Childhood (ages 2-9 years) and adolescence (ages 10-19 years) make up important periods of human life. Food preferences and dietary behaviors are developing during this time, and health status can impact noncommunicable disease (NCD) risk in adulthood. Many of the behaviors associated with developing NCD are modifiable and include dietary behaviors. Globally, children and adolescents are impacted by NCD, and obesity prevalence is growing among this population. One of the recommendations for combating obesity is to promote the consumption of healthy foods and beverages and the reduction of sugar-sweetened beverage intake. In order to assess beverage patterns, the Healthy Beverage Index (HBI) was created for adults. This tool provides a score from 0-100, with higher scores indicating better adherence to evidence-based beverage recommendations. Because many beverage recommendations for children and adolescents differ from those for adults, the purpose of this thesis was to develop the HBI for U.S. Children and Adolescents (HBI-CA). National Health and Nutrition Examination Survey (NHANES) data was used to calculate HBI-CA scores among a sample of U.S. children and adolescents. The HBI-CA resulted in scores similar to the adult HBI and provides a reference of beverage pattern quality in this population. Significant differences in scores were found among males and females and certain races. Evaluation of the HBI-CA demonstrated its construct validity and reliability. The HBI-CA still needs to undergo predictive validity tests. Overall, the HBI-CA provides a method to assess beverage pattern quality in clinical, public health, and research settings for this important population. / Master of Science / Children (ages 2-9 years) and adolescents (ages 10-19 years) makeup an important population for the implementation of dietary interventions because they are still developing their food preferences and dietary behaviors. The rise of obesity among these age groups indicates that their dietary behaviors may not be aligned with recommendations. Beverages can easily be overlooked as a dietary component, but they currently constitute a large portion of daily energy intake. In order to assess beverage pattern quality in this population, the Healthy Beverage Index for U.S. Children and Adolescents (HBI-CA) was developed based on the HBI for adults. This tool provides a score from 0-100, with higher scores indicating better adherence to evidence-based beverage recommendations. The HBI-CA also provides a resource of comprehensive beverage recommendations for these age groups, which was previously limited in the literature. National Health and Nutrition Examination Survey (NHANES) data was used to calculate HBICA scores among a sample of U.S. children and adolescents. The HBI-CA resulted in scores similar to the adult HBI and provides a reference of beverage pattern quality in this population. Significant differences in scores were found among males and females and certain races. Evaluation of the HBI-CA demonstrated its ability to reliably and consistently measure beverage pattern quality. Future evaluation of the HBI-CA should include examination of the relationship between HBI-CA scores and dietary-related health outcomes. Overall, the HBI-CA provides a method to assess beverage pattern quality in clinical, public health, and research settings for this important population.

Hypothesis: "By an environmental change in high school vending machines, making water available, students will choose water over the sugar sweetened sodas." This document highlights a case study analysis of vendor-provided refill data for forty-five beverage vending machines at two campus sites in one high school district in 2003 and 2004. The innovative study and publicized negotiated soda contract of a 50:50 (healthy to unhealthy) beverage ratio stipulation became the “Win-Win-WEAN” compromise, in which exposure to healthier beverage options for students might prove to provide the same income opportunity for the school district. An overview of the political climate in California leading to this local advocacy for reduced availability of sodas on school campuses, which began in 1999 before the passage of Senate Bill 19- Pupil Nutrition, Health Achievement Act of October 2001 (SB-19) is also addressed. The quagmire to generate and implement this unique pilot of a 5-year contract stipulating a 50:50 ratio, with strategic placement of qualified healthy beverages in the top slots of the 45 machines, is discussed to give context of the beverage industry practices. The ratio stipulation was intended to target one significant area of empty calories in students’ daily environments in attempt to help reverse the unprecedented obesity epidemic among adolescents. The agreement voted upon by the Santa Maria Joint Union School District’s Board of Trustees in a public meeting, as noted in the minutes of August 14, 2002, was not implemented as originally approved and thus a series of negotiation meetings began, prompting this data analysis. The 50:50 ratio, per SB-19, was not achieved