Soft Drink Consumption Patterns Among Western Australians

ObjectiveTo examine soft drink consumption across age, gender, socioeconomic, and body weight status groups within an adolescent and adult population.DesignCross-sectional telephone survey.ParticipantsWestern Australian residents (n = 1,015) aged 16–65 years, selected through random dialing.Variables MeasuredFrequency and quantity of sugar-sweetened and diet soft drinks consumption, sociodemographic characteristics.AnalysisThe Kruskal-Wallis test of association for non-parametric data was used to explore differences in quantity of soft drinks consumed. Logistic regression models used to explore type of soft drinks consumed by sociodemographic factors and weight status.ResultsA greater proportion of females consumed no soft drinks (29.2%) or diet soft drinks only (20.9%), compared with males (21.7% and 14.0%, respectively) (P < .05). The youngest (16–24 years) consumers of sugar-sweetened soft drinks consumed twice (median, 3 cups/wk) as much as the eldest (55–65 years) (1.5 cups/wk) (P < .05). Respondents classified as overweight or obese were 1.7 times more likely to drink both sugar-sweetened and diet soft drinks compared with other respondents (P = .02).Conclusions and ImplicationsThis study identified a high prevalence of soft drink consumption within the population (74.5%). These results identify young people (16–24 years of age), as well as males, as population groups to target through public health interventions to reduce soft drink consumption.     

Depressive symptoms during pregnancy: Exploring the role of sitting

Statement of problemStudies exploring relationships between sitting and mental health have been conducted in child and adult, but not pregnant populations. Depression during pregnancy is associated with deleterious outcomes for mothers and children, and shortcomings have been identified in current management strategies. Modifiable lifestyle behaviors may provide more acceptable alternatives to current management strategies if shown to be important. The aim of this study was to explore the relationship between sitting behavior and depressive symptoms in a population of pregnant Australian women.MethodsThis pilot cross-sectional study included 81 pregnant women in Brisbane, Australia. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS). Sitting behavior was measured using the Australian Women's Activity Survey (AWAS). Several potential covariates were also assessed. Linear regression analyses were used to explore the relationship between sitting and depressive symptoms, whilst controlling for known covariates.ResultsThe model investigating “total sitting time” showed no association with depressive symptoms (F = .77, p = 0.38). The model investigating “planned leisure sitting time” was statistically significant (F = 4.42, p = 0.04): significant contributors to the model variance were HADS anxiety score (p = 0.003) and number of existing children (p = 0.02). “Planned leisure sitting time” showed a statistical trend toward significance (p = 0.06).ConclusionsThis study suggests further investigation of the relationship between sitting, particularly planned leisure sitting, and depression during pregnancy is warranted. Future research should include a larger sample and an objective measure of leisure time sitting.     

Association Between Sugar-Sweetened Beverage Intake and Mortality Risk in Women: The California Teachers Study

