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Article: Family Talk

Furlong, Mairead / McGuinness, Colm / Mulligan, Christine Marie / McGarr, Sharon Lisa / McGilloway, Sinead

2024 Volume 15, Page(s) 1287378

Abstract: Background: Parental mental illness (PMI) is common and places children at high risk of developing psychological disorders. : Methods: A total of 83 families with PMI, with children aged 5-18 years, were randomly assigned on a 2:1 ratio to receive ... ...

Abstract	Background: Parental mental illness (PMI) is common and places children at high risk of developing psychological disorders. Methods: A total of 83 families with PMI, with children aged 5-18 years, were randomly assigned on a 2:1 ratio to receive either the FT intervention (n=55 families) or usual services (n=28 families) across 10 adult, child and primary care mental health sites in Ireland. Parental disorders included anxiety/depression (57%), Bipolar Disorder (20%), Borderline Personality Disorder (12%), Post-Traumatic Stress Disorder (8%) and psychosis (2%). Detailed assessments with parents were conducted at baseline and 6-month follow up. Results: FT led to significant improvements in family functioning and child behaviour at 6-month follow up when compared to usual services, with medium effect sizes indicated. Parent participants with lower mental health literacy at baseline also showed significant post-intervention improvements. Those parents with less severe mental illness at baseline, and families with more partner and economic supports, reported additional significant post-intervention improvements in child depression/anxiety and parental mental health symptoms. The cost of FT amounted to €761.50 per family, although this decreased to €415.31 when recurring costs only were included. Conclusion: The findings from this study, which was conducted within the context of a national programme to introduce family-focused practice in Ireland, demonstrate that FT is a low-cost intervention that improved child and family psychosocial functioning across different mental health disorders within routine adult, child and primary care mental health services. The findings contribute to the growing evidence base for FT, and provide a robust basis to inform practice and policy development for families with parental mental illness both in Ireland and elsewhere. Clinical trial registration: https://www.isrctn.com/ISRCTN13365858, identifier ISRCTN13365858.
Language	English
Publishing date	2024-03-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2024.1287378
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Article ; Online: Qualitative analysis of front-of package labeling policy interactions between stakeholders and Health Canada.

Jawad, Aalaa / Mulligan, Christine / Savona, Natalie / L'Abbé, Mary R

Frontiers in public health

2023 Volume 11, Page(s) 982908

Abstract: Background: Front-of-package labelling regulations proposed by Health Canada in their Healthy Eating Strategy (2016) were finally passed in 2022, but remain unimplemented. This study analyzed interactions that occurred between stakeholders and ... ...

Abstract	Background: Front-of-package labelling regulations proposed by Health Canada in their Healthy Eating Strategy (2016) were finally passed in 2022, but remain unimplemented. This study analyzed interactions that occurred between stakeholders and government related to this policy proposal to identify key themes and policy implications. Methods: A qualitative framework analysis was conducted on publicly available documents for stakeholder correspondences related to front-of-package that occurred between 2016 and 2019 in Health Canada's Meetings and Correspondence on Healthy Eating database. Five sequential steps were applied: familiarization, identifying a thematic framework, indexing, charting, and mapping and interpretation. A complex systems (i.e., a dynamic system with multiple interconnecting components) lens was incorporated in the final step to deepen the analysis. Results: Hundred and seventy-three documents were included, the majority from industry stakeholders ( Conclusion: Interactions with industry stakeholders on health food policy proposals require careful consideration, given it may suit their interests to generate delays and policy discordance. Explicitly setting out the principles of engagement and actively encouraging non-industry stakeholder representation provides a more balanced approach to policy consultation and development.
MeSH term(s)	Canada ; Food Industry ; Nutrition Policy ; Qualitative Research ; Product Labeling/legislation & jurisprudence ; Stakeholder Participation ; Databases, Factual
Language	English
Publishing date	2023-04-06
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.982908
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Article ; Online: Child-appealing packaged food and beverage products in Canada-Prevalence, power, and nutritional quality.

Mulligan, Christine / Vergeer, Laura / Kent, Monique Potvin / L'Abbé, Mary R

PloS one

2023 Volume 18, Issue 5, Page(s) e0284350

Abstract: Background: Children are frequently exposed to marketing on food packaging. This study evaluated the presence, type and power of child-appealing marketing and compared the nutritional quality of child-appealing vs. non-child-appealing Canadian packaged ... ...

