00;00;02;28 - 00;00;04;15
Hi. Good afternoon, everybody.

00;00;04;15 - 00;00;06;28
We are so pleased
you have joined us for the DNPAO

00;00;08;01 - 00;00;09;02
seminar series.

00;00;09;02 - 00;00;12;29
This seminar will focus on new data
on added sugar intake in the US

00;00;13;09 - 00;00;16;20
and the impact of community actions
to reduce added sugars.

00;00;16;28 - 00;00;19;19
So. So glad you could join us. Afterwards,

00;00;19;19 - 00;00;23;08
this webinar will eventually
be posted to the DNPAO website.

00;00;23;09 - 00;00;26;16
So if you've missed some of our past
webinars, you can go there

00;00;26;24 - 00;00;28;25
to find previous ones.

00;00;30;02 - 00;00;32;26
And I'm Janelle Gunn. I'm here
to moderate our webinar today.

00;00;32;26 - 00;00;35;12
We have a really great panel today.

00;00;35;12 - 00;00;35;27
I think you'll hear

00;00;35;27 - 00;00;40;21
a lot of great information,
get some good resources and things to use.

00;00;40;27 - 00;00;44;23
So just a few housekeeping items
as we get started with the webinar.

00;00;45;04 - 00;00;46;27
So this is a Zoom webinar.

00;00;46;27 - 00;00;48;05
It's going to be recorded

00;00;48;05 - 00;00;50;13
and so if you're not comfortable with it
being recorded,

00;00;50;13 - 00;00;54;03
we ask that you disconnect at this time.
To have the best experience,

00;00;54;03 - 00;00;57;24
we encourage you to use your Zoom webinar
app or website to view the slides

00;00;58;03 - 00;01;00;13
and to participate in today's meeting.

00;01;00;13 - 00;01;02;07
All participants are muted.

00;01;02;07 - 00;01;05;02
Following our three presentations,
we will have a question

00;01;05;02 - 00;01;06;13
and answer session.

00;01;06;13 - 00;01;09;05
So the Q&A box is open,
so feel free at any time

00;01;09;05 - 00;01;11;17
to go ahead and answer
any questions that you have.

00;01;12;11 - 00;01;15;07
We'll be loading them in
and getting ready to respond.

00;01;15;20 - 00;01;19;09
Um, and then also at the end
they'll be time as well.

00;01;20;00 - 00;01;21;24
So let's go ahead and get started. So

00;01;23;03 - 00;01;23;14
why is

00;01;23;14 - 00;01;26;10
CDC having a webinar on added sugar
as well?

00;01;26;18 - 00;01;29;25
Our Division focuses on

00;01;30;07 - 00;01;33;20
nutrition, physical activity
and obesity here at CDC.

00;01;33;20 - 00;01;37;16
And we really are helping Americans
eat healthy and be physically active

00;01;37;16 - 00;01;40;14
through their life span.
And through the nutrition component,

00;01;40;14 - 00;01;41;25
we really focused on

00;01;41;25 - 00;01;45;25
how can we help Americans eat consistent
with the dietary guidelines for Americans.

00;01;46;16 - 00;01;50;01
And this is in the last iteration
of the dietary guidelines,

00;01;50;01 - 00;01;50;18
is the first time

00;01;50;18 - 00;01;53;26
we saw a specific recommendation
for added sugars for young children.

00;01;54;05 - 00;01;58;20
And in the last two editions, there
has been one for the general population.

00;01;59;06 - 00;02;01;09
So the dietary guidelines has

00;02;02;15 - 00;02;05;13
the recommendation
to consume less than 10% of calories

00;02;05;22 - 00;02;07;20
per day, starting at the age of two.

00;02;07;20 - 00;02;08;29
And then for children under two,

00;02;08;29 - 00;02;12;23
they recommend to avoid foods
and beverages with added sugars.

00;02;16;15 - 00;02;19;29
Also of interest is that added sugars
or reducing added

00;02;19;29 - 00;02;24;13
sugars is a leading health indicator
for the Healthy People 2030 Initiative.

00;02;24;13 - 00;02;28;19
And if you're familiar with healthy
people, it sets national goals to help

00;02;29;25 - 00;02;32;02
help us sort of target our our efforts.

00;02;32;14 - 00;02;35;05
And a leading health indicator is one
that's been prioritized

00;02;35;05 - 00;02;38;05
because of its potential
large impact on health.

00;02;38;05 - 00;02;41;13
So this was elevated
in this last iteration as an area

00;02;42;00 - 00;02;44;22
that could have a lot of impacts
on health.

00;02;44;22 - 00;02;46;26
So we've been doing the work in this area.

00;02;46;26 - 00;02;50;28
Hopefully you've seen some of our recent
articles that we have on added sugars,

00;02;50;28 - 00;02;52;03
so we put them in here.

00;02;52;03 - 00;02;55;18
Also the references
in case that you want to find them

00;02;55;18 - 00;02;58;18
and also want to share some other
work we've been doing on

00;02;59;17 - 00;03;00;19
communications as well.

00;03;00;19 - 00;03;03;02
So you can see on the bottom here
there's an infographic

00;03;03;08 - 00;03;06;03
I did just a couple of screenshots
of the infographic.

00;03;06;03 - 00;03;08;04
It's not the whole infographic here.

00;03;08;04 - 00;03;10;21
There's a link in the chat box
if you want to check it out.

00;03;11;06 - 00;03;14;27
But um, ways that we've been sort of
focusing our efforts on added sugars,

00;03;15;02 - 00;03;17;19
the second image
I selected here I thought was a great one

00;03;17;19 - 00;03;20;20
because it really helps show
how added sugars might fit into

00;03;20;20 - 00;03;23;22
your broader nutrition work and it fits
into the nutrition standards work.

00;03;23;22 - 00;03;27;29
So we have efforts in the early care
and education setting and in food

00;03;27;29 - 00;03;32;01
service guidelines, and added sugars
can be a component of those efforts.

00;03;32;01 - 00;03;34;11
So be sure to check out the infographic.

00;03;35;03 - 00;03;38;15
We've also been doing some communications
like that.

00;03;38;16 - 00;03;39;25
We call it a micro campaign,

00;03;39;25 - 00;03;43;17
so a little bit of work
on raising awareness on added sugars.

00;03;43;22 - 00;03;45;23
We revived the Rethink Your Drink

00;03;46;22 - 00;03;48;18
campaign to do this.

00;03;48;18 - 00;03;51;15
We've been doing some digital testing of

00;03;52;19 - 00;03;56;01
messaging related to
to Rethink Your Drink, focusing on

00;03;56;17 - 00;04;00;09
some of the negative health consequences,
but also choosing water

00;04;00;09 - 00;04;04;06
and other beverages and then we've been
kind of testing these in real times.

00;04;04;06 - 00;04;07;18
We did some Google ad buys
and other things to see the response.

00;04;08;03 - 00;04;11;12
Here are some examples of some of the
the digital ads we've been using

00;04;11;12 - 00;04;15;05
and we've really been learning in time
and updating based on what

00;04;15;05 - 00;04;16;10
we're hearing from

00;04;16;10 - 00;04;19;28
from people in terms of what's resonating,
what kind of imagery is resonating.

00;04;20;12 - 00;04;24;15
And then we link these to our Rethink
Your Drink web page.

00;04;24;15 - 00;04;27;00
So feel free to check that out as well.

00;04;27;00 - 00;04;29;28
That has some broader information
on reducing added sugars.

00;04;30;22 - 00;04;35;06
So these ads can be found in our State
Community Health Media Center.

00;04;35;19 - 00;04;37;20
There is a web address there.

00;04;38;00 - 00;04;41;07
These ads, along with lots of other great
ads, can be found there.

00;04;41;07 - 00;04;45;06
These are either free or low cost.
The ones that CDC produces are free.

00;04;45;28 - 00;04;49;04
They're audience tested
and so have supporting materials

00;04;49;14 - 00;04;50;23
in English, in other languages.

00;04;50;23 - 00;04;54;19
We uploaded some great new photos
that could be used for your work

00;04;54;19 - 00;04;58;11
beyond added sugars,
but great new diverse imagery too there.

00;04;58;11 - 00;05;01;14
So if you're not already part
of the State Community Health Media Center

00;05;02;04 - 00;05;04;25
log in and join
and have some access to those things.

00;05;05;07 - 00;05;07;19
Also, you'll hear from Alaska later today.

00;05;07;19 - 00;05;09;28
And they have some of their materials
in the media center.

00;05;09;28 - 00;05;14;09
So a great resource for you all. Also
just want to note that DNPAO

00;05;14;19 - 00;05;19;15
has a set of multimedia tools,
infographics, badges, audio, etc.

00;05;19;15 - 00;05;22;01
So there's a URL for that as well.

00;05;22;17 - 00;05;25;18
Let's get to the real purpose for today,
and we have a really great panel.

00;05;25;18 - 00;05;27;19
I'm excited about our panel today

00;05;27;19 - 00;05;29;23
and the information
that they have to share with you.

00;05;29;23 - 00;05;30;13
So I'm going to do a

00;05;30;13 - 00;05;33;21
little introduction now
and then we're just going to keep moving

00;05;34;07 - 00;05;37;15
and not stop in between,
and then we'll finish with some Q&A.

00;05;37;25 - 00;05;39;24
So first, I'm pleased to have Dr.

