Role of sugars in the apical hook development of Arabidopsis etiolated seedlings.

KEY MESSAGE: The sugar supply in the medium affects the apical hook development of Arabidopsis etiolated seedlings. In addition, we provided the mechanism insights of this process. Dicotyledonous plants form an apical hook structure to shield their young cotyledons from mechanical damage as they emerge from the rough soil. Our findings indicate that sugar molecules, such as sucrose and glucose, are crucial for apical hook development. The presence of sucrose and glucose allows the apical hooks to be maintained for a longer period compared to those grown in sugar-free conditions, and this effect is dose-dependent. Key roles in apical hook development are played by several sugar metabolism pathways, including oxidative phosphorylation and glycolysis. RNA-seq data revealed an up-regulation of genes involved in starch and sucrose metabolism in plants grown in sugar-free conditions, while genes associated with phenylpropanoid metabolism were down-regulated. This study underscores the significant role of sugar metabolism in the apical hook development of etiolated Arabidopsis seedlings.

Kids SIPsmartER reduces sugar-sweetened beverages among Appalachian middle-school students and their caregivers: a cluster randomized controlled trial.

BACKGROUND: High consumption of sugar-sweetened beverages (SSB) is a global health concern. Additionally, sugar-sweetened beverage (SSB) consumption is disproportionately high among adolescents and adults in rural Appalachia. The primary study objective is to determine the intervention effects of Kids SIPsmartER on students' SSB consumption. Secondary objectives focus on caregivers' SSB consumption and secondary student and caregiver outcomes [e.g, body mass index (BMI), quality of life (QOL)]. METHODS: This Type 1 hybrid, cluster randomized controlled trial includes 12 Appalachian middle schools (6 randomized to Kids SIPsmartER and 6 to control). Kids SIPsmartER is a 6-month, 12 lesson, multi-level, school-based, behavior and health literacy program aimed at reducing SSB among 7th grade middle school students. The program also incorporates a two-way text message strategy for caregivers. In this primary prevention intervention, all 7th grade students and their caregivers from participating schools were eligible to participate, regardless of baseline SSB consumption. Validated instruments were used to assess SSB behaviors and QOL. Height and weight were objectively measured in students and self-reported by caregivers. Analyses included modified two-part models with time fixed effects that controlled for relevant demographics and included school cluster robust standard errors. RESULTS: Of the 526 students and 220 caregivers, mean (SD) ages were 12.7 (0.5) and 40.6 (6.7) years, respectively. Students were 55% female. Caregivers were mostly female (95%) and White (93%); 25% had a high school education or less and 33% had an annual household income less than $50,000. Regardless of SSB intake at baseline and relative to control participants, SSB significantly decreased among students [-7.2 ounces/day (95% CI = -10.7, -3.7); p < 0.001, effect size (ES) = 0.35] and caregivers [-6.3 ounces/day (95% CI = -11.3, -1.3); p = 0.014, ES = 0.33]. Among students (42%) and caregivers (28%) who consumed > 24 SSB ounces/day at baseline (i.e., high consumers), the ES increased to 0.45 and 0.95, respectively. There were no significant effects for student or caregiver QOL indicators or objectively measured student BMI; however, caregiver self-reported BMI significantly decreased in the intervention versus control schools (p = 0.001). CONCLUSIONS: Kids SIPsmartER was effective at reducing SSB consumption among students and their caregivers in the rural, medically underserved Appalachian region. Importantly, SSB effects were even stronger among students and caregivers who were high consumers at baseline. TRIAL REGISTRATION: Clincialtrials.gov: NCT03740113. Registered 14 November 2018- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03740113 .

Estimated reductions in type 2 diabetes burden through nutrition policies in AZAR cohort population: A PRIME microsimulation study for primary health care.

