Association of a Sweetened Beverage Tax With Purchases of Beverages and High-Sugar Foods at Independent Stores in Philadelphia.

Importance: The relationship between a sweetened beverage tax and changes in the prices and purchases of beverages and high-sugar food is understudied in the long term and in small independent food retail stores where sugar-sweetened beverages are among the most commonly purchased items. Objective: To examine whether a 1.5 cent-per-fluid-ounce excise tax on sugar- and artificially sweetened beverages Philadelphia, Pennsylvania, was associated with sustained changes in beverage prices and purchases, as well as calories purchased from beverages and high-sugar foods, over 2 years at small independent stores. Design, Setting, and Participants: This cross-sectional study used a difference-in-differences approach to compare changes in beverage prices and purchases of beverages and high-sugar foods (candy, sweet snacks) at independent stores in Philadelphia and Baltimore, Maryland (a nontaxed control) before and 2 years after tax implementation, which occurred on January 1, 2017. Price comparisons were also made to independent stores in Philadelphia's neighboring counties. Main Outcomes and Measures: Changes in mean price (measured in cents per fluid ounce) of taxed and nontaxed beverages, mean fluid ounces purchased of taxed and nontaxed beverages, and mean total calories purchased from beverages and high-sugar foods. Results: Compared with Baltimore independent stores, taxed beverage prices in Philadelphia increased 2.06 cents per fluid ounce (95% CI, 1.75 to 2.38 cents per fluid ounce; P < .001), with 137% of the tax passed through to prices 2 years after tax implementation, while nontaxed beverage prices had no statistically significant change. A total of 116 independent stores and 4738 customer purchases (1950 [41.2%] women; 4351 [91.8%] age 18 years or older; 1006 [21.2%] White customers, 3185 [67.2%] Black customers) at independent stores were assessed for price and purchase comparisons. Purchases of taxed beverages declined by 6.1 fl oz (95% CI, -9.9 to -2.4 fl oz; P < .001), corresponding to a 42% decline in Philadelphia compared with Baltimore; there were no significant changes in purchases of nontaxed beverages. Although there was no significant moderation by neighborhood income or customer education level, exploratory stratified analyses revealed that declines in taxed beverage purchases were larger among customers shopping in low-income neighborhoods (-7.1 fl oz; 95% CI, -13.0 to -1.1 fl oz; P = .001) and individuals with lower education levels (-6.9 fl oz; 95% CI, -12.5 to -1.3 fl oz; P = .001). Conclusions and Relevance: This cross-sectional study found that a tax on sweetened beverages was associated with increases in price and decreases in purchasing. Beverage excise taxes may be an effective policy to sustainably decrease purchases of sweetened drinks and calories from sugar in independent stores, with large reductions in lower-income areas and among customers with lower levels of education.

Cannabis sativa L. and Its Extracts: Regulation of Cannabidiol in the European Union and United Kingdom.

The lawful sale of Cannabis sativa L. and its extracts including Cannabidiol is not harmonized under European Union law. Such products have in the most part been classified as novel foods and thus illegal for sale in Europe without prior authorization. The regulation of such substances not only spans EU and Member State food laws but also international conventions on illicit drug and psychoactive substances. An understanding of the laws governing the sale of these compounds can help business and academia better understand the challenges consumers may face in selecting products lawfully placed on the market, whilst identifying the unique challenges imposed from the marketing of Cannabis-based foods.

Health and Economic Impacts of the National Menu Calorie Labeling Law in the United States: A Microsimulation Study.