during the performance life of the contract between the school district and the beverage vendor. School district administration fiscal year-end data in March 2005 confirmed that the hypothesis of a net profit sales quota of $60,000 was rejected, as there was a $7,300 shortfall. The data analyzed did determine that the highest selling, single beverage productwas un-flavored (plain) water with a 65% share. This information was contrary to the beverage vendor and school district business superintendents’ pre-conceived ideas that water in the machines would cause them to lose money. In reality water was the highest revenue generator beverage. The $60,000 minimum guaranteed annual commission, which was in actuality a sales quota projection, was still acknowledged as a contractual commitment by the vendor so no actual deficiency in fund payments was experienced by the school district. The profit margin for both water and other products was 40 cents per can. The data analysis showed that water was indeed the highest selling beverage regardless of equipment malfunction, restocking failures, and misrepresentation of drinks as healthy by vending machine placement and clever advertising with label changes for the same beverage. When water was included in the vending machines, students responded with immediate purchasing of water, demonstrating the 4th of five distinct stages of readiness for behavior change as “Action” following the principles of Drs’ Prochaska and Di Clemete’s Trans-Theoretical model. This model outlines different levels toward sustained behavior change and typical timelines of each relative stage of change. Keywords: beverage consumption, sodas, obesity, empty calories.

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INTRODUCTION: Dental caries erosion are both multifactorial diseases. One common factor for both diseases is acid attack on dental enamel. Some beverages contain both erosive acids and cariogenic carbohydrates, thus, promoting both types of disease. Previous literature has examined beverages as single source exposures, despite the fact that beverage consumption is a complex process that contains several beverage. A few studies have examined the patterns of beverage consumption and dental caries in both children and adults. These studies found a significant positive relationship between sugar sweetened beverages consumption and caries. These studies did not differentiate between regular and diet soda, so the relationship between diet/low calorie sweetener drinks and dental caries is not established. In contrast with caries, the association between beverage consumption patterns and erosion has not been studied before. OBJECTIVES: Examine the effect of diet drinks on dental caries and erosion among a representative sample of US children and adults. METHODS: All analyses conducted using cluster analysis to account for the complexity of beverage consumption and to better understand the effect of different consumption patterns on the dentition. NHANES data was used to be able to generalize the results to the US population. RESULTS: In children, we managed to define 6 different clusters including: water, milk, juice drinks, 100% juice, soda, and diet drinks. None of the clusters demonstrated statistically significant associations with dental caries. While individuals with high soda consumption had the highest caries risk, diet drinks had no effect on dental caries. On the other hand, adults were grouped into 4 distinct clusters: water, soda, diet drinks, and coffee/tea. The diet drinks cluster was not associated with higher DMFT score, while high soda consumption demonstrated increased DMFT. In contrast, high diet drinks consumption increased the risk for erosion, although this relationship was not statistically significant. CONCLUSION: This dissertation showed that diet drinks are not associated with dental disease. While we can not recommend consuming these drinks based on this one cross sectional study, we believe that more studies should be conducted so that we can draw a final conclusion regarding oral disease and diet drinks. / 2022-10-24T00:00:00Z

The study sample was comprised of 18,953 subjects aged 18 years and older who participated in the Third National Health and Nutrition Examination Survey. Preference for diet soda over regular soda was higher in females as compared to males and in Caucasians as compared to other races. Mean alcohol consumption was almost three times higher in males than in females. Undiagnosed hypertension was more common in males than in females, in 65-90 than in 50-64 year olds, and in people with less than high school education compared to those with higher education. Diastolic pressure was correlated with the level of consumption of diet soda, coffee, tea, and alcohol. Diet soda and alcohol consumption had a statistically significant positive relationship with hypertension even after adjusting for demographic variables and body mass index. The study provides useful information of the patterns of beverage uses and the prevalence of hypertension in the United States.