Background: Given the impact of high intake of sugar-sweetened beverages on type 2 diabetes, intervention to reduce their consumption can be a top priority for any health system. Thus, the purpose of the present study is to simulate the impact of policy options related to reduce consumption of sugar-sweetened beverages (SSBs) on the prevalence and mortality of type 2 diabetes in Iranian men and women. Methods: A discrete event simulation (DES) model was used to predict the effect of several policy options on the prevalence and death from type 2 diabetes in Azar Cohort Databases. Population age- and sex-specific prevalence and incidence rate of diagnosed diabetes were derived from the national health data. The Preventable Risk Integrated Model (PRIME) model was used for coding the input parameters of simulation using R and Python software. Results: The prevalence and mortality rate of type 2 diabetes under the scenario of reduced consumption of SSBs indicated that the highest and the lowest prevalence and mortality rates of type 2 diabetes for men and women were related to no policy condition and replacing SSBs with healthy drinks, like water, respectively. Also, the maximum "number of deaths postponed/ prevented" from type 2 diabetes was related to replacing SSBs with water (n=2015), and an integration of reformulation and applying 10% tax on SSBs (n=1872), respectively. Conclusion: Simulating the effect of different policy options on reducing the consumption of SSBs showed "replacing of SSBs with water" as the most effective policy option in Iranian setting.

Characterization of a novel ribose-5-phosphate isomerase B from Curtobacterium flaccumfaciens ZXL1 for D-allose production.

Enzymatic preparation of rare sugars as an alternative to traditional sweeteners is an effective strategy to achieve a low-calorie healthy diet. Ribose-5-phosphate isomerase B (RpiB) is a key enzyme in the non-oxidative branch of the catalytic pentose phosphate pathway. Here, we investigated the potential of Curtobacterium flaccumfaciens ZXL1 (C. flaccumfaciens ZXL1) derived RpiB (CfRpiB) in D-allose preparation. The optimal reaction conditions for recombinant CfRpiB were found experimentally to be pH 7.0, 55 °C, and no metal ions. The kinetic parameters Km, kcat, and catalytic efficiency kcat/Km were 320 mM, 4769 s-1, and 14.9 mM-1 s-1 respectively. The conversion of D-allulose by purified enzyme (1 g L-1 ) to D-allose was 13% within 1 h. In addition, homology modeling and molecular docking were used to predict the active site residues: Asp13, Asp14, Cys72, Gly73, Thr74, Gly77, Asn106, and Lys144.

Implementation of an Electronic Clinical Decision Support System for the Early Recognition and Management of Dysglycemia in an Inpatient Mental Health Setting Using CogStack: Protocol for a Pilot Hybrid Type 3 Effectiveness-Implementation Randomized Controlled Cluster Trial.

BACKGROUND: Severe mental illnesses (SMIs), including schizophrenia, bipolar affective disorder, and major depressive disorder, are associated with an increased risk of physical health comorbidities and premature mortality from conditions including cardiovascular disease and diabetes. Digital technologies such as electronic clinical decision support systems (eCDSSs) could play a crucial role in improving the clinician-led management of conditions such as dysglycemia (deranged blood sugar levels) and associated conditions such as diabetes in people with a diagnosis of SMI in mental health settings. OBJECTIVE: We have developed a real-time eCDSS using CogStack, an information retrieval and extraction platform, to automatically alert clinicians with National Health Service Trust-approved, guideline-based recommendations for dysglycemia monitoring and management in secondary mental health care. This novel system aims to improve the management of dysglycemia and associated conditions, such as diabetes, in SMI. This protocol describes a pilot study to explore the acceptability, feasibility, and evaluation of its implementation in a mental health inpatient setting. METHODS: This will be a pilot hybrid type 3 effectiveness-implementation randomized controlled cluster trial in inpatient mental health wards. A ward will be the unit of recruitment, where it will be randomly allocated to receive either access to the eCDSS plus usual care or usual care alone over a 4-month period. We will measure implementation outcomes, including the feasibility and acceptability of the eCDSS to clinicians, as primary outcomes, alongside secondary outcomes relating to the process of care measures such as dysglycemia screening rates. An evaluation of other implementation outcomes relating to the eCDSS will be conducted, identifying facilitators and barriers based on established implementation science frameworks. RESULTS: Enrollment of wards began in April 2022, after which clinical staff were recruited to take part in surveys and interviews. The intervention period of the trial began in February 2023, and subsequent data collection was completed in August 2023. Data are currently being analyzed, and results are expected to be available in June 2024. CONCLUSIONS: An eCDSS can have the potential to improve clinician-led management of dysglycemia in inpatient mental health settings. If found to be feasible and acceptable, then, in combination with the results of the implementation evaluation, the system can be refined and improved to support future successful implementation. A larger and more definitive effectiveness trial should then be conducted to assess its impact on clinical outcomes and to inform scalability and application to other conditions in wider mental health care settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT04792268; https://clinicaltrials.gov/study/NCT04792268. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/49548.