00;05;39;24 - 00;05;41;12
Sohyun Park joining us.

00;05;41;12 - 00;05;43;18
She is my colleague at DNPAO.

00;05;43;18 - 00;05;46;00
She's been with DNPAO since 2009.

00;05;46;10 - 00;05;47;23
She's a lead epidemiologist

00;05;47;23 - 00;05;51;18
and she's contributed to a wealth
of expertise and experience in the areas

00;05;51;18 - 00;05;55;21
of added sugar, sugar sweetened beverages,
drinking water and obesity.

00;05;56;03 - 00;05;59;19
Dr. Park has authored more than 130 peer
reviewed manuscripts,

00;05;59;19 - 00;06;03;13
four reports,
two book chapters and 126 abstracts.

00;06;03;13 - 00;06;04;12
And she's an author.

00;06;04;12 - 00;06;07;27
I think on most of those articles
I shared with you on the previous slide.

00;06;08;11 - 00;06;11;13
Next, super excited to be joined by Dr.

00;06;11;13 - 00;06;12;11
Fran Fleming.

00;06;12;11 - 00;06;14;02
She is the director of Marketing
Initiatives

00;06;14;02 - 00;06;17;29
at the Rudd Center for Food Policy and
Health at the University of Connecticut.

00;06;18;08 - 00;06;22;29
Her work focuses on analyzing the amount
type and nutrition of foods

00;06;22;29 - 00;06;26;26
and beverages marketed to children,
adolescents and parents of young children.

00;06;26;28 - 00;06;29;19
She also determines
the effects of exposure of food marketing

00;06;29;29 - 00;06;32;20
and examines
race, racial and ethnic differences

00;06;32;27 - 00;06;36;11
in race and exposure and the impact
of targeted marketing practices.

00;06;37;06 - 00;06;40;19
And then lastly, we'll hear
a great presentation from our colleague

00;06;40;19 - 00;06;44;11
Ann Potempa. She’s the Chronic Disease
Communications Team lead

00;06;44;17 - 00;06;46;16
in the Alaska Department of Public Health.

00;06;46;16 - 00;06;48;16
She has focused her career on health
communication

00;06;49;02 - 00;06;51;11
and education for more than 20 years.

00;06;51;11 - 00;06;55;09
She started and continues to manage the state’s
ten year-old Play Every Day

00;06;55;15 - 00;06;58;18
social marketing campaign, which promotes
increased opportunities for daily

00;06;58;18 - 00;07;01;23
physical activity
and decreased consumption of added sugars.

00;07;02;04 - 00;07;03;04
In addition, Ms..

00;07;03;04 - 00;07;06;16
Potempa provides public health,
social marketing and health communication

00;07;06;26 - 00;07;10;21
consultation to agencies and partners
nationally and internationally.

00;07;11;05 - 00;07;12;28
So you can see we have a great panel
today.

00;07;12;28 - 00;07;16;15
Excited to get started with our panel.

00;07;16;15 - 00;07;20;26
And for that I would like to now
turn it over to my colleague, Dr.

00;07;20;26 - 00;07;21;18
Sohyun Park.

00;07;22;27 - 00;07;24;21
Thank you, Janelle.

00;07;24;29 - 00;07;26;01
Good afternoon.

00;07;26;01 - 00;07;29;25
Thanks for giving me this opportunity
to share our work on sugar

00;07;29;25 - 00;07;31;20
sweetened beverages.

00;07;31;20 - 00;07;34;09
Some examples of added sugars

00;07;34;09 - 00;07;38;11
include, but not limited to sucrose,
dextrose, tables

00;07;38;11 - 00;07;42;12
sugars, syrups,
honey and sugars from concentrate.

00;07;42;25 - 00;07;47;04
Adverse health consequences
associated with eating and drinking

00;07;47;04 - 00;07;49;24
too much added sugars include obesity,

00;07;50;08 - 00;07;53;25
type two diabetes, cardiovascular disease
and dental carries.

00;07;54;21 - 00;07;57;16
Sugar sweetened beverages,
also known as SSB,

00;07;57;27 - 00;08;02;21
are liquids sweetened with various forms
of added sugars that add calories

00;08;02;28 - 00;08;06;24
such as regular soda,
fruit drinks, sweetened coffee

00;08;07;09 - 00;08;10;17
and tea drinks and sports and energy
drinks.

00;08;11;08 - 00;08;13;18
SSBs are the leading sources

00;08;13;18 - 00;08;16;01
of added sugars in the American diet.

00;08;16;20 - 00;08;19;08
Today
I'm going to share three recent studies

00;08;19;08 - 00;08;22;27
that we published on added
sugars and sugar sweetened beverages.

00;08;23;15 - 00;08;27;26
For the first study,
we examined characteristics of US

00;08;27;26 - 00;08;32;29
children and adolescents
who reported high intake of added sugars

00;08;33;10 - 00;08;37;05
and eating occasions
and top sources of added sugars

00;08;37;05 - 00;08;41;03
that contributed to
intakes among high consumers.

00;08;42;07 - 00;08;43;01
We used the

00;08;43;01 - 00;08;47;05
National Health and Nutrition
Examination Survey data

00;08;47;07 - 00;08;51;07
from 2015 to 2018 among over

00;08;51;07 - 00;08;55;12
5200 youths aged 2 to 19 years.

00;08;56;11 - 00;09;01;03
In this study, we defined high consumers
as consuming greater

00;09;01;03 - 00;09;06;04
than 15% of total daily calorie
intake from added sugars.

00;09;06;18 - 00;09;11;00
So this is 1.5 times higher than 2020

00;09;11;00 - 00;09;16;01
to 2025 Dietary Guidelines
for Americans recommendations,

00;09;16;08 - 00;09;20;16
which is less than 10% of total daily
calorie intake.

00;09;21;17 - 00;09;23;19
Variables of interest were selected

00;09;23;20 - 00;09;27;18
sociodemographic characteristics
of youth in household.

00;09;28;09 - 00;09;31;04
In result, we found that overall

00;09;31;17 - 00;09;34;06
34.4% of the youth

00;09;34;15 - 00;09;36;21
were classified as high consumers.

00;09;37;20 - 00;09;41;06
When we look at by characteristics, the prevalence of high

00;09;41;06 - 00;09;46;03
consumers was significantly higher
among older children,

00;09;46;23 - 00;09;52;09
non-Hispanic black or white children,
and children with head of household

00;09;52;09 - 00;09;57;08
education of high school or some college
compared to their counterparts.

00;09;57;29 - 00;10;00;20
By eating occasions among high consumers,

00;10;01;16 - 00;10;06;20
41% of added sugars
were consumed during snack occasions

00;10;06;20 - 00;10;11;00
followed by dinner time 23%, lunch time,

00;10;11;00 - 00;10;14;24
20% and breakfast time, 17%.

00;10;16;01 - 00;10;17;29
And here are five

00;10;17;29 - 00;10;21;13
leading sources of added sugars,
which together

00;10;21;17 - 00;10;25;12
providing about 80% of added sugars

00;10;25;13 - 00;10;27;28
among high consumers on a given day.

00;10;29;08 - 00;10;33;10
43% of the contribution
came from sweetened beverages,

00;10;33;15 - 00;10;37;04
followed by 15% from sweet bakery

00;10;37;04 - 00;10;39;19
products, 9% from candy,

00;10;40;05 - 00;10;42;14
7% from other desserts,

00;10;42;20 - 00;10;45;12
and 5% from ready to eat cereals.

00;10;45;20 - 00;10;51;00
For the second studies, we examined
the characteristics of US adults

00;10;51;13 - 00;10;54;10
who reported high intakes of added sugars

00;10;54;29 - 00;10;58;24
and eating occasions
and top sources of added sugars

00;10;59;09 - 00;11;02;24
that contributed to intakes
among high consumers.

00;11;03;29 - 00;11;08;12
We used National Health and Nutrition
Examination Survey data

00;11;08;26 - 00;11;14;08
from 2015 to 2018 among over 9600 adults

00;11;14;21 - 00;11;16;28
aged 20 years and older.

00;11;18;04 - 00;11;20;02
Same as the children’s study,

00;11;20;02 - 00;11;23;15
we defined high consumers
as consuming greater

00;11;23;15 - 00;11;28;12
than 15% of total daily
calorie intake from added sugars.

00;11;29;17 - 00;11;32;07
Variables of interest were selected
sociodemographic

00;11;32;07 - 00;11;35;22
characteristics
of adults in household.

00;11;36;17 - 00;11;40;29
In result, we found that overall about 30%

00;11;40;29 - 00;11;44;14
of adults
were classified as high consumers.

00;11;45;04 - 00;11;49;08
When we look at by characteristics,
the prevalence of high consumers

00;11;49;08 - 00;11;54;14
was significantly higher
among younger adults, non-Hispanic black.

00;11;54;23 - 00;11;59;10
Were white adults, adults
with lower education level

00;12;00;25 - 00;12;03;15
as well as adults who were not married

00;12;03;22 - 00;12;07;17
or adults with a lower incomes
compared to their counterparts.

00;12;08;24 - 00;12;10;28
By eating occasions among high

00;12;10;28 - 00;12;15;09
consumers of added
sugars, the contribution of

00;12;15;09 - 00;12;20;02
intake from added
sugar was highest during snack occasions

00;12;20;24 - 00;12;26;09
43%, and followed by dinner time
24%, and lunch

00;12;26;09 - 00;12;29;18
time, 19% and breakfast time,

00;12;29;18 - 00;12;32;03
which was 15% on a given day.