BackgroundThe evidence linking sugar-sweetened beverage (SSB) intake and mortality risk is conflicting, and associations between various SSB subtypes and mortality remain unclear.ObjectiveTo examine the association between baseline SSB intake, subtypes of SSB intake, and mortality risk in women.DesignProspective cohort study.Participants/settingParticipants of the California Teachers Study (n = 100,314; median age = 53 years) free of cardiovascular disease, cancer, and diabetes at baseline (1995-1996) were followed from 1995 to 2015. Baseline SSB intake was defined as caloric soft drinks (regular soft drinks, not diet soda), sweetened bottled waters or teas, and fruit drinks; and was derived from a self-administered food frequency questionnaire.Main outcome measureMortality was ascertained via annual linkage with state- and nationwide mortality records and the National Death Index over 20 years.Statistical analysisMultivariable-adjusted Cox proportional hazards models were used to generate hazard ratios (HRs) and 95% CIs for assessing associations between SSB intake and mortality. Rare/never consumers were the comparator group.ResultsThere were a total of 14,143 deaths over 20 years (30.5% from cardiovascular disease; 29.2% from cancer). In women who consumed ≥ 7 servings/week of SSBs at baseline (4% of participants), the multivariable-adjusted HRs were not significant for all-cause, cardiovascular disease-specific, or cancer-specific mortality. Consuming ≥ 7 servings/week of baseline caloric soft drink was associated with a higher risk of all-cause (HR = 1.26, 95% CI 1.10 to 1.46; P for trend = 0.02) and cancer-specific (HR = 1.33, 95% CI 1.08 to 1.63; P for trend = 0.08) mortality. In secondary analyses, consuming ≥ 1.5 c/day of baseline SSBs was associated with all-cause mortality (HR = 1.12, 95% CI 1.02 to 1.24; P for trend = 0.01).ConclusionsAlthough the baseline frequency of total SSB intake was not significantly associated with mortality, consuming ≥ 7 servings/week of caloric soft drinks was associated with higher risk of all-cause and cancer-specific mortality. Findings support public health efforts to reduce caloric soft drink consumption.     

Food patterns of Australian children ages 9 to 13 y in relation to ω-3 long chain polyunsaturated intake

ObjectiveThe aim of this study was to examine food patterns of Australian children ages 9 to 13 y in relation to ω-3 long-chain polyunsaturated fatty acid (ω-3 LCPUFA) intake.MethodsSecondary analysis was conducted on nationally representative food data of 1110 Australian children ages 9 to 13 y (525 boys and 585 girls) that was obtained using two 24-h recalls. Principle component factor analysis was used to identify food patterns. Discriminant function analysis was used to identify the relationship between the food patterns and total ω-3 LCPUFA intake.ResultsFour major food patterns emerged for each sex. For boys these were labeled: “snack foods,” “soft drinks,” “vegetables,” and “pork and meat chops, steak, and mince.” For girls they were labeled: “vegetables,” “take-away,” “tea, coffee, iced coffee drinks” and “canned meals and soup.” Fish consumption bought from take-away outlets was more frequently consumed in the “soft drink” (r = 0.577) and take-away (r = 0.485) food pattern in boys and girls, respectively. In contrast, fish prepared at home was more often consumed in “vegetables” in both boys (r = 0.018) and girls (r = 0.106), as well as in the “pork and meat chops, steak and mince” food pattern in boys (r = 0.060). There was a trend that in boys, the “vegetables” group discriminated children who consumed ω-3 LCPUFA levels similar to adequate intakes (AI) (P = 0.067), whereas in girls, the take-away food pattern discriminated for being a fish consumer (P = 0.060).ConclusionsDietary patterns associated with a high consumption of vegetables and “take-aways” food that include meat and fish are likely to positively influence dietary ω-3 LCPUFA intake in Australian children.     

Associations between Parental Limits,School Vending Machine Purchases,and Soft Drink Consumption among Kentucky Middle School Students

ObjectiveTo examine associations between parental limits on soft drinks and purchasing soft drinks from school vending machines and consuming soft drinks among middle school students.DesignSecondary analysis of cross-sectional data from the middle school Youth Risk Behavior Survey.SettingEight public middle schools in central Kentucky.ParticipantsAll sixth- through eighth-grade students in 7 schools and all eighth-grade students in 1 school (n = 4,049).Variables MeasuredSelf-reported parental limits on soft drink intake, school vending machine soft drink purchases, soft drink consumption, and control variables.AnalysisChi-square and binary logistic regression analyses.ResultsCompared to students with no parental limits on soft drink consumption, students with the strictest limits were less likely to purchase soft drinks from school vending machines and consume soft drinks; conversely, students with minor parental limitations were more likely to consume soft drinks. The odds of consuming soft drinks were nearly 4 times greater when students purchased soft drinks from school vending machines than when they did not.Conclusions and ImplicationsFurther research may enhance understanding of the influence of varying degrees of parental limitations. Efforts to reduce children's soft drink consumption may be augmented by policies limiting soft drink purchases in schools.     

