven years, the Leverhulme Centre for Integrative Research on Agriculture and Health has built a portfolio of successful and innovative research, trained a new cadre of interdisciplinary researchers in "Agri-Health," and built an international research community with a particular focus on strengthening research capacity in low- and middle-income countries. The evolution of this programme is described, and key factors contributing to its success are discussed that may be of general value in designing interdisciplinary research programmes directed at supporting global development goals.

19.
BMJ ; 366: l4786, 2019 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-31484641

RESUMO

OBJECTIVE: To estimate the potential impact on body mass index (BMI) and prevalence of obesity of a 20% price increase in high sugar snacks. DESIGN: Modelling study. SETTING: General adult population of the United Kingdom. PARTICIPANTS: 36 324 households with data on product level household expenditure from UK Kantar FMCG (fast moving consumer goods) panel for January 2012 to December 2013. Data were used to estimate changes in energy (kcal, 1 kcal=4.18 kJ=0.00418 MJ) purchase associated with a 20% price increase in high sugar snacks. Data for 2544 adults from waves 5 to 8 of the National Diet and Nutrition Survey (2012-16) were used to estimate resulting changes in BMI and prevalence of obesity. MAIN OUTCOME MEASURES: The effect on per person take home energy purchases of a 20% price increase for three categories of high sugar snacks: confectionery (including chocolate), biscuits, and cakes. Health outcomes resulting from the price increase were measured as changes in weight, BMI (not overweight (BMI <25), overweight (BMI ≥25 and <30), and obese (BMI ≥30)), and prevalence of obesity. Results were stratified by household income and BMI. RESULTS: For income groups combined, the average reduction in energy consumption for a 20% price increase in high sugar snacks was estimated to be 8.9×103 kcal (95% confidence interval -13.1×103 to -4.2×103 kcal). Using a static weight loss model, BMI was estimated to decrease by 0.53 (95% confidence interval -1.01 to -0.06) on average across all categories and income groups. This change could reduce the UK prevalence of obesity by 2.7 percentage points (95% confidence interval -3.7 to -1.7 percentage points) after one year. The impact of a 20% price increase in high sugar snacks on energy purchase was largest in low income households classified as obese and smallest in high income households classified as not overweight. CONCLUSIONS: Increasing the price of high sugar snacks by 20% could reduce energy intake, BMI, and prevalence of obesity. This finding was in a UK context and was double that modelled for a similar price increase in sugar sweetened beverages.


Assuntos
Comércio , Obesidade/epidemiologia , Lanches , Açúcares/efeitos adversos , Impostos , Adolescente , Adulto , Índice de Massa Corporal , Ingestão de Energia , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Modelos Biológicos , Modelos Econômicos , Obesidade/etiologia , Obesidade/prevenção & controle , Prevalência , Reino Unido/epidemiologia , Adulto Jovem
20.
Soc Sci Med ; 235: 112361, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31262504

RESUMO

While most food is consumed at home, food eaten out-of-home plays an important role in diets and it has been associated with higher energy intake and higher body weight. Beyond prepared meals, there is limited understanding of what foods people buy out-of-home and where they buy them from. This study analyses out-of-home food purchases by food groups and food outlet types, and estimates socio-economic differences in these expenditure patterns. We used a nationally representative product-level dataset of expenditures (n=2,734,987) on foods and non-alcoholic beverages for out-of-home consumption for 9,704 respondents in Great Britain (June 2015-December 2017). Population weighted estimates of per capita weekly expenditures and shares of expenditure were derived for four outlet types and eight food groups. We used linear multi-level modelling to determine differences in expenditure patterns by socio-economic status (SES) characterised via occupational social grade. Out-of-home purchases make up 25-39% of total food and beverage expenditures. Mid- and high-SES respondents spent nearly twice as much (£17.76 and £15.11 weekly), compared to low-SES respondents (£9.69) for out-ofhome food consumption. A third of expenditures across SES (36-37%) were spent in venues other than restaurants or fast-food and takeaway outlets. Meals accounted for 60% of expenditures, but a third was spent on beverages (10-12% non-alcoholic cold beverages, 17-18% hot beverages) and 9-10% on snacks. Mid- and low-SES respondents had a greater share of expenditure in takeaway and fast-food outlets, supermarkets and convenience stores, and on cold non-alcoholic beverages. Overall, low-SES respondents spent less on out-of-home foods but the share of this expenditure across different foods or outlets varied less. While restaurants, fast-food and takeaway outlets were a major source of out-of-home purchases, a significant proportion was spent in other outlets. Policies targeting out-of-home consumption should therefore consider the full range of foods as well as the diversity of places where they are sold.


Assuntos
Gastos em Saúde/normas , Restaurantes/estatística & dados numéricos , Fatores Socioeconômicos , Bebidas Adoçadas com Açúcar/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Gastos em Saúde/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Características de Residência/classificação , Características de Residência/estatística & dados numéricos , Restaurantes/classificação , Reino Unido
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