BACKGROUND: Excess caloric intake is linked to weight gain, obesity, and related diseases, including type 2 diabetes mellitus and cardiovascular disease (CVD). Obesity incidence is rising, with nearly 3 in 4 US adults being overweight or obese. In 2018, the US federal government finalized the implementation of mandatory labeling of calorie content on all menu items across major chain restaurants nationally as a strategy to support informed consumer choice, reduce caloric intake, and potentially encourage restaurant reformulations. Yet, the potential health and economic impacts of this policy remain unclear. METHODS AND RESULTS: We used a validated microsimulation model (CVD-PREDICT) to estimate reductions in CVD events, diabetes mellitus cases, gains in quality-adjusted life years, costs, and cost-effectiveness of the menu calorie labeling intervention, based on consumer responses alone, and further accounting for potential industry reformulation. The model incorporated nationally representative demographic and dietary data from National Health and Nutrition Examination Surveys 2009 to 2016; policy effects on consumer diets and body mass index-disease effects from published meta-analyses; and policy effects on industry reformulation, policy costs (policy administration, industry compliance, and reformulation), and health-related costs (formal and informal healthcare costs, productivity costs) from established sources or reasonable assumptions. We modeled change in calories to change in weight using an established dynamic weight-change model, assuming 50% of expected calorie reductions would translate to long-term reductions. Findings were evaluated over 5 years and a lifetime from healthcare and societal perspectives, with uncertainty incorporated in both 1-way and probabilistic sensitivity analyses. Between 2018 and 2023, implementation of the restaurant menu calorie labeling law was estimated, based on consumer response alone, to prevent 14 698 new CVD cases (including 1575 CVD deaths) and 21 522 new type 2 diabetes mellitus cases, gaining 8749 quality-adjusted life years. Over a lifetime, corresponding values were 135 781 new CVD cases (including 27 646 CVD deaths), 99 736 type 2 diabetes mellitus cases, and 367 450 quality-adjusted life years. Assuming modest restaurant item reformulation, both health and economic benefits were estimated to be about 2-fold larger than based on consumer response alone. The consumer response alone was estimated to be cost-saving by 2023, with net lifetime savings of $10.42B from a healthcare perspective and $12.71B from a societal perspective. Findings were robust in a range of sensitivity analyses. CONCLUSIONS: Our national model suggests that the full implementation of the US calorie menu labeling law will generate significant health gains and healthcare and societal cost-savings. Industry responses to modestly reformulate menu items would provide even larger additional benefits.

Nutrition Policies Designed to Change the Food Environment to Improve Diet and Health of the Population.

The risk of chronic disease is widespread. In the United States, nearly 60% of the population has at least 1 chronic health condition. Among the most common are cardiovascular disease, obesity, and type 2 diabetes, all of which are associated with poor diet quality. At these levels, strategies are needed that can effectively impact widespread dietary practices and population nutrition and health. Increasingly, the food environment has been recognized as a powerful influencer of the quality of diets of community members. Local nutrition policies can effectively change the food environment in ways that increase access and affordability to healthful food and beverage choices and reduce access to and affordability of less healthful food and beverage choices. While much of the effort to change dietary practices is focused on education, this paper discusses 3 strategies by which nutrition policy can improve the dietary practices of individuals: (1) promoting healthy food purchases in the retail food environment, (2) improving access to healthy foods and beverages in food assistance programs, and (3) reducing access to less healthy foods and beverages through the use of taxes. Often enhanced by educational efforts, these strategies, used by government, business, and voluntary organizations, together make it easier for the public to make healthful dietary choices and thereby reduce the risk of chronic disease.

Corporate political activity of the dairy industry in France: an analysis of publicly available information.

OBJECTIVE: In the present study, we used a structured approach based on publicly available information to identify the corporate political activity (CPA) strategies of three major actors in the dairy industry in France. DESIGN: We collected publicly available information from the industry, government and other sources over a 6-month period, from March to August 2015. Data collection and analysis were informed by an existing framework for classifying the CPA of the food industry. Setting/Subjects Our study included three major actors in the dairy industry in France: Danone, Lactalis and the Centre National Interprofessionnel de l'Economie Laitière (CNIEL), a trade association. RESULTS: During the period of data collection, the dairy industry employed CPA practices on numerous occasions by using three strategies: the 'information and messaging', the 'constituency building' and the 'policy substitution' strategies. The most common practice was the shaping of evidence in ways that suited the industry. The industry also sought involvement in the community, establishing relationships with public health professionals, academics and the government. CONCLUSIONS: Our study shows that the dairy industry used several CPA practices, even during periods when there was no specific policy debate on the role of dairy products in dietary guidelines. The information provided here could inform public health advocates and policy makers and help them ensure that commercial interests of industry do not impede public health policies and programmes.

Socioeconomic Differences in the Association Between Competitive Food Laws and the School Food Environment.

BACKGROUND: Schools of low socioeconomic status (SES) tend to sell fewer healthy competitive foods/beverages. This study examined whether state competitive food laws may reduce such disparities. METHODS: School administrators for fifth- and eighth grade reported foods and beverages sold in school. Index measures of the food/beverage environments were constructed from these data. Schools were classified into SES tertiles based on median household income of students' postal zip code. Regression models were used to estimate SES differences in (1) Healthy School Food Environment Index (HSFEI) score, Healthy School Beverage Environment Index (HSBEI) score, and specific food/beverage sales, and (2) associations between state competitive food/beverage laws and HSFEI score, HSBEI score, and specific food/beverage sales. RESULTS: Strong competitive food laws were positively associated with HSFEI in eighth grade, regardless of SES. Strong competitive beverage laws were positively associated with HSBEI particularly in low-SES schools in eighth grade. These associations were attributable to schools selling fewer unhealthy items, not providing healthy alternatives. High-SES schools sold more healthy items than low-SES schools regardless of state laws. CONCLUSIONS: Strong competitive food laws may reduce access to unhealthy foods/beverages in middle schools, but additional initiatives are needed to provide students with healthy options, particularly in low-SES areas.

