Study uses game theory to rethink our pandemic responses

Dartmouth researchers find masking, social distancing compete for public support

Dartmouth College

With flu season upon us and coronavirus a persistent threat, Dartmouth researchers propose a new way of thinking about masking and social distancing rules that is more responsive to what people feel is necessary at a given time—and may help increase cooperation.

Based on game theory, the study breaks from the existing science by considering mask wearing and social distancing as two distinct and competing actions. This dynamic gives public health officials more flexibility to adapt to epidemics and encourage cooperation, the researchers report in the Proceedings of the National Academy of Sciences. The authors used the standard computer model epidemiologists employ to simulate how people behave during outbreaks and develop public health guidelines.

The error officials often make is considering masking and social distancing as two sides of the same coin, says Feng Fu, the study's corresponding author and an associate professor of mathematics at Dartmouth. Both measures have typically been thought of as a single action known as nonpharmaceutical interventions, or NPIs, that are intended to control disease without using medication.

Instead, Fu and first author Alina Glaubitz, who was a doctoral student under Fu and received her PhD from Dartmouth this year, found that people respond to the two actions very differently. In their model, people switched between masking and social distancing—or rejected both—depending on how serious and widespread they perceived a disease as being. The model did not factor in a public health mandate to mask or social distance, but rather considered them as actions people take up voluntarily.

Fu, who specializes in game theory, says that masking, distancing, and doing nothing are in competition with each other when people choose an NPI independently. Infection levels and cost effectiveness determine which actions win out.

For example, Fu's research group analyzed public sentiment during the COVID-19 pandemic. They found that the public initially resisted social distancing—defined as low-density gatherings at which people can maintain at least six feet of separation from each other or avoid physical contact altogether—because of the economic costs and mental health effects, but transitioned toward it as infections spread.

Fu and Glaubitz report that over the long-term, however, people trend toward masking or taking no protective action. And once people prefer a less invasive public health measure such as masking, it's difficult for them to re-adopt a more stringent one like social distancing, which is the most costly and disruptive of the NPIs studied.

"Understanding these shifts in how people are perceiving the benefit versus the cost of an intervention is key to timing them effectively and enhancing cooperation," Fu says.

"Mathematical models have become an increasingly important part of understanding and fighting against infectious diseases," says Glaubitz, whose PhD is in evolutionary game theory and infectious disease dynamics. "Our work provides a foundation for understanding the conditions under which the public may favor certain protective behaviors."

Policymakers could gauge which measures people are likely to adopt based on official surveys, public sentiment such as on social media, and what the local economy can absorb, Fu says.

"We show that choices matter—both the measures policymakers implement and the timing of them," he says. "Recommendations need to align with the public's natural preferences to minimize resistance."

But the coronavirus has borne out repeatedly that public sentiment does not consistently align with the measures public health officials think are necessary to contain an outbreak.

Fu and Glaubitz's model suggests that health officials adopt a dual behavioral response that bundles multiple lighter interventions such as masking and moderate reductions in social contact. They refer to this approach as a "Swiss cheese" strategy that provides mostly solid disease mitigation, but with more "holes" for infection to spread than stringent measures would permit.

"While imperfect, layering multiple lighter measures can achieve effective mitigation while aligning with the natural progression of public preferences," Fu says.

"Communication is essential—clearly explaining why a particular measure is necessary and presenting less burdensome options can help foster compliance and trust," he says. "Individuals' decisions, while not always perfectly rational, can still lead to disease mitigation in most cases."

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Journal

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2407308121 

Method of Research

Computational simulation/modeling

Subject of Research

People

Article Title

Social dilemma of nonpharmaceutical interventions: Determinants of dynamic compliance and behavioral shifts

Article Publication Date

4-Dec-2024

 

Protecting the health of wildlife ecosystems

While the plague doesn’t affect humans like it did in the 1300s, it can still wreak havoc on animal populations

University of Missouri-Columbia

 

image: 

Deborah Anderson

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Credit: University of Missouri

COLUMBIA, Mo. -- The plague is one of the deadliest bacterial infections in human history. An estimated 50 million Europeans died from it in the mid-1300s when it was known as the “Black Death.”

