Briefing Book for Prof Tutor Only**


Running head: BRIEFING BOOK SEC 2

Briefing Book Sec 2

Summary Sheet for each cluster of articles

Renán Peña

SOPH 603: Assessment and Intervention: Wicked Problems in Public Health

Texas A&M University School of Public Health

November 4, 2018


Peer-Reviewed Article #1

Elisabeth, L. M., & Merete, H. H. (2018). Soft drinks for lunch? self-control, intentions and

social influences. British Food Journal, 120(8), 1735-1748.


 Question: How much self-control do kids have during lunch at school?

 Methods: Multiple logistic regression was used to explore associations between the independent variables and SSB consumption. Psychometric evaluation of the self-control

measure included factor analysis and internal consistency reliability. A web-based survey

was conducted among 694 Norwegian high school students.

 Major Finding(s): o Factor analysis resulted in two food-related self-control dimensions: resistance

and avoidance.

o Multiple logistic regression showed that intentions was the strongest predictor of SSB consumption in the sample.

o Avoidance and descriptive peer norms appeared as weaker predictors. o Food-related lifestyle, parenting styles and parenting practices have been found to

be associated with SSB consumption in adolescents. Overly strict practices may

have adverse effects on eating behavior by increasing the consumption of

unhealthy foods. For younger children, it is suggested that this may be the result

of an increased appeal of the restricted foods that lead to over-consumption in

situations where restrictions are removed.

o Perceived peer behavior (i.e. descriptive norms) is also shown to be important, and in some cases even more strongly associated with adolescents’ intake than the

actual behavior of the members of the peer group. Influence from peers seems as

an important element for understanding adolescents’ SSB consumption.

 Key Facts: o Options are available to the students o Competing facilities with SSBs are a factor o Availability and accessibility have consistently been identified as important


o Positive association between intentions and SSB consumption during school lunch

 Feasibility/Scalability: o The study only measured one county in Norway and did not take into account

other parts of the country where behavior to SSBs may be different

o The study did not account for SSBs consumed outside of the school setting or time

 Key quote: “Today’s food environment with its ready availability of low-nutrient/high- energy foods and beverages calls not only for structural and social-environmental

interventions to confront unhealthy temptations. Also personal tools like self-controlling

strategies may be helpful to steer adolescents’ food and beverage consumption in a

favourable direction—at least in contexts where structural and social-environmental

interventions are not planned in the near future.”


Peer-Reviewed Article #2

Gortmaker, S. L., Wang, Y. C., Long, M. W., Giles, C. M., Ward, Z. J., Barrett, J. L., . . .

Cradock, A. L. (2015). Three interventions that reduce childhood obesity are projected to

save more than they cost to implement. Health Affairs, 34(11), 1932-65A.


 Question: Can we reduce childhood obesity by the year 2025 in the United States and how much will it cost?

 Methods: Evidence review and microsimulation modeling project concerning the cost effectiveness and population-level impact of seven interventions

 Major Finding(s): o The childhood obesity epidemic in the US affects all segments of society. o Communities and health agencies have limited resources to address high rates of

childhood obesity and need to know how best to invest those resources.

o Reducing television viewing and other screen time leads to significant reductions in BMI and obesity prevalence, mainly via dietary changes.

 Key Facts: o For adolescence an excess weight has accumulated for more than a decade, with

an average imbalance of almost 200 extra kcal/day. The typical adult with a BMI

greater than 35 consumes 500 kcal/day more than is needed to maintain a healthy

body weight. Improving energy balance via improved diet and physical activity

early in childhood thus requires much smaller changes than those needed once

obesity is established in adolescence and adulthood.

o There is clear evidence of the effectiveness of reducing the intake of sugar sweetened beverages on reducing BMI and obesity prevalence.

o Three of the interventions studied were found to be cost-saving across the range.

 Policy Implications: o The elimination of the tax deductibility of advertising costs for television ads seen

by children and adolescents for nutritionally poor foods and beverages

o Restaurant menu calorie labeling modeled on the federal menu regulations to be implemented under the Affordable Care Act.

o Implementation of nutrition standards for federally reimbursable school meals sold through the National School Lunch.

o Implementation of nutrition standards for all foods and beverages sold in schools outside of reimbursable school meals.

o Improved early childhood education policies and practices. o A nationwide fourfold increase in the use of adolescent bariatric surgery.

 Feasibility/Scalability: The reach of bariatric surgery, the smallest, was very limited, even assuming a fourfold increase in the number of adolescents who receive the


 Key quotes (if relevant): “Setting nutrition standards for school meals would reach a very large population of children and have a substantial impact.”

 Key stakeholders: US policy makers, researchers, and nutrition and physical activity experts to provide advice concerning the selection of interventions, evaluation of data,

analyses, and implementation and equity issues.


Commentary/ Opinion Article #1

Sugary drinks linked to high death toll for diabetes. (2015). Medical Economics, 92(15), 68.

Retrieved from

 Question: Are sugary drinks linked to high death toll for diabetes?

 Major Finding(s): o Sugary drinks may lead to an estimated 184,000 adult deaths each year worldwide o Reduced consumption of SSBs could potentially save tens of thousands of deaths


o There is a direct impact on diabetes and the obesity-related effects on cardiovascular disease CVD, diabetes and cancer.

 Key Facts: o Researchers estimate that SSB consumption may have been responsible for

approximately 133,000 deaths from diabetes, 45,000 deaths from cardiovascular

disease (CVD), and 6,450 deaths from cancer.

o Estimates of consumption were made from 62 dietary surveys including 611,971 individuals, conducted between 1980 and 2010 across 51 countries, along with

data on national availability of sugar in 187 countries and other information. This

o allowed capture of geographical, gender and age variation in consumption levels of SSBs in different populations.

 Key quotes (if relevant): o “Many countries in the world have a significant number of deaths occurring from

a single dietary factor, sugar-sweetened beverages. It should be a global priority

to substantially reduce or eliminate SSBs from the diet.”

o “Sugar-sweetened beverages (SSB) are a single, modifiable component of diet that can impact preventable death/disability in adults in high, middle, and low-

income countries, according to the study authors, indicating an urgent need for

strong global prevention programs.”


Commentary/ Opinion Article #2

Keller, J. (1995). Sweet perspective. Beverage World, 114(1589), 4. Retrieved from

 Question: How will the dissolution of sugar supports affect high-fructose corn syrup (HFCS) sweetened beverages?

 Major Finding(s): o Free market production will lead to fair prices on all sugars o The nations sugar policy and the shifts are likely to alter beverage production o Forward-thinking HFCS suppliers, thanks to major continuing investments have

in place an efficient infrastructure with which they can bring to market top-quality

sweetener at a price likely below the free-market price of refined cane or beet


o Large investments in HFCS have affected the production of SSBs and how feasible it is to make cheaper drinks

 Key Facts: o 75 percent of all North American HFCS production is dedicated to beverages o There is a need for the ongoing presence of HFCS suppliers and their market-

balancing choice.

o The 1974 switch from sucrose to HFCS was triggered by the volatility of a free market, when a wretched sugar beet crop in Europe pushed the global price of

sucrose sky-high.

 Key quotes (if relevant): o “Last November US voters sent our government a message: Dissolve yourself a


o “The phase-out of the sugar supports isn’t official yet, and the timing is very far from being settled. But from here, it looks like a win-win-win situation. Now

that’s sweet.”

 Key stakeholders (if relevant): o Refined sugar producers o HFCS producers o Investors for both sucrose and HFCS