Programa de investigación de la calidad sanitaria de los alimentos (ICSA): 30 años de vigilancia sanitaria de los alimentos en Barcelona / The ICSA Program: 30 Years of Health Surveillance of Foods in Barcelona

La Agencia de Salud Pública de Barcelona (ASPB) dispone, desde 1984, del Programa de Investigación de la Calidad Sanitaria de los Alimentos (ICSA) como instrumento para la vigilancia de determinados parámetros químicos y microbiológicos relacionados con el estado sanitario de los alimentos comercializados en la ciudad. Este trabajo analiza la importancia de la vigilancia en salud, particularizando con el análisis de la utilidad y beneficios del programa ICSA. El objetivo principal del programa es valorar si, una vez en el mercado, los alimentos cumplen con la ausencia y/o niveles de tolerancia establecidos para determinados parámetros. No obstante, su carácter abierto permite incorporar o suprimir parámetros o alimentos reflejando nuevos peligros emergentes o intereses más allá de lo legislado. Además, el programa no solo obtiene una visión puntual de los parámetros estudiados en cada edición sino que la acumulación de datos en el tiempo permite evaluar riesgos, realizar cálculos de ingestas de contaminantes a través de la dieta, analizar tendencias, valorar la efectividad de las normativas para la reducción de contaminantes o ayudar en la planificación de programas de control. La información resultante se divulga local e internacionalmente, formando parte de los trabajos de recopilación de contaminantes de agencias de salud estatales y europeas, lo que muestra que es posible desarrollar un sistema de vigilancia a nivel local pero con alcance y objetivos globales y con información útil para gestores, administraciones, operadores económicos y consumidores (AU)

The Food Health Quality Research Program (Investigación de la Calidad Sanitaria de los Alimentos [ICSA]) of the Public Health Agency of Barcelona (Agencia de Salud Pública de Barcelona [ASPB]) was initiated in 1984 to carry out surveillance of certain chemical and microbiological parameters related to the sanitary and safety of foods sold in the city. The present article analyzes the importance of health surveillance and provides details of the uses of the ICSA program. The main aim of this program is to evaluate whether marketed foods comply with the absence and/or established tolerance levels of specific parameters. Nevertheless, the program is able to incorporate or suppress parameters or foods that pose emerging dangers or interests not represented in current legislation. Besides, the program not only obtains a view of the parameters studied at a specific time period in each report, but also accumulates data over time, allowing risk assessment, calculation of dietary intake of contaminants, analysis of tendencies, and evaluation of the effectiveness of regulations to reduce contaminants. The program can also help in the planning of food control programs. The information obtained is disseminated nationally and internationally and is included in dossiers of contaminants issued by national and European health agencies. This demonstrates that a locally-developed surveillance system can have a wider scope and broader objectives and can provide useful information for managers, administrations, economic operators and consumers (AU)

Why fat taxes won't make us thin.

Increasing prevalence of overweight and obesity has led policy-makers to consider health-related taxes to limit the consumption of unhealthy foods and beverages. Such taxes are currently already in place in countries in Europe (e.g. Hungary, France and Finland) and in various states in the USA. Although these taxes are possibly efficient in reducing by a small amount the consumption of targeted products if the tax is fully transmitted to the consumer, there is too little available evidence on what will be consumed instead and whether these food substitutions undermine the hoped-for health benefits of the tax. We also know very little on how the food supply side will respond and what overall impact this will have. Without a proper appreciation of the potential indirect impacts we do not know the overall impact of taxes foods on unhealthy foods and beverages and further that there is a very real possibility that they may not be beneficial for health after all.

Are good ideas enough? The impact of socio-economic and regulatory factors on GMO commercialisation.

