Adverse Health Effects of Sugar-Sweetened Beverages
Consumption of Sugar-sweetened beverages (SSB) is rising as global health concern and multiple adverse effects are associated with its consumption. Abundant evidence is available in the form of systemic reviews and meta analysis to establish exposure and effect relationship between SSB and obesity. Moreover, it has been observed that SSB is the autonomous risk factor for metabolic disease like type 2 diabetes and cardiovascular disease and few cancers and dental caries (Te Morenga et al., 2012; Malik et al., 2013). As consumption of SSB is associated with multiple health issues, its magnitude is high on health and well-being of the person (Malik et al., 2010). Consumption of SSBs is more in Aboriginal and Torres Strait Islander people as compared to the other population.
Along with obesity, there is high prevalence of metabolic disease in these people. A research project entitled ‘Next Step’ identified association between food choices and exposure to diseases as priority research area. This project is applicable throughout Australia and more emphasis is given to Aboriginal and Torres Strait Islander people. This project has more importance because it is a community driven project and importance has been given to the needs and interests of Aboriginal and Torres Strait Islander people (King and Brown, 2015). Comprehensive intervention for SSB consumption, need to be planned which address at multiple levels because there is widespread availability of SSB and it is in high demand specifically in the children. As a result, there high magnitude of negative health impact of SSB and it is difficult to control by planning small scale or localised intervention. It is evident that people in the lower socio-economic status are more vulnerable to adverse health conditions as compared to the people in high-socioeconomic status (Pampel et al., 2010).
Aboriginal and Torres Strait Islander people belongs to low socio-economic class as compared to non-indigenous people. In these people, adverse health conditions might be due to more exposure to behavioural and environmental health risk factors, poor living conditions and inadequate education. Cultural aspects and racism also have major impact on the health inequalities among indigenous and non-indigenous people in Australia. Hence, for these people community driven intervention need to be carried out (AHMAC, 2015).
As compared to the global context prevalence of obesity is more in Indigenous children. One of the prominent reason observed for increased prevalence of obesity is consumption of refined carbohydrates like SSB (Singh et al., 2010). There is a biological link between the obesity and consumption of SSB. These SSBs overcome the homeostatic regulatory system and it lead to reduced satiety and consequently excessive consumption of energy (Hu, 2013). Hence, Australian Dietary Guidelines recommend to limit consumption of SSB in the form soft drink and cordial. Australian Medical Association and Public Health Association of Australia also addressed importance of intervention to limit consumption of SSB. Intervention measures include heavy taxation of soft drinks, channelling of revenue from sale of soft drinks to preventive measures, ban on sale of soft drinks in schools, ban on promotion and advertising of soft drinks to the children. These efforts are in line with the international trials for reduction in SSB consumption. However, there is scarcity of literature for description of SSB consumption based on source, demographic and other dietary habits (NHMRC, 2013; AHMAC, 2015).
Prevalence of Sugar-Sweetened Beverage Consumption in Indigenous Children
National Children’s Nutrition and Physical Activity Survey (NCNPAS) conducted survey among 4,487 children aged between 2 and 16 years. In this survey, it was concluded that SSB intake is high in Australian children and it is the need of hour to implement public health intervention. In this survey, it was observed that supermarkets are the primary source of SSB. Most of these children consumed these beverages at the home. Inadequate education of parents and children about the health consequences of SSB consumption are mainly responsible for more consumption of SSB among Aboriginal and Torres Strait Islander children. SSB contributed approximately 4 % energy in children of age between 2 – 3years old and approximately 7.5 % energy in children between 14-16 years old. Independence in the children of age 14-16 years old is mainly responsible for more consumption of SSB, even though it is evident that approximately 75 % of the children used to consume SSB at home. Previous interventions mainly focused on the fast food for assessing consumption of SSB. Due to recent findings, focus of the intervention should be diverted towards SSB consumption in supermarket and consumption at home. There is variation among children of different age group for SSB consumption. Children in age group between 2- 3 years prefers to drink sweetened juice and 2 – 5 years prefers to drink sweetened fruit punch and fruit juice. Consumption of SSB at the critical phase of growth and development can have major impact on the health of child for the rest of life (Hafekost et al., 2011; NCNPAS, 2007).
