Beverage Choices Research Articles

P152 Snacks Offered to Young, Recreational Soccer Players

<h3>Background</h3> Organized sports offer opportunities to promote healthy eating among children. Yet, research on older children shows that unhealthy snacks and beverages are often offered during sports events. <h3>Objective</h3> Assess attitudes of coaches and parents toward sports snack policies and what snack foods and beverages are offered to child athletes; and determine nutrient content of available sports snacks. <h3>Study Design, Setting, Participants</h3> Beverage and snack questionnaires were distributed among all parents (n = 120) and coaches (23) participating in a recreational under 5 years old (U5) and under 6 years old (U6) soccer league within a large Southeastern town. Snack observations for randomly selected U5 and U6 teams (n = 18) were recorded using an observational checklist following all scheduled combined practices/games. <h3>Measurable Outcome/Analysis</h3> Beverage and snack questionnaires assessed socio-demographic information; types, as well as frequency, of snacks and beverages offered to children; reasons for snack and beverage choices; and attitudes toward snack policies. Mean values across all observed snack foods and beverages were calculated for the following key nutrients: calories, protein, fat, carbohydrates, fiber, sugars, and sodium. <h3>Results</h3> Forty-four parents (36.7% response rate) and 23 coaches (100%) completed the questionnaire. Nutrition was the primary factor in snack and beverage selection. Yet, parents and coaches reported offering many low-nutrient foods to their children as snacks. Parents and coaches were receptive to different policy options to support healthy snack options. A total of 687 items were observed across 32 U5 and 28 U6 teams. The most popular snack category was grain-based desserts (31.3% of all snack foods) and 54.9% of all beverages were sugar-sweetened. Less than half (44.4%) of all snack foods and beverages met USDA snack nutrition standards. Snacks offered, on average, 205 calories per child. No vegetables were served during the observations. <h3>Conclusions</h3> Numerous nutrition education opportunities exist to improve the snack food and beverage offerings among parents and coaches in recreational sports settings.

P62 Impact Evaluation Results of Rethink Your Drink Nevada: A Campaign to Promote Healthful Beverage Choices Among SNAP Households

<h3>Objective</h3> To evaluate the effectiveness of Rethink Your Drink Nevada (RYD), a multi-component campaign aimed at promoting healthful beverage choices and reducing intake of sugar-sweetened beverages (SSB) among young, school-age children. <h3>Use of Theory or Research</h3> The approaches of the RYD campaign reflect the principles of social marketing and the social ecological theory. <h3>Target Audience</h3> SNAP-eligible households with 1 or more children between the ages of 6 and 12 located in select Nevada counties. <h3>Program Description</h3> RYD includes a blend of education; marketing; and policy, system, and environmental (PSE) approaches designed to encourage parents/guardians to limit children's consumption of SSB and to provide more healthful beverages. A stoplight theme (also referred to as "whoa, slow, go") was featured in all materials in FY 2019 as a way to convey the relative healthfulness of common drinks. <h3>Evaluation Methods</h3> An online survey was conducted with a random sample of SNAP households from 1 intervention county (Washoe County, n = 1000) and a comparison county where the intervention was not active (Clark County, n = 1000). A unique survey was used for the 2 groups but both surveys contained questions regarding knowledge and behavior related to SSB. The intervention county survey also included questions to assess respondents' self-reported exposure to each of the RYD components. Respondents received a $10 e-gift card. <h3>Results</h3> The survey response rate was 7.5%, including 64 households from the intervention county and 86 households from the comparison county. The results showed that the intervention county respondents with moderate or high exposure to the RYD campaign more often limited their child's intake of SSB vs the comparison county (<i>P</i> < .05). In addition, the intervention group respondents (all exposure groups) had higher knowledge of whoa, slow, and go drinks vs the comparison county respondents (<i>P</i> < .001). <h3>Conclusions</h3> These findings suggest that the RYD campaign may be useful in changing behaviors and increasing knowledge related to SSB. <h3>Funding</h3> Supplemental Nutrition Assistance Program - Education.

