Дисертації: "Sugar sweeted beverages"

1

Hedrick, Valisa E. "Development and Evaluation of a Brief Questionnaire to Assess Habitual Beverage Intake (BEVQ-15): Sugar-Sweetened Beverages and Total Beverage Energy Intake." Diss., Virginia Tech, 2011. http://hdl.handle.net/10919/77240.

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Attention on beverage intake, specifically sugar-sweetened beverages (SSB), has increased in recent years (1). Energy-containing beverages do not provide the same satiety as solid foods, and intake of solid food is not spontaneously reduced when energy-containing beverages are consumed (2,3). This may contribute to positive energy balance (1). Conversely, a reduction in energy intake occurs by replacing SSB with water and may facilitate weight loss (4,5). A valid, reliable and sensitive assessment tool for quantifying beverage consumption and determining its influence on weight status could help advance research on this topic. Three studies were conducted to develop the BEVQ, a self-administered quantitative beverage intake questionnaire. First study (n=105): the 19-item BEVQ's validity was examined by comparing participant's beverage intake to the "gold standard" of dietary intake assessment, food intake records; reliability was assessed by comparing two BEVQ's, administered two weeks apart. The BEVQ demonstrated acceptable validity (R2=0.53, water g; 0.46, 0.61 total beverage g, kcal; 0.49, 0.59 SSB g, kcal) as well as reliability (all correlations P<0.001) (6). Second study (n=1,596): the BEVQ underwent exploratory factor analyses (EFA) to identify the potential to reduce items. Three beverage items, which contributed <10% to total beverage intake g, kcal, were eliminated; EFA identified beer and light beer as a combined category. The refinement led to the 15-item BEVQ, which produced a lower readability score of 4.8 and shorter administration time (~2 min) (7). Third study (n=70): the ability of the BEVQ-15 to detect changes in beverage intake was evaluated by increasing participant water and fruit juice consumption and evaluating BEVQ-15 outcomes before and after the feeding period. Increases in water, juice and total beverage (g) were detected during the intervention period (P<0.001) (8). This rapid, valid, reliable and sensitive beverage intake assessment tool may determine the habitual intake of SSB and other beverages, and evaluate the effectiveness of clinical and public health interventions which aim to address national SSB recommendations. Future work is needed to evaluate the validity and reliability of the BEVQ-15 in children, as well as develop cost-effective noninvasive biomarkers that can objectively estimate intake of specific foods/dietary components (9).
Ph. D.

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2

Potgieter, Bianca. "Die rol en belang van suikerbelasting in Suid-Afrika." Diss., University of Pretoria, 2017. http://hdl.handle.net/2263/65711.

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The former finance minister stated in his budget speech in 2016 that sugar tax would come into force in South Africa from 1 April 2017. The treasury's reason for implementing sugar taxation is to reduce the health problems caused by sugar. It is nothing new to use fiscal measures to recover both taxes and to prevent health problems but it was not yet possible to reach a definite conclusion about the impact of sugar tax on the consumption of sugary drinks and the prevalence of obesity. The reason for this is that there is evidence that the implementation of food tax in different countries has shown different results in terms of public health issues and tax benefits. In South Africa, the implementation of sugar tax can either reduce the prevalence of obesity and thereby have a positive effect on the economy or its implementation may adversely affect the economy. If treasury does not implement sugar tax the economy can also be adversely affected by the prevalence of obesity. This dissertation deals with the effects of non-communicable diseases and sugar tax on the South African economy. The focus is on how sugar tax is being implemented internationally and how South Africa intends to implement sugar tax.
Die voormalige minister van finansies het in sy begrotingstoespraak in 2016 vermeld dat suikerbelasting vanaf 1 April 2017 in Suid-Afrika in werking gaan tree. Die tesourie se rede vir die implementering van suikerbelasting is om, in samewerking met die Departement van Gesondheid, die gesondheidsprobleme wat deur suiker veroorsaak word te verminder. Dit is niks nuuts om fiskale maatstawwe te gebruik om beide belasting in te vorder en gesondheidsprobleme te voorkom nie, maar dit was nog nie moontlik om tot ’n definitiewe gevolgtrekking te kom oor die impak van suikerbelasting op die verbruik van suikerversoete drankies en die voorkoms van vetsug nie. Die rede hiervoor is dat daar bewyse is dat die implementering van voedselbelasting in verskillende lande verskillende resultate getoon het in terme van openbare gesondheidskwessies en belastingvoordele. In Suid-Afrika kan die implementering van suikerbelasting óf die voorkoms van vetsug verminder en sodoende die ekonomie bevoordeel óf die implementering daarvan kan die ekonomie negatief beïnvloed. Indien die tesourie nie suikerbelasting implementeer nie kan die ekonomie as gevolg van die voorkoms van vetsug negatief beïnvloed word. Die kern van hierdie skripsie handel oor die gevolge van nieoordraagbare siektes en suikerbelasting op die Suid-Afrikaanse ekonomie. Daar word spesifiek gefokus op hoe suikerbelasting internasionaal geïmplementeer word en hoe Suid-Afrika beoog om suikerbelasting te implementeer.
Mini Dissertation (LLM)--University of Pretoria, 2017.
Mercantile Law
LLM
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3

Vargas, García Elisa Joan. "Interventions to influence consumption of sugar-sweetened beverages." Thesis, University of Leeds, 2017. http://etheses.whiterose.ac.uk/19710/.

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Evidence for higher intakes of sugar-sweetened beverages (SSBs) driving the risks of obesity, type 2 diabetes and cardiovascular disease is increasing. As a result, SSBs have been targeted across public health interventions worldwide, including Mexico, which has one of the highest levels of consumption of SSB and alarmingly high childhood obesity rates. This thesis aimed to determine the effectiveness of interventions and intervention’s components to reduce consumption of SSBs and to develop and implement an intervention in school-aged children in central Mexico. A systematic review and meta-analysis was undertaken to examine the impact that interventions have had to reduce SSB intake or increase water intake across all age groups. Identification and analysis of behavior change techniques used in interventions was also undertaken. Exploratory analyses on data from children in central Mexico indicated that 12% of 6 to 15 year olds met criteria for Metabolic Syndrome. Consequently, a 12-week school-based programme was developed to influence consumption of SSB through promotion of water intake. Sixteen classes in four schools were allocated to the intervention group (N= 2 schools, 8 classes) or control group (N= 2 schools, 8 classes). Participants were 337 children aged 7-12 years (222 in intervention and 115 in controls). Pooled estimates from meta-analyses indicated that interventions modestly influence SSB intakes in children (-92 mL/day (95% confidence interval [CI] -145 to -39) 18 studies, P < 0.01) but not in adolescents (-52 mL/ day, 95% CI -121 to 17; 4 studies, P = 0.14) or in adults (-23 mL/day, 95% CI -56 to 9; 7 studies, P = 0.16). Pooled estimates of water intakes were only possible for interventions in children and these were indicative of increases in water intake (MD +80 mL/day, 95% CI 6 to 155; 6 studies, P = 0.04). There was some evidence to suggest model/demonstrating the behaviour or parental involvement helped to reduce SSB intake. Results from the study in Mexico highlighted that intervention and control groups achieved reductions in daily intake of SSB by -61 mL/day and -132 mL/day, respectively, with the difference between groups not being statistically significant (71 mL/day; 95% CI: 94 to 236; p=0.4). Consumption of water throughout the day decreased in both groups (Intervention: -169 mL/day; 95% CI: -275 to -62 vs controls: 235 mL/day; 95% CI: -369 to -102). Information from a process evaluation highlighted difficulties in children and staff to deliver and adhere to activities as planned. In conclusion, community-level interventions can influence positive changes in consumption of SSB in children but not in adolescents or adults; an educational and environmental approach focusing on the promotion of water intake in Mexican children was insufficient to improve consumption patterns of SSB and water. Interventions in the future could potentially be benefitted by longer implementation as well as parental involvement.

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4

Yuhas, Maryam. "Improving Rural Health Disparities: Understanding and Addressing Intake of Added Sugars and Sugar-Sweetened Beverages among Adults and Adolescents." Diss., Virginia Tech, 2019. http://hdl.handle.net/10919/100730.

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Around 46.2 million Americans living in rural areas are disproportionately burdened by health disparities. Likewise, obesity and obesity-associated diseases (e.g., diabetes, cardiovascular disease) are much higher for rural residents when compared to their urban counterparts. There is a high need to understand and address the nutritional determinants of these health inequities among adults and adolescents. One area of concern in rural dietary habits pertains to added sugars and more specifically, sugar-sweetened beverages (SSB). Excessive added sugars and SSB intake have been strongly linked to many of the nutrition and chronic disease disparities impacting rural residents. Moreover, studies conducted in rural populations have found high consumptions of these in both adults and adolescents. There is an opportunity to better understand added sugars and SSB patterns in rural populations to inform the development of culturally relevant, multi-level interventions that address high consumption. Study #1 is a cross-sectional study that explores top food and beverage sources of added sugars in the diet of adults (n = 301) living in rural areas of Southwest Virginia. Study #2 uses a nationally representative sample of adolescents (n = 1,560) from the Family Life, Activity, Sun, Health and Eating (FLASHE) study sponsored by the National Cancer Institute, to explore factors across the levels of the socioecological model associated with adolescent SSB intake. Study #3 utilizes focus groups and a pilot trial to understand language preferences, acceptability and use of SMS aimed at caregivers to reduce SSB intake in both caregivers and adolescents living in rural areas of Southwest Virginia (n = 33). Collectively, these three studies offer recommendations and culturally relevant strategies for future large-scale trials aimed at reducing SSB intake among adolescents and caregivers in rural communities and ultimately reducing rural health disparities.
Doctor of Philosophy

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5

MacDougall, Carly Rimmer. "Validity, Reliability, and Sensitivity of the d13C Added Sugar Biomarker in Children and Adolescents." Thesis, Virginia Tech, 2016. http://hdl.handle.net/10919/81182.

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Currently, 17.1% of 2-19 year olds are obese. While obesity is a multifactorial disease, energy imbalance is commonly cited as a primary etiology. Excess consumption of added sugar (AS) from corn and cane sweeteners has been implicated as a leading contributor to weight gain in youth and adults. Children and adolescents are among the highest consumers of AS, which account for 16% of their total daily calories (~318 calories/d), which is above American Heart Association, World Health Organization, and Dietary Guidelines for Americans recommendations. Although a strong temporal relationship has been established between weight gain and increased consumption of corn and cane sweeteners, a causal relationship is difficult to determine due to the inherent limitations of self-report dietary assessments (i.e., measurement errors such as underreporting). Further, obtaining accurate dietary intake data from children and adolescents is challenging due to the high dietary variability observed in this population. To overcome the limitations of self-report dietary assessments, the Institute of Medicine has recognized the need to develop and validate objective biomarkers of dietary intake.One such biomarker is the delta (δ) 13C biomarker; preliminary studies suggest that the δ13C biomarker is a valid, objective indicator of AS intake in adults and holds promise for children and adolescents. Establishing δ13C as a valid, reliable and sensitive means for assessing habitual AS intake in children and adolescents provides valuable objective dietary information with the potential to address a pressing public health concern, which is the relationship between AS intake and health.
Master of Science

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6

Du, Yuerong, and 杜月蓉. "Sugar sweetened beverages and childhood dental caries : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206918.

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Background Dental caries on primary and permanent teeth is a common chronic disease worldwide with negative effects on children`s quality of life, both in the present and future. Sugar intake is a risk factor for caries. However, the association between sugar-sweetened beverages (SSBs) and dental caries is unclear. Methods A systematic review of relevant literature was performed in PubMed, Cochrane Library and ScienceDirect to locate every journal article in English assessing the association between SSBs and dental caries up to May 2014. Quality assessment criteria were formed by 10 essential items in STROBE statement. Results Fourteen studies were included in the present review, of which 11 were cross-sectional studies and 3 were cohort studies. Study participants were recruited from dentistry units, schools or communities. Interview-based or self-reported questionnaires for parents or caregivers were measurement tools for exposure variables. Clinical/dental examination was used to assess the outcome variables in participating children. Decayed, missing, and filled system was used among studies to record caries status. Sources of potential bias may be measurement on exposure and outcome as well as sources and methods of participants selection. Confounding existed due to nature of observational study and possible confounders included age, gender, education and location of children as well as socioeconomic position and oral health awareness of parents. Synthesis of results suggested that there may be a positive association between SSBs and dental caries, providing evidence for policymaking and recommendations for further studies. Conclusions Sugar-sweetened beverages intake could be considered as positively associated with childhood dental caries. Prevention strategy on individual level and population level on dental caries should put more attention on SSBs. Further experimental studies or research with advanced epidemiological instruments are needed for more confident recommendations on preventive strategies.
published_or_final_version
Public Health
Master
Master of Public Health

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7

Chan, Tol. "Sugar-Sweetened Beverage Consumption Frequency vs. BMI: National Health and Nutrition Examination Survey 2003-2004." Digital Archive @ GSU, 2011. http://digitalarchive.gsu.edu/iph_theses/186.