Abstract	Background: Children are frequently exposed to marketing on food packaging. This study evaluated the presence, type and power of child-appealing marketing and compared the nutritional quality of child-appealing vs. non-child-appealing Canadian packaged foods and examined the relationship between nutrient composition and marketing power. Methods: Child-relevant packaged foods (n = 5,850) were sampled from the Food Label Information Program 2017 database. The presence and power (# of techniques displayed) of child-appealing marketing were identified. Fisher's Exact test compared the proportion of products exceeding Health Canada's nutrient thresholds for advertising restrictions and Mann Whitney U tests compared nutrient composition between products with child- /non-child-appealing packaging. Pearson's correlation analyzed the relationship between nutrient composition and marketing power. Results: 13% (746/5850) of products displayed child-appealing marketing; the techniques used, and the power of the marketing varied ([Formula: see text] 2.2 techniques; range: 0-11). More products with child-appealing packaging than with non-child appealing packaging exceeded Health Canada's thresholds (98% vs. 94%; p < .001). Products with child-appealing packaging (vs. non-child-appealing) were higher in total sugars (median: 14.7 vs. 9 g/RA; p < .001) and free sugars (11.5 vs. 6.2 g/RA; p < .001), but lower in all other nutrients. There was weak overall correlation between marketing power and nutrient levels. Results varied by nutrient and food category. Conclusions: Unhealthy products with powerful child-appealing marketing displayed on package are prevalent in the food supply. Implementing marketing restrictions that protect children should be a priority.
MeSH term(s)	Humans ; Prevalence ; Canada ; Food ; Beverages ; Nutritive Value ; Marketing/methods ; Sugars
Chemical Substances	Sugars
Language	English
Publishing date	2023-05-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0284350
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Article ; Online: Top Sodium Food Sources in the American Diet-Using National Health and Nutrition Examination Survey.

Ahmed, Mavra / Ng, Alena Praneet / Christoforou, Anthea / Mulligan, Christine / L'Abbé, Mary R

Nutrients

2023 Volume 15, Issue 4

Abstract: Reducing population-level sodium intake can reduce hypertension, an important preventative strategy to lower the risk of cardiovascular diseases, the leading cause of death in the United States. Considering that most dietary sodium is derived from ... ...

Abstract	Reducing population-level sodium intake can reduce hypertension, an important preventative strategy to lower the risk of cardiovascular diseases, the leading cause of death in the United States. Considering that most dietary sodium is derived from prepackaged foods, this study quantitatively estimates the proportion contribution and mean sodium intake from key food category contributors to total sodium intake in the US population. Data from the 2017-2018 National Health and Nutrition Examination Survey, which collected interviewer-administered 24 h dietary recalls from Americans (
MeSH term(s)	United States ; Nutrition Surveys ; Sodium ; Energy Intake ; Diet ; Vegetables ; Sodium, Dietary
Chemical Substances	Sodium (9NEZ333N27) ; Sodium, Dietary
Language	English
Publishing date	2023-02-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15040831
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Article: The impact of characters like Tony the Tiger and other child-targeted techniques used in food and beverage marketing.

Mulligan, Christine / Remedios, Lauren / Ramsay, Tim / Pauzé, Elise / Bagnato, Mariangela / Potvin Kent, Monique

Frontiers in nutrition

2023 Volume 10, Page(s) 1287473

Abstract: Introduction: Food marketing's impact is a function of exposure and power, both of which contribute to children's poor diet quality and obesity risk. Children's exposure to food marketing is well documented, however, few studies have assessed the impact ...

Abstract	Introduction: Food marketing's impact is a function of exposure and power, both of which contribute to children's poor diet quality and obesity risk. Children's exposure to food marketing is well documented, however, few studies have assessed the impact of specific persuasive marketing techniques or aspects of 'power' on children. Methods: This study administered an online survey to 1,341 Canadian children (9-12 years) aiming to determine the impact of: (1) child-targeted vs. adult-targeted marketing, and (2) licensed characters vs. spokes characters on children's food preferences and behavioral intentions. Participants were randomized to a single condition in each survey part and viewed 3 static food advertisements displaying the features of that condition (e.g., child-targeted advertising or licensed characters), and answered 3 Likert-scale (5-point) questions after each exposure. For each condition within each research question, there were four outcome variables related to the impact of marketing on children: food preference, purchase intent, pester power, and total impact. ANOVA tested the difference in impact (Likert scores) between conditions overall and for each outcome, with Bonferroni Results: A greater average total impact was observed among children exposed to child-targeted ads (mean Likert score 3.36) vs. adult-targeted ads (mean score 2.75; Discussion: Overall, this study showed that child-targeted ads and those using characters - especially spokes characters - have a strong overall impact on children's food preferences, purchase intents, and pester power, and support the implementation of comprehensive marketing restrictions to protect children.
Language	English
Publishing date	2023-12-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2776676-7
ISSN	2296-861X
ISSN	2296-861X
DOI	10.3389/fnut.2023.1287473
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Article ; Online: Nutritional quality and price of plant-based dairy and meat analogs in the Canadian food supply system.