00;12;33;12 - 00;12;38;04
Here are the top five leading sources
of added sugars, which together

00;12;38;04 - 00;12;41;14
providing about 76% of added

00;12;41;18 - 00;12;44;17
sugars
among high consumers on a given day.

00;12;46;04 - 00;12;49;25
42% of the contribution
came from sweetened beverages,

00;12;50;08 - 00;12;52;27
followed by 12% from tea,

00;12;53;17 - 00;12;56;09
11% from sweet bakery products,

00;12;56;20 - 00;12;59;21
7% from jams, syrups, sugars

00;13;00;02 - 00;13;02;06
and 5% from candy.

00;13;03;05 - 00;13;06;14
For the third study, we estimated

00;13;06;20 - 00;13;11;10
dietary intake of added sugars
by 50 states and DC,

00;13;12;00 - 00;13;17;17
and also examined the factors associated
with added sugar intake among US

00;13;17;17 - 00;13;20;26
adults. To increase the sample size,

00;13;20;29 - 00;13;27;00
we combined 2010 and 2015
National Health Interview Survey Cancer

00;13;27;00 - 00;13;30;23
Control Supplement,
which had dietary intake data

00;13;30;23 - 00;13;33;13
among over 52,000 adults.

00;13;34;25 - 00;13;39;05
Using nine questions on beverages
and food with added sugars,

00;13;39;21 - 00;13;43;08
dietary added
sugar intakes were estimated.

00;13;44;13 - 00;13;47;05
Exploratory measures were selected
sociodemographic

00;13;47;05 - 00;13;51;11
characteristics,
census regions, and states.

00;13;52;08 - 00;13;54;18
Overall, the estimated

00;13;54;18 - 00;13;57;27
mean dietary intake of added sugar

00;13;58;04 - 00;14;00;20
was 17 teaspoons per day

00;14;01;02 - 00;14;05;13
among US adults in 2010 and 2015.

00;14;06;22 - 00;14;08;02
Estimated added

00;14;08;02 - 00;14;11;22
sugar intake varied
by sociodemographic characteristics.

00;14;12;18 - 00;14;14;23
For example, mean added

00;14;14;23 - 00;14;17;19
as sugar intake was significantly higher

00;14;18;04 - 00;14;20;10
among younger adults, male

00;14;20;20 - 00;14;25;07
non-Hispanic black or Hispanic adults,
those who were not married,

00;14;26;01 - 00;14;29;24
adults with a lower education,
or lower household income.

00;14;30;10 - 00;14;34;29
Adults living in the non-metropolitan,
and adults two living in Northeast

00;14;35;03 - 00;14;39;06
Midwest, or South
compared to their counterparts.

00;14;40;04 - 00;14;42;23
For the first time, we were able to report

00;14;43;01 - 00;14;46;25
added a sugar intake
for all 50 states and D.C..

00;14;48;01 - 00;14;49;25
As shown in this map

00;14;49;25 - 00;14;51;29
estimated added the sugar intake

00;14;52;09 - 00;14;58;18
varied by state and ranged from 14.8
teaspoons per day in Alaska

00;14;59;04 - 00;15;03;10
to 21.2 teaspoons per day in Kentucky.

00;15;04;26 - 00;15;08;18
That concludes my presentation
and thank you for your time.

00;15;08;29 - 00;15;11;29
Now I will turn it over
to Dr. Fran Fleming.

00;15;13;18 - 00;15;15;11
Thank you, Suzanne.

00;15;15;11 - 00;15;17;26
So, hi, my name is Dr.

00;15;18;04 - 00;15;22;07
Fran Fleming-Milici, and I am from the Rudd Center
for Food Policy and Health.

00;15;22;21 - 00;15;26;15
I'm going to talk to you today
about sugary drink

00;15;26;15 - 00;15;28;26
marketing to children
and parents of young children.

00;15;29;19 - 00;15;32;03
So first, I'm going to talk about why

00;15;32;03 - 00;15;34;17
we study
sugary drink marketing to young children.

00;15;35;07 - 00;15;39;11
Research conducted at the Rudd Center
and by many other researchers

00;15;40;01 - 00;15;44;17
has concluded that marketing sugary drinks
to young children

00;15;44;17 - 00;15;49;10
influences their attitudes and preferences
for the drinks that are marketed.

00;15;50;04 - 00;15;54;00
And it also increases
is what we call pester power.

00;15;54;13 - 00;15;57;26
If anyone has spent any time with a child

00;15;58;06 - 00;16;03;03
and unhealthy food in the area,
they know what I'm talking about.

00;16;03;08 - 00;16;07;08
When a child sees marketing
for an unhealthy product,

00;16;07;23 - 00;16;12;00
it's determined that this is something
that really influences

00;16;12;17 - 00;16;16;14
pestering adults for purchasing of it
or for wanting it.

00;16;17;04 - 00;16;19;09
And then finally, we know that

00;16;20;17 - 00;16;22;04
marketing also

00;16;22;04 - 00;16;26;03
influences consumption of sugary drinks
that are available

00;16;26;08 - 00;16;29;04
and also has effects of longer term
consumption.

00;16;29;13 - 00;16;31;23
So the following images on
the slides are examples.

00;16;31;23 - 00;16;33;22
So I just wanted to note that.

00;16;33;22 - 00;16;36;12
So how are children
exposed to sugary drink marketing?

00;16;36;29 - 00;16;42;28
So many of us think about
advertising on TV as a major contributor,

00;16;42;28 - 00;16;45;17
or we think about advertising,
we think of TV ads.

00;16;45;28 - 00;16;50;03
But that's just one way kids are exposed
to marketing of sugary drinks.

00;16;50;18 - 00;16;53;18
Now, a lot of us as adults

00;16;53;18 - 00;16;56;14
and also children are spending
a lot of time on other screens.

00;16;56;26 - 00;17;01;23
And unhealthy sugary drinks are marketed
to children in that space.

00;17;02;09 - 00;17;06;22
They are also marketed to children
in other ways, including store displays

00;17;07;01 - 00;17;11;16
on the front of package of products
that you'll see in the supermarket,

00;17;12;08 - 00;17;15;23
outdoor, outside advertising,
and then at events

00;17;15;23 - 00;17;19;05
that are for families
such as, you know, parades or concerts.

00;17;19;18 - 00;17;22;13
When we've studied
sugary drink marketing recently

00;17;22;21 - 00;17;24;24
and in a report
that I'm about to talk about,

00;17;25;02 - 00;17;28;29
we focused on two categories of drinks
marketed

00;17;28;29 - 00;17;32;13
to young children, sweetened drinks,
and they include flavored waters,

00;17;32;23 - 00;17;36;07
fruit drinks and drink
mixes and unsweetened drinks.

00;17;36;07 - 00;17;41;02
And these are the 100% juice products
and also the newer products

00;17;41;02 - 00;17;44;22
that are on the market
that are a blend of juice and water.

00;17;45;05 - 00;17;49;10
So in this report, we looked at the sales,
nutrition and marketing of these drinks

00;17;49;21 - 00;17;53;24
and we found that when it look,
we look at sugary drinks sales,

00;17;54;00 - 00;17;59;04
really the vast majority of sales, 62%,
are for sweetened children's drinks.

00;17;59;04 - 00;18;02;24
It's fruit drinks and flavored waters.
Less on unsweetened.

00;18;03;07 - 00;18;08;29
And then when we look at the nutrition,
we find that 65% contain added sugars

00;18;09;09 - 00;18;13;15
and many also contain what we call diet
sweeteners, which is something that

00;18;14;18 - 00;18;16;27
is a term
that's not the most popular term.

00;18;16;27 - 00;18;20;17
But certainly non-nutritive sweeteners
is something that is

00;18;20;29 - 00;18;24;00
we use as researchers,
but it's not something that comes to mind

00;18;24;19 - 00;18;28;23
when other people are thinking
about these these sweeteners.

00;18;29;11 - 00;18;32;26
And these include natural sweeteners
such as stevia,

00;18;32;28 - 00;18;37;12
stevia leaf extract or monk fruit
are also sucralose and other things

00;18;37;21 - 00;18;39;13
like that, low calorie sweeteners.

00;18;39;13 - 00;18;42;12
So a lot of children's
drinks contain these

00;18;43;13 - 00;18;46;11
diet sweeteners and we were really
surprised about that in our research.

00;18;46;27 - 00;18;51;11
We also found that most of the products
contained images of fruit

00;18;51;11 - 00;18;56;15
on the packaging,
but only 35% contained any juice at all.

00;18;56;27 - 00;18;59;02
And then the sweetened drinks
that we studied,

00;18;59;18 - 00;19;03;07
a third of them contained four
or more teaspoons of added sugar.

00;19;03;19 - 00;19;07;09
And when we look at the exposure
just on TV alone,

00;19;07;16 - 00;19;11;16
we found that children saw two times
as many ads for the sweetened drinks

00;19;11;16 - 00;19;14;07
as they did for drinks
without added sweeteners.

00;19;14;17 - 00;19;18;13
And for these sweetened drinks,
they saw four times as many ads as adults saw.

00;19;18;22 - 00;19;22;17
So these
these ads on TV are directed to children.