Do situational factors impact alcoholic beverage choice

Do situational factors impact alcoholic beverage choice

Late Evening Food Patterns of U.S. Adults Are Differentially Associated with Total Energy Intake and Diet Quality: Results from What We Eat in America, NHANES 2013–2016

Abstract Objectives Eating later versus earlier in the day has been associated with higher energy intake and lower diet quality. However, since food and beverage choices vary, these relationships may not be true of all late evening (LE) eating patterns. The goal of this study was to identify LE patterns of U.S. adults and determine their associations with energy intake and diet quality. Methods One day of dietary intake collected from 9861 adults 20 + years of age (4829 males and 5032 females) in What We Eat in America, NHANES 2013–2016 was analyzed. LE consumption was any food/beverage intake that began between 8:00 pm and 11:59 pm. Hierarchical cluster analysis was used to develop LE food/beverage patterns based on percentage of LE energy provided by each of 23 food groups with adjustment for gram weight. Adjusted estimates of energy intake and Healthy Eating Index (HEI) score were compared between reporters in each LE pattern and non-reporters. Results Nearly two-thirds (64.4%) of adults were LE reporters. The 11 LE patterns identified accounted for 65.9% of the variance in LE energy intake. The 6 most prevalent LE patterns were characterized by intake of sweets, sandwiches, and beverages (23.0% of adults); mixed dishes, meat, and vegetables (12.3%); savory snacks and alcohol (9.5%); candy, nuts, and seeds (5.2%); fruit and 100% juice (4.1%); and milk and dairy drinks (3.4%). Fewer than 3% of adults fell into each of the 5 remaining patterns (white potatoes, pizza, cereal, cooked grains, and legumes). Compared to non-reporters, LE reporters in 7 of the 11 patterns had higher mean total daily energy intake (P &amp;lt; 0.001), ranging from 12.6% higher for sweets, sandwiches, and beverages to 26.7% higher for pizza. Mean HEI scores were higher in 2 patterns (fruit and 100% juice, 56.5; legumes, 59.4) and lower in 1 pattern (pizza, 44.5) than for non-reporters (50.6). Conclusions LE food/beverage consumption is common among U.S. adults. Although most current LE patterns are associated with higher energy intake and few with better diet quality, exceptions were seen, notably for patterns characterized by fruit and legumes. For the majority of LE reporters, modifying LE food/beverage choices to better align with dietary guidance could considerably improve the nutrient density of the overall diet. Funding Sources ARS, USDA.

Perspective: The Role of Beverages as a Source of Nutrients and Phytonutrients

ABSTRACTThe Dietary Guidelines for Americans (DGA) provide nutrition advice for Americans >2 y of age. The 2020–2025 DGA proposes a life stage approach, focusing on birth through older adulthood. Limited recommendations for beverages exist except for milk, 100% fruit juice, and alcohol. The goal of this article is to provide a better understanding of the role of beverages in the diet using current scientific evidence. A Medline search of observational studies, randomized controlled trials, and meta-analyses was undertaken using key beverage words. We highlight the role beverages can play as a part of the DGA and considered beverages not traditionally included, such as those that are phytonutrient dense. Our primary consideration for beverage consumption targeted healthy Americans aged ≥2 y. However, with the proposed expansion to the life span for the 2020–2025 DGA, we also reviewed evidence for infants and toddlers from birth to 24 mo. Examples are provided on how minor changes in beverage choices aid in meeting recommended intakes of certain nutrients. Guidance on beverage consumption may aid in development of better consumer products to meet broader dietary advice. For example, beverage products that are nutrient/phytonutrient dense and lower in sugar could be developed as alternatives to 100% juice to help meet the fruit and vegetable guidelines. Although beverages are not meant to replace foods, e.g., it is difficult to meet the requirements for vitamin E, dietary fiber, or essential fatty acids through beverages alone, beverages are important sources of nutrients and phytonutrients, phenolic acids and flavonoids in particular. When considering the micronutrients from diet alone, mean intakes of calcium (in women), potassium, and vitamins A, C, and D are below recommendations and sodium intakes are well above. Careful beverage choices could close these gaps and be considered a part of a healthy dietary pattern.