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Objective: Over the past several decades, increase in SSB consumption has coincided with increasing rates of obesity. This study evaluated the association between SSB consumption and BMI. Methods: FFQ data from NHANES 2003-2004 was used to examine 100% orange juice, sugar-sweetened fruit drinks, soft drinks, and other beverage consumption frequency vs. mean BMI. ANOVA, relative risk, and linear regression analyses were done. Results: ANOVA found significant differences in mean BMI across consumption frequencies for orange juice (p=.001), sugar-sweetened fruit drinks (p<.001), and soft drinks (p<.001). Increased risk of being obese was associated with increasing consumption frequency for orange juice (RR=1.282), sugar-sweetened fruit drinks (RR=1.417), and soft drinks (RR=1.749). Multiple linear regression found significant positive associations between mean BMI and sugar-sweetened fruit drinks (b=.056, p=.004) and soft drinks (b=.134, p=.001). Conclusion: This study found that mean BMI was positively associated with certain beverage consumption frequency (sugar-sweetened fruit drinks, soft drinks consumed during summer, soft drinks consumed during rest of year), but not others (100% orange juice). Fewer significant results were found when confounding variables were controlled. Drinking soft drinks or sugar-sweetened fruit drinks increased the risk of obesity more than drinking natural fruit juices.

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8

Ferguson, Katherine E. "Demographic Factors and Beverage Consumption Patterns: Health Literacy, Education, and Income Level." Thesis, Virginia Tech, 2011. http://hdl.handle.net/10919/42513.

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Over the past several decades, the prevalence of overweight and obesity has increased to 68% of American adults1. During this same time period, there has been an increase in sugar-sweetened beverage consumption. This increase in added sugar consumption, particularly from sugar-sweetened beverages, has been theorized as a possible contributor to the obesity epidemic2,3,4. Sugar-sweetened beverages are the number one source of added sugars in the American diet and organizations such as the American Heart Association have addressed this issue of added sugar consumption due to its association with negative health outcomes5. A variety of demographic factors have been linked to increased added sugar consumption6. Health literacy is another variable which may influence beverage consumption patterns, specifically sugar-sweetened beverage consumption. To date only one study has investigated this association, and the authors reported an inverse relationship between health literacy scores and sugar-sweetened beverage consumption7. Therefore, the purpose of this investigation was to determine what demographic variables serve as predictors of consumption of sugar-sweetened beverages, water, milk, and total beverage calories. This could allow for appropriate interventions to be developed targeting healthier beverage consumption patterns in specific sub-populations.
Master of Science

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9

Mitko, Veronica Ann. "Understanding Consumption of Sugar-Sweetened Beverages by Adolescents with Dental Caries." The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1434205745.

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10

Griecci, Christina F. "Evaluating Multi-Level Factors Influencing Adolescent Sugar Sweetened Beverage Consumption." eScholarship@UMMS, 2018. https://escholarship.umassmed.edu/gsbs_diss/972.

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Background: Sugar sweetened beverages (SSBs) comprise the largest source of added sugars in US adolescents’ diets. SSB consumption is pervasive in US culture and is a critical risk factor for weight gain and obesity in adolescents. This thesis evaluates multi-level factors that influence adolescent SSB consumption. Methods: The first two aims of this thesis utilized data from the cross sectional, internet based Family Life, Activity, Sun, Health and Eating (FLASHE) study to: 1) examine availability of SSBs in multiple settings (home, school, neighborhood) and adolescent SSB consumption, 2) examine the associations between perceptions of parenting practices and adolescent SSB consumption. The third aim used focus group discussions to understand adolescents’ perceptions about SSBs. Results: We found that SSB availability in the home was an important predictor of adolescent SSB consumption, regardless of SSB availability in other settings. Also, parenting practices that facilitate adolescent SSB consumption are associated with higher adolescent SSB consumption, but discussing/negotiating SSB behaviors is not associated with adolescent SSB consumption. Adolescents’ described their attitudes, reinforcements, knowledge, and sources of influence around SSBs which are multifactorial and complex. Conclusions: This thesis identified potential targets for addressing adolescent SSB consumption through availability of SSBs at home, parenting practices, and adolescent perceptions around SSBs. These are important modifiable factors in the adolescents’ sociocultural environment that should be targeted in future dietary interventions to influence adolescent SBB consumption.

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11

Thsehla, Masedikwe Mokwape Evelyn. "The Economic Effects of Diabetes and Sugar-Sweetened Beverage Taxes." Thesis, University of Pretoria, 2020. http://hdl.handle.net/2263/79020.

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The aim of this study is to analyse the effects of diabetes and sugar-sweetened beverages on the South African economy. The study was motivated by the prevalence of diabetes in South Africa and the cost of managing diabetes. In 2016, diabetes was the second leading cause of mortality in the country. Current studies show that more than 7% of healthcare expenditure is spent on diabetes care. Sugar-sweetened beverages have been linked to the increase in the prevalence of diabetes. Three independent studies are conducted to investigate the link between diabetes, sugar-sweetened beverages (SSB) and the economy. Firstly, we study the impact of diabetes on labour market outcomes in South Africa using regression analysis. We achieve this through using probit models, propensity score matching and linear instrumental variable methods to account for endogeneity of diabetes. We find through the analysis that individuals with diabetes are less likely to be employed when compared to individuals without diabetes. Secondly, we investigate the economy-wide impact of diabetes using a computable general equilibrium model. We assessed the impact of diabetes on GDP, household welfare and sectoral outputs. We find that diabetes reduces sectoral outputs, household consumption as well as GDP. Thirdly, we investigate the effects of sugar-sweetened beverages tax on the economy. We analyse this by simulating the effects of the tax together and the envisaged health benefits from the tax. The results of the analysis show that in the short-run poor households are negatively affected. The negative effect is however reversed in the long-run when the net health benefits of the SSB tax are considered. Overall, the main finding of this research is that diabetes has a negative effect on the South African economy. This negative effect can however be offset by targeted tax policy interventions.
Thesis (PhD)--University of Pretoria, 2020.
Economics
PhD
Unrestricted

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12

Alhamad, Rahaf. "A Comparison of the Consumption of Sugar-Sweetened Beverages by College Students in Body Mass Index Groups." Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent1618783798673423.

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13

Gadah, Nouf Saleh. "Liquid calories : an investigation of the satiety effects of sugar-sweetened beverages." Thesis, University of Bristol, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.680129.

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There is currently much debate about the role of added sugar in our diet in relation to weight gain and obesity. In particular, sugar-sweetened beverages are thought to be articularly problematic, with some claims that ' liquid calories' are not sensed by the petite control system. Research findings spanning over 3 decades have shown that this not the case - these studies have used a procedure in which participants consume a drink containing sugar, or a control drink (water, or a drink sweetened with a low-energy sweetener), and subsequently eat a meal in which their food intake is measured covelily. This 'preload, test-meal procedure' has shown that consuming sugar in a drink does suppress appetite, but not sufficiently to fully 'compensate' for the calories in that drink. This thesis focused on aspects of study design in relation to the preload, test-meal procedure. Five experiments were conducted (testing a total of349 participants, eating a total of 698 test meals). The energy compensation (EC) for sugar in the traditional (commonly-used) cross-over design was modest when a sugar-sweetened beverage was matched to a low-energy sweetened beverage in terms of flavour, appearance and volume (37%, p = .048). Analyses suggested that this design may underestimate compensation due to a 'carry-over' effect, possibly arising from learning about the satiety effect of the sweet drink served on the first occasion carrying over to influence satiety experienced for the (higher or lower energy) sweet drink served on the second occasion. Consistent with this, compensation was greater when in another experiment water (familiar as nonsatiating, and different in taste and appearance to the sugar-containing drink) was used as a control- EC was 91 % (p = .009). The improved EC in this experiment was more apparent in men (123%) than in women (39%). In two further experiments, the satiety effects of sugar were examined in betweensubjects designs after controlling for baseline meal intake. Using this approach to avoid carry-over effects, the EC of sugar versus low-energy sweetener was 63% (p = .01). Again, EC was greater in men (109%) than in women (16%). This gender difference was not explained by differences in cognitive control of eating between men and women (i.e., women were not more likely than men to endorse restraint, meal planning, etc. as reasons for ending their meal). Another between-subjects design study varying the viscosity of a sugar versus low-energy sweetener preload showed that, contrary to current claims, EC for sugar in a drink was not less than EC for sugar consumed in semi-solid Gelly) and solid (candy) foods. Taken together, this thesis shows that the satiating effect of sugar in a drink has been underestimated by previous research. Nonetheless, it is likely that use of low-energy sweeteners will reduce energy intake, and therefore the risk of overweight and obesity, because they, like the use of fat replacers, reduce dietary energy density.

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14

Franckle, Rebecca L. "Sugar-Sweetened Beverages and Their Role in Obesity Prevention Programs and Policies." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:27201729.

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It is well established that sugar-sweetened beverages (SSBs) are associated with obesity and chronic diseases. Although there is some emerging evidence that consumption of added sugars is declining in the United States, on average Americans’ consumption still exceeds recommended levels. Consequently, it is imperative that researchers continue to delve further into the question of exactly how SSBs influence obesity and associated chronic diseases, as well as consider creative and novel strategies for reducing their impact on consumers’ health. Several important gaps in the research are addressed by this dissertation. Chapter one considers the role of SSBs and overall diet quality with respect to the growing body of evidence that demonstrates an association between sleep duration and obesity. We used linear regression to examine the associations of sleep duration with dietary indicators in elementary school students taking part in a multi-sector, community-based obesity prevention intervention (the Massachusetts Childhood Obesity Research Demonstration Project). We found that students who reported sleeping <10 hours/day consumed soda more frequently and vegetables less frequently compared with students who reported optimal sleep. Chapter two assesses whether fast food customers are worse at estimating the caloric content of their meal when their purchase includes a high-calorie beverage (HCB). We used linear regression to examine the association between purchasing HCB and calorie estimation among adult and adolescent fast food customers, and found that among adults, drinking HCB contributes to underestimating calories. HCB may be influencing calorie estimation in a unique way compared to high-calorie food items. Chapter three considers the relevance of SSBs with respect to proposed changes to the Supplemental Nutrition Assistance Program (SNAP). Using sales data from a large supermarket chain in the Northeast, we used multivariate analysis of variance to determine whether there is an association between SNAP receipt and shopping patterns. We found that SNAP shoppers spent more than non-SNAP shoppers on sugar-sweetened beverages, red meat, and cold convenience foods, and spent less on fruits, vegetables and poultry. Each chapter lends additional support for a focus on SSB consumption in obesity prevention efforts and will inform the development of prevention strategies in the future.

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15

Crosby, Benjamin Lloyd. "Sugar-Sweetened Beverage Taxes in Vermont: Media Framing and Public Perception." ScholarWorks @ UVM, 2017. http://scholarworks.uvm.edu/graddis/696.

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This thesis explores the conversation surrounding the recent attempts by the Vermont Legislature to pass a Sugar-Sweetened Beverage tax in the years 2014-2016. We explore the common perceptions expressed by a sample of Vermont residents and also look at how Vermont media outlets portrayed the tax through frames of reference. Framing is a method of emphasizing certain points of an issue. This thesis reports the common opinions of Vermonters, the media framing of the issue, and if there is any relationship between them in two academic journal articles. The first article looks at the common frames used in Vermont media during the 2014-2016 period. Classifying 10 pro- and anti-tax frames from 30 common arguments, the article analyzes the use of these frames, their prevalence in different news outlets, and their frequency during time periods. The article also looks at sponsors of these frames and measures which frames individuals and organizations are sponsoring. The study finds that anti-tax advocates most often cite economic hindrances as a reason to oppose the tax and pro-tax advocates predominately cite health benefits and economic tax benefits as a reason to support the tax. In the final year, pro-tax advocates sponsored economic benefits more than any other frames and this argument coincided with the statewide discussion of a budget shortfall. The second article measures the relationship between the media portrayal of the Sugar-Sweetened Beverage tax and the opinions of Vermont citizens regarding the tax. By looking at the prevalence of pro- and anti-tax frames usage in each year, a logistic regression model was built to measure the odds of people favoring tax based off of independent variables, including frames. Vermont residents fluctuated in their opinion of the tax over the years. It was found that in 2015, pro-tax frames made people more likely to support the tax. Democrats were also more likely to support the tax and Republicans were more likely to oppose the tax. This thesis provides insight into the conversation surrounding Sugar-Sweetened Beverage taxes in Vermont. It helps to shed light on the issue, how different groups feel about the issue, and how frames of thought presented through the media can relate to Vermonters' opinion of the tax.