Thanks to improved sanitation, public health measures and antibiotics, the Centers for Disease Control and Prevention now reports an average of only seven human cases of plague in the U.S. each year. While humans are largely safe from it, particularly in the eastern half of the U.S., the disease continues to wipe out prairie dog colonies and infect other rodents in the western half of the U.S.

Through the years, scientists have learned more about the role animals — especially rodents — play in the dissemination of the plague, and researchers at the University of Missouri have recently uncovered another alarming way the disease can be passed: from mother flea to offspring.

Deborah Anderson, a professor in Mizzou’s College of Veterinary Medicine, was the principal investigator on a recent study, which was published in Nature. Read on to learn more about Anderson and why her groundbreaking research is important to animals and humans.

Why did you come to Mizzou?

After the events of September 11, 2001, the federal government provided funding for public universities to invest in bioterrorism defense research — which led to the creation of the building on Mizzou’s campus now known as the Laboratory for Infectious Disease Research (LIDR).

The LIDR is one of only 12 labs in the United States that is classified as Biosecurity Level 3, meaning Mizzou is equipped to safely research diseases that are pathogenic and treatable. As a researcher who studies infectious diseases, there are not many places that can support my research interests like Mizzou can. I knew I had to come here.

Why is it important Mizzou does this type of research?

Resources like LIDR are crucial for driving cutting-edge breakthroughs that protect public health and tackle global challenges. As a leading research university and member of the prestigious Association for American Universities, Mizzou’s top-tier researchers and state-of-the-art facilities are helping us prepare for — and fight against — diseases so we can save lives and improve the health of both animals and humans.

Rodents — especially prairie dogs — are particularly vulnerable to the plague. Entire colonies have been wiped out, impacting the broader ecosystem. In 2009, the plague killed more than 80% of the remaining population of black-footed ferrets — one of the most endangered mammals in the world — who eat prairie dogs as their main food source.

Should people be scared of getting the plague?

No. The Centers for Disease Control and Prevention reports an average of only seven human cases of plague in the United States each year, primarily in the southwestern U.S. The threat to the general public is low, but since there are no plague vaccines licensed for human use, we need to be prepared for any potential threat.

How does this research contribute to the concept of One Health?

This research is a perfect example of how Mizzou prioritizes One Health — the idea that the health of people, animals and the environment are all interconnected. Studying animals can ultimately reduce the chances of humans being exposed to infectious diseases, and the more we learn about how fleas transmit the plague, the more we can help public health officials monitor the health of wildlife ecosystems.

Why is Mizzou uniquely positioned to tackle this type of research?

Our recent study was made possible with an award from the UM System’s Research and Creative Works Strategic Investment Program. The program is part of $260 million in strategic investments the UM System announced in 2018.

This award enabled us to build a multidisciplinary team of vector-borne disease collaborators from the College of Veterinary Medicine; the College of Agriculture, Food and Natural Resources; and the School of Medicine. We are all within walking distance of each other, so we are more likely to have spontaneous discussions, serve on committees together and learn from each other. When it comes to interdisciplinary collaboration, as well as extensive expertise in both basic sciences and vector-borne diseases, Mizzou is among the best.

How is this research conducted safely at Mizzou?

Due to the extensive safety protocols we have in place at the LIDR, I always feel safe when handling bacteria. I am thankful that Mizzou encourages its researchers to see the bigger picture and to tackle challenges that impact society in a safe and secure way.

“Transovarial transmission of Yersinia pestis in its flea vector Xenopsylla cheopis” was published in Nature. Funding was provided by the National Institutes of Health.