Evaluation of Fast-Food Restaurant Kids' Meal Beverage Offerings 1 Year After a State-Level Healthy Beverage Default Policy.

Introduction: Ordering from kids' menus and children's restaurant consumption is associated with greater purchasing and intake, respectively, of sugar-sweetened beverages. In response, policymakers have enacted strategies to improve the healthfulness of kids' meal offerings. This study investigated restaurant kids' meal beverage offerings and compliance with an Illinois healthy beverage default act, effective from January 1, 2022. Methods: Using a pre-post intervention (Illinois)-comparison (Wisconsin) site research design, fast-food restaurant audit data were collected before and 1 year after the Illinois Healthy Beverage Default Act from 6 platforms: restaurant interior and drive-thru menu boards and websites/applications and 3 third-party ordering platforms (DoorDash, Uber Eats, and Grubhub). Analyses included 62-110 restaurants across platforms. Difference-in-differences-weighted logistic regression models with robust SEs, clustered on restaurants, were estimated to assess pre to 1-year postpolicy changes in overall compliance for each audit setting in Illinois relative to that in Wisconsin. Results: This study found no statistically significant (p<0.05) changes in the compliance of kids' meal beverage default offerings associated with the enactment of the Illinois Healthy Beverage Default Act in Illinois relative to that in Wisconsin at fast-food restaurants. There were some observed differences in results in the restaurants' physical locations versus online that are worth noting. That is, after the enactment of the Illinois Healthy Beverage Default Act, the results showed greater odds of fast-food restaurants exclusively offering healthy beverage defaults with kids' meals on restaurant interior (OR=1.83, 95% CI=0.93, 3.58) and drive-thru (OR=2.38, 95% CI=0.95, 5.96) menus, with weak statistical significance (p<0.10). However, the policy was not associated with either meaningful or statistically significant changes in healthy beverage default offerings on restaurant websites or third-party online ordering platforms. Conclusions: This study found limited evidence of changes in kids' meal beverage offerings attributable to the Illinois Healthy Beverage Default Act. Future investigations of communication channels that support awareness and implementation and the resources required for implementation and enforcement may provide insight that is key to improving compliance.

Sources of free sugar in the diet of Saudi children.

Introduction: Data concerning sources of free sugar (FS) in the diet of Saudi children are limited. Identification of the top sources of FS would permit to develop tailored interventions that aid in meeting the recommendations of the World Health Organization for FS (≤ 25 g/day). This study aimed to investigate sources of FS in children's diet. Methods: A cross-sectional data of healthy children ages between 6 and 12 years who reside in Saudi Arabia were gathered from their mothers using online platforms (WhatsApp, Facebook, and X) (n = 424; 210 boys and 214 girls). An interview was conducted through the phone with the mother and her child to collect data pertaining FS intake using a validated food frequency questionnaire. Results: The primary sources of FS were Sweetened Beverages, followed by Sugars, Sweet Bakery Products, Other Desserts, and Candies, of which the added sugar consisted mostly of its total sugar. The consumption of FS coming from solid food sources for the highest quartile of children almost doubled the amount of FS coming from liquid food sources. Compared to boys, girls in the top quartile of FS intake consumed significantly higher amounts of solid sugars (p = 0.030). Only the intake of FS coming from Sweetened Beverages was associated negatively with age of children (p = 0.032). Discussion: Public health interventions should emphasize the necessity of reducing the consumption of the top sources of FS to practically achieve the recommendations of FS intake.