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16

St, John Mallary Nichole. "Understanding adolescents' beliefs about sugar-sweetened beverages using the Theory of Planned Behavior." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1561800537216618.

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17

Chainani, Anjali A. "Sugar-Sweetened Beverage Taxes| Learning from Passage and Failure in California Cities." Thesis, University of the Sciences in Philadelphia, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13859719.

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Since 2014, voters in four California cities approved ballot measures seeking to levy a penny-per-ounce tax on sugar-sweetened beverages (SSBs). Prior to these instances of success, over 128 local and state SSB tax proposals in the U.S. failed passage since 2009. The recent success of SSB tax passage in California presented an opportunity to explore factors associated with SSB tax passage, and to explore if John Kingdon’s Multiple Streams Approach (MSA) applied in cases where the tax passed. The study also identified how Kingdon’s theory may be modified in cases involving local governments.

I conducted a retrospective qualitative analysis using primary and secondary data collection to compare the outcome of SSB tax proposals across California cities. I interviewed 22 individuals using semi-structured telephone interviews to learn about each city’s SSB tax proposal and process. Successful and unsuccessful SSB tax proposals were compared to learn from both passage and failure.

Five key themes or patterns were associated with cases of success including: (1) advanced planning, (2) building support, (3) voter engagement, (4) messaging, and (5) media. Cities that failed to pass the tax did not achieve consensus about the problem, or the proposed solution. A policy that is perceived as technically unfeasible has reduced chances of survival. The MSA provided a useful framework for analyzing factors associated with SSB tax success, however it remains unclear how much independence there is between the three streams at the local policymaking level. Based on the results from this study, I proposed a modification to the problem stream by adding a typology of events to further analyze factors associated with why a policy alternative may rise or fall on an agenda.

The results from this project have the potential to broaden the application of the MSA theory. The findings from this study will be useful to policymakers and advocates in cities that utilize direct or representative democracy, and may lead to other local level SSB tax adoption in the future. Policy entrepreneurs play an important role in shaping the course of how a problem is perceived. Problems and solutions that resonate with voters are more likely to rise on an agenda. This project also demonstrates the value of learning from policy failures. In some cases, iterating a strategy after a failure may be the only way to innovate towards a successful outcome over time.

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18

Cook, Emily Ryland. "Pilot Findings from a Randomized Controlled Trial Targeting Sugar-Sweetened Beverage Behaviors." Thesis, Virginia Tech, 2012. http://hdl.handle.net/10919/41969.

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Background: Low health literacy and increased sugar-sweetened beverage (SSB) consumption are two broad public health concerns facing the United States. For example, it is estimated that 90 million Americans have insufficient literacy skills (IOMC, 2004) and low health literacy is associated with poorer health outcomes (Berkman et. al., 2011). Furthermore, SSBs contribute about 80% of added sugars in the diet (Nielsen & Popkin, 2004) and have been associated with poor health outcomes, including obesity, type II diabetes, bone fractures, dental caries, and coronary heart disease. Despite these findings, there is limited research related to how to effectively decrease SSB intake among adults. Additionally, there have been few studies investigating health literacy interventions that target health behaviors in community settings (Allen et.al, 2011). Objective: As guided by the Theory of Planned Behavior (TPB) and constructs of health literacy, this 5-week, 2-arm randomized controlled pilot trial, used mixed methods to examine the effects of an intervention to decrease SSB (SipSmartER), as compared to a matched-contact control condition targeting physical activity (Move More). The primary aims of this pilot project were to evaluate participantâ s feedback through process and summative evaluation as well as evaulate intervention content and/or delivery through process evaluation by staff tracking for quality improvements. Secondary aims included the assessment of changes in theorized mediating variables and health behaviors among participants. Methods: Twenty-five participants (mean age = 42Â±14 years, mean BMI = 34.3Â±7.5 kg/m2, 19 females, 12 African Americans, 9 (high school education) residing in Roanoke, VA were randomized to either SipSmartER (n=14) or Move More (n=11) to begin the 5-week intervention. Inclusion criteria consisted of participants being 18 years of age or older, English speaking, consuming greater than 200 kcal/day of SSB, and being without medical conditions in which physical activity would be contraindicated. Both 5-week interventions included two interactive small group sessions (Weeks 1 & 5) and three support telephone calls (Weeks 2, 3 & 4). Pre-post data was obtained using previously validated instruments including Beverage Intake Questionnaire (Bev-Q), Theory of Planned Behavior constructs addressing SSB and physical activity, media literacy, subjective numeracy, Stanford Leisure-Time Activity Cateogorical Item (L-CAT), and quality of life. Descriptive statistics, ANOVA, and regression models were used in data analysis. Results: Although SSB consumption decreased more among the SipSmartER participants (-257Â±622.6 kcal/day) than Move More (-200Â±404.6 kcal/day) there were no significant group by time differences. However, among all participants, changes in TPB constructs significantly predicted changes in SSB (R2=0.592; F=2.485; p=0.080) and physical activity behaviors (R2=0.621; F=2.813; p=0.056). Participant and staff feedback were very positive, ranging from 4.2-5.0 on a 5-point likert scale that included questions about intervention organization, flow, effectiveness, engagement, and enjoyment. Favorite themes that emerged with SipSmartER participants when asking about small group sessions included, realizing how much sugar is found in SSBs, understanding the health risks associated with drinking too much sugar, realizing how much sugar was being consumed during the day, and learning about better alternatives. Conclusion: Findings suggest promise for the piloted intervention to reduce SSB consumption through targeted TPB and health literacy strategies. This pilot study has allowed further refinement and execution of a larger trial that includes a larger sample and longer study duration (i.e. 6-months) and follow-up period (i.e. 18-months).
Master of Science

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19

Bigornia, Sherman Jesse. "Childhood adiposity: measurement and effects of sugar-sweetened beverage and dairy intakes." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12284.

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Thesis (Ph.D.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
Problem: The correlation between various adiposity measures has implications for studies examining abdominal fatness. We hypothesized that central and total fat measures would be strongly correlated during childhood, resulting in similarly sized associations with intakes of sugar-sweetened beverages (SSBs) and dairy. Methods: Participants of the Avon Longitudinal Study of Parents and Children were examined at ages 9, 11 , 13, and 15 (n=3,796 to 6,495) where anthropometry and dual-energy X-ray absorptiometry (DXA) data were collected. Diet was assessed at 10 and 13 (n=2,455). Correlations between adiposity measures were determined cross-sectionally at each age. Linear and logistic regression were used to examine the effects of SSB and dairy intakes, respectively, on adiposity at 13 y. Excess total body fat mass (TBFM) and waist circumference (WC) were defined as the top quintile of participants for the respective adiposity measure. Results: TBFM, BMI, and WC were strongly correlated (r=0.85-0.95) and these associations generally weakened after age 11. BMI and we explained similar amounts of variation in TBFM. In dietary analyses, change in SSB consumption from 10 to 13 was positively associated with BMI (standardized β=0.07, P<0.001), TBFM (β=0.07, P=0.003), and WC (β=0.10, P<0.001) at 13. Adjustment for BMI attenuated SSB and we associations by 56% (β=0.042, P=0.02). Children in the top quartile of full-fat dairy intake at 10 were at reduced risk of excess TBFM (OR=0.63: 0.41-0.99), overweight (OR=0.65: 0.40, 1.06), and excess WC (OR=0.58, 0.38-0.90) at 13 compared to those in the bottom quartile. In general, results for total and reduced-fat dairy were directionally similar, but weakened compared to full-fat dairy fmdings. Conclusions: We demonstrated that we and total fat measures (BMI and TBFM) were highly correlated, suggesting that WC can be a proxy for total adiposity. In support of this, the effect sizes of dairy and to a lesser extent SSB consumption on we and total adiposity measures were comparable. Further, adjustment for BMI attenuated the effect of SSB intakes on WC. These results indicate that dietary exposures should be examined independently and in a standardized fashion to compare effect sizes between adiposity measures as associations may be very similar during childhood.

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20

Thompson, Helaina. "Awareness and opinions about sugar-sweetened beverage policy in a university setting." Thesis, University of Iowa, 2019. https://ir.uiowa.edu/etd/7036.

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The purpose of this study was to explore awareness and opinions about sugar-sweetened beverage policy—specifically pouring rights contracts—on a university campus. Participants were 915 students, staff, and faculty currently studying or under employment at the University of Iowa. Participants completed an online survey. Nearly two-thirds (64.2%) of participants reported not being aware of pouring rights prior to completing the survey. Over one-third (38.0%) of participants reported they agreed with universities engaging in pouring rights contracts, while 30.9% of participants neither agreed or disagreed, and 31.0% disagreed with universities engaging in pouring rights contracts. Respondents who identified as male, undergraduate students, and those who agreed that individuals are responsible for their own sugar-sweetened beverage consumption were more likely to support engaging in pouring rights contracts. Understanding awareness, support, and determinants of support for pouring rights contracts is important for those involved in establishing policies targeting sugar-sweetened beverage availability on college campuses.

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21

Morris, Sean. "An Analysis of Beverage Consumption in the United States Using the National Health and Examination Survey 2007-2017." ScholarWorks @ UVM, 2019. https://scholarworks.uvm.edu/graddis/984.

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Sugar-Sweetened Beverages (SSBs) are liquids sweetened with various forms of added sugar. They are the leading source of calories and added sugar in the American diet (Drewnowski & Rehm, 2014; National Cancer Institute, 2016; Powell, Chriqui, Khan, Wada, & Chaloupka, 2013). The health and nutrition literature has increasingly identified added sugars and SSBs as a key potential contributor to a host of public health issues including obesity, type 2 diabetes, hypertension, and cardiovascular disease (Johnson et al., 2009; Malik, Popkin, Bray, Despres, & Hu, 2010; Vartanian, Schwartz, & Brownell, 2007). Concern about these public health crises has recently animated regional and local campaigns to attempt to limit consumption of these items through taxes and other policies. These policy proposals have raised demand for information and research about the drivers and effects SSB and beverage consumption in general. This study documents the major systems that have been used to categorize different types of SSBs and proposes a new beverage categorization typology – the Synthesized Beverage Categorization System – that cross references information from the What We Eat In America Food Categories and the Food Patterns Equivalents Database to offer the most precise SSB typology available today. The remaining sections use reported dietary intake data from the National Health and Nutrition Examination Survey (NHANES) to analyze consumption patterns of sugary beverage subtypes in a number of ways. First this study lays the groundwork for future studies of beverage consumption by examining consumption patterns of major SSB subtypes for adults and children by a number of variables commonly used in dietary intake analysis. Second, this article provides an analysis of sociodemographic trends in the consumption of several major sugary-beverage subtypes by age group, race and gender. Finally, consumption patterns of conventional and “non-traditional” SSBs are provided for the last 4 NHANES data collection cycles to analyze recent trends in reported intake of calories and added sugars from sugary beverages.

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22

Light, Heather. "The effect of consumption of different sugar-sweetened beverages on the development of obesity and related metabolic disorders in young female rats." Morgantown, W. Va. : [West Virginia University Libraries], 2007. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=5327.

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Thesis (M.S.)--West Virginia University, 2007.
Title from document title page. Document formatted into pages; contains x, 77 p. : ill. Includes abstract. Includes bibliographical references (p. 65-77).

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23

Newton, Kelsie Olivia. "Associations Between Sugar-sweetened Beverage Intake and Habitual Diet, Anthropometric Factors, Physical Activity, Functionality and Blood Lipid Profile in Older Adults." Miami University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=miami1574679568131159.

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24

Noel, Lauren Elizabeth. "The Role of Health Literacy in Intervention Engagement, Teach Back Performance, and Perceptions of Intervention Components." Thesis, Virginia Tech, 2013. http://hdl.handle.net/10919/23117.

