Assessing Legislative Interest for a Sugar-Sweetened Beverage Tax in a Midwestern State

BACKGROUND: This study sought to ascertain the opinions of members of the Kansas Legislature regarding pending sugar-sweetened beverage taxation legislation, including perceptions that such a tax would generate revenue or be associated with personal sugar-sweetened beverage consumption habits. METHODS: This study utilized a cross-sectional survey design and was conducted by administering an electronic or telephone survey of the 2010-2011 Kansas Legislature. Publicly-listed contact information for the 165 members in both chambers of the 2010-2011 Kansas Legislature was obtained. State legislators were invited via e-mail, telephone, or both to complete the survey. The main outcome measure was the degree of agreement or disagreement with the idea of sugar-sweetened beverage taxation. RESULTS: Seventy-eight legislators (47.3%) responded. Of these, 90.5% disagreed or strongly disagreed with taxation of sugar-sweetened beverages, and 86.5% disagreed or strongly disagreed with taxation of sugar-sweetened beverages if generated funds were set aside to subsidize healthy choices. Party affiliation, geographic area represented, and personal consumption of sugar-sweetened behaviors were not associated significantly with legislators’ opinions of sugar-sweetened beverage taxation. CONCLUSIONS: The majority of respondents in the Kansas Legislature reported opposing a sugar-sweetened beverage tax. While some respondents identified obesity as a problem, taxation of sugar-sweetened beverages was not a favorable option among Kansas legislators

F as in Fat: How Obesity Threatens America's Future 2011

Outlines 2008-10 national and state obesity rates, health indicators, and policies to address the epidemic; regional, economic, and social barriers to healthy choices; impact of the 2010 healthcare reform and Let's Move initiative; and recommendations

Legislative and Executive Branch Developments Affecting the United States Department of Agriculture Supplemental Nutrition Assistance Program

For more than forty years, the United States Department of Agriculture Supplemental Nutrition Assistance Program (SNAP; formerly Food Stamps) has offered nutrition assistance to nearly forty million eligible individuals and families each month. This article first provides a brief overview of the evolution of the United States’ largest domestic food security and nutrition safety net program. Then, the article reviews Congressional actions taken regarding SNAP during the 2018 Farm Bill deliberations, appropriations for fiscal years 2017 through 2020, and oversight (in)activities. The article focuses on Congressional activities regarding block grants; participant eligibility; benefit adequacy, issuance, and redemption; and strengthening SNAP’s nutritional impacts. Next, the article discusses a variety of executive orders, administrative actions, initiatives, nominations, budget proposals, and tweets with SNAP implications put forth thus far by President Donald Trump, the 45th President of the United States. These actions include the America’s Harvest Box, natural disaster responses, the public charge rule, tariffs on Chinese imports, and various agency relocations and reorganizations. The article reflects on how each of these legislative and executive developments might impact SNAP\u27s organization, operations at the federal, tribal, state and retailer levels, and, ultimately, eating patterns and health of participating and eligible children and families, persons with disabilities, and elders

Community insights into, and an international perspective on the role food environments and diet play in the self-management of type 2 diabetes mellitus in urban and rural South Africa

Philosophiae Doctor - PhDType 2 diabetes mellitus (T2DM) and pre-diabetes contribute increasingly to the global burden of disease. Along with other behavioural risk factors, diet plays a key role in the onset and management of the disease, in turn largely determined by what foods are immediately accessible in local food environments. With this in mind, this thesis aims to answer the research question: What role do local food environments play in promoting or inhibiting access to healthy foods as part of the self - management of T2DM in urban and rural communities in South Africa, and what can be learned from an international perspective? Specific research objectives include, to: 1. Understand the current national-level policy context with regard to the observed rise in NCDs, their proximal determinants (specifically an observed change in diet patterns), and contributing environmental factors; 2. Identify the current food-related environmental factors associated with the onset and/or management of T2DM in an urban and a rural setting (as well as in four additional international settings in order to provide an international perspective); 3. Explore community perspectives of the role the local food environment plays in the self-management of T2DM in an urban and a rural setting; and, consequently 4. Recommend intervention- and/or policy-related actions that can be implemented based on study findings. A review of the literature and relevant policies was conducted towards achieving the first research objective. Quantitative data were systematically collected at an urban and rural site in South Africa through the creation of an ‘environmental profile’ in an attempt to achieve the second objective – comparable urban and rural data was also collected as part of a larger study at two other international sites (Kampala, Uganda and Stockholm, Sweden) to provide an international perspective. Included in the third objective is the collection of qualitative data through a community based participatory research method at the same urban and rural sites in South Africa. Finally, intervention and/or policy-related recommendations are developed based on study findings and in consultation with relevant stakeholders through interviews

