Removing sweets from checkouts linked to huge fall in unhealthy snack purchases

Policies aimed at removing sweets and crisps from checkouts could lead to a dramatic reduction to the amount of unhealthy food purchased to eat ‘on the go’ and a significant reduction in that purchased to take home, suggests new research led by the University of Cambridge.

The study, published in the journal PLOS Medicine, found that 17% fewer small packages of sugary confectionary, chocolate and potato crisps were bought and taken home from supermarkets immediately after introducing a checkout food policy. Even more dramatically, 76% fewer purchases were bought and eaten ‘on-the-go’ from supermarkets with checkout food policies compared to those without.

Large supermarket chains such as Tesco, Asda and Sainsbury’s have captured the majority of the grocery market and play a major role in shaping food preferences and purchasing behaviour.

Retail practices such as product displays, positioning, promotions and pricing can all influence consumers’ choices in stores.

Supermarket checkouts provide a unique location for prompting purchases as all customers have to pass through them to pay and may spend considerable time in queues; however, the majority of food at supermarket checkouts could be considered unhealthy. Over the last decade, many UK supermarket groups have made voluntary commitments to remove or limit unhealthy foods at the tills or to provide healthier options.

“Many snacks picked up at the checkout may be unplanned, impulse buys — and the options tend to be confectionary, chocolate or crisps,” says Dr Jean Adams from the Centre for Diet and Activity Research at the University of Cambridge. “Several supermarkets have now introduced policies to remove these items from their checkouts, and we wanted to know if this had any impact on people’s purchasing choices.”

To examine the effect that the introduction of checkout food policies in major supermarket chains has had on shoppers’ purchasing habits, Dr Adams led a team of researchers at the universities of Cambridge, Stirling and Newcastle who analysed data from the Kantar Worldpanel’s Consumer panel for food, beverages and household products. Six out of the nine major supermarkets introduced checkout food policies between 2013 and 2017. (The researchers anonymised the information to avoid ‘naming and shaming’ companies.)

Firstly, the team looked at how purchases of less healthy common checkout foods brought home changed following the implementation of checkout policies. They used data from over 30,000 UK households from 12 months before to 12 months after implementation.

The researchers found that implementation of a checkout food policy was associated with an immediate 17% reduction in purchases. After a year, shoppers were still purchasing over 15% fewer of the items compared to when no policy was in place.

Next, they looked at data from 7,500 shoppers who recorded food bought and eaten ‘on-the-go’ during 2016-17 from supermarkets with and without checkout food policies. On-the-go purchases are often impulsive and can be the result of children pestering their parents. The researchers found that shoppers made 76% fewer annual purchases of less healthy common checkout foods from supermarkets with checkout food policies compared to those without.

As the study was not a randomised control trial, it was not possible to say definitely that the changes in purchasing behaviour were due to the checkout food policies. Stores that chose to have checkout food policies may have been different from those that did not. Or shoppers may have changed to purchasing larger packages from the same stores, or similar products from stores that aren’t supermarkets.

“Our findings suggest that by removing sweets and crisps from the checkout, supermarkets can have a positive influence on the types of purchases their shoppers make,” says Dr Katrine Ejlerskov, the study’s first author. “This would be a relatively simple intervention with the potential to encourage healthier eating. Many of these purchases may have been impulse buys, so if the shopper doesn’t pick up a chocolate bar at the till, it may be one less chocolate bar that they consume.”

“It may seem obvious that removing unhealthy food options from the checkout would reduce the amount that people buy, but it is evidence such as this that helps build the case for government interventions to improve unhealthy behaviours,” adds Dr Adams.

“One such intervention might be to introduce nutritional standards for checkout food as suggested in the Government’s recent Childhood Obesity Plan. Such a government-led policy might prove attractive to supermarkets as it would provide a level playing field across the sector.”

###

The work was undertaken by the authors as part of the Public Health Research Consortium. The Public Health Research Consortium is funded by the Department of Health and Social Care Policy Research Programme.

