October 2014 Digest Archive

Easy-to-Read Calorie Information Reduces Teens’ Sugary Drink Purchases 

Adolescents who see signs explaining the amount of physical activity they would need to do to burn off the calories in a sugary drink are more likely to purchase a lower calorie beverage, a healthier beverage, or a smaller sized beverage, according to a study published in the American Journal of Public Health.

Researchers from Johns Hopkins’ Bloomberg School of Public Health installed signs in six corner stores in low-income, predominantly black neighborhoods in Baltimore. The researchers used four randomly posted signs with calorie information: (1) total calories; (2) number of teaspoons of sugar in a sugar-sweetened beverage; and (3) number of minutes of running; or (4) number of miles of walking necessary to burn off the calories in a sugar-sweetened beverage. They then collected the purchase data of a sample of black adolescents who appeared to be between the ages of 12 and 18.

Before the signs were posted, 98 percent of drinks purchased were for sugary beverages. After, regardless of the type of sign the adolescents saw, the number dropped to 89 percent. When compared with purchasing behaviors when there was no signage, the most effective sign was the one which told shoppers they would have to walk 5 miles to burn off the drink’s calories.

In addition, the authors assert that the teens continued to make healthier choices weeks after the signs were removed.

This study adds to the growing evidence suggesting that simply showing calorie counts on products and menus is not enough to help consumers make healthier choices, according to the authors.

"People don’t really understand what it means that a typical soda has 250 calories," says study leader Sara N. Bleich, PhD, an Associate Professor in the Department of Health Policy and Management at the Bloomberg School. "If you're going to give people calorie information, there’s probably a better way to do it. What our research found is that when you explain calories in an easily understandable way such as how many miles of walking needed to burn them off, you can encourage behavior change."

The study was supported by a grant from the Robert Wood Johnson Foundation through its Healthy Eating Research program. 

Regular Consumption of Sugar-Sweetened Soda Accelerates Cellular Aging 

Regular consumption of sugar-sweetened soda influences disease development, not only by straining the body’s metabolic control of sugars, but also through accelerated cellular aging of tissues, according to a study published in the American Journal of Public Health.  

Researchers at the University of California, San Francisco (UCSF) examined the mechanisms behind soda’s link to diet-related diseases such as diabetes, heart disease, and obesity.

They studied telomeres, the protective units of DNA that cap the ends of chromosomes in cells. The length of telomeres within white blood cells — where it can most easily be measured — has previously been associated with human lifespan, according to the authors. Short telomeres have been associated with the development of chronic diseases of aging, including heart disease, diabetes, and some types of cancer.

The researchers then analyzed data from 5,309 adults in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2002. They found that people who drank more sugary soda tended to have shorter telomeres.

Based on the way telomere length shortens on average with chronological age, the researchers calculated that daily consumption of a 20-ounce soda was associated with 4.6 years of additional biological aging.

This effect on telomere length is comparable to the effect of smoking, or to the effect of regular exercise in the opposite, anti-aging direction, according to Postdoctoral fellow Cindy Leung, ScD, from the UCSF Center for Health and Community, and lead author of the study.

The authors assert that this study adds a new consideration to the list of links that has tied sugary beverages to diet-related diseases and has motivated legislators and activists to champion initiatives to tax sugar-sweetened beverages to reduce consumption and improve public health.  

Soda Industry Recycles Strategies to Block Tax Efforts 

The tactics used by the soda industry to defeat a 2013 soda tax proposal in Telluride, Colorado, bear a striking resemblance to those used to block similar efforts in other cities, according to a news analysis by researchers at Berkeley Media Studies Group (BMSG). 

The researchers reviewed newspaper and blog coverage related to the Telluride tax proposal and compared findings to previous news analyses of soda tax proposals in Richmond and El Monte, CA.

They found recurring industry strategies such as generating anti-tax arguments that fuel a community's existing tensions, and expressing those arguments to the media in a veiled way, so that opposition appears to come from within the community.

The report shows that in Telluride, the industry focused on the town's spirit of individualism and used messages that portrayed the tax proposal as government overreach. In Richmond, the industry crafted its arguments to exacerbate the city's already-existing racial and class divisions, portraying the tax as discriminatory to low-income communities and communities of color. In El Monte, industry spokespeople evoked fears that the government would mismanage the use of the revenue.

In each case, the soda industry relied on front groups to carry its anti-tax messages, giving the illusion of a grassroots-based opposition.

These findings have implications for other cities looking to propose a soda tax. The authors assert that the industry follows patterns, and encourages advocates to know their opposition and anticipate what they will say.