Lee, Jennifer J / Srebot, Sophia / Ahmed, Mavra / Mulligan, Christine / Hu, Guanlan / L'Abbé, Mary R

Journal of food science

2023 Volume 88, Issue 8, Page(s) 3594–3606

Abstract: There has been an increased consumer interest and public health emphasis on plant-based protein foods, resulting in a rise in the availability of highly processed plant-based analogs. The objectives of this study were to assess the nutritional quality ... ...

Abstract	There has been an increased consumer interest and public health emphasis on plant-based protein foods, resulting in a rise in the availability of highly processed plant-based analogs. The objectives of this study were to assess the nutritional quality and the price of plant-based dairy and meat analogs compared to their respective animal-derived products and to examine the association between processing levels and the nutritional quality among these products. Using a branded food composition database, products in cheese, yogurt, milk, and meat categories were examined (n = 3231). Products were categorized as plant-based analogs versus animal-derived products using the ingredient list. Products were examined for their nutrient content, overall nutritional quality using the Food Standards Australia New Zealand nutrient profiling model, price, and processing levels using the NOVA classification. All plant-based analogs had lower protein and higher total carbohydrate, sugar, and fiber content compared to their respective animal-derived products. Compared to their respective animal-derived products, plant-based milk and meat analogs had lower energy, total fat, and saturated fat content; plant-based yogurt and meat analogs had lower sodium content; and all plant-based dairy analogs had lower calcium content. Plant-based cheese and yogurt analogs were more expensive than animal-based products; however, there was no significant difference among milk and meat products. There was no association between processing levels and overall nutritional quality among dairy and meat products. Plant-based analogs may be part of a healthy and affordable diet to reduce the intakes of nutrients of concern; however, additional compositional guidelines and/or labeling may be needed to highlight the differences in the levels of nutrients to encourage.
MeSH term(s)	Animals ; Dairy Products ; Canada ; Nutritive Value ; Diet ; Milk ; Meat
Language	English
Publishing date	2023-07-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	241615-3
ISSN	1750-3841 ; 0022-1147
ISSN (online)	1750-3841
ISSN	0022-1147
DOI	10.1111/1750-3841.16691
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Article ; Online: Nutritional quality and price of plant‐based dairy and meat analogs in the Canadian food supply system

Lee, Jennifer J. / Srebot, Sophia / Ahmed, Mavra / Mulligan, Christine / Hu, Guanlan / L'Abbé, Mary R.

Journal of Food Science. 2023 Aug., v. 88, no. 8 p.3594-3606

2023

Abstract: There has been an increased consumer interest and public health emphasis on plant‐based protein foods, resulting in a rise in the availability of highly processed plant‐based analogs. The objectives of this study were to assess the nutritional quality ... ...

Abstract	There has been an increased consumer interest and public health emphasis on plant‐based protein foods, resulting in a rise in the availability of highly processed plant‐based analogs. The objectives of this study were to assess the nutritional quality and the price of plant‐based dairy and meat analogs compared to their respective animal‐derived products and to examine the association between processing levels and the nutritional quality among these products. Using a branded food composition database, products in cheese, yogurt, milk, and meat categories were examined (n = 3231). Products were categorized as plant‐based analogs versus animal‐derived products using the ingredient list. Products were examined for their nutrient content, overall nutritional quality using the Food Standards Australia New Zealand nutrient profiling model, price, and processing levels using the NOVA classification. All plant‐based analogs had lower protein and higher total carbohydrate, sugar, and fiber content compared to their respective animal‐derived products. Compared to their respective animal‐derived products, plant‐based milk and meat analogs had lower energy, total fat, and saturated fat content; plant‐based yogurt and meat analogs had lower sodium content; and all plant‐based dairy analogs had lower calcium content. Plant‐based cheese and yogurt analogs were more expensive than animal‐based products; however, there was no significant difference among milk and meat products. There was no association between processing levels and overall nutritional quality among dairy and meat products. Plant‐based analogs may be part of a healthy and affordable diet to reduce the intakes of nutrients of concern; however, additional compositional guidelines and/or labeling may be needed to highlight the differences in the levels of nutrients to encourage.
Keywords	calcium ; cheeses ; energy ; fiber content ; food availability ; ingredients ; lipid content ; meat ; milk ; models ; nutrient content ; nutrient databanks ; nutritive value ; plant source protein ; prices ; public health ; sodium ; sugars ; yogurt ; Australia ; New Zealand
Language	English
Dates of publication	2023-08
Size	p. 3594-3606.
Publishing place	John Wiley & Sons, Ltd
Document type	Article ; Online
Note	JOURNAL ARTICLE
ZDB-ID	241615-3
ISSN	1750-3841 ; 0022-1147
ISSN (online)	1750-3841
ISSN	0022-1147
DOI	10.1111/1750-3841.16691
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Article ; Online: Evaluating the potential implications of canadian front-of-pack labelling regulations in generic and branded food composition databases.