Reference

Ejlerskov, KT et al. Supermarket policies on less healthy food at checkouts: natural experimental evaluation using interrupted time series analyses of purchases. PLOS Medicine; 18 Dec 2018

Researcher Profile: Dr Jean Adams

“Most people have a vague idea about what eating better involves — more fruit and veg, less fat and sugar — and they also often have an aspiration to eat better,” says Dr Jean Adams. “But they don’t always manage to put this aspiration into practice.”

Jean’s research group in the Centre for Diet and Activity Research (CEDAR) asks why this is the case — and what can be done about it. “We’re particularly interested in how we can provide environments that make it easier for everyone to eat better. This might involve making healthier foods more available, cheaper, attractive, or easier to prepare.”

Jean began her career studying medicine at Newcastle University, but admits she “never really enjoyed it.” But between her second and third year at medical school, she did a research year and realised this was where her passion lay. She went on to study for a PhD in public health and since then her career has involved public health research, rather than clinical medicine.

“I do a lot of talking and listening to people working in local and national government to understand what sorts of opportunities they feel are coming up and what research they would find helpful. In Cambridge we then try and focus on what the most rigorous and useful research we could do would be.”

Jean hopes that her research will lead to more people finding it easier to eat better. “Poor diet accounts for as much death and disease in the UK as tobacco smoking, so we are trying to address a major problem,” she says.

While she finds her work interesting and rewarding, she says research can be more prosaic than it is sometimes painted. “I have never had a Eureka moment and no-one’s ever slapped a sheaf of papers on my desk that explains everything! In my experience, research is more about grinding things out with a lot of refining and polishing leading to incremental accumulation of knowledge.”

Nor is it particularly glamorous: “The CEDAR offices are in a slightly dingy corner deep in the heart of Addenbrooke’s Hospital. We have a small meeting room with a big white board. Sometimes I think that whiteboard has been the key vehicle for almost all of the great research CEDAR has produced!”

But fortunately, it can be both enjoyable and exhilarating. “My favourite meetings are the ones where we talk about ideas and share our brain power to arrive at new insights. I particularly enjoy when someone makes me see an old problem in a new way, or helps me crystallise some vague ideas that have been bubbling in my head for a while.

“We also try not to take ourselves too seriously and have a lot of fun along the way.”

---

Story Source:

Materials provided by University of Cambridge. The original story is licensed under a Creative Commons License. Note: Content may be edited for style and length.

---

Journal Reference:

1. Katrine T. Ejlerskov, Stephen J. Sharp, Martine Stead, Ashley J. Adamson, Martin White, Jean Adams. Supermarket policies on less-healthy food at checkouts: Natural experimental evaluation using interrupted time series analyses of purchases. PLOS Medicine, 2018; 15 (12): e1002712 DOI: 10.1371/journal.pmed.1002712

https://www.sciencedaily.com/releases/2018/12/181218171553.htm

Tiny implantable device short-circuits hunger pangs, aids weight loss

More than 700 million adults and children worldwide are obese, according to a 2017 study that called the growing number and weight-related health problems a “rising pandemic.”

New battery-free, easily implantable weight-loss devices developed by engineers at the University of Wisconsin-Madison could offer a promising new weapon for battling the bulge.

In laboratory testing, the devices helped rats shed almost 40 percent of their body weight. Results of the study were published today (Dec. 17, 2018) in the journal Nature Communications.

Measuring less than 1 centimeter across, or about a third of the area of a U.S. penny, the tiny devices — which are safe for use in the body and implantable via a minimally invasive procedure — generate gentle electric pulses from the stomach’s natural churning motions and deliver them to the vagus nerve, which links the brain and the stomach.

That gentle stimulation dupes the brain into thinking that the stomach is full after only a few nibbles of food.

“The pulses correlate with the stomach’s motions, enhancing a natural response to help control food intake,” says Xudong Wang, a UW-Madison professor of materials science and engineering.

Unlike gastric bypass, which permanently alters the capacity of the stomach, the effects of the new devices also are reversible. When Wang and his collaborators removed the devices after 12 weeks, the study’s rats resumed their normal eating patterns and weight bounced right back on.

