Evidence map›Paper›PMID 32188524›Full record

ArticlePublic health nutrition2020

The relationship between joining a US free trade agreement and processed food sales, 2002-2016: a comparative interrupted time-series analysis.

Krycia Cowling, Elizabeth A Stuart, Roni A Neff, Jon Vernick, Daniel Magraw, Keshia Pollack Porter

Abstract read
In one paragraph

Article in Public health nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Food environment solutions for childhood obesity in Latin America and among Latinos living in the United States.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Krycia CowlingDepartment of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Baltimore, MD21205, USA.ORCID 0000-0003-2489-5390
Elizabeth A StuartDepartment of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Hampton House 839, Baltimore, MD21205, USA.
Roni A NeffDepartment of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Room W7010, 615 N. Wolfe Street, Baltimore, MD21205, USA.
Jon VernickDepartment of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Hampton House 594, Baltimore, MD21205, USA.
Daniel MagrawPaul H. Nitze School of Advanced International Studies, Johns Hopkins University, Room 417, 1619 Massachusetts Avenue NW, Washington, DC20036, USA.
Keshia Pollack PorterDepartment of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Hampton House 380A, Baltimore, MD21205, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo examine changes in sales of highly processed foods, including infant formulas, in countries joining free trade agreements (FTAs) with the US.

designAnnual country-level data for food and beverage sales come from Euromonitor International. Analyses are conducted in a comparative interrupted time-series (CITS) framework using multivariate random-effects linear models, adjusted for key confounders: gross domestic product (GDP) per capita, percent of the population living in urban areas and female labor force participation rate. Memberships in other FTAs and investment treaties are also explored as possible confounders.

settingChanges are assessed between 2002 and 2016.

participantsTen countries joining US FTAs are compared with eleven countries without US FTAs in force; countries are matched on national income level, world region and World Trade Organization membership.

resultsAfter countries join a US FTA, sales are estimated to increase by: 0·89 (95 % CI 0·16, 1·6; P = 0·016) kg per capita per annum for ultra-processed products, 0·81 (95 % CI 0·47, 1·1; P < 0·001) kg per capita per annum for processed culinary ingredients and 0·17 (95 % CI 0·052, 0·29; P = 0·005) kg per capita under age 5 per annum for baby food. No significant change is estimated for minimally processed foods. In statistical models, large unexplained variations in country-specific trends suggest additional unmeasured country-level factors also impact sales trends following entry into US FTAs.

conclusionsThese findings strongly support the conclusion that joining US FTAs can contribute to detrimental changes in national dietary consumption that increase population risk of non-communicable diseases.

Indexed as

BeveragesFood, ProcessedChild, PreschoolCommerceFast FoodsFeeding BehaviorFemaleHumansInfant FormulaDietNatural experimentNoncommunicable diseasesProcessed foodsTrade

Identifiers

PMID32188524
PMCPMC10200605

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.