Portion Sizes of Ultra-Processed Foods in the United States, 2002 to 2021.

Objectives. To assess the US food industry's response to calls from public health authorities to reduce portion sizes by comparing current with past sizes of selected examples of single-serve ultra-processed packaged and fast foods. Methods. We obtained manufacturers' information about current portion sizes and compared it with sizes when first introduced and in 2002. Results. Few companies in our sample reduced portion sizes since 2002; all still sold portions of ultra-processed foods in up to 5-times-larger sizes than when first introduced. Conclusions. Policies and practices focused on reducing portion size could help discourage the consumption of excessive amounts of ultra-processed foods. (Am J Public Health. 2021;111(12):2223-2226. https://doi.org/10.2105/AJPH.2021.306513).

Longitudinal geo-referenced field evidence for the heightened BMI responsiveness of obese women to price discounts on carbonated soft drinks.

There is increasing interest in the effect that food environments may have on obesity, particularly through mechanisms related to the marketing and consumption of calorie-dense, nutrient-poor foods and sugary beverages. Price promotions, such as temporary price discounts, have been particularly effective in the marketing of carbonated soft drinks (CSDs) among consumers. Research has also suggested that the purchasing behavior of consumer groups may be differentially sensitive to price discounts on CSDs, with obese women particularly sensitive. In addition, the intensity of price discount in a person's food environment may also vary across geography and over time. This study examines whether the weight change of obese women, compared to overweight or normal BMI women, is more sensitive to the intensity of price discounts on CSDs in the food environment. This study used longitudinal survey data from 1622 women in the Montreal Neighborhood Networks and Health Aging (MoNNET-HA) Panel. Women were asked to report their height and weight in 2008, 2010 and 2013 in order to calculate women's BMI in 2008 and their change of weight between 2008 and 2013. Women's exposure to an unhealthy food environment was based on the frequency in which their neighborhood food stores placed price discounts on CSDs in 2008. The price discount frequency on CSDs within women's neighborhoods was calculated from Nielsen point-of sales transaction data in 2008 and geocoded to participant's forward sortation area. The prevalence of obesity and overweight among MoNNET-HA female participants was 18.3% in 2008, 19.9% in 2010 and 20.7% in 2013 respectively. Results showed that among obese women, exposure to unhealthy food environments was associated with a 3.25 kilogram (SE = 1.35, p-value = 0.02) weight gain over the five-year study period. Exposure to price discounts on CSDs may disproportionately affect and reinforce weight gain in women who are already obese.

Determinants of the Consumption of Regular Soda, Sport, and Energy Beverages in Spanish Adolescents.

Increasing sugar-sweetened beverages (SSB) consumption and associated health impacts warrant health-policy action. We assessed associations of socioeconomic and lifestyle variables with adolescents' consumption of regular soda (RSD), sport (SD), and energy (ED) drinks. Cross-sectional study of 3930 Spanish adolescents (2089 girls, 1841 boys) aged 13-18 years). We compared frequency of consuming each SSB type (European Food Safety Authority questionnaire) with sociodemographic and lifestyle variables (standardized questions). RSD, SD, and ED were consumed at least weekly by 72.7%, 32.3%, and 12.3% of participants, respectively, and more frequently (p < 0.001) by boys, compared to girls. Multivariate ordinal logistic regression showed inverse association between RSD, SD, and ED consumption and parental occupation-based socioeconomic status (p < 0.01). Daily smoking was associated (p < 0.001) with higher ED (OR 3.64, 95% CI 2.39-5.55) and RSD (OR 2.15, 95% CI 1.56-2.97) consumptions. SD intake was associated inversely with smoking (OR 0.60, 95% CI 0.40-0.89, p = 0.012) and directly with physical activity (OR 2.93, 95% CI 2.18-3.95, p < 0.001). School performance was lower among ED (OR 2.14, 95% CI, 1.37-3.35, p = 0.001) and RSD (OR 1.81, 95% CI 1.24-2.64, p = 0.002) consumers, compared to SD. Maleness and low socioeconomic status predicted SSB consumption. Smoking and low school performance were associated with higher ED and RSD intakes.

