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PloS One 2022Simulation modeling methods are an increasingly common tool for projecting the potential health effects of policies to decrease sugar-sweetened beverage (SSB) intake....
INTRODUCTION
Simulation 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.
METHODS
We 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.
RESULTS
Sixty-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).
DISCUSSION
Most 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.
Topics: Beverages; Computer Simulation; Consumer Behavior; Humans; Policy; Sugar-Sweetened Beverages; Taxes
PubMed: 36191026
DOI: 10.1371/journal.pone.0275270 -
Nutrients Feb 2019Gluten free (GF) products have been reported to be more expensive and less available than their gluten containing counterparts. We examined the current U.S. cost and...
Gluten free (GF) products have been reported to be more expensive and less available than their gluten containing counterparts. We examined the current U.S. cost and availability of GF products and made comparisons to the marketplace over a decade ago. Cost, determined by price per ounce and availability of a "market basket" of regular and GF products across four venues and five geographic regions was compared using a student's test. GF products were more expensive (overall 183%), and in all regions and venues ( < 0.001). GF products from mass-market producers were 139% more expensive than the wheat-based version of the same product. Availability of GF products was greatest (66%) in the health food and upscale venues. In contrast to the results of the 2006 study, the cost of GF products has declined from 240% to 183% (adjusted for inflation). The introduction of mass-market production of GF products may have influenced the increase in availability and overall reduction of cost since 2006. The extent to which the cost of GF products impacts dietary adherence and quality of life for those on a GFD warrants exploration.
Topics: Celiac Disease; Cost of Illness; Diet, Gluten-Free; Food; Food Labeling; Foods, Specialized; Humans; Nutritive Value
PubMed: 30769836
DOI: 10.3390/nu11020399 -
Surgical Infections Aug 2015Modern day burn care continues to wage an uphill battle against an enemy that evolves faster than we can develop weapons. Bacteria (bioburden) are everywhere and can... (Review)
Review
BACKGROUND
Modern day burn care continues to wage an uphill battle against an enemy that evolves faster than we can develop weapons. Bacteria (bioburden) are everywhere and can infiltrate anywhere within our susceptible population of burn patients. This is why prevention of infection is key to improving their survival and outcome.
PURPOSE
To reduce the incidence of infection in the burn patient population.
MATERIALS
Review of pertinent recent literature regarding infection prevention and control in the intensive care unit setting.
RESULTS
We propose that bioburden is one of the central elements in the infectious cycle that is ever-present in burn units. The mechanism of bacterial entry into the unit and subsequent transmission and infection are delineated. Recommendations for mitigating this risk are provided to guide future clinicians in their care of burn patients.
CONCLUSIONS
The treatment of infection and sepsis against highly adaptable bacteria is often insurmountable by ill patients. In this process, bioburden needs to be corralled to have any success. Thus, preventing organisms from entering the unit and transferring onto other patients, and eliminating the bacteria dwelling in the unit are all necessary actions in this battle. Ultimately, maintaining a culture that is constantly wary of this risk only can achieve this goal.
Topics: Bacterial Infections; Bacterial Load; Burn Units; Burns; Humans; Wound Infection
PubMed: 26207399
DOI: 10.1089/sur.2013.135 -
The Journal of Nutrition Nov 2021Protein quality is an important component of protein intake to support growth, development, and maintenance of essential body tissues and functions. Therefore, protein... (Review)
Review
Protein quality is an important component of protein intake to support growth, development, and maintenance of essential body tissues and functions. Therefore, protein quality should be emphasized as a key characteristic during protein food selection within the larger context of healthy dietary patterns, especially when considering the wide variance of protein quality across animal- and plant-based foods. However, the USDA Dietary Guidelines for Americans (DGA) do not address specific protein quality recommendations within their protein foods ounce equivalents guidance or as a component of Healthy U.S. Style, Healthy Vegetarian, and Healthy Mediterranean Style dietary patterns. In addition, the protein foods ounce equivalents within the DGA are not established on any obvious metabolic equivalency characteristic [i.e., energy, protein, or essential amino acid (EAA) content], which creates misleading messaging of equivalent functional and metabolic benefit across protein foods. EAA content is a key characteristic of protein quality and can be a practical focal point for protein intake recommendations and achieving healthy dietary patterns. This review discusses the importance of protein quality, the state of messaging within DGA recommendations, and proposes EAA density (i.e., EAA content relative to total energy) as one practical approach to improve current dietary recommendations. Two recent publications that evaluated the DGA protein foods ounce equivalents based on metabolic effect and their application within DGA recommended dietary patterns are discussed.