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Background: Low health literacy is a significant problem affecting our country. While the associations between low health literacy and poorer health outcomes have been well documented (Berkman et al., 2011), the literature lacks evidence of effective strategies to address health literacy in the context of health behaviors such as diet and physical activity (PA). Likewise, few interventions have reported on how health literacy status influences performance and engagement in the intervention. Two potential intervention strategies include the teach back method or teach to goal approach and interactive voice response (IVR) technology. These strategies hold promise as a means of improving health literacy and reaching vulnerable, low health literate populations, but these strategies have not been widely explored in the literature (Paasche-Orlow et al., 2005; Baker et al., 2011; Schillinger et al., 2009; Bennett et al., 2012; Piette et al., 1999). Primary Aims: This research was embedded in a larger trial, Talking Health, which is a 6-month, 2 group randomized controlled trial to determine the effects of a health behavior intervention on reducing sugar-sweetened beverage (SSB) consumption in Southwest Virginians. The primary aims of this study were to examine the associations between health literacy status and 1) number of rounds of teach back needed to reinforce key concepts, 2) proportion of correct answers on the first round of teach back, 3) level of intervention engagement (i.e., completion rates for teach back call, IVR calls, and small group classes), and 4) perceptions of the intervention components. Methods: The data reported represent the first 3 cohorts of the Talking Health trial including participants in Lee, Giles, and Pulaski Counties. Eligibility requirements included being 18 years or older, English speaking, consuming at least 200 calories per day from SSB, able to participate in moderate intensity PA, and having reliable access to a telephone. Data were collected at baseline and at the 6-month follow-up assessment. Health literacy was assessed using the validated Newest Vital Sign. Participants were randomized to a behavioral intervention aimed at decreasing SSB consumption (SipSmartER) or to a matched-contact control group targeting PA (Move More). Both groups participated in 3 small group education sessions, received a live teach back call, and 11 supportive IVR calls. Participants completed a summative evaluation at the 6-month follow-up, which captured their perceptions of the intervention components. ANOVAs were used to measure differences in outcomes by health literacy status, randomized condition, and interactions. Results: Of the 125 enrolled participants, 92.0% were Caucasian, 76.8% were female, 29.6% had d high school education, 64.0% had <$25,000 annual household income, and 32.8% had low health literacy skills. Eighty-five participants (68.0%) completed the teach back call. The overall model when looking at the degree to which health literacy status and randomized condition predicted the number of rounds of teach back needed to reinforce key concepts was significant (F= 8.323, p < 0.001). Out of 3 possible teach back attempts, participants in the low health literacy category required a significantly higher number of teach back attempts as compared to those with high health literacy (F= 16.769, p <0.001), and participants randomized to Move More required a significantly higher number of teach back attempts compared to SipSmartER participants (F=7.296, p= 0.008). Similarly, the overall model when looking at the degree to which health literacy status and randomized condition predicted the proportion correct on the first round of teach back was significant (F= 9.836, p<0.001), such that those with higher health literacy status (F= 19.176, p< 0.001) and those randomized to SipSmartER condition answered a significantly higher proportion of questions correct (F= 9.783, p= 0.002). Intervention engagement including completion of the small group education sessions, the live teach back call, and the IVR calls did not vary significantly across randomized condition or literacy levels. Low health literate participants had a significantly higher overall perceived satisfaction with the IVR, as compared to high health literate participants (F= 5.849, p= 0.020). However, perceptions of other intervention components (e.g., small group sessions, teach back call, personal action plans, drink diaries/exercise logs,) were similar among participants with low and high health literacy status and across randomized conditions. Conclusion: These data confirm the importance for multiple teach back opportunities and additional exposure to health information to ensure participant comprehension of key intervention content"in particular for those with lower health literacy. This research also supports that IVR is an effective approach to reaching vulnerable, low health literate populations. Future research should investigate the efficacy and cost-effectiveness of utilizing teach back methods delivered using automated technologies. Future research also is needed to determine how teach back performance are related to other study factors such as retention, engagement, and health outcomes.
Master of Science

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25

Edfeldt, Johan, and Edfeldt Linn Petersson. "Should Sweden impose excise tax on sugar-sweetened beverages in order to improve public health?" Thesis, Blekinge Tekniska Högskola, Institutionen för industriell ekonomi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-14519.

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In recent time, several reports have been published about a more and more unhealthy population world wide, with increasing Body Mass Index (BMI) in welfare countries, such as Sweden. Diseases, such as obesity and diabetes, which is strongly connected to a high BMI, have increased and together with them also the medical expenses for society/state. Several initiatives have been started, in different countries, to tackle these problems and some have introduced a “sugar tax” on unhealthy products, like candy and soda, which has become a well- debated subject also in Sweden today. In this MBA master thesis, a literature study has been conducted with the goal of evaluating if an excise tax should be introduced in an efficient way on unhealthy sugar-sweetened beverages in Sweden. This case study is built on secondary data where reports and official statistics, from governments and health authorities/organizations, have been studied both for Sweden as well as from other countries. There has been a particular focus on Sweden's neighbouring countries Denmark and Finland, who has both experiences in the implementation of a “sugar tax”. Our theory is that introducing an excise tax on sugar-sweetened beverages will reduce the demand and consumption of these products, which will reduce welfare disease such as obesity and diabetes and yield a tax income for the state. However it is important to have in mind that the reduced consumption also will result in less tax income from the no longer sold goods, fewer personnel employed in the producing industries etc. The results showed that the overall sugar consumption actually has decreased in Sweden, as well as the overall consumption of sugar-sweetened beverages. However during the same time period the average calorie consumption and BMI has continued to increase resulting in a more unhealthy population that results in increased medical expenses. In conclusion an excise tax on sugar-sweetened beverages will not solve the welfare disease problems but may positively influence health. However it comes with a price also for the state from both gains and loss in tax incomes and increased administrations costs for managing the new tax. Finally it should be noted that since sugar-sweetened beverages are unhealthy products, which do not contribute to any positive health effects, sugar taxation might still be considered.

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26

Reinhold, Maggie Marie. "Exploring the Reach and Representativeness of Participants Enrolled in a Behavioral Intervention Targeting Sugar-Sweetened Beverage Consumption." Thesis, Virginia Tech, 2015. http://hdl.handle.net/10919/51180.

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BACKGROUND: Understanding the reach and representativeness of participants enrolled in behavioral trials, including nutrition and physical activity trials, helps inform the generalizability of study findings and potential public health impacts. Exploring the reach and representativeness of trials that target low socioeconomic and low health literate participants in rural and medically underserved areas, such as southwest Virginia (SWVA), is especially important. The proposed research is part of Talking Health, a six-month, pragmatic randomized-control trial aimed at decreasing sugar-sweetened beverage (SSB) consumption (SIPsmartER) as compared to matched contact control targeting improving physical activity (MoveMore). This community-based trial targets an 8-county region in SWVA. OBJECTIVES: Guided by the reach dimension of the RE-AIM framework, the primary objectives of this study were to determine if eligible and enrolled participants in the Talking Health trial were representative of: 1) eligible, but declined participants, and 2) the broader targeted 8-county region based on 2010 US county level census data. We hypothesized that eligible and enrolled participants would be represented in terms of age, race, ethnicity, educational attainment, income, and health literacy when compared to eligible and declined participants, as well as to the broader US census data. We also hypothesized that males would be underrepresented. METHODS: Eligibility requirements for the study included being 18 years of age or older, having reliable access to a telephone, drinking 200 kilocalories of SSB per day, and being a resident of SWVA. A variety of recruitment strategies were used such as active recruitment at health departments, free clinics, and local businesses with help from Virginia Cooperative Extension agents along with passive methods such as flyers, newspaper ads, and word of mouth. The eligibility screener included basic demographic information such as gender, age, race, marital status, occupation, income, educational attainment, number of children in household, and insurance provider. The screener also had three validated subjective health literacy questions. Statistical analysis included descriptive statistics, independent sample t-tests, Chi-square tests, and One Way ANOVA tests to examine the representativeness of enrolled participants. RESULTS: In total, 1,056 participants were screened, 620 were eligible (58.7%), and 301 (48.5%) enrolled. On average, demographic data for enrolled participants included: 93% Caucasian; 81.4% female; income of $23,173±$17,144; 32% high school (HS) education; and health literacy score 4.5±2.2(3=High, 15=Low). Among eligible participants, when comparing enrolled vs. declined participants there were significant differences (p<0.05) in educational attainment [enrolled=32% HS, declined=48% HS], health literacy scores [enrolled=4.5(2.2), declined=5.0(3.1)], gender [enrolled=81% female, declined=73% female], age [enrolled=41.8(13.4) years, declined=38.3(13.6) years], and race [enrolled=93% white, declined=88% white]. However there were no significant differences in ethnicity and income. When compared to average US Census data across the eight counties, enrolled participants had a higher educational attainment [enrolled sample=68%HS, Census=58%HS], higher proportion of females [enrolled sample=81%, Census=48%], and lower mean income [enrolled sample= $23,173, Census=$36,675]. There were no meaningful differences in terms of race and ethnicity between the enrolled sample and Census data. DISCUSSION: Contrary to our hypothesis, eligible and enrolled participants differed from non-enrolled participants in terms of age, race, education, and health literacy. Our enrolled sample was slightly older, predominately Caucasian, with higher educational attainment and higher health literacy. However, as hypothesized, there were no significant differences for ethnicity and income status, and men were underrepresented. When the study sample was compared to US Census data, the sample was well represented in terms of age, race, and ethnicity; however, enrolled participants had a much lower average annual income and a higher educational attainment. Men were also underrepresented when compared to the census data. There was no census data to compare health literacy status, which limits information regarding the representativeness of the enrolled sample. Importantly, this study has revealed the representativeness of individuals enrolled in this behavioral trial, helps inform the generalizability of study findings, and identifies future research for community-based studies targeting rural and medically underserved areas in SWVA. For example, future behavioral interventions need concerted recruitment strategies to target males, individuals with lower health literacy status, and individuals with less than a high school degree. Exploring and addressing barriers for study enrollment among these sub-groups is also important.
Master of Science

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27

Acero, Darlene. "A Sugar-Sweetened Beverage Intervention's Effect on Non-Nutritive Sweetener Consumers and Consumption Patterns." Thesis, Virginia Tech, 2019. http://hdl.handle.net/10919/101705.

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The overconsumption of added sugars leads to negative effects on health such as an increased risk for obesity, cardiovascular disease, and diabetes. With approximately 50% of added sugars in the American diet being attributed to sugar-sweetened beverage (SSB) intake, non-nutritive sweeteners (NNS) are recommended as potential replacements. The purpose of this secondary analysis of Talking Health, a 6-month SSB reduction intervention, was to explore 1) changes in NNS consumption patterns between SIPsmartER (n=101) and MoveMore (n=97) interventions, and 2) differences in demographics between three groups of various SSB-NNS consumption change patterns (Group 1: decreased SSB, increased NNS; Group 2: decreased SSB, no change in NNS; Group 3: increased SSB, regardless of NNS). Results showed that the SIPsmartER intervention significantly created more new NNS users than MoveMore after the 6 month intervention. There were significant between group over time differences for intake of aspartame, sucralose, and total NNS, with intake increasing for SIPsmartER participants as compared to MoveMore. However, when exploring demographics between the three SSB-NNS consumption change groups, no differences were found between those who successfully decreased SSB while increasing NNS and the other groups. While diet beverages were the most commonly consumed dietary source of NNS across groups over time, other sources such as tabletop sweeteners, yogurt, and meal replacement products contributed to total NNS intake. Future research is needed to identify those who would benefit most from using NNS as a tool to decrease SSB intake. This will help inform future interventions and provide appropriate strategies to decrease added sugars intake.
Master of Science

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28

Hansen, Erica Nicole. "College Students' Fruit, Vegetable, and Sugar Sweetened Beverage Intake According to Dinner Group Participation." BYU ScholarsArchive, 2013. https://scholarsarchive.byu.edu/etd/3876.

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Objective: To compare the fruit, vegetable, and sugar sweetened beverage intake of college students who do and do not participate in dinner groups. Also, to determine if dinner group participation affects college students' perception of their overall health and adequacy of their fruit and vegetable intake. Design: A quantitative study of college students' fruit, vegetable, and sugar sweetened beverage intake through a one-time online survey. Setting: The survey was accessed via the internet at the time and place of students' convenience. Participants: A sample of 10,000 students was randomly selected from Brigham Young University's population of single students. 3,651 responded (a 37% response rate), but only 548 met our requirements and completed the survey. Sixty-one percent were female, 39% were male. Subgroups included students not belonging to a dinner group (n=243), students who met with a dinner group 1-3 times per week (n=167), and students who met with a dinner group 4 or more times per week (n=138).Main Outcome Measure(s): The independent variable measured was dinner group membership. Food intakes and perceptions were dependent variables. Food intakes were collected using adapted Behavior Risk Factor Surveillance System recall questions. Perceptions were reported on a 1-5 Likert rating scale. Analysis: Post-hoc Tukey-Kramer adjustments were made to analysis of variance comparing intake and perception means. Statistical significance was set at p <0.05. Results: Prevalence of dinner group membership was 13%. Dinner group members drank significantly less soda than non-dinner group members (p=0.03). Intakes of fruits and vegetables did not differ between subgroups. Students' perception of the adequacy of their fruit and vegetable intake was aligned with their actual intake (p=0.0001); students who ate fewer cups rated their intake as poor more frequently than students who ate more cups. Dinner group members perceived better overall health and improved intake of fruit and vegetables from their participation in dinner groups. Conclusions: Though dinner group membership does not appear to affect fruit and vegetable intake, benefits were seen in reduced sugar sweetened beverage consumption. Further research may be warranted to examine other nutritional factors associated with dinner group membership as dinner groups may provide a unique opportunity for nutrition education and interventions and may provide more long term benefits than short term.