Effect of Maternal Health Literacy and WIC Participation on Selection of Sugar-Sweetened Beverages and Energy Dense Foods

Background: In the United States almost a quarter of children 2-5 years of age are considered overweight or obese. Many potential causes have been implicated including low maternal health literacy and high intake of sugar-sweetened beverages (SSBs). The effects of maternal health literacy, Women, Infant, and Children (WIC) participation, on selection of SSBs and energy dense foods needs to be examined. Aims: To examine correlations between maternal health literacy and selection of SSBs and energy dense foods during a feeding simulation (FS) for their children. WIC participation and SSB (or 100% juice) selection was also examined. Methods: Thirty-two mothers of 2 and 3-year-old children completed a demographic survey, and health literacy assessment (Newest Vital Sign, NVS) and a child feeding simulation (FS). For the FS, participants were presented with 37 discreet food and beverage choices with representation from each food group and some non-food group (e.g. soda, non-carbonated sugar-sweetened beverage, butter). The outcome variable comprised ratings of respondents from the NVS scale. The scale was dichotomized into two separate groups, representing “low-health-literacy” and “high-health-literacy”. Stratified analyses were conducted to examine whether percentage of calories as well as total number of calories selected daily varied by caloric density grouping of foods and beverages into “Go” (‘Almost Anytime’ foods), “Slow” (‘Sometimes’ foods), and “Whoa” (‘Once in a While’ foods). Results: Results indicate about a third of mothers had either high likelihood/possible limited health literacy. Mothers with lower scores on a health literacy assessment were not more likely to select less healthy choices. Examination of distribution of the percentage of calories consumed in three different caloric density groups were not statistically significant, indicating that there is no difference in the types of calories which are dense, or healthy by how health literate a respondent was. In addition, there was a not statistically significant difference among mean total number of daily calories consumed by health literacy level. Parents who were more likely to choose an SSB or juice during breakfast had a lower rating on the NVS questionnaire (p=0.108), whereas parents who choose a sugar-sweetened beverage or juice for lunch (p=0.305) or dinner (p=0.323) actually had a higher NVS score. However, none of these findings were statistically significant. WIC participants were significantly more likely to choose a SSB or juice for breakfast than were non-WIC participants (p=0.004). There were no significant differences in whether parents chose sugar-sweetened beverages or juice for lunch (p=0.427), dinner (p=0.433), or snack time (p=1.000). Conclusions: Health literacy and WIC participation does not appear to have an impact on selection of energy-dense foods and SSBs. Clinical implications: Health literacy is an important parameter to consider when educating patients but dietary implications may not be relevant.

Correlates of sugar-sweetened beverage consumption of Malaysian preschoolers aged 3 to 6 years

BackgroundThere is little information about the diet, lifestyle and parental characteristics associated with habitual sugar-sweetened beverage (SSB) consumption in Asian children. The aim of the present study was to assess cross-sectional associations between habitual SSB consumption and preschoolers’ diet, physical activity, sedentary behaviour as well as parental and child characteristics in Malaysian preschoolers aged 3 to 6 y.MethodsA total of 590 preschoolers, comprising 317 boys and 273 girls were included. Pre-pilot parental questionnaires were used to assess diet, physical activity (PA) and sedentary behaviour practices and anthropometry was assessed in preschoolers and their parents.ResultsMultiple logistic regression analyses showed that preschoolers with more frequent weekly intake of snacks [OR 2.7; 95% CI, 1.6–4.4; p < 0.001] and monthly fast food consumption [OR 3.5; 95% CI, 1.9–6.3; p < 0.001], were associated with higher SSB intake (≥5 days in a week), after adjustments of potential confounders. Preschoolers with higher daily fruit and vegetable intake had lower SSB intake [OR 0.4; 95% CI, 0.2–0.8; p = 0.011]. A positive association of higher weekly vigorous PA [OR 2.0; 95% CI, 1.1–3.7; p = 0.030] and daily screen-based practices [OR 2.0; 95% CI, 1.2–3.6; p < 0.001] on habitual SSBs intake was also substantiated.ConclusionMultiple diet, physical activity and sedentary behaviour factors were significantly associated with SSB intake among Malaysian preschoolers. Continued effort is required to encourage healthier beverage choices, as well as healthy diet and active lifestyle practices among children during the critical early years of growth and development.