Soft Drink and Juice Consumption and Renal Cell Carcinoma Incidence and Mortality in the European Prospective Investigation into Cancer and Nutrition.

BACKGROUND: Renal cell carcinoma (RCC) accounts for more than 80% of kidney cancers in adults, and obesity is a known risk factor. Regular consumption of sweetened beverages has been linked to obesity and several chronic diseases, including some types of cancer. It is uncertain whether soft drink and juice consumption is associated with risk of RCC. We investigated the associations of soft drink and juice consumption with RCC incidence and mortality in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: A total of 389,220 EPIC participants with median age of 52 years at recruitment (1991-2000) were included. Cox regression yielded adjusted HRs and 95% confidence intervals (CI) for RCC incidence and mortality in relation to intakes of juices and total, sugar-sweetened, and artificially sweetened soft drinks. RESULTS: A total of 888 incident RCCs and 356 RCC deaths were identified. In models including adjustment for body mass index and energy intake, there was no higher risk of incident RCC associated with consumption of juices (HR per 100 g/day increment = 1.03; 95% CI, 0.97-1.09), total soft drinks (HR = 1.01; 95% CI, 0.98-1.05), sugar-sweetened soft drinks (HR = 0.99; 95% CI, 0.94-1.05), or artificially sweetened soft drinks (HR = 1.02; 95% CI, 0.96-1.08). In these fully adjusted models, none of the beverages was associated with RCC mortality (HR, 95% CI per 100 g/day increment 1.06, 0.97-1.16; 1.03, 0.98-1.09; 0.97, 0.89-1.07; and 1.06, 0.99-1.14, respectively). CONCLUSIONS: Consumption of juices or soft drinks was not associated with RCC incidence or mortality after adjusting for obesity. IMPACT: Soft drink and juice intakes are unlikely to play an independent role in RCC development or mortality.

Impacts of the 2008 Great Recession on dietary intake: a systematic review and meta-analysis.

BACKGROUND: The 2008 Great Recession significantly impacted economies and individuals globally, with potential impacts on food systems and dietary intake. We systematically reviewed evidence on the impact of the Great Recession on individuals' dietary intake globally and whether disadvantaged individuals were disproportionately affected. METHODS: We searched seven databases and relevant grey literature through June 2020. Longitudinal quantitative studies with the 2008 recession as the exposure and any measure of dietary intake (energy intake, dietary quality, and food/macronutrient consumption) as the outcome were eligible for inclusion. Eligibility was independently assessed by two reviewers. The Newcastle Ottawa Scale was used for quality and risk of bias assessment. We undertook a random effects meta-analysis for changes in energy intake. Harvest plots were used to display and summarise study results for other outcomes. The study was registered with PROSPERO (CRD42019135864). RESULTS: Forty-one studies including 2.6 million people met our inclusion criteria and were heterogenous in both methods and results. Ten studies reported energy intake, 11 dietary quality, 34 food intake, and 13 macronutrient consumption. The Great Recession was associated with a mean reduction of 103.0 cal per adult equivalent per day (95% Confidence Interval: - 132.1, - 73.9) in high-income countries (5 studies) and an increase of 105.5 cal per adult per day (95% Confidence Interval: 72.8, 138.2) in middle-income countries (2 studies) following random effects meta-analysis. We found reductions in fruit and vegetable intake. We also found reductions in intake of fast food, sugary products, and soft drinks. Impacts on macronutrients and dietary quality were inconclusive, though suggestive of a decrease in dietary quality. The Great Recession had greater impacts on dietary intake for disadvantaged individuals. CONCLUSIONS: The 2008 recession was associated with diverse impacts on diets. Calorie intake decreased in high income countries but increased in middle income countries. Fruit and vegetable consumption reduced, especially for more disadvantaged individuals, which may negatively affect health. Fast food, sugary products, and soft drink consumption also decreased which may confer health benefits. Implementing effective policies to mitigate adverse nutritional changes and encourage positive changes during the COVID-19 pandemic and other major economic shocks should be prioritised.

Changes in soft drinks purchased by British households associated with the UK soft drinks industry levy: controlled interrupted time series analysis.

