***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To assess current beverage consumption patterns and anticipated reaction to an added 20 % tax on these products . DESIGN A r and om-digit dialled telephone interview lasting 20 min was administered to assess demographics , beverage consumption behaviours and intentions regarding consumption of sugar-sweetened beverages in the event of an additional tax on these beverages . SETTING Respondents were recruited throughout the USA . SUBJECTS The study included 592 adults . RESULTS Sixty-nine per cent of respondents reported consuming at least one pre-packaged sugar-sweetened beverage in the past week ; those who consumed sugar-sweetened beverages averaged seven pre-packaged beverages per week . Ninety-one per cent knew that frequent consumption of soft drinks increases risk of obesity . Thirty-six per cent supported a tax on sugar-sweetened beverages with greatest support among those aged 18 - 24 years , those with BMI < 30 kg/m2 and those with higher levels of education ( P < 0·05 ) . Over one-third of respondents said that they would cut back on their sweetened beverage consumption in the event of an added 20 % tax on these beverages . CONCLUSIONS Our findings suggest that an added tax on these beverages could influence some to cut down on their consumption , reducing their risk of obesity and related illnesses OBJECTIVE Fiscal policies may form a solution in improving dietary intake . This study aim ed to examine the effectiveness of varying taxing and subsiding schemes to stimulate healthier food purchases . METHODS A r and omized controlled trial with three levels of price reduction on healthy foods ( no ; 25 % ; 50%) × three levels of price increase on unhealthy foods ( 5 % ; 10 % ; 25 % ) factorial design was used . 150 participants were r and omized into one of nine conditions and were asked to purchase groceries at a web-based supermarket . Data were collected in the Netherl and s in January-February 2010 and analyzed using analysis of covariance . RESULTS Subjects receiving 50 % discount purchased significantly more healthy foods than subjects receiving no ( mean difference=6.62 items , p<0.01 ) or 25 % discount ( mean difference=4.87 items , p<0.05 ) . Moreover , these subjects purchased more vegetables ( mean difference=821 g;p<0.05 compared to no discount ) . However , participants with the highest discount also purchased significantly more calories . No significant effects of the price increases on unhealthy foods were found . CONCLUSION Price decreases are effective in stimulating healthy food purchases , but the proportion of healthy foods remains unaffected . Price increases up to 25 % on unhealthier products do not significantly affect food purchases . Future studies are important to vali date these results in real supermarkets and across different countries Background Indigenous Australians suffer a disproportionate burden of preventable chronic disease compared to their non-Indigenous counterparts – much of it diet-related . Increasing fruit and vegetable intakes and reducing sugar-sweetened soft-drink consumption can reduce the risk of preventable chronic disease . There is evidence from some general population studies that subsidising healthier foods can modify dietary behaviour . There is little such evidence relating specifically to socio-economically disadvantaged population s , even though dietary behaviour in such population s is arguably more likely to be susceptible to such interventions .This study aims to assess the impact and cost-effectiveness of a price discount intervention with or without an in-store nutrition education intervention on purchases of fruit , vegetables , water and diet soft-drinks among remote Indigenous communities . Methods / Design We will utilise a r and omised multiple baseline ( stepped wedge ) design involving 20 communities in remote Indigenous Australia . The study will be conducted in partnership with two store associations and twenty Indigenous store boards . Communities will be r and omised to either i ) a 20 % price discount on fruit , vegetables , water and diet soft-drinks ; or ii ) a combined price discount and in-store nutrition education strategy . These interventions will be initiated , at one of five possible time-points , spaced two-months apart . Weekly point-of-sale data will be collected from each community store before , during , and for six months after the six-month intervention period to measure impact on purchasing of discounted food and drinks . Data