True Cost Accounting for Food

This book explains how True Cost Accounting is an effective tool we can use to address the pervasive imbalance in our food system. Calls are coming from all quarters that the food system is broken and needs a radical transformation. A system that feeds many yet continues to create both extreme hunger and diet-related diseases, and one which has significant environmental impacts, is not serving the world adequately. This volume argues that True Cost Accounting in our food system can create a framework for a systemic shift. What sounds on the surface like a practice relegated to accountants is ultimately a call for a new lens on the valuation of food and a new relationship with the food we eat, starting with the reform of a system out of balance. From the true cost of corn, rice and water, to incentives for soil health, the chapters economically compare conventional and regenerative, more equitable farming practices in and food system structures, including taking an unflinching look at the true cost of cheap labour. Overall, this volume points towards the potential for our food system to be more human-centred than profit-centred and one that has a more respectful relationship to the planet. It sets forth a path forward based on True Cost Accounting for food. This path seeks to fix our current food metrics, in policy and in practice, by applying a holistic lens that evaluates the actual costs and benefits of different food systems, and the impacts and dependencies between natural systems, human systems, agriculture and food systems. This volume is essential reading for professionals and policymakers involved in developing and reforming the food system, as well as students and scholars working on food policy, food systems and sustainability

Spiced: The Global Marketing of Psychoactive Substances

Graham hopes to expose marketing’s role in sustaining our addiction to sugar, tobacco, and other psychoactive substances and to then inspire a discussion of strategies for reining in that marketing.

Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco.