00;19;23;20 - 00;19;26;15
We recently we just studied

00;19;26;15 - 00;19;29;18
food and beverages on YouTube channels.

00;19;30;10 - 00;19;35;17
These are this is a space that is really
popular for young children to be in now.

00;19;36;03 - 00;19;40;17
When we looked at these YouTube
made for kids child influencer channels,

00;19;40;28 - 00;19;44;15
we found that four out of every ten videos
that we examined

00;19;44;22 - 00;19;46;02
had branded food or drinks.

00;19;46;02 - 00;19;50;13
And this is mostly candy, salty snacks
and also sugary drinks and ice cream.

00;19;50;25 - 00;19;53;20
And when you look at the numbers
for these, it's pretty shocking.

00;19;54;19 - 00;19;58;26
The the this these two channels here,
you can see the high numbers alone.

00;19;59;21 - 00;20;01;26
But, you know, taken together,

00;20;02;06 - 00;20;05;22
the amount of exposure
that children can get

00;20;05;22 - 00;20;09;23
by by viewing these child influencer
videos is really quite high.

00;20;10;05 - 00;20;14;11
And the children in these videos
are not only showing

00;20;14;11 - 00;20;17;17
these products in the background,
but they're also interacting with them

00;20;17;17 - 00;20;18;25
or consuming them.

00;20;18;25 - 00;20;21;07
And we know from other research
that that's something

00;20;21;07 - 00;20;25;04
that could really influence children
even more than just a static placement.

00;20;26;06 - 00;20;27;24
And more recently,

00;20;27;24 - 00;20;32;09
the past few years, we've focused
on two categories of sugary drinks

00;20;32;09 - 00;20;35;19
that are marketed to parents
as appropriate for young children.

00;20;36;02 - 00;20;40;07
I call these gateway sugary drinks
because they're really the drinks

00;20;40;07 - 00;20;44;18
that young children would be most likely
to consume first in their life lifetime.

00;20;45;17 - 00;20;48;28
Neither of these drinks are recommended
by child health experts.

00;20;49;13 - 00;20;52;07
They're marketed to parents
as healthy or necessary.

00;20;52;07 - 00;20;55;29
And we know that the marketing influences
parents choices.

00;20;56;05 - 00;20;57;25
As Janelle pointed out,

00;20;57;25 - 00;21;02;00
children under the age of two
on the new based on the new DGAs,

00;21;02;00 - 00;21;04;16
should not have any added sugar at all.

00;21;05;02 - 00;21;08;26
But as I'm about to show you, the products
that are marketed to them

00;21;08;27 - 00;21;12;09
or marketed to parents as appropriate
for them do have added sugar.

00;21;12;22 - 00;21;15;16
So fruit
drinks are frequently marketed as healthy.

00;21;15;16 - 00;21;19;09
As I mentioned earlier, with pictures
of fruit, or lots of different

00;21;19;09 - 00;21;24;17
claims on the front of package
about things being natural or healthy

00;21;24;17 - 00;21;28;13
or having water
as in the term on the front of

00;21;28;14 - 00;21;32;02
a package that really confuses
and misleads parents.

00;21;32;15 - 00;21;35;13
And when we've talked to parents
in focus groups,

00;21;35;27 - 00;21;39;18
we find that these techniques
that companies use are really

00;21;40;24 - 00;21;41;24
influential.

00;21;41;24 - 00;21;45;23
So one parent said that when they see
the pictures of fruit in the packaging,

00;21;45;23 - 00;21;49;03
you think that the product actually
has this in it.

00;21;49;19 - 00;21;52;20
And then these products are also cross
branded.

00;21;52;28 - 00;21;54;17
And what I mean by Cross branded

00;21;54;17 - 00;21;57;20
is that some of them have products
that are 100% juice

00;21;58;08 - 00;22;03;09
or these diluted juice water blends,
but also flavored waters and fruit drinks.

00;22;03;18 - 00;22;06;07
And they're all kind of packaged
the same as you see here.

00;22;06;08 - 00;22;09;29
So one parent talked about looking
at the packaging, coming home

00;22;09;29 - 00;22;14;14
from the supermarket and then realizing,
oh, this really isn't 100%

00;22;14;14 - 00;22;17;18
juice that I purchased
and I need to go back and return it.

00;22;18;15 - 00;22;21;25
So the marketing creates
this these misperceptions.

00;22;22;13 - 00;22;23;27
We've done a number of studies.

00;22;23;27 - 00;22;27;27
Parents have a lot of trouble identifying
the ingredients in these drinks

00;22;28;03 - 00;22;31;19
and distinguishing between the unsweetened
and the sweetened options.

00;22;32;00 - 00;22;34;29
People parents have told us
they look for real or natural

00;22;34;29 - 00;22;38;15
or vitamin C when they're
purchasing drinks for their child.

00;22;38;23 - 00;22;42;26
But these types of claims
are really common on sweetened drinks.

00;22;43;10 - 00;22;46;26
And while parents are concerned about diet
sweeteners and do not want to give them

00;22;46;26 - 00;22;51;14
to their children, they don't recognize
that children's drinks contain them.

00;22;52;02 - 00;22;55;29
So they misperceive,
you know, fruit drinks as healthy.

00;22;56;05 - 00;22;59;09
And when when in the research
that we've done, we found that when

00;22;59;28 - 00;23;03;02
parents perceive a drink to be health
healthy

00;23;03;02 - 00;23;06;05
for their child, they're more likely
to serve it to their child.

00;23;06;05 - 00;23;09;25
So this contributes to parents’
purchases and serving of a drink.

00;23;10;10 - 00;23;12;19
And toddler milks are another category

00;23;13;00 - 00;23;15;12
that are marketed to parents.

00;23;16;00 - 00;23;19;19
They contain really just powdered
milk, added sugar

00;23;19;19 - 00;23;22;19
and vegetable oils
and other vitamins and additives.

00;23;22;19 - 00;23;26;11
But they are marketed
as the next step after infant formula.

00;23;26;21 - 00;23;30;17
And these drinks have more sodium
and less protein than plain cow's milk.

00;23;30;25 - 00;23;31;27
And they're expensive.

00;23;31;27 - 00;23;33;22
They can cost four times as much.

00;23;33;22 - 00;23;36;16
And giving a child
sweetened drinks at this age

00;23;36;22 - 00;23;40;15
may increase a child's preference
for sweet and then also cause them

00;23;40;15 - 00;23;43;22
to dislike the unsweetened drinks
that a parent tries to introduce.

00;23;44;10 - 00;23;47;07
But if you look at the claims
on the packaging, you would never know

00;23;47;07 - 00;23;50;26
that these drinks have added sugar
or are not appropriate

00;23;51;05 - 00;23;56;01
because they're filled with claims
and it makes parents feel as if they need

00;23;56;01 - 00;23;58;23
to give these to their child
for their child to be healthy.

00;23;59;18 - 00;24;03;06
The other issue is that they're
put right next to trusted infant formula

00;24;03;14 - 00;24;05;01
and they look very similar.

00;24;05;01 - 00;24;07;27
So parents have talked
about seeing them on the shelf

00;24;08;02 - 00;24;11;21
when their child, a toddler,
is a picky eater, which is very common

00;24;12;07 - 00;24;15;05
for something like picky
eating is a very common thing

00;24;15;05 - 00;24;20;09
for a type of toddler to experience
or for parents to maybe get frustrated by.

00;24;20;10 - 00;24;26;02
But these products are marketed
as, you know, the answer to the problem.

00;24;26;09 - 00;24;29;05
And if you look at the packaging,
they look very similar

00;24;29;05 - 00;24;30;08
to the infant formula.

00;24;30;08 - 00;24;32;19
Parents trust these products.

00;24;32;19 - 00;24;34;05
The infant formula products.

00;24;34;05 - 00;24;39;16
And so that trust can get put right on
to the same brand of toddler milk.

00;24;40;05 - 00;24;43;28
So again, we found that
marketing influences parents’

00;24;43;28 - 00;24;45;29
purchases of these products.

00;24;45;29 - 00;24;50;17
So the marketing claims mislead
parents about the product's benefits.

00;24;51;09 - 00;24;55;06
And parents believe
that the marketing claims are true.

00;24;55;07 - 00;24;58;13
But if you look a little bit further,
they're not supported

00;24;58;13 - 00;25;00;10
by any type of science.

00;25;00;10 - 00;25;05;12
And parents who believe that the marketing
claims were real and believed in them

00;25;05;16 - 00;25;08;27
were more likely to serve their toddler
milks to their child.

00;25;09;12 - 00;25;12;25
And the other issue is that caregivers
have provided these to infants.

00;25;13;02 - 00;25;16;03
Infant formula is specially formulated
for infants

00;25;16;03 - 00;25;18;23
needs, and toddler
milks should not be given to infants.

00;25;19;03 - 00;25;22;22
But we have done research
and found out that that has happened.

00;25;23;17 - 00;25;27;15
So we've done a lot of research
and there are a lot of efforts

00;25;27;15 - 00;25;30;02
around addressing sugary drink marketing
that we've done.

00;25;30;02 - 00;25;33;08
We've created counter marketing videos
to reduce parents

00;25;33;08 - 00;25;36;29
provision of toddler milks
and fruit drinks to their young children.

00;25;37;08 - 00;25;39;20
And they're available
in English and Spanish.