Enablers and barriers to implementation of and compliance with school-based healthy food and beverage policies: a systematic literature review and meta-synthesis.

Schools have been recognised as a potential setting for improving young peoples' food and beverage choices; however, many schools fail to adhere to healthy food and beverage policy standards. The current study aimed to explore the enablers and barriers to effective implementation of and compliance with school-based food and beverage policies. Systematic review and meta-synthesis. Eight electronic databases were searched for articles in June 2019. Studies were eligible for inclusion if they reported on implementation and/or compliance of school-based food and/or beverage policies with outcomes relating to enablers and/or barriers. This review had no restrictions on study design, year of publication or language. Seventy-two full-text articles were assessed for eligibility, of which twenty-eight were included in this review. Studies conducted globally that focused on schools. School-based healthy food and beverage policies. Financial (cost of policy-compliant foods, decreased profit and revenue), physical (availability of policy-compliant foods, close geographical proximity to unhealthy food outlets) and social (poor knowledge, understanding, and negative stakeholders' attitudes towards policy) factors were the most frequently reported barriers for policy implementation. Sufficient funding, effective policy communication and management, and positive stakeholders' attitudes were the most frequently reported enablers for policy implementation. There is a need for better communication strategies, financial and social support prior to school-based food policy implementation. Findings of this review contribute to a thorough understanding of factors that underpin best practice recommendations for the implementation of school-based food policy, and inform those responsible for improving public health nutrition.

Spaces of Intemperance & the British Raj 1860–1920

ABSTRACT The history of the British Empire in India is one awash with alcohol. Drinking was a common practice throughout colonial society, acting as social necessity and source of a public anxiety. However, rather than only acknowledging what and why individuals in colonial India drank, it is of equal importance to consider where they did so. Despite its ubiquity, alcohol consumption in India was responsive to the dynamics of space and place, and both the habits of drinkers and the social, military or governmental response to their actions altered greatly depending on locations individuals were able to access, and in which they consumed alcohol. This article draws focus on the spatiality of colonial drinking through an examination of key environs that characterise the British experience of India, and in which colonial Britons drank regularly. Examining published sources alongside archival material, the article argues that drinking in colonial India is rendered simultaneously private and public, personal and socially performative, as a result of the hybrid spaces in which individuals access alcohol. The culture of drinking in colonial context, and the manner through which the drinker is constantly under scrutiny makes the act of drinking as much to do with social performance as it is to do with personal taste, with space in each instance a governing influence on choice of beverage, intent, behaviour, and the perceived identity of the drinker themselves.

Acceptability and feasibility of a café-based sustainable food intervention in the UK.

