Nudging sugar portions: a real-world experiment

Background Sugar overconsumption is a major contributor to overweight and obesity, with daily consumption greatly exceeding the WHO’s recommendations. The aim of the present study was to determine whether using a functionally modified sugar shaker as a food environment nudge could be an effective means to reduce the sugar used in hot beverages. Methods Sugar shakers were functionally modified to reduce the amount of sugar in each pour by 47%. A real-world experiment was conducted to compare the amount of added sugar per hot beverage during default and nudge conditions over the course of four weeks (17,233 hot beverages sold) in a university take-away café. In addition, 59 customers were surveyed to evaluate the acceptance of the intervention. Results Modifying the functional design of sugar shakers resulted in a reduction of added sugar by 20% (d = 1.35) compared to the default condition. In the survey, most participants evaluated the intervention strategy positively. Conclusion The present real-world experiment demonstrates that a simple environmental intervention can significantly reduce sugar consumption in public places while meeting with consumer approval, making it a promising means of reducing sugar overconsumption.

Hospital Food Service Strategies to Improve Food Intakes among Inpatients: A Systematic Review

This review aims to identify hospital food service strategies to improve food consumption among hospitalized patients. A systematic search that met the inclusion and exclusion criteria was manually conducted through Web of Science and Scopus by an author, and the ambiguities were clarified by two senior authors. The quality assessment was separately conducted by two authors, and the ambiguities were clarified with all the involved authors. Qualitative synthesis was used to analyze and summarized the findings. A total of 2432 articles were identified by searching the databases, and 36 studies were included. The majority of the studies applied menu modifications and meal composition interventions (n = 12, 33.3%), or included the implementation of the new food service system (n = 8, 22.2%), protected mealtimes, mealtime assistance and environmental intervention (n = 7, 19.4%), and attractive meal presentation (n = 3, 8.3%). Previous studies that used multidisciplinary approaches reported a significant improvement in food intake, nutritional status, patient satisfaction and quality of life (n = 6, 16.7%). In conclusion, it is suggested that healthcare institutions consider applying one or more of the listed intervention strategies to enhance their foodservice operation in the future.

Environmental Intervention in a University Canteen with Focus on Decision Guidance—Effects on Sale and Daily Consumption of Vegetables and Fruit

The purpose of the study was to evaluate whether an environmental intervention in a university canteen changes the sale and daily consumption of vegetables and fruit among canteen users. The intervention focused on decision guidance, including a positive incentive and nudging. In a pretest−posttest-design, daily sales data of pieces (pcs) of vegetable components and fruit, as well as the sale per main component (pcs/mc), were assessed. Here, 20 opening days were analyzed, each after the intervention (t1) and in the same period of the previous year (t0). Vegetable and fruit consumption were assessed in a controlled pretest−posttest design (3-day-dietary-record, t0 and t1). The intervention group (IG; n = 46) visited the canteen ≥ once/week, and the control group (CG; n = 49) < once/week. At t1, the sale of absolute vegetable components did not change (t0: 132.3 ± 49.7 pcs, p > 0.05), but more per main component were sold at t1 (t0: 0.54 ± 0.09, Δ: 0.09 ± 0.13 pcs/mc, p < 0.05). In addition, the sale of fruit (t0: 17.4 ± 11.6, Δ: 8.3 ± 10.8 pcs, p < 0.05; t0: 0.07 ± 0.03, Δ: 0.05 ± 0.07 pcs/mc, p < 0.001) increased after the intervention. The total consumption of vegetables (IG, t0: 260 ± 170 g/d, CG, t0: 220 ± 156 g/d; p > 0.05) and fruit (IG, t0: 191 ± 109 g/d; CG, t0: 186 ± 141 g/d; p > 0.05), however, did not change. To effectively change daily consumption, the intervention needs to be expanded.

Stand Out in Class: Investigating the Potential Impact of a Sit–Stand Desk Intervention on Children’s Sitting and Physical Activity during Class Time and after School

Sedentary behaviour (sitting) is a risk factor for adverse health outcomes. The classroom environment has traditionally been associated with prolonged periods of sitting in children. The aim of this study was to examine the potential impact of an environmental intervention, the addition of sit–stand desks in the classroom, on school children’s sitting and physical activity during class time and after school. The ‘Stand Out in Class’ pilot trial was a two-arm cluster randomised controlled trial conducted in eight primary schools with children from a mixed socioeconomic background. The 4.5 month environmental intervention modified the physical (six sit–stand desks replaced standard desks) and social (e.g., teachers’ support) environment. All children wore activPAL and ActiGraph accelerometers for 7 days at baseline and follow-up. In total 176 children (mean age = 9.3 years) took part in the trial. At baseline, control and intervention groups spent more than 65% of class time sitting, this changed to 71.7% and 59.1% at follow-up, respectively (group effect p < 0.001). The proportion of class time spent standing and stepping, along with the proportion of time in light activity increased in the intervention group and decreased in the control group. There was no evidence of any compensatory effects from the intervention after school. Incorporating sit–stand desks to change the classroom environment at primary school appears to be an acceptable strategy for reducing children’s sedentary behaviour and increasing light activity especially during class time. Trial registration: ISRCTN12915848 (registered: 09/11/16).