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29

Hill, Catelyn Elizabeth. "Validity and Reliability of the BEVQ-15 in Children and Adolescents." Thesis, Virginia Tech, 2016. http://hdl.handle.net/10919/81260.

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The prevalence of children and adolescents who are considered overweight or obese has grown drastically in the United States. Childhood overweight and obesity is associated with serious long-term health consequences, including an increased risk for cardiovascular disease, type 2 diabetes, strokes, and different types of cancers. Added sugar intake (AS), in the form of sugar-sweetened beverages (SSB), may contribute to weight gain and obesity development in children and adolescents. Due to the negative health implications of SSB consumption, a valid and reliable brief beverage intake assessment tool is needed for children and adolescents to advance research in this area. The BEVQ-15 food frequency questionnaire has been validated as a tool to assess habitual beverage intake in adults. By validating this tool in youth, there will be a rapid, feasibly administered method to assess beverage intake in children and adolescents. The purpose of this investigation was to determine the comparative validity and test-retest reliability of the BEVQ-15 for assessing usual beverage intake in children and adolescents. Participants (n=326) completed four laboratory sessions, which included providing demographic information, assessment of height/weight, and four record-assisted 24 hour dietary recalls (24HR) from January 2014-September 2015. The BEVQ was completed at 2 sessions (BEVQ1, BEVQ2). Validity was assessed by comparing beverage intake from dietary recalls (24HR) to the BEVQ1; reliability was assessed by comparing BEVQ responses at two sessions (BEVQ1, BEVQ2). Data analysis included descriptive statistics, paired sample t-tests, independent sample t-tests, and chi-squared test, and one-way ANOVA tests. Comparisons of validity and reliability were also made within two subsets; children (aged 6-11) and adolescents (aged 12-18). In the full sample, self-reported water and total sugar-sweetened beverage intake (in fl oz and kcal) were not different between BEVQ1 and 24HR. Responses between BEVQ1 and BEVQ2 were not different in intake (fl oz) or energy (kcal) for water, milk, and total sugar-sweetened beverages. In children, milk and energy (kcal) for total beverages were not different between BEVQ1 and 24HR. No differences were reported between BEVQ1 and BEVQ2 across beverage categories. In adolescents, water and energy (kcal) for total-sugar sweetened beverages were not different between BEVQ1 and 24HR. No differences were reported between BEVQ1 and BEVQ2 with the exception of sweetened juice drinks and total beverages. Overall, these results demonstrate that the BEVQ-15 appears to be a valid and reliable tool to assess habitual water and total SSB intake in children and adolescents. This tool could further epidemiological and clinical research examining the impact of SSB intake, as well as intake of other beverages, on health.
Master of Science

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30

Fang, Xingzhi, and 方行陟. "A systematic review of the impact of sugar-sweetened beverage consumption on children and adolescent obesity." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206908.

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Background The consumption of sugar-sweetened beverage (SSBs) among children and adolescents, particularly carbonated soft drinks, are always blamed to be the contributor to the epidemic of overweight and obesity. With the number of obese population increased, people become increasingly more focus on the relationship between SSB and the weight gain problems. However, because there are some characteristics of these beverages that people can get energy and happiness, so that people enjoy drinking sugar-sweetened beverage especially children who like sugar and sweet. So, people are still wondering the association between SSB and obesity. Methods A literature search was performed using Google scholar and Pubmed to locate all relevant articles in English that study the impacts of SSB on the weight gain and obesity on children and adolescent up to December 2013. Findings Eleven core references were found to study the association between SSB and the weight gain among children and adolescent including 4 randomized trial studies, 6 cross-sectional studies and 1 case-control study. Conclusions The data collected from large cross-sectional studies, especially the long-term studies shows that there is a positive association between the intake of SSB and the weight gain and obesity in children and adolescent. A case control study based on hospital shows that the children who with less soft-drink consumptions have lower prevalence of obesity and overweight. In addition, the randomized control trials indicate that the greater consumption of SSB, the easier to gain weights among children and adolescents. Although more evidence are needed, the sufficient evidence exists now are not encouraging the public to intake too many sugar-sweetened beverage as a healthy behavior.
published_or_final_version
Public Health
Master
Master of Public Health

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31

Morrill, Kristin E., Benjamin Aceves, Luis A. Valdez, Cynthia A. Thomson, Iman A. Hakim, Melanie L. Bell, Jessica A. Martinez, and David O. Garcia. "Feasibility and acceptability of a beverage intervention for Hispanic adults: a protocol for a pilot randomized controlled trial." BIOMED CENTRAL LTD, 2018. http://hdl.handle.net/10150/627156.

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Background: In the U.S., Hispanics have among the highest rates of overweight and obesity when compared to other racial/ethnic groups placing them at a greater risk for obesity-related disease. Identifying intervention strategies to reduce caloric intake and/or improve cardiometabolic health in Hispanics is critical to reducing morbidity and mortality among this large and growing population. Evidence exists to support diet-specific behavioral interventions, including beverage modifications, in reducing obesity-related health risks. However, the acceptability and feasibility of a beverage intervention in obese Hispanic adults has not been robustly evaluated. Methods: The objective of this pilot study is to assess the feasibility and acceptability of a randomized, controlled beverage intervention in 50 obese Hispanic adults ages 18-64 over 8-weeks. Eligible participants were obese (30-50.0 kg/m(2)), between the ages 18-64, self-identified as Hispanic, and were able to speak, read, and write in either English and/or Spanish. Study recruitment was completed August 2017. Upon the completion of baseline assessments, participants will be randomized to either Mediterranean lemonade, Green Tea, or flavored water control. After completing a 2-week washout period, participants will be asked to consume 32 oz. per day of study beverage for 6-weeks while avoiding all other sources of tea, lemonade, citrus, juice, and other sweetened beverages; water is permissible. Primary outcomes will be recruitment, retention, and acceptability of the intervention strategies. Our study will also evaluate participant-reported tolerance and as an exploratory aim, assess safety/toxicity-related to renal and/or liver function. Fasting blood samples will be collected at baseline and 8-weeks to assess the primary efficacy outcomes: total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Secondary outcomes include fasting glucose, hemoglobin A1c (HbA1c), and high-sensitivity C-reactive protein (hs-CRP). Discussion: This pilot study will provide important feasibility, safety, and early efficacy data necessary to design a larger, adequately-powered randomized controlled trial.

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CAMPBELL, BROOKE MADISON. "SUGAR SWEETENED BEVERAGES INTAKE IN 9-12 YEAR OLD CHILDREN AT RISK OF TYPE 2 DIABETES." Thesis, The University of Arizona, 2016. http://hdl.handle.net/10150/612624.

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Over the past few decades, the consumption of sugar-sweetened beverages (SSBs) in adolescents has increased dramatically. There has also been a rise in Type 2 Diabetes (T2D). The E.P.I.C. (Encourage Practice Inspire Change) Kids Intervention program is among the first community- and family-based diabetes prevention interventions for children, ages 9-12, who are at risk of developing T2D. The purpose of EPIC Kids program is to provide information, resources, and strategies for children and their parents regarding nutrition, physical activity, and healthy behaviors that can improve their wellbeing, help manage their weight, and prevent T2D. Researchers are investigating the link between increased SSB consumption and T2D risk. To assess SSB consumption, two, 24-hour diet recalls were conducted at baseline and 12-week measurement sessions with the 28 youth. One weekday recall and one weekend day recall were collected. At baseline, the average total SSB consumption was 0.9 servings (8oz) and at12 weeks, 0.73 servings. There was no significant change in SSB consumption. Future activities include analysis of the entire sample of EPIC Kids participants (n=48), which will allow for a more robust evaluation of intervention-related changes in SSBs, and provide contextual data on factors associated with SSB consumption and determinants of change.

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33

Esbjörnson, Malin. "A review of non-nutritive sweetenersand sugar-sweetened beverages and theirimpact on body mass and health." Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-39430.

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34

Clemitson, Jo-Anne. "Exploring the role of the retailer marketing mix in stimulating consumer demand for sugar-free vs sugar-sweetened beverage variants." Diss., University of Pretoria, 2017. http://hdl.handle.net/2263/59806.

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Concerns about obesity are becoming as prevalent as under-nutrion. Obesity is associated with a host of health and economic problems, and as such is becoming a prevelant topic for discussion among academics and the public in general, and is therefore of particular concern to the business world. There is a strong focus on reducing sugar consumption, ans with the announcement of the implementation of a sugar tax in South Africa, retailers have been identified as a crucial element in the value chain in providing healthier alternatives to consumers. They have the ability to utilise elements of the marketing mix to influence consumers' in-store purchase decisions and respond to the demand for healthier, sugar-free products. This study focuses on the effectiveness of price, placement and assortment as levers of the marketing mix with which retailers can drive demand. Quasi-experimental and experimental event-based time series studies were conducted with a focus on carbonated soft drinks. Quantitative price and sales units data were gathered from a prominent South African retailer. Two separate studies were conducted, one to understand the impact of the presence of promotional pricing as well as the depth of discount, and the second to understand the impact of a shelf format on consumer demand for sugar-free products. Data were analysed using multiple regression analysis in order to gain insights into the impact of changes of the marketing mix on consumer demand. Key findings of these studies are summarised in a framework that outlines the priority of marketing mix elements for retailers to utilise in order to drive demand for sugar-free products. Assortment was found to be the first requirement, ensuring there is availability of sugar-free variants to meet purchase motivations. Secondly, the presence of a pricing promotion was key, followed by the depth of the promotional discount. It was established that consumers within the CSD category were attuned to pricing promotions, and if retailers take the decision to drive sugar-free products, these products should be prioritised for pricing investment over sugar-sweetened alternatives. Results showed that merchandising the shelf according to sugar content (shelf format) had no impact on the demand for sugar-free products. The findings of this research built on the literature around marketing mix elements within retail, as well as studies around influencing consumers to purchase and consumer healthier products.
Mini Dissertation (MBA)--University of Pretoria, 2017.
ms2017
Gordon Institute of Business Science (GIBS)
MBA
Unrestricted

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35

Lane, Hannah Grace. "Development and feasibility testing of a theory-based intervention to reduce sugar-sweetened beverage consumption among Central Appalachian adolescents." Diss., Virginia Tech, 2016. http://hdl.handle.net/10919/72293.

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Children and adolescents consume sugar-sweetened beverages (SSBs) excessively, which is associated with childhood obesity, dental caries, and increased risk for cardiovascular disease and type 2 diabetes. Interventions spanning the socio-ecological model (i.e., intrapersonal, interpersonal, environmental, policy) have been shown to reduce SSB consumption under controlled conditions. However, not much is known about their potential to work under "real-world" conditions. This information can ensure that effective programs reach populations that could most benefit, such as children and adolescents in Central Appalachia, who consume three to four times more SSBs than their American peers. Central Appalachia is a rural, geographically isolated region where attempts to reduce SSBs are challenged by limited resources, skepticism toward health programs/providers, and pervasive cultural norms around SSBs. This dissertation describes three studies (2014-2016) that address these challenges by testing multi-level interventions that prioritize cultural acceptability and feasibility. The first study was a systematic review of child and adolescent SSB studies using the RE-AIM (reach, efficacy/effectiveness, adoption, implementation, maintenance) framework to evaluate whether studies reported elements necessary for replicability, such as resources needed for delivery or factors that might prevent participation. The review revealed that available evidence does not provide this information, and recommended that future studies prioritize evaluating and reporting these elements. The second and third studies describe methods to test implementation of Kids SIPsmartER, a theory-based program targeting various socio-ecological levels, in an Appalachian Virginia county. The second study engaged a group on local middle school youth (n=9) in adapting the program, which targeted universal theoretical constructs, to ensure that it was culturally acceptable and demonstrated potential to generate community-wide changes. The third study used a randomized controlled design to determine whether Kids SIPsmartER was feasible as a school-based program. This study tested the program's potential reduce SSBs, as well as whether it was accepted, in demand, and able to be practically implemented within schools, the most common gathering place for rural adolescents. Taken together, these studies provide the foundation for larger, more controlled studies that prioritize both efficacy and replicability, in order to reduce the disproportionate burden of SSBs and associated diseases across Central Appalachia.
Ph. D.

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36

Comber, Dana Lynn. "Individual and Worksite Environmental Factors Associated with Habitual Beverage Consumption among Overweight and Obese Adults." Thesis, Virginia Tech, 2011. http://hdl.handle.net/10919/32457.

