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Discretionary, energy‐dense, nutrient‐poor food and drinks are heavily marketed and readily available in retail settings frequented by adolescents. This study examines associations between food purchasing practices in various retail settings and dietary intake among Australian adolescents. Participants were students in years 8 to 11 (ages 12‐17 years) who completed the 2009‐10 (n = 13 790), 2012‐13 (n = 10 309) or 2018 (n = 9102) National Secondary Students' Diet and Activity (NaSSDA) cross‐sectional survey. Multistage stratified random sampling was used. An online survey completed at school assessed self‐reported frequency of food purchasing practices in various retail settings and consumption of discretionary food, sugary drinks, fruit and vegetables. Generalised linear regression models examined associations between food purchasing practices and dietary behaviour. Relative to students who brought lunch from home, those who purchased lunch from school or nearby outlets reported higher intake of discretionary food and sugary drinks and lower fruit intake. Buying lunch from school was also associated with lower vegetable intake. Buying food or drinks on the school commute, outside school grounds during school hours, from supermarket checkouts, and using mobile phone apps were each associated with higher discretionary food and sugary drink intake (all P< .01). Purchasing food or drink in various retail settings is associated with higher intake of discretionary food and drink among Australian adolescents, and some purchasing practices appeared to displace fruit and vegetable intake. These findings highlight a need to improve the accessibility and promotion of healthier food and drink options in schools and other retail settings.

To examine active school travel trends and predictors among Australian secondary school students (aged 12–17) between 2009 and 2018.

Objective: To examine active school travel trends and predictors among Australian secondary school students (aged 12–17) between 2009 and 2018. Methods: Three cross‐sectional surveys (2009‐10: N=13,790; 2012‐13: N=10,309; and 2018: N=9,102) using a web‐based self‐report questionnaire. Logistic regression was used to identify differences in active travel (to and/or from school every weekday) between survey years and predictors. Results: From 2009‐10 to 2012‐13 to 2018, active travel decreased from 33.6% to 32.3% to 29.5% among females, and from 37.4% to 36.6% to 32.6% among males. Distance, female sex and regional location were associated with a lower likelihood of active travel. Students with pocket money, those who spoke a language other than English at home, and Aboriginal and/or Torres Strait Islander students were more likely to actively travel. Conclusions: Between 2009‐10 and 2018, active school travel among secondary students in Australia declined. Several factors were found to be associated with active travel. Implications for public health: This is the first national study on active travel trends among secondary students in Australia. The recent decline requires action given the increasing prevalence of overweight and climate change.

This study reexamines a lynchpin of Neo-Babylonian Levantine Phoenician historiography: Nebuchadnezzar II’s purported thirteen-year siege of Tyre in the early sixth century bce. This detail about the length of the siege can be found only in Josephus’ (first century ce) writings, but this study’s new assessment of the (sixth-fifteenth century ce) manuscript evidence shows that the more commonly transmitted length of the siege was “three years and ten months.” Other manuscript variations further illustrate that there was little continuous cultural memory of the length of the event. When coupled with (a) other chronological problems in Josephus’ works, (b) a review of the complex Biblical, Mesopotamian, and Classical relevant literary sources, and (c) the lack of current evidence for any destruction levels or siegeworks at the site of Tyre, the case for insisting other sources be synchronized with this thirteen-year framework weakens. Shorter sieges or raids, blockades of the island or inland ports, and periodic Babylonian military presence to extract personnel and resources are all likely scenarios for Tyre and other Levantine sites during Nebuchadnezzar’s 43-year reign. Discarding a single “thirteen-year siege” as a reliable historical detail allows scholars of the Neo-Babylonian period in the central coastal Levant to shift their attention to more interesting questions, including exploring the causes and impacts of the evident changes in Tyre’s seaward and inland trading patterns in the sixth-fifth centuries.

