Preventing non-communicable diseases in Guatemala through sugary drink reduction and capacity building

通过减少含糖饮料和能力建设来预防危地马拉的非传染性疾病

• 批准号: 9440045
• 负责人: Christina Ann Roberto
• 金额: $ 18.83万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9440045
• 关键词: Address; Adolescent; Advertisements; Beverages; Calories; Cardiovascular Diseases; Cessation of life; Childhood; Chile; Cities; Consumption; Country; Data; Empirical Research; Enrollment; Excision; Exposure to; Faculty; Food; Food Labeling; Goals; Guatemala; Guatemalan; Health; High Prevalence; Income; Institutes; Intake; Intervention; Knowledge; Label; Liquid substance; Malignant Neoplasms; Malnutrition; Mexico; Non-Insulin-Dependent Diabetes Mellitus; Nutrition Labeling; Obesity; Overweight; Parents; Policies; Policy Maker; Population; Poverty; Prevalence; Privatization; Randomized; Regulation; Research; Research Personnel; Research Training; Risk; Risk Factors; Sales; Schools; Sodium; Students; Surveys; System; Testing; Text; Time; Tobacco; United States; Woman; Work; World Health Organization; base; behavior influence; burden of illness; cancer type; design; experimental study; interest; international center; low and middle-income countries; prevent; quitline; saturated fat; smoking prevalence; statistics; sugar; training opportunity

PROJECT SUMMARY Guatemala is a lower middle income country struggling with the “double-burden” of disease (malnutrition and obesity coexisting). It has the second highest prevalence of childhood stunting in the world (49%) and a rising prevalence of overweight and obesity, particularly among women (49%). This is concerning because obesity is a risk factor for numerous health problems, including type 2 diabetes, cardiovascular disease, and at least thirteen different types of cancers. Consumption of sugary drinks is strongly associated with obesity and related health problems. In Guatemala, sales of sugary drinks have increased 25% in the last decade (101.1 liters per capita) and Guatemala has one of the highest per capita intakes of sugary beverages worldwide (mean 2.69 servings per day, higher than Mexico (2.40) and the United States (1.89)). The World Health Organization, has identified research on global strategies to reduce sugary drink intake as a key need. Food labeling has become a popular policy approach to address high levels of sugary drink intake. Some countries are interested in placing health warning labels on sugary drinks, but there are no real-world studies testing the effects of such labels. The first aim of the proposed research is to test the effect of repeated exposure to warning labels on mean fluid ounces of sugary drinks purchased by adolescents in Guatemala. This study will examine how repeated exposure to sugary drink warning labels influences 1500 adolescents' purchases at school stores over time. We will enroll six schools in the study (three private and three public). Each pair of matched private/public schools will be randomized to 1 of 3 labeling conditions: 1) kilocalorie (kcal) label (control); 2) text warning labels; or 3) graphic warning labels displaying amounts of sugar. In this six-week study, we will collect sales data during two weeks without labels, two weeks when labels are displayed, and two weeks after labels have been removed. We will also conduct surveys with 1500 students. Our hypotheses are: 1) graphic warning labels will be most effective at decreasing volume of sugary drinks purchased; 2) text warning labels will be less effective than graphic, but more effective than calorie labels; and 3) sales of sugary drinks will decline after label removal, but will remain lower than baseline levels. The second aim of the proposed research is to systematically assess non-communicable disease (NCD) research capacity at the Cancer Institute in Guatemala (INCAN). We will conduct a formal assessment of NCD research capacity at INCAN using an established hierarchy of nine research capacity needs. Finally, our third aim is to catalyze NCD research capacity building in Guatemala by 1) working with faculty, trainees, and fellows on the proposed empirical research; and 2) offering a short course on NCD research for INCAN trainees and researchers. Our long-term goal is to build research capacity for studies that can evaluate policy interventions like food labels to address NCDs in Guatemala.

项目摘要 危地马拉是一个中低收入国家，正在与疾病的“双重负担”（营养不良和 肥胖共存）。它是世界上儿童发育迟缓发病率第二高的国家（49%）， 超重和肥胖的流行率，特别是妇女（49%）。这是因为肥胖是 许多健康问题的风险因素，包括2型糖尿病，心血管疾病，至少 13种不同类型的癌症含糖饮料的消费与肥胖密切相关， 相关的健康问题。在危地马拉，含糖饮料的销售额在过去十年中增长了25%（101.1 危地马拉是世界上人均含糖饮料摄入量最高的国家之一 (mean每天2.69份，高于墨西哥（2.40份）和美国（1.89份）。世界卫生 联合国儿童基金会（儿童基金会）已确定，减少含糖饮料摄入量的全球战略研究是一项关键需求。食品 标签已成为解决高含糖饮料摄入量的流行政策方法。一些国家 有兴趣在含糖饮料上贴上健康警告标签，但没有真实世界的研究测试 这些标签的影响。这项研究的第一个目的是测试重复暴露于 危地马拉青少年购买的含糖饮料的平均液体盎司上的警告标签。本研究将 研究重复接触含糖饮料警告标签如何影响1500名青少年的购买行为， 学校随着时间的推移我们将在研究中招募六所学校（三所私立学校和三所公立学校）。每对 匹配的私立/公立学校将被随机分配到3个标签条件之一：1）千卡（kcal）标签 （对照）; 2）文本警告标签;或3）显示糖量的图形警告标签。在这六周里， 研究中，我们将收集两周内的销售数据，没有标签，两周内有标签， 两周后，标签被移除。我们还将对1500名学生进行调查。我们的假设 是：1）图形警告标签将是最有效的减少量的含糖饮料购买; 2）文字 警告标签将不如图形有效，但比卡路里标签更有效; 3）含糖食品的销售 标签去除后，饮料将下降，但仍将低于基线水平。第二个目标 拟议的研究是系统地评估非传染性疾病（NCD）的研究能力， 危地马拉癌症研究所（INCAN）。我们将对非传染性疾病研究能力进行正式评估， INCAN使用九个研究能力需求的既定层次。最后，我们的第三个目标是催化 危地马拉非传染性疾病研究能力建设：1）与教师、学员和研究员合作， 经验研究; 2）为INCAN受训人员和研究人员提供关于非传染性疾病研究的短期课程。我们 长期目标是建立研究能力，以评估食品标签等政策干预措施， 解决危地马拉的非传染性疾病问题。