Background: Poor beverage consumption habits pose significant health concerns. Delivering health behavior change interventions via social media is an emerging area of health research and may provide a promising way to minimize barriers such as cost, intervention delivery time, and access. However, there is limited research on online social support health behavior change delivered through Instagram. Objectives: 1) Assess the validity and reproducibility of the updated BEVQ-15, a beverage intake questionnaire; 2) Review the current literature on the availability and effectiveness of mobile phone interventions targeting sugar-sweetened beverage (SSB) consumption; and 3) Use the updated BEVQ-15 to conduct the Healthy Beverage Habits pilot study, which is an online social networking worksite intervention aimed at improving Healthy Beverage Index (HBI) scores. Methods: The Healthy Beverage Habits study was an online randomized controlled pilot trial with an 8-week intervention and a 4-week maintenance period delivered through Instagram. The materials were adapted from the in-person SIPsmartER SSB reduction intervention. Data analysis included RM-ANOVAs to test for differences in beverage intake between the Instagram intervention group and the E-mail control group. Results: For the Healthy Beverage Habits trial, no significant between group over time differences were found. However, the Instagram group demonstrated a significant reduction in total beverage kcal (mean difference±SE=-156±48; p=0.049), and increase in total HBI scores (mean difference±SE= 11.9±2.3; p=0.025) from baseline to the end of the maintenance period. No within group differences were demonstrated for the E-mail control group over the intervention or maintenance period. The study retention rate was 38%, with 39 participants initially enrolled and 15 participants completing all study visits through maintenance. Results for the validity and reproducibility of the updated BEVQ-15 and a review of the availability and effectiveness of mobile phone interventions targeting SSB consumption are presented. Conclusions: Mobile phone-delivered interventions may be a promising method for improving beverage intake quality. Technologically-based interventions targeting beverage consumption should consider utilizing multiple forms of mobile-phone contact methods. The preliminary findings from the Healthy Beverage Habits trial highlight the need for more rigorous studies that determine which technology and intervention components are most effective for mobile-delivered beverage consumption interventions. / Doctor of Philosophy / Background: Poor beverage consumption habits pose significant health concerns. Delivering health behavior change interventions via social media is an emerging area of health research and may provide a promising way to minimize barriers such as cost, intervention delivery time, and access. However, there is limited research on online social support health behavior change delivered through Instagram. Objectives: 1) Assess the validity and reproducibility of the updated BEVQ-15, a beverage intake questionnaire which estimates habitual average daily intake of 15 beverage categories as well as total sugar-sweetened beverages (SSB) and total beverages. 2) Review the current literature of the availability and effectiveness of mobile phone interventions targeting SSB consumption. 3) Use the updated BEVQ-15 to conduct The Healthy Beverage Habits pilot study, which is an online social networking worksite intervention aimed at improving Healthy Beverage Index (HBI) scores. Methods: The updated BEVQ-15 was assessed for agreement between the BEVQ-15 and dietary recalls. Researchers compared beverage intake between two BEVQ-15 administrations. The Healthy Beverage Habits pilot study was an 8-week intervention with a 4-week maintenance period. Data analysis included testing for differences in beverage intake between the Instagram group and the E-mail group. Results: The updated BEVQ-15 demonstrated moderate agreement between the BEVQ-15 and dietary recalls for total SSB intake and total beverage intake. All beverage variables were significantly correlated. For the systematic review, 11 of the 17 studies (65%) were successful in reducing SSB consumption through mobile phone delivery. The successful studies used multiple types of technology. There were no significant differences for any beverage variable between the Instagram and E-mail groups over time. However, for within group changes, Instagram significantly reduced total beverage kcals and improved total HBI score, while the E-mail group did not demonstrate any significant changes. Conclusions: Mobile phone-delivered interventions may be a promising method for improving beverage intake quality. Technologically-based interventions targeting beverage consumption should consider utilizing multiple forms of mobile-phone contact methods. The preliminary findings from the Healthy Beverage Habits pilot trial highlight the need for more rigorous studies that determine which technology and intervention components are most effective for mobile-delivered beverage consumption interventions.

