Association of a Workplace Sales Ban on Sugar-Sweetened Beverages With Employee Consumption of Sugar-Sweetened Beverages and Health,JAMA Internal Medicine

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Association of a Workplace Sales Ban on Sugar-Sweetened Beverages With Employee Consumption of Sugar-Sweetened Beverages and Health
JAMA Internal Medicine ( IF 22.5 ) Pub Date : 2020-01-01 , DOI: 10.1001/jamainternmed.2019.4434
Elissa S Epel _{1,

2} , Alison Hartman ₂ , Laurie M Jacobs ₃ , Cindy Leung ₄ , Michael A Cohn ₅ , Leeane Jensen ₆ , Laura Ishkanian ₆ , Janet Wojcicki _{2,

7} , Ashley E Mason _{1,

5} , Robert H Lustig _{3,

7} , Kimber L Stanhope ₈ , Laura A Schmidt _{3,

9}

Affiliation

Importance Reductions in sugar-sweetened beverage (SSB) intake can improve health, but are difficult for individuals to achieve on their own. Objectives To evaluate whether a workplace SSB sales ban was associated with SSB intake and cardiometabolic health among employees and whether a brief motivational intervention provides added benefits to the sales ban. Design, Setting, and Participants This before-after study and additional randomized trial conducted from July 28, 2015, to October 16, 2016, at a Northern California university and hospital assessed SSB intake, anthropometrics, and cardiometabolic biomarkers among 214 full-time English-speaking employees who were frequent SSB consumers (≥360 mL [≥12 fl oz] per day) before and 10 months after implementation of an SSB sales ban in a large workplace, with half the employees randomized to receive a brief motivational intervention targeting SSB reduction. Interventions The employer stopped selling SSBs in all workplace venues, and half the sample was randomized to receive a brief motivational intervention and the other half was a control group that did not receive the intervention. This intervention was modeled on standard brief motivational interventions for alcohol used in the workplace that promote health knowledge and goal setting. Main Outcomes and Measures Outcomes included changes in SSB intake, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and measures of abdominal adiposity. The primary associations tested were the correlation between changes in SSB intake and changes in HOMA-IR. Results Among the 214 study participants, 124 (57.9%) were women, with a mean (SD) age of 41.2 (11.0) years and a baseline mean (SD) body mass index of 29.4 (6.5). They reported a mean daily intake of 1050 mL (35 fl oz) of SSBs at baseline and 540 mL (18 fl oz) at follow-up-a 510-mL (17-fl oz) (48.6%) decrease (P < .001). Reductions in SSB intake correlated with improvements in HOMA-IR (r = 0.16; P = .03). Those not randomized to receive the brief intervention reduced their SSB intake by a mean (SD) of 246.0 (84.0) mL (8.2 [2.8] fl oz), while those also receiving the brief intervention reduced SSB intake by 762.0 (84.0) mL (25.4 [2.8] fl oz). From baseline to follow-up, there were significant reductions in mean (SE) waist circumference (2.1 [2.8] cm; P < .001). Conclusions and Relevance This study's findings suggest that the workplace sales ban was associated with a reduction in SSB intake and a significant reduction in waist circumference among employees within 10 months. The randomized clinical trial portion of this study found that targeting those at high risk with a brief motivational intervention led to additional improvements. Workplace sales bans may offer a promising new private-sector strategy for reducing the health harms of SSB intake. Trial Registration ClinicalTrials.gov identifier: NCT02585336.

中文翻译：

工作场所禁售含糖饮料与员工食用含糖饮料和健康的关联

重要性减少含糖饮料 (SSB) 的摄入量可以改善健康，但个人难以独自实现。目的评估工作场所 SSB 销售禁令是否与员工的 SSB 摄入量和心脏代谢健康有关，以及简短的动机干预是否为销售禁令提供了额外的好处。设计、设置和参与者这项前后研究和额外的随机试验于 2015 年 7 月 28 日至 2016 年 10 月 16 日在北加州大学和医院进行，评估了 214 名全日制英语学生的 SSB 摄入量、人体测量学和心脏代谢生物标志物- 在大型工作场所实施 SSB 销售禁令之前和之后 10 个月经常使用 SSB 的员工（每天≥360 mL [≥12 fl oz]），一半的员工随机接受针对减少 SSB 的简短激励干预。干预雇主停止在所有工作场所销售 SSB，一半样本随机接受简短的激励干预，另一半是未接受干预的对照组。这种干预模仿了工作场所使用酒精的标准简短动机干预，以促进健康知识和目标设定。主要结果和测量结果包括 SSB 摄入量的变化、胰岛素抵抗的稳态模型评估 (HOMA-IR) 和腹部肥胖的测量。测试的主要关联是 SSB 摄入量变化与 HOMA-IR 变化之间的相关性。结果在 214 名研究参与者中，124 名 (57.9%) 是女性，平均 (SD) 年龄为 41.2 (11.0) 岁，基线平均 (SD) 体重指数为 29.4 (6.5)。他们报告说，基线时平均每日摄入 1050 毫升（35 液量盎司）SSB，随访时为 540 毫升（18 液量盎司），减少 510 毫升（17 液量盎司）（48.6%）（P < . 001）。SSB 摄入量的减少与 HOMA-IR 的改善相关（r = 0.16；P = .03）。那些没有随机接受简短干预的人减少了他们的 SSB 摄入量平均 (SD) 246.0 (84.0) mL (8.2 [2.8] fl oz)，而那些也接受简短干预的人减少了 762.0 (84.0) mL 的 SSB 摄入量（ 25.4 [2.8] 液量盎司）。从基线到随访，平均 (SE) 腰围显着减少（2.1 [2.8] 厘米；P < .001）。结论和相关性本研究' 调查结果表明，工作场所销售禁令与 10 个月内员工 SSB 摄入量减少和腰围显着减少有关。本研究的随机临床试验部分发现，针对高危人群进行简短的动机干预会带来额外的改善。工作场所销售禁令可能为减少 SSB 摄入对健康造成的危害提供了一个有希望的新私营部门战略。试验注册 ClinicalTrials.gov 标识符：NCT02585336。工作场所销售禁令可能为减少 SSB 摄入对健康造成的危害提供了一个有希望的新私营部门战略。试验注册 ClinicalTrials.gov 标识符：NCT02585336。工作场所销售禁令可能为减少 SSB 摄入对健康造成的危害提供了一个有希望的新私营部门战略。试验注册 ClinicalTrials.gov 标识符：NCT02585336。

更新日期：2020-01-01

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