Risk Of Other Non-communicable Diseases Research Articles

Optimising message framing to advance cancer prevention pricing interventions in the UK and US

Abstract Background One-third of the burden of cancer is associated with four health harming behaviours - tobacco use, alcohol consumption, poor diet and physical inactivity. The growing evidence base supporting price-related policies to curb over consumption is of interest to governments globally. However, implementation requires public and policy-maker support. The aim of this study is to enhance our understanding of the features of message framing that influence public support for price-related policies in relation to tobacco, alcohol, and sugar. Methods We conducted 18 semi-structured interviews (9 UK and 9 USA) exploring knowledge, attitudes, and beliefs of 4 price policies in relation to tobacco, alcohol and sugar. Interviewees included cancer policy advocates, cancer survivors and members of the public. We used NVivo 12 to organise the data for inductive and deductive thematic analysis. Results Common supportive features included: (i) highlighting the health benefit (eg reduced cancer risk), arising from impact on purchasing behaviour; (ii) indirectly making the health harm associated with consumption clear. Common unsupportive features included: (i) policy effectiveness will depend on size of the financial penalty and consumer response; (ii) such policies are unfair on sensible consumers and potentially regressive. Interviewees were more supportive of price-related policies for products containing tobacco where they perceived a stronger association with cancer risk. Conclusions This study reveals important differences in levels of persuasiveness arising from the framing of messages to promote price-related policies. The results informed the identification of 4 frames to be tested in a multi-factorial quantitative study, currently under way. These frames can be characterised as: F1 - To reduce the financial strain on healthcare systems; F2 - For the protection of children; F3 - To reduce cancer risk; and F4 - To reduce the risk of other non-communicable diseases. Key messages Tailoring the framing of price-related policies in relation to the product they are applied to may increase public acceptability. This may in turn facilitate their implementation.

Pregestational overweight and obesity are associated with differences in gut microbiota composition and systemic inflammation in the third trimester.

The obesity epidemic is a global challenge, and the velocity of propagation is high in the population at reproductive age. Overweight and obesity during pregnancy have been associated with high birth weight and an increased risk of childhood obesity, reinforcing the risk of other non-communicable diseases. Obesity involves chronic low-grade systemic inflammation. New biomarkers for early detection of obesity risk are urgently required. The aim of this study was to identify the connection between pregestational BMI (pre-BMI) status and inflammatory biomarkers during the third trimester of pregnancy and their association with intestinal microbiota composition. Fifty-four pregnant women were classified according to pre-pregnancy BMI as normoweight, overweight, or obese. Weight gain, inflammatory biomarkers (hs_CRP, haptoglobin, and suPAR), and microbiota composition were assessed during the third trimester. A significant lower weight gain for obese mothers and a positive correlation between pre-BMI and inflammatory biomarkers were detected (Spearman’s correlation). Haptoglobin levels were significantly higher in overweight and obese mothers. Higher Firmicutes levels and a higher ratio Firmicutes/Bacteroidetes were observed in the overweight and obese subjects. High hs_CRP and haptoglobin levels were also correlated with decreased microbiota diversity (Shannon index), whereas haptoglobin and hs_CRP values were correlated with several microbiota components, such as Ruminococcus gnavus and Faecalibacterium, and with specific phyla in the normoweight and overweight mothers; no significant associations with microbiota were found for suPAR. In conclusion, haptoglobin and hs_CRP reflected pregestational BMI status and related microbiota components, but haptoglobin was a better biomarker for microbiota associated with overweight. suPAR was associated with low grade inflammation dependent on pre-pregnancy BMI, but it was not related to deviated microbiota profiles.