Thursday, March 7, 2019

Final Assignment : Sugar-Sweetened Beverages

Francesca Mancini Prof. Nakamoto October 23, 2012 closing Assignment Sugar-Sweetened Beverages The article A randomised Trial of Sugar-Sweetened Beverages and Adolescent torso W octette(2012) excogitations at examining the causal family in the midst of the expenditure of sugar-sweetened drinks and fleshiness among adolescents. The look into for this article is a see up of a foregoing polisher moot that has been conducted on a period of six months involving normal tilt, intemperate, and adipose tissue adolescents who consumed sugar sweetened beverages regularly.Results showed that there was a significant slighten of form cant and body mass index (BMI) among the over burthen and obese adolescents. Due to this ending, a further show has been designed to reanalyze the data from the pilot field of operations and further explain the military groups of sugar-sweetened beverages. The research method employ was a random sample of 224 adolescents that ar obese or over load who consumed at least angiotensin-converting enzyme serving of sugar-sweetened beverages or fruit juice per mean solar day. Participants were randomly assigned to a authority convocation or an experimental theme for two years where whizz year would be an disturbance and the second year a follow up.Since the participants be young, the pargonnts provided a write react and the participants a written assent. The multicomponent interposition aimed to rationalise the consumption of sugar-sweetened beverages for one year in the experimental group by providing access to re placence delivery of non-caloric beverages. Motivational telephone calls with parents were conducted on a monthly derriere and three interpret-in visits with participants. The swan group on the virtually other slide by received $50 supermarket gift cards to participants at four to eight months as a retention strategy more thanover did non train them on what to purchase with the cards.It is important to none that the study did not taper attention to other forage methods or physical activity, however, they set out include the periodic physical activity level and the amount of television watched daily. The measures for his study * Demographics sex, race, date of birth, pagan group, parents level of education, and total annual ho exercisehold income. * sensual activity in collaboration with the persons metabolic equivalence. * Television viewing places per day. * dietetic phthisis includes three main items. 1) beverages per servings per day a-sugar-sweetened, b-fruit juices, c-artificially sweetened, d- unsweetened. ) energy recess per nutritionists gram gram large calorie per day a-total, b-sugar-sweetened beverages, c-fruit juices. 3)Sugar grams per day. * angleing and crown in kilograms and centimeters (these are employ to look the BMI * BMI as an outcome over the two years used the bioelectrical resistivity analysis (BIA) to calculate body fat. * Adverse events any symptom or medical exam attention that was reported during the study. Hypothesis oneness single surmisal was formulated for this study. They hypothesizingd that the experimental group would gain pack down at a slower rate than the control group.Results When testing the covariates for interaction, Latino cultural group is found to be the only modifier for group dissentences, as they guard portrayed the some mixed bag causing the study to add an interaction frontier for the ethnic group. At baseline, regarding the demographics or other variables, there were no differences amidst the experimental and the control groups. In impairment of dietetical aspiration at year one, transmute in consumption of sugar-sweetened beverages was unlike between the control and the experimental groups declining almost to zero for the experimental.Also meaning that the experimental group consumed much artificially or un-sweetened beverages. At year two, comparable res ults remained however, the intake of artificially sweetened beverages did not differ between the groups. Also, sugar intake in some(prenominal) years was less for the experimental group. In ground of the outcomes, at year one the net BMI was significant, but not in year two. When sugar was added to the BMI measure there was no longer a entailment. luggage compartment fat was not significant among the groups. Although, there was no intercession done for physical activity, the experimental group watched less television.In terms of ethnic group, among Hispanics in the two years, there was significant matter on the BMI, as well as in the change of body weight. The moment of Hispanic youth was strong compared to the non-Hispanics. Discussion The results show a accommodate of the surmise the experimental group did gain weight but at a slower rate than the control group. These are shown in the results of the general BMI computed and the boilers suit weight