Project description:IntroductionSimulation modeling methods are an increasingly common tool for projecting the potential health effects of policies to decrease sugar-sweetened beverage (SSB) intake. However, it remains unknown which SSB policies are understudied and how simulation modeling methods could be improved. To inform next steps, we conducted a scoping review to characterize the (1) policies considered and (2) major characteristics of SSB simulation models.MethodsWe systematically searched 7 electronic databases in 2020, updated in 2021. Two investigators independently screened articles to identify peer-reviewed research using simulation modeling to project the impact of SSB policies on health outcomes. One investigator extracted information about policies considered and key characteristics of models from the full text of included articles. Data were analyzed in 2021-22.ResultsSixty-one articles were included. Of these, 50 simulated at least one tax policy, most often an ad valorem tax (e.g., 20% tax, n = 25) or volumetric tax (e.g., 1 cent-per-fluid-ounce tax, n = 23). Non-tax policies examined included bans on SSB purchases (n = 5), mandatory reformulation (n = 3), warning labels (n = 2), and portion size policies (n = 2). Policies were typically modeled in populations accounting for age and gender or sex attributes. Most studies focused on weight-related outcomes (n = 54), used cohort, lifetable, or microsimulation modeling methods (n = 34), conducted sensitivity or uncertainty analyses (n = 56), and included supplementary materials (n = 54). Few studies included stakeholders at any point in their process (n = 9) or provided replication code/data (n = 8).DiscussionMost simulation modeling of SSB policies has focused on tax policies and has been limited in its exploration of heterogenous impacts across population groups. Future research would benefit from refined policy and implementation scenario specifications, thorough assessments of the equity impacts of policies using established methods, and standardized reporting to improve transparency and consistency.
Project description:IssuesImplementation of alcohol control policy is a global priority as alcohol contributes to negative individual health and societal impacts. However, there are no available reviews that comprehensively provide tools and measurements for assessing the implementation of alcohol control policy. This study reviews tools and measurements for assessing alcohol policy implementation. Policies considered include alcohol pricing and taxation, alcohol marketing control, physical availability control and drink-driving policy.ApproachWe conducted a scoping review from Scopus, Web of Science and the World Health Organization's website. We included studies on policy implementation for the four most effective prevention policies published worldwide between 2000 and 2021.Key findingsThe search yielded 11,654 articles and these were narrowed down to 39 included studies. Of these 39 studies, almost half assessed the implementation of a drink-driving policy (n = 19), followed multipolicy (n = 12) and physical availability control (n = 8). There was no single study assessing policy implementation of pricing and taxation or alcohol marketing control. The majority of the studies were conducted in high-income countries (n = 31). Globally, there is no standardised tool or guidelines for measuring the policy implementation of these four policies. The tools for measuring policy implementation mostly focused on a single policy, and few covered multiple policies.ImplicationsWe recommend developing standardised tools and measurements to monitor policy implementation across multiple policies at country levels.ConclusionThis review highlighted a lack of comprehensive and standardised tools to assess policy implementation and the limited number of studies on alcohol policy implementation in low- and middle-income countries.
Project description:ObjectiveEnergy drinks are consumed for a variety of reasons, including to boost mental alertness and energy. We assessed associations between demographic factors and various high-risky behaviours with energy drink consumption as they may be linked to adverse health events.DesignWe conducted cross-sectional analysis including basic descriptive and multivariable-adjusted logistic regression analyses to characterise demographic and behavioural factors (including diet quality, binge drinking and illicit drug use, among others obtained via questionnaires) in relation to energy drink consumption.SettingWe used data from two large US-based cohorts.Participants46 390 participants from Nurses' Health Study 3 (NHS3, n 37 302; ages 16-31) and Growing Up Today Study (GUTS, n 9088, ages 20-55).ResultsOf the 46 390 participants, 13·2 % reported consuming ≥ 1 energy drink every month. Several risky behaviours were associated with energy drink use, including illegal drug use (pooled OR, pOR: 1·45, 95 % CI: 1·16, 1·81), marijuana use (pOR: 1·49, 95 % CI: 1·28, 1·73), smoking (pOR: 1·88. 95 % CI: 1·55, 2·29), tanning bed use (pOR: 2·31, 95 % CI: 1·96, 2·72) and binge drinking (pOR: 2·53, 95 % CI: 2·09, 3·07). Other factors, such as high BMI, e-cigarette use and poor diet quality were found to be significantly associated with higher energy drink consumption (P values < 0·001).ConclusionsOur findings show that energy drink consumption and high-risk behaviours may be related, which could potentially serve as not only as a talking point for providers to address in outreach and communications with patients, but also a warning sign for medical and other health practitioners.