A survey was conducted among Indigenous children and in this survey, it was found that approximately 65 % Indigenous children are consuming soft drinks containing SSB and out of this approximately 55 % children are consuming these drinks at home. 85 % of these SSB drinks are purchased from supermarkets. Both parents and children were incorporated in this survey and children between age group 11 – 16 years were the target group. Data was collected by using standard questionnaires. It was hypothesized that consumption of SSB can lead to augmentation of cases of obesity in Indigenous children. Based on this hypothesis, protocol was developed to carry out actual health promotion programme. Our hypothesis exhibited similar response to 2007 Australian National, Children’s Nutrition and Physical Activity Survey.
Following are the sample of questions from the survey:
- How much amount of SSB is present in the soft-drinks ?
- Whether parents are accompanying children while drinking SSB containing soft-drinks ?
- What is frequency of purchase of soft drinks from supermarkets?
- What is frequency of soft drink consumption at home ?
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Name of the programme : Health promotion programme for the reduction of children’s consumption of sugar sweetened beverages (SSB) among South Australian Aboriginal and Torres Strait Islander children. |
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Target group : In this study, Aboriginal and Torres Strait Islander children between age group of 2 – 16 years will be selected. 600 children will be selected. Out of these 300 will be enrolled in the intervention group and 300 will be enrolled in the control group. Out of 300 children in each intervention and control group, 150 male children and 150 female children will be enrolled. All these children will from the rural areas and they will be within the radius of 100 km because it will be feasible to access each and every child. Written consensus will be taken from the family members to avoid purchase of SSBs and use of SSBs for children. |
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Goal : To reduce consumption of SSB food and to control obesity in South Australian Aboriginal and Torres Strait Islander children. |
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Health problem: Excess consumption of SSB is directly proportional to the development of overweight and obese children in Aboriginal and Torres Strait Islander population. Different health and social determinants like socioeconomic status, psychological risk factors of the family members, social capital, educational status and lifestyle risk factors are mainly responsible for the occurrence of obesity in these children (Dickson and Manalo, 2014). Food price and parents capability to SSB containing foods are the major determinants for more consumption of SSB in aboriginal children. Other determinants include accessibility, marketing exposure and accompanying peer influence. Parents of the Aboriginal children are unable to provide nutritious and healthy diet and medical treatment to their children due to unemployment and less income. Aboriginal parents are associated with varied psychological risk factors like psychological distress, food insecurity and financial stress (Markwick et al., 2015). Hence, their decision-making ability gets hampered and they can’t take timely decision to provide necessary medical and dietary intervention to their child. There is scarcity of social capital among all the stakeholders of Aboriginal community. Hence, they can’t avail financial assistance and they can’t take advise for their neighbours because most of the people in the Aboriginal community possesses similar social status. Lack of proper education among the Aboriginal parents is important determinant for the occurrence of obesity in children. Due to lack of education, these parents are not aware of the adverse health effects of SSB. Due to lack of education and psychological risk factors these parents can’t discuss health conditions of their children with non-indigenous people. Hence, they can’t get information about healthy lifestyle. Lifestyle risk factors is one of the prominent reasons responsible for the prevalence of obesity in Aboriginal children. Disproportionate and unhealthy food intake is responsible for obesity in these children (Markwick et al., 2014; Johnston et al., 2013). |
Objectives : · To improve knowledge and awareness of negative impacts of consumption of SSB drinks. · To reduce the consumption of SSB drinks in boys and girls of school going and non-going of age 2 – 16 years in Aboriginal population of South Australia in 24 months duration. |
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Strategies : Reduction in the SSB consumption will comprise of stakeholders from different fields. Nurses, physicians, retired health professionals, school teachers, paediatrician, research scientist, research assistants and social workers. Overall activity of the programme will be monitored by the principle investigator. Specific responsibility will be handled by each stakeholder. Teachers and retired health professionals will provide education and training to the children and parents. Nurses, physicians and paediatrician will perform health assessment and monitor health of the children. Data collection will be performed by the research scientist and data analysis will be performed by research scientist. Statistical analysis of the collected data will be performed by statistician. Social workers will increase awareness of the importance of reducing consumption of SSB (Ma et al., 2016; Souza et al., 2013). Education about the health