A Brief Motivational Intervention Differentially Reduces Sugar-sweetened Beverage (SSB) Consumption

Background Environmental and behavioral interventions hold promise to reduce sugar-sweetened beverage (SSBs) consumption. Purpose To test, among frequent SSB consumers, whether motivations to consume SSBs moderated the effects of (a) a workplace SSB sales ban (environmental intervention) alone, and (b) a “brief motivational intervention” (BI) in addition to the sales ban, on changes in SSB consumption. Methods We assessed whether (1) baseline motivations to consume SSBs (craving, psychological stress, or taste enjoyment) impacted changes in daily SSB consumption at 6-month follow-up among frequent (&gt;12oz of SSBs/day) SSB consumers (N = 214); (2) participants randomized to the BI (n = 109) versus to the sales ban only (n = 105) reported greater reductions in SSB consumption at follow-up; and (3) motivations to consume SSBs moderated any changes in SSB consumption. Results In response to the sales ban alone, individuals with stronger SSB cravings (+1 SD) at baseline showed significantly smaller reductions in daily SSB consumption at 6-month follow-up relative to individuals with weaker (−1 SD) SSB cravings (2.5 oz vs. 22.5 oz), p &lt; .01. Receiving the BI significantly increased reductions for those with stronger SSB cravings: Among individuals with stronger cravings, those who received the BI evidenced significantly greater reductions in daily SSB consumption [M(SE) = −19.2 (2.74) oz] than those who did not [M(SE) = −2.5 (2.3) oz, p &lt; .001], a difference of 16.72 oz. Conclusions Frequent SSB consumers with stronger SSB cravings report minimal reductions in daily SSB consumption with a sales ban only, but report greater reductions if they also receive a motivational intervention. Future multilevel interventions for institutions should consider both environmental and individualized multi-level interventions. Clinical Trial information NCT02585336.

The Effectiveness of Equipment Provisions on Rural Middle School Students’ Physical Activity During Lunch Recess

Background: Environmental provisions can boost students’ discretionary participation in physical activity (PA) during lunchtime at school. This study investigated the effectiveness of providing PA equipment as an environmental intervention on middle school students’ PA levels and stakeholders’ perceptions of the effectiveness of equipment provisions during school lunch recess. Methods: A baseline–intervention research design was used in this study with a first baseline phase followed by an intervention phase (ie, equipment provision phase). A total of 514 students at 2 middle schools (school 1 and school 2) in a rural area of the western United States were observed directly using the System for Observing Play and Leisure Activity in Youth instrument. Interviews were conducted with stakeholders. Paired-sample t tests and visual analysis were conducted to explore differences in PA levels by gender, and common comparison (with trustworthiness measures) was used with the interview data. Results: The overall percentage of moderate to vigorous PA levels was increased in both schools (ranging from 8.0% to 24.0%). In school 2, there was a significant difference in seventh- and eighth-grade students’ moderate to vigorous PA levels from the baseline. Three major themes were identified: (1) unmotivated, (2) unequipped, and (3) unquestionable changes (with students becoming more active). Conclusions: Environmental supports (access, equipment, and supervision) significantly and positively influenced middle school students’ lunchtime PA levels.

Economic and Toxicological Aspects of Pesticide Management Practices: Empirical Evidence from Turkey

The aim of this study was to evaluate the economics and toxicological aspects of pesticide management practices for sustainable chickpea production. The results of this study demonstrated that the average usage of pesticides is 877.30 g per hectare as an active ingredient in the chickpea growing. The average usages per hectare of active ingredient of insecticides, fungicides, and herbicides were calculated to be 1.50 g, 638.80 g, and 237.00 g, respectively. Fungicides are the biggest pesticide group used with 72.81% of total weight of active ingredients. It was calculated that the crop protection cost was EUR 75.65 per hectare, having the portion of 12 % of average production cost. The study revealed that the most common pesticides used by the farmers in chickpea growing were moderately hazardous and non-acute hazard categories. Based on the results of this study, it is suggested that the government should carry out effective agro-environmental intervention policies and farmer extension programs should be aimed at balancing the amounts of pesticides used per hectare for the sustainable, dynamic environment and prevention of pesticide toxicity. Keywords: chickpea, pesticide practices, economic, toxicological, Turkey