OBJECTIVE: To determine changes in household purchases of drinks and confectionery one year after implementation of the UK soft drinks industry levy (SDIL). DESIGN: Controlled interrupted time series analysis. PARTICIPANTS: Members of a panel of households reporting their purchasing on a weekly basis to a market research company (average weekly number of participants n=22 183), March 2014 to March 2019. INTERVENTION: A two tiered tax levied on manufacturers of soft drinks, announced in March 2016 and implemented in April 2018. Drinks with ≥8 g sugar/100 mL (high tier) are taxed at £0.24/L and drinks with ≥5 to <8 g sugar/100 mL (low tier) are taxed at £0.18/L. Drinks with <5 g sugar/100 mL (no levy) are not taxed. MAIN OUTCOME MEASURES: Absolute and relative differences in the volume of, and amount of sugar in, soft drinks categories, all soft drinks combined, alcohol, and confectionery purchased per household per week one year after implementation of the SDIL compared with trends before the announcement of the SDIL. RESULTS: In March 2019, compared with the counterfactual estimated from pre-announcement trends, purchased volume of drinks in the high levy tier decreased by 155 mL (95% confidence interval 240.5 to 69.5 mL) per household per week, equivalent to 44.3% (95% confidence interval 59.9% to 28.7%), and sugar purchased in these drinks decreased by 18.0 g (95% confidence interval 32.3 to 3.6 g), or 45.9% (68.8% to 22.9%). Purchases of low tier drinks decreased by 177.3 mL (225.3 to 129.3 mL) per household per week, or 85.9% (95.1% to 76.7%), with a 12.5 g (15.4 to 9.5 g) reduction in sugar in these drinks, equivalent to 86.2% (94.2% to 78.1%). Despite no overall change in volume of no levy drinks purchased, there was an increase in sugar purchased of 15.3 g (12.6 to 17.9 g) per household per week, equivalent to 166.4% (94.2% to 238.5%). When all soft drinks were combined, the volume of drinks purchased did not change, but sugar decreased by 29.5 g (55.8 to 3.1 g), or 9.8% (17.9% to 1.8%). Purchases of confectionery and alcoholic drinks did not change. CONCLUSIONS: Compared with trends before the SDIL was announced, one year after implementation, the volume of soft drinks purchased did not change. The amount of sugar in those drinks was 30 g, or 10%, lower per household per week-equivalent to one 250 mL serving of a low tier drink per person per week. The SDIL might benefit public health without harming industry. TRIAL REGISTRATION: ISRCTN18042742.

Prevalence and risk factors of gastroesophageal reflux disease in a rural Indian population.

BACKGROUND: Studies on frequency and risk factors of gastroesophageal reflux disease (GERD) in the rural Indian population are scanty. METHODS: This household survey was undertaken by the trained interviewers in the adult population (≥ 18 years) in four villages in northern India using translated-validated Enhanced Asian Rome III and hospital anxiety and depression questionnaires. RESULTS: Of 2774 subjects, 2019 (72.8%) had no heartburn. Heartburn frequency was as follows: 314 (11.3%) once/week, 143 (5.2%) twice/week, 85 (3.1%) thrice/week, 69 (2.5%) four times/week, 48 (1.7%) five times/week, 18 (0.6%) six times/week, 41 (1.5%) daily, 37 (1.4%) > once daily. A total of 298 (10.7%) had GERD (definition: heartburn > twice/week). Older age (36.5 vs. 35 years), non-Hindu religion (7, 2.4% vs. 30, 1.2%), lower education (127, 42.6% vs. 789, 31.9%), lower socioeconomic class (94, 31.5% vs. 517, 20.9%) and income (below Indian National Rupees [INR] 458; 105, 35.2% vs. 599, 24.2%), non-vegetarian diet (15, 5% vs. 105, 4.2%), intake of tea/coffee (260, 87.2% vs. 1687, 68.1%), carbonated soft drinks (216, 72.5% vs. 1234, 49.8%), and alcohol (48, 16.1% vs. 313, 12.6%), tobacco chewing (116, 38.9% vs. 681, 27.5%), and smoking (105, 35.2% vs. 672, 27.1%) were associated with GERD on univariate analysis. On multivariate analysis, body mass index > 25 kg/m2 (odds ratio [OR] 1.23; 95% CI 0.88-1.71), predominant rice eating (1.13; 0.74-1.74), tobacco chewing and smoking (1.68; 1.24-2.30 and 1.36; 0.99-1.88), and alcohol (1.2; 0.78-1.83) and carbonated soft drinks (2.48; 1.79-3.44) intake were associated with GERD. A total of 122 (41%) had associated functional dyspepsia. Psychological comorbidities were commoner among those with than without GERD. CONCLUSION: In this rural Indian population, 10.7% had GERD and predominant rice eating, tobacco chewing, and carbonated soft drink intake were the risk factors. Psychological comorbidities were common.