The Rudd Center recently co-hosted a tweet chat with BMSG about the analysis, which can be found here.  

Companies Disproportionately Target Minority and Low Income Children and Adolescents with Unhealthy Food and Beverage TV Ads  

TV Child

Research shows that obesity prevalence and related health burdens are greater among U.S. racial/ethnic minority and low-income populations and that targeted advertising may contribute to this disparity.

In a recently released policy brief by Bridging the Gap, researchers used designated market area (DMA) spot television ratings to assess geographic differences in child and adolescent exposure to food-related advertisements based on DMA-level racial/ethnic and income characteristics.

On average, children’s and adolescents’ exposure to local food and beverage ads was significantly higher in DMAs that had higher percentages of black children and adolescents, and significantly lower in DMAs with higher median incomes.

Of particular note, the study found that black racial and lower-income groups had greater exposure to fast-food restaurant ads compared to full-service restaurant ads. The same groups also had greater exposure to sugary drink ads compared to non-sugary drink ads, which is suggestive of targeted marketing of unhealthy products.

The authors assert that strong nutrition standards for foods and beverages promoted to both children and adolescents are needed to help reduce exposure to unhealthy products and increase exposure to healthy ones.

Employment Opportunities at the Rudd Center

The Rudd Center is recruiting candidates for several new positions, to begin on January 2, 2015 at the center's new location in Hartford, CT. These positions include research assistants, a statistician, and a communications professional. For more information please visit the Rudd Center’s employment page.  


Retail Checkout Aisles Filled with Junk Food 

A study by the Center for Science in the Public Interest of checkout aisles at a variety of supermarket and non-food retailers found that 90 percent of food for sale was candy, energy bars, chips, cookies, and other junk foods, and 60 percent of the beverages were soda and other sugar-sweetened drinks.

Researchers at CSPI analyzed checkout aisles at 30 retailers representing 14 different store types in the Washington, D.C., metropolitan area, including supermarkets such as Giant Food, Trader Joe's, Whole Foods, and Safeway, and non-grocery stores, such as CVS, Dollar Tree, Office Depot, Old Navy, RadioShack, and Ace Hardware.

They characterized only eight percent of food items as "healthier," and just two percent of foods such as nuts and fruit, as actually "healthy." Their assessment of drinks for sale at standard checkout aisles showed that less than 20 percent were for water.

CSPI asserts that because of this, checkout aisles are contributing to the obesity epidemic.

"In this age of diabetes and obesity, it's unethical for retailers to push people to buy and consume extra calories that will harm their health," said CSPI Senior Nutrition Policy Counsel Jessica Almy. "Food stores should set nutrition standards for the foods at checkout and non-food retailers should get out of the junk food business altogether."  

Illinois Public Health Institute Releases Tip Sheets to Help Implement Smart Snacks in School 

Smart Snacks

The Illinois Public Health Institute(IPHI) has released tip sheets to help schools implement the Smart Snacks regulation while minimizing a financial loss. The strategies come from eight school districts across the country that improved nutrition standards for their snack and à la carte food and beverages, known as "competitive foods," and maintained food service revenue.

The tip sheets contain hands-on strategies for Food Service Directors, cafeteria staff, teachers, principals, and families, focused on marketing, selling, and serving healthier food and beverages to middle and high school students. The tip sheets are:

1. Finances: Strategies to Maintain Revenues with Healthier Competitive Foods Standards

2. Creating and Implementing Policies for Healthier Competitive Foods Standards

3. Improving Access to Healthy Foods and Beverages Through Healthier Competitive Foods Standards

4. Student Education and Engagement to Support Healthier Competitive Foods Standards

5. Improving Cafeteria Strategies to Support Healthier Competitive Foods Standards

On November 14, 12pm-1:30pm CST, IPHI will host a webinar for schools, nutritionists, public health professionals, and anyone interested in these strategies. The webinar will feature presenters from CDC and participating school districts. Register here.  

Request for Proposal, Health Equity Consultant 

The Rudd Center is seeking a health equity consultant to help meet health equity objectives for a “Voices for Healthy Kids” initiative. The consultant will work with and advise the Center to plan, develop, and identify action steps to strengthen and institutionalize its commitment to health equity in this initiative. This will include national coalition building and policy advocacy technical assistance activities. More information on the Request for Proposal can be found here.  

Just Published by the Rudd Center

Strategic Science and Communications can Improve Food Marketing Practices 

Prominent organizations like the Institute of Medicine and the World Health Organization have warned that food and beverage advertising contributes to childhood obesity. To address these concerns, food companies have pledged to advertise only "healthier dietary choices" in child-directed media. However, many public health advocates question whether the food industry’s pledges will improve its child-targeted marketing practices in a meaningful way.