00;25;40;00 - 00;25;45;01
We also have filed an FDA citizen petition
requesting that the labeling of toddler

00;25;45;01 - 00;25;48;14
milks change so that parents understand
what these drinks really are.

00;25;49;02 - 00;25;52;28
We also have done research to determine
what might be best

00;25;52;28 - 00;25;56;00
to put on the front of package
so that parents know

00;25;56;00 - 00;25;59;15
the ingredients that are in the drinks
that they're selecting for their children.

00;26;00;04 - 00;26;04;09
And we submitted research and comments
recently to the FTC,

00;26;04;17 - 00;26;08;02
and they've been investigating ways
to protect kids

00;26;08;02 - 00;26;10;26
from stealth marketing on digital media.

00;26;11;13 - 00;26;15;29
And we continue to challenge
industry, industry with our research.

00;26;16;09 - 00;26;19;20
And we examined racial and ethnic targeted
marketing

00;26;20;08 - 00;26;23;26
to try and get policy
changes and company changes.

00;26;24;09 - 00;26;25;10
Thank you.

00;26;25;18 - 00;26;30;01
I want to thank you,
thank the team and our funders

00;26;30;13 - 00;26;34;18
for being able to fund the research
and for all the effort

00;26;34;18 - 00;26;38;21
that gets put into the research
that I just presented here.

00;26;39;03 - 00;26;41;04
And here are the references

00;26;41;04 - 00;26;45;07
and here are links
to all of the resources that we have.

00;26;45;08 - 00;26;49;12
I believe that they will also be sent
to people

00;26;49;12 - 00;26;52;02
who are participating
in this webinar today.

00;26;52;12 - 00;26;53;29
Thanks very much for your time.

00;26;53;29 - 00;26;56;18
It's an honor
to be here to present to you.

00;26;56;18 - 00;26;59;16
Next up, Ann is going to be talking to you.

00;27;00;21 - 00;27;01;29
Thank you so much.

00;27;01;29 - 00;27;04;18
My name is Ann Potempa
and I am a public health

00;27;04;18 - 00;27;07;00
communications specialist in Alaska.

00;27;07;22 - 00;27;11;08
It was great to hear that presentation
on sugary drink marketing.

00;27;11;08 - 00;27;13;26
And I'm going to be talking about
how we use

00;27;13;26 - 00;27;17;19
in Alaska social marketing campaigns
to promote the opposite,

00;27;17;19 - 00;27;21;06
to promote healthy drinks
like water and unflavored white milk.

00;27;22;00 - 00;27;26;08
So Alaska is a recipient of the CDC's
State Physical Activity

00;27;26;17 - 00;27;31;05
and Nutrition grant. In each state
that receives this grant has its own

00;27;31;05 - 00;27;33;25
unique way of addressing
the grant objectives.

00;27;34;28 - 00;27;37;18
I'm going to talk to you
about how Alaska's Physical activity

00;27;37;18 - 00;27;41;13
and nutrition program integrated
a social marketing campaign called Play

00;27;41;13 - 00;27;44;23
Every Day into its work
to support the grant objective

00;27;44;23 - 00;27;48;07
of improving nutrition
for families of preschool age children.

00;27;48;28 - 00;27;52;11
Play Every Day is an evidence
based campaign with the goal of promoting

00;27;52;12 - 00;27;56;05
health behaviors that help Alaska children
grow up at a healthy weight.

00;27;56;19 - 00;27;58;23
And that's a really important goal
in our state

00;27;58;23 - 00;28;03;05
where about one out of three children
is growing up with overweight or obesity.

00;28;03;25 - 00;28;08;06
We call Alaska's campaign Play Every Day
because it started with the emphasis

00;28;08;06 - 00;28;12;23
of increasing opportunities for kids to
get closer to the national recommendation

00;28;12;23 - 00;28;16;22
for daily physical activity, or,
as we call it, play every day.

00;28;17;17 - 00;28;21;07
In more recent years, we've added
messaging focused on reducing sugary

00;28;21;07 - 00;28;25;15
drink consumption among children
and promoting water or white milk instead.

00;28;26;16 - 00;28;27;10
Today, I'm going to

00;28;27;10 - 00;28;31;05
discuss an evaluation that showed Alaska's
mothers changed the drinks

00;28;31;05 - 00;28;34;19
they served their families
because of our Play Every Day campaign.

00;28;35;10 - 00;28;38;25
I'm proud to say that I helped launch Play
Every Day more than ten years ago

00;28;38;25 - 00;28;42;04
with our state's physical activity
and nutrition program manager,

00;28;42;13 - 00;28;44;24
and it's been running continuously
since that.

00;28;45;14 - 00;28;48;03
We've been able to accomplish that
by using innovative

00;28;48;03 - 00;28;51;13
partnerships
and by braiding multiple funding sources

00;28;51;13 - 00;28;55;05
that includes federal grants across
various health programs.

00;28;56;03 - 00;28;59;20
Twice during the past decade,
we've completed evaluations that show

00;28;59;20 - 00;29;04;06
the campaign is reaching our priority
audience, improving knowledge about drinks

00;29;04;16 - 00;29;07;28
and positively changing behaviors
that are related to nutrition.

00;29;08;25 - 00;29;12;12
Today, I'm going to focus on
our most recent evaluation that showed

00;29;12;12 - 00;29;16;12
how the Play Every Day campaign
reached a priority group of Alaska parents

00;29;17;00 - 00;29;20;11
to motivate serving fewer
sugary drinks to their young children.

00;29;21;16 - 00;29;24;20
As a social marketing campaign,
we follow key steps.

00;29;25;00 - 00;29;28;19
We use research to inform
and to evaluate our work.

00;29;29;06 - 00;29;33;18
We hold focus groups with parents
in our priority audience, including those

00;29;33;18 - 00;29;37;03
who say they regularly serve sugary drinks
to their young children.

00;29;37;25 - 00;29;41;19
We use those groups to better understand
parents knowledge, attitudes

00;29;41;19 - 00;29;46;08
and behaviors, and we also use them
to test messages before we finalize them.

00;29;46;26 - 00;29;49;01
Play Every Day shares motivating messages

00;29;49;01 - 00;29;50;21
in many ways.

00;29;50;21 - 00;29;54;12
This includes working with key partners,
including child care and preschool

00;29;54;12 - 00;29;59;01
providers, health care providers
and a nonprofit tribal organization

00;29;59;01 - 00;30;01;27
providing health care services
for Alaska Native families.

00;30;02;20 - 00;30;05;08
It includes reaching parents
wherever they are.

00;30;05;20 - 00;30;09;14
That includes paid placement of messages
through short public service

00;30;09;14 - 00;30;13;03
announcements
on TV, through websites and social media,

00;30;13;16 - 00;30;17;00
and on print materials
that are really easy for us in Alaska

00;30;17;00 - 00;30;20;04
to mail and distribute
to remote rural parts of our state.

00;30;21;01 - 00;30;24;21
It also includes writing blogs
and sharing them through listservs

00;30;24;29 - 00;30;27;07
that can reach thousands of families
each time.

00;30;27;27 - 00;30;31;04
It includes earned media,
which means working with things

00;30;31;04 - 00;30;35;00
like newspapers, TV and radio stations
to get articles published.

00;30;35;18 - 00;30;40;12
This slide shows a recently published article that featured our campaign evaluation.

00;30;41;11 - 00;30;43;12
A number of times during the past decade,

00;30;43;12 - 00;30;47;00
we've tested messages with our priority
audience before we made them.

00;30;47;23 - 00;30;50;09
We want to make sure
we're creating messages that speak

00;30;50;09 - 00;30;53;06
to the audience and spark motivation
to change.

00;30;53;25 - 00;30;58;16
One message that resonated with Alaska
parents was this one that uses social

00;30;58;16 - 00;30;59;09
math.

00;30;59;22 - 00;31;03;15
It uses a simple visual comparison
to show that a small sweetened

00;31;03;15 - 00;31;07;29
fruit drink can have as much sugar
as eight powdered mini donuts.

00;31;08;16 - 00;31;12;20
A little Alaska native girl
in this PSA stacks those donuts

00;31;12;20 - 00;31;16;14
showing that the stack reaches
higher than the top of the drink bottle.

00;31;17;03 - 00;31;21;19
I don't have time to show this right now,
so I've included the link to this video

00;31;21;27 - 00;31;22;16
at the bottom.

00;31;22;16 - 00;31;25;28
You can also find our campaign's
YouTube channel at YouTube.

00;31;27;15 - 00;31;28;16
YouTube.com.

00;31;28;16 - 00;31;29;21
slash, Play Every Day AK

00;31;29;21 - 00;31;31;25
I'll have links on the last slide.

00;31;32;26 - 00;31;35;14
It's important
to evaluate social marketing campaigns

00;31;35;14 - 00;31;38;08
like Play Every Day
to ensure you're reaching your audience,

00;31;38;18 - 00;31;41;23
improving knowledge
and positively changing health behaviors.

00;31;42;12 - 00;31;46;22
Evaluations can be expensive, particularly
if you plan to create

00;31;46;22 - 00;31;50;21
and field the special survey
just for campaign evaluation alone.

00;31;51;14 - 00;31;55;24
We were successful by using a different
lower cost approach this time.