The role of physical activity enjoyment on the acute mood experience of exercise among smokers with elevated depressive symptoms

ProblemDepressive symptoms are consistently shown to be related to poor smoking cessation outcomes. Aerobic exercise is a potential treatment augmentation that, given its antidepressant and mood enhancing effect, may bolster cessation outcomes for smokers with elevated depressive symptoms. Lower enjoyment of physical activity may inhibit the acute mood enhancing effects of aerobic exercise. The current study investigated the associations between depressive symptoms, physical activity enjoyment and the acute mood experience from exercise among low-active smokers with elevated depressive symptoms.MethodDaily smokers with elevated depressive symptoms (N = 159; M_age = 45.1, SD = 10.79; 69.8% female) were recruited for a randomized controlled exercise-based smoking cessation trial. Participants self-reported levels of depressive symptoms, physical activity enjoyment, and rated their mood experience (assessed as “mood” and “anxiety”) before and after a standardized aerobic exercise test.ResultsHierarchical regression analysis revealed that depressive symptom severity accounted for significant unique variance in physical activity enjoyment (R² = 0.041, t = −2.61, p = 0.010), beyond the non-significant effects of gender and level of tobacco dependence. Additionally, physical activity enjoyment was a significant mediator of the association between depressive symptom severity and acute mood experience (“mood” and “anxiety”) following the exercise test.ConclusionsPhysical activity enjoyment may explain, at least in part, how depressive symptom severity is linked to the acute mood experience following a bout of activity. Interventions that target increasing physical activity enjoyment may ultimately assist in enhancing the mood experience from exercise, and therefore improve smoking cessation likelihood, especially for smokers with elevated depressive symptoms.     

Exploring the Impact of Racism on Black Youth: A Multidimensional Examination of Discriminatory Experiences Across Place and Time

PurposeCommunity violence disproportionally impacts Black youth. Experiences of racism and discrimination may create additional challenges for youth recovering from violence exposure. This study used ecological momentary assessment to elucidate how perceptions of racism and social support influence health and safety outcomes among Black youth following violence exposure.MethodsTwenty-five Black youth (14–19 years old, 60% female) who had witnessed violence within the past three months completed a baseline survey that assessed discrimination experiences, social support, post-traumatic stress symptoms (PTS), and perceived safety. Youth completed ecological momentary assessments three times daily for two weeks about the place they were in, people they were with, their current emotional state, and in-the-moment racism perceptions. Multilevel models estimated the relationship between overall and time-varying perceptions of racism and social support, PTS symptoms, and perceived safety.ResultsOverall, 76% of youth reported at least one discrimination experience at baseline. Prior discrimination was associated with higher PTS (B = 1.86, p = .001) and depressive symptoms (B = 0.13, p = .013) at baseline. Youth who reported higher overall perceptions of racism in-the-moment reported higher PTS (B = 0.50, p = .002) and lower perceived safety (B = ?0.53, p = .001). In-the-moment perceptions of racism were associated with lower perceived safety in that place (B = ?0.09, p < .01). Emotional and instrumental support were associated with lower PTS and higher perceived safety (p < .05).DiscussionExperiences of racism and being in discriminatory places impacted youth’s depressive symptoms, PTS symptoms, and perceived safety. Interventions attuned to in-the-moment experiences of racism, and that leverage social support, are needed to support Black youth exposed to violence and discrimination.     

