Background Efficacious strategies to reduce sugar-sweetened beverage (SSB) consumption among youth are needed. This pilot study assessed the feasibility and preliminary efficacy of a community-based youth empowerment intervention to reduce SSB consumption and obesity risk among a low-income, ethnically diverse sample of youth. Methods The H 2 GO! intervention was pilot-tested in an afterschool setting (Boys and Girls Clubs (BGC)) in Massachusetts, USA. One site was randomized to receive the intervention; the other site received standard programming. Youth ages 9–12 years and their parents/caregivers were eligible to participate. A total of N = 110 parent-child pairs ( N = 55 parent-child pairs per site) were recruited. The 6-week intervention consisted of group-based weekly sessions delivered by trained BGC staff and youth-led activities that engaged parents. Child outcomes included self-reported SSB and water intake and measured body mass index z scores (zBMI). Parent outcomes included self-reported SSB and water intake, SSB purchasing, and availability of SSBs at home. Outcomes were measured at baseline, 2 months, and 6 months. Generalized linear and logistic regression models were used to estimate intervention effects over time. Results The final analytic study sample consisted of 100 child participants (38% Black, 20% Hispanic, 13% White, 12% Multiracial, 11% Asian) and 87 parent participants (78.2% female; 78.2% reporting eligibility for the free-or-reduced price lunch program). 6-month retention rates were ≥ 82%. Intervention attendance rates among intervention child participants ( N = 51) averaged 78.1% (SD = 10.3). Over half (56.0%) of child participants were overweight or obese at baseline. Relative to the comparison site, intervention site child participants had decreased SSB intake (β = − 1.64; 95% CI: 2.52, − 0.76), increased water intake (β = 1.31; 95% CI: 0.38, 2.23), and decreased zBMI (− 0.23 units; 95% CI: − 0.31, − 0.14) over 6 months ( p < 0.001). Intervention parent participants also reported decreased SSB intake (β = − 1.76; 95% CI: − 2.56, − 0.96) and increased water intake (β = 1.75; 95% CI: 1.11, 2.40) than comparison parent participants at 6 months ( p < 0.001). Conclusions Findings demonstrate the potential of a youth empowerment intervention on reducing SSB intake and zBMI among a diverse sample. Findings will guide a larger cluster-randomized controlled trial to test intervention efficacy on preventing childhood obesity, as well as inform future interventions that aim to target additional diet and physical activity behaviors through youth empowerment. Trial registration ClinicalTrials.gov NCT02890056 . Registered 31 August 2016. Electronic supplementary m...

Background Sugar-sweetened beverage (SSB) consumption contributes to obesity, a risk factor for 13 cancers. While SSB taxes can reduce intake, the health and economic impact on reducing cancer burdens in the United States (US) are unknown, especially among low-income Americans with higher SSB intake and obesity-related cancer burdens. Methods We used the Dietary Cancer Outcome Model (DiCOM), a probabilistic cohort state-transition model, to project health gains and economic benefits of a penny-per-ounce national SSB tax on reducing obesity-associated cancers among US adults age 20+ years by income. Results A national SSB tax was estimated to prevent 22,075 (95% uncertainty interval [UI] = 16,040 to 28,577) new cancers cases and 13,524 (95% UI = 9,841 to 17,681) cancer deaths among US adults over a lifetime. The policy was estimated to cost $1.70 (95% UI = $1.50 to $1.95) billion for government implementation and $1.70 (95% UI = $1.48 to $1.96) billion for industry compliance, while saving $2.28 (95% UI = $1.67 to $2.98) billion cancer-related healthcare costs. The SSB tax was highly cost-effective from both a government affordability perspective (incremental cost-effectiveness ratio [ICER] = $1,486, 95% UI = -$3,516 to $9,265 per quality-adjusted life year [QALY]) and a societal perspective (ICER = $13,220, 95% UI = $3,453 to $28,120 per QALY). Approximately 4,800 more cancer cases and 3,100 more cancer deaths would be prevented, and $0.34 billion more healthcare cost savings would be generated among low-income (federal poverty-to-income ratio [FPIR] ≤1.85) than higher-income individuals (FPIR &gt;1.85). Conclusions A penny-per-ounce national SSB tax is cost-effective for cancer prevention in the US, with the largest health gains and economic benefits among lower-income Americans.

Objectives. To quantify disparities in health and economic burdens of cancer attributable to suboptimal diet among US adults. Methods. Using a probabilistic cohort state-transition model, we estimated the number of new cancer cases and cancer deaths, and economic costs of 15 diet-related cancers attributable to suboptimal intake of 7 dietary factors (a low intake of fruits, vegetables, dairy, and whole grains and a high intake of red and processed meats and sugar-sweetened beverages) among a closed cohort of US adults starting in 2017. Results. Suboptimal diet was estimated to contribute to 3.04 (95% uncertainty interval [UI] = 2.88, 3.20) million new cancer cases, 1.74 (95% UI = 1.65, 1.84) million cancer deaths, and $254 (95% UI = $242, $267) billion economic costs among US adults aged 20 years or older over a lifetime. Diet-attributable cancer burdens were higher among younger adults, men, non-Hispanic Blacks, and individuals with lower education and income attainments than other population subgroups. The largest disparities were for cancers attributable to high consumption of sugar-sweetened beverages and low consumption of whole grains. Conclusions. Suboptimal diet contributes to substantial disparities in health and economic burdens of cancer among young adults, men, racial/ethnic minorities, and socioeconomically disadvantaged groups. (Am J Public Health. Published online ahead of print October 14, 2021:e1–e11. https://doi.org/10.2105/AJPH.2021.306475 )

Key Points Question What is the estimated association between added-sugar labeling and obesity-related cancer rates in the US? Findings This economic evaluation of Nutrition Facts added-sugar labeling and obesity-related cancer rates estimated that implementing the policy was associated with a reduction of 30 000 new cancer cases, 17 100 cancer deaths, and $1600 million in medical costs among US adults over a lifetime. This policy would generate net savings of $704 million from a societal perspective and $1590 million from a health care perspective. Meaning These model findings suggest added-sugar labeling would be associated with reduced costs and lower rates of obesity-related cancers.