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The number of overweight adults has risen to two-thirds of the population, thus increases in energy intake, particularly from beverages are of great concern. Sugar-sweetened beverage (SSB) intake has increased by 222 calories in recent decades, which contributes a significant source of added sugars to the American diet. It has been reported that water consumers have a lower overall energy intake (~194 kcals) as compared to non-consumers of water therefore substituting water for SSBs may facilitate weight loss and weight management. Evidence also indicates that diet quality follows a socioeconomic gradient, and that the environment has a powerful influence on beverage consumption. Thus, modifying the food environment could be a promising strategy for promoting healthier beverage consumption behavior. A large portion of the US population spends their day at a worksite making the worksite a viable setting for implementing environmental approaches to promote effective behavior change. At this time, it is unclear if a reduction of SSB intake would be a viable dietary weight management intervention strategy. Therefore, our purpose was to determine if water, SSB intake, SSB energy, total beverage intake, and total beverage energy varies with individual and environmental factors among overweight and obese employees from 28 worksites involved in a randomized controlled weight management trial. These findings may contribute to the development of tailored weight management programs aimed to improve beverage consumption patterns.
Master of Science

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37

Riebl, Shaun Karl. "Understanding Adolescents' Sugary Beverage Consumption: A Review and Application of the Theory of Planned Behavior." Diss., Virginia Tech, 2015. http://hdl.handle.net/10919/73380.

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Introduction: Weight problems not only affect adults, but youth as well. Excessive sugar-sweetened beverage (SSB) consumption is suggested to be a contributor to youth overweight and obesity and other cardiometabolic risk factors. Parents, although probably not readily admitted by adolescents, are known to influence youth's dietary beliefs and practices. Using theoretical models, like the Theory of Planned Behavior (TPB) that accounts for intention, attitudes, norms, and perceptions of control, to develop interventions can be more effective in changing health-risk behaviors versus those not grounded in theory. Methods: A systematic literature review and meta-analysis on how the TPB has been applied to youth's diet-related behaviors was conducted. Subsequently, a mixed methods investigation of adolescents' (n=100) and parents' (n=66) SSB consumption and exploratory analysis of parents' responses to adolescents' beverage choices was carried out. Results: From 34 articles, attitude was identified as having the strongest relationship with behavioral intention (mean r=0.52), and intention as the most common predictor of youth's diet-related behavior (mean r=0.38, both p<0.001). However, in the mixed methods analysis adolescents' subjective norm was the strongest predictor of intention to limit sugary beverage consumption to less than one cup per day (b=0.57, p=0.001). Intention was the strongest predictor of SSB intake in parents and adolescents (b=-47, p=0.01; b=-37, p≤0.05). The TPB explained more variance in parents' SSB consumption than adolescents' (R²=0.22 versus R²=0.38, both p≤0.001, respectively). At lower levels of intention to limit SSB consumption and higher levels of parental encouragement to consume SSBs, adolescents' predicted SSB intake was highest (p=0.059) suggesting that some adolescents may be influenced by their parent's reactions to their sugary beverage choices while others may not. Conclusions: Intention appears to be a strong construct influencing adolescents' diet-related behaviors, specifically SSB consumption, and this intention may be influenced by parents and other social factors. Future work can tap into adolescents' peer network and role models or authority figures to identify how these groups and individuals influence and moderate the intention to limit sugary beverage consumption.
Ph. D.

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38

Opoku-Acheampong, Audrey Anima. "Assessing physical activity, fruit and vegetable intake and sugar-sweetened beverage consumption patterns of college students." Thesis, Kansas State University, 2014. http://hdl.handle.net/2097/17557.

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Master of Science
Department of Human Nutrition
Tandalayo Kidd
Objective: The aims of this study were to test the effectiveness of a 15-month intervention in reducing sugar-sweetened beverage (SSB) consumption among college students and to assess fruit and vegetable intake and physical activity habits and their relationship to SSB consumption in order to improve health outcomes. Design: Randomized, controlled study. Participants: One hundred and fifty-six college students (18-24 y) from a Midwestern university, primarily female (72%), white (89%) and freshmen (51%). Intervention: Participants were randomized to control and intervention groups. Participants in the control group received no information on healthful behaviors. The intervention occurred in two stages: 1) Participants received three stage-tailored messages on healthful behaviors weekly for 10 weeks; 2) After the 3-month physical assessment, participants received 3 stage-tailored messages monthly and one email encouraging them to visit the portal page. Main Outcome Measure(s): Stages of Change for physical activity and fruit and vegetable intake; self-reported physical activity scores, self-reported fruit and vegetable intake and SSB consumption habits. Analysis: Changes in SSB consumption patterns were determined using generalized linear mixed models and linear regression models tested associations between fruit and vegetable intake, physical activity and SSB consumption. Linear mixed models were used to explore relationship between stage of change and fruit and vegetable intake and physical activity. Results: The 15-month intervention did not significantly reduce SSB consumption in the intervention group (p > 0.05). Participants recorded low fruit and vegetable intake and moderate physical activity scores. Conclusions and Implications: The high SSB consumption and low fruit and vegetable intake observed could increase students’ risk for weight gain and obesity-related conditions. Thus, college campuses can help student maintain physical activity behavior while helping them to improve their eating habits.

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Wilburn, Grace Alexandra. "Exploring Cross-Sectional Relationships between Health Literacy, Dietary Intake, Physical Activity, and Anthropometric/Biological Variables among Residents in Southwest Virginia." Thesis, Virginia Tech, 2014. http://hdl.handle.net/10919/48027.

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BACKGROUND: Low health literacy and numeracy are significant problems facing the United States. Recent research focuses heavily on the role health literacy and numeracy play in perception of disease risk, health care costs, all-cause mortality, and access to care; however, there has been relativity little emphasis on the relationships between health literacy or numeracy with health promotion behaviors, such as nutrition or physical activity. As our nation continues to face challenges with the high prevalence of obesity and other chronic diseases, it is increasingly important to understand the role that health literacy and numeracy play in nutrition and physical activity behaviors, as well as in the prevalence and control of chronic disease. PRIMARY AIMS: The proposed research is embedded within a larger randomized-control trial, Talking Health, which is a 2-arm behavioral trial targeting residents in eight counties in southwest Virginia with sugar-sweetened beverage (SSB) consumption as the primary outcome. The primary aims of this cross-sectional study, using baseline Talking Health data, are to 1) examine correlations among health literacy and numeracy measures, namely the Newest Vital Sign (NVS), separated by reading (NVS Reading) and math (NVS Math) scores, the Rapid Estimate of Adult Literacy in Medicine (REALM), and the Subjective Numeracy Scale (SNS); 2) explore the relationships between demographic factors and the NVS, REALM, and SNS scores; 3) determine the relationships between the NVS, REALM, and SNS and dietary quality [i.e. Health Eating Index (HEI) scores], physical activity behaviors, and anthropometric and biological variables (body mass index, blood pressure, fasting blood lipids, and fasting blood glucose); and 4) determine if NVS, REALM, and SNS scores predict metabolic syndrome (MetS), while controlling for relevant demographic factors. METHODS: Eligibility requirements for the study include being 18 years of age or older, having reliable access to a telephone, drinking ≥200 kilocalories of SSB per day, and being a resident of Southwest Virginia. Using previously validated instruments and standardized data collection protocol, a variety of baseline variables was collected on 264 participants. Health literacy was measured using the NVS and REALM and health numeracy was measured using the SNS. Dietary intake was measured via three 24-hour dietary recalls and HEI scores were calculated. Physical activity behaviors were assessed using the Godin Leisure Time Exercise Questionnaire. Weight was measured using a calibrated digital Tanita scale (Model: 310GS), height was measured using a portable research-grade stadiometer, blood pressure measurements were made with an OMRON automated oscillometric device (Model: HEM-907XL), and fasting blood samples were obtained via a finger stick and the CardioChek PA system was used to assess blood glucose, cholesterol, and triglycerides. MetS scores were determined based on an adaptation of the National Cholesterol Education Program guidelines. Statistical analysis included descriptive statistics, simple correlations (Pearson bivariate), one-way ANOVAs, and regression models. RESULTS: Of 264 enrolled participants (mean age 41.1 + 13.5 years; 92.0% Caucasian; 81.8% female; 30.6% > high school education; 42% > $15,000 annual income), 33.7% were classified as having a high probability of low health literacy or possibility of low health literacy as measured by the NVS, 19.7% had less than a high school reading level as measured by the REALM, and 45.4% had low health numeracy as measured by the SNS. Additionally, 78.8% were overweight or obese and 29.0% meet the criteria for metabolic syndrome. Nine of the ten correlations between the NVS Total, NVS Reading, NVS Math, REALM, and SNS were statistically significant (p < .01, two-tailed). NVS scores were found to be significantly different by age (F = 2.36, p = .05), race (F = 4.49, p = .03), education level (F = 20.97, p < .001), and income (F = 13.88, p < .001); while REALM scores were only significantly different by race (F = 3.74, p = .05), education level (F = 21.06, p < .001), and income (F = 6.80, p < .001). SNS scores were significantly different by gender (F = 12.40, p = .001), education level (F = 11.01, p < .001), and income (F = 14.45, p < .001). Only systolic blood pressure, diastolic blood pressure, and strength training activity was found to be significantly different by health literacy and/or numeracy level; however, when controlling for hypertension medication use and/or demographic variables, only the relationship between health literacy (i.e, NVS) and strength training activity remained significant (R2 = 0.09, p = .01). Finally, health literacy and numeracy were not found to be predictive of metabolic syndrome while controlling for demographic variables. DISCUSSION: Although numerous demographic factors were related to baseline health literacy and numeracy levels, anthropometric/biological variables, physical activity behaviors, and diet quality did not differ by health literacy and health numeracy level, with the exception of systolic blood pressure and strength training activity. This research helps to fill the gaps in the literature surrounding the prevalence of health literacy, health numeracy, and health promoting behaviors and chronic disease among rural residents in medically underserved counties in southwest Virginia. While few cross-sectional relationships were found, future research from this RCT should examine if health literacy and health numeracy moderates or mediates intervention changes in anthropometric/biological variables, physical activity behaviors, diet quality, and metabolic syndrome scores.
Master of Science

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40

Bremer, Molly Catherine. "Dietary Intake Changes in Response to a Sugar-Sweetened Beverage Reduction Trial for SNAP Participants and Nonparticipants." Thesis, Virginia Tech, 2017. http://hdl.handle.net/10919/86237.

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It is unknown if participation in the Supplemental Nutrition Assistance Program (SNAP) influences the magnitude of improvement in dietary intake in response to dietary interventions. Adults with low socioeconomic status (SES) tend to have lower overall dietary quality as compared to those with higher SES. However, low SES adults are more likely to receive benefits from SNAP, which gives nutrition assistance to millions of eligible Americans. The objective of this investigation is to examine differences in dietary intake between 1) SNAP participants, 2) those eligible for SNAP but not receiving (nonparticipants), and 3) those ineligible for SNAP, in response to an intervention targeting a reduction in sugar-sweetened beverage (SSB) consumption. Adult participants (n=146) from Southwest Virginia were enrolled in a 6-month, community-based trial, SIPsmartER. Participants provided SNAP enrollment status and 3 24-hour dietary recalls at baseline and 6-months. Dietary variables (SSB, macronutrients, etc.) and dietary quality data (Healthy Eating Index [HEI-2010]) were derived from nutritional analysis software (NDS-R 2011). Statistical analyses included descriptives and repeated-measures ANOVA. Although SNAP participation and eligibility status did not impact the overall effectiveness of this dietary intervention, the within group data suggests that those eligible for SNAP but not participating (n=30) may be at a disadvantage to improving their dietary intake as compared to those at a similar household income who receive SNAP benefits (n=56) or ineligible individuals at a higher income level (n=60). Future research is needed to explore if participant's ability to maintain long-term adherence to the dietary changes differs between groups.
Master of Science

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41

Málaga, Chávez Renzo Mauricio, and Velarde Dalia Jazmín Martínez. "Fruits, vegetables and sweetened beverages dietary patterns among individuals with glucose metabolism disorder." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2021. http://hdl.handle.net/10757/656504.