effects of SSB will be provided to children and family members of the intervention programme. Also, children and family members in the intervention group will be banned from purchasing SSB from supermarket and consumption of SSB at their homes will also be restricted. In control group children, education about SSB will not be provided and there will not be any ban on the purchase and consumption of SSB. For non-school going children and their parents education will be provided at community centres and health centres. Education will be provided in the form of theoretical classes and games which would be helpful for keeping abstained from the consumption of SSB (Avery et al., 2015; Zoellner et al., 2016). Educational and health promotion programme will comprise of (Rauba et al., 2017): · Development of school wellness committee comprising of ‘sugar free’ lesson plan. · Posters displaying ‘sugar free life’ in cafeteria of the school. · Lessons will be presented to teachers during weekly staff get-together and in parents meeting. Suggestions from the parents and teachers will be considered for improvement in the programme. · Lessons will comprise of information about the adverse health conditions related to the SSB, lifestyle measures to prevent development of obesity, healthy diet formula for the children and alternative drinks for SSB like real fruit juice. · Letters comprising of instructions to avoid purchase and use of SSB will be sent to home of each student. · Special seminars will be arranged by nutritionist. · Weekly 4 X 45 min. lessons will be arranged. · Weekly 1 X 60 min. lesson will be planned of lifestyle modifications. · Students will be advised to take part sports with more physical activity. · Discounts will be provided for the bottles of real fruit juices in the cafeteria. · Surveys will be conducted for parents and students to assess improvement in the awareness of sugar free life. Based on the outcome of the surveys, necessary modifications in the programme will be implemented. · Weekly once home delivery of healthy drinks like real fruit juice. Children in both intervention group and control group will be monitored for consumption of amount of SSBs and types of SSBs for one year. All the enrolled children will also be assessed for obesity. Body weight and body mass index will be evaluated for assessment of obesity for 24 months. Data collection: Dara related to amount of SSB consumption, type of SSB, body weight and body mass index will be collected. Semi-structured interviews will be conducted for parents of the children for amount and quality of SSB consumption. Semi-structured interviews have the option of slight modification in the framework of questions. Questionnaires will be prepared based on the validated questions based on the literature and these questions will be prepared by experts in the field. Data related to food consumption will be collected over the phone by enquiring with parents. Research assistance will collect data for food consumption. Data related to body weight and body mass index will be measured and recorded by nurses and other healthcare professionals. Body weight and body mass index data will be collected at designated healthcare centres. Data analysis: Collected data will be stored in Microsoft Excel and mean and standard deviation will be calculated for this data. Compiled data will be verified and reviewed by research assistance and research scientist respectively. For each children data will be stored in coded form to maintain confidentiality of the data. Data will be presented in the form of tables and graphs and these will be prepared separately for intervention group and control group. Power calculation will be done for statistical significance. Mean difference between intervention group and control will calculated. Within each group, data will be calculated and presented for boys and girls separately. Statistical analysis will be performed by using SPSS 18.0 software (SPSS Inc., Chicago, IL, USA). For comparison intervention group and control; and boys and girls of the same group, either ‘t’ test or one-way repeated measures ANOVA will be implemented. Post hoc comparisons and correlation analysis will be performed by implementing Tukey test and Pearson’s coefficients (Petrie and Sabin, 2016). |
Life course Health Development model (LCHDM) is applicable in this intervention of reduction in SSB consumption in indigenous children. This is based on the development of health throughout lifetime. This evolution of health is specific for certain period. This intervention is specifically designed for children below 16 years. Hence, LCHDM is more relevant to this SSB consumption reduction programme. Growth, development and health of children specifically dependent on the health status of the children in the childhood. Unhealthy food and condition like obesity in childhood can adversely affect that particular person in adulthood. Embedding component of LCHDM specifically focused on integrating concept experiences for improving structure and functioning of the person. This embedding concept can be applicable for improving educational and nutritional status of the children. This concept is helpful in policy development for health promotion. According to LCHDM, assessment of the individual can be performed throughout life because negative impacts of nutrition and health can be extended throughout life. In this intervention also, SSB food can influence obesity in adulthood also. According to LCHDM, functional trajectory assessment is an important component. SSB induced obesity in children can adversely affect functional activity of children (Halfon et al., 2014; Cheng and Solomon, 2014).
