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Public Health Nutrition Sep 2017Philadelphia passed a 1·5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to...
OBJECTIVE
Philadelphia passed a 1·5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to understand how revenue from SBT can be used to fund programmes to address education and other social determinants of health. The objective of the present study was to simulate quality pre-kindergarten attendance, educational achievement and sugar-sweetened beverage (SSB) consumption among Philadelphia children and adolescents under six intervention scenarios: (i) no intervention; (ii) 10 000 additional quality pre-kindergarten slots; (iii) a 1·5-cent-per-ounce SBT; (iv) expanded pre-kindergarten and 1·5-cent-per-ounce SBT; (v) a 3-cent-per-ounce SBT; and (vi) expanded pre-kindergarten and 3-cent-per-ounce SBT.
DESIGN
We used an agent-based model to estimate pre-kindergarten enrolment, educational achievement and SSB consumption under the six policy scenarios. We identified key parameters in the model from the published literature and secondary analyses of the Panel Study of Income Dynamics - Child Development Supplement.
SETTING
Philadelphia, Pennsylvania, USA.
SUBJECTS
Philadelphia children and adolescents aged 4-18 years.
RESULTS
A 1·5-cents-per-ounce tax would reduce SSB consumption by 1·3 drinks/week among Philadelphia children and adolescents relative to no intervention, with larger effects among children below the poverty level. Quality pre-kindergarten expansion magnifies the effect of the SBT by 8 %, but has the largest effect on moderate-income children just above the poverty level. The SBT and quality pre-kindergarten programme each reduce SSB consumption, but primarily benefit different children and adolescents.
CONCLUSIONS
Pairing an excise tax with a complementary programme to improve a social determinant of health represents a progressive strategy to combat obesity, a disease regressive in its social patterning.
Topics: Adolescent; Adolescent Nutritional Physiological Phenomena; Beverages; Child; Child, Preschool; Computer Simulation; Diet, Carbohydrate Loading; Dietary Sugars; Educational Status; Family Characteristics; Financial Support; Health Status Disparities; Health Transition; Humans; Models, Economic; Obesity; Philadelphia; Poverty; Quality Control; Schools, Nursery; Social Determinants of Health; Taxes
PubMed: 28774355
DOI: 10.1017/S1368980017001756 -
Clinical Therapeutics Jul 2019Lifestyle may be important in the development of rheumatoid arthritis (RA). Therefore, changing behaviors may delay or even prevent RA onset. This article reviews the... (Review)
Review
PURPOSE
Lifestyle may be important in the development of rheumatoid arthritis (RA). Therefore, changing behaviors may delay or even prevent RA onset. This article reviews the evidence basis for the associations of lifestyle factors with RA risk and considers future directions for possible interventions to reduce RA risk.
METHODS
The literature was reviewed for cross-sectional studies, case-control studies, cohort studies, and clinical trials investigating potentially modifiable lifestyle factors and RA risk or surrogate outcomes on the path toward development such as RA-related autoimmunity or inflammatory arthritis. The evidence related to cigarette smoking, excess weight, dietary intake, physical activity, and dental health for RA risk were summarized.
FINDINGS
Cigarette smoking has the strongest evidence base as a modifiable lifestyle behavior for increased seropositive RA risk. Smoking may increase seropositive RA risk through gene-environment interactions, increasing inflammation and citrullination locally in pulmonary/oral mucosa or systemically, thereby inducing RA-related autoimmunity. Prolonged smoking cessation may reduce seropositive RA risk. Evidence suggests that excess weight can increase RA risk, although this effect may differ according to sex, serologic status, and age at RA onset. TDietary intake may also affect RA risk: overall healthier patterns, high fish/omega-3 polyunsaturated fatty acid consumption, and moderate alcohol intake may reduce RA risk, whereas caffeine and sugar-sweetened soda consumption might increase RA risk. The impact of physical activity is less clear, but high levels may reduce RA risk. Periodontal disease might induce citrullination and RA-related autoimmunity, but the effect of dental hygiene behaviors on RA risk is unclear. Although the effect size estimates for these lifestyle factors on RA risk are generally modest, there may be relatively large public health benefits for targeted interventions given the high prevalence of these unhealthy behaviors. With the exception of smoking cessation, the impact of behavior change of these lifestyle factors on subsequent RA risk has not been established. Nearly all of the evidence for lifestyle factors and RA risk were derived from observational studies.