00;31;56;16 - 00;32;00;08
We leveraged our ability
to add campaign evaluation questions

00;32;00;21 - 00;32;03;28
to a trusted state survey
that was already in place.

00;32;05;04 - 00;32;08;14
We are including questions
on what's called the Alaska Childhood

00;32;08;14 - 00;32;11;28
Understanding Behavior Survey,
which is abbreviated as CUBS.

00;32;12;17 - 00;32;15;06
It's run through our Alaska Division
of Public Health.

00;32;15;20 - 00;32;18;11
It's a systematic survey
with a strong history

00;32;18;11 - 00;32;21;02
in the state,
and it's a great match for our campaign.

00;32;21;22 - 00;32;24;04
Our current materials are geared toward

00;32;24;04 - 00;32;26;13
Alaska parents with preschoolers at home.

00;32;27;04 - 00;32;31;08
This survey is filled out by Alaskan
mothers of three year old children.

00;32;32;14 - 00;32;35;13
We know what
parents time and attention is limited,

00;32;35;13 - 00;32;39;11
especially on surveys like this
that have established sets of questions.

00;32;39;24 - 00;32;42;25
We were able to add about
five questions to the end,

00;32;42;25 - 00;32;45;24
and while small in number,
that these questions really hit

00;32;45;24 - 00;32;49;12
all the key areas we wanted to focus on
for campaign evaluation.

00;32;49;29 - 00;32;52;10
Did our messages reach our audience?

00;32;52;10 - 00;32;55;05
Did they give parents
new information about drinks

00;32;55;05 - 00;32;56;24
They served their kids?

00;32;56;24 - 00;33;00;03
Did parents talk about
and share these messages with others?

00;33;00;16 - 00;33;03;29
And ultimately, did our messages change
what drinks parents

00;33;03;29 - 00;33;06;06
served their young children?

00;33;06;06 - 00;33;09;01
We added our survey questions
in early 2020,

00;33;09;01 - 00;33;11;09
and they will remain on the survey
through this year.

00;33;12;00 - 00;33;15;08
The results on this slide
are from our first year of analysis,

00;33;15;17 - 00;33;20;24
and at that point we analyzed
responses from 476 Alaska mothers.

00;33;21;10 - 00;33;22;12
The analysis showed

00;33;22;12 - 00;33;26;01
that many families were seeing
and hearing a Play Every Day campaign.

00;33;26;20 - 00;33;29;00
34% of Alaskan mothers

00;33;29;00 - 00;33;32;11
had seen the campaign
about sugary drinks in the past 12 months.

00;33;33;05 - 00;33;36;03
Many parents who had seen
it had positive responses.

00;33;36;21 - 00;33;39;25
Among those who saw the campaign, 39%.

00;33;39;25 - 00;33;42;12
said it gave them new information
about drinks they serve.

00;33;42;29 - 00;33;46;11
43% said
they talked about or shared these messages

00;33;46;11 - 00;33;50;04
with others.
And 21% said they changed the drinks

00;33;50;04 - 00;33;54;04
they served their three year old children
because of the campaign messages.

00;33;54;21 - 00;33;58;11
That's one out of five
Alaska parents seeing the campaign

00;33;58;11 - 00;34;01;02
and changing the drinks
they serve because of the messages.

00;34;01;12 - 00;34;05;14
And that's really the ultimate goal
of the campaign to positively change

00;34;05;14 - 00;34;08;26
nutrition behaviors
among Alaska families with young children.

00;34;09;14 - 00;34;12;06
It's been our goal to publish results
from our social marketing

00;34;12;06 - 00;34;15;06
campaign to improve nutrition
among Alaska's families.

00;34;15;06 - 00;34;16;26
And we did that this fall

00;34;16;26 - 00;34;18;04
through a special supplement

00;34;18;04 - 00;34;20;12
of the peer reviewed Health
Promotion Practice journal.

00;34;21;03 - 00;34;25;02
Our findings in this journal are
definitely written in a scientific style.

00;34;25;15 - 00;34;28;13
So I wanted to make sure
that we were also sharing those findings

00;34;28;13 - 00;34;30;25
in more everyday words with the Alaskans
we serve.

00;34;31;16 - 00;34;35;10
I rewrote those results in a blog that we
published on our Play Every Day website.

00;34;35;22 - 00;34;38;10
We shared that statewide
through an email listserv

00;34;38;10 - 00;34;42;02
that is free, and it was opened
by more than 12,500 people.

00;34;42;15 - 00;34;45;16
We also recorded and shared our results
through a podcast

00;34;45;20 - 00;34;48;04
and links
to all of those are on this slide.

00;34;49;00 - 00;34;52;05
It's also our priority
to share our Play Every Day materials

00;34;52;05 - 00;34;55;25
with other public health agencies
across the country at no cost to them.

00;34;56;14 - 00;34;59;06
Over the past
few years, we've submitted many videos

00;34;59;06 - 00;35;03;01
and related messages to the CDC, State
and Community Health Media Center.

00;35;03;22 - 00;35;07;21
That center is an online library
for all types of materials that relate to

00;35;07;21 - 00;35;12;04
physical activity, nutrition and chronic
disease prevention and management.

00;35;13;03 - 00;35;13;27
CDC best

00;35;13;27 - 00;35;18;14
practices for social marketing campaigns
like this one say they are most effective

00;35;18;14 - 00;35;21;21
at improving knowledge and behaviors
when they are sustained

00;35;22;04 - 00;35;25;12
and reach the priority audience
with enough frequency over time.

00;35;26;03 - 00;35;29;25
We've worked really hard to sustain
Play Every Day for more than a decade.

00;35;30;14 - 00;35;35;02
Alaska families now recognize the campaign
and say they make changes because of it.

00;35;35;24 - 00;35;39;09
This year, we will continue our ongoing
evaluation of our sugary

00;35;39;09 - 00;35;41;16
drink campaign about campaign.

00;35;41;16 - 00;35;44;10
We are also this week and next week

00;35;44;13 - 00;35;47;00
conducting focus groups
with our priority audience.

00;35;47;11 - 00;35;51;27
We're testing possible new messages
and focus groups to learn from our priority

00;35;51;27 - 00;35;57;08
audience of parents both in urban
and rural communities across our state

00;35;57;24 - 00;36;01;28
in regions with high obesity prevalence.
We're also making sure that we hear

00;36;01;28 - 00;36;05;14
from parents who say they regularly serve
sugary drinks to their little kids.

00;36;06;06 - 00;36;09;25
And we’ll be creating and sharing
these new messages informed

00;36;09;25 - 00;36;11;27
by these focus groups this summer and fall.

00;36;13;07 - 00;36;13;21
Thank you for

00;36;13;21 - 00;36;17;20
inviting me today to talk about Alaska's
Physical Activity Nutrition program,

00;36;17;20 - 00;36;20;04
our Play Every Day campaign
and our evaluation.

00;36;21;07 - 00;36;23;15
This campaign really does
show the great value

00;36;23;15 - 00;36;26;04
of integrating health communication
and social marketing

00;36;26;04 - 00;36;29;26
into public health programs,
and that that can lead to positive changes

00;36;29;26 - 00;36;33;17
in knowledge, attitudes and behaviors
and ultimately health outcomes.

00;36;34;00 - 00;36;37;29
My name and my phone number
and my email address are on the slide.

00;36;38;06 - 00;36;42;26
We also have our campaign website,
which is playeveryday dot alaska dot gov

00;36;43;11 - 00;36;45;26
and, the URLs for our Facebook

00;36;45;26 - 00;36;49;03
page, Instagram page and YouTube.

00;36;49;03 - 00;36;50;16
Janelle, I'm going to hand it back to you.

00;36;50;16 - 00;36;51;15
Thank you.

00;36;52;14 - 00;36;53;18
Great. Thank you.

00;36;53;18 - 00;36;57;15
I'd like to thank all of our panelists
for a really great presentation today.

00;36;57;29 - 00;36;59;24
I also want to
thank you all in the audience.

00;36;59;24 - 00;37;01;26
I've seen all kind of emotions pop up.

00;37;01;26 - 00;37;04;25
So appreciate your interacting with us.

00;37;05;06 - 00;37;07;24
You can still put your questions
in the Q&A box.

00;37;07;24 - 00;37;10;19
And we're going to move to questions
and answers now.

00;37;11;06 - 00;37;12;20
So thanks again to our panelists.

00;37;12;20 - 00;37;15;03
And let's kick off some questions.

00;37;17;02 - 00;37;18;19
Fran, the first one is for you.

00;37;18;19 - 00;37;22;12
Can you describe the new ways companies
are marketing sugary drinks to youth?

00;37;24;00 - 00;37;27;29
Well, one of the ways that we're
most concerned about is on digital media.

00;37;27;29 - 00;37;30;06
As I discussed

00;37;30;08 - 00;37;32;10
earlier in the presentation.

00;37;32;20 - 00;37;35;25
The really challenging part
about measuring

00;37;35;25 - 00;37;39;10
exposure is that data are not available.

00;37;39;11 - 00;37;43;01
So, for example,
the way that we can measure exposure

00;37;43;10 - 00;37;45;23
to advertising on TV,

00;37;46;01 - 00;37;49;08
there's actually third party data
that gives us numbers.

00;37;49;19 - 00;37;53;02
But on digital media,
we all know that it's

00;37;54;04 - 00;37;56;26
responding to behavior.