Asthma, long-term asthma control medication and tooth wear in American adolescents and young adults.

OBJECTIVE: This study explored the associations of asthma and long-term asthma control medication with tooth wear among American adolescents and young adults. METHODS: Data from 2186 participants of the National Health and Nutrition Examination Survey (NHANES) were used. Asthma and prescribed long-term medication were collected through questionnaires. The number of surfaces with tooth wear was determined during clinical examinations. Associations were tested in Hurdle regression models adjusting for confounders. RESULTS: The prevalence of tooth wear was 58%, with an average of 6.1 (SD: 4.0) surfaces affected among those with the condition. The prevalence of asthma was 10.3%, with 2.9% of participants using long-term medication for asthma control. In the adjusted regression model, asthma was not associated with tooth wear. However, long-term control medication was associated with greater odds of having tooth wear (odds ratio: 3.33; 95%CI: 1.24-8.97), but it was not associated with the number of surfaces with tooth wear among those with the condition (rate ratio: 1.01; 95% CI: 0.58-1.75). CONCLUSION: This cross-sectional analysis of national data shows that taking long-term asthma medication was positively associated with having tooth wear.

Estimación de la ingesta de calcio y fosfato a partir de bebidas analcohólicas / Calcium and phosphate intake from analcoholic beverages

El calcio (Ca) es un nutriente crítico para la salud, especialmente en los períodos de crecimiento. Sin embargo, la mayoría de los individuos argentinos no alcanzan la ingesta diaria recomendada. Por su parte, el fósforo (P) es un nutriente cuya ingesta suele estar por encima de la recomendada. Este tipo de desequilibrio en la ingesta de ambos nutrientes conlleva a una pérdida de masa ósea. El consumo de bebidas analcohólicas (BA) se ha incrementado en los últimos años, sobre todo en la población infantil, desplazando el consumo de agua y lácteos. El objetivo de este trabajo fue estimar el aporte de Ca y P a partir de BA diferentes de agua. Se evaluaron 59 muestras, cuya mediana y rango de Ca fue de 7,74 [0,00 a 111,29] mg/l y de P 55,17 [0,16 a 957,00] mg/l. Los jugos en polvo son los que mayor contenido de Ca presentaron y las bebidas deportivas aquellas donde se halló el mayor contenido de P. Considerando un consumo de 500 ml/día de BA se estarían incorporando 3,87 mg Ca y 27,59 mg P. El creciente consumo de BA, su bajo contenido de Ca y la concomitante reducción del consumo de lácteos contribuyen a una inadecuada ingesta de Ca. (AU)

Calcium (Ca) is a critical nutrient, especially during periods of growth. However, the majority of Argentine individuals do not reach the recommended daily intake. On the other hand, phosphorus (P) is a nutrient with an intake usually above the recommended values. This type of imbalance between the intake of the nutrients leads to loss of bone mass. Soft drinks consumption (BA) has increased in recent years, especially in children, displacing the consumption of water and dairy products. The aim of this work was to estimate the Ca and P content in BA other than water. 59 samples were evaluated, with a median and range of Ca of 7.74 [0.00 to 111.29] mg/l and of P of 55.17 [0.16 to 957.00] mg/l. Powdered juices are the ones with the highest Ca content, and sports drinks are the beverages in which the highest P content was found. Based on a BA consumption of 500 ml/day, 3.87 mg Ca and 27.59 mg P would be incorporated. Therefore, the increased consumption of BA, their low Ca content, and the concomitant reduction in dairy consumption contribute to an inadequate intake of Ca. (AU)

How Coca-Cola Shaped the International Congress on Physical Activity and Public Health: An Analysis of Email Exchanges between 2012 and 2014.