Effects of Carbohydrate Intake on Anopheles darlingi and Anopheles deaneorum Fitness under Lab-Reared Conditions.

The maintenance of a highly productive colony of anopheline mosquitoes requires standardized methods in order to obtain a sufficient number of homogeneous individuals for malaria research. In this context, nutritional status may affect survival, fecundity, and the capacity to support pathogen development. Here we assess the effects of carbohydrate sources on fecundity, survival, and susceptibility to Plasmodium vivax infection in colonies of Anopheles darlingi and Anopheles deaneorum mosquitoes. Newly emerged females from each species were fed either 10% sugar or 15% honey solutions until the end of each experiment. The type of carbohydrate meal did not impact any entomological parameters for An. deaneorum, except for survival. For both species, honey meal significantly increased median survival post-emergence by three to four days, probably due to its nutritional value. For An. darlingi fed with honey, a higher mean frequency in stage 5 was observed at 48 h post-blood-meal, which could indicate a delay in the digestion process. However, no effects on fecundity parameters were observed. Regarding susceptibility, An. darlingi fed with sugar exhibited a low intensity of sporozoites, although any negative effects of sucrose on sporozoites invasions in the salivary glands are unknown. Based on the increase in mosquito survival, a carbohydrate source composed of 15% honey solution could be better for maintaining An. darlingi and An. deaneorum in the lab-rearing context.

Impact of Nutritional Supplements on the Fitness of the Parasitoid Binodoxys communis (Gahan).

Alterative nutritional foods consumed by adult parasitoids play an important role in their fitness and ability to control pests because of food scarcity in many crops. While adult parasitoids feed on various sugars, they vary in their nutritional value for parasitoids. We assessed the effects of seven sugars (fructose, glucose, sucrose, trehalose, maltose, melezitose, and sorbitol) on the longevity, parasitism ability, parasitism behavior, and flight ability of B. communis, an important parasitoid of cotton aphids. We found that access to glucose, sucrose, or fructose, increased B. communis adult longevity more than the other sugars offered. All sugars except trehalose increased the parasitism rate to more than 50% compared to the starved control (only provided with water). We then compared parasitoid behaviors of wasps fed glucose, sucrose, or fructose to that of the starved control (with access only to water) and found that those fed B. communis spent more time either examining or attacking aphids than parasitoids in the control group, which spent more time walking or resting. Also, consumption of glucose, sucrose, or fructose also significantly improved the flight ability (the total flight distance, flight time, and average flight speed) of B. communis.

Green Extraction of Pectin from Sugar Beet Flakes and Its Application in Hydrogels and Cryogels.

Sugar beet flakes, a by-product of the sugar industry, were used as a source for pectin extraction that was performed using conventional citric acid extraction (CE) and two non-conventional extraction techniques-microwave-assisted extraction (MAE) and pulsed ultrasound-assisted extraction (PUAE). The influence of extraction conditions was studied for each technique based on pectin yield and galacturonic acid content, and spectroscopic, chromatographic and colorimetric methods were used for pectin characterization. Better results for pectin yield were achieved through CE (20.80%), while higher galacturonic acid content was measured in pectin extracted using PUAE (88.53 g/100 g). Pectin extracted using PUAE also presented a higher degree of methylation and acetylation. A significant increase in the molecular weight of pectin was observed for the PUAE process (7.40 × 105 g/mol) by comparison with conventional extraction (1.18 × 105 g/mol). Hydrogels and cryogels prepared with pectin from sugar beet flakes also showed differences in physicochemical parameters determined by the method of pectin extraction. Hydrogels had higher bulk density values irrespective of the pectin extraction method, and overall lower values of the textural parameters. Cryogels prepared with pectin from CE showed higher values of the textural parameters of hardness, adhesiveness, cohesiveness, gumminess and chewiness, while gels obtained with pectin from MAE and PUAE had higher thermal stability. The results of this study prove that sugar beet flakes can be considered a potential source for pectin production, and the extracted pectin is suitable for obtaining hydrogels and cryogels with physicochemical parameters comparable to the commercial citrus and apple pectin available on the market.

