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Taxes, legislation and politics are social determinants of health, which can impact health through multiple pathways. The purpose of this study was to review regulations regarding sugar-sweetened beverage (SSB) taxation and describe taxation/exemption of various beverage categories. We reviewed SSB taxation regulations from Mexico, the United Kingdom, Berkeley, Philadelphia, San Francisco and South Africa. Supplementary government documents and academic publications were also reviewed to further discern beverage taxation/exemption and zero-rating. There were a number of beverage types that fell clearly into typically taxed or exempt/zero-rated categories across all six jurisdictions (e.g. pop/soda as taxed and water as zero-rated). Exemptions and ambiguities within the six regulations can generally be grouped as a lack of clarity regarding the meaning and use of milk; the meaning of 'medical purposes' and 'supplemental'; the point at which a beverage is prepared; the form of concentrate (i.e. liquid/frozen/powder) or medium used (e.g. water, coffee); and location of preparation or business size of retailer. SSB tax regulations are complex, unclear, vary across jurisdiction and leave several beverage types with added sugar exempt from taxation or at risk of a legal challenge. Lastly, tax exemptions generally reflect and perpetuate existing sociopolitical dynamics within the food system. [ABSTRACT FROM AUTHOR]

Health educators are increasingly publicizing the noxious health effects of sugar-sweetened beverages (SSB). American counties are implementing SSB taxes, as modeled after the 'success' of tobacco policies, to address the 'obesity crisis'. Under-explored is how the linking of SSB to a stigmatized condition, 'obesity', has affected attitudes toward the purchasing and consumption of SSB and those individuals who purchase and consume SSB. This study sought to explore individuals' attitudes and experiences with SSB in rural Michigan. Three themes emerged: Negativity, Egregious beverages and Implicated imbibers. These attitudes were situated within a context of increased exposure to SSB health discourses, particularly among younger participants. Additional themes arose regarding which SSB were labelled especially problematic, who should or should not be drinking SSB, as well as the consequences of drinking SSB. Pop/soda, energy drinks, and diet pop/soda were identified as particularly harmful, albeit for different reasons – sugar, caffeine, and unnatural additives. Many participants reported reacting negatively when they saw children of higher weights drinking SSB, though judgement was reserved for parents. Ultimately, SSB and their consumers appear increasingly stigmatized in ways that carry important equity implications for already marginalized groups. [ABSTRACT FROM AUTHOR]

Moralism, myths, and presumptions regarding relationships between diet, exercise, weight, and disease incidence persist. It is unclear to what extent researchers contribute to presumptions concerning weight, lifestyle, and diabetes, and how often these relationships are thoroughly, distinctly delineated in intervention literature. Our purpose in this paper is to focus on interventions designed to prevent the onset of diabetes and to explore how weight is framed and discussed within randomized controlled trials (RCTs), to examine how diabetes prevention is constructed. We completed a search of several electronic databases for records published between 2007 and November 2016. Selection criteria included RCTs with a follow-up period of ≥12 months; adult participants with type 2 diabetes/pre-diabetes; and lifestyle interventions classified as dietary, exercise, and/or behavioral. Nineteen articles were identified for inclusion and subject to thematic content analysis. Two superordinate themes emerged from the analysis – entangled mechanisms and the meaning of weight and prevention through compliance. The relationship between obesity and adverse health outcomes was presented in some studies as taken-for-granted but underlain by unspecified mechanisms. Participants' behaviors were also presented as central to forestalling diabetes, and behaviors were depicted as 'compliance', 'resistance', or 'adherence'. Researchers' biases and assumptions contribute to the discursive construction of diabetes as a product of patients' irresponsible behaviors and subsequent fatness. This work extends previous critiques of RCTs in general to 'diabesity' RCTs by exploring how interventions are constructed as failures due to participants' noncompliance despite evident etiological uncertainty. [ABSTRACT FROM AUTHOR]

Background: Diabetes prevalence is substantially higher among Canadian First Nations populations than the non-First Nation population. Fasting serum triglycerides have been found to be an important predictor of incident diabetes among non-indigenous populations. However, there is a great need to understand diabetes progression within specific ethnic groups, particularly First Nations populations. Objective: The purpose of this study was to test for an association between fasting serum triglycerides and incident diabetes, changes in insulin resistance and changes in β-cell function in a Manitoba First Nation cohort. Methods: Study data were from two diabetes screening studies in Sandy Bay First Nation in Manitoba, Canada, collected in 2002/2003 and 2011/2012. The cohort was composed of respondents to both screening studies (n=171). Fasting blood samples and anthropometric, health and demographic data were collected. A generalised linear model with Poisson distribution was used to test for an association between fasting triglycerides and incident diabetes. Results: There were 35 incident cases of diabetes among 128 persons without diabetes at baseline. Participants who developed incident type 2 diabetes were significantly older and had significantly higher body mass index (BMI; p=0.012), total cholesterol (p=0.007), fasting triglycerides (p<0.001), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (p<0.001). Fasting triglyceride level was found to be a statistically significant positive predictor of incident diabetes independent of age, sex and waist circumference at baseline. Participants with triglycerides in the highest tertile (≥2.11 mmol/l) had a 4.0-times higher risk of developing incident diabetes compared to those in the lowest tertile (p=0.03). Notably, neither waist circumference nor BMI were significant predictors of incident diabetes independent of age, sex and triglycerides. Conclusion: Fasting triglycerides may be useful as a clinical predictor of insulin resistance and diabetes development among First Nations populations. Unlike other ethnic groups, BMI and waist circumference may be less important factors in diabetes development. [ABSTRACT FROM AUTHOR]

Background. Diabetes and diabetes complications are substantially higher among Canadian First Nations populations compared with the general Canadian population. However, incidence data using detailed individual assessments from a population-based cohort have not been undertaken. Objective. We sought to describe incident diabetes, hypertension and dyslipidemia in a population-based cohort from a Manitoba Ojibway First Nation community. Design. Study data were from 2 diabetes screening studies in Sandy Bay First Nation in Manitoba, Canada, collected in 2002/2003 and 2011/2012. The cohort comprised of respondents to both screening studies (n=171). Health and demographic data were collected using a questionnaire. Fasting blood samples, blood pressure and anthropometric data were also collected objectively. Incident diabetes, hypertension and dyslipidemia were determined. Generalized linear models with Poisson distribution were used to estimate risk of incident diabetes and cardiometabolic conditions according to age and sex. Results. There were 35 (95% CI: 26, 45) new cases of diabetes among 128 participants without diabetes at baseline (27 or 3.3% per year). While participants who were 50 years and older at baseline had a significantly higher risk of incident diabetes at follow-up compared with participants aged 18-29 at baseline (p=0.012), more than half of the incident cases of diabetes occurred among participants aged less than 40 at baseline. There were 28 (95% CI: 20, 37) new cases of dyslipidemia at follow-up among 112 without dyslipidemia at baseline (25%). There were 36 (95% CI: 31, 42) new cases of hypertension among 104 participants without hypertension at baseline (34.6%). Women had half the risk of developing hypertension compared with men (p=0.039). Conclusions. Diabetes incidence is very high, and the number of new cases among those younger than 40 is a concern. Additional public health and primary care efforts are needed to address the diabetes burden in this First Nation community. [ABSTRACT FROM AUTHOR]

This article presents a study conducted to determine the patterns of fruit and vegetable intake in Canadian elderly and to identify socio-demographic factors that were associated with the low consumption. The fruit and vegetable food group is frequently identified to be a crucial food group in disease prevention, especially disease that are age-related. The methodology and results of the study are discussed.