Wang’s device has several advantages over an existing unit that stimulates the vagus nerve for weight loss. That existing unit, “Maestro,” approved by the Food and Drug Administration in 2015, administers high-frequency zaps to the vagus nerve to shut down all communication between the brain and stomach. It requires a complicated control unit and bulky batteries which frequently must be recharged.

That ongoing maintenance can be a big barrier to use, says Luke Funk, a surgery professor in UW-Madison’s Division of Minimally Invasive, Foregut and Bariatric Surgery. “One potential advantage of the new device over existing vagus nerve stimulators is that it does not require external battery charging, which is a significant advantage when you consider the inconvenience that patients experience when having to charge a battery multiple times a week for an hour or so.”

In fact, Wang’s device contains no batteries, no electronics, and no complicated wiring. It relies instead on the undulations of the stomach walls to power its internal generators.

That means the device only stimulates the vagus nerve when the stomach moves.

“It’s automatically responsive to our body function, producing stimulation when needed,” says Wang. “Our body knows best.”

Wang is a world expert in wearable and implantable capacitive electricity-generating devices, having previously created implantable nanogenerators that harvest energy from people’s beating hearts and breathing, a motion-powered bandage for wound healing, and other such devices.

He and his collaborators patented the weight-loss device through the Wisconsin Alumni Research Foundation and are moving forward with testing in larger animal models. If successful, they hope to move toward human trials.

“Our expectation is that the device will be more effective and convenient to use than other technologies,” says Wang.

---

Story Source:

Materials provided by University of Wisconsin-Madison. Note: Content may be edited for style and length.

---

Journal Reference:

1. Guang Yao, Lei Kang, Jun Li, Yin Long, Hao Wei, Carolina A. Ferreira, Justin J. Jeffery, Yuan Lin, Weibo Cai, Xudong Wang. Effective weight control via an implanted self-powered vagus nerve stimulation device. Nature Communications, 2018; 9 (1) DOI: 10.1038/s41467-018-07764-z

https://www.sciencedaily.com/releases/2018/12/181217164112.htm

Takeda to List American Depositary Shares on New York Stock Exchange

Takeda Pharmaceutical Company Limited (TSE: 4502) (“Takeda”) today announced that the listing and trading of its American Depositary Shares (“ADSs”) on the New York Stock Exchange (“NYSE”) is expected to commence on December 24, 2018. Takeda’s ADSs currently trade over-the-counter. The ADSs will now trade under the ticker symbol “TAK” and The Bank of New York Mellon will continue to act as the depositary bank for the ADS program.

Takeda will maintain its headquarters in Japan and its primary listing on the Tokyo Stock Exchange (the “TSE”), as well as its current listings on local Japanese stock exchanges.

“Our dual listing on the NYSE and TSE reflects our position as a leading global biopharmaceutical company and will provide wider capital markets access with expanded trading hours for our investors worldwide,” said Costa Saroukos, Chief Financial Officer of Takeda. “We look forward to closing our acquisition of Shire in the coming weeks and driving long-term value for our shareholders as a combined company.”

With its listings in Japan and the United States, Takeda will be able to access two of the world’s largest capital markets and is the only pharmaceutical company listed on both the TSE and the NYSE. The new NYSE listing will also facilitate ownership of Takeda shares following its acquisition of Shire plc (“Shire”) (the “Acquisition”) which, subject to the Shire scheme of arrangement being sanctioned by the Jersey court, is expected to complete on January 8, 2019. Under the terms of the Acquisition, Shire shareholders will be entitled to receive $30.33 in cash and either 0.839 new Takeda shares or 1.678 Takeda ADSs for each Shire share held.