Dietary change is needed to improve health and reduce the environmental burden of food production and consumption. Using an Intervention Mapping approach, this study aimed to explore the views caterers and customers held towards point-of-choice interventions that promote healthy and environmentally friendly (EF) food and beverage choices at the University of Sheffield. Intervention options proposed during focus groups were devised using the Nuffield Bioethics ladder of intervention. Ten focus groups were held involving caterers (n = 16) and customers (n = 45). Thematic analysis was conducted on the transcripts of caterer and customer focus groups seperately, and then comparisons were made to identify concerns about the acceptability and feasibility of intervention options. Attitudes towards intervention options varied considerably amongst stakeholders, with the greatest disparity of opinion in the acceptability of interventions that restrict or limit personal choice, particularly with regards to meat consumption. Information provision was favoured as an acceptable intervention by both customers and caterers. However, labelling products in terms of their environmental impact was considered practically unfeasible. Social norms around eating also emerged as influencing the acceptability and feasibility of interventions with concerns raised about: shaming customers who chose meat, the exclusivity of vegan choices and the limited availability and appeal of meatless café options. Financial considerations were the main priority of caterers when discussing point-of-choice interventions. An acceptable and feasible café-based intervention ought to increase awareness and understanding of healthy and EF food choices, protect customer choice and avoid additional costs.

Do drinking buddies matter for young children?: Preschoolers’ conformity to remote peers’ beverage choices

Young children tend to follow others’ food preferences. Whether this conformity applies to actual food/beverage consumption, however, is understudied. The present study tested whether sixty-three 3- to 6-year-old preschoolers conformed to remote peers’ beverage taste preferences. Participants indicated taste preference between two beverage options (standard v. sweetened), independently and after having been told that remote peers selected the opposite beverage. After the social influence manipulation, beverage preference and quantity consumed were measured. Results revealed a trend of conformity both in beverage preferences and subsequent private consumption patterns. These findings suggest that peers may be influential social reference figures for young children not just for beverage choice but also for associated consumption behavior. Age and thirst status was also found to be correlated with conformity, such that peers may play a more important role as preschoolers get older and that thirst may weaken social influence by peers.

Can the updated nutrition facts label decrease sugar-sweetened beverage consumption?

Sugar-sweetened beverages are the primary source of added sugar consumption in the U.S, and the Food and Drug Administration recently updated the Nutrition Facts Label to communicate the amount of added sugars in manufactured food. The changes to the Nutrition Facts Label (NFL) is concurrent with some cities implementing policies that place an excise tax on sugar-sweetened beverages. While sugar-sweetened beverages taxes may be effective at changing quantity demanded, the updated NFL has the potential to shift the demand curve by decreasing friction and mental gaps associated with the communication of nutrition information. We conducted a randomized control trial using eye tracking technology to determine if the updated NFL garnered more visual attention or affected beverage choice. Participants were also exposed to an information intervention to determine if the updated NFL affected choice after receiving information about added sugars. We found that consumers were more visually attentive to nutrition information displayed by the updated NFL; however, viewing the updated label did not affect choice of beverages nor did it improve the effectiveness of the dietary information on subsequent choices.

School nutrition: Support for providing healthy food and beverage choices in schools.

The implementation of nutrition policies and guidelines in Canadian schools has increased the availability and consumption of nutrient-rich foods while reducing access to and consumption of foods and beverages that are high in sugars, sodium, and saturated fats. Positive changes in health outcomes for children and youth, such as improved body mass indices, have been observed. However, observed impacts of school nutrition policies on academic performance have been mixed. This statement reviews key elements of school nutrition policies, with specific focus on nutrition standards. School nutrition policies should align with recommendations in Canada's Food Guide and promote nutrient-rich foods and beverages that are lower in saturated fat, sugar, and sodium.

Caribbean Diaspora Healthy Nutrition Outreach Project (CDHNOP): A Qualitative and Quantitative Approach to Caribbean Health.