00;37;56;26 - 00;37;59;20
When you look for a pair of shoes,
the shoes pop up later

00;37;59;20 - 00;38;01;04
that you were looking for.

00;38;01;04 - 00;38;02;12
We've all experienced that.

00;38;02;12 - 00;38;06;23
Well, the marketing is happening to kids
in the same way when they're shared

00;38;06;23 - 00;38;11;06
spaces on computers, you know, shared time
and any type of behavior

00;38;11;06 - 00;38;15;04
might be encouraging or discouraging,
we don't know.

00;38;15;12 - 00;38;18;00
So we can't get numbers on exposure.

00;38;18;07 - 00;38;23;05
What we do see is that food and beverage
marketers really pioneered marketing

00;38;23;05 - 00;38;28;16
with some of the best campaigns on
digital media, and it's a great concern.

00;38;28;18 - 00;38;32;13
So we are in the research
community, is continuing,

00;38;32;14 - 00;38;37;10
trying to try to do more to understand
it better, understand the effects of it.

00;38;37;21 - 00;38;40;10
And I'm hoping that

00;38;40;10 - 00;38;43;10
there'll be policies that might be able
to restrict some of that.

00;38;44;18 - 00;38;44;29
Thanks.

00;38;44;29 - 00;38;45;27
Thanks for your answer.

00;38;45;27 - 00;38;47;24
Yes, my social media thinks I have

00;38;47;24 - 00;38;51;10
a young child based on the work
we're doing, looking at things.

00;38;51;21 - 00;38;53;08
My kids are older now.

00;38;53;08 - 00;38;55;21
Sohyun, the next question is for you.

00;38;55;22 - 00;38;58;26
What state level
data sources are available for added sugar

00;38;58;26 - 00;39;01;26
intake or sugar
sweetened beverage intake data?

00;39;02;08 - 00;39;05;14
So right now
we don't really have state level data.

00;39;05;17 - 00;39;11;09
The ones that we show, we were able
to combine some of the national survey.

00;39;11;24 - 00;39;14;15
They were collected, but due to redesign

00;39;14;24 - 00;39;17;08
they will no longer collect
every five years.

00;39;18;00 - 00;39;21;08
So the data by states are very limited.

00;39;21;28 - 00;39;26;17
But one way that we try to collect data is
using BRFSS.

00;39;26;21 - 00;39;29;09
So we trying to collect the data,

00;39;30;06 - 00;39;33;15
among others in BRFSS in upcoming years.

00;39;33;15 - 00;39;35;09
So that's the only way.

00;39;35;09 - 00;39;37;18
But often we only have national data.

00;39;37;23 - 00;39;38;29
Thanks Sohyun.

00;39;38;29 - 00;39;42;22
And I would add,
we did have some state level data

00;39;42;22 - 00;39;44;12
for young children

00;39;44;12 - 00;39;47;22
in collaboration BRFSS from
the National Survey of Children's Health.

00;39;48;22 - 00;39;51;03
That was
one of the articles we shared earlier.

00;39;51;04 - 00;39;52;14
So thank you.

00;39;54;00 - 00;39;56;05
Ann, next question is for you.

00;39;56;05 - 00;39;59;02
How do public health agencies
go about funding successful

00;39;59;02 - 00;40;02;23
social marketing campaigns
like the one that you shared with us and

00;40;03;24 - 00;40;06;14
what can be done to help sustain
those year to year?

00;40;08;11 - 00;40;08;23
Thanks.

00;40;08;23 - 00;40;10;24
Those are great question.

00;40;10;27 - 00;40;13;05
Again,
I mentioned that Play Every Day has been able

00;40;13;05 - 00;40;17;12
to be sustained for ten years
and that really has come from

00;40;17;20 - 00;40;21;08
some innovation inside our team
to come up with ways

00;40;22;06 - 00;40;24;17
to to braid funding from multiple

00;40;24;17 - 00;40;27;19
funding sources together.

00;40;27;19 - 00;40;32;28
So what we've learned over the years
is that one grant or one source of funding

00;40;32;28 - 00;40;36;02
typically doesn't
have enough available dollars in it

00;40;36;16 - 00;40;40;04
or it can't be used for all parts
of the social marketing process,

00;40;40;04 - 00;40;45;05
everything from focus groups
to creation to placement, to evaluation.

00;40;45;13 - 00;40;49;24
But by working together across
different programs and different grants,

00;40;50;06 - 00;40;54;01
we can braid that together and have it

00;40;54;04 - 00;40;57;04
go toward the functions of the process
that we need it to.

00;40;57;13 - 00;41;02;15
And then as funding fluctuates over
the years, we can adjust budgets that way.

00;41;02;15 - 00;41;06;17
And that's really been the way that we
have been able to continue this campaign.

00;41;06;29 - 00;41;10;06
And we've borrowed from that strategy
when we have launched new

00;41;10;11 - 00;41;14;06
social marketing campaigns
for other health promotion issues as well.

00;41;14;27 - 00;41;15;18
Thank you.

00;41;16;27 - 00;41;17;29
Fran, if I can direct the

00;41;17;29 - 00;41;21;02
question to you, is milk
considered a sugary drink?

00;41;22;11 - 00;41;26;16
While flavored
milk would be considered a sugary drink

00;41;26;16 - 00;41;30;09
because it has added
sugars, the naturally occurring sugar

00;41;30;09 - 00;41;34;10
that is in milk does not put it
into a category of sugary drinks.

00;41;34;20 - 00;41;37;23
Now, I must add that
I am not a registered dietitian,

00;41;37;23 - 00;41;41;02
but that is my understanding
of the drinks.

00;41;41;02 - 00;41;42;25
And we do,

00;41;42;25 - 00;41;47;19
even though the report I shared we looked
at other types of children's drinks

00;41;48;21 - 00;41;52;14
and in that particular report
we did not look at flavored milks.

00;41;52;23 - 00;41;55;28
But when we collect data
or do other research,

00;41;55;29 - 00;42;00;02
we want to understand a child's
sugary drink consumption,

00;42;00;07 - 00;42;04;01
we do measure their consumption
of flavored milk or parents

00;42;04;01 - 00;42;05;17
serving of flavored milk to the child.

00;42;06;23 - 00;42;09;18
I want to acknowledge
we've got a couple of questions in the Q&A

00;42;09;18 - 00;42;12;22
about the American Heart Association
recommendation for added sugar

00;42;13;04 - 00;42;17;13
and it not being totally in sync
with the Dietary Guidelines for Americans,

00;42;17;13 - 00;42;19;01
I just would point out that they

00;42;19;01 - 00;42;22;22
both recommend that we lower added
sugar intake and that they both recommend

00;42;22;22 - 00;42;25;24
that their young children
don't have any added sugars.

00;42;25;24 - 00;42;29;17
And as you probably know,
the Dietary Guidelines for Americans

00;42;29;17 - 00;42;33;18
that the new committee is in session now

00;42;33;18 - 00;42;36;11
and will be having a new edition in 2025.

00;42;37;17 - 00;42;39;18
Sohyun, if I can direct this question to you,

00;42;39;29 - 00;42;43;23
why did the authors use the greater

00;42;43;23 - 00;42;47;22
than 15% of the DGA recommendation
as a cut off for high consumers?

00;42;48;21 - 00;42;50;15
There's so for

00;42;50;15 - 00;42;52;04
was it based on two things?

00;42;52;04 - 00;42;56;18
So it was also based on the data
distribution and as well as messaging.

00;42;57;14 - 00;43;00;11
So we also have another paper

00;43;00;11 - 00;43;03;12
actually published,
but it wasn't presented today.

00;43;03;20 - 00;43;06;20
So we have
we wanted to have consistent messaging of

00;43;06;20 - 00;43;09;28
what is we
define as high consumers say was

00;43;11;09 - 00;43;13;21
1.5 times higher in that case

00;43;13;25 - 00;43;18;22
was one third of youth or adults
were falling into the category.

00;43;20;01 - 00;43;23;06
And Ann, the next question is for you.
Was there any feedback

00;43;23;06 - 00;43;26;13
from families on social
or marketing materials that surprised you?

00;43;26;27 - 00;43;29;18
Like type of messaging or what was more

00;43;29;18 - 00;43;31;23
or less effective
that your team thought it would be?

00;43;32;23 - 00;43;33;01
Yeah.

00;43;33;01 - 00;43;35;01
One of my favorite parts

00;43;35;01 - 00;43;38;26
of working the social marketing process
is these focus groups.

00;43;39;03 - 00;43;42;29
You get parents in the room
for a couple hours and you hear

00;43;43;13 - 00;43;46;26
just really great stories
of their real life experiences.

00;43;47;00 - 00;43;49;07
What makes sense to them, what doesn't?

00;43;49;07 - 00;43;52;18
I think some of the things and like I
said, we're doing focus groups right now.

00;43;52;18 - 00;43;54;18
We just did one on two nights ago.

00;43;54;18 - 00;43;55;25
I'm going to do one tonight again.

00;43;55;25 - 00;44;00;29
And and we hear we hear that parents
are starting to serve sugary drinks

00;44;00;29 - 00;44;05;03
at really young ages, sometimes
one to sometimes younger than one.

00;44;05;29 - 00;44;08;01
The common drinks that we're seeing, as

00;44;09;01 - 00;44;10;10
you heard the term gateway

00;44;10;10 - 00;44;13;16
drinks before, but chocolate flavored
milk is a big one.