In connection with the listing on the NYSE, Takeda filed a registration statement on Form 20-F on December 6, 2018, and Amendment No. 1 thereto on December 17, 2018. Takeda’s Form 20-F is available online at www.sec.gov and will be available online at https://www.takeda.com/investors/reports shortly before the listing. Takeda shareholders have the ability to receive a hard copy of this documentation, free of charge, by contacting Takeda Investor Relations by telephone at +81-3-3278-2306 or by e-mail at takeda.ir.contact@takeda.com.

https://www.businesswire.com/news/home/20181218005892/en/Takeda-Announces-Listing-American-Depositary-Shares-New

Vapers Exposed to Fewer Toxins Than Conventional Smokers: Study

Electronic cigarette users take in lower levels of potentially harmful compounds than smokers, a new study shows.

But e-cigarette users are exposed to much higher levels of these compounds than people who don’t use the devices and don’t smoke.

“The findings are striking, because we now have solid evidence that e-cigarettes — while they still expose users to some toxicants — appear to significantly reduce this exposure compared to combustible cigarettes,” said study first author Maciej Goniewicz. He’s an associate professor at Roswell Park Comprehensive Cancer Center in Buffalo, N.Y.

However, “that reduction in exposure did not extend to dual users. This is important information for any e-cigarette users who continue to smoke tobacco cigarettes,” Goniewicz said in a center news release.

The data suggest that potential harm reduction can only be achieved if smokers switch completely to e-cigarettes and discontinue use of traditional cigarettes, said Goniewicz.

The study comes at the same time the U.S. Surgeon General is saying “aggressive” action is needed to stop teen use of e-cigarettes.

“Aggressive steps” must be taken by parents, teachers, health providers and government officials to prevent children and teens from using electronic cigarettes,” U.S. Surgeon General Jerome Adams said in an advisory issued Tuesday.

For young people, “nicotine is dangerous and it can have negative health effects,” Adams told the Associated Press. “It can impact learning, attention and memory, and it can prime the youth brain for addiction.”

For the new study, researchers analyzed data from 5,000 U.S. adults who took part in the Population Assessment of Tobacco and Health (PATH) study, between 2013 and 2014.

Those who used e-cigarettes only were exposed to toxins associated with tobacco use, but at significantly lower levels than smokers. Levels of exposure among people who used both e-cigarettes and cigarettes were similar to those who used cigarettes alone.

The toxins included nicotine, tobacco-specific nitrosamines (TSNAs), volatile organic compounds (VOCs) and metals, according to the study.

More than 90 percent of the e-cigarette-only users previously used cigarettes. Among e-cigarette-only users, 56 percent used e-cigarettes daily, while 20 percent of dual users used e-cigarettes daily.

Cigarette consumption was similar between cigarette-only smokers and dual users — about 15 cigarettes a day, the researchers found.

“Our goal was to give the public reliable information about the actual impacts that smoking and vaping have on individual users,” Goniewicz said.

Study senior author Andrew Hyland, chair of health behavior at Roswell Park, said the study underscores the dangers of conventional cigarettes.

“We know that quitting cigarettes improves health dramatically, but we don’t know much about possible risks from smoking and vaping together,” Hyland said.

“These data are clear that cigarette smoking is the primary factor responsible for exposure to the toxicants measured in this study. Stopping smoking completely is the best thing a smoker can do for their health,” Hyland said.

The findings were published Dec. 14 in the journal JAMA Network Open.

More information

The American Heart Association has more on quitting smoking.

SOURCE: Roswell Park Comprehensive Cancer Center, news release, Dec. 14, 2018

https://consumer.healthday.com/cancer-information-5/electronic-cigarettes-970/vapers-exposed-to-fewer-toxins-than-conventional-smokers-study-740715.html

Take High Blood Pressure Meds? Exercise Might Work Just as Well

If you have high blood pressure, hitting the gym may be as helpful as taking drugs to lower your numbers, researchers say.

There’s “compelling evidence that combining endurance and dynamic resistance training was effective in reducing [blood pressure],” according to the authors of a new report.

The British researchers stressed that it’s still too early to recommend that people toss their antihypertensive meds, and exercise instead — there’s not yet been a head-to-head trial of drugs versus exercise for blood pressure.

But comparing the numbers from hundreds of blood pressure trials involving either exercise or medication suggests they have the same benefit, said the team led by Huseyin Naci. He’s a health policy researcher at the London School of Economics and Political Science.

