Gayathri Kumar

Self-reported advertising exposure to sugar-sweetened beverages among US youth.

OBJECTIVE According to the Federal Trade Commission, in 2009, the top food category with teen-directed marketing expenditures was sugar-sweetened beverages (SSB). The present study reports on exposure to SSB advertisements using self-report data from adolescents. DESIGN Cross-sectional study design using descriptive statistics to assess self-reported frequency of exposure to SSB advertisements and multivariable logistic regression to examine associations between frequency of SSB advertising exposure and sociodemographic variables. SETTING Online survey conducted at home. SUBJECTS US adolescents aged 12-17 years (n 847). RESULTS Among the surveyed adolescents, 42 % to 54 % reported seeing/hearing SSB advertisements ≥1 time/d. Those aged 14-15 years were more likely to report seeing/hearing soda, sports drink and energy drink advertisements ≥1 time/d than 16- to 17-year-olds. Males were more likely to report seeing/hearing sports drink advertising ≥1 time/d than females. Non-Hispanic black adolescents were more likely to report seeing/hearing fruit drink and sports drink advertisements ≥1 time/d than non-Hispanic white adolescents. Adolescents whose parents had high-school education or less were more likely to report seeing/hearing soda, fruit drink and energy drink advertisements ≥1 time/d than adolescents whose parents were college graduates. CONCLUSIONS Almost half of the adolescents sampled reported daily SSB advertising exposure, with higher exposure among African Americans and adolescents with less educated parents. These data can help inform potential actions that decision makers might take, such as education of adolescents and their caregivers on the potential impact of beverage advertising, especially among groups at higher risk for obesity.

Perceptions About Energy Drinks Are Associated With Energy Drink Intake Among U.S. Youth

Purpose. Energy drinks are growing in popularity among youth because of their stimulant properties. However, they can increase blood pressure and are associated with serious consequences such as cardiac arrest. This study examined the associations between energy drink perceptions and energy drink consumption among youth. Design. The design was a cross-sectional study using the YouthStyles Survey 2011. Setting. The online survey was administered at home. Subjects. Subjects were youths aged 12 to 17 years in the summer of 2011 (n = 779). Measures. Energy drink consumption, perceptions about energy drinks, and sociodemographic and behavioral variables were measured. Analysis. Chi-square and multivariable logistic regression analyses were used. Results. Overall, 9% of youth drank energy drinks, 19.5% agreed that energy drinks are safe drinks for teens, and 12.5% agreed that energy drinks are a type of sports drink. The proportion of youth consuming energy drinks once per week or more was highest among youth aged 16 to 17 years and among those who are physically active three to six times a week. The odds for drinking energy drinks once per week or more was higher among youth who agreed that energy drinks are safe drinks for teens (odds ratios [OR] = 7.7, 95% confidence intervals [CI] = 3.6, 16.4) and among those who agreed that energy drinks are a type of sports drink (OR = 5.0, 95% CI = 2.4, 10.7). Conclusions. These findings suggest that many youth may be unaware or misinformed about the potential health effects and nutritional content of energy drinks. Efforts to improve education among youth about the potential adverse effects of consuming energy drinks are needed.

Association between reported screening and counseling about energy drinks and energy drink intake among U.S. adolescents

OBJECTIVE Possible adverse health consequences of excessive energy drink (ED) consumption have led to recommendations by the American Academy of Pediatrics discouraging ED intake by youth. However, limited information on ED counseling by health care providers exists. METHODS Data was obtained from the 2011 YouthStyles Survey administered to youth aged 12-17 (n=815). The outcome variable was ED consumption (none vs. ≥1 time/week) and exposure variables were screening and counseling about ED (if doctor/nurse asked about ED consumption and if doctor/nurse recommended against ED consumption). RESULTS Approximately 8.5% of youth consumed energy drinks weekly, 11.5% reported being asked by their doctor/nurse about frequency of ED consumption, and 11.1% were advised by their doctor/nurse against ED intake. Multivariable logistic regression analysis revealed that the odds for drinking ED ≥1 time/week was significantly higher in youth who were asked how often they drank ED by their doctor/nurse (odds ratio=2.46) vs. those who were not asked. CONCLUSION About 1 in 9 youth reported receiving counseling discouraging ED consumption from their doctor/nurse, and a greater proportion of youth who were screened about ED also reported ED consumption. PRACTICE IMPLICATIONS Efforts by health care providers to educate youth about potential harms of consuming ED are needed.

Healthful Nutrition of Foods in Navajo Nation Stores: Availability and Pricing

Purpose. Low availability and affordability of healthier foods in food stores on the Navajo Nation (NN) may be a community-level risk factor for the high prevalence of obesity among the Navajo people. This study assessed the availability and pricing of foods and beverages in supermarkets and convenience stores throughout the NN. Design. Descriptive study design using the Nutrition Environment Measurement Survey in Stores audit tool. Setting. Supermarkets (n = 13) and convenience stores (n = 50) on NN and border-town supermarkets (n = 9). Subjects. Not applicable. Measures. Availability and pricing of healthy and less-healthy foods. Analysis. Descriptive and χ2 analyses. Results. Navajo convenience stores offered fewer healthier food options compared to Navajo supermarkets. In Navajo convenience stores, 100% whole grain products, reduced-fat cheese, lean meats, reduced-fat chips, and fat-free or light hot dogs were available in fewer stores than their corresponding less-healthy versions (all with p < .05). In both Navajo supermarkets and convenience stores, 100% whole wheat bread, lean cold cuts, and reduced-fat cheese were all more expensive per unit than their corresponding less-healthy versions (all with p < .05). Conclusions. According to this study, healthier foods are not as readily available in Navajo convenience stores as they are in Navajo supermarkets. Improving access to and affordability of healthier foods in reservation stores of all sizes may support healthy eating among Navajo residents.

Proportion of Adults Who Identified Walking As a US Surgeon General Priority

In September 2015, Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities (Call to Action) was released. This descriptive study reports the proportion of adults who responded to the 2016 Summer ConsumerStyles survey (N = 4,114) who identified walking as the activity the US Surgeon General recently promoted in the Call to Action to help Americans be more physically active. Less than half of adults (44%) correctly identified walking. Adults who were aged 18 to 24 years (35%), were male (43%), were non-Hispanic white (42%), or were physically inactive (36%) were less likely to identify walking than their counterparts. This study highlights an opportunity to raise awareness and promote the Call to Action, especially among certain populations.

Research highlightResearch highlights from the status report for Step it up! The surgeon general's call to action to promote walking and walkable communities

In September 2015, the Office of the Surgeon General, U.S. Department of Health and Human Services, released Step it up! The surgeon general’s call to action to promote walking and walkable communities (Call to Action) to increase walking among people across the USA. The Call to Action also recognized that walkable communities can accommodate wheelchair rolling and are inclusive of persons with disabilities. The Status Report for the Call to Action was released in 2017, summarizing the state of walking and walkability in the USA when the Call to Action was released and describing select actions done since to sustain the messages and promote the goals of the Call to Action (Table 1). These Research highlights briefly summarize the key findings of the Status Report.