In a paper recently published in the journal Critical Public Health, Rudd Center researchers evaluate the progress made by manufacturers of ready-to-eat breakfast cereals in promoting nutritious choices to children through their pledges. The study also evaluates the role scientific research might play in influencing corporate behavior.

The analysis is the first of its kind to provide a case study of the potential for success, as well as the limitations of, a public health strategy to incentivize food companies to voluntarily improve child-targeted marketing practices through strategic research and communications.

Researchers conducted a series of studies beginning in 2008 to evaluate child-targeted marketing by cereal companies. One report, called Cereal FACTS, aimed to understand the extent of cereal marketing to, and its impact on, children; disseminate these findings to parents, the media, the public health community, policy-makers, and industry representatives; and encourage cereal companies to shift child-targeted marketing toward the more nutritious products in their portfolios. Additional studies examined the impact of that marketing on children’s eating behaviors.

In 2012, a follow-up analysis of Cereal FACTS demonstrated some improvements in the nutritional quality and marketing of child-targeted cereals, although these cereals remained the least healthy products in company portfolios.

According to the researchers, cereal companies have implemented more improvements than most other food and beverage companies, most likely because of scrutiny from researchers and advocacy groups, and government initiatives.

The case study suggests that further improvements in food marketing to children will require continued pressure from researchers, advocates, and the government. The authors assert that while the food industry will likely continue to promise to be part of the childhood obesity solution, researchers must continue to independently evaluate the accuracy of companies’ statements by examining the nutritional quality of products marketed to children and the extent and impact of the marketing.

The authors note that while advocates can use the research to mobilize parents and pressure companies to change, government policies that protect children from exposure to marketing of unhealthy products may be necessary to ensure meaningful change.  

Anti-Fat Bias of Obesity Specialists in 2001 Versus 2013 

Weight Bias
Rudd Center research shows that individuals perceived as overweight or obese face widespread anti-fat bias, which leads to prejudice, negative stereotyping, and discrimination.

According to research previously published in Psychological Review, this bias may manifest as either explicit or implicit bias. Explicit bias refers to conscious negative attitudes, often represented by discrimination and prejudice against a social group. Implicit bias is defined as negative attitudes that are activated outside of conscious attention.

While the presence of weight bias among obesity specialists has been documented, little is known about whether these explicit and implicit attitudes have changed over time. Research just published in Obesity examined the two types of weight bias among obesity specialists and the changes in them since 2001.

Researchers measured explicit anti-fat bias and conducted the Implicit Association Test during the 2013 ObesityWeek Conference. The data was compared to data from a study conducted at a 2001 meeting of this group.

They found lower levels of implicit anti-fat bias in 2013 compared to 2001, among obesity researchers, clinicians, and other specialists. However, they found higher levels of some types of explicit anti-fat bias in 2013 compared to 2001.

Although explicit anti-fat attitudes appeared to increase from 2001 to 2013, explicit attitudes are relatively easier to change than implicit ones. These results suggest that despite widespread anti-fat bias, there is promise for reducing it and improving research and treatment.

Authors include A. Janet Tomiyama, University of California, Los Angeles; Laura E. Finch, University of California, Los Angeles; Angela C. Incollingo Belsky, University of California, Los Angeles Julia Buss, University of California, San Francisco; Carrie Finley, The Cooper Institute; Marlene Schwartz, The Rudd Center; and Jennifer Daubenmi, Osher Center for Integrative Medicine.  

Weight Bias Hinders Obesity Solutions 

The problem of societal bias, stigma, and discrimination toward individuals with obesity impedes progress toward evidence-based solutions, according to a commentary by Rebecca Puhl, PhD, Rudd Center’s Deputy Director, and Theodore Kyle, RPh, MBA, member of the Roundtable on Obesity Solutions and Advocacy Advisor of The Obesity Society.

"We must separate the disease of obesity from the people who are affected and implement solutions for obesity while maintaining respect and dignity for children and adults with this disease," assert the authors in an Institute of Medicine Perspectives piece.

Combating weight bias requires efforts to increase public awareness of weight stigma and its health impacts, challenge societal stereotypes and attributions of blame for body weight, combat harmful messages in the media that promote stigma, disseminate interventions that support and empower rather than stigmatize or shame persons with obesity, and implement stigma reduction efforts in settings where weight bias is prevalent, such as in schools, the workplace, and in health care.

According to Rudd Center research, weight bias leads to social and economic inequality, as well as adverse mental and physical health consequences, for individuals with obesity.