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Journal

Nature

DOI

10.1038/s41467-024-51668-0 

Method of Research

Experimental study

Subject of Research

Animals

Article Title

Transovarial transmission of Yersinia pestis in its flea vector Xenopsylla cheopis

 

SwRI-led study explores risks of chemical exposure from household products

SwRI, EPA analyze 81 items made from a variety of materials

Southwest Research Institute

 

image: 

An SwRI-led study, published in the Environmental Science & Technology journal, examined four years of data captured with advanced chromatography, time of flight mass spectrometry (GCxGC-TOFMS), suspect screening, non-targeted analysis and the SwRI-developed machine-learning method Highlight™. The image depicts chemical features captured using GCxGC-TOFMS.

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Credit: Southwest Research Institute

SAN ANTONIO — December 4, 2024 — Southwest Research Institute (SwRI) collaborated with the Environmental Protection Agency (EPA) to characterize the chemical makeup of 81 common household items. Researchers also evaluated the potential risk to users.

Exposure to chemicals can cause negative health effects, according to the Centers for Disease Control and Prevention. Building on previous research to identify chemicals in consumer goods, SwRI and EPA also analyzed how samples of rubber, plastic, clothing, upholstery and fabric responded to environmental factors, such as a hot car or being worn.

The study, published in the Environmental Science & Technology journal, examines four years of data captured with advanced chromatography, suspect screening, non-targeted analysis and the SwRI-developed machine-learning method Highlight™. Instead of screening a sample against individual known compounds, this method allows scientists to identify, characterize and evaluate a large library of chemicals through suspect-screening analysis. The method identified 88,795 unique chemical features and 1,883 compound groups from 13 analytical batches.

“Highlight leverages machine learning algorithms for rapid pattern matching, which accelerated the workflow,” said William Watson, a research engineer in SwRI’s Intelligent Systems Division and the study’s lead author.

Another aim of the study was to advance the field of exposomics, which explores how a lifetime of chemical exposure from the environment, diet, lifestyle and other sources impacts human health. Characterizing chemicals in household items and common sources of exposure may help with future biomonitoring efforts.

“Consumer products don’t just consist of one chemical. Think of it as a mixed bag of related chemicals,” said Dr. Kristin Favela, a staff scientist in SwRI’s Chemistry and Chemical Engineering Division. “We wanted to determine if chemicals in the samples were ‘emittable’ or ‘extractable’ to understand the magnitude and likelihood of human chemical exposure.”

SwRI exposed samples of clothing, upholstery, fabrics, rubber and plastics to two different heat settings and solvent strengths. The researchers wanted to determine if the test samples would emit chemical vapors that might be inhaled in an indoor environment, like a hot car, or if worn. The study also explored whether chemicals could be extracted to better understand real-world exposure risks, such as when a child chews on a household item.

“Along with helping to advance our understanding of the risk chemical exposure poses to the public, this study also demonstrates our capability to use machine learning and Highlight findings to retrospectively analyze and understand older datasets,” said Watson.

Using EPA’s Toxicity Forecasting program, ToxCast, the team performed an additional analysis and interpretation to predict risk based on human exposure and available biological activity data. Among the 88 confirmed chemicals that were both extractable and emittable, 66 had available ToxCast data, and a majority of the ToxCast in vitro assay data (92%, an average of 441 assays per chemical) indicated no activity dependent on concentration.  No data was available for the other 22 chemicals. However at a higher concentration, synthetic antioxidant BKF, which can be used to stabilize plastics and rubbers, did show adverse effects when exposure reached 42.3 mg/kg/day. The research may help advance a screening model that can predict emission activity for household items.

The title of the paper is “Discerning Emittable from Extractable Chemicals Identified in Consumer Products by Non-Targeted GCxGC-TOFMS,” and it appears in Environmental Science & Technology journal and can be accessed at: https://pubs.acs.org/doi/10.1021/acs.est.4c07903.

For more information, visit https://www.swri.org/industry/chemical-analysis-services/floodlight-non-targeted-analysis-system.