There is currently limited direct evidence of how sponsorship of scientific conferences fits within the food industry's strategy to shape public policy and opinion in its favour. This paper provides an analysis of emails between a vice-president of The Coca-Cola Company (Coke) and prominent public health figures in relation to the 2012 and 2014 International Congresses of Physical Activity and Public Health (ICPAPH). Contrary to Coke's prepared public statements, the findings show that Coke deliberated with its sponsored researchers on topics to present at ICPAPH in an effort to shift blame for the rising incidence of obesity and diet-related diseases away from its products onto physical activity and individual choice. The emails also show how Coke used ICPAPH to promote its front groups and sponsored research networks and foster relationships with public health leaders in order to use their authority to deliver Coke's message. The study questions whether current protocols about food industry sponsorship of scientific conferences are adequate to safeguard public health interests from corporate influence. A safer approach could be to apply the same provisions that are stipulated in the Framework Convention on Tobacco Control on eliminating all tobacco industry sponsorship to the food industry.

Inequidad en el consumo de gaseosas en Argentina: análisis en base a los datos de las Encuestas Nacionales de Gastos de los Hogares (ENGHo) de los años 1996-1997, 2004-2005 y 2012-2013 / Inequity in consumption of carbonated beverage in Argentina: analysis based on data from the National Household Expenditure Surveys (ENGHo) (1996-2013)

FUNDAMENTOS: El consumo de gaseosas se asocia positivamente al padecimiento de enfermedades cardiovasculares. Dicho consumo difiere entre países de distinto nivel de ingreso y entre individuos de distinto nivel socioeconómico. A pesar de gravar el consumo de estas bebidas, Argentina se ubica entre lospaíses de mayor consumo de gaseosa per cápita, lo que motiva estudiar su distribución según región y nivel socioeconómico. MÉTODOS: A partir de 3 encuestas nacionales de gastos de los hogares (1996-2013) se efectúan pruebas de diferencia de medias (test de Welch y Games-Howell al 5%) entre 12 sub-regiones del país y entre deciles de gasto per cápita para el consumo mensual de gaseosa por adulto equivalente. Asimismo, se verifica la presencia de inequidad a partir del cómputo del índice de concentración de Wagstaff. RESULTADOS: Entre las provincias que conforman el noroeste argentino no se encuentran diferencias significativas en el consumo, pero sí entre ellas y las que conforman la Patagonia. Valores positivos del índice de concentración indican que no existe inequidad en el consumo de gaseosas. CONCLUSIONES: Si bien no se verificó inequidad en el consumo en ningún período, la evolución decreciente del índice de concentración indicaría un aumento del consumo entre hogares más pobres

BACKGROUND: Carbonated beverage consumption is positively associated with cardiovascular disease. Such consumption differs between countries of different income levels and between individuals of different socioeconomic levels. Despite taxing the consumption of these drinks, Argentina is among the countries with the highest consumption of soda per capita, which motivates studying its distribution according to region and socioeconomic level. METHODS: From 3 national surveys of household expenditures (1996-2013), mean difference tests (Welch and Games-Howell test at 5%) are carried out between 12 sub-regions of the country and between deciles of per capita spending for the monthly consumption of soda per equivalent adult. Likewise, the presence of inequity is checked from the computation of the Wagstaff concentration index. RESULTS: Among the provinces that are part of the Argentine northwest, there are no significant differences in consumption, but there are differences between them and those that are part of Patagonia. Positive values of the concentration index indicate that there is no inequity in the consumption of carbonated beverage. CONCLUSIONS: Although there was no inequity in consumption in any period, the decreasing evolution of the concentration index would indicate an increase in consumption among poorer households

Associations of Non-Alcoholic Beverages with Major Depressive Disorder History and Depressive Symptoms Clusters in a Sample of Overweight Adults.