In recent years scientific literature has seen an increase in publications describing new transgenic applications. Although technically-sound, these promising developments might not necessarily translate into products available to the consumer. This article highlights the impact of external factors on the commercial viability of Genetically Modified (GM) animals in the pharmaceutical and food sectors. Through the division of the production chain into three Policy Domains -Science, Market and Public- I present an overview of the broad range of regulatory and socio-economic components that impacts on the path towards commercialisation of GM animals. To further illustrate the unique combination of forces that influence each application, I provide an in-depth analysis of two real cases: GM rabbits producing human polyclonal antibodies (pharmaceutical case study) and GM cows producing recombinant human lactoferrin (food case study). The inability to generalise over the commercial success of a given transgenic application should encourage researchers to perform these type of exercises early in the R & D process. Furthermore, through the analysis of these case studies we can observe a change in the biopolitics of Genetically Modified Organisms (GMOs). Contrary to the GM plant biopolitical landscape, developing states such as China and Argentina are placing themselves as global leaders in GM animals. The pro-GM attitude of these states is likely to cause a shift in the political evolution of global GMO governance.

Are good ideas enough?: The impact of socio-economic and regulatory factors on GMO commercialisation

In recent years scientific literature has seen an increase in publications describing new transgenic applications. Although technically-sound, these promising developments might not necessarily translate into products available to the consumer. This article highlights the impact of external factors on the commercial viability of Genetically Modified (GM) animals in the pharmaceutical and food sectors. Through the division of the production chain into three Policy Domains -Science, Market and Public- I present an overview of the broad range of regulatory and socio-economic components that impacts on the path towards commercialisation of GM animals. To further illustrate the unique combination of forces that influence each application, I provide an in-depth analysis of two real cases: GM rabbits producing human polyclonal antibodies (pharmaceutical case study) and GM cows producing recombinant human lactoferrin (food case study). The inability to generalise over the commercial success of a given transgenic application should encourage researchers to perform these type of exercises early in the R & D process. Furthermore, through the analysis of these case studies we can observe a change in the biopolitics of Genetically Modified Organisms (GMOs). Contrary to the GM plant biopolitical landscape, developing states such as China and Argentina are placing themselves as global leaders in GM animals. The pro-GM attitude of these states is likely to cause a shift in the political evolution of global GMO governance.

Like your labels?

The descriptive "conventions" used on food labels are always evolving. Today, however, the changes are so complicated (partly driven by legislation requiring disclosures about environmental impacts, health issues, and geographical provenance) that these labels more often baffle buyers than enlighten them. In a light-handed manner, the article points to how sometimes reading label language can be like deciphering runes­and how if we are familiar with the technical terms, we can find a literal meaning, but still not see the implications. The article could be ten times longer because food labels vary according to cultures­but all food-exporting cultures now take advantage of our short attention-span when faced with these texts. The question is whether less is more­and if so, in this contest for our attention, what "contestant" is voted off.

Prescribing pork in Israel.

Both Judaism and Islam have prohibited eating pork and its products for thousands of years. Scholars have proposed several reasons for the ban to which both religions almost totally adhere. Pork, and the refusal to eat it, possesses powerful cultural baggage for Jews. Israel has legislated two related laws: the Pork Law in 1962, that bans the rearing and slaughter of pigs across the country, and the Meat Law of 1994, prohibiting all imports of nonkosher meats into Israel. While not abounding, Israeli pork-eaters certainly exist, and a small number of pig-breeding farms operate in the country, mostly in Christian villages. The influx of Russian immigrants in the 1990s helped boost sales of pork, but the force of the taboo remains so powerful that many secular Israelis still eschew pork dishes, while willing to eat less charged nonkosher items such as shellfish. A porchetta feast recently held in the Muslim-Jewish town of Jaffa, defied the religious and cultural taboo. It was a celebration of a book by Dr. Eli Landau, The White Book, which is the first Hebrew-language collection of pork recipes. Fearing repercussions, Israeli publishers unanimously refused to publish it and the book chain stores declined to display it. As a result, Landau published it himself.

Reviving red snapper.

Red snappers in the Gulf of Mexico once hovered on the brink of extinction, their population having dropped to 2 percent of what had historically swum in the Gulf. But thanks to a recently introduced plan that turns the conventional wisdom of fisheries management on its head, the picture has begun to change. Called Individual Fishing Quotas (IFQs), the new regulations, which give a guaranteed allotment of fish to each participant instead of applying industry-wide quotas, went into effect for Gulf of Mexico Red Snapper (Lutjanus campechanus) in early 2007. The results were immediate and so profound that the Gulf Fishery Management Council voted earlier this year to increase the annual limit on red snapper to nearly 7 million pounds from 5 million.