on physical , social and economic factors influencing weekly store sales will be collected in order to identify important covariates . Intervention fidelity and mediators of behaviour change will also be assessed . Discussion This study will provide original evidence on the effectiveness and cost-effectiveness of price discounts with or without an in-store nutrition education intervention on food and drink purchasing among a socio-economically disadvantaged population in a real-life setting .Trial registration Australian New Zeal and Clinical Trials Registry : BACKGROUND Reducing fruit and vegetable ( F&V ) prices is a frequently considered policy to improve dietary habits in the context of health promotion . However , evidence on the effectiveness of this intervention is limited . OBJECTIVE The objective was to examine the effects of a 50 % price discount on F&Vs or nutrition education or a combination of both on supermarket purchases . DESIGN A 6-mo r and omized controlled trial within Dutch supermarkets was conducted . Regular supermarket shoppers were r and omly assigned to 1 of 4 conditions : 50 % price discounts on F&Vs , nutrition education , 50 % price discounts plus nutrition education , or no intervention .  A total of 199 participants provided baseline data ; 151 ( 76 % ) were included in the final analysis .  F&V purchases were measured by using supermarket register receipts at baseline , at 1 mo after the start of the intervention , at 3 mo , at 6 mo ( end of the intervention period ) , and 3 mo after the intervention ended ( 9 mo ) . RESULTS Adjusted multilevel models showed significantly higher F&V purchases ( per household/2 wk ) as a result of the price discount ( + 3.9 kg ; 95 % CI : 1.5 , 6.3 kg ) and the discount plus education intervention ( + 5.6 kg ; 95 % CI : 3.2 , 7.9 kg ) at 6 mo compared with control . Moreover , the percentage of participants who consumed recommended amounts of F&Vs ( ≥400 g/d ) increased from 42.5 % at baseline to 61.3 % at 6 mo in both discount groups ( P = 0.03 ) . Education alone had no significant effect . CONCLUSIONS Discounting F&Vs is a promising intervention strategy because it result ed in substantially higher F&V purchases , and no adverse effects were observed . Therefore , pricing strategies form an important focus for future interventions or policy . However , the long-term effects and the ultimate health outcomes require further investigation . This trial was registered at the IS RCT N Trial Register as number IS RCT N56596945 and at the Dutch Trial Register ( http://www.trialregister.nl/trialreg/index.asp ) as number NL22568.029.08 Background Some governments have recently shown a willingness to introduce taxes on unhealthy foods and drinks . In 2011 , the Irish Minister for Health proposed a 10 % tax on sugar sweetened beverages ( SSBs ) as a measure to combat childhood obesity . Whilst this proposed tax received considerable support , the Irish Department of Finance requested a Health Impact Assessment of this measure . As part of this assessment we set out to model the impact on obesity . Methods We used price elasticity estimates to calculate the effect of a 10 % SSB tax on SSB consumption . SSBs were assumed to have an own-price elasticity of −0.9 and we assumed a tax pass-on rate to consumers of 90 % . Baseline SSB consumption and obesity prevalence , by age , sex and income-group , for Irel and were taken from the 2007 Survey on Lifestyle and Attitude to Nutrition . A comparative risk assessment model was used to estimate the effect on obesity arising from the predicted change in calorie consumption , both for the whole population and for sub-groups ( age , sex , income ) . Sensitivity analyses were conducted on price-elasticity estimates and tax pass-on rates . Results We estimate that a 10 % tax on SSBs will result in a mean reduction in energy intake of 2.1 kcal/person/day . After adjustment for self-reported data , the 10 % tax is predicted to reduce the percentage of the obese adult population ( body mass index [ BMI ] ≥30 kg/m2 ) by 1.3 % , equating to 9,900 adults ( 95 % credible intervals : 7,750 to 12,940 ) , and the overweight or obese population ( BMI ≥ 25 kg/m2 ) by 0.7 % , or 14,380 adults ( 9,790 to 17,820 ) . Reductions in obesity are similar for men ( 1.2 % ) and women ( 1.3 % ) , and similar for each income group ( between 1.1 % and 1.4 % across income groups ) . Reductions in obesity are greater in young adults than older adults ( e.g. 2.9 % in adults aged 18–24 years vs 0.6 % in adults aged 65 