Effect of parboiling treatment times on the physicochemical, cooking, textural, and pasting properties and amino acid, phenolic, and sugar profiles of germinated paddy rice from different rice varieties.

In this research, parboiling was carried out at different times (5 and 15 min) on germinated paddy rice (GPR) from various basmati and non-basmati varieties. The results showed that as the parboiling time increased from 5 to 15 min, Δ $\Delta $ E, ash content, total dietary fiber, mineral content, cooking time, and textural properties increased while L*, lipid content, total starch, gruel solid loss, water absorption, oil absorption, foaming capacity, sugar profile, and total phenolic and flavonoid content decreased as compared to GPR. All pasting properties of GPR increased except breakdown as the parboiling time increased from 5 to 15 min. Parboiling altered the properties of GPR due to starch gelatinization. Total essential amino acid and gamma-aminobutyric acid decreased as the parboiling time (5 to 15 min) increased. The germinated parboiled brown rice could create a highly nutritious alternative to regular brown rice as it offers improved texture and cooking qualities.

Efficacy of administering a sugar-free flavor before dental injections on pain perception in children: A split-mouth randomized crossover clinical trial.

BACKGROUND: Sweet taste administration before dental injections helps to control associated pain in children. AIM: To evaluate the efficacy of using a sugar-free flavor on pain perception during dental injections. DESIGN: Children (n = 84) aged 4-9 (mean 6.71 ± 1.55) years who required buccal infiltration bilaterally participated in this split-mouth randomized crossover study. On the test side (flavor visit), infiltration injections were applied after receiving a sugar-free flavor. On the control side (no flavor visit), sterile water was administered. Demographic characteristics, body mass index (BMI), and sweet taste preference (STP) were recorded. Pain perception during injection was measured using heart rate (HR), sound, eyes, and motor (SEM) scale, and Wong-Baker Faces pain scale (WBFPS). RESULTS: Most children had healthy weight (72.6%) and equal STP (32.1%). In the test side, mean HR during injection, HR differences before and during injection, and SEM scores were significantly lower (p < .001, for all). There was no significant difference in the WBFPS between both visits. Flavor had a significant effect on pain reduction (p = .001 for HR, p = .000 for SEM), whereas age, gender, BMI, STP, and treatment side did not. Treatment sequence had a significant effect on total SEM scores (p = .021); children who received the flavor during their first visit had lower SEM scores. CONCLUSION: Using a sugar-free flavor before dental injections helps in reducing associated pain in children.

Transcriptomic and metabolomic analyses reveal the importance of ethylene networks in mulberry fruit ripening.

Mulberry (Morus alba L.) is a climacteric and highly perishable fruit. Ethylene has been considered to be an important trigger of fruit ripening process. However, the role of ethylene in the mulberry fruit ripening process remains unclear. In this study, we performed a comprehensive analysis of metabolomic and transcriptomic data of mulberry fruit and the physiological changes accompanying the fruit ripening process. Our study revealed that changes in the accumulation of specific metabolites at different stages of fruit development and ripening were closely correlated to transcriptional changes as well as underlying physiological changes and the development of taste biomolecules. The ripening of mulberry fruits was highly associated with the production of endogenous ethylene, and further application of exogenous ethylene assisted the ripening process. Transcriptomic analysis revealed that differential expression of diverse ripening-related genes was involved in sugar metabolism, anthocyanin biosynthesis, and cell wall modification pathways. Network analysis of transcriptomics and metabolomics data revealed that many transcription factors and ripening-related genes were involved, among which ethylene-responsive transcription factor 3 (MaERF3) plays a crucial role in the ripening process. The role of MaERF3 in ripening was experimentally proven in a transient overexpression assay in apples. Our study indicates that ethylene plays a vital role in modulating mulberry fruit ripening. The results provide a basis for guiding the genetic manipulation of mulberry fruits towards sustainable agricultural practices and improve post-harvest management, potentially enhancing the quality and shelf life of mulberry fruits for sustainable agriculture and forestry.