IMPLICATIONS
There are many potentially modifiable lifestyle factors that may affect RA risk. Improving health behaviors could have large public health benefits for RA risk given the high prevalence of many of the RA risk-related lifestyle factors. However, future research is needed to establish the effects of lifestyle changes on RA risk or surrogate outcomes such as RA-related autoimmunity or inflammatory arthritis.
Topics: Arthritis, Rheumatoid; Epidemiologic Studies; Exercise; Female; Humans; Male; Middle Aged; Oral Health; Patient Education as Topic; Risk Reduction Behavior; Smoking Cessation
PubMed: 31196646
DOI: 10.1016/j.clinthera.2019.04.021 -
BMJ Open Oct 2022This study estimates the effect of chronic disease diagnoses (CDDs) on elderly Chinese individuals' alcohol consumption behaviour.
OBJECTIVES
This study estimates the effect of chronic disease diagnoses (CDDs) on elderly Chinese individuals' alcohol consumption behaviour.
SUBJECTS AND PARTICIPANTS
Our analysis was applied to a publicly available dataset that covers 5724 individuals aged 50 or above and spans 15 years (2000-2015: six waves) from the China Health and Nutrition Survey.
DESIGN
The outcome variables are elderly individuals' weekly consumption of alcoholic beverages: beer, red wine, Chinese spirits and total alcohol intake. The explanatory variable of primary interest is the number of chronic diseases diagnosed (including hypertension, diabetes, stroke and myocardial infarction). Other covariates concern sample individuals' sociodemographic and health-related characteristics. A Chamberlain-Mundlak correlated random-effect Tobit model is adopted to simultaneously account for the clustering of 'zeros' in the outcome variable and endogeneity issues such as omitted variables and reverse causality.
RESULTS
Our estimation suggests that, on average, an additional chronic disease diagnosed by medical doctors reduced an elderly Chinese individual's weekly consumption of beer, red wine and Chinese spirits, respectively, by 1.49 (95% CI -2.85 to -0.13), 0.93 (95% CI -1.63 to -0.23) and 0.89 (95% CI -1.23 to -0.54) ounces. These effects translate into a reduction of 0.95 (95% CI -1.29 to -0.60) ounces in total weekly alcohol consumption and a reduction of 24% (95% CI -0.35 to -0.14) in the incidence of excessive drinking. Further explorations suggest that elderly Chinese individuals' alcohol consumption is most responsive to diabetes and stroke diagnoses, but the effects vary across different beverages. Moreover, males, rural residents, smokers and those living with non-drinkers respond to CDDs more strongly than their respective counterparts.
CONCLUSION
While CDDs reduced alcohol consumption among elderly Chinese individuals, they failed to stop all heavy drinkers from excessive drinking. Relevant policies and measures are thus needed to urge heavy drinking patients to quit excessive drinking.
Topics: Aged; Alcohol Drinking; Alcoholic Beverages; China; Chronic Disease; Diabetes Mellitus; Humans; Male; Risk Factors; Stroke
PubMed: 36220320
DOI: 10.1136/bmjopen-2022-062920 -
JTCVS Techniques Jun 2021
PubMed: 34318264
DOI: 10.1016/j.xjtc.2021.03.022 -
The Journal of Nutrition May 2023Limited research evidence exists on the effects of red meat on gut microbiota in human adults. (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of Adding Lean Red Meat to a U.S.-Style Healthy Vegetarian Dietary Pattern on Gut Microbiota and Cardiovascular Risk Factors in Young Adults: a Crossover Randomized Controlled Trial.
BACKGROUND
Limited research evidence exists on the effects of red meat on gut microbiota in human adults.
OBJECTIVE
We aim to assess the effects of consuming a Healthy U.S.-Style Dietary Pattern (HDP), without or with unprocessed or processed lean red meats, on gut microbiota and fecal short-chain fatty acid (SCFA) levels in healthy young adults. Secondary outcomes are cardiovascular disease risk factors.
METHODS
We conducted a randomized, controlled, crossover trial with 3 3-wk dietary interventions, each separated by a 5-wk washout period with habitual dietary intake. Nineteen participants (8 females, age 26 ± 4 y old, BMI 23 ± 3 kg/m) consumed 3 study diets in random order: 1) healthy lacto-ovo vegetarian diet (LOV); 2) LOV plus 3 ounces/d of cooked unprocessed lean red meat (URM); and 3) LOV plus 3 ounces/d of cooked processed lean red meat (PRM). Fecal and fasting blood samples were collected before and during the last 2 wk of each intervention. We measured fecal bacterial community structure using 16S rRNA amplicon sequencing (V4 region, primers 515F-806R). Community diversity, structure, and taxonomic composition were computed using Mothur v.1.44.3.