Importance of a Community-Driven Intervention
WHO in 2002 recommended to implement Obesity and diet related chronic disease prevention policy. More than 100 countries are implementing this policy and there is positive outcome are evident as a result of implementation of this policy. This policy is useful in establishing relationship between diet, physical activity and nutrition based chronic disease like obesity. Obesity mainly occurs due more energy consumption in the form of foods like SSB and less energy expenditure decline in physical activity. This policy includes activities like food based dietary guidelines, nutritional counselling and food labelling. Promotion of health-related messages through different media proved most useful strategy for the implementation of this policy. Promotion of fruits and vegetable consumption and regulation on sale of high energy food for children proved fruitful in controlling diet induced chromic disease like obesity in children. Implementation of this policy in school based interventions proved beneficial in controlling obesity in children. School based interventions include banning unhealthy food vending machines in the schools, surveys to identify children with potential risk, improvement in the quality of the school meal and ban on advertising of food products in schools (Malik et al., 2013; Ogata and Hayes, 2014). In this programme policies related to social support and social determinant of health will be addressed. This health promotion programme will be carried out on evidence based research and socially and culturally appropriate methods will be implemented (Visagie and Schneider, 2014).
Ottawa Charter for Health Promotion was adopted at international health conference. National developments in Indigenous health promotion is the part of Ottawa Charter. Healthy life to all the Indigenous people can be provided by affording nutritious food and ensuring optimum physical activity. There is a provision for providing community-controlled health services to Indigenous people in culturally appropriate manner. For the promotion of health among Indigenous people, Aboriginal community-controlled health services (ACCHSs) was established in 1971 in Sydney. According to Ottawa Charter, health promotion is augmentation in control over and improvement in health. There should be complete physical, mental and social well-being of the individual or group of individuals. In this health promotion programme also, efforts will be taken to provide complete management of the children with obesity to enable their proper growth. Health promotion is not the mere responsibility of healthcare sector, however other stakeholders should also contribute to change life-style of the people to enable health promotion. In this health promotion programme, there is need of contribution from other stakeholders like teachers, family members and social workers for the reduction of SSB consumption in the children (Potvin and Jones, 2011; Roden and Jarvis, 2012).
Australian Dietary Guidelines and Intervention Initiatives
Australian Health Survey estimated that consumption of SSB is approximately 50 % in Aboriginal and Torres Strait Islander people and it is approximately 34 % in non-indigenous people (ABS, 2013). Obesity trend is similar to the SSB consumption among Aboriginal and Torres Strait Islander people and non-indigenous people. Aboriginal and Torres Strait Islander people exhibited more obesity as compared to the non-indigenous people. Approximately 66 % adults and 30 % children are associated with obesity in Aboriginal and Torres Strait Islander population (2015). In addition to this occurrence of non-communicable diseases is also more in indigenous people as compared to the non-indigenous people. Next step, a community driven research project was implemented in collaboration with South Australian Aboriginal Health Research Accord. Outcome of this project established that SSB is mainly responsible for the poor health of Indigenous children and it should be projected as national health issue. It is evident from the studies, Aboriginal people and children and people are less educated and less employed. Hence, they are living in poor housing conditions. These are responsible for the less knowledge about the adverse health effects of SSB food in Indigenous people and children. It has been established that early food choices of child can lead to later life food preferences. Parents control over child’s food choices can result in the lesser consumption of SSB drinks by the child. Public health strategies in the form of health education to the parents can effectively reduce consumption of SSB drinks. Variations in the consumption of SSB drinks among children of various age groups warrants age specific intervention to reduce SSB consumption (Fiorito et al., 2010). High consumption of SSB drinks is directly proportional to the poor dietary education and lesser physical activities (Ranjit et al., 2010).
Evaluation of health promotion programmes designed for the children’s is necessary because implementation of the wrong programme can impact health of the children for life-long. Reduction in the consumption of SSB consumption will be implemented in the Indigenous children of Australia. This health promotion programme will be implemented according to the socio-ecological model of health and health-promotion principles. This programme will be specifically targeted towards children; however, parents will also be incorporated in the programme. Hence, this programme will bring overall improvement in the health of the society. This programme will bring changes in the physical, social and economic aspects of the of Indigenous children and their parents and improvements in the behavioural aspects (Nakkash et al., 2012).
Proposed Health Promotion Program for Indigenous Children in South Australia
For evaluation of the successful decrement in the consumption of SSB, data will be collected in the form of survey and interview. Data related to SSB consumption will be collected prior to and after completion of the health promotion programme. Data related to sales of SSB will be collected from the school canteen and home of children. Impact outcome will be evaluated based on the by asking questions to the children and parents. Questions will be asked related to the amount of SSB consumption and change in behaviour of the children (Wallace et al., 2014).