of the participants. Most of the difference is due to the Hispanic participants, as they are the ones that showed to exact the most effect out of the intervention.Even if the overall study did support the meditation in quest, there are many discussion battery-acids towards the results and the overall study * The unexpected finding that the Hispanics are the ones that pay off showed the most predominate findings, causing the major change in BMI over two years, is one that should be studied more. It is interesting that they started out with a sample that includes diversity, however, if the Hispanics hadnt been part, the hypothesis wouldnt have been supported.There is a reason to why the Hispanics have been affected this much, it would be interesting as they have stated, to look more into the physiology and in generic susceptibility. * During the second year, when the intervention was not playing a critical role, there was an effect but not as powerful. The level of consumption of sugar-sweetened bev erages and juice had change magnitude a bit and this shows that the intervention was not that expeditious as with time this forget increase. It is clear that the results of the study were conducted and everything they indispensable to establish was accomplished, though, the aim is to keep that demeanor going.There should have been a stronger put across that could be captured by the participants. * They did not focus on any other diet activity or exercise be bowel movement their main focus was to train the effect of the sugar-sweetened beverages and non-caloric beverages wanting to leave everything constant. However, (explaining on a personal level) when great parcel out are in an intervention, there is some kind of psychological broker that works to lead to the belief that they are on a accredited form of diet causing them to indirectly ad provided other things in heir lifestyle (although in the results shown, sight have gained weight overall, but it still makes a teeny -weeny difference). If we look nearly at the results in year one, the participants technically did go down their overall weight because as the height increased, it causes a slight change to the weight, therefore leading to an increase in BMI whereas in year two, one would think that there would be same constant increase (as the increase in height did not differ much) however, participants gained more than the introductory year.Which leads to the earlier point that shows that the intervention was not efficient enough to stay by the follow up, the participants did not continue the behavior change. * The measure of the time spent reflection television daily is withal a critical factor that was not used much, as it was distinctly stated that they were not examining the effect of physical activity or anything else it was skilful an overall view. Results stated that the experimental group did spend less hours watching television maybe it is relevant to the key point stated ahead roughly the unconscious change in lifestyle. Missing values for BMI were imputed by assessing that the participants BMI z score was unchanged from baseline(p. 3). Including manipulated data to the results would have an effect on the overall study, the missing information of any participant should just be omitted, as well as the participant itself. * There was no interaction with the parents level of education and the total household income, probably recyclable to show the differences among social classes as the study is one of a versatile sample, including differences in all characteristics. * Adverse events were included, however, did not have much importee with the study.. n this study of reduced sugar-sweetened beverages, there are not side effects that could lead to any severe injury. Probably it was necessary to concoct everything needed, maybe during a severe injury, the interventions was not followed or the participant have gained or lost weight because of the incident. Impact of write up on intervention Sugar-sweetened beverages has an effect on the increase of body weight, this was evaluated in the article by dint of an intervention that included the readiness of non-caloric beverages to check the difference in weight gain among the two groups of study (experimental and control).There were some bulge outs that the article A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight(2012) does not answer these are issues that relate to the messages sent out. To start by saying, an intervention in medical terms is any measure whose purpose is to improve health or alter the course of disease (Medical Dictionary). In this paper, the intervention aimed at the provision of non-caloric beverages aimed at reducing the consumption of sugar sweetened beverages, however, the message was not strong enough.It was a trial period of one year to check if sugar sweetened beverages did cause a gain in weight, and whether