BACKGROUND: Meta-analysis of observational studies concluded that soft drinks may increase the risk of depression, while high consumption of coffee and tea may reduce the risk. Objectives were to explore the associations between the consumption of soft drinks, coffee or tea and: (1) a history of major depressive disorder (MDD) and (2) the severity of depressive symptoms clusters (mood, cognitive and somatic/vegetative symptoms). METHODS: Cross-sectional and longitudinal analysis based on baseline and 12-month-follow-up data collected from four countries participating in the European MooDFOOD prevention trial. In total, 941 overweight adults with subsyndromal depressive symptoms aged 18 to 75 years were analyzed. History of MDD, depressive symptoms and beverages intake were assessed. RESULTS: Sugar-sweetened soft drinks were positively related to MDD history rates whereas soft drinks with non-nutritive sweeteners were inversely related for the high vs. low categories of intake. Longitudinal analysis showed no significant associations between beverages and mood, cognitive and somatic/vegetative clusters. CONCLUSION: Our findings point toward a relationship between soft drinks and past MDD diagnoses depending on how they are sweetened while we found no association with coffee and tea. No significant effects were found between any studied beverages and the depressive symptoms clusters in a sample of overweight adults.

Erosión dental en una muestra de niños valencianos. Prevalencia y evaluación de los hábitos de alimentación / Dental erosion in a sample of Valencian children. Prevalence and evaluation of eating habits

INTRODUCCIÓN: la erosión dental es la pérdida patológica, crónica, localizada e indolora de los tejidos dentarios, producida por la acción química de ácidos y sin la intervención de la acción de microorganismos. En los últimos años se ha observado un incremento significativo de la prevalencia de esta patología, especialmente en niños y adolescentes. OBJETIVOS: determinar la prevalencia de la erosión dental en la dentición temporal mediante el índice Basic Erosive Wear Examination (BEWE) en niños de entre 5 y 12 años, y determinar los hábitos de alimentación que pueden favorecer en ellos el desarrollo de lesiones. MÉTODOS: se llevó a cabo un estudio transversal en una muestra de 391 niños. Se realizó una encuesta donde se analizaron los hábitos de alimentación, y se realizó una exploración clínica de los dientes temporales empleando el índice BEWE. RESULTADOS: la prevalencia de la erosión dental en la muestra estudiada fue del 19,7 %, presentándose con mayor frecuencia lesiones iniciales. CONCLUSIONES: el 30,62 % de la población estudiada presentaba riesgo bajo de erosión dental, observándose un aumento del riesgo a medida que aumentaba el consumo de bebidas ácidas (bebidas gaseosas, bebidas isotónicas y zumos de frutas) y frutas ácidas, como naranjas, uvas y manzanas

INTRODUCTION: dental erosion is the pathological, chronic, localized and painless loss of dental tissues, produced by the chemical action of acids, where the action of microorganisms is not involved. In recent years, a significant increase in the prevalence of this pathology has been observed, especially in children and adolescents. OBJECTIVES: to determine the prevalence of dental erosion in temporary dentition using the Basic Erosive Wear Examination Index (BEWE) in children between 5 and 12 years of age, and to determine the eating habits that may favor the development of these lesions. METHODS: a cross-sectional study was carried out on a sample of 391 children. A survey was conducted where eating habits were analyzed and a clinical examination of the temporary teeth was performed using the BEWE index. RESULTS: the prevalence of dental erosion in the studied sample was 19.7 %, with mild lesions being most common. CONCLUSIONS: in all, 30.62 % of the studied population had a low risk of dental erosion, and risk was seen to increase with consumption of acidic beverages (soft drinks, isotonic drinks and fruit juices) and acidic fruits such as oranges, grapes and apples

Temporal variation in food consumption of Brazilian adolescents (2009-2015).