Background:Obesity prevention and its associated co-morbidities such as diabetes require a multi-tiered, culturally sensitive, population-based approach. South Florida’s tri-county area is home to approximately 75% of Florida’s total Caribbean immigrant population. This project is the first Caribbean-focused intervention using the Go-Slow-Whoa or GSW format which designates whether a food or beverage should be chosen frequently (Go – green), less often (Slow – yellow), or rarely (Whoa – red) based on the content of nutrients, sodium, fat, and sugar.Specific Aims:1. To create and evaluate culturally appropriate nutrition materials for the Caribbean diaspora population in Broward County (i.e. tailor existing GSW evidence-based materials for this population). 2. To quantify which social determinants of health are most relevant to this population.Methods:Mixed methods were utilized in this study. The qualitative, exploratory arm consisted of semi-structured focus groups that included 38 subjects from five Caribbean countries most represented in South Florida: Jamaica, Haiti, Trinidad and Tobago, Cuba and Dominican Republic. The quantitative arm employed descriptive and inferential statistics to analyze social determinants of health (SDOH) obtained from a modified National Association of Community Health Centers’ PRAPARE survey. Intercept survey data was also collected from a convenience sample of 24 Caribbean immigrants in Broward County.Findings:Analysis revealed a lack of culturally appropriate foods and exercise examples in the current GSW materials. At 92% and 82% respectively, an overwhelming majority of our intercept surveys indicated that our revised, culturally appropriate materials were helpful in making positive food and beverage choices. Further study is required to determine which SDOH variables are relevant to this population.Conclusions:Health disparities and inequity in the healthy living education of our Caribbean subpopulation are best addressed using an inclusive research frame that captures the cultural essence and preferences of this understudied community.

Examining beverage-specific trends in youth drinking in Australia before and after the implementation of the alcopops tax.

Alcohol consumption among young Australians has declined markedly since the early 2000s. As yet, there has been no data on how this decline has been spread across different beverages and instead high-level survey data with significant potential for recall and other bias has been used. Trends in beverage choice among young people following an increase in the 'alcopops' tax have also not received much attention. Data on 'yesterday' drinking occasions were obtained from five waves (2004, 2007, 2010, 2013, 2016) of the National Drug Strategy Household Survey. A total of 23 536 respondents aged 14-29 years were included in this study. Descriptive and regression analyses were conducted to explore trends in alcohol consumption and changes in beverage preferences. Youth drinking declined by 45% across the study period, with declines of 66% in premix, 48% in spirits, 46% in beer and 33% in wine. Consumption of premix was significantly lower in 2013 and 2016 compared to 2007 amongst the overall sample, males, females, respondents aged 14-21 and 22-29 years, light and heavy drinkers. Significant reductions were also observed in the consumption of premix immediately following the tax (2010) for the younger age group, males and light drinkers. Youth consumption of alcohol has declined during the study period with significant variation across beverage types. We found some evidence of a separate impact for the alcopops tax, although for some groups, declines in premix consumption occurred well after the implementation of the tax.

Fluid intake in children

AbstractIntroductionWe monitored fluid intake in children. The hydration of children during morning school classes and on consumption of high-calorie drinks. Subclinical dehydration, expressed as urine osmolarity above 800 mmol / kg, may result in lack of concentration and less effective listening.Population and methodologyThe population included 3,360 children aged as follows: a) 6–35 months, b) 4–6 years, c) 7–10 years d) 11–14 years. 103 children aged 10.3 ± 1 years were included in the study regarding body hydration. The evaluation looked at the intake of food and fluids consumed by children in full-day diet over a period of 3 to 5 days and recorded by the Nutridan program. Child hydration was assessed using three urine osmolarity samples taken at bedtime, in the morning and just before lunch break. The data was evaluated statistically against the reference values for nutrient intake of DACH.Results and discussionThe median water intake in children was 101–103% of the Dietary Reference Values (DRV). In the b, c, d groups, the median was 81% - 82%, i.e 75% of DRV. 10% of 4 to 6-year-old children had water intake below 49% of DRV, 10% of 7 to 10 year-olds less than 54% of DRV and 10% of 11 to 14-year-olds less than 50% of DRV. A study regarding school children has showed that only 70% of the children drink at breakfast. 27% of the children do not consume any fluids in the morning. The mean urine osmolarity was 724 in the morning and 738 mmol / kg just before lunch. Children who had drunk less than 250 ml of water during breakfast or less than 400 ml of water during breakfast and second breakfast had a urine osmolarity of 910 and 850 mmol / kg respectively just before lunch. In school children, the proportion of sugars received from sweetened beverages accounted for 19.1% of their total calorie intake. 10% of the children in groups c) and d) had this value higher than 28.2 and 30.4% respectively. The results based on full-day diet show that sweetened drinks account for 79% of fluids consumed by children at school, whereas only for 72% at home.The results of our studies have identified the areas where it is necessary to provide education regarding nutrition of children, to raise awareness of the importance of fluid intake, particularly focusing on the systematic approach and the choice of appropriate beverages ensuring adequate fluid intake.