Diet quality plays a vital role in the prevention of prevalent non‐communicable diseases; however, misperceptions of healthiness of common foods and beverages may be undermining Australians’ attempts to maintain a healthy diet. The current study aimed to assess the extent and nature of differences in public and expert opinion in the foods, beverages and dietary patterns that are considered healthy. A cross‐sectional online survey of 1,097 Victorian adults aged 18‐64 and 134 professional dietitians and nutritionists assessed healthiness perceptions of foods, beverages and dietary patterns, self‐reported dietary patterns, and factors considered when making healthy choices. Differences in perceptions and dietary patterns between samples and by sex, socio‐economic area and level of education were assessed using multivariable logistic regression. There were large discrepancies in which items the public and expert samples considered healthy. Females and those in high socio‐economic areas tended to report healthiness perceptions that aligned with the expert sample to a greater degree than their counterparts. Personal judgement of products was important to both samples when making decisions about healthy choices. The public and expert samples differed greatly in healthiness perceptions with significant variation by demographics. Well‐funded, sustained public health campaigns are needed to provide the public with evidence‐based health and nutrition information and combat persuasive, misleading messaging from popular media and marketing.

The LiveLighter®healthy weight and lifestyle social marketing campaign, developed in Western Australia, employs graphic advertising to communicate negative health effects of overweight and motivate behaviour change. This study extends prior evidence of the effectiveness of the LiveLighter®campaign by evaluating its implementation in a new jurisdiction. A controlled cohort design was employed in intervention (Vic) and comparison states (SA), with and without campaign exposure. Population surveys conducted at baseline (BL) (n = 1000 each state), had 75% retention at follow‐up (FU) (Vic: n = 715; SA: n = 787). Total campaign awareness was moderate (61.5%). Exposed respondents indicated the campaign was “believable” (91.0%), made a strong argument for reducing weight (87.3%), made them “stop and think” (70.1%), motivated action to reach/stay a healthy weight (59.1%) and was “relevant” (55.6%). The proportion of respondents indicating “toxic fat build up” was a health consequence of overweight increased significantly from BL to FU in Vic and to a lesser extent in SA (Vic:55.7% vs 75.9%; SA:58.1% vs 62.6%, interaction P< .001). The proportion indicating cancer is a health consequence of overweight increased significantly from BL to FU in Vic, but not in SA (Vic:77.1% vs 83.4%; SA:77.8% vs 78.1%, interaction P< .05). This study extends the evidence base for the LiveLighter®campaign. Sustained campaign activity with clear behavioural recommendations is required to translate improved knowledge into behaviour change. Evidence‐based mass media campaigns can positively impact health behaviours to address the unsustainable increasing burdens of unhealthy weight, dietary risk and inadequate physical activity. A National Obesity Campaign is needed and LiveLighter®is a ready‐made, relevant Australian resource.

The aim of this study was to describe advertising expenditure for sugary drinks compared with alternative cold non‐alcoholic beverages (artificially sweetened beverages, plain water, plain milk) between 2016 and 2018 across Australian media channels.

Objective: The aim of this study was to describe advertising expenditure for sugary drinks compared with alternative cold non‐alcoholic beverages (artificially sweetened beverages, plain water, plain milk) between 2016 and 2018 across Australian media channels. Methods: Monthly estimates of advertising expenditure for non‐alcoholic beverages were obtained from Nielsen Media and aggregated by product type and media. Results: Total sugary drink advertising expenditure between 2016 and 2018 ($129.5M) significantly exceeded expenditure on artificially sweetened drinks ($23.26M), plain water ($14.27M), and plain milk ($31.30M). Television and out‐of‐home advertising accounted for the largest share of sugary drink advertising (45%, 35%). Expenditure on out‐of‐home advertising was more heavily dominated by sugary drinks (75%) than advertising in all media combined (65%). Sugary drink advertising peaked in warmer months and was lowest in August. Soft drinks (26%), flavoured milks (24%) and energy drinks (21%) accounted for the majority of sugary drink advertising. Conclusions: Cold non‐alcoholic beverage advertising in Australian media is dominated by the advertising of sugary drinks. Implications for public health: Restricting unhealthy beverage advertising on television and out‐of‐home media may be most effective initially. However, comprehensive restrictions capturing a broader range of media and settings would be optimal to prevent displacement and limit advertising reach and exposure.