BACKGROUND: Worldwide population has been increasingly exposed to ultra-processed foods, which are associated with obesity. Adolescence is a transition period of life and WHO recommends the surveillance of risk factors to the adolescents' health, such as diet, because experiences in this phase can result in health risks. OBJECTIVE: To assess the trends in food consumption of adolescents from Brazilian capitals according to sociodemographic variables, based on data from the National Survey of School Health (PeNSE). METHODS: Data from in 2009, 2012 and 2015 of a total of 173,310 9th graders enrolled in public and private schools in Brazilian capitals and in the Federal District were assessed. Food consumption was assessed from regular consumption (five or more times a week) of healthy eating markers (beans; vegetables; fruit) and unhealthy eating markers (sweets; soft drinks; fried salty snacks). For sociodemographic variables, we considered macro regions; age; race/ skin color; gender; school administrative status. We assessed these markers trends for the population and, additionally, the analyses were stratified by gender, race/ skin color, and school administrative status. Statistical significance of the temporal trends was assessed by linear regression model. RESULTS: Over six years, three types of change in Brazilian adolescents' diet were observed: decreasing regular consumption of beans, sweets and soft drinks, increasing regular consumption of vegetables, and stable consumption of fruit and fried salty snacks. CONCLUSION: Brazilian adolescents' diet composition has changed in a short period, and therefore it is necessary to monitor it to propose actions aimed at this public.

The Importance of Sweet Beverage Definitions When Targeting Health Policies-The Case of Switzerland.

Since high-sweet beverage intake is associated with health risks, defining what this term encompasses is relevant to the strategies confronting this problem. This study assessed both the sociodemographic factors associated with sweet beverage consumption in Switzerland and the amount consumed. According to the current definition in Switzerland (SB-CUR), sweet beverages include soft drinks, juices with added-sugar, and low-calorie sweet beverages. Using this definition and the representative menuCH survey (n = 2057; ages 18-75), the average daily sweet beverage intake was determined and compared with a new sweet beverage definition (SB-NEW), which included all beverages with free sugars and low-calorie sweeteners. A generalized linear model was used to investigate correlates of sweet beverage consumption. Sweet beverage consumption under the SB-CUR and SB-NEW definition was 240.6 g/day and 329.7 g/day, respectively, with 100% juice consumption accounting for 66% of the difference. Carbonated drinks (sodas), low-calorie sweet beverages, and 100% juices were the highest contributors, each around 60 g/day. SB-NEW intake was higher in individuals who were male, young adults (aged 18-29), from German-speaking regions, obese, or had a lower level of education. As sweet beverage consumption was much higher under the SB-NEW definition, this could have implications for health policies aimed at reducing sugar intake.

Nothing beats taste or convenience: a national survey of where and why people buy sugary drinks in Australia.

OBJECTIVE: There is limited knowledge of what influences sugary drink purchasing decisions in the Australian population. This study aimed to identify the most common locations and reasons across different demographic groups for purchasing sugary drinks in Australia. METHODS: A total of 891 respondents (who purchased sugary drinks for personal consumption at least occasionally) from a broader national population telephone survey of Australian adults conducted in 2017 (n=3,430) were included in the analysis. RESULTS: 'Taste' was a ubiquitous reason for purchase (94%) and the majority also agreed with 'easily available' (76%). Males, younger people and people of lower socioeconomic status (SES) were significantly more likely to agree that sugary drinks were 'cheap' and 'better value than water'. Furthermore, males and younger people were more likely to report buying sugary drinks because they were 'part of a meal deal'. The most common purchase locations were supermarkets (56%), followed by convenience stores (19%) and food or entertainment venues (17%). CONCLUSION: Taste is paramount in decisions to purchase sugary drinks, and widespread availability and value for money support consumption. Implications for public health: Policies and interventions targeting point-of-sale sugary drink purchasing decisions among the most 'at risk' consumers are warranted.

The impact of UK soft drinks industry levy on manufacturers' domestic turnover.

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.

Examination of food consumption in United States adults and the prevalence of inflammatory bowel disease using National Health Interview Survey 2015.