For now, one U.S. expert said, exercise should be considered an “and” rather than an “or” when it comes to treating high blood pressure.

“Exercise is a pillar in the foundation of treatment for hypertension, but for those patients that require drug therapy, exercise is not a replacement for medication,” said Dr. Guy Mintz. He directs cardiovascular health at the Sandra Atlas Bass Heart Hospital in Manhasset, N.Y.

The new research was published online Dec. 18 in the British Journal of Sports Medicine.

In the study, Naci’s team analyzed data from 197 clinical trials that assessed the effects of structured workouts on lowering systolic blood pressure, the top number in a reading. The investigators also looked at data from 194 trials that examined the impact of prescription drugs on blood pressure. In total, the studies included nearly 40,000 people.

Overall, blood pressure was lower in people treated with drugs than in those who did an exercise regimen, the researchers reported. However, for people with high blood pressure in particular — systolic readings over 140 mm Hg — exercise appeared just as effective as most drugs in lowering blood pressure.

Also, the effectiveness of exercise against high blood pressure rose the higher the threshold that was used to define high blood pressure — anything above 140 mm Hg.

The types of exercise in the studies included: endurance, such as walking, jogging, running, cycling and swimming; dynamic resistance, such as strength training with weights; isometric resistance, such as the static push-ups (planks); and a combination of endurance and resistance.

Naci and his colleagues stressed that there were no studies in which exercise and blood pressure-lowering drugs were compared head-to-head, and the number of people in some of the studies was relatively small.

All of that means that, for now, people shouldn’t try to replace blood pressure meds with exercise.

“We don’t think, on the basis of our study, that patients should stop taking their antihypertensive medications,” Naci said in a journal news release. “But we hope that our findings will inform evidence-based discussions between clinicians and their patients.”

Another U.S. heart specialist agreed with that assessment.

“Exercise, at any risk level for cardiovascular disease, is shown to improve not only how long one lives, but also lowers the risk of heart attacks and strokes,” noted Dr. Satjit Bhusri, a cardiologist at Lenox Hill Hospital in New York City.

People who are already taking a high blood pressure medication are among “the best to benefit from exercise,” Bhusri said.

“It is possible to slowly take patients off blood pressure medications as they improve their lifestyle with exercise and diet management, but for most this is a very difficult goal to reach,” Bhusri stressed. So, “we do not recommend stopping medications until close observation and discussion with their physician,” he explained.

For his part, Mintz said exercise works its magic against high blood pressure through a combination of weight loss, improved artery health and changes in chemicals controlling blood flow.

“I feel that patients should adhere to the current exercise guidelines in the United States, of performing moderate exercise of 150 minutes per week (30 minutes, five times a week), or vigorous exercise for 75 minutes per week,” he said. “This is a reasonable and obtainable goal for patients, as an adjunct to appropriate diet.”

But for most people with high blood pressure, “exercise alone will not be enough to control their blood pressure,” and that’s where medication comes in, Mintz said.

“Patients should not stop their medications, even if they are involved in a regular aerobic exercise program, unless consistent control of their hypertension is corroborated by their physician,” he said.

More information

The U.S. Centers for Disease Control and Prevention outlines how to prevent high blood pressure.

SOURCES: Satjit Bhusri, M.D., cardiologist, Lenox Hill Hospital, New York City; Guy L. Mintz, M.D., director of cardiovascular health and lipidology, Sandra Atlas Bass Heart Hospital, Manhasset, N.Y.; British Journal of Sports Medicine, news release, Dec. 18, 2018

https://consumer.healthday.com/cardiovascular-health-information-20/high-blood-pressure-health-news-358/take-high-blood-pressure-meds-exercise-might-work-just-as-well-740679.html

Lexicon pain drug advances after clearing early clinical test

A phase 1a trial of Lexicon Pharmaceuticals’ LX9211 has met its primary objectives. The study found the AAK1 inhibitor was well tolerated, teeing Lexicon up to advance the neuropathic pain prospect.