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

Made available in DSpace on 2015-04-16T14:49:06Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1152474 bytes, checksum: 26700a7c34b11ab01884eb96bde9f8b1 (MD5) Previous issue date: 2013-03-04 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The central theme of thesis lies upon alcohol consumption amongst young people, under a social marketing perspective. The research is justified by an analysis on the consumer as an agent who generates imbalance in the exchange system, deriving from excessive alcohol consumption in youth. This indication has as immediate consequence a broadening of the marketing view either as an activity or a knowledge, thus becoming an area oriented for the system s balance. This study aimed to analyze determining factors for alcohol consumption predisposition, to measure and to hypothesize, based on the theoretical model proposed. Hence, a literature review on prospective constructs which might influence alcohol consumption oh youngsters was carried. To enable the empirical research s operationalization, 322 questionnaires were administered, with young people from 18 to 30 years old. With presential application in the city João Pessoa. Generally speaking, result show that social reference (family and friends), sociability and personal satisfaction influence on the perceived risk, social stigmatization and feeling of self-confidence was found in the study s analysis context. In the study s final part, theoretical and practical implications are presented along with limitations and recommendations for future research. / Esta dissertação tem como tema central o consumo de bebidas alcoólicas entre os jovens, tratado sob a perspectiva do marketing social. A pesquisa é justificada por analisar o consumidor, como um agente que gera desequilíbrios no sistema de troca decorrentes do consumo excessivo de álcool na juventude. Esta indicação tem como consequência imediata a ampliação da visão do marketing enquanto atividade ou conhecimento, pois passa a ser compreendida como uma área orientada para equilibrar o sistema. O objetivo desse estudo foi analisar os fatores condicionantes da predisposição do consumo de bebidas alcoólicas, mensurar e levantar hipóteses com base em uma proposta de modelo teórico. Para isso foi desenvolvido uma revisão de literatura elencando os potenciais construtos que influenciariam os jovens a consumirem bebidas. Para viabilizar a operacionalização da pesquisa empírica, foram aplicados 322 questionários, com jovens entre 18 e 30 anos, com aplicação presencial na cidade de João Pessoa. De maneira geral, os resultados indicaram que a referência social (familiares e amigos), sociabilidade e satisfação pessoal influenciam na predisposição do consumo de bebidas alcoólicas, não tendo sido observada influência de outros elementos como risco percebido, estigmatização social e sensação de autoconfiança no contexto de análise do estudo. Ao final do estudo são apresentadas as implicações teóricas e práticas, bem como as limitações e recomendações de futuras pesquisas na temática em questão.

O estudo teve por objetivo avaliar o uso de álcool no padrão binge em usuários de drogas. Trata-se de um estudo transversal, exploratório, da abordagem quantitativa, desenvolvido em um Centro de Atenção Psicossocial - Álcool e Drogas. A amostra foi composta por 140 usuários de drogas em tratamento. Constituíram instrumentos para coleta de dados: informações sociodemográficas, Escala de Gravidade de Dependência do Álcool (SADD), AUDIT-C, Escala de Severidade de Dependência de Drogas (SDS), Cocaine Craving Questionnaire-Brief (CCQ-Brief) e The Drinker Inventory of Consequences (DrInC). A amostra caracterizou-se predominantemente por adultos do sexo masculino, solteiros, cor negra/parda, com baixo nível de escolaridade, que professavam a religião católica. A maioria dos participantes fez uso de bebida alcoólica no padrão binge e nível severo de dependência alcoólica e de drogas. Na presente amostra não foram verificadas associações entre o consumo no padrão binge e situações de violências. Os usuários também apresentaram consequências mais graves nos aspectos físicos, interpessoais, intrapessoal, controle de impulso e responsabilidade social avaliadas pela escala DrInC. O uso pesado de álcool tem sido uma prática muito comum entre usuários de cocaína e crack, o que representa graves riscos para a saúde física e social dessas pessoas. Os resultados