Physical activity characteristics and depressive symptoms in older Latino adults

BackgroundPhysical activity (PA) has been consistently associated with fewer depressive symptoms in observational and intervention studies. Emphasis on leisure-time PA, reliance on self report measures of PA, and lack of inclusion of racial/ethnic minority populations have contributed to uncertainty regarding the minimal and optimal dose (minutes/day), intensity (i.e., light, moderate, or vigorous), bout duration (i.e., incidental vs. 10-min bouts), and domain (i.e., leisure-time, occupational, and household) of PA for reducing and preventing depressive symptoms across diverse populations.PurposeTo investigate the relationship between PA characteristics (i.e., dose, intensity, bout duration, and domain) and depressive symptoms in older Latinos using both objective and subjective measures of PA.MethodsOlder Latinos (n = 174) completed questionnaires and wore accelerometers for seven days. Accelerometer output provided daily minutes of sedentary, light, and moderate-vigorous PA (MVPA) overall and in 10-min bouts. The Community Healthy Activity Model Program for Seniors (CHAMPS) questionnaire provided daily minutes of leisure-time PA, household PA, and sedentary activities. Hierarchical linear regression analysis was used to predict Center for Epidemiological Studies Depression Scale (CES-D) score.ResultsAfter controlling for established correlates of depressive symptoms (i.e., demographics, acculturation, and health characteristics), MVPA in ≥10-min bouts independently predicted fewer depressive symptoms (β = ?.231, ΔR2 = .052, p ≤ .01) and household PA greater depressive symptoms (β = .263, ΔR2 = .056, p ≤ .001).ConclusionsResults suggest that PA intensity, bout duration, and domain influence the strength and direction of the relationship between PA and depressive symptoms in older Latino adults.     

The Influence of Chronological Period of Data Collection on Differences in Reported Dietary Intake Among School-Aged Children Surveyed in 39 Countries

ObjectiveTo examine whether dietary intake reported by school-aged children relates to the chronological period of data collection.DesignCross-sectional surveys in 39 countries in different monthly periods of the 2009–2010 school year.SettingsQuestionnaires were completed in schools anonymously.ParticipantsChildren from 39 countries, aged 11, 13, and 15 years (n = 209,320).Main Outcome MeasuresDaily consumption of fruits, vegetables, sweets, and soft drinks, derived from a food frequency questionnaire.AnalysisMultivariate logistic regression (applied for 3 countries); 2-level random intercept logistic regression (applied for 36 countries).ResultsMonthly variations in food intake among students from Canada, England, and Norway, where data collection took place almost all months of the school year, revealed significantly lower daily consumption of food items in January to February. A 2-level random intercept logistic regression model for 36 countries, where questionnaires were administered in relatively shorter periods, indicated the lowest likelihood of fruit and soft drink consumption when the data were collected in March to April (β = −0.30; P = .006, compared with October to December) and in January to February (β = −0.65; P = .018, compared with May to June), respectively.Conclusions and ImplicationsThe chronological period of data collection must be considered when comparing children's reported food consumption, but this effect is small relative to cross-national variations in dietary patterns.     

Gender differences in the longitudinal associations of depressive symptoms and leisure-time physical activity with cognitive decline in ≥ 57 year-old Taiwanese

ObjectiveThis study investigates the role of gender in the associations of long-term depressive symptoms and leisure-time physical activity (LTPA) with the risk of cognitive decline in elderly Taiwanese.MethodWe analyzed 3679 subjects (age ≥ 57) in the 2003 and 2007 datasets of the Taiwan Longitudinal Survey on Aging, of which data were collected via face-to-face interviews by trained interviewers. We excluded proxy respondents. Multivariable logistic regression analysis examined the associations of long-term depressive symptoms (increased symptoms: CES-D10 scores from < 10 to ≥ 10; decreased symptoms: from ≥ 10 to < 10) and LTPA (frequency, duration, and intensity) with cognitive decline (a decrease of two or more SPMSQ scores).ResultsWomen had significant higher percentages of cognitive impairment, compared to men, at the baseline (5.9 vs. 1.5%; χ² = 51.24, p < 0.001) and end-point (10.8 vs. 5.2%;χ² = 39.5, p < 0.001). Men with long-term depressive symptoms had 5.28 greater odds of cognitive decline (OR = 5.28, 95%CI = 2.84–9.82, p < 0.001) and men with increased depressive symptoms had 2.09 greater odds (2.09, 1.24–3.51, p = 0.006). No such association was observed in women. Men with consistently high LTPA had 65% (0.35, 0.19–0.65, p = 0.001) and women with increased LTPA had 43% (0.57, 0.34–0.93, p = 0.024) reduction in odds of developing cognitive decline.ConclusionWe found gender differences in the longitudinal association between depressive symptoms and cognitive decline. Long-term LTPA may loosen the association between long-term depressive symptoms and cognitive decline. These findings are useful in the identification of vulnerable elderly in the Taiwanese population and public health interventions should focus on assisting their cognitive aging.     