Sports Dietitians Australia Position Statement: Nutrition for Exercise in Hot Environments.

It is the position of Sports Dietitians Australia (SDA) that exercise in hot and/or humid environments, or with significant clothing and/or equipment that prevents body heat loss (i.e.,exertional heat stress), provides significant challenges to an athlete's nutritional status, health, and performance. Exertional heat stress, especially when prolonged, can perturb thermoregulatory, cardiovascular, and gastrointestinal systems. Heat acclimation or acclimatization provides beneficial adaptations and should be undertaken where possible. Athletes should aim to begin exercise euhydrated. Furthermore, preexercise hyperhydration may be desirable in some scenarios and can be achieved through acute sodium or glycerol loading protocols. The assessment of fluid balance during exercise, together with gastrointestinal tolerance to fluid intake, and the appropriateness of thirst responses provide valuable information to inform fluid replacement strategies that should be integrated with event fuel requirements. Such strategies should also consider fluid availability and opportunities to drink, to prevent significant under- or overconsumption during exercise. Postexercise beverage choices can be influenced by the required timeframe for return to euhydration and co-ingestion of meals and snacks. Ingested beverage temperature can influence core temperature, with cold/icy beverages of potential use before and during exertional heat stress, while use of menthol can alter thermal sensation. Practical challenges in supporting athletes in teams and traveling for competition require careful planning. Finally, specific athletic population groups have unique nutritional needs in the context of exertional heat stress (i.e.,youth, endurance/ultra-endurance athletes, and para-sport athletes), and specific adjustments to nutrition strategies should be made for these population groups.

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.

A Material Perspective of Wood, Smoke, and BBQ

For those of us who have attempted to barbecue (BBQ), wood matters. Smoking delicious meats is effectively a chemical process that involves control over combustion of organic materials. Here, we get joint insight from a local pitmaster and a materials scientist.

Do we practice what we preach? Assessing the food environment in Malta’s only state hospital

Abstract Introduction Food environments are likely to be key contributors to the development of diabetes and obesity. Hospitals should strive to create a model food environment that facilitates and promotes a healthy eating behaviour among visitors, patients and staff. The study objective was to evaluate foods and beverages available for purchase in vending machines at Malta’s only state hospital. Methods An observational study gathered data regarding location, type of food and beverage items available in the vending machines found within the public areas within the only state hospital in Malta. All items on sale were categorized into ’healthy’ and ’unhealthy’ food and beverage according to pre-defined criteria. Results There were 33 vending machines: sixteen offered beverage options, and the remainder contained food items, which displayed exclusively confectionary items. The beverage machines were identically stocked so that bottled water contributed 17%, diet soft drinks 33% and regular soft drinks 50% of overall beverage choices. Fresh vegetables or fruit were not available for sale (except for 1 beverage machine offering fresh squeezed orange juice) with most items on display classified as ‘unhealthy’. Conclusions Hospital food environments should complement health professionals’ efforts in promoting healthier lifestyles, however, the majority of foods and beverages available for purchase at Malta’s only state hospital through vending machines is unhealthy. Urgent action is required to rectify the current situation. Key messages Vending machines offered ’unhealthy’ choices to patients, relatives and staff. Hospital food environment should promote healthier food and beverage options.