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Journal

Environmental Science & Technology

DOI

10.1021/acs.est.4c07903 

Method of Research

Computational simulation/modeling

Subject of Research

Not applicable

Article Title

Discerning Emittable from Extractable Chemicals Identified in Consumer Products by Non-Targeted GCxGC-TOFMS

 BETTER LIVING THROUGH CHEMISTRY

Review paper: MDMA-assisted therapy could improve neurorehabilitation of injured service members beyond PTSD

UCLA Health psychiatrist says medication could remove barriers to effective treatment, therapy for service members who have experienced trauma

University of California - Los Angeles Health Sciences

A UCLA Health analysis of MDMA-assisted therapy research suggests that the drug could improve outcomes of treatment of a wider range of trauma-related conditions experienced by military personnel beyond the current focus on post-traumatic stress disorder (PTSD) by increasing a collaborative and trusting relationship between a client and therapist. 

The review paper, authored by UCLA Health assistant clinical professor of psychiatry Walter Dunn and published in the journal NeuroRehabilitation, explains that even in the absence of PTSD, military service members who have sustained a neurological injury in training or combat, such as a traumatic brain injury, can experience emotional and cognitive challenges that can complicate their treatment and recovery.  

Dunn, a veteran of the U.S. Marine Corps and staff psychiatrist at the Veterans Affairs Greater Los Angeles Healthcare System, said the abrupt transition, especially for young, healthy service members, from the rigorous demands of military service to facing the possibility of medical discharge can lead to feelings of isolation, self-doubt and other emotions that can interfere with the neurorehabilitation process.  

Clinical trials of MDMA-assisted therapy in treating patients with PTSD suggest it may improve their ability to tolerate treatment and reduce dropout rates, Dunn said. The results from these trials and in other studies among healthy populations suggest the drug’s effects in facilitating social connections, improved self-esteem and increased neural and behavioral plasticity could also benefit service members undergoing neurorehabilitation for other conditions and injuries, Dunn states. 

“These are service members who are in peak physical condition and they suddenly suffer a catastrophic injury, one that could dramatically change the course of their life,” Dunn said. “MDMA-assisted therapy could be very helpful in this context.” 

Namely, Dunn said the drug’s effects could improve the relationship and trust between therapist and patient through its amplification of social reward in doses of 75 mg to 125 mg. No studies have directly investigated MDMA’s effects on therapeutic alliance in the context of neurorehabilitation. MDMA may also work to counter the impacts of low self-esteem that lead to emotional dysfunction and poor coping strategies. 

Dunn also cites a need for more study on MDMA’s effects on neuroplasticity – which is the brain’s ability to adapt and change – in humans. Mouse studies cited in the review found MDMA reduced anxiety behavior, improved working memory and social reward learning through neuroplastic mechanisms.  

The review paper was published following the decision earlier this year by the U.S. Federal Drug Administration (FDA) in August to reject an application for the use of MDMA-assisted therapy to treat post-traumatic stress disorder. The U.S. Drug Enforcement Agency classifies MDMA as a Schedule I narcotic, which is considered to be a drug that has “no currently accepted medical use and a high potential for abuse.” 

Dunn served as a member of the FDA’s independent advisory board that reviewed the application for MDMA-assisted therapy for post-traumatic stress disorder. Dunn was the only member who voted in favor of recommending approval of the application based on both safety and efficacy. 

“By its very nature, military service involves exposure to stressful and adverse experiences.  It is an inherently dangerous profession,” Dunn said.  “This reality highlights the critical need for a sustained commitment to developing new treatments to support those who serve in the armed forces.” 

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DOI

10.3233/NRE-230270 

Method of Research

Literature review

Subject of Research

Not applicable

Article Title

MDMA for treatment of PTSD and neurorehabilitation in military populations

 

Wanjiru Kamau-Rutenberg takes leading role in African sustainable agricultural research efforts

The Alliance of Bioversity International and the International Center for Tropical Agriculture

 

image: 

Dr. Kamau-Rutenberg’s leadership aligns with the Alliance’s mission to foster inclusive agricultural prosperity and climate resilience across Africa.