Topics: Amino Acids, Essential; Animals; Diet; Health Status; Nutrition Policy; United States
PubMed: 34386826
DOI: 10.1093/jn/nxab262 -
Mayo Clinic Proceedings. Innovations,... Apr 2021The sudden outbreak and global spread of COVID-19 demanded a tremendous amount of attention for viral respiratory infections (VRIs) in modern times. Evidence accumulated... (Review)
Review
The sudden outbreak and global spread of COVID-19 demanded a tremendous amount of attention for viral respiratory infections (VRIs) in modern times. Evidence accumulated over the past few decades increasingly suggests the importance of recognizing the background and context of lifestyle factors in the prevention of VRIs recurrence. The focus of attention has specifically been on how to optimize respiratory barrier function and immune function during the period of the pandemic outbreak. This viewpoint discusses the impact of a healthy lifestyle on VRIs and demonstrates a practical approach to preventing the occurrence of VRIs based on contemporary evidence.
PubMed: 33585798
DOI: 10.1016/j.mayocpiqo.2020.12.008 -
JAMA Dermatology Nov 2017Because moisturizer use is critical for the prevention and treatment of numerous dermatological conditions, patients frequently request product recommendations from...
IMPORTANCE
Because moisturizer use is critical for the prevention and treatment of numerous dermatological conditions, patients frequently request product recommendations from dermatologists.
OBJECTIVE
To determine the product performance characteristics and ingredients of best-selling moisturizers.
DESIGN AND SETTING
This cohort study involved publicly available data of the top 100 best-selling whole-body moisturizing products at 3 major online retailers (Amazon, Target, and Walmart). Products marketed for use on a specific body part (eg, face, hands, eyelids) were excluded.
MAIN OUTCOMES AND MEASURES
Pairwise comparisons of median price per ounce on the basis of marketing claims (eg, dermatologist recommended, fragrance free, hypoallergenic) and presence of ingredients represented in the North American Contact Dermatitis Group (NACDG) series were conducted using Wilcoxon rank sum tests. The effect of vehicle type (eg, ointment, lotion, cream, butter) was assessed using the Kruskal-Wallis test. Cross-reactors and botanicals for fragrances were derived from the American Contact Dermatitis Society's Contact Allergen Management Program database.
RESULTS
A total of 174 unique best-selling moisturizer products were identified, constituting 109 713 reviews as of August 2016. The median price per ounce was $0.59 (range, $0.10-$9.51 per ounce) with a wide range (9400%). The most popular vehicles were lotions (102 [59%]), followed by creams (22 [13%]), oils (21 [12%]), butters (14 [8%]), and ointments (3 [2%]). Only 12% (n = 21) of best-selling moisturizer products were free of NACDG allergens. The 3 most common allergens were fragrance mix (n = 87), paraben mix (n = 75), and tocopherol (n = 74). Products with the claim "dermatologist recommended" had higher median price per ounce ($0.79; interquartile range [IQR], $0.56-$1.27) than products without the claim ($0.59; IQR, $0.34-$0.92). Products with the claim "phthalate free" had higher median price per ounce ($1.38; IQR, $0.86-$1.63) than products without the claim ($0.59; IQR, $0.35-$0.91). Lotions (median, $0.49; IQR, $0.31-0.68) were statistically less expensive per ounce than butters (median, $1.20; IQR, $0.76-$1.63), creams (median, $0.80; IQR, $0.69-$1.25) and oils (median, $1.30; IQR, $0.64-$2.43). For products with a claim of "fragrance free," 18 (45%) had at least 1 fragrance cross-reactor or botanical ingredient. Products without any ingredients in the NACDG (median, $0.83; IQR, $0.47-$1.69) were not statistically more expensive per ounce than products with 1 or more allergens (median, $0.60; IQR, $0.35-$1.06).
