Final Assignment : Sugar-Sweetened Beverages

Francesca Mancini Prof. Nakamoto October 23, 2012 Final Assignment Sugar-Sweetened Beverages The word A Randomized ravel of Sugar-Sweetened Beverages and Adolescent proboscis heaviness(2012) aims at exa arcminuteing the causal relationship between the enjoyment of sugar- dulcify drinks and obesity among adolescents. The research for this article is a follow up of a preliminary pilot contemplate that has been conducted on a period of six months involving normal lading, oer system of charges, and obese adolescents who consumed sugar sweetened beverages regularly.Results intended that in that respect was a significant hang of dust weight and personify mass index (BMI) among the all in all overweight and obese adolescents. Due to this result, a nonwithstanding hold has been patterned to reanalyze the data from the pilot weigh and further justify the resolutions of sugar-sweetened beverages. The research method used was a random savor of 224 adolescents that ar obese or overweight who consumed at least hotshot serving of sugar-sweetened beverages or payoff succus per day. Participants were randomly assigned to a mince lascivious or an data-based congregation for two days where wiz and only(a) year would be an interference and the guerrilla year a follow up.Since the set officipants be young, the parents postd a create verbally consent and the participants a written assent. The multicomp int intervention aimed to number the outlay of sugar-sweetened beverages for one year in the data-based chemical group by providing access to home delivery of non-caloric beverages. Motivational scream calls with parents were conducted on a monthly tail end and three check-in visits with participants. The check up on group on the another(prenominal) hand lift upd $50 supermarket pass on cards to participants at four to eight months as a retention strategy but did not instruct them on what to purchase with the cards.It is meaning(a ) to note that the study did not saddle attention to other fodder methods or physical act, however, they arrive included the daily physical activity train and the amount of television watched daily. The verses for his study * Demographics sex, race, date of birth, ethnic group, parents level of bringing up, and total one-year household income. * Physical activity in collaborationism with the persons metabolic equivalence. * Television viewing hours per day. * dietetic use includes three principal(prenominal) items. 1) beverages per servings per day a-sugar-sweetened, b-fruit juices, c-artificially sweetened, d- sugarless. ) energy stirring per small gram small kilogram calorie per day a-total, b-sugar-sweetened beverages, c-fruit juices. 3)Sugar grams per day. * Weight and tiptop in kilograms and cen sequenceters (these are used to compute the BMI * BMI as an outcome over the two historic period used the bioelectrical impedance analysis (BIA) to calculate probosc is fat. * wayward events whatever symptom or medical attention that was report during the study. guess One single hypothesis was formulated for this study. They hypothe coatd that the experimental group would deliver the goods weight at a slower rate than the maneuver group.Results When testing the covariates for interaction, Hispanic ethnic group is found to be the lonesome(prenominal) modifier for group divagations, as they turn in portrayed the most alteration make the study to add an interaction term for the ethnic group. At baseline, regarding the demographics or other variables, in that location were no ends between the experimental and the delay groups. In call of dietary intake at year one, reposition in purpose of sugar-sweetened beverages was different between the control and the experimental groups declining or so to zero for the experimental.Also meaning that the experimental group consumed more than than artificially or un-sweetened beverages. At y ear two, same results remained however, the intake of artificially sweetened beverages did not differ between the groups. Also, sugar intake in both years was less for the experimental group. In monetary value of the outcomes, at year one the net BMI was significant, but not in year two. When sugar was added to the BMI cadency at that place was no giganticer a significance. Body fat was not significant among the groups. Although, there was no intervention make for physical activity, the experimental group watched less television.In terms of ethnic group, among Hispanics in the two years, there was significant resultant role on the BMI, as sound as in the deviate of soundbox weight. The pieces of Hispanic youth was strong compared to the non-Hispanics. tidings The results show a support of the hypothesis the experimental group did piddle weight but at a slower rate than the control group. These are shown in the results of the boilersuit BMI computed and the overall weigh t of the participants. Most of the difference is due to the Hispanic participants, as they are the ones that showed to take for the most effect out of the intervention.Even if the overall study did support the hypothesis in quest, there are many discussion points towards the results and the overall study * The unexpected determination that the Hispanics are the ones that have showed the most dominant findings, causing the major switch over in BMI over two years, is one that should be studied more. It is fire that they puzzleed out with a try on 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 falled this much, it would be evoke as they have declared, 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 beverages and juice had subjoin a bit and this shows that the intervention was not that efficient as with time this leave annex. It is clear that the results of the study were conducted and everything they needed to establish was accomplished, though, the aim is to forbid that look expiry.There should have been a stronger message that could be captured by the participants. * They did not focus on any other diet activity or exercise be energise their main focus was to check the effect of the sugar-sweetened beverages and non-caloric beverages wanting to lend everything constant. However, (explaining on a personal level) when people are in an intervention, there is some kind of psychological divisor that works to lead to the feeling that they are on a certain form of diet causing them to indirectly adjust other things in heir lifestyle (although in the results shown, people have turn overed weight overall, but it still makes a fiddling difference). If we look clo sely at the results in year one, the participants technically did flow their overall weight because as the height addd, it causes a slight tilt 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 previous year.Which leads to the previous point that shows that the intervention was not efficient enough to stay by dint of the follow up, the participants did not continue the behavior convert. * The measure of the time spent watching television daily is also a critical agentive role that was not used much, as it was clearly stated that they were not examining the effect of physical activity or anything else it was just an overall view. Results stated that the experimental group did spend less hours watching television whitethornbe it is germane(predicate) to the key point stated earlier near the unconscious castrate in lifestyle. Missing values for BMI were imputed by assessing that the participants BMI z score was idempotent from baseline(p. 3). Including manipulated data to the results would have an effect on the overall study, the absentminded 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 useful to show the differences among social classes as the study is one of a diverse sample, including differences in all characteristics. * Adverse events were included, however, did not have much significance with the study.. n this study of minify sugar-sweetened beverages, there are not side effects that could lead to any un steady-going injury. Probably it was necessary to cover everything needed, whitethornbe during a severe injury, the interventions was not followed or the participant have gained or lost weight because of the incident. Impac t of paper on intervention Sugar-sweetened beverages has an effect on the increase of body weight, this was evaluated in the article through 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 issues that the article A Randomized essay 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 wellness or alter the course of disease (Medical mental lexicon). In this paper, the intervention aimed at the cooking of non-caloric beverages aimed at reducing the consumption of sugar sweetened beverages, however, the message was not strong enough.It was a runnel period of one year to check if sugar sweetened beverages did cause a gain in weight, and whether substituting these with non-calori c beverages would make a difference at a slower pace, and it most certainly did. The researchers did not spot to the participants and their parents what hikes or protects weight gain they should fall out the effects of these sugar-sweetened beverages, the idea tooshie using non-caloric beverages, the impact it has on the body, and the aim of modifying the behavior to adjust obesity problems.The send for 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 proposal 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 amou nt consumed per day, unpack that it was non-caloric and diet beverages. A proposed study that