00;44;14;02 - 00;44;16;11
Fruit drinks is the other leading one.

00;44;16;11 - 00;44;20;11
I think what we hear more and more
and we're exploring new messaging on

00;44;20;11 - 00;44;24;11
this front is the the great confusion
between what is a fruit drink

00;44;24;20 - 00;44;28;05
and what is a fruit juice
and how to tell the difference

00;44;28;05 - 00;44;32;06
and how much of even a fruit
juice should be consumed.

00;44;32;08 - 00;44;34;28
So these are some of the things
that we're exploring.

00;44;34;28 - 00;44;37;25
And then, you know, in Frances’ great talk.

00;44;37;25 - 00;44;42;03
All of these words on these front
labels are so confusing to parents.

00;44;42;03 - 00;44;45;27
And so a number of our messages,
when you go on our website,

00;44;45;27 - 00;44;49;10
we have a library of all of our messages
we've made for physical activity

00;44;49;10 - 00;44;51;23
and for sugary drinks,
you're welcome to look through them all.

00;44;51;23 - 00;44;55;00
But we've done a lot of work
trying to get parents

00;44;55;00 - 00;44;58;06
to look beyond the front label
where those buzzwords are

00;44;58;06 - 00;45;02;23
and to turn the bottle around and look for
the includes added sugars line

00;45;03;05 - 00;45;06;26
and sort of the truth
of what is really in these drinks.

00;45;08;04 - 00;45;08;21
Janelle, can I

00;45;08;21 - 00;45;11;21
just add to that, if you don't mind?

00;45;11;24 - 00;45;14;20
I kind of alluded to,
but I didn't go into detail

00;45;15;00 - 00;45;17;23
Ann, I'm really not surprised at all
by what you're

00;45;17;23 - 00;45;20;09
hearing from parents,
because I've heard the same thing, too.

00;45;20;23 - 00;45;22;20
One thing that we just studied is

00;45;22;20 - 00;45;25;12
what would happen
if you put on the front of package.

00;45;25;23 - 00;45;30;13
If a product contained added sugars, diet
sweeteners and the percent juice

00;45;30;22 - 00;45;34;07
on these children's drink products,
the flavor, you know, the sweetened

00;45;34;07 - 00;45;37;24
and the unsweetened ones
just in a very simple box.

00;45;38;03 - 00;45;42;06
And we found that it really helped
parents understand

00;45;43;03 - 00;45;46;29
what was a sugary drink, what wasn't,
and it reduced their perceived

00;45;46;29 - 00;45;50;14
healthfulness of fruit drinks,
which I think is really important.

00;45;51;11 - 00;45;54;02
But, you know,
this is something, again, we need to

00;45;54;02 - 00;45;57;21
we are going to be putting in a petition
to the FDA for changes.

00;45;58;11 - 00;46;02;11
But company, you know,
the industry is really resistant

00;46;02;11 - 00;46;06;04
to change
because they know how these work.

00;46;06;04 - 00;46;11;13
They know that it confuses parents
and so I expect that there'll be

00;46;11;13 - 00;46;15;03
a lot of pushback, just as there is
with other things happening right now.

00;46;15;21 - 00;46;19;00
So it's really frustrating
because in a way it's really transparency

00;46;19;00 - 00;46;19;22
of information.

00;46;19;22 - 00;46;22;02
It's not really telling people what to do.

00;46;22;08 - 00;46;24;19
It's giving people information
for them to decide.

00;46;24;29 - 00;46;27;08
And I think that's something really
everybody could get behind.

00;46;28;14 - 00;46;28;26
Thanks.

00;46;28;26 - 00;46;31;12
And I have another question for you, Fran.

00;46;32;01 - 00;46;36;03
It says the industry spends money
on marketing sugar sweetened beverages and

00;46;36;03 - 00;46;39;28
targets and sort of targeting marketing,
marketing to communities of color.

00;46;39;28 - 00;46;43;05
And could you say something on effective
and promising

00;46;43;11 - 00;46;46;08
strategies to counter that?

00;46;46;08 - 00;46;49;05
Yeah, I mean, the targeted marketing work

00;46;49;05 - 00;46;53;12
that we do
is it's really challenging to all

00;46;53;13 - 00;46;57;01
we need to have to be for companies
to be accountable.

00;46;57;07 - 00;47;01;28
What we what we have found is that we
look at the numbers in terms

00;47;01;28 - 00;47;06;25
of advertising placement on black targeted
channels, on Spanish language channels

00;47;06;25 - 00;47;11;06
and their reach and we see that
the least healthy foods are put

00;47;11;06 - 00;47;15;12
there are very little healthy foods are
placed on these types of channels.

00;47;15;26 - 00;47;19;21
And then we look at the company
statements, and the company statements

00;47;19;21 - 00;47;23;22
have a lot of statements
about caring about the communities,

00;47;23;29 - 00;47;27;24
about other DEI initiatives,
and they really run counter

00;47;27;24 - 00;47;31;03
to what we're seeing,
where they actually put their money.

00;47;31;10 - 00;47;35;04
Because if you cared about the communities
that you're serving in, that

00;47;35;24 - 00;47;38;24
you you're explaining
or your best customers, you would

00;47;39;04 - 00;47;43;23
market better products instead of picking
the least healthy products that you have

00;47;44;02 - 00;47;48;17
and placing those on particular channels
to reach particular audiences.

00;47;48;27 - 00;47;53;10
Shining a light on these practices
is important for the research,

00;47;54;04 - 00;47;58;12
but we do ask for policies
different types of policies,

00;47;59;05 - 00;48;00;26
for media companies

00;48;00;26 - 00;48;04;29
to create policies, for example,
about the percentage of products

00;48;04;29 - 00;48;06;21
that should be healthy,
that need to be healthy,

00;48;06;21 - 00;48;10;17
or that there's some sort of standard
that's put in place.

00;48;11;06 - 00;48;15;23
But, you know, it's it's it's really hard
to get companies to change.

00;48;15;23 - 00;48;20;22
And I, I think we know that
that's frequently is part of the problem

00;48;20;22 - 00;48;22;04
is that we

00;48;22;04 - 00;48;24;20
you know companies don't want to change
because what's working

00;48;25;04 - 00;48;28;15
is is bringing them dollars
and they're not really in the business

00;48;28;15 - 00;48;29;05
of public health.

00;48;29;05 - 00;48;31;13
They're in the business of of profit.

00;48;32;04 - 00;48;36;26
So I think that we need to put policies
in that create a level playing field.

00;48;36;26 - 00;48;40;27
Government policies are things
that do that so that one company doesn't

00;48;41;03 - 00;48;45;09
lose market share to another if they try
to, say, promote healthier products.

00;48;45;24 - 00;48;48;13
But if there was a government policy
that went across everybody

00;48;48;21 - 00;48;51;23
and no one would have to,
you know, stick their neck out

00;48;52;04 - 00;48;55;14
and lose profits. Thank you.

00;48;56;15 - 00;48;58;21
Sohyun, we have a couple of data questions.

00;48;58;21 - 00;49;03;07
So, one, is there any data source
for artificially artificially sweetened

00;49;03;07 - 00;49;04;17
beverage consumption?

00;49;04;17 - 00;49;07;00
And I’ll just asked the other one to
and maybe you can add them together.

00;49;07;07 - 00;49;09;10
Were you able at all to look at

00;49;10;04 - 00;49;12;14
sugar intake amongst Asian adults.

00;49;14;01 - 00;49;17;15
For the artificial sweeteners?

00;49;17;15 - 00;49;18;04
Probably.

00;49;18;04 - 00;49;22;10
NHANES could be,
but there isn't really data source.

00;49;22;10 - 00;49;27;13
So it's only, the national data, NHANES.
And the Asian population

00;49;28;04 - 00;49;30;29
they were included as other race groups.

00;49;31;16 - 00;49;35;21
Due to the small sample size, we cannot
really pull out only the population.

00;49;36;14 - 00;49;41;25
But in overall the other population
that include Asian population,

00;49;42;00 - 00;49;45;26
their consumption is lower than others.

00;49;46;15 - 00;49;47;03
Thank you.

00;49;47;03 - 00;49;49;19
Well,
I see we're running to the end of time,

00;49;49;19 - 00;49;54;12
so I'd like to thank all our panelists
today for a great DNPAO seminar series.

00;49;54;23 - 00;49;57;22
As I said earlier,
this will be on our website.

00;49;57;22 - 00;50;00;12
So if you want to go back
and watch it again or you know

00;50;00;13 - 00;50;02;22
you heard something,
you want to think about some more,

00;50;02;22 - 00;50;03;20
you can check it out.

00;50;03;20 - 00;50;06;20
Our previous seminars are also hosted
there.

00;50;07;07 - 00;50;10;18
Um, we'd like to wrap this
just a few minutes early

00;50;10;18 - 00;50;13;15
because we're the Division of Nutrition,
Physical Activity, and Obesity.

00;50;13;15 - 00;50;16;00
So I encourage you
to take these last couple of minutes

00;50;16;00 - 00;50;18;02
to walk around your house,
get a few steps in.

00;50;18;03 - 00;50;21;04
So thank you again to our panelists
and thank you all for joining us today for

00;50;21;04 - 00;50;22;15
the seminar series. Thanks.