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2 Setting the Stage
Pages 7-20

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From page 7...
... It is during this transformational period that infants and young children learn how and what to eat. What is learned stems from the home setting and the family environment, and depends on a variety of factors, including "culture, ethnicity, socioeconomic status, feeding practices, and what foods happen to be available," said Birch.
From page 8...
... One hundred percent fruit juice accounts for approximately 1.5 percent of total energy intake among infants 6 to 11.9 months of age and 5.9 percent among children 12 to 23.9 months of age 1  This section summarizes information presented by Anna Maria Siega-Riz.
From page 9...
... Compared to 2005–2008, the overall prevalence of 100 percent fruit juice intake in 2009–2012 decreased among infants 0 to 5.9 and 6 to 11.9 months of age (Miles and Siega-Riz, 2017)
From page 10...
... Approximately 1 percent of children 0 to 5.9 months of age reportedly consumed any sugar-sweetened beverages on the day of the survey. This proportion increased to 50 percent among children 36 to 47.9 months of age, making sugar-sweetened beverage intake more prevalent than 100 percent fruit juice intake in this age group.
From page 11...
... At the end her presentation, Story described potential future analyses of the FITS 2016 data and discussed what she perceived as evidence gaps. She suggested that opportunities exist to use FITS 2016 to explore beverage intake patterns by meal and snack occasion, by location (including different child care settings as compared to the home setting)
From page 12...
... Through CHOICES, Gortmaker's team has evaluated strategies directly related to sugar-sweetened beverages, a category of beverages he defined as including "soda, sports drinks, fruit drinks and punches, [and] sweetened tea," but not including flavored milk or 100 percent fruit juice.
From page 13...
... After providing the context of evidence of effect, Gortmaker described the published results from his group's microsimulation models for three interventions: sugar-sweetened beverage excise tax, Smart Snacks in Schools, and the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) (Gortmaker et al., 2015)
From page 14...
... Although it is likely to not have a large effect on obesity, the models indicated that replacing 100 percent fruit juice with water in a typical child care center with 30 children could save approximately $1,000 per year at that center, noted Gortmaker. He emphasized that sugar-sweetened beverage habits and practices start early in life, and that opportunities exist to make early care and educational settings healthier.
From page 15...
... . Further emphasizing this point, she reported that an analysis using 2005–2010 NHANES data found that 83 percent of children 1 to 19 years of age consumed tap water, 10 percent consumed bottled water, and 7 percent reportedly consumed no water (Patel et al., 2013)
From page 16...
... Hecht recounted a conversation she had with a coordinator of the Rhode Island Department of Health program offering voluntary testing in Rhode Island child care centers. The coordinator indicated that participation in the program had been low because the child care centers feared the cost of remedying any issue found.
From page 17...
... Water Promotion Hecht emphasized the importance of drinking water promotion and education, together with improving access, as a key facilitator in boosting water consumption in preference to sugar-sweetened beverages, and she showed a variety of promotional materials aimed at the early years. Hecht concluded by outlining barriers to and opportunities for the role of drinking water access and promotion in an effort to eliminate sugar-sweetened beverage consumption in children 0 to 5 years of age.
From page 18...
... When an audience member proposed looking at sugar-sweetened beverage consumption by acculturation status, Siega-Riz noted that the NHANES sample would be too small, especially if also broken down by age group. Testing of Drinking Water Drawing from an audience member-submitted question, Birch asked Hecht to describe what has facilitated the passing of regulations for testing
From page 19...
... Gortmaker remarked that funds are generally allocated for testing rather than remedying any issues found, although Hecht noted that the initiative in California has money for both testing and remediation. Siega-Riz proposed that some of the funds from the excise tax on sugar-sweetened beverages could be put toward resolving water contamination issues found through testing, creating what she perceived as "a win-win solution." Hecht agreed with Siega-Riz, but thought this approach could create equity issues, given where the sugar-sweetened beverage excise taxes have been approved at the city level.
From page 20...
... Birch also asked the session speakers about tactics to target older siblings, caregivers, gatekeepers, and parents, as "children of this age do not make the initial decision to try a [sugar-sweetened beverage] ." Story stated that we have to re-educate and increase the knowledge about limiting the consumption of 100 percent fruit juice.


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