Addition of low sodium does not increase sensitivity to glucose in wild-type mice, or lead to partial glucose taste detection in T1R3 knock-out mice.

The sodium glucose cotransporter 1 (SGLT1) has been proposed as a non-T1R glucosensor contributing to glucose taste. Studies have shown that the addition of NaCl at very weak concentrations to a glucose stimulus can enhance signaling in the gustatory nerves of mice and significantly lower glucose detection thresholds in humans. Here, we trained mice with (wild-type; WT) and without (knockout; KO) a functioning T1R3 subunit on a two-response operant detection task to differentially respond to the presence or absence of a taste stimulus immediately after sampling. After extensive training (∼40 sessions), KO mice were unable to reliably discriminate 2 M glucose+0.01 M NaCl from 0.01 M NaCl alone, but all WT mice could. We then tested WT mice on a descending array of glucose concentrations (2.0-0.03 M) with the addition of 0.01 M NaCl vs. 0.01 M NaCl alone. The concentration series was then repeated with glucose alone vs. water. We found no psychophysical evidence of a non-T1R taste transduction pathway involved in the detection of glucose. The addition of NaCl to glucose did not lower taste detection thresholds in WT mice, nor did it render the stimulus detectable to KO mice, even at 2 M. The proposed pathway must contribute to functions other than sensory-discriminative detection, at least when tested under these conditions. Detection thresholds were also derived for fructose and found to be 1/3 log10 lower than for glucose, but highly correlated (r = 0.88) between the two sugars, suggesting that sensitivity to these stimuli in this task was based on a similar neural process.

Investigation of the growth of Listeria in plant-based beverages.

The objective of the present study was to evaluate whether the content of sugar, protein, fat, or fibre in commercially available and specially formulated plant-based beverages (oat, soya and pea) influences the growth rates of Listeria. Beverages were inoculated with a strain cocktail of Listeria (approximately 1 × 103 CFU/mL), and the data demonstrated that Listeria could proliferate in all tested beverages. Moreover, varying concentrations of naturally occurring or added sugar (0-3.3%), protein (3.3-5%), fat (1.1-3.5%) and added fibre (0-1.5%) did not have a statistically significant (p > 0.05) impact on the growth rates of Listeria in the tested plant-based beverages. These data suggest that the wide variety of commercial plant-based beverages serve as an ideal medium for the growth of Listeria irrespective of product composition. All the various products tested provided sufficient nutrients to support at least a 2.6-log increase of Listeria within 16 h at room temperature, with some beverages supporting a 3-log increase. Therefore, these data highlight the importance of careful storage and handling of these increasingly varied and popular products.

Sugar signals pedal the cell cycle!

Cell cycle involves the sequential and reiterative progression of important events leading to cell division. Progression through a specific phase of the cell cycle is under the control of various factors. Since the cell cycle in multicellular eukaryotes responds to multiple extracellular mitogenic cues, its study in higher forms of life becomes all the more important. One such factor regulating cell cycle progression in plants is sugar signalling. Because the growth of organs depends on both cell growth and proliferation, sugars sensing and signalling are key control points linking sugar perception to regulation of downstream factors which facilitate these key developmental transitions. However, the basis of cell cycle control via sugars is intricate and demands exploration. This review deals with the information on sugar and TOR-SnRK1 signalling and how they manoeuvre various events of the cell cycle to ensure proper growth and development.

Identifying sources of variation in added sugar intake for Alaska Native children using a hair biomarker.