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Credit: Alliance of Bioversity International and CIAT.

December 4, 2024 

[Nairobi, Kenya] – The Alliance of Bioversity International and CIAT is pleased to announce Dr. Wanjiru Kamau-Rutenberg’s appointment as Managing Director for the Africa region. With a distinguished career spanning leadership in food systems, social inclusion, and gender-sensitive agricultural innovation, Dr. Kamau-Rutenberg brings a wealth of expertise to this critical role. 

Dr. Kamau-Rutenberg’s leadership aligns with the Alliance’s mission to foster inclusive agricultural prosperity and climate resilience across Africa. Her extensive academic background and professional accomplishments position her to drive impactful solutions in collaboration with regional and global stakeholders. 

A Leader of Distinction 

Dr. Kamau-Rutenberg’s career reflects a deep commitment to addressing systemic barriers in agriculture and empowering communities through innovation. She is the Founder and inaugural Executive Director of Black Women in Executive Leadership (B-WEL) and previously served as Director of African Women in Agricultural Research and Development (AWARD) as well as a Senior Fellow at the Ford Foundation in New York. 

Her professional journey includes leadership roles at Schmidt Futures, Akili Dada, and the University of San Francisco, board seats at the Syngenta Foundation, the Autodesk Foundation, and the Global Food Banking Network as well as Advisory Council roles at the Gender Fund of Co-Impact, the Malabo Montpellier Panel, and the African Climate Foundation, among others. 

Dr. Kamau-Rutenberg holds a PhD and Master’s in Political Science from the University of Minnesota, and a Bachelor of Arts in Politics and a PhD (Honoris Causa) from Whitman College in Washington, USA. 

A Vision for the Future 

Upon joining the Alliance, Dr. Kamau-Rutenberg enthused: 

“It is the honor of a lifetime to get to serve as the next Africa Managing Director for the Alliance! I am particularly excited to join the CGIAR at this exciting moment for the African continent as we face both the daunting challenges, especially those posed by climate change, but also the tremendous opportunity to re-shape the future of food systems on the continent at this exciting moment of population and economic growth.  I consider myself fortunate to get to build upon my successors and colleagues’ tremendous efforts and to join our partners as together we build towards a food secure and prosperous Africa”. 

Building on Strong Foundations 

Announcing the appointment, Juan Lucas Restrepo, the Alliance Director General, stated, “Wanjiru brings with her an exceptional background of leadership, innovation, and dedication to inclusive, agriculture-driven prosperity. Her deep expertise in agricultural development, gender equity, and social inclusion will be instrumental in advancing the Alliance’s mission in Africa.  With Dr. Kamau-Rutenberg’s exceptional leadership, the Alliance– a CGIAR research center— will continue to drive transformative change, ensuring agricultural innovation remains at the forefront of Africa’s development agenda.”

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 For more information or interview requests, please contact: 

Edith Mutui 

Africa Communications Officer 

e.mutui@cgiar.org  

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About the Alliance 
The Alliance of Bioversity International and CIAT delivers research-based solutions that harness agricultural biodiversity and sustainably transform food systems to improve people’s lives. To do so, the Alliance works with local, national and multinational partners across Latin America and the Caribbean, Asia and Africa, and with the public and private sectors. With partners, the Alliance generates evidence and mainstreams innovations in large-scale programs to create food systems and landscapes that sustain the planet, drive prosperity and nourish people in a climate crisis.  

 

 

With Indigenous heritage sites under threat, KFN-SFU collaborative study identifies pathways to enforce Nation-led cultural heritage protection

Simon Fraser University

A new research collaboration between the K’ómoks First Nation and Simon Fraser University highlights how Indigenous cultural heritage policies can protect archaeological sites threatened by development, given inadequate provincial heritage protection laws.