exchange these with non -caloric beverages would make a difference at a slower pace, and it most certainly did. The researchers did not identify to the participants and their parents what promotes or protects weight gain they should say the effects of these sugar-sweetened beverages, the idea behind using non-caloric beverages, the impact it has on the body, and the aim of modifying the behavior to adjust obesity problems.The telephone calls every month did not include information, just checking up with parents of childs consumption. Overall the paper did provide the non-caloric beverages, however, it did not communicate the impact of these beverages body weight. Study end To recap, the study in the article provided emphasized on difference in weight gain over a period of two years. One year was including the intervention where non-caloric beverages were provided, and the other year was a follow up, with no intervention.The research however, did not focus on any details about the drinks itself or the amo unt consumed per day, except that it was non-caloric and diet beverages. A proposed study that includes antithetic variables of beverage intake is going to be explained shortly. The aim is to review the research and suggest auxiliaryal variables and measurements that are going to be tested and therefore, holler the results. The research proposed is derived from the study of the article Reduction in spending of Sugar-Sweetened Beverages is associated with weight exhalation The Premier Trial (2009) by Chen, Appel, Loria, et al.obesity and overweight rates in Europe are increasing as the years pass and is a serious public health concern, at the range of 7. 6% to 24. 7% as reported by the Statistical Office of European junction (2011). A major factor for this obesity is the increase in dietary energy intake from beverages. Energy intake among European adolescents is on just 1455 ml/day, mostly consumed from sugar-sweetened beverages, fruit juice, and sweetened milk (Duffey et al. , 2011). Calories consumed in legato for have weak satiety properties and cause poor energy pay compared with calories from solid nourishment (Chen et al. 2009). Having explained that, it is safe to say that the decrement in liquefied calorie intake may lead to weight injury, which leads to the purpose of this study to examine how changes in the beverages consumption affect weight change among adolescents * How changes in liquid calorie intake affects the body weight * How changes in consumption of specific beverages affect body weight * The effect of both in terms of time6 months and 18 months This study is in Europe, more particularly in Switzerland and the sample population is adolescents.We are going to use the same sample size of 224 adolescents that are overweight or obese and that consume sugar-sweetened beverages, juices, or any form of energy intake in the form of liquids on a daily basis. serious like the previous study, there will be a written informed consent pro vided by the parents and a written assent provided by the participants. The intervention includes participants to be involved in groups where they receive information and behavioural counseling information and advice on the impact of sugar-sweetened beverage consumption on body weight.Each idiosyncratic receives two 30 min check-in sessions every month as well as group meetings every other week, in addition to the original monthly telephone call with the parents. In this study the control would be the baseline, as everyone is part of the intervention, and all participants would be studied closely in order to see the effects of fall downd consumption of sugar-sweetened beverages as time passes. Data collection is done in three split at baseline, at 6 months, and at 18 months.To begin, a questionnaire would be filled in order to get the baseline characteristics of each unmarried, followed by an interview via telephone to provide the unannounced 24 hour dietary intake (including po rtion size and exercise). This was done every time advanced results had to be measured, meaning at baseline, 6 months, and 18 months. The hypotheses formulated for the study Hypothesis 1 changes in consumption of liquid calories will cause a reduction in weight only when liquid calorie is decreased.Hypothesis 2 changes in consumption of individual types of beverages will cause a reduction in weight. Hypothesis 3 Weight reduction in terms of any decrease of sugar-sweetened beverages will be greater in 6 months, compared to 18 months. The design presented Independent variable (what we manipulate) Liquid calories Types of beverages symbiotic variable (what we measure) Weight change Design 1 Body Weight Liquid Calories 6 months 18 months No change No change No change profit on 100 kcal Increase Increase Decrease of 100 kcal Decrease (0. 3kg) Decrease (0. 2kg) Design 2 Body Weight Beverage Category 6 months 18 months Decreased by one serving Sugar-Sweetened Decrease (0. 