indicam a necessidade de estratégias interventivas para controle do uso de álcool nessa população / The study aimed to evaluate the binge-drinking among drugs users. It is a cross-sectional study of a quantitative approach. The study was developed in a Psychosocial Attention Center - Alcohol and drugs. The sample was composed of 140 drug users in treatment. The tools of data collection were: sociodemographic information, Short Alcohol Dependence Data (SADD), The Alcohol Use Disorders Identification Test (AUDIT-C), Severity Dependence Scale (SDS), Cocaine Craving Questionnaire-Brief (CCQ-Brief) and Drinker Inventory of Consequences (DrInC). The sample was characterized predominantly by being adults, males, singles, black / brown color, with low education level, who professed the Catholic religion. Most participants made the use of alcohol in binge-drinking and severe levels of alcoholism and addiction. In the present sample was not identified associations between the binge- drinking and violence situations. Users also present more serious consequences in the physical, interpersonal, intrapersonal aspects, impulse control and social responsibility evaluated by DrInC scale. Heavy use of alcohol has been a very common practice for cocaine and crack users, which represents serious risks to physical and social health of these users. The results indicate the need for intervention strategies of alcohol use control with this population

Darbo tikslas. Išanalizuoti alkoholinių gėrimų reklamos situaciją Lietuvoje, gyventojų požiūrį į jos draudimą. Darbo uždaviniai. 1. Išanalizuoti esamą alkoholinių gėrimų reklamą. 2. Nustatyti moksleivių požiūrį į alkoholinių gėrimų reklamą. 3. Nustatyti gyventojų požiūrį į alkoholinių gėrimų reklamos draudimą. 4. Išanalizuoti esminius reklamos kūrimo principus, įvertinti jų naudojimą reklamuojant alkoholinius gėrimus. 5. Įvertinti esamos alkoholinių gėrimų reklamos atitikimą egzistuojančiai įstatyminei bazei, jos pobūdį. Tyrimo metodika. 2007 m. rugsėjo mėn. alkoholinių gėrimų reklamos monitoringo duomenų analizė. Viešosios nuomonės tyrimas. Alkoholinių gėrimų reklamos analizė, atitikimas įstatyminei bazei. Kokybinis moksleivių nuomonės tyrimas. Rezultatai. Lyginant televiziją, spaudą, radiją bei lauko reklamą, daugiausiai alkoholinių gėrimų reklamų 2007 m. rugsėjo mėnesį buvo televizijoje, čia reklama pasiekia daugiausiai gyventojų. Nors stipriųjų alkoholinių gėrimų reklamos transliacijos laikas televizijoje ribojamas, tačiau jas matė 56 proc. tyrime dalyvavusių moksleivių, o 44 proc. apklaustųjų nurodė stipriųjų alkoholinių gėrimų reklamas matę spaudoje. Beveik pusė apklaustų respondentų pritaria alkoholinių gėrimų reklamos uždraudimui. Nors alkoholis yra ypatinga ir valstybės kontroliuojama prekė, jo reklamai naudojamos beveik visos priemonės, kurios naudojamos ir kitų prekių ar produktų reklamai. Išvados. 1. Dažniausiai alkoholiniai gėrimai reklamuojami televizijoje ir... [toliau žr. visą tekstą] / Aim of the study. To analyze the situation of alcohol advertising in Lithuania and the attitude of Lithuanians towards the ban of alcohol advertising. Objectives. 1. To analyze the advertising of alcoholic beverages. 2. To identify the attitude of school students towards the advertising of alcoholic beverages. 3. To determine the attitude of Lithuanian inhabitants towards the ban of alcohol advertising. 4. To analyze the fundamental principles of how advertising is being created and to estimate its application while advertising alcoholic beverages. 5. To evaluate if the current advertisements of alcoholic beverages conform with the present legal basis and its nature. Methods. Gathered data analysis using monitoring of alcoholic beverage advertisements. Public opinion poll. Advertising analysis of alcoholic beverages and its conformance with legal basis. The quantitative school’s pupil’s survey. Results. After comparing the number of advertisements showed on television, print press, radio and outdoor ads showed in September of 2007, it was identified that most of alcoholic beverage ads were showed on TV, as this kind of advertising reaches the majority of people. Although the broadcast time for advertising strong alcoholic beverages on TV is restricted, these ads were seen by 56 percent of pupils participating in the research and 44 percent admitted seeing strong alcoholic beverage ads in the printing press. Almost half of the polled pupils approve the banning of advertising... [to full text]