Dataset Information

The Healthy Wight Commitment Foundation pledge: calories purchased by U.S. households with children, 2000-2012.

ABSTRACT: An independent evaluation of the Healthy Weight Commitment Foundation (HWCF) marketplace pledge found that the participating companies met and exceeded their interim 2012 sales reduction pledge.This follow-up study conducted in 2013 used purchase data from 2000 to 2012 among U.S. households with children and compared trends in calorie purchases of HWCF, non-HWCF name brands, and private label (PL) products in the pre-pledge period (2000-2007) and the post-pledge period (2008-2012); controlled for potential effects of concurrent changes in demographic and economic factors, including the Great Recession and food prices; and assessed whether the HWCF marketplace pledge was associated with reductions in consumer packaged goods (CPG) calorie purchases by households with children.There has been a significant per capita decline in average daily CPG caloric purchases between 2000 and 2012 among households with children from all brand categories. Based on pre-pledge trends, declines in CPG caloric purchases were already occurring. However, post-pledge reductions in calories purchased from HWCF brands were less than expected, and reductions in calories purchased from non-HWCF name brands and PLs were greater than expected after economic, sociodemographic, and secular factors were accounted for.If the 16 HWCF companies had been able to maintain their pre-pledge trajectory, there should have been an additional 42 kcal/capita/day reduction in calories purchased from HWCF products in 2012 among households with children. A lack of change in total CPG calories purchased between 2011 and 2012 calls into question the sustainability of the decline and a need for continued monitoring.

SUBMITTER: Ng SW

PROVIDER: S-EPMC4171651 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

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The Healthy Wight Commitment Foundation pledge: calories purchased by U.S. households with children, 2000-2012.

Ng Shu Wen SW Popkin Barry M BM

American journal of preventive medicine 20141001 4

<h4>Context</h4>An independent evaluation of the Healthy Weight Commitment Foundation (HWCF) marketplace pledge found that the participating companies met and exceeded their interim 2012 sales reduction pledge.<h4>Evidence acquisition</h4>This follow-up study conducted in 2013 used purchase data from 2000 to 2012 among U.S. households with children and compared trends in calorie purchases of HWCF, non-HWCF name brands, and private label (PL) products in the pre-pledge period (2000-2007) and the ...[more]

PMID: 25240968

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Project description:ImportanceNearly one-third of the 150 million US adults who are employed are obese. A workplace program that reduces employees' caloric intake could help prevent obesity.ObjectiveTo determine if implementation of a hospital workplace cafeteria healthy eating program was associated with reduction in calories purchased by employees over 2 years.Design, setting, and participantsA longitudinal cohort study of 5695 employees who purchased food with their employee identification card before and after implementation of a workplace cafeteria healthy eating program was conducted from December 1, 2009, to February 29, 2012, in a hospital in Boston, Massachusetts. Statistical analysis was conducted from April 6, 2018, to May 14, 2019.ExposureAfter a 3-month baseline period, "traffic light" food labels (in which green indicates healthy, yellow indicates less healthy, and red indicates least healthy) and choice architecture (product placement) changes were implemented permanently.Main outcome and measuresMain outcomes were changes in calories of employees' purchases from baseline (December 1, 2009, to February 28, 2010) to the same quarter 1 year (December 1, 2010, to February 28, 2011) and 2 years (December 1, 2011, to February 29, 2012) later. Purchases were obtained from sales data linked to employee identification cards. The hypothesized association of estimated changes in daily calories consumed with employees' weight was calculated using a dynamic model of weight change. Analyses were adjusted for age, sex, race/ethnicity, and job type.ResultsAmong the 5695 employees in the study, 4057 were women and 1638 were men, and the mean (SD) age was 40 (12) years. Baseline purchases had a mean of 565 kcal per transaction (95% CI, 558-572 kcal) and decreased 19 kcal per transaction (95% CI, -23 to -15 kcal) at 1 year and 35 kcal per transaction (95% CI, -39 to -31 kcal) at 2 years (-6.2%; P < .001) relative to baseline. The largest reduction was from red-labeled items, decreasing 42 kcal per transaction at 2 years (95% CI, -45 to -39 kcal) from a mean of 183 kcal per transaction (95% CI, 177-188 kcal) at baseline (-23.0%; P < .001). Calories from green-labeled items increased 6 kcal per transaction (95% CI, 3-9 kcal) from a mean of 152 kcal per transaction (95% CI, 149-155 kcal) (4.0%; P < .001), and calories from yellow-labeled items did not change. Among frequent purchasers (≥36 transactions per quarter; n = 453), total kilocalories per quarter at baseline was 41 784, which, averaged over the entire follow-up, decreased a mean of 4275 kcal/quarter (95% CI, -5325 to -3224 kcal) over 2 years. Assuming no compensatory changes in diet or activity, this equated to a reduction of 47 kcal per day and estimated a 2.0-kg weight loss over 3 years.Conclusions and relevanceA workplace cafeteria traffic light-labeling and choice architecture program was associated with a sustained decrease in calories purchased, particularly from unhealthy foods. Point-of-purchase programs could help improve dietary intake and prevent obesity in employees.