Lexicon licensed LX9211 from Bristol-Myers Squibb in 2016 after working with the Big Pharma to characterize the AAK1 target through a neuroscience drug discovery alliance. Since taking charge of the program, Lexicon has wrapped up IND-enabling studies and put LX9211 through an early-phase test designed to assess safety and identify the maximum tolerated dose.

Now, Lexicon has data from that early-phase test. Lexicon is yet to share a close look at the data but painted the outcome of the trial as a surprise-free success in its summary of the findings.

“The initial clinical data for LX9211 confirms the drug candidate’s preclinical profile,” Lexicon R&D Executive Vice President Praveen Tyle said in a statement. “LX9211 was well tolerated with predictable pharmacokinetics. At doses tested, drug levels of LX9211 were at biologically relevant concentrations and support the therapeutic potential of this highly selective inhibitor of AAK1.”

Lexicon generated the data in a clinical trial that enrolled healthy volunteers and grouped them into 10 cohorts that received daily doses of LX9211 ranging from 5 mg to 200 mg. According to Lexicon, the pharmacokinetics support once-daily dosing, at most, and were dose proportional across almost all of the evaluated range. No drug-related serious adverse events were reported.

Boosted by the findings, Lexicon is planning to move LX9211 into a multiple ascending dose study in the first quarter of next year. The trial will move Lexicon a step closer to learning whether LX9211 can treat neuropathic pain without causing addiction and other complications associated with the use of existing painkillers.

Lexicon identified AAK1 as a target that could yield drugs with such properties by testing 3,097 mouse knockout lines. The research led to the characterization of AAK1 and to the agreement with Bristol-Myers, which gave Lexicon full rights to LX9211 in return for regulatory and commercial milestones that start with the initiation of a phase 2 trial.

https://www.fiercebiotech.com/biotech/lexicon-pain-drug-advances-after-clearing-early-clinical-test

Idorsia’s selatogrel hits goals in phase 2 cardiovascular trials

Idorsia’s P2Y12 receptor antagonist selatogrel has significantly inhibited platelet aggregation in two phase 2 trials. The primary endpoint successes in patients with stable coronary artery disease (CAD) or acute myocardial infarction (AMI) set Idorsia up to plan the initiation of a phase 3 study.

Switzerland’s Idorsia, which spun out of Actelion as part of the Johnson & Johnson acquisition, has designed selatogrel to quickly inhibit platelet aggregation by acting on the P2Y12 receptor. As drugs such as Plavix have shown, targeting P2Y12 can prevent the formation of blood clots and thereby improve cardiovascular outcomes.

More recently, AstraZeneca’s Brilinta has shown that direct-acting, reversibly binding antagonists of P2Y12 can have wider therapeutic windows and superior efficacy than Plavix and its ilk. However, Idorsia thinks there is still a need for P2Y12 antagonists that have a lower risk of bleeding side effects.

To test whether selatogrel can meet that need, Idorsia initiated two phase 2 trials of the drug. One of the trials enrolled 346 patients with stable CAD and gave them one of two doses of selatogrel or placebo. The other trial enrolled 48 patients with confirmed AMI and randomized them to receive one of two doses of selatogrel on top of antithrombotic treatment.

Both of the trials used platelet aggregation following a single subcutaneous injection as their primary endpoint, and both studies met that objective. Upward of 89% of patients in the treatment arms of the trials experienced the predefined extent of platelet aggregation inhibition. Aggregation inhibition was seen within 15 minutes—an important consideration in AMI—and remained at a high level for four to eight hours.

Idorsia is yet to share more efficacy data and has only discussed the safety results in broad terms, stating that no patients suffered treatment-emergent serious bleeds. Further details of the safety data will be important given the propensity for drugs that act on P2Y12 to increase the risk of bleeding.

Researchers at Idorsia are preparing to share more data at an upcoming scientific congress while gearing up for the next stage of development. Idorsia plans to discuss its plans for phase 3 with regulators at the upcoming end of phase 2 meetings.

https://www.fiercebiotech.com/biotech/idorsia-s-selatogrel-hits-goals-phase-2-cardiovascular-trials