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Introduction: Little is known about dietary patterns among individuals with type 2 diabetes mellitus (T2DM) in Peru. This study aimed at determining whether there is association between glucosa metabolism disorder and consumption of fruits, vegetables and sweetened beverages. Material and Methods: Secondary analisis of a population-based cross-sectional study conducted in Tumbes, a región in northern Peru. The outcomes variable were consumption of fruits, vegetables and sweetened beverages, defined by self-report, whilst the exposure was glucose metabolism disorder status (euglicemic, with T2DM bit not aware of diagnosis, and with T2DM and aware of diagnosis), defined by the oral glucose tolerance test. To assess the associations of interest, Poisson regression models with robust variance were created, and prevalence ratios (PR) and 95% confidence intervals (95% CI) were reported. Results: A total of 1607 individuals, mean age 48.2 (SD:10.6); and 809 (50.3%) females, was enrolled. The prevalence of T2DM was 11.0% (95%CI: 9.5%-12.6%), and out of them, 105 (59.7%) had previous diagnosis. Only 213 (13.3%) reported consuming sweetened beverages > once/week, whilst 409 (25.5%) and 736 (45.8%) reported consuming vegetables and fruits, respectively. Those with previous T2DM diagnosis had lower probability of consuming sweetened beverages (sometimes vs. never: PR=0.57; 95%CI: 0.41-0.78, and >once/week vs. never PR=0.39; 95%CI: 0.18-0.85). Both the consumption of fruits and vegetables were similar among those with and without previous T2DM diagnosis. Conclusions: Compared to euglycemic subjects, individual with previous T2DM diagnosis had lower consumption of sweetened beverages, but such association was not present among those with T2DM but without previous diagnosis. Fruits and vegetables consumption were not different between the different glucose metabolism disorder categories.
Introducción: Poco se conoce sobre los patrones de dieta de individuos con diabetes mellitus tipo 2 (DM2) en Perú. El objetivo del presente estudio fue determinar si existe asociación entre la alteración del metabolismo de la glucosa y ciertos patrones de dieta (consumo de bebidas azucaradas, verduras y frutas). Materiales y métodos: Análisis secundario de un estudio poblacional de tipo transversal realizado en Tumbes, en el norte del Perú. Las variables resultado fueron consumo de bebidas azucaradas, consumo de verduras y consumo de frutas, definidas por autorreporte; mientras que la exposición fue la alteración del metabolismo de la glucosa (euglicémico, con DM2 pero sin diagnóstico previo, y con DM2 y diagnóstico previo), basado en la prueba de tolerancia oral a la glucosa. Para evaluar las asociaciones de interés se crearon modelos de regresión de Poisson con varianza robusta y se reportaron razones de prevalencia (RP) e intervalos de confianza al 95% (IC 95%) Resultados: Un total de 1607 individuos, media de edad de 48 , 2 (DE: 10,6), y 809 (50,3%) mujeres, fueron enrolados. La prevalencia de DM2 fue de 11,0% (IC95%: 9,5% -12,6%), y de ellos, 105 (59,7%) tuvieron diagnóstico previo. Solo 213 (13,3%) reportaron consumir bebidas azucaradas> 1 vez / semana, mientras que 409 (25,5%) y 736 (45,8%) reportaron consumir verduras y frutas en forma casi diaria, respectivamente. Aquellos con diagnóstico previo de DM2 tuvieron menor probabilidad de consumir bebidas azucaradas (algunas veces vs.Nunca: RP = 0,57; IC95: 0,41-0,78 y> 1 vez / semana vs.Nunca: RP = 0,39 ; IC95%: 0,18-0,85). Ni el consumo de frutas ni el de verduras fue mayor en aquellos con o sin diagnóstico previo de DM2. Conclusiones: Comparados con los euglicémicos, los individuos con diagnóstico previo de DM2 tuvieron un menor consumo de bebidas azucaradas, pero dicha asociación no estuvo presente en aquellos con DM2 sin diagnóstico previo. El consumo de frutas y verduras no fue diferente entre las categorías de alteración del metabolismo de la glucosa estudiadas.
Tesis

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42

Tyhurst, Maja. "Application of The Theory of Planned Behavior in a Randomized Control Trial Targeting Sugar-Sweetened Beverage Intake and Physical Activity in Southwest Virginia." Thesis, Virginia Tech, 2015. http://hdl.handle.net/10919/52920.

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BACKGROUND: Health-related interventions informed by behavioral theory have been shown to be more effective in changing behaviors as compared to those that are not. The Theory of Planned Behavior (TPB) has been used to successfully predict and explain a variety of health related behaviors, including sugar-sweetened beverage (SSB) intake and physical activity (PA). The TPB assumes that behavioral intentions are the most important determinant of behavior. Intentions are the function of individual's attitudes toward the behavior (these evaluations can be positive or negative), subjective norms (social standards and expectations surrounding the behavior), and perceived behavioral control (perception of the ease with which the behavior can be performed). According to literature, behavioral intentions predict 20% - 40% of the variance in health behaviors with attitudes beings the strongest predictor of diet, and perceived behavioral control being the strongest predictor of physical activity related intentions. Excessive SSB consumption and inadequate PA have been highly associated with the obesity epidemic, and related comorbidities such as cardiovascular disease and type-2 diabetes. Understanding and targeting these behaviors through application of health behavior theories, such as the TPB, is important. PRIMARY AIMS: This research is embedded within a larger 2-arm randomized-control trial, Talking Health, which targets residents in rural southwest Virginia. Guided by the TPB, the overall goal of the Talking Health trial is to determine the effectiveness of a 6-month intervention aimed at decreasing SSB intake (SIPsmartER) compared to a matched contact control aimed at increasing PA (MoveMore). Each condition includes three classes, one teach-back call, and 11 interactive voice response (IVR) calls. The primary aims of this secondary analysis of Talking Health are to 1) determine if single-item TPB indicators are correlated with multi-item TPB scales for SSB and PA; 2) examine how baseline TPB variables predict participation in the SIPsmartER and MoveMore; 3) determine how the IVR TPB variables assessed during IVR calls predict future SSB and PA behaviors reported in a subsequent IVR call; and 4) explore how TPB variables change over the course of the teach back and 11 IVR calls. METHODS: Eligibility requirements included being 18 years of age or older, having reliable access to a telephone, drinking 200 kilocalories of SSB per day, and having no contraindications for moderate-intensity physical activity. The present research utilizes data from the baseline health assessment, class attendance and IVR and teach back calls completion data, as well as data collected in teach-back and 11 IVR calls. Multi-item TPB constructs for both SSB and PA behaviors were assessed at baseline (measured on a 7-point Likert scale). Each IVR call assessed self-reported past week behavior (ounces of SSB or minutes of PA) and four single-item TPB constructs including behavioral intentions, perceived behavioral control, instrumental attitudes, affective attitudes, and subjective norms. Participation was measured as the number out of 15 activities completed by participants (three classes, one teach back call, and 11 IVR calls). Statistical analysis included descriptive statistics, Chi square tests, independent T-tests, Pearson's correlations, Cronbach's α, and sequential multi-step regression models. Multiple data imputations were used to account for missing data. RESULTS: Of the 301 participants, 81% were female and 93% were Caucasian. The mean age of participants was 48.8 ± 13.5. Additionally, 32% of participants completed high school education, 55% earned < $20,000 per year, 32% had a full time or part time job, and 33% were classified as low health literate. Single-item indicators for both SSB-TPB questions (r > 0.60) and PA-TPB questions (r > 0.69) were highly correlated with their multi-item scales. Baseline TPB variables did not predict the participation rates in either SIPsmartER (F=1.763, R2=0.057, P=0.124) or MoveMore (F=0.815, R2=0.028, P=0.541) conditions. Of the nine SIPsmartER IVR regression models, eight were significant, and the SSB-TPB variables predicted about 30% of the variance in SSB behavior. Of the nine MoveMore IVR regression models, all were significant, and the PA-TPB variables predicted about 20% of the variance in SSB behavior. In both conditions, the majority of variance was explained by behavioral intentions and the addition of other TPB variables (perceived behavioral control, instrumental attitudes, affective attitudes, and subjective norms) explained substantially less variance in the behaviors. There were no notable patterns of change in TPB variables over 11 IVR calls for either SIPsmartER or MoveMore participants. DISCUSSION: Our findings show that single-item indicators can be used as reliable measures of the TPB constructs. The TPB model did not show significant predictive value when it comes to participation in SIPsmartER or MoveMore. On the other hand, our findings show that TPB model explained about 30% (SSB) and about 20% (PA) of variance in behavior. Although significant changes in IVR TPB variables were found between the two time points in several instances for both SSB and PA behavior, there were no patterns of change over time. Based on our findings, assessing behavioral intentions as the goal behavior in each IVR call may be the most useful application of the TPB. Other TPB variables can be assessed using single-item indicators.
Master of Science

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43

Kruzliakova, Natalie Anne. "The Role of Individual and Organizational Health Literacy on Health Behaviors and Health Outcomes." Diss., Virginia Tech, 2018. http://hdl.handle.net/10919/82867.

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Health literacy (HL) is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Low HL has been associated with poorer self-reported health status, inability to manage chronic conditions, and less use of preventive services. More research is needed to explore the relationship between HL and sugar-sweetened beverage (SSB) intake and physical activity (PA). Although numerous HL interventions are evident in the literature, those that test HL as a moderator of effectiveness are lacking. Additionally, it has been recognized that systems-level HL efforts are necessary to lessen the burden of low HL. This dissertation addresses these needs with three unique studies that took place within the rural, medically underserved southwest Virginia region. Study 1 was a secondary analysis that examined the relationship and responsiveness of the Stanford Leisure-Time Activity Categorical Item (L-Cat) and adapted Godin Leisure-Time Exercise Questionnaire (GLTEQ) and determined if baseline HL status moderated intervention effects. There was high agreement L-Cat and adapted GLTEQ for classifying individuals as meeting PA recommendations. Baseline HL status did not moderate change in L-Cat or adapted GLTEQ measures. Study 2 was a secondary analysis that determined if 6-month change in SSB intake predicted 6-month change in body mass index (BMI), weight, and quality of life (QOL), and determined if HL moderated these relationships. The regression models for weight and QOL were not significant. The BMI model was significant. Six-month change in SSB intake, experimental condition, and age were significant predictors for the BMI model. As hypothesized, HL did not moderate relationships in any models. Study 3 details a multilevel mixed-methods needs assessment and collaboratively developed organizational HL improvement plan within the Virginia Department of Health (VDH). Staff responses revealed about half reported doing well across HL domains (written communication, oral communication, self-management and empowerment, supportive systems). However, needs were observed across all domains, with most improvement needed in written communication domain. There were significant correlations between clients' HL status and their perceptions of VDHs' HL practices, indicating potential areas of improvement within VDH.
Ph. D.

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44

Mardiyati, Nur. "Correlations between college students’ perception and goal of body weight, and their consumption behaviors of sugar-sweetened beverages and fried potatoes." Thesis, Kansas State University, 2015. http://hdl.handle.net/2097/19228.

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Master of Science
Department of Human Nutrition
Tandalayo Kidd
Weiqun Wang
The number of overweight and obese college students in the United States has remained high, which could be related to the comfort food and beverages consumed. Sugar-sweetened beverages and fried potatoes are beverages and comfort food commonly consumed by college students. Furthermore, people’s behavior is affected by their perceptions and goals. Thus, this study aimed to assess the correlations between the perception, goal of body weight, and sugar-sweetened beverages and fried potatoes consumption behaviours of college students. A cross-sectional survey of 371 college students was conducted via a self-reporting questionnaire that included information related to sugar-sweetened beverages and fried potato consumption behavior in the past month. The involved students also described their body weight perception and future goal. Spearman correlation and Chi-square analyses were performed to examine the associations. There were significant associations (p<0.0001) between perception of body weight and goal of body weight, regular soda consumption and other sweetened beverage consumption, regular soda consumption and fried potato consumption, and other sweetened beverage consumption and fried potatoes consumption. In addition, there were significant correlations between goals of body weight and other sweetened beverage consumption (p=0.0370). These findings confirmed that perception of body weight was associated with goal of body weight and provided a significant importance for educational intervention to students on improving awareness of healthy body weight and eating.

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45

Bailey, Angela. "Exploring health disparities in rural regions of Virginia: The impact of health literacy and social capital." Diss., Virginia Tech, 2016. http://hdl.handle.net/10919/78318.

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In the United States, low-income, ethnic/racial minorities and rural populations are at increased risk for poorer health outcomes compared to higher income, non-minorities, and urban populations. Two key determinants that influence rural health disparities are health literacy and social capital. Health literacy can be described as an individual-level factor and defined as, "the degree to which individuals have the capacity to obtain, process, and understand the basic health information and services needed to make appropriate health decisions." Social capital is a concept that accounts for the role of collective social functioning and has been defined as, "the features of social structures, such as levels of interpersonal trust and norms of reciprocity and mutual aid" which act as resources for individuals to facilitate collective action." The overarching goal of this research is to explore factors influencing health disparities, including health literacy, social capital in two rural regions of Virginia. The first study is embedded in Talking Health, a larger 2-arm RCT targeting adults in rural Southwest Virginia and examined participants' perceptions of and satisfaction with components of a behavioral intervention designed using health literacy concepts to decrease sugary beverage intake in rural, low-health literacy participants. The second study is also embedded in the Talking Health trial, yet focused on the maintenance of behavior 12-months after the intervention concluded. Guided by RE-AIM, this study examined the reach, effectiveness and implementation of a 12-month randomized extended care intervention aimed at enhancing long-term maintenance of behavior change and study retention when compared to a control condition. The last study is part of a larger telephone surveillance survey conducted in the Dan River Region located in south central Virginia. This study described current levels of social capital in the Dan River Region and examined the influence of social capital on FV consumption, physical activity, sugary beverage intake and BMI on a sample of rural and urban adults.
Ph. D.