The study, published in the journal Frontiers in Environmental Archaeology, spotlights K’ómoks First Nation’s cultural heritage policy – developed to abate the onslaught of archaeological site destruction in their southern core territory (the Comox Valley, Hornby and Denman Islands) – and the need for provincial legislation and municipal policies to implement Nation-led archaeological site protection.
 
Archaeological sites such as ancestral villages and burial grounds hold evidence of deep histories and connections to place that are inextricably tied to cultural identity. These sites have profound cultural, spiritual, and scientific value.
 
The K’ómoks First Nation’s Cultural Heritage Policy (CHP) and associated archaeology permit system outline requirements for archaeological site investigations and protections that surpass the standards mandated by provincial heritage laws, which many experts and Indigenous communities find lacking.
 
“We implemented the CHP to address a dire need for protection of our cultural heritage sites. We were witnessing and reporting infraction after infraction because the Heritage Conservation Act fails to protect archaeological sites that aren’t already registered,” says Candace Newman, co-author and K’ómoks First Nation Elected Councillor. “We believe the systematic recovery of only 10 per cent of our cultural heritage as required by provincial legislation isn’t enough when so much has already been erased by historical development. We’re seeing an unprecedented boom in development in our territory, and we have the opportunity to protect our heritage now, before all these sites are erased.”
 
Since the CHP program began, compliance has steadily increased. The Nation issued 27 permits in 2021, 42 in 2022, 65 in 2023, and 115 to date in 2024.
 
In 2024, KFN's archaeology and referrals coordinator role was at capacity and was turned into two full-time archaeologist positions to manage the permits, preserve, document and promote K'ómoks' cultural heritage, and to build further capacity by creating archaeological monitoring and research positions. All archaeology positions are self-funded through the permit system, fee for service field work, and academic research collaborations.
 
“This exercise of self-determination by K’ómoks represents a significant opportunity for reconciliation that can be emulated in other regions of the province,” says co-author Sean Markey, professor and director of the School of Resource & Environmental Management at SFU.
 
The study found the CHP provides a pathway to reconciliation and greater certainty for local governments, developers, and landowners regarding land use planning, but there remains a lack of provincial legal backing to enforce the K’ómoks policy. However, K’ómoks’ position is that their duty to protect their cultural heritage is a protected right under s.35 of the Canadian Constitution and that this right cannot be infringed upon or impeded by provincial laws or local government policies.
 
“The K’ómoks CHP, and other Indigenous-led policies like it, provide a clear avenue for better honoring and protecting Indigenous heritage, says co-author Dana Lepofsky, a professor of archaeology at SFU. “However, this cannot be a one-sided endeavour. The provincial government needs to get behind these initiatives to support both Nations and local and regional planners to more fully protect Indigenous heritage.”

AVAILABLE EXPERTS

CANDACE NEWMAN, Elected Councillor, K’ómoks First Nation
communications@komoks.ca

SEAN MARKEY, professor, director, Resource & Environmental Management
sean_markey@sfu.ca

DANA LEPOFSKY, professor, Archaeology
dlepofsk@sfu.ca

CONTACT

MATT KIELTYKA, SFU Communications & Marketing 
236.880.2187 | matt_kieltyka@sfu.ca

NICOLE GAVAC, KFN Communications
250.339.4545 | communications@komoks.ca

Simon Fraser University 
Communications & Marketing | SFU Media Experts Directory
778.782.3210

ABOUT SIMON FRASER UNIVERSITY

Who We Are
SFU is a leading research university, advancing an inclusive and sustainable future. Over the past 60 years, SFU has been recognized among the top universities worldwide in providing a world-class education and working with communities and partners to develop and share knowledge for deeper understanding and meaningful impact. Committed to excellence in everything we do, SFU fosters innovation to address global challenges and continues to build a welcoming, inclusive community where everyone feels a sense of belonging. With campuses in British Columbia’s three largest cities—Burnaby, Surrey and Vancouver—SFU has eight faculties that deliver 364 undergraduate degree programs and 149 graduate degree programs for more than 37,000 students each year. The university boasts more than 200,000 alumni residing in 145+ countries.