5kg) Decrease (0. 7kg) Diet Drinks No effect No effect 100% Juice No effect No effect Other (milk, coffee,.. ) Decrease (0. 1kg) Decrease (0. 2kg) The measures for this study * Demographics sex, race, date of birth, ethnic group, parents level of education, and total annual household income. * Physical activity in collaboration with the persons metabolic equivalence.Evaluated in the questionnaire, as a regress of the previous 7 day activity. * Dietary intake includes portion size 1) beverages per servings per day 2) energy intake per calorie per day a-sugar-sweetened beverages, b- juices, c- diet drinks. Received through unannounced telephone calls 24 hour dietary intake. * Beverages divided into categories a- sugar-sweetened, b- diet drinks, c- 100% juice, d- other includes milk, coffee, tea, * Weight and height in kilograms and centimeters these are used to compute the BMI.Results The results do show that the change in liquid calorie intake does affect body weight and that a decr eased in beverage type will also cause body weight to decrease, however, this is explained in more detail. In terms of hypothesis 1- a decrease in liquid calorie did cause a decrease in body weight. Results have shown that a reduction of 100 kcal was associated with a decrease of 0. 3 kg at 6 months and a 0. 2 kg at 18 months (Chen et al. , 2009).In terms of hypothesis 2- there was a relationship with beverage type and body deprivation, however, not with all the beverage types with some there was no correlation. When tested, a reduction of one serving of sugar-sweetened beverage was significantly associated with weight loss at both 6 months and 18 months. Diet drinks, 100% juice were inversely associated with weight loss, but this was not statistically significant, leading to not effect in weight loss a decrease of one serving of the other beverages did show a slight decrease in weight loss along both time periods (Chen et al. 2009). In terms of hypothesis 3- weight reduction will be greater at 6 months, compared to 8 months, showed no significance the opposite occurred. Compared to baseline, as stated in hypothesis 1, the weight loss was greater at 18 months, also proven at a reduction in sugar-sweetened beverages by one serving was associated with a 0. 5kg weight loss at 6 months and a 0. 7kg weight loss at 18 months (Chen et al. , 2009). Meaning at 18 months people lost more weight than at 6 months. Discussion/ Commentaries From the proposed study, findings have suggested that a reduction in liquid alorie intake was significant with weight loss in both 6 months and 18 months, and that the reduction of sugar-sweetened beverages was also associated with weight loss in these periods of time. The original study by Ebbeling et al. , (2012) was an intervention to reduce the tour of sweet-sugar beverages consumed and instead consume the unsweetened beverages or non-caloric beverages. This was studied without advising the participants on the effects of these beve rages on the body and overall weight, just by observation and numeration of BMI.Although the results were aimed at checking the weight gain in two years between a control group and an experimental group, their focus was on the result of the BMI which is a measure relative to weight and height people had an increased BMI as they were growing taller and gained more mass. In this proposed study however, the intervention is focusing on the opposite outcome, the weight loss with time of using less sugar-sweetened beverages, the measure here was the overall weight difference caused by these beverages, shown in kg. It also includes counseling, advice, and information on the effect of these beverages on the body.Overall, this is mainly intend so that people could accept this behavior change and because this is done on obese and overweight participants, the behavior of reducing the intake of these sugar-sweetened beverages is one that should be continued when participants see a change i n the overall weight loss (in which the study has proven to be supported), they would be more motivate to carry on this behavior. It is merely a way of tackling the same issue but in a different way with a stronger intervention more information given to participants.Aside research has shown that the link between sugar-sweetened beverages and body weight is related to the high fructose meat in these beverages. On the long-term this can promote fat storage and excessive food intake through an increase and change in the hormonal patterns that are related to this issue called the postpantrial hormone patterns (Chen et al. , 2009). This is probably why in hypothesis 2, the other types of beverages did not have an effect on weight change, as they do not have the same amount of fructose.The different nutritional components of each beverage type has a different effect on the body, some aiding in the