The association between past and current physical activity and depressive symptoms in young adults: a 10-year prospective study

PurposeThe objectives of this study were to assess (1) the longitudinal associations of past moderate-to-vigorous physical activity (MVPA) and involvement in team sports during secondary school with depressive symptoms in early adulthood, and (2) the cross-sectional associations of current MVPA and involvement in team sports with depressive symptoms during young adulthood.MethodsData were drawn from the Nicotine Dependence in Teens study, which is an ongoing prospective cohort study of 1293 adolescents aged 12–13 years at baseline (52% female). Data analyses involved latent growth curve modeling and multiple hierarchical linear regression models.ResultsCurrent MVPA (β = ?0.12), but not past MVPA, participation was significantly negatively related to depressive symptoms during young adulthood (P < .05). Both current and past involvement in team sports were significantly negatively related to depressive symptoms (β ≥ ?0.09; P < .05); however, these associations were no longer significant (P = .08) when covariates were controlled for.ConclusionsFindings provide insight about the unique associations between the timing and type of physical activity and depressive symptoms, suggesting that physical activity within team sport contexts should be encouraged so that young adults may experience less depressive symptoms.     

The effects of 60 minutes of supervised weekly walking (in a single vs. 3–5 session format) on depressive symptoms among older women: Findings from a pilot randomized trial

ObjectiveTo investigate the effects of training frequency on psychological benefits resulting from a walking program among older women with subsyndromal depression.MethodsAll participants were randomly assigned to a 4-week-long self-paced walking program including one (G₁) or three to five (G_3–5) weekly training sessions. They completed the Geriatric Depression Scale (GDS) as a measure of depressive symptoms during the intervention and one month later.ResultsUsing statistics for small-n designs, it appeared that, at the end of the program, a significantly greater proportion of women in G_3–5 reported GDS values below the cutoff score of 10 (i.e., indicative of the absence of any depressive symptoms) compared to women in G₁ (5 of 6 vs. 1 of 6; Φ² = 0.48; p < .05). The GDS scores after treatment were significantly lower than baseline scores in both groups (Z = 2.20; p < .03, and Z = 1.99; p < .05 respectively), but the mean decrease of depressive symptoms was significantly larger in G_3-5 (48.9%) than in G₁ (22.7%).ConclusionBreaking 60 min of weekly walking into shorter periods on 3–5 days a week appears to be more effective to alleviate depressive symptoms in older women with subsyndromal depression.     

Is the Consumption of Energy Drinks Associated With Academic Achievement Among College Students?