Project description:ObjectiveTo evaluate whether calorie labeling of menus in large restaurant chains was associated with a change in mean calories purchased per transaction.DesignQuasi-experimental longitudinal study.SettingLarge franchise of a national fast food company with three different restaurant chains located in the southern United States (Louisiana, Texas, and Mississippi) from April 2015 until April 2018.Participants104 restaurants with calorie information added to in-store and drive-thru menus in April 2017 and with weekly aggregated sales data during the pre-labeling (April 2015 to April 2017) and post-labeling (April 2017 to April 2018) implementation period.Main outcome measuresPrimary outcome was the overall level and trend changes in mean purchased calories per transaction after implementation of calorie labeling compared with the counterfactual (ie, assumption that the pre-intervention trend would have persisted had the intervention not occurred) using interrupted time series analyses with linear mixed models. Secondary outcomes were by item category (entrees, sides, and sugar sweetened beverages). Subgroup analyses estimated the effect of calorie labeling in stratums defined by the sociodemographic characteristics of restaurant census tracts (defined region for taking census).ResultsThe analytic sample comprised 14 352 restaurant weeks. Over three years and among 104 restaurants, 49 062 440 transactions took place and 242 726 953 items were purchased. After labeling implementation, a level decrease was observed of 60 calories/transaction (95% confidence interval 48 to 72; about 4%), followed by an increasing trend of 0.71 calories/transaction/week (95% confidence interval 0.51 to 0.92) independent of the baseline trend over the year after implementation. These results were generally robust to different analytic assumptions in sensitivity analyses. The level decrease and post-implementation trend change were stronger for sides than for entrees or sugar sweetened beverages. The level decrease was similar between census tracts with higher and lower median income, but the post-implementation trend in calories per transaction was higher in low income (change in calories/transaction/week 0.94, 95% confidence interval 0.67 to 1.21) than in high income census tracts (0.50, 0.19 to 0.81).ConclusionsA small decrease in mean calories purchased per transaction was observed after implementation of calorie labeling in a large franchise of fast food restaurants. This reduction diminished over one year of follow-up.

Project description:Introduction:Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries. This longitudinal study (1) estimated the prevalence of purchased behavioral health care and (2) identified patient and visit characteristics predicting receipt of purchased behavioral health care in acute care facilities from 2000 to 2014. Materials and Methods:Medical claims with Major Diagnostic Code 19 (mental disorders/diseases) or 20 (alcohol/drug disorders) as primary diagnoses and TRICARE as the primary/secondary payer were analyzed for MHS beneficiaries (n = 17,943) receiving behavioral health care in civilian acute care facilities from January 1, 2000, to December 31, 2014. The primary dependent variable, receipt of purchased behavioral health care, was modeled for select mental health and substance use disorders from 2000 to 2014 using generalized estimating equations. Patient characteristics included time, age, sex, and race/ethnicity. Visit types included inpatient hospitalization and emergency department (ED). Time was measured in days and visits were assumed to be correlated over time. Behavioral health care was described by both frequency of patients and visit type. The University of South Carolina Institutional Review Board approved this study. Results:From 2000 to 2014, purchased care visits increased significantly for post-traumatic stress disorder, adjustment, anxiety, mood, bipolar, tobacco use, opioid/combination opioid dependence, nondependent cocaine abuse, psychosocial problems, and suicidal ideation among MHS beneficiaries. The majority of care was received for mental health disorders (78.8%) and care was most often received in EDs (56%). Most commonly treated diagnoses included mood, tobacco use, and alcohol use disorders. ED visits were associated with being treated for anxiety (excluding post-traumatic stress disorder; Adjusted odds ratio [AOR]: 9.14 [95% confidence interval (CI): 8.26, 10.12]), alcohol use disorders (AOR = 1.67 [95% CI: 1.53, 1.83]), tobacco use (AOR = 1.16 [95% CI: 1.06, 1.26]), nondependent cocaine abuse (AOR = 5.47 [95% CI: 3.28, 9.12]), nondependent mixed/unspecified drug abuse (AOR = 7.30 [95% CI: 5.11, 10.44]), and psychosis (AOR = 1.38 [95% CI: 1.20, 1.58]). Compared with adults age 60 yr and older, adolescents (ages 12-17 yr), and adults under age 60 yr were more likely to be treated for suicidal ideation, adjustment, mood, bipolar, post-traumatic stress disorder, nondependent cocaine, and mixed/unspecified drug abuse. Adults under age 60 yr also had increased odds of being treated for tobacco use disorders, alcohol use disorders, and opioid/combination opioid dependence compared with adults age 60 yr and older. Conclusions:Over the past 15 yr, purchased behavioral health care received by MHS beneficiaries in acute care facilities increased significantly. MHS beneficiaries received the majority of purchased behavioral health care for mental health disorders and were treated most often in the ED. Receiving behavioral health care in civilian EDs raises questions about access to outpatient behavioral health care and patient-centered care coordination between civilian and military facilities. Given the influx of new Veterans Health Administration users from the MHS, findings have implications for military, veteran, and civilian facilities providing behavioral health care to military and veteran populations.

Dataset Information

The Healthy Wight Commitment Foundation pledge: calories purchased by U.S. households with children, 2000-2012.

Publications

The Healthy Wight Commitment Foundation pledge: calories purchased by U.S. households with children, 2000-2012.

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