years and over ) . Conclusions This study suggests that a tax on SSBs in Irel and would have a small but meaningful effect on obesity . While such a tax would be perceived as affecting the whole population , from a health prospect i ve the tax will predominantly affect younger adults who are the main consumers of SSBs Objectives : To investigate the importance of cost and awareness of health- or disease-promoting properties of foods and meals for choices by customers of a cafeteria . Design : A non-r and omized intervention study . Setting : A medium size cafeteria in the Harvard School of Public Health . Participants : Customers of the cafeteria mainly consisting of public health students , faculty , and school staff and workers from the medical campus . Intervention : The purchase of healthy foods and dishes was subsidized and their prices reduced by 20 % . This promotion was accompanied by the distribution of educational material . Main Outcome Measures : Change in consumption of healthy and less healthy foods . Analysis : The geometric mean was used to calculate the change in consumption . Results : During the intervention , we observed a 6 % increase in the consumption of healthy foods ( 95 % confidence interval [ CI ] ; 5 % to 8 % ) , and a 2 % decline in the consumption of less-healthy foods ( 95 % CI ; −1 % to −4 % ) . After the prices returned to their original levels , the consumption of healthy foods increased further to 17 % ( 95 % CI ; 13 % to 20 % ) and a 2 % decline in the consumption of less-healthy foods ( 95 % CI ; % 1 to −5 % ) persisted . Conclusions : Subsidizing healthful meals and educating consumers about the importance of a healthy diet can result in a modest increase in the selection of healthy foods and meals that can be maintained beyond the periods of subsidy and promotion BACKGROUND This study reports the effect of providing Norwegian school children with free fruit or vegetables every school day and the effect of an existing fee-based School Fruit Programme . METHODS Seventh grade pupils and their parents completed question naires at baseline ( autumn 2001 ) and at follow-up ( spring 2002 ) . Nine schools participated in the School Fruit Programme for free ( Free fruit ) , nine schools took part at st and ard conditions ( Paid fruit ) , and 20 schools  did not take part in the subscription programme ( No fruit ) . A total of 795 7th grade rs ( 11 or 12 years old at baseline ) participated both at baseline and at follow-up . RESULTS At follow-up , pupils attending the Free fruit schools had significantly higher intake of fruit and vegetables at school than the pupils at the Paid fruit and No fruit schools ( P < 0.001 , mean intakes were 1.1 , 0.4 and 0.2 portions , respectively ) . Subscribers at the Paid fruit schools had significantly higher intake than the non-subscribers at the same schools . CONCLUSIONS Providing a free piece of fruit or a vegetable is an effective strategy to increase school children 's  fruit and vegetable intake . The existing School Fruit Programme appears to increase the intake among the subscribers , but thereby also tends to increase an existing difference in consumption patterns among subscribers and non-subscribers BACKGROUND Traditional methods to improve population diets have largely relied on individual responsibility , but there is growing interest in structural interventions such as pricing policies . OBJECTIVE The aim was to evaluate the effect of price discounts and tailored nutrition education on supermarket food and nutrient purchases . DESIGN A 2 x 2 factorial r and omized controlled trial was conducted in 8 New Zeal and supermarkets . A total of 1104 shoppers were r and omly assigned to 1 of the following 4 interventions that were delivered over 6 mo : price discounts ( 12.5 % ) on healthier foods , tailored nutrition education , discounts plus education , or control ( no intervention ) . The primary outcome was change in saturated fat purchased at 6 mo . Secondary outcomes were changes in other nutrients and foods purchased at 6 and 12 mo . Outcomes were assessed by using electronic scanner sales data . RESULTS At 6 mo , the difference in saturated fat purchased for price discounts on healthier foods compared with that purchased for no discount on healthier foods was -0.02 % ( 95 % CI : -0.40 % , 0.36 % ; P = 0.91 ) . The corresponding difference for tailored nut 
    Output:
    
Although moderate in quality , there was consistent evidence that taxation and subsidy intervention influenced dietary behaviors .