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Objectives |
Impact Indicators |
Data Collection |
Strategies |
Process Indicators |
Data Collection |
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1. To reduce the consumption of SSB drinks in boys and girls of school going and non-going of age 2 – 16 years in Aboriginal population of South Australia in 24 months duration. |
SSB reduction programme will be beneficial for the all the stakeholders participated on the programme. Hence, it would be helpful in improving overall health of Aboriginal children and consequently quality of life of Aboriginal community. School teachers involved in this programme will get opportunity to learn adverse effect of SSB consumption on health. This would be completely different learning for them other than regular school curricula. These teachers can implement this learning at their homes also. Nurse and healthcare professionals would get opportunity to implement healthcare and nutrition services outside hospitals. Hence, they would get opportunity to implement social skills along with medical skills. There would be improvement in the overall health status of the Aboriginal community. This programme would be helpful in establishing effective communication and coordinated work among different stakeholders. |
Quantitative data will be collected in the form of quantity and frequency of SSB food. Body weight and BMI of the enrolled children will also be recorded. |
1.Education about the ill effects of SSB food to the children and parents will be provided. To evaluate implementation of education gained, quantity and frequency of SSB consumption will be recorded. This SSB consumption will be corelated with the body weight and BMI of the children. It would be helpful in evaluating effectiveness of intervention. 2.Incentives and prizes will be offered to the participants and their parents to promote participation in the health advancement programme. 3.Unscheduled vigilance will be performed to check implementation of the scheduled educational programme. |
This programme will produce valid and robust results because number of participants included in this programme are sufficient for power calculation. This programme is implemented on specific target population. Hence, results of this programme would give data about specific Aboriginal children population. This data can be extrapolated to the Aboriginal children throughout the Australia. Withdrawal rate is less in this programme. This programme incorporates integrated services of different stakeholders like healthcare professional, teaching professionals, nutritionists and family members. Participant satisfaction will be assessed based on comfort level, understanding of the programme, appropriate distance of the healthcare care centre, cost of programme to the participants, complexity of educational material and convenient time. Relation of participant children and their parents with different professionals will evaluated. Evaluation of purpose fulfilment of the programme will be performed by enquiring relevance and interest of participants in the programme. Efficiency of programme will be determined by corelating number of training programmes conducted and reduction in SSB consumption. |
Number of participants enrolled will be compared with the similar number of participants from similar type of studies. It would be helpful in validating obtained results. Data related to the identity proof as Aboriginal children and number of enrolled children per 100 Aboriginal children will be collected. It would be helpful in establishing community specific implementation of the programme and participation of Aboriginal community in the programme. Data related to withdrawal rate will be collected by counting number of withdrawn participants out of enrolled participants. Data to assess participant satisfaction will be collected by asking them respective questions. Efficiency of the programme will be evaluated by counting number educational interventions conducted and reduction in SSB consumption by number of children. |
(Blomqvist et al., 2014; Issel and and Wells, 2017)
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Health issue: Increased consumption of SSB containing drinks. |
Goal : To reduce consumption of SSB food and to control obesity in South Australian Aboriginal and Torres Strait Islander children. |
Outcome evaluation: Diminished consumption of SSB drinks indicates augmentation in the awareness of the negative impacts of SSB containing drinks among children, parents and school teachers. Change is children’s behaviour and attitude were observed due to improvement in the knowledge of children, parents and school teachers. |
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Determinants: Socioeconomic status, psychological risk factors of the family members, social capital, educational status, lifestyle risk factors, price, accessibility, marketing exposure and accompanying peer influence. |
Objectives : To reduce the consumption of SSB drinks in boys and girls of school going and non-going of age 2 – 16 years in Aboriginal population of South Australia in 24 months duration. |
Impact evaluation: Programme proved successful. This programme diverted attitude and behaviour of the children towards reduced consumption of SSB. This outcome can be beneficial for longer duration because future generations can be healthy. These outcomes can be extrapolated to all the children in Aboriginal community and such health promotion strategy can be implemented at other geographical locations of Australia. |
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Strategies: Education and health promotion programme will be implemented in schools and at community centres. Education will be provided in the form of theoretical classes and games which would be helpful for keeping abstained from the consumption of SSB. Children and family members in the intervention group will be banned from purchasing SSB from supermarket and consumption of SSB at their homes will also be restricted. ‘Sugar free’ lesson plan will be incorporated in the school curricula. Posters displaying ‘sugar free life’ in cafeteria of the school. Discounts will be provided for the bottles of real fruit juices in the cafeteria. Weekly once home delivery of healthy drinks like real fruit juice. |
Process evaluation: Every aspect and each step of programme should be assessed to establish relationship between steps implemented in the programme and its respective outcome. It would be helpful evaluating whether implemented strategies are useful in achieving objectives of the programme. This programme also would be helpful in validating process of the programme, so that it can be implemented at other population and geographical areas. |
References:
Australian Bureau of Statistics. (2013). Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012–13. Canberra: Australia Bureau of Statistics, 2013. Retrieved from https://www.abs.gov.au/ausstats/[email protected]/mf/4727.0.55.001 on 31.10.2017.