Mulligan, Christine / Lee, Jennifer J / Vergeer, Laura / Ahmed, Mavra / L'Abbé, Mary R

BMC public health

2022 Volume 22, Issue 1, Page(s) 1866

Abstract: Background: Canada proposed the implementation of mandatory front-of-pack (FOP) labelling regulations, whereby foods meeting or exceeding thresholds for nutrients-of-concern (i.e., total sugars, saturated fat, sodium) must display a 'high-in' FOP symbol ...

Abstract	Background: Canada proposed the implementation of mandatory front-of-pack (FOP) labelling regulations, whereby foods meeting or exceeding thresholds for nutrients-of-concern (i.e., total sugars, saturated fat, sodium) must display a 'high-in' FOP symbol (FOP). The objective of the study was to evaluate the potential implications of the proposed regulations using Canadian generic and branded food composition databases. Methods: A generic food composition database of products consumed by Canadians, Canadian Nutrient File (CNF) 2015 (n = 3,677), and a branded food composition database of packaged foods and beverages, Food Label Information Program (FLIP) 2017 (n = 17,521), were used to evaluate the number and proportion of foods that would display a FOP symbol based on the details of the proposed FOP labelling regulations published in 2018. Results: Overall, 35.5% (n = 1,306) of products in CNF 2015 and 63.9% (n = 11,193) of products in FLIP 2017 would display a FOP symbol for at least one nutrient-of-concern exceeding proposed thresholds. Soups, Combination Dishes, and Desserts categories in CNF 2015 and Combination dishes, Soups, and Meats categories in FLIP 2017 would have the highest proportion of products that would display a FOP symbol. Although displaying a FOP symbol for one nutrient was most common in both CNF 2015 (n = 992; 27.0%) and FLIP 2017 (n = 7,296, 41.6%), the number (i.e., 0-3) and type (i.e., saturated fat, sodium, total sugar) of nutrients displayed varied by food category. Conclusion: While the generic database, containing both packaged and unpackaged foods, revealed a low prevalence of foods that would display a FOP symbol, the branded database showed that the proposed FOP labelling regulations would identify over 60% of packaged foods with excess contents of nutrients-of-concern. Considering the high prevalence of packaged foods in Canada that would meet or exceed the thresholds of nutrients-of-concern, the proposed FOP labelling regulations should be implemented in a timely manner to help consumers easily identify foods high in nutrients-of-concern and encourage manufacturer-driven product reformulations.
MeSH term(s)	Canada ; Food Labeling ; Humans ; Nutritive Value ; Sodium ; Sugars
Chemical Substances	Sugars ; Sodium (9NEZ333N27)
Language	English
Publishing date	2022-10-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-022-14269-4
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Article ; Online: Lobbying and nutrition policy in Canada: a quantitative descriptive study on stakeholder interactions with government officials in the context of Health Canada's Healthy Eating Strategy.

Gaucher-Holm, Alexa / Mulligan, Christine / L'Abbé, Mary R / Potvin Kent, Monique / Vanderlee, Lana

Globalization and health

2022 Volume 18, Issue 1, Page(s) 54

Abstract: Background: The political activities of industry stakeholders must be understood to safeguard the development and implementation of effective public health policies.: Methods: A quantitative descriptive study was performed using data from Canada's ... ...