RESULTS
The addition of unprocessed or processed lean red meats to a LOV HDP did not influence short-term changes in bacterial taxonomic composition. Independent of red meat intake, the HDP led to changes in 23 bacteria; reductions in serum total cholesterol (TC) and LDL-C concentrations; but no changes in fecal SCFA, serum triglycerides, HDL-C concentrations, TC/HDL-C ratio, or blood pressures. With data from all 3 diet interventions combined, changes in some bacteria were associated with improvements in TC, LDL-C, triglycerides, and HDL-C concentrations, and TC/HDL-C ratio.
CONCLUSIONS
Healthy young adults who adopt an HDP that may be vegetarian or omnivorous, including lean red meat, experience short-term changes in gut microbial composition, which associate with improvements in multiple lipid-related cardiovascular risk factors. NCT03885544, https://clinicaltrials.gov/ct2/show/NCT03885544?cond=NCT03885544&draw=2&rank=1.
Topics: Female; Humans; Young Adult; Adult; Cardiovascular Diseases; Gastrointestinal Microbiome; Cholesterol, LDL; RNA, Ribosomal, 16S; Risk Factors; Diet; Red Meat; Triglycerides; Heart Disease Risk Factors; Vegetarians; Cross-Over Studies
PubMed: 36921804
DOI: 10.1016/j.tjnut.2023.03.013 -
The American Journal of Gastroenterology Feb 2021A new tablet-based bowel prep for colonoscopy has been developed containing poorly absorbed sulfate salts which act to retain water within the intestinal lumen resulting...
INTRODUCTION
A new tablet-based bowel prep for colonoscopy has been developed containing poorly absorbed sulfate salts which act to retain water within the intestinal lumen resulting in a copious diarrhea, thereby cleansing the bowel. This study evaluated the safety and efficacy of these oral sulfate tablets (OST) compared with a US FDA-approved bowel prep solution containing PEG3350, electrolytes, and ascorbate (polyethylene glycol and ascorbate [PEG-EA]).
METHODS
Five hundred fifteen adult patients (mean 57y) were enrolled in this single-blind, multicenter, noninferiority study. Subjects were assigned either PEG-EA or OST to be administered in a split-dose regimen starting the evening before colonoscopy. PEG-EA was taken according to its approved labeling (1 L of prep solution with 16 oz. of additional water) in the evening and again in the morning. OST patients took a total of 24 tablets. OST patients were administered 12 tablets in the evening, and the following morning. Patients consumed 16 ounces of water with each dose of 12 tablets and drank an additional 32 oz. of water with each dose. Colonoscopies were performed by blinded investigators. Cleansing efficacy was evaluated globally and segmentally using a 4-point scale (Excellent-no more than small bits of feces/fluid which can be suctioned easily; achieves clear visualization of the entire colonic mucosa. Good-feces and fluid requiring washing and suctioning, but still achieves clear visualization of the entire colonic mucosa. Fair-enough feces even after washing and suctioning to prevent clear visualization of the entire colonic mucosa. Poor-large amounts of fecal residue and additional bowel preparation required). Scores of Good or Excellent were considered to be a success. Safety was assessed by spontaneously reported adverse events, solicited ratings of expected prep symptoms, and laboratory testing.
RESULTS
A high rate of cleansing success was seen with OST (92%), which was noninferior to PEG-EA (89%). Only a small proportion of subjects rated their expected gastrointestinal symptoms as severe (<5% for both preps). No clinically significant differences were seen between preps for chemistry and hematology parameters. No serious adverse experiences were reported with OST.
DISCUSSION
Sulfate tablets achieved a high level of cleansing in the study, comparable with US FDA-approved preps. OST was noninferior to PEG-EA in this study and achieved significantly more Excellent preps overall and in the proximal colon. The OST prep was well-tolerated, with a similar rate of spontaneously reported adverse experiences to PEG-EA and a low rate of severe expected gastrointestinal symptoms.