CONCLUSIONS AND RELEVANCE
Best-selling moisturizers vary widely by price and product characteristics. Given the lack of readily available comparison data on moisturizer efficacy, dermatologists should balance consumer preference, price, and allergenicity in their recommendations.
Topics: Administration, Cutaneous; Allergens; Cohort Studies; Commerce; Consumer Behavior; Emollients; Humans; Perfume; Statistics, Nonparametric
PubMed: 28877310
DOI: 10.1001/jamadermatol.2017.3046 -
The American Journal of Clinical... Aug 2022Animal models have demonstrated that maternal nutrition can alter fetal vulnerability to prenatal alcohol exposure (PAE). Few human studies have examined the role of...
BACKGROUND
Animal models have demonstrated that maternal nutrition can alter fetal vulnerability to prenatal alcohol exposure (PAE). Few human studies have examined the role of nutrition in fetal alcohol spectrum disorders (FASD).
OBJECTIVES
Our objectives were to examine whether fetal vulnerability to PAE-related growth restriction is modified by: 1) rate of gestational weight gain; or prenatal dietary intakes of 2) energy, 3) iron, or 4) choline.
METHODS
In a prospective longitudinal birth cohort in Cape Town, South Africa, 118 heavy-drinking and 71 abstaining/light-drinking pregnant women were weighed and interviewed regarding demographics, alcohol, cigarette/other drug use, and diet at prenatal visits. Infant length, weight, and head circumference were measured at 2 wk and 12 mo postpartum.
RESULTS
Heavy-drinking mothers reported a binge pattern of drinking [Mean = 129 mL (∼7.2 drinks)/occasion on 1.3 d/wk). Rate of gestational weight gain and average daily dietary energy, iron, and choline intakes were similar between heavy-drinking women and controls. In regression models adjusting for maternal age, socioeconomic status, cigarette use, and weeks gestation at delivery, PAE [ounces (30 mL) absolute alcohol per day] was related to smaller 2-wk length and head circumference and 12-mo length, weight, and head circumference z-scores (β = -0.43 to -0.67; all P values <0.05). In stratified analyses for each maternal nutritional measure (inadequate compared with adequate weight gain; tertiles for dietary energy, iron, and choline intakes), PAE-related growth restriction was more severe in women with poorer nutrition, with effect modification seen by weight gain, energy, iron, and/or choline for several anthropometric outcomes.
CONCLUSIONS
Gestational weight gain and dietary intakes of energy, choline, and iron appeared to modify fetal vulnerability to PAE-related growth restriction. These findings suggest a need for screening programs for pregnant women at higher risk of having a child with FASD to identify alcohol-using women who could benefit from nutritional interventions.
Topics: Alcohol Drinking; Animals; Birth Cohort; Child; Choline; Diet; Ethanol; Female; Fetal Alcohol Spectrum Disorders; Fetal Growth Retardation; Gestational Weight Gain; Humans; Iron; Pregnancy; Prenatal Exposure Delayed Effects; Prospective Studies; South Africa
PubMed: 35441212
DOI: 10.1093/ajcn/nqac101 -
Addiction (Abingdon, England) Apr 2020Washington Initiative 1183 (I-1183), a 2012 law that privatized liquor retail sales and distribution in Washington State, USA, has had two opposing effects on liquor...