Project description:Cost-effective regulatory and fiscal interventions are recommended to address non-communicable diseases. While some countries are advancing regarding these actions, others have found it difficult to approve them.Aimto conduct a scoping review to answer the question "What factors have influenced the adoption of food taxes, front-of-pack labeling and restrictions on marketing to children?".MethodsA scoping review was developed from four databases. Studies that described and analyzed policy processes were included. Analysis was performed to identify the barriers and enablers mentioned under the guidance of Swinburn et al., Huang et al., Mialon et al., and Kingdon.Results168 documents were identified, describing experiences from five regions or groups and 23 countries, which have generated 1584 examples of 52 enablers (689 examples; 43.5%) and 55 barriers (895 examples; 56.5%) that may have influenced policies. The main enablers were related to the government environment and governance and to civil society strategies. Corporate political activity strategies were the main examples of barriers.ConclusionsThis scoping review consolidated barriers and facilitators related to policies aimed at reducing ultra-processed foods consumption, demonstrating that factors related to the actions of governments and civil society are the main facilitators. On the other hand, as the most interested actor in promoting the consumption of these products, the strategies adopted by the companies that produce these products constitute the main barrier to these policies in all the studied countries and should be overcome.
Project description:It has been suggested that consuming alcohol mixed with energy drink (AMED) may increase total alcohol consumption. Aims of this systematic review and meta-analysis were (i) to compare alcohol consumption of AMED consumers with alcohol only (AO) consumers (between-group comparisons), and (ii) to examine if alcohol consumption of AMED consumers differs on AMED and AO occasions (within-subject comparisons). A literature search identified fourteen studies. Meta-analyses of between-group comparisons of N = 5212 AMED consumers and N = 12,568 AO consumers revealed that on a typical single drinking episode AMED consumers drink significantly more alcohol than AO consumers (p = 0.0001, ES = 0.536, 95%CI: 0.349 to 0.724). Meta-analyses of within-subject comparisons among N = 2871 AMED consumers revealed no significant difference in overall alcohol consumption on a typical drinking episode between AMED and AO occasions (p = 0.465, ES = -0.052, 95%CI: -0.192 to 0.088). In conclusion, between-group comparisons suggest that heavy alcohol consumption is one of the several phenotypical differences between AMED and AO consumers. Within-subject comparisons revealed, however, that AMED consumption does not increase the total amount of alcohol consumed on a single drinking episode.
Project description:BackgroundAlcohol policies stand out among other noncommunicable disease-relevant policies for the lack of uptake. Composite indicators have been developed to measure the effects of alcohol control policy. We investigated whether drinking patterns among demographic groups from general population samples of drinkers from diverse countries are associated with alcohol control policy as measured by the International Alcohol Control (IAC) Policy Index.MethodsRepresentative samples of adult drinkers from 10 countries (five high-income and five middle-income) were surveyed about alcohol consumption, using beverage and location-specific questions.MeasurementsThe IAC Policy Index was analyzed with frequency, typical occasion quantity, and volume consumed. Analyses used mixed models that included interactions between country IAC Policy Index score and age group, gender, and education level.FindingsEach increase in IAC policy index score (reflecting more effective alcohol policy) was associated with a 13.9% decrease in drinking frequency (p = 0.006) and a 16.5% decrease in volume (p = 0.001). With each increase in IAC Policy Index score, both genders decreased for all three measures, but men less so than women. Women decreased their typical occasion quantity by 1.2% (p = 0.006), frequency by 3.1% (p < 0.001), and total volume by 4.2% (p < 0.001) compared to men. Low and mid-education groups decreased their typical occasion quantity by 2.6% (p < 0.001) and 1.6% (p = 0.001), respectively, compared to high education, while for drinking frequency the low education group increased by 7.0% (p < 0.001). There was an overall effect of age (F = 19.27, p < 0.0001), with 18-19 and 20-24-year-olds showing the largest decreases in typical occasion quantity with increasing IAC policy index score.ConclusionsThe IAC Policy Index, reflecting four effective policies, was associated with volume and frequency of drinking across 10 diverse countries. Each increase in the IAC Policy Index was associated with lower typical quantities consumed among groups reporting heavy drinking: young adults and less well-educated. There is value in implementing such alcohol policies and a need to accelerate their uptake globally.
Project description:Energy drink (ED) consumption among Israeli-Arab adolescents is widespread. This study aimed to investigate the acute glycemic and insulin effects of EDs in healthy adolescents. Seventy-one Israeli-Arab adolescents (56% girls, average age 16.04 ± 1.03 years) participated in a non-randomized, case-controlled, open-label study. Participants consumed ED (n = 36) or a volume- and carbohydrate-matched non-caffeinated soft drink (SD, n = 35), followed by a 2 h glucose tolerance test. Blood glucose was measured at baseline and 15, 30, 60, and 120 min post-consumption (T0, T15, T30, T60 and T120, respectively). Serum insulin concentration and caffeine relative intensity were determined 45 min post-consumption (T45). Blood glucose levels peaked significantly at T15 and remained significantly higher at T30 in the ED group compared to the SD group (p = 0.005, p = 0.017, respectively). Insulin concentrations were substantially higher at T45 in the ED group (t [64] = 2.794, p = 0.001). This pattern was especially prominent in heavy ED consumers. A positive correlation emerged between the amount of caffeine consumed (mg/kg), blood glucose levels at T15 and T30, and insulin concentration at T45. This study is the first to demonstrate the glycemic and insulin responses to ED consumption in adolescents, suggesting that regulatory measures limiting ED sales to adolescents could improve their health.