Sugars from sugar-sweetened beverages (SSBs) are an important risk factor for tooth decay. The study goal was to determine if there was variation in added sugar intake across communities and between and within households. In this cross-sectional study, intakes of total sugar, added sugar, and sugar-sweetened beverages (SSBs) were estimated for 282 Alaska Native children ages 0-10 years from 131 households in three Yukon-Kuskokwim (YK) Delta communities using biomarker equations based on hair carbon and nitrogen isotope ratios previously developed for the Yup'ik population. ANOVA was used to assess associations between each predictor (community and household) and outcome (estimated total sugars, added sugars, and SSB intake). Between- and within-household variation was estimated using a linear mixed-effects model with a random intercept for households with three or more children. There was no significant difference in mean estimated total sugar (p = 0.29), added sugar (p = 0.24), or SSB intake (p = 0.40) across communities. Significant variations were observed between and within households, with within-household variation amounting to 59% of the between-household variation. Added sugar intake in Alaska Native children from the three study communities is higher than the recommended maximum, and the variation is greater within households than between households.

Support for a hypothetical sugar-sweetened beverage tax in Taiwan.

Sugar-sweetened beverages (SSBs) are drinks that contain added sugar or sweeteners and provide calories with no additional nutrients, and some countries have imposed additional taxes on the SSBs to reduce consumption, which is considered an SSB tax policy. This study used a cross-sectional online survey to examine the patterns of public support for an SSB tax in Taiwan. The sample included 1617 adults aged ≥ 20 years, who answered the survey questionnaire between May 2020 and April 2021. The respondents were recruited using convenience sampling, but sampling weights were applied to represent the Taiwanese population. Generalized ordered logit models with sampling weights were used to examine the correlates of public support for an SSB tax. Results showed that ~60% of the respondents supported the SSB tax and 47% perceived the tax to be effective. The respondents who were aware of the perceived health risks of SSBs or those who believed that one should be partly responsible for the health impact of SSBs were more likely to show support for the SSB tax. In adjusted regression models, both one's perceived risk and perceived responsibility of SSBs were positively associated with the perceived effectiveness of the SSB tax after sociodemographic characteristics were controlled. These research findings show evidence that there is public support for implementing an SSB tax to reduce SSB consumption in Taiwan.

A systematic review of the association between food insecurity and behaviours related to caries development in adults and children in high-income countries.

OBJECTIVES: To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high-income countries. METHODS: A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non-dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high-income countries. Studies specifically looking at food insecurity during the COVID-19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale (with modifications for cross-sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. RESULTS: Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross-sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross-sectional studies including 336 585 participants was equivocal, particularly in the sugar-sweetened beverage (SSB) consumption post-hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross-sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross-sectional studies, 138 102 participants). A single cross-sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. CONCLUSIONS: This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self-care in food insecure populations.

National taxation on sugar-sweetened beverages and its association with overweight, obesity, and diabetes.

BACKGROUND: Consumption of sugar-sweetened beverages (SSBs) has been linked to several adverse health outcomes, thus many countries introduced taxation to reduce it. OBJECTIVES: To summarize national SSB taxation laws and to assess their association with obesity, overweight and diabetes. METHODS: We conducted a systematic scoping review up to January 2022 on PubMed, Web of Science, Embase, and Google Search to identify taxes on SSBs. An interrupted time series analysis (ITSA) was conducted on 17 countries with taxation implemented in 2013 or before to evaluate the level and slope modifications in the rate of change of standardized prevalence rates of overweight, obesity, and diabetes. Random-effects meta-regression was used to assess whether year of entry into force of the law, national income, and tax design affected observed results. RESULTS: We included 76 tax laws issued between 1940 and 2020 by 43 countries, which were heterogeneous in terms of tax design, amount, and taxed products. Among children and adolescents, ITSA showed level or slope reduction for prevalence of overweight and obesity in 5 (Brazil, Samoa, Palau, Panama, Tonga) and 6 (El Salvador, Uruguay, Nauru, Norway, Palau, Tonga) countries out of 17, respectively. No clear pattern of modification of results according to investigated factors emerged from the meta-regression analysis. CONCLUSIONS: Taxation is highly heterogeneous across countries in terms of products and design, which might influence its effectiveness. Our findings provide some evidence regarding a deceleration of the increasing prevalence rates of overweight and obesity among children occurring in some countries following introduction of taxation. PROSPERO registration number: CRD42021233309.