Topics: Cathartics; Colonoscopy; Drug Combinations; Female; Humans; Magnesium Sulfate; Male; Middle Aged; Nausea; Patient Satisfaction; Polyethylene Glycols; Potassium Chloride; Preoperative Care; Single-Blind Method; Sulfates; Tablets; Vomiting
PubMed: 33165006
DOI: 10.14309/ajg.0000000000001020 -
Physiological Reviews Jul 2020
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Estrone; Fibrinolysin; Hospitalization; Humans; Pandemics; Pneumonia, Viral; Risk Factors; SARS-CoV-2
PubMed: 32412329
DOI: 10.1152/physrev.00017.2020 -
The American Journal of Clinical... Dec 2022Whole-grain (WG) foods are defined by the Dietary Guidelines for Americans (DGA), FDA, AHA, American Association of Cereal Chemists International (AACCI), and Whole... (Observational Study)
Observational Study
BACKGROUND
Whole-grain (WG) foods are defined by the Dietary Guidelines for Americans (DGA), FDA, AHA, American Association of Cereal Chemists International (AACCI), and Whole Grains Council (WGC) in different ways with diverse focuses on grain components only, whole foods, or nutrient contents.
OBJECTIVES
We aimed to compare estimated WG food intake among US adults using different definitions.
METHODS
For each definition, we estimated the mean intake and trends of WG food consumption using survey-weighted 24-h dietary recalls from nationally representative samples of 39,755 US adults aged 20+ y from 8 cycles (2003-2018) of the NHANES. This is an observational study that used deidentified and publicly available datasets.
RESULTS
The estimated mean consumption of WG foods (ounces equivalents/2000 kcal/d, oz. eq./d) varied by definition. In 2017-2018, the AHA (mean [SEM]: 1.05 [0.07] oz. eq./d) and WGC (0.95 [0.07]) definitions yielded the highest amounts, followed by the DGA (0.81 [0.06]), AACCI (0.73 [0.05]), and FDA (0.53 [0.04]). Using all definitions except for WGC, US adults increased WG food intake from 2003-2004 to 2017-2018 with the largest increase (61.5%) using the AHA (from 0.65 to 1.05 oz. eq./d), followed by DGA (0.50 to 0.81) and AACCI (0.51 to 0.73) definitions. For each definition, the main sources of WG foods consumed by US adults were ready-to-eat cereals, cooked grains and cereals, and breads (including rolls and tortillas). For all definitions except the AHA, non-Hispanic White adults and individuals with college degrees or above consumed higher levels of WG foods than non-Hispanic Blacks and those with lower levels of education.
CONCLUSIONS
Different definitions affect the determination of WG foods, estimated intakes, and associated trends in WG food consumption among US adults. These findings call for a standardized definition of WG foods to guide consumers, industry, and policymakers in promoting WG intake in the US.Clinical Trial Registration: Not Applicable.
Topics: Adult; Humans; United States; Nutrition Surveys; Whole Grains; Diet; Nutrition Policy; Edible Grain; Eating
PubMed: 36446403
DOI: 10.1093/ajcn/nqac267 -
Public Health Nutrition Oct 2023To examine the effectiveness of a workplace sugar-sweetened beverage (SSB) sales ban on reducing SSB consumption in employees, including those with cardiometabolic... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To examine the effectiveness of a workplace sugar-sweetened beverage (SSB) sales ban on reducing SSB consumption in employees, including those with cardiometabolic disease risk factors.
DESIGN
A controlled trial of ethnically diverse, full-time employees who consumed SSB heavily (sales ban 315; control 342). Outcomes included standardised measures of change in SSB consumption in the workplace (primary) and at home between baseline and 6 months post-sales ban.
SETTING
Sutter Health, a large non-profit healthcare delivery system in Northern California.
PARTICIPANTS
Full-time employees at Sutter Health screened for heavy SSB consumption.
RESULTS
Participants were 66·1 % non-White. On average, participants consumed 34·7 ounces (about 1 litre) of SSB per d, and the majority had an elevated baseline BMI (mean = 29·5). In adjusted regression analyses, those exposed to a workplace SSB sales ban for 6 months consumed 2·7 (95 % CI -4·9, -0·5) fewer ounces of SSB per d while at work, and 4·3 (95 % CI -8·4, -0·2) fewer total ounces per d, compared to controls. Sales ban participants with an elevated BMI or waist circumference had greater post-intervention reductions in workplace SSB consumption.
CONCLUSIONS
Workplace sales bans can reduce SSB consumption in ethnically diverse employee populations, including those at higher risk for cardiometabolic disease.
Topics: Humans; Sugar-Sweetened Beverages; Beverages; Workplace; Cardiovascular Diseases
PubMed: 37465952
DOI: 10.1017/S1368980023001386 -
British Journal of Anaesthesia Oct 2013
Topics: Anesthesia, General; Anesthesiology; Female; Humans; Intraoperative Awareness; Male; Physicians
PubMed: 24027143
DOI: 10.1093/bja/aet156