Evaluation of the behavioural impact of Western Australia's LiveLighterhealthy weight and lifestyle campaign focussed on decreasing consumption of sugar‐sweetened beverages (SSBs) using graphic imagery, as well as monitoring unintended consequences. A cohort design with pre‐campaign telephone survey of Western Australian adults aged 25‐49 (Time 1 May/Jun 2013: N = 1504) undertaken and repeated following the campaign (Time 2 Aug/Sep 2013: N = 822). Post‐campaign awareness was 67% with respondents in low socio‐economic areas most likely to report viewing the campaign frequently. There was evidence of reduced SSB intake from baseline to follow‐up among frequent (4+/week) SSB consumers (22% cf. 16%; P =0.003) and some evidence among overweight (BMI 25+) weekly SSB consumers (56% cf. 48%; P =0.013). There was also some evidence consumption of sweet food decreased (3+/week: 53% cf. 48%; P =0.035) while fruit, vegetable and fast food consumption remained stable. Knowledge of potential health consequences of SSBs increased (70% cf. 82%; P <0.001) with no change in knowledge of potential health consequences of overweight generally (86% cf. 89%). Importantly, there was no increase in endorsement of overweight stereotypes. The LiveLighter“Sugary Drinks” campaign positively impacted adults’ knowledge and behaviour with regard to SSB consumption in a pattern specific to the campaign messaging and without adverse impact on weight‐related stereotypes. Findings support the use of mass media for healthy lifestyle change. They suggest the public are receptive to undertaking the campaign's simple concrete lifestyle recommendation and provide an indication of the campaign dose required to achieve positive behaviour change.

Objective:To assess the frequency, duration and nature of unhealthy marketing during the highest‐rating sporting event in Australia in 2017. Methods:A content analysis of the 2017 Australian Football League (AFL) Grand Final television broadcast identified episodes of unhealthy food and sugary drink, alcohol and gambling marketing (and pro‐health marketing as a comparison). Results:There were 559 unhealthy marketing episodes (47 minutes 17 seconds). Most (81%) were for unhealthy food and sugary drink products, while alcohol (9%) and gambling (10%) were less frequent. The total duration of unhealthy marketing was delivered primarily via fixed advertising (55%), dynamic advertising (32%) and branded objects (11%). For unhealthy food and sugary drinks, at least one episode was visible 25% of the time. For each of alcohol and gambling, at least one episode was visible 4% of the time. Unhealthy food and sugary drink marketing peaked in Quarter 2. Pro‐health marketing was limited, with 26 episodes (2 minutes 59 seconds). Conclusions:The 2017 AFL Grand Final broadcast featured a high frequency and extensive duration of unhealthy marketing, especially for unhealthy food and sugary drink brands. Implications for public health:Findings strengthen evidence supporting calls to increase regulation of sport sponsorship by unhealthy brands.

To assess the frequency, duration and nature of unhealthy marketing during the highest‐rating sporting event in Australia in 2017.

Simple dog burials, dating primarily to the second half of the 1st millennium B.C.E. (Persian–Hellenistic periods [ca. 6th–1st centuries B.C.E.]), have been excavated at more than a dozen Levantine sites, ranging from a handful of burials to more than 1,000 at Ashkelon. This study systematizes previously discussed canine interments, distinguishing intentional whole burials from other phenomena (e.g., dogs found in refuse pits), and suggests a new interpretation in light of human mortuary practice in the Iron Age II–III-period (ca. 10th–4th centuries B.C.E.) Levant. The buried dogs seem to be individuals from unmanaged populations living within human settlements and not pets or working dogs. Frequent references to dogs in literary and epigraphic Northwest Semitic evidence (including Hebrew, Phoenician, and Punic personal names) indicate a complex, familiar relationship between dogs and humans in the Iron Age Levant, which included positive associations such as loyalty and obedience. At some point in the mid-1st millennium B.C.E., mortuary rites began to be performed by humans for their feral canine “neighbors” in a manner resembling contemporaneous low-energy–expenditure human burials. This behavioral change may represent a shift in the conception of social boundaries in the Achaemenid–Hellenistic-period Levant.

