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In politically contested health debates, stakeholders on both sides present arguments and evidence to influence public opinion and the political agenda. The present study aimed to examine whether stakeholders in the Soft Drinks Industry Levy (SDIL) debate sought to establish or undermine the acceptability of this policy through the news media and how this compared with similar policy debates in relation to tobacco and alcohol industries.
Quantitative and qualitative content analysis of newspaper articles discussing sugar-sweetened beverage (SSB) taxation published in eleven UK newspapers between 1 April 2015 and 30 November 2016, identified through the Nexis database. Direct stakeholder citations were entered in NVivo to allow inductive thematic analysis and comparison with an established typology of industry stakeholder arguments used by the alcohol and tobacco industries.
Proponents and opponents of SSB tax/SDIL cited in UK newspapers.
Four hundred and ninety-one newspaper articles cited stakeholders’ (n 287) arguments in relation to SSB taxation (n 1761: 65 % supportive and 35 % opposing). Stakeholders’ positions broadly reflected their vested interests. Inconsistencies arose from: changes in ideological position; insufficient clarity on the nature of the problem to be solved; policy priorities; and consistency with academic rigour. Both opposing and supportive themes were comparable with the alcohol and tobacco industry typology.
Public health advocates were particularly prominent in the UK newspaper debate surrounding the SDIL. Advocates in future policy debates might benefit from seeking a similar level of prominence and avoiding inconsistencies by being clearer about the policy objective and mechanisms.
To explore nutrition and food provision in pre-school nurseries in order to develop interventions to promote healthy eating in pre-school settings.
Quantitative data were gathered using questionnaires and professional menu analysis.
In the community, at pre-school nurseries.
All 130 nurseries across Liverpool were a sent questionnaire (38 % response rate); thirty-four menus were returned for analysis (26 % response rate).
Only 21 % of respondents stated they had adequate knowledge on nutrition for pre-school children. Sixty-one per cent of cooks reported having received only a ‘little’ advice on healthy eating and this was often not specific to under-5 s nutrition. Fifty-seven per cent of nurseries did not regularly assess their menus for nutritional quality. The menu analysis revealed that all menus were deficient in energy, carbohydrate, Fe and Zn. Eighty-five per cent of nurseries had Na/salt levels which exceed guidelines.
Nurseries require support on healthy eating at policy, knowledge and training levels. This support should address concerns relating to both menu planning and ingredients used in food provision and meet current guidelines on food provision for the under-5 s.
To explore nutrition and food provision in pre-school nurseries in order to develop interventions to promote healthy eating in early years settings, especially across deprived communities.
An ethnographic approach was used combining participant observation with semi-structured interviews. Research participants were selected purposively using convenience sampling.
Community pre-school nurseries.
Nursery managers (n 9), cooks (n 6), staff (n 12), parents (n 12) and children at six nurseries (four private and two attached to children's centres) in Liverpool, UK.
Private nurseries had minimal access to information and guidelines. Most nurseries did not have a specific healthy eating policy but used menu planning to maintain a focus on healthy eating. No staff had training in healthy eating for children under the age of 5 years. However, enthusiasm and interest were widespread. The level and depth of communication between the nursery and parents was important. Meal times can be an important means of developing social skills and achieving Early Years Foundation Stage competencies.
Nurseries are genuinely interested in providing appropriate healthy food for under-5s but require support. This includes: improved mechanisms for effective communication between all government levels as well as with nurseries; and funded training for cooks and managers in menu planning, cost-effective food sourcing and food preparation. Interventions to support healthy eating habits in young children developed at the area level need to be counterbalanced by continued appropriate national-level public health initiatives to address socio-economic differences.
To determine the extent to which national and local UK guidelines for the early years sector address key recommendations for encouraging healthy eating based on best available evidence.
Phase 1 comprised a literature review to identify new evidence to assess current relevance of the Caroline Walker Trust (CWT) ‘Eating well for under-5 s in child care’ guidelines. Phase 2 assessed the completeness of seven local to national-level government guidelines by comparison with the ‘gold standard’ CWT guidelines.
Desk-based review using secondary data.
Research literature and statutory guidelines on healthy eating in early years settings.
Phase 1 retrieved seventy-five papers, of which sixty were excluded as they addressed compliance with nutritional and food-based standards only. One report examined a social marketing tool and was deemed too narrow. The remaining fourteen documents assessed interventions to encourage healthy eating in early years settings. Following quality assessment, seven documents were included. Nine key recommendations were identified: (i) role of government; (ii) early years setting policy/guidelines; (iii) training; (iv) menu planning; (v) parents; (vi) atmosphere and encouragement; (vii) learning through food; (viii) sustainability; and (ix) equal opportunities. Phase 2 identified that all seven guidelines included the nine key recommendations but sporadic cover of sub-key recommendations.
More detail is needed on how early years settings can encourage children to eat healthily. Research is required to develop second-layer guidance for interactive materials. Clear processes of communication and support for parents are required. Ways food relates to children's wider learning and social development need further thought, requiring collaboration between the Department of Health and the Department for Education.
To examine the potential public health impact on CHD and stroke mortality of replacing one ‘unhealthy’ snack with one ‘healthy’ snack per person, per day, across the UK population.
Nutritional information was obtained for different ‘unhealthy’ (such as crisps, chocolate bars, cakes and pastries) and ‘healthy’ snack products (such as fresh fruit, dried fruit, unsalted nuts or seeds). Expected changes in dietary intake were calculated. The mean change in total blood cholesterol levels was estimated using the Keys equation. The effect of changing cholesterol and salt levels on CHD deaths and on stroke deaths was calculated using the appropriate equations from the Law and He meta-analyses. The estimated reductions in cardiovascular deaths were then tested in a sensitivity analysis.
Substituting one ‘healthy’ snack would reduce saturated fat intake by approximately 4·4 g per person per day, resulting in approximately 2400 fewer CHD deaths and 425 fewer stroke deaths per year. The associated 500 mg decrease in salt intake would result in approximately 1790 fewer CHD deaths and 1330 fewer stroke deaths.
Simply replacing one unhealthy snack with one healthy snack per day might prevent approximately 6000 cardiovascular deaths every year in the UK.
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