Despite widely reported side effects, use of energy drinks has increased among college students, who report that they consume energy drinks to help them complete schoolwork. However, little is known about the association between energy drink use and academic performance. We explored the relationship between energy drink consumption and current academic grade point average (GPA) among first-year undergraduate students. Participants included 844 first-year undergraduates (58.1 % female; 50.7 % White). Students reported their health behaviors via an online survey. We measured energy drink consumption with two measures: past month consumption by number of drinks usually consumed in 1 month and number consumed during the last occasion of consumption. We used multiple linear regression modeling with energy drink consumption and current GPA, controlling for gender, race, weekend and weekday sleep duration, perceived stress, perceived stress management, media use, and past month alcohol use. We found that past month energy drink consumption quantity by frequency (p < 0.001), and energy drinks consumed during the last occasion (p < 0.001), were associated with a lower GPA. Energy drinks consumed during the last occasion of consumption (p = 0.01) remained significantly associated with a lower GPA when controlling for alcohol use. While students report using energy drinks for school-related reasons, our findings suggest that greater energy drink consumption is associated with a lower GPA, even after controlling for potential confounding variables. Longitudinal research is needed that addresses whether GPA declines after continued use of energy drinks or if students struggling academically turn to energy drinks to manage their schoolwork.     

Trajectories of Depressive Symptoms Over 2 Years Postpartum Among Overweight or Obese Women

BackgroundAlthough depressive symptoms are common postpartum, few studies have followed women beyond 12 months postpartum to investigate changes in the number and severity of these symptoms over time, especially in overweight and obese women. Using two complementary analytical methods, this study aims to identify trajectories of depressive symptoms over 2 years postpartum among overweight or obese mothers, and assess the demographic, socioeconomic, and health covariates for these trajectories.MethodsUsing longitudinal data from two behavioral intervention studies (Kids and Adults Now!-Defeat Obesity [KAN-DO] and Active Mothers Postpartum (AMP); n = 844), we used latent growth modeling to identify the overall trajectory of depressive symptoms and how it was related to key covariates. Next, we used latent class growth analysis to assess the heterogeneity in the depressive symptom trajectories over time, and thereby, identify subgroups of women with distinct trajectories.FindingsThe overall trajectory of depressive symptoms over 2 years postpartum was relatively stable in our sample. However, the presence of three distinct latent class trajectories (stable-low [82.5%], decreasing symptoms [7.3%], and increasing symptoms [10.2%]), identified based on trajectory shape and mean depressive symptom score, supported heterogeneity in depressive symptom trajectories over time. Lower maternal education was related to a higher symptom score, and poorer subjective health status at baseline predicted inclusion in the increasing symptoms trajectory.ConclusionsIn some overweight or obese mothers, postpartum depressive symptoms do not resolve quickly. Practitioners should be aware of this phenomenon and continue to screen for depression for longer periods of time postpartum.     

Temporal Relationship Between Depressive Symptoms and Cognition in Mid and Late Life: A Longitudinal Cohort Study

ObjectivesTo examine the bidirectional temporal relationship between depressive symptoms and cognition in relation to risk, reaction, and prodrome.DesignCross-lag analysis of longitudinal data collected online at baseline and 12-month follow-up.Setting and ParticipantsA United Kingdom population cohort of 11,855 participants aged 50 years and over.MeasuresPatient Health Questionnaire-9 (depressive symptoms), cognitive measures: Paired Associate Learning, Verbal Reasoning, Spatial Working Memory, and Digit Span.ResultsDepressive symptoms predicted a decline in paired associates learning [β = −.020, P = .013, (95% confidence interval [CI], ‒.036, −.004)] and verbal reasoning [β = −.014, P = .016, (95% CI ‒.025, −.003)] but not vice versa. Depressive symptoms predicted [β = −.043, P < .001, (95% CI ‒.060, −.026); β = −.029, P < .001, (95% CI ‒.043, −.015)] and were predicted by [β = −.030, P = < .001, (95% CI ‒.047, −.014); β = −.025, P = .003, (95% CI ‒.041, −.009)], a decline in spatial working memory and verbal digit span, respectively.Conclusions and ImplicationsDepressive symptoms may be either a risk factor or prodrome for cognitive decline. In addition, a decline in attention predicts depressive symptoms. Clinical implications and implications for further research are discussed.     