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46

Cardoso, Larissa Barbosa. "Essays on economics of obesity and food prices : theory and evidences for Brazil." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/132933.

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O objetivo desta tese é analisar a influência do preço dos alimentos sobre o crescimento da obesidade no Brasil e avaliar os efeitos de uma política baseada no preço como instrumento de prevenção da obesidade. Essas questões foram analisadas em três ensaios que utilizam da estrutura econômica, baseada no princípio de racionalidade econômica, para compreender as escolhas individuais quanto à ingestão e gasto calóricos e a dinâmica do ganho de peso dos brasileiros. O ensaio 1 identifica as principais mudanças no índice de massa corporal (IMC) dos brasileiros e estima a contribuição dos preços dos alimentos a partir dos métodos de distribuição relativa e de decomposição contrafactual. Verificou-se que, concomitante ao aumento da obesidade, um deslocamento para a direita da distribuição do IMC revelando: a) uma maior densidade de indivíduos nas regiões de sobrepeso e obesidade; e b) um aumento do IMC mediano uma maior dispersão em torno deste. Os resultados indicaram que o aumento de preço observado entre 2002 e 2009 foi importante para conter o avanço da obesidade. Contudo, o efeito dessa variação (efeito nível) foi inferior àquele verificado para a mudança do impacto dos alimentos sobre o IMC (efeito estrutura). Os preços de alimentos como refrigerantes, carne e leite integral mostraram-se bastante significativos. Por outro lado, a renda e os anos de estudo contribuíram positivamente para o aumento do IMC no período analisado. Considerando os efeitos obtidos para o preço de refrigerantes sobre o IMC, bem como sua associação positiva do consumo desta bebida com obesidade, os ensaios 2 e 3 avaliaram os efeitos individuais e agregados, respectivamente, da adoção uma política de saúde baseada no aumento de impostos sobre bebidas açucaradas. No ensaio 2, adotou-se o modelo de duas partes para estimar as elasticidades preço demanda, as quais indicaram que o aumento do preço de bebidas açucaradas (refrigerantes e sucos) reduz o consumo, especialmente dos grupos que mais consomem destas bebidas. O resultado sobre o peso apresentou magnitude modesta, porém esta medida mostrou-se relevante na prevenção da obesidade, dado que maiores perdas de peso foram observadas na faixa próxima ao IMC correspondente à obesidade. Os efeitos em termos agregados foram simulados a partir do modelo de preços derivado da matriz de insumo produto, e os resultados mostram que uma política tributária sobre refrigerantes tende a gerar poucos efeitos adversos para a economia, com redução da produção do referido setor e daqueles diretamente inter-relacionados sendo compensada pelo aumento na produção de outros setores. O mesmo foi observado para o emprego, que apresentou variação positiva. No que se refere ao consumo, dado que em termos individuais o aumento tributário de 10% contribui para reduzir o consumo em 6,1%, a despesa de consumo agregado das famílias sofreria redução de 2,1%, com maior redução verificada na faixa de renda intermediária. Diante disso, conclui-se que a redução no preço dos alimentos mais calóricos observada nos últimos anos teve impacto sobre o peso dos brasileiros, e portanto, poderia ser levada em consideração na estruturação de políticas públicas para o combate à obesidade.
The objective of this thesis is to analyze the influence of the price of food on the growth of obesity in Brazil and to assess the effects of a policy based on price as a prevention instrument against obesity. These issues were analyzed in three essays that make use of the economic structure, based on the principle of economic rationality, in order to understand individual choices about calorie intake and expenditure and the dynamics of weight gain of Brazilians. Essay 1 identifies the main changes in Body Mass Index (BMI) of Brazilians and estimates the contribution of food prices from the relative distribution method and of counterfactual decomposition. It was verified that, concomitant to the increase in obesity, there is a shift towards the right of the BMI distribution revealing: a) a greater density of individuals in the regions of overweight and obesity; and b) an increase of the medium BMI a major dispersion around this. The results indicated that the price increases observed between 2002 and 2009 were important to contain the advance of obesity. However, the effect of that variation (level effect) was lower than that observed for the change of the impact of food on BMI (structure effect). The prices of foods such as soft drinks, meat and whole milk showed to be quite significant. On the other hand, income and years of study contributed positively for the increase of the BMI in the analyzed period. Considering the effect obtained for the price of soft drinks on BMI, as well as the positive association of consumption of this type of beverage with obesity, essays 2 and 3 evaluated the individual and aggregate effects, respectively, of the adoption of a health policy based on the increase of taxes on sugary drinks. In essay 2, the two part model was adopted in order to estimate the price-demand elasticity, which indicated that the price increase of sugary drinks (soft drinks and juices) reduce the consumption, especially of the groups that most consume these beverages. The result on weight presented a modest magnitude; however this measure showed to be relevant in the prevention of obesity, since the greater weight losses were observed in the group nearest to the BMI corresponding to obesity. The effects in aggregate terms were simulated parting from the price model derived from the product input matrix, and the results show that a tax policy on soft drinks tends to generate few adverse effects for the economy, with a production reduction of that sector and those directly interrelated being offset by increased production in other sectors. The same was observed for employment, which presented a positive variation. Regarding consumption, since in individual terms the 10% tributary increase contributed to reduce consumption in 6,1%, the aggregate consumption expenditure of households would suffer a reduction of 2.1%, with greater reductions observed in the middle-income range. Therefore, it is concluded that the reduction in the price of high-calorie foods observed in recent years has had an impact on the weight of Brazilians, and therefore, could be taken into account in the structuring of public policies for the fight against obesity.

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Najar, Carol Argelia, Jessi Nataly Vila-Quispe, Laura Astete-Robilliard, and Antonio Bernabe-Ortiz. "Association between household socioeconomic level and consumption of fast food and soft drinks: A cross-sectional assessment of the Young Lives cohort in Peru." Asociacion Espanola de Dietistas-Nutricionistas, 2020. http://hdl.handle.net/10757/655884.

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Introduction: The consumption of fast food and soft drinks is a risk factor for developing overweight and obesity. This study aimed at assessing if there is association between household socioeconomic level and the consumption of fast food and soft drinks among children. Material and Methods: A cross-sectional assessment of the data from the third round (2009-2010) of the youngest cohort of the Young Lives study in Peru was conducted. Sampling was conducted in three stages: In the first one, the country was divided into equal geographical regions, excluding the 5% of the richest district; in the second stage, 20 sentinel sites were chosen and an area within each sentinel site was selected. Finally, in the third stage, eligible children were selected. Outcomes were the self-reported consumption of fast food and soft drinks (never, sometimes, and always), whereas the exposure was household socioeconomic status (in quintiles). Crude and adjusted models were created between variables of interest using Poisson regression models, with robust variance, to report prevalence ratios (PR) and 95% confidence intervals (95% CI). Results: Data of 1901 children, of which 942 (49.6%) were girls, with a mean age of 7.5 (SD: 0.5) was analyzed. A total of 24.1% (95%CI: 22.2%-26.1%) reported always consuming fast food, whilst this number was 22.4% (20.5%-24.3%) for soft drinks. Compared to the lowest socioeconomic quintile, those who were in higher socioeconomic status had more probability of consuming fast food and soft drinks (Chi-squared for trends <0.001). The highest socioeconomic quintile had a greater probability to always consume fast food (PR=1.42; 95%CI: 1.08-1.88) and soft drinks (PR=1.71; 95%CI: 1.24-2.37). Conclusions: This study shows that there is a significant association between the household socioeconomic level and the consumption of soft drinks and fast food.
Revisión por pares

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48

Brownbill, Aimee Lee. "Marketing and Consumer Perceptions of Sugar-Containing Beverages Positioned as Healthy or as Having Health-Related Benefits." Thesis, 2020. http://hdl.handle.net/2440/127016.

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Reducing population consumption of sugar-containing beverages is widely acknowledged as an important public health measure to address high population prevalence of overweight and obesity and related non-communicable diseases. In this thesis, I address marketing as a key driver of consumption and explore how advertising may function to negate increasing consumer concerns about sugar in beverages. My specific aims were to investigate how sugar-containing beverages are being marketed as healthy, or as having health-related benefits, and, how health-related marketing influences consumers’ perceptions of the healthfulness of these beverages. In study one, I conducted a cross-sectional audit of sugar-containing beverages sold in 17 Australian supermarkets during 2016. I analysed the content of 945 sugar-containing beverage labels to assess the extent and nature of explicit and implicit features that positioned them as healthy or better-for-you. I found that 88% of labels displayed advertising that positioned the beverage as healthy or better-for-you. Certain types of beverages were strongly positioned in this way. I also examined the use of the Health Star Rating System, a government-endorsed front-of-pack labelling scheme, in a sub-set analysis of 762 ready-to-drink sized beverages. I found that in its voluntary nature the system was preferentially displayed on high sugar products that scored a healthy rating, namely juices. In this way the system functioned more as tool for advertising juices than a comprehensive tool for informing consumers. In study two, I further explored the positioning of sugar-containing beverages as healthy or better-for-you in television advertisements. All advertisements on free-to-air television from one Australian major network were collected during 2016. I qualitatively analysed 37 unique advertisements from beverage manufacturers to examine health-related messaging in sugar-containing beverage television advertisements. I observed that beverages were positioned as contributing a functional role to promote and enhance physical, mental and social health and wellbeing. In this way, advertisements were situated in wider understandings and conceptualisations of health. In study three, I explored how young adults conceptualise the healthfulness of sugar-containing beverages. I conducted seven semi-structured focus groups with South Australians aged 18 to 25 years (n=32) to elicit information on perceptions regarding beverage healthfulness and how participants evaluated whether a beverage was healthy, or healthier than others. I found that conceptualisation of beverage healthfulness was a balancing act in which participants weighed up their perceptions of beverage ingredients and properties that they saw to be harmful to health, necessary for health, and beneficial to health. In beverages that are positioned as healthy, ingredients and properties perceived as health-promoting appeared to outweigh concern for sugar content. The studies provide insight into how sugar-containing beverages are being advertised within the current sugar-conscious era and how this positioning aligns with consumers’ understanding of health-promoting products. This body of work highlights the gaps in current advertising regulations that allow beverages high in sugar to be positioned as healthy or as having health-related benefits and makes recommendations for strengthening these regulations. Further, this body of work can be used to inform public health interventions which seek to counter misperceptions of beverage healthfulness.
Thesis (Ph.D.) -- University of Adelaide, School of Public Health, 2020

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Liu, Mei-Chun, and 劉玫君. "The Exploration of Taxing Sugar-Sweetened Beverages." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/99591576591433860451.

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50

Edward, Bernice. "Association Between Sugar-sweetened Beverage Consumption and Overweight /Obesity by Physical Activity Status and Socio-demographic Factors in U.S. Adolescents: Analysis of the 2015 Youth Risk Behavior Survey." 2017. http://scholarworks.gsu.edu/iph_theses/498.

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INTRODUCTION: Research has strongly linked increased consumption of sugar-sweetened beverages (SSBs) to obesity/overweight in youth. AIM: This study aims to: (1) examine SSB consumption rates in high school students nationwide, (2) explore association between SSB consumption and adiposity (overweight/obesity), (3) examine gender, racial/ethnic, and physical activity (PA) status differences in SSB consumption. METHODS: The Youth Risk Behavior Survey (YRBS)-2015 was employed in this study. Weighted percentages were used to examine differences in SSB consumption and adiposity prevalence by gender, race and PA status. Multivariate logistic regression was used to determine association between SSB consumption and adiposity. Adjusted and unadjusted odds ratios and 95% CIs were calculated. RESULTS: Overall, 20% of students drank sodas daily ≥ 1 times a day and about 14% drank sports drinks daily. More male students consumed both sodas and sports drinks than female students. Soda consumption was largest in the group with zero days PA (25%) and consumption of sports drinks was highest in the daily PA category (24%) than the other categories. Multivariate logistic regression revealed higher odds of obesity among male students as compared to female students (OR=1.7, 95% CI=1.4, 2.1) and among Hispanic students as compared to white students (OR=1.5, 95% CI=1.2, 1.8), after adjusting for all other covariates. Students who engaged in daily PA had lower odds of obesity than those who had no PA (OR=0.6, 95% CI=0.5, 0.8). There was no significant difference in the odds of obesity between those who consumed SSBs and those who did not. DISCUSSION: This study provides insight into SSB consumption trends in US adolescents by socio- demographic factors and PA status, as well as its association with adiposity. Male gender, certain racial minorities and lack of physical activity can potentially be responsible for greater SSB consumption. Sports drinks consumption is high even in physically active youth. Lack of association between SSB intake and adiposity may be due to the limited SSBs included.

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