Objective:DrinkWise Australia is an alcohol industry Social Aspects/Public Relations Organisation (SAPRO). We assessed the Australian public's awareness of DrinkWise, beliefs about its funding source, and associations between funding beliefs and perceptions of DrinkWise. Methods:A total of 467 adult weekly drinkers completed an online cross‐sectional survey in February 2016. Results:Half the sample had heard of DrinkWise (48.6%); of these, the proportion aware that DrinkWise is industry funded (37.0%) was much smaller than the proportion believing it receives government funding (84.1%). Respondents who incorrectly believed DrinkWise receives government funding were more likely to hold a favourable perception of the organisation's credibility, trustworthiness and respectability than those who did not believe it receives government funding (75.9% vs. 58.3%; p=0.032). Conclusions:The drinking population is vulnerable to believing that alcohol industry public relations organisations such as DrinkWise are government funded, which in turn is associated with more favourable perceptions of the organisation's credibility, trustworthiness, and respectability. Implications for public health:Favourable perceptions of DrinkWise may enhance the industry's ability to delay or dilute potentially effective alcohol control policies. Future research should investigate whether educating the public about DrinkWise's alcohol industry funding alters the public's perception of how credible, trustworthy and respectable the organisation is.

DrinkWise Australia is an alcohol industry Social Aspects/Public Relations Organisation (SAPRO). We assessed the Australian public's awareness of DrinkWise, beliefs about its funding source, and associations between funding beliefs and perceptions of DrinkWise.

Increases in socially desirable responses in self-reports might occur in the context of ongoing public education. We examine concordance of trends in two long-term studies monitoring population impact for SunSmart. One study employed telephone interviews of Melbourne residents; the other entailed observations at public recreation venues across Melbourne. The studies assessed people’s sun protection on identical weekend dates (Nw = 33 dates). Data from five summers between 1992 and 2001 (n~ 23,000 individuals) were analysed. A body cover index score was calculated for participants on each date. Outcomes were aggregated separately for Saturdays and Sundays by date and year. Regression analyses tested whether these trends differed by survey method. The pattern of change in body cover over time was similar for both surveys. Self-reported body cover was consistently higher than observed body cover, suggesting that social desirability bias may be present. Regression analyses showed no divergence between self-reported and observed trends in mean body cover, suggesting no evidence of significant increased social desirability bias in self-reporting over time. Findings suggest that self-report offers a valid means of assessing change in a population’s sun protection compliance over time, at least when self-reports are precisely focussed for time and activity context.

Objective:To provide a comprehensive overview of trends in news coverage about sun protection issues in an Australian setting over a 14‐year period. Methods:A content analysis was performed on all relevant articles (N=547) published in two major daily newspapers, The Age and the Herald Sun, from 1993 to 2006. Articles were coded for article type, prominence, theme, spokesperson, topic slant and opinion slant. Results:The most frequent themes were the health effects of ultraviolet (UV) radiation exposure (24% of articles), education/prevention (14%) and product issues (12%). Themes that became more dominant over time were vitamin D issues, solaria issues and fake tans. Sixty per cent of articles included a pro‐sun protection spokesperson and 12% an anti‐sun protection spokesperson, with the profile of anti‐sun protection spokespeople increasing over time. Half the articles reported on topics positive for sun protection, whereas 18% reported on negative topics; however, this difference narrowed considerably from 2001 onwards. In opinionated articles, the opinions expressed by authors were mainly positive (57%) rather than negative (7%) for sun protection. Conclusions and implications:The findings suggest that the mix of sun protection issues covered and views of sun protection have changed over time, resulting in greater coverage of controversies and issues not necessarily positive for sun protection objectives. These findings imply that evaluation of paid skin cancer prevention public education campaigns may need to take account of the changing news media environment in which they take place.