Australian Bureau of Statistics. (2015). Australian Health survey: nutrition first results-Foods and Nutrients, 2011–12. Table 18: Consumption of Sweetened Beverages. Canberra: Australian Bureau of Statistics, 2015. Retrieved from https://www.abs.gov.au/AUSSTATS/[email protected]/Lookup/4364.0.55.007Main+Features12011-12.on 31.10.2017.
Australian Health Ministers’ Advisory Council. (2015). Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report. Canberra: AHMAC, 2015. Retrieved from https://www.pmc.gov.au/sites/default/files/publications/Aboriginal_and_Torres_Strait_Islander_HPF_2014%20-%20edited%2016%20June2015.pdf. On 31.10.2017.
Avery A, Bostock L, McCullough F. (2015). A systematic review investigating interventions that can help reduce consumption of sugar-sweetened beverages in children leading to changes in body fatness. J Hum Nutr Diet. 28(1), pp. 52-64.
Blomqvist P, Ojala E, Kettunen T, Poskiparta M, Kasila K. (2014). Community-based oral health promotion practices targeted at children and adolescents in Finland–developing an assessment tool. Community Dent Oral Epidemiol. 42(3), pp. 245-53.
Cheng TL, Solomon BS. (2014). Translating Life Course Theory to clinical practice to address health disparities. Matern Child Health J. 18(2), pp. 389-95.
Dickson M, Manalo G. (2014). The beyond borders initiative: Aboriginal, Torres Strait Islander and international public health students: engaging partners in cross-cultural learning. Educ Health (Abingdon). 27(2), pp. 132-7.
Fiorito LM, Marini M, Mitchell DC, Smiciklas-Wright H, Birch LL. (2010). Girls’ early sweetened carbonated beverage intake predicts different patterns of beverage and nutrient intake across childhood and adolescence. J Am Diet Assoc. 110(4), pp. 543-550.
Hafekost, K., Mitrou, F., Lawrence, D., and Zubrick, S. R. (2011). Sugar sweetened beverage consumption by Australian children: Implications for public health strategy. BMC Public Health. 11: 950. doi: 10.1186/1471-2458-11-950.
Halfon N, Larson, K, Lu, M, Tullis, E, Russ S. (2014). Lifecourse health development: past, present and future. Maternal and Child Health Journal, 18(2), pp. 344-65.
Health Council of South Australia, 2015. Retrieved from https://ahcsa.org.au/app/uploads/2014/11/AHCSA_Next_Steps_2015.pdf on 31.10.2017.
Hodges BC, Videto, D M. (2011). Assessment and Planning in Health Programs. Jones & Bartlett.
Hu FB. (2013). Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes Rev. 14, pp. 606–19.
Issel L M, Wells R. (2017). Health Program Planning and Evaluation. Jones & Bartlett Learning.
Johnston L, Doyle J, Morgan B, Atkinson-Briggs S, Firebrace B, Marika M, Reilly R, Cargo M, Riley T, Rowley K. (2013). A review of programs that targeted environmental determinants of Aboriginal and Torres Strait Islander health. Int J Environ Res Public Health. 10(8), 3518-42.
King R, Brown A. (2015). Next steps for Aboriginal Health Research: exploring how research can improve the health and wellbeing of aboriginal people in South Australia. Adelaide: Aboriginal .
Ma Y, He FJ, Yin Y, Hashem KM, MacGregor GA. (2016). Gradual reduction of sugar in soft drinks without substitution as a strategy to reduce overweight, obesity, and type 2 diabetes: a modelling study. Lancet Diabetes Endocrinol. 4(2), pp. 105-14.
Markwick A, Ansari Z, Sullivan M, McNeil J. (2015). Social determinants and psychological distress among Aboriginal and Torres Strait islander adults in the Australian state of Victoria: a cross-sectional population based study. Soc Sci Med. 128, pp. 178-87.