Project description:ObjectivesGlobal consumption of caffeinated energy drinks (CED) has been increasing dramatically despite increasing evidence of their adverse health effects. Temporary price discounting is a rarely investigated but potentially powerful food marketing tactic influencing purchasing of CED. Using grocery transaction records generated by food stores in Montreal, we investigated the association between price discounting and purchasing of CED across socio-economic status operationalized by education and income levels in store neighbourhood.MethodsThe outcome, log-transformed weekly store-level sales of CED, was modelled as a function of store-level percent price discounting, store- and neighbourhood-level confounders, and an interaction term between discounting and each of tertile education and income in store neighbourhood. The model was separately fit to transactions from supermarkets, pharmacies, supercentres, and convenience stores.ResultsThere were 18,743, 12,437, 3965, and 49,533 weeks of CED sales from supermarkets, pharmacies, supercentres, and convenience stores, respectively. Percent price discounting was positively associated with log sales of CED for all store types, and the interaction between education and discounting was prominent in supercentres: -0.039 [95% confidence interval (CI): -0.051, -0.028] and -0.039 [95% CI: -0.057, -0.021], for middle- and high-education neighbourhoods relative to low-education neighbourhoods, respectively. Relative to low-income areas, the associations of discounting and log CED sales in supercentres for neighbourhoods with middle- and high-income tertile were 0.022 [95% CI: 0.010, 0.033] and 0.015 (95% CI: -0.001, 0.031), respectively.ConclusionPrice discounting is an important driver of CED consumption and has a varying impact across community education and income.
Project description:BackgroundThe purpose of this study was to identify how various negative health indicators are associated with energy drink consumption frequency among 13- and 15-year-old Finnish adolescents.MethodsData (N = 2429) from the nationally representative international Health Behaviour in School-aged Children study (2018) were analyzed via descriptive analysis and logistic regression analyses, with control for salient covariates. Relative risks (RR) were derived from the adjusted odds ratios.ResultsEven infrequent energy drink consumption was associated with various negative health indicators. Moreover, as compared to non-users, frequent energy drink consumers were more likely to report several health-compromising behaviors: current smoking (RR = 9.85, 95% CI: 5.68-16.02), current snus use (RR = 3.62, 95% CI: 1.80-6.85), cannabis use (RR = 3.42, 95% CI: 1.69-6.52), alcohol consumption (RR = 3.08, 95% CI: 2.49-3.71), problematic social media use (RR = 2.53, 95% CI:1.68-3.72), short sleep (RR = 2.12, 95% CI: 1.69-2.60), skipping breakfast (RR = 1.87, 95% CI: 1.51-2.29), drunkenness (RR = 1.59, 95% CI: 1.11-2.23), inadequate tooth brushing (RR = 1.28, 95% CI: 1.05-1.54). In addition, frequent energy drink consumption was associated with perceived negative health indicators: feelings of insufficient sleep (RR = 1.56, 95% CI: 1.11-2.15), low self-rated health (RR = 1.48, 95% CI: 1.15-1.87), and multiple health complaints (RR = 1.31, 95% CI: 1.07-1.56).ConclusionsEnergy drink consumption, even infrequent, was associated with several negative health indicators, and the reporting of these increased with the frequency of energy drink consumption. The findings support the concerns of health authorities regarding the negative associations between energy drink consumption and health, even among persons as young as 13 years. There is evidence to support specific policy level actions, including restrictions on the sale of energy drinks to adolescents. This measure has been proposed in a Finnish government program, but implementation has yet to occur. Moreover, marketing of these beverages in platforms that are popular among adolescents (e.g., the social media) should be rigorously evaluated, and comprehensive interventions and actions implemented to ensure that adolescents, parents/guardians, and professionals working with adolescents (e.g., in schools) have a good understanding of the links between energy drink consumption and health.
Project description:This study examined the association between energy drink consumption and substance use among adolescents and tested whether sex and/or grade level (i.e., middle vs. high school) moderate the association. Data were derived from the 2017 Ontario Student Drug Use and Health Survey, a representative survey of students in 7th to 12th grade. Analyses included 10,662 students who self-reported information on energy drink consumption and substance use. Poisson regression models were used with adjustments for important covariates. Energy drink consumption was associated with tobacco cigarette smoking (incidence rate ratio (IRR): 3.74; 95% confidence interval (CI): 3.22-4.35), cannabis use (IRR: 2.90; 95% CI: 2.53-3.32), binge drinking (IRR: 2.46; 95% CI: 2.05-2.96), opioid use (IRR: 2.23; 95% CI: 1.85-2.68), and alcohol use (IRR: 1.31; 95% CI: 1.26-1.36). The associations of energy drink consumption with tobacco cigarette smoking, cannabis use, and alcohol consumption were modified by grade level (two-way interaction terms p < 0.05). The association between energy drink consumption and substance use was generally much stronger among middle school students compared with high school students. The findings suggest that middle school students may be more vulnerable to the negative effects of energy drinks in relation with substance use.