Various diets and food components have been implicated as one of the environmental factors associated with inflammatory bowel disease (IBD). Patients are often recommended nutritional guidelines to manage disease symptoms. However, the current food consumption pattern of US adults with IBD that are nationally representative is unclear. A secondary analysis of National Health Interview Survey 2015 was performed to characterize the estimated US adults with IBD and their food intake and consumption frequency using bivariate and multivariate logistic regression. Fries were consumed by a greater number of people with IBD. IBD population drank less 100% fruit juice and ate more cheese and cookies than non-IBD population. Intake of fries (OR 1.60, 95% CI 1.14-2.25) and sports and energy drinks (OR 1.46, 95% CI 1.07-1.97) and more frequent drinking of regular soda were significantly associated with the likelihood of having been told one have IBD, while popcorn (OR 0.73, 95% CI 0.548-0.971) and milk (OR 0.70, 95% CI 0.497-0.998) were associated with smaller odds, adjusting for covariates. Foods typically labeled as junk food were positively associated with IBD. Nonetheless, of the assessed 26 foods, we found eating patterns between IBD and non-IBD population to be mostly analogous. It is unclear whether the results reflect potential change in food intake in IBD population long before the survey interview. Understanding the role of food intake in IBD risk/prevalence would benefit from identifying other environmental factors (i.e. food desert), food processing (i.e. frying), and potential bioactive food components that can induce intestinal inflammation that can increase the individual's susceptibility to IBD.

The association between beverage consumption pattern and dental problems in Iranian adolescents: a cross sectional study.

BACKGROUND: With regard to the increasing consumption rates of unhealthy beverages among adolescents, the main purpose of the present study was to determine the association between beverage intake pattern and dental caries and tooth erosion in this age group. METHODS: A total sample of 600 adolescents was recruited in this study using a multistage cluster random sampling method in the city of Kerman, in the southeast of Iran, in 2017. Then, the Decayed, Missed and Filled Teeth (DMFT) index and the Tooth Wear Index (TWI) were registered for each participant. A Beverage Frequency Questionnaire was also employed to estimate typical beverage intake frequency. Correspondingly, negative binominal regression and logistic regression were performed to determine the independent variables associated with the DMFT index and the TWI. RESULTS: The findings revealed that the highest consumed beverage in daily living was tea in both genders, followed by sweetened soft beverages, as well as milk and kefir/yogurt drink. The results of the DMFT index were also significantly different in participants that had never consumed milk compared with those who had used milk on a daily basis. Moreover, the DMFT index in participants who had never consumed sweetened soft beverages was 39%, less than those who had had a daily intake of such beverages. Also, the chance of tooth erosion for participants who had never used sweetened soft beverages was 94%, lower than that in daily consumers. CONCLUSIONS: The results of this study revealed that adolescents had an unhealthy beverage intake pattern. Furthermore, milk consumption was beneficial to dental caries, whereas use of soft drinks associated with more dental caries and tooth erosion.

Carbonating the household diet: a Pakistani tale.

OBJECTIVE: Carbonated beverage consumption is associated with various adverse health conditions such as obesity, type 2 diabetes and CVD. Pakistan has a high burden of these health conditions. At the same time, the carbonated beverage industry is rapidly growing in Pakistan. In this context, we analyse the trends and socioeconomic factors associated with carbonated beverage consumption in Pakistan. DESIGN: We use six waves of the cross-sectional household surveys from 2005-2006 to 2015-2016 to analyse carbonated beverage consumption. We examine the trends in carbonated beverage consumption-prevalence for different economic groups categorised by per capita household consumption quintiles. We estimate the expenditure elasticity of carbonated beverages for these groups using a two-stage budgeting system framework. We also construct concentration curves of carbonated beverage expenditure share to analyse the burden of expenditure across households of different economic status. SETTING: Pakistan. PARTICIPANTS: Nationally representative sample of households in respective survey waves. RESULTS: We find that the wealthier the household, the higher is the prevalence of carbonated beverage consumption, and the prevalence has increased for all household groups over time. From the expenditure elasticity analysis, we observe that carbonated beverages are becoming an essential part of food consumption particularly for wealthier households. And, lastly, poorer households are bearing a larger share of carbonated beverage expenditure in 2014-2016 than that in 2006-2008. CONCLUSION: Carbonated beverages are becoming an increasingly essential part of household food consumption in Pakistan. Concerns about added sugar intake can prompt consideration of public health approaches to reduce dietary causes of the disease burden in Pakistan.