Markwick A, Ansari Z, Sullivan M, Parsons L, McNeil J. (2014). Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: a cross-sectional population-based study in the Australian state of Victoria. Int J Equity Health. 13(1):91. doi: 10.1186/s12939-014-0091-5.
Malik VS, Pan A, Willett WC, et al. (2013). Sugar-sweetened beverages and weight gain in children and adults: a systematic review and metaanalysis. Am J Clin Nutr. 98, pp. 1084–102.
Malik VS, Popkin BM, Bray GA, et al. (2010). Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a metaanalysis. Diabetes Care. 33, pp. 2477–83.
Malik VS, Willett WC, Hu FB. (2013). Global obesity: trends, risk factors and policy implications. Nat Rev Endocrinol. 9(1), pp. 13-27.
NHMRC. (2013). Australian dietary guidelines. Canberra: National Health and Medical Research Council, 2013. Retrieved from https://www.nhmrc.gov.au/guidelines-publications/n29-n30-n31-n32-n33-n34. On 31.10.2017.
National Children’s Nutrition and Physical Activity Survey (NCNPAS). (2007). The 2007 Australian National Children’s Nutrition and Physical Activity Survey. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/8F4516D5FAC0700ACA257BF0001E0109/$File/childrens-nut-phys-survey.pdf on 31.10.2017.
Nakkash RT, Alaouie H, Haddad P, El Hajj T, Salem H, Mahfoud Z, Afifi RA. (2012). Process evaluation of a community-based mental health promotion intervention for refugee children. Health Educ Res. 27(4), pp. 595-607.
Ogata BN, Hayes D. (2014). Position of the Academy of Nutrition and Dietetics: nutrition guidance for healthy children ages 2 to 11 years. J Acad Nutr Diet. 114(8), pp. 1257-76.
Pampel F C, Krueger, P M, Denney, J T. (2010). Socioeconomic Disparities in Health Behaviors. Annu Rev Sociol, 36, pp. 349–370.
Petrie, A., and Sabin, C. (2009). Medical Statistics at a Glance. John Wiley & Sons.
Potvin L, Jones CM. (2011). Twenty-five years after the Ottawa Charter: the critical role of health promotion for public health. Can J Public Health. 102(4), pp. 244-8
Ranjit N, Evans MH, Byrd-Williams C, Evans AE, Hoelscher DM. (2010). Dietary and activity correlates of sugar-sweetened beverage consumption among adolescents. Pediatrics. 126(4), pp. :e754-761.
Rauba J, Tahir A, Milford B, Toll A, Benedict V, Wang C, Chehab L, Sanborn T. (2017). Reduction of Sugar-Sweetened Beverage Consumption in Elementary School Students Using an Educational Curriculum of Beverage Sugar Content. Glob Pediatr Health. 4:2333794X17711778. doi: 10.1177/2333794X17711778.
Roden J, Jarvis L. (2012). Evaluation of the health promotion activities of paediatric nurses: is the Ottawa Charter for Health Promotion a useful framework? Contemp Nurse. 41(2), pp. 271-84.
Singh GM, Micha R, Khatibzadeh S, et al. (2015). Estimated global, regional, and national disease burdens related to sugar-sweetened beverage consumption in 2010. Circulation. 132, pp. 639–66.
Souza RA, Mediano MF, Souza Ade M, Sichieri R. (2013). Reducing the use of sugar in public schools: a randomized cluster trial. Rev Saude Publica. 47(4), pp. 666-74.
Te Morenga L, Mallard S, Mann J. (2012). Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ. 346, p.e7492.
Zoellner JM, Hedrick VE, You W, Chen Y, Davy BM, Porter KJ, Bailey A, Lane H, Alexander R, Estabrooks PA. (2016). Effects of a behavioral and health literacy intervention to reduce sugar-sweetened beverages: a randomized-controlled trial. Int J Behav Nutr Phys Act. 13:38. doi: 10.1186/s12966-016-0362-1.
Visagie S, Schneider M. (2014). Implementation of the principles of primary health care in a rural area of South Africa. Afr J Prim Health Care Fam Med. 6(1), pp. E1-E10.
Wallace LM, Brown KE, Hilton S. (2014). Planning for, implementing and assessing the impact of health promotion and behaviour change interventions: a way forward for health psychologists. Health Psychol Rev. 8(1), pp. 8-33.
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