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Journal

Frontiers in Environmental Archaeology

DOI

10.3389/fearc.2024.1427458 

Article Title

Indigenous cultural heritage policies as a pathway for Indigenous sovereignty and the role of local governments: an example with K'ómoks First Nation, British Columbia

 

Eating dark but not milk chocolate linked to reduced risk of type 2 diabetes

Clinical trials needed to confirm findings and help identify reasons for dark chocolate’s protective effect, say researchers

BMJ Group

Eating five servings of dark chocolate a week is associated with a reduction in the risk of type 2 diabetes, according to a long-term US study published by The BMJ today.

Global rates of type 2 diabetes are set to rise to 700 million by 2045. Chocolate contains high levels of flavanols (a natural compound found in fruits and vegetables) which have been shown to promote heart health and reduce the risk of type 2 diabetes. But the link between chocolate consumption and risk of type 2 diabetes remains controversial due to inconsistent results.

In addition, most previous studies have not looked at whether eating dark and milk chocolate – which have different cocoa, milk and sugar content – might have different impacts on the risk of type 2 diabetes.

To explore this further, researchers combined data from three long-term US observational studies of female nurses and male healthcare professionals with no history of diabetes, heart disease or cancer when they were recruited.

Using food frequency questionnaires completed every four years, they analysed associations between type 2 diabetes and total chocolate consumption for 192,208 participants, and chocolate subtype (dark and milk) consumption for 111,654 participants over an average monitoring period of 25 years.

As changes in bodyweight strongly predict risks of type 2 diabetes, the authors also used these food questionnaires to assess participants’ total energy intake.

In the analyses for total chocolate, 18,862 people developed type 2 diabetes. After adjusting for personal, lifestyle, and dietary risk factors, the authors found that people who ate at least five servings a week of any type of chocolate (where one serving is equal to a standard chocolate bar/pack or 1 oz) showed a significant 10% lower rate of type 2 diabetes compared with those who rarely or never ate chocolate.

In analyses by chocolate subtypes, 4,771 people developed type 2 diabetes. After adjusting for the same risk factors, people who ate at least five servings a week of dark chocolate showed a significant 21% lower risk of type 2 diabetes, but no significant associations were found for milk chocolate intake.

The researchers also found a 3% reduced risk of type 2 diabetes for each additional weekly serving of dark chocolate (a dose-response effect). Increased consumption of milk, but not dark, chocolate was associated with long term weight gain.

Although dark chocolate has similar levels of energy and saturated fat to milk chocolate, the authors explain that the high levels of flavanols in dark chocolate might offset the effects of saturated fat and sugar on weight gain and the risk of other cardiometabolic diseases such as diabetes.

The authors acknowledge that the observational nature of this study prevents firm conclusions from being drawn about causality and, although they took account of lifestyle and dietary factors linked to type 2 diabetes, other unknown factors may have affected the results. Most participants were non-Hispanic older white adults, so the findings may not apply to other groups, they add.

However, they point out that results remained largely unchanged after adjusting for additional factors, suggesting that they are robust. 

As such, they conclude: “Increased consumption of dark, but not milk, chocolate was associated with lower risk of type 2 diabetes. Increased consumption of milk, but not dark, chocolate was associated with long term weight gain. Further randomized controlled trials are needed to replicate these findings and further explore the mechanisms.”

[Ends]

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Journal

The BMJ

DOI

10.1136/bmj-2023-078386 

Method of Research

Observational study

Subject of Research

People

Article Title

Chocolate intake and risk of type 2 diabetes: prospective cohort studies

Article Publication Date

4-Dec-2024

COI Statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/ and declare: support from the National Institutes of Health for the submitted work. JEM reports receiving investigator initiated grants from Mars Edge. EBR is on the scientific advisory board and has received research funding from the US Department of Agriculture/US Highbush Blueberry growers commodity group.