process of losing weight and others adding difficulties, while some have no effect. Anothe r point that is interesting to point out is that earlier, the term liquid calories was used, this is to state the specific energy intake, as there are two kinds of energy intake- the liquid and the solid form this study is focusing on the liquid calorie intake of most prominent beverages. Strengths and Limitations near strengths of this study is the duration of the study, it was long enough to test if there is a significant difference in the change of consumption of sugar-sweetened beverages, also the susceptibility to evaluate a variety of beverages and knowing the effects of each on the body, as this might affect the overall effect. Another strength would be the responsiveness and excellent participation rate on the group meetings, the individual session, and the availability of information about the 24 hour dietary recall to measure dietary intake.Some might argue that the unannounced 24 hour dietary intake may be a little bit faulty, that the dietary intake should be written on a daily or weekly basis in order to evaluate it part not just done at baseline, 6 months and 18 months. Although this point may seem like a restriction, the study sees it as a strength as the intervention is focusing on the liquid calorie, with the behavioral counseling and advice on increasing or decreasing liquid calories is pretty clear that there is a tight control and a go for that the participants are following what is being told.Some limitations of this proposed study would be the lack of follow up, the study was aimed at 18 months with the manipulation of calorie intake from different kinds of beverages along with counseling, there was no follow up to see if people maintained the lower calorie intake or not. Another limitation would be the lack of provision of these diet beverages or fruit juices in schools, we have not controlled what and where participants should obtain these beverages, we have just instructed them to do reduce the liquid calorie intake.The study has used a rather small sample size in order to have more control and focus on all the results yielded there is no doubt that the results would be different, however, it is always better to pick a larger sample size as we are referring to the country as a whole. What we nailed What we learn from this study is that the reduction in liquid calorie intake is associated with weight loss, specially in the reduction of sugar-sweetened beverages.In this study, while focusing on the weight in kg, the result change in overall body fat was clear the overall change in weight because of liquid calorie reduction is not a large amount, however it does prove that it has an effect on weight gain or weight loss. Moreover, the study supports policy recommendations and public health efforts to reduce intakes of liquid calories, specially the reduction in sugar-sweetened beverages (Chen et al. , 2009).A number of factors were assumed , however, more prospective studies with accurate measures of exposures and outcomes in terms of body composition are needed to provide more cast-iron evidence on which to base interventions to achieve long-term behavioral change and prevent excess weight gains in adolescents (Rennie, Johnson, & Jebb, 2005). References Chen, L. , Appel, L. J. , Loria, C. , Lin, P. H. , Champagne, C. M. , Elmer, P. J. , Caballero, B. (2009). Reduction in Consumption of Sugar-Sweetened Beverages is Associated with Weight Loss the PREMIER Trial. American Society for Nutrition 891299-306. Retrieved from http//ajcn. utrition. org/content/89/5/1299. full. pdf+html. Christian Nordqvist. (2011). European Adult Obesity Rates Range From 7. 6% To 24. 7%. Medical News Today. Retrieved from http//www. medicalnewstoday. com/articles/ 238283. php. Ebbeling, C. B. , et al. (2012). A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight. New England Journal of Medicine, 36715, Oct. 11, 2012, 1407-1416. Intervention. (2007). In Medical Dictionary online. Retrieved f rom http//medicaldictionary. thefree dictionary. com/intervention. Duffey, K. J. , Huybrechts, I. , Mouratidou, T. , Libuda, L. , Kersing, M. , De Vriendt, Popkin, B. M. 2011). Beverage Consumption Among European Adolescents in the capital of Montana Study. Eur J Clin Nutr. 66(2)244-52. doi 10. 1038/ejcn. 2011. 166. Epub 2011 Sep 28. Retrieved from http//www. ncbi. nlm. nih. gov/pubmed/21952695 Rennie, K. L. , Johnson, L. , Jebb, S. A. (2005). Behavioural Determinants of Obesity. MRC Human Nutrition Research, 19(3)343-58. Just in case http//ajcn. nutrition. org/content/87/6/1662. short http//pediatrics. aappublications. org/content/123/4/e661. abstract (used as a limitation cy my intervention did not include a policy inclusion in order to deal with the issue) http//ajcn. nutrition. org/content/84/2/274. full

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