Abstract	Background: The political activities of industry stakeholders must be understood to safeguard the development and implementation of effective public health policies. Methods: A quantitative descriptive study was performed using data from Canada's Registry of Lobbyists to examine the frequency and governmental target of lobbying that occurred between various types of stakeholders (i.e., industry versus non-industry) and designated public office holders (DPOH) regarding Health Canada's Healthy Eating Strategy, from September/2016 to January/2021. Initiatives of interest were revisions to Canada's Food Guide, changes to the nutritional quality of the food supply, front-of-pack nutrition labelling and restrictions on food marketing to children. Results: The majority of registrants (88%), and corporations and organizations (90%) represented in lobbying registrations had industry ties. Industry-affiliated stakeholders were responsible for 86% of communications with DPOH, interacting more frequently with DPOH of all ranks, compared to non-industry stakeholders. Most organizations and corporations explicitly registered to lobby on the topic of marketing to children (60%), followed by Canada's Food Guide (48%), front-of-pack nutrition labelling (44%), and the nutritional quality of the food supply (23%). The food and beverage industry, particularly the dairy industry, was the most active, accounting for the greatest number of lobbying registrations and communications, followed by the media and communication industry. Conclusions: Results suggest a strategic advantage of industry stakeholders in influencing Canadian policymakers. While some safeguards have been put in place, increased transparency would allow for a better understanding of industry discourse and help protect public health interests during the policy development process.
MeSH term(s)	Canada ; Child ; Diet, Healthy ; Food Industry ; Government Employees ; Humans ; Lobbying ; Nutrition Policy
Language	English
Publishing date	2022-05-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2185774-X
ISSN	1744-8603 ; 1744-8603
ISSN (online)	1744-8603
ISSN	1744-8603
DOI	10.1186/s12992-022-00842-4
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Article ; Online: Nutrient intakes and top food categories contributing to intakes of energy and nutrients-of-concern consumed by Canadian adults that would require a 'high-in' front-of-pack symbol according to Canadian labelling regulations.

Lee, Jennifer J / Ahmed, Mavra / Ng, Alena Praneet / Mulligan, Christine / Flexner, Nadia / L'Abbé, Mary R

PloS one

2023 Volume 18, Issue 5, Page(s) e0285095

Abstract: Canada recently mandated front-of-pack (FOP) labelling regulations, where foods meeting and/or exceeding recommended thresholds for nutrients-of-concern (i.e., saturated fat, sodium, and sugars) must display a 'high-in' FOP nutrition symbol. However, ... ...

Abstract	Canada recently mandated front-of-pack (FOP) labelling regulations, where foods meeting and/or exceeding recommended thresholds for nutrients-of-concern (i.e., saturated fat, sodium, and sugars) must display a 'high-in' FOP nutrition symbol. However, there is limited research on the amounts and sources of foods consumed by Canadians that would require a FOP symbol. The objective was to examine the intakes of nutrients-of-concern from foods that would display a FOP symbol and to identify the top food categories contributing to intakes for each nutrient-of-concern. Using the first day 24-hour dietary recall from the nationally representative 2015 Canadian Community Health Survey-Nutrition (CCHS), Canadian adults' intakes of nutrients-of-concern from foods that would display a FOP symbol was examined. Foods were assigned to 1 of 62 categories to identify the top food categories contributing to intakes of energy and nutrient-of-concern that would display a FOP symbol for each nutrient-of-concern. Canadian adults (n = 13,495) consumed approximately 24% of total calories from foods that would display a FOP symbol. Foods that would display a FOP symbol for exceeding thresholds for nutrients-of-concern accounted for 16% of saturated fat, 30% of sodium, 25% of total sugar, and 39% of free sugar intakes among Canadian adults. The top food category contributing intakes of each nutrient-of-concern that would display a FOP symbol were nutrient-specific: Processed meat and meat substitutes for saturated fat; Breads for sodium; and Fruit juices & drinks for total and free sugars. Our findings show that Canadian FOP labelling regulations have the potential to influence the intakes of nutrients-of-concern for Canadian adults. Using the findings as baseline data, future studies are warranted to evaluate the impact of FOP labelling regulations.
MeSH term(s)	Adult ; Humans ; Food Labeling ; Canada ; Eating ; Nutrients ; Dietary Carbohydrates ; Sugars ; Sodium ; Nutritive Value
Chemical Substances	Dietary Carbohydrates ; Sugars ; Sodium (9NEZ333N27)
Language	English
Publishing date	2023-05-18
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0285095
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