 

End food and drink industry’s infiltration of UK children’s education, say experts

Kellogg’s and Greggs have sponsored school breakfast clubs in the UK for more than two decades, reaching many thousands of primary school children; Experts say tactics are highly problematic and require much greater scrutiny

BMJ Group

An investigation published by The BMJ today reveals widespread influence of food and drink brands in schools and nurseries – through breakfast clubs, nutrition guidance, and healthy eating campaigns - while rates of obesity in the UK have worsened.

Experts say the tactics are “subtle but very problematic” and require much greater scrutiny and pushback.

Organisations influencing food provision and education in schools include Kellogg’s, Greggs, Nestle, and the British Nutrition Foundation, a “policy development” charity whose funders include Coca Cola, PepsiCo, Mars, Nestle, and McDonald’s, reports journalist Emma Wilkinson.

For example, Kellogg’s has donated £5.7 million to UK schools through a partnership with the Magic Breakfast charity, while the Greggs Foundation – a charitable arm part funded by the high street bakery chain – says it now has 898 breakfast clubs supporting more than 62,000 children a day, with a target to reach 1,000 clubs.

Lindsey MacDonald, CEO of Magic Breakfast, told The BMJ that food supplied as part of their breakfast provision “meets government school food standards” while Nathan Atkinson, director of Rethink Food, an education programme supported by the Greggs Foundation to teach children the importance of physical activity, healthy diets, and sustainability, says the Greggs Foundation “funds the programme and does not influence any of the content.”

The full extent to which schools make use of these resources in the UK is unclear, but Rob Percival, head of food policy at the Soil Association, argues that “an organisation sponsored by McDonald's, Mars and Nestle shouldn't be within 100 miles of children's food education.”

“They're positioning themselves as part of the solution by getting behind and sponsoring this food education programme,” he adds.

This is also one of the strong concerns held by May van Schalkwyk at the London School of Hygiene and Tropical Medicine, who describes the issue as “subtle but very problematic” and is calling for far greater scrutiny.

She also points out that at the same time as doing this corporate social responsibility work, the food industry also employs tactics including pushing back against plans to restrict unhealthy food advertising across Transport for London.

Jennie Cockroft, director of Purely Nutrition that runs the PhunkyFoods programme, which provides nutritional and healthy living guidance in schools and is part-funded by Nestle, says public health funding for school health across the UK is woefully inadequate and has been for years. “If the food industry is part of the problem, then surely, they should be contributing to the solution – providing that this is done in the right way.”

Greg Fell, president of the Association of Directors of Public Health, says: “There is a wealth of evidence to suggest that by being involved in school programmes, harmful products are normalised. The evidence about the risks of harm is also often distorted and instead, blame is shifted to individual choice and personal responsibility.”

The government has announced plans to introduce free breakfast clubs in every primary school. A spokesperson said: “We encourage all schools to promote healthy eating and provide nutritious food and drink, and all maintained schools and academies must comply with the School Food Standards.

“Separately, we will fix the NHS and create the healthiest generation of children in our history by shifting our focus from treatment to prevention, starting by banning junk food ads aimed at children.”

Kelloggs said it believed there was still a role for it in supporting breakfast clubs, including through secondary schools and as complimentary grants for primary schools who need more. Greggs also said it would continue to support schools and their pupils where need is greatest.

[Ends] 

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Journal

The BMJ

DOI

10.1136/bmj.q2661 

Article Title

Big Food has infiltrated UK children’s education: stealth marketing exposed

Article Publication Date

4-Dec-2024

COI Statement

Competing interests: I have read and understood BMJ policy on declaration of interests and have the following interest to declare: I have been a school governor at a secondary school since September 2023. I have not been party to any discussions or decisions around food education or provision in the school.