BACKGROUND: Overeating and harmful alcohol and tobacco use have been linked to the aetiology of various non-communicable diseases, which are among the leading global causes of morbidity and premature mortality. As people are repeatedly exposed to varying sizes and shapes of food, alcohol and tobacco products in environments such as shops, restaurants, bars and homes, this has stimulated public health policy interest in product size and shape as potential targets for intervention. OBJECTIVES: 1) To assess the effects of interventions involving exposure to different sizes or sets of physical dimensions of a portion, package, individual unit or item of tableware on unregulated selection or consumption of food, alcohol or tobacco products in adults and children.2) To assess the extent to which these effects may be modified by study, intervention and participant characteristics. SEARCH METHODS: We searched CENTRAL, MEDLINE, EMBASE, PsycINFO, eight other published or grey literature databases, trial registries and key websites up to November 2012, followed by citation searches and contacts with study authors. This original search identified eligible studies published up to July 2013, which are fully incorporated into the review. We conducted an updated search up to 30 January 2015 but further eligible studies are not yet fully incorporated due to their minimal potential to change the conclusions. SELECTION CRITERIA: Randomised controlled trials with between-subjects (parallel-group) or within-subjects (cross-over) designs, conducted in laboratory or field settings, in adults or children. Eligible studies compared at least two groups of participants, each exposed to a different size or shape of a portion of a food (including non-alcoholic beverages), alcohol or tobacco product, its package or individual unit size, or of an item of tableware used to consume it, and included a measure of unregulated selection or consumption of food, alcohol or tobacco. DATA COLLECTION AND ANALYSIS: We applied standard Cochrane methods to select eligible studies for inclusion and to collect data and assess risk of bias. We calculated study-level effect sizes as standardised mean differences (SMDs) between comparison groups, measured as quantities selected or consumed. We combined these results using random-effects meta-analysis models to estimate summary effect sizes (SMDs with 95% confidence intervals (CIs)) for each outcome for size and shape comparisons. We rated the overall quality of evidence using the GRADE system. Finally, we used meta-regression analysis to investigate statistical associations between summary effect sizes and variant study, intervention or participant characteristics. MAIN RESULTS: The current version of this review includes 72 studies, published between 1978 and July 2013, assessed as being at overall unclear or high risk of bias with respect to selection and consumption outcomes. Ninety-six per cent of included studies (69/72) manipulated food products and 4% (3/72) manipulated cigarettes. No included studies manipulated alcohol products. Forty-nine per cent (35/72) manipulated portion size, 14% (10/72) package size and 21% (15/72) tableware size or shape. More studies investigated effects among adults (76% (55/72)) than children and all studies were conducted in high-income countries - predominantly in the USA (81% (58/72)). Sources of funding were reported for the majority of studies, with no evidence of funding by agencies with possible commercial interests in their results.A meta-analysis of 86 independent comparisons from 58 studies (6603 participants) found a small to moderate effect of portion, package, individual unit or tableware size on consumption of food (SMD 0.38, 95% CI 0.29 to 0.46), providing moderate quality evidence that exposure to larger sizes increased quantities of food consumed among children (SMD 0.21, 95% CI 0.10 to 0.31) and adults (SMD 0.46, 95% CI 0.40 to 0.52). The size of this effect suggests that, if sustained reductions in exposure to larger-sized food portions, packages and tableware could be achieved across the whole diet, this could reduce average daily energy consumed from food by between 144 and 228 kcal (8.5% to 13.5% from a baseline of 1689 kcal) among UK children and adults. A meta-analysis of six independent comparisons from three studies (108 participants) found low quality evidence for no difference in the effect of cigarette length on consumption (SMD 0.25, 95% CI -0.14 to 0.65).One included study (50 participants) estimated a large effect on consumption of exposure to differently shaped tableware (SMD 1.17, 95% CI 0.57 to 1.78), rated as very low quality evidence that exposure to shorter, wider bottles (versus taller, narrower bottles) increased quantities of water consumed by young adult participants.A meta-analysis of 13 independent comparisons from 10 studies (1164 participants) found a small to moderate effect of portion or tableware size on selection of food (SMD 0.42, 95% CI 0.24 to 0.59), rated as moderate quality evidence that exposure to larger sizes increased the quantities of food people selected for subsequent consumption. This effect was present among adults (SMD 0.55, 95% CI 0.35 to 0.75) but not children (SMD 0.14, 95% CI -0.06 to 0.34).In addition, a meta-analysis of three independent comparisons from three studies (232 participants) found a very large effect of exposure to differently shaped tableware on selection of non-alcoholic beverages (SMD 1.47, 95% CI 0.52 to 2.43), rated as low quality evidence that exposure to shorter, wider (versus taller, narrower) glasses or bottles increased the quantities selected for subsequent consumption among adults (SMD 2.31, 95% CI 1.79 to 2.83) and children (SMD 1.03, 95% CI 0.41 to 1.65). AUTHORS' CONCLUSIONS: This review found that people consistently consume more food and drink when offered larger-sized portions, packages or tableware than when offered smaller-sized versions. This suggests that policies and practices that successfully reduce the size, availability and appeal of larger-sized portions, packages, individual units and tableware can contribute to meaningful reductions in the quantities of food (including non-alcoholic beverages) people select and consume in the immediate and short term. However, it is uncertain whether reducing portions at the smaller end of the size range can be as effective in reducing food consumption as reductions at the larger end of the range. We are unable to highlight clear implications for tobacco or alcohol policy due to identified gaps in the current evidence base.This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1002/14651858.CD011045.pub