BACKGROUND AND AIMS
Washington Initiative 1183 (I-1183), a 2012 law that privatized liquor retail sales and distribution in Washington State, USA, has had two opposing effects on liquor purchases: it has increased access to liquor and imposed new fees on retailers and distributors. This study aimed to estimate the effect of I-1183 on monthly alcohol purchases during the post-I-1183 period (June 2012-December 2014) compared with the pre-I-1183 period (January 2010-May 2012).
DESIGN
DIFFERENCES-IN-DIFFERENCES STUDY: Setting and participants The study included households participating in the Nielsen Consumer Panel Dataset living in metropolitan and surrounding areas in Washington State and 10 control states. Measurements Outcomes were alcohol purchases by type (ounces of liquor, wine, beer and total alcohol or ethanol). Findings I-1183 was associated with a 6.34-ounce (P < 0.001) and a 2.01-ounce (P < 0.001) increase in monthly liquor and ethanol purchases, respectively, per household in the post-policy period spanning 31 months compared with monthly purchases in control states. In a longitudinal subgroup analysis, low and moderate alcohol purchasers increased monthly purchases of ethanol and high purchasers decreased purchases of ethanol. Conclusions Enacting 'Washington Initiative 1183', a law that privatized sale and distribution of liquor and imposed new fees on retailers and distributors, appears to have been associated with an approximate 82% increase in monthly liquor purchases and 26% increase in monthly ethanol purchases by households in metropolitan and surrounding areas in Washington State, USA.
Topics: Alcoholic Beverages; Commerce; Consumer Behavior; Family Characteristics; Humans; Privatization; Washington
PubMed: 31670853
DOI: 10.1111/add.14875 -
Health Equity 2022To describe the variability in the availability and price of sugary drinks, low-calorie drinks, and water/seltzer across high- and low-poverty census tracts in the five...
OBJECTIVE
To describe the variability in the availability and price of sugary drinks, low-calorie drinks, and water/seltzer across high- and low-poverty census tracts in the five boroughs of New York City (NYC).
DESIGN
Cross-sectional study. Our primary analysis compared the overall sample of beverages. Secondary analyses included tests for differences in the availability of beverage categories by neighborhood poverty level.
SETTING
We collected data from 106 stores (31 supermarkets, 29 convenience stores, 29 pharmacies, 9 Targets, and 8 Dollar Trees) in NYC. Fifty-four stores were located in high-poverty census tracts and 52 were located in low-poverty census tracts.
RESULTS
The mean Price per 0.03-liter of sugary drinks across the sample was $0.08, which was significantly higher than the price of low-calorie drinks ($0.07, =0.01) but not different from water/seltzer ($0.08, =0.65). Sugary drinks and water/seltzer were available in 91% of retailers, and low-calorie drinks were available in 87% of retailers. There was no statistical difference in availability of sugary drinks compared with low-calorie drinks or water/seltzer overall or within high- or low-poverty census tracts. Analyzed by store type, the mean price per ounce of sugary drinks differed significantly from water/seltzer at convenience stores, pharmacies, and Target stores (bodegas: $0.08 vs. $0.09, =0.03; pharmacies: $0.11 vs. $0.08, =0.02; Target stores: $0.07 vs. $0.09, =0.01).
CONCLUSIONS
Sugary drinks were available in most food retail settings in NYC, with little variation by census tract poverty level. Interventions that raise the price of sugary drinks to make healthier alternatives, such as water, the more affordable option should be considered.
PubMed: 35557551
DOI: 10.1089/heq.2021.0069 -
The New England Journal of Medicine Dec 2020
Topics: BNT162 Vaccine; COVID-19; COVID-19 Vaccines; Humans; RNA, Messenger; SARS-CoV-2; Vaccination; Viral Vaccines
PubMed: 33301245
DOI: 10.1056/NEJMe2034717