Smoking and mortality among persons aged 75–94

ObjectivesExamine the effect of current level of smoking and lifetime tobacco consumption on mortality in persons 75–94 years of age.MethodsData were from a representative sample of older Jewish persons in Israel, which included 1,200 self-respondent participants aged 75–94 (Mean = 83.1, SD = 5.3) from the Cross-Sectional and Longitudinal Aging Study (CALAS). Data collection took place during 1989–1992. Mortality data on 95.1% of the sample at 20-year follow up were recorded from the Israeli National Population Registry.ResultsThe following variables adversely affected mortality for the whole sample: Smoking 11–20 cigarettes daily (HR = 1.276, p < .05), smoking over 20 cigarettes daily (HR = 1.328, p < .05), total tobacco consumption (HR = 1.002, p < .01), and heavy lifetime tobacco consumption (HR = 1.270, p < .01). Results were similar for persons aged 75–84, but the effect of smoking seems to decrease or disappear for ages 85 and above.ConclusionThis is the first report of all-cause mortality risk in both genders of a representative population aged 75 and over. Increased mortality risk is related to high daily quantity of current smoking, and to cumulative amount of lifetime smoking. The effect of smoking may disappear for ages 85 and above, and should be studied in larger oldest–old samples.     

Influence of the San Francisco,CA, Sugar-Sweetened Beverage Health Warning on Consumer Reactions: Implications for Equity from a Randomized Experiment

BackgroundIn 2020, San Francisco, CA, amended an ordinance requiring warning labels on advertisements for sugary drinks to update the warning message. No studies have evaluated consumer responses to the revised message.ObjectivesTo evaluate responses to the 2020 San Francisco sugary drink warning label and to assess whether these responses differ by demographic characteristics.DesignRandomized experiment.Participants and settingDuring 2020, a convenience sample of US parents of children aged 6 months to 5 years (N = 2,160 included in primary analyses) was recruited via an online panel to complete a survey. Oversampling was used to achieve a diverse sample (49% Hispanic/Latino[a], 34% non-Hispanic Black, and 9% non-Hispanic White).MethodsParticipants were randomly assigned to view a control label (“Always read the Nutrition Facts Panel”) or the 2020 San Francisco sugary drink warning label (“SAN FRANCISCO GOVERNMENT WARNING: Drinking beverages with added sugar(s) can cause weight gain, which increases the risk of obesity and type 2 diabetes.”). Messages were shown in white text on black rectangular labels.Main outcome measuresParticipants rated the labels on thinking about health harms of sugary drink consumption (primary outcome) and perceived discouragement from wanting to consume sugary drinks. The survey was available in English and Spanish.Statistical analyses performedOrdinary least squares regression.ResultsThe San Francisco warning label elicited more thinking about health harms (Cohen’s d = 0.24; P < 0.001) than the control label. The San Francisco warning label also led to more discouragement from wanting to consume sugary drinks than the control label (d = 0.31; P < 0.001). The warning label’s influence on thinking about harms did not differ by any participant characteristics, including age, gender, race/ethnicity, education, income, or language of survey administration (all P values for interactions > 0.12).ConclusionsSan Francisco’s 2020 sugary drink warning label may be a promising policy for informing consumers and encouraging healthier beverage choices across groups with diverse demographic characteristics.     

Benefits of Cognitive Behavioral Therapy for Insomnia for Women Veterans with and without Probable Post-Traumatic Stress Disorder

ObjectiveThis study compared the benefits of cognitive–behavioral therapy for insomnia for sleep, mental health symptoms, and quality of life (QoL) in a sample of women veterans with and without probable post-traumatic stress disorder (PTSD) comorbid with insomnia disorder.MethodsSeventy-three women veterans (30 with probable PTSD) received a manual-based 5-week cognitive–behavioral therapy for insomnia treatment as part of a behavioral sleep intervention study. Measures were completed at baseline, post-treatment, and 3-month follow-up. Sleep measures included the Insomnia Severity Index, Pittsburgh Sleep Quality Index, sleep efficiency measured by actigraphy, and sleep efficiency and total sleep time measured by sleep diary. Mental health measures included the PTSD Checklist-5, nightmares per week, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 scale. QoL was measured with the Short Form-12. Linear mixed models compared changes over time across groups. Independent t tests examined PTSD symptom changes in women veterans with probable PTSD.ResultsBoth groups demonstrated improvements across sleep (ps < .001–.040), mental health symptoms (ps < .001), and QoL measures (ps < .001). The probable PTSD group reported greater improvements in diary sleep efficiency (p = .046) and nightmares per week (p = .001) at post-treatment and in total sleep time (p = .029) and nightmares per week (p = .006) at follow-up. Most participants with probable PTSD experienced clinically significant reductions in PTSD symptoms at post-treatment (66.7%) and follow-up (60.0%). Significant reductions in intrusive and arousal/reactivity symptoms were maintained at follow-up.ConclusionsCognitive–behavioral therapy for insomnia improves insomnia, mental health symptoms, and QoL among women veterans, with greater improvement in those with probable PTSD.     

Diet Soft Drink Consumption is Associated with the Metabolic Syndrome: A Two Sample Comparison

Comparative analyses of soft drink intakes in samples from the United States and Europe, and assessed intakes in relation to prevalence of metabolic syndrome (MetS) and its individual components are currently lacking. We used data collected on cardiovascular health and dietary intakes in participants from two cross-sectional studies: the Maine-Syracuse Longitudinal Study (MSLS), conducted in Central New York, USA in 2001–2006 (n = 803), and the Observation of Cardiovascular Risk Factors in Luxembourg Study (ORISCAV-LUX), conducted in 2007–2009 (n = 1323). Odds ratios for MetS were estimated according to type and quantity of soft drink consumption, adjusting for demographic, lifestyle and dietary factors, in both studies. In both studies, individuals who consumed at least one soft drink per day had a higher prevalence of MetS, than non-consumers. This was most evident for consumers of diet soft drinks, consistent across both studies. Diet soft drink intakes were also positively associated with waist circumference and fasting plasma glucose in both studies. Despite quite different consumption patterns of diet versus regular soft drinks in the two studies, findings from both support the notion that diet soft drinks are associated with a higher prevalence of MetS.     

A pilot study to assess the feasibility and acceptability of a community based physical activity intervention (involving internet,telephone, and pedometer support), integrated with medication and mood management for depressed patients

ObjectiveTo assess the feasibility and acceptability of a multi-component intervention to treat depression in primary care.MethodsA single group prospective design was used to examine the feasibility and acceptability of a 12-week intervention combining antidepressant medication, brief behavioral counseling and physical activity (PA) promotion, and also associated changes in depression and various self-reported measures. A sample of adults with mild-to-moderate major depression and willingness to take antidepressant medication were recruited through local primary care clinics. A Research Nurse Practitioner (RNP) prescribed the selective serotonin reuptake inhibitor, escitalopram (10–20 mg), and provided brief weekly counseling. In addition participants received a pedometer, printed materials, and weekly emails addressing behavioral skills to increase their physical activity. Participants' depressive symptoms, quality of life and PA attitudes were surveyed at baseline, 6 and 12 weeks. At week 12 they also reported their satisfaction with the study components.ResultsOf the 36 participants recruited, 64% of participants completed measures at week 12, 30% completed all 12 counseling sessions and 60% responded to half the emails. By week 12, participants reduced their depressive symptom scores (by 4.7; p < .001), improved their quality of life scores (by 9.7; p < .001) and increased their daily step counts (by 2449.2; p < .03). Of the 23 who responded, over 70% thought the pedometer, calls and print materials helped improve their mood. Those who completed more counseling were more likely to reduce their depressive symptoms at week 12 (r = −.46; p < .05).ConclusionThis pilot study demonstrated the feasibility and acceptability of a multi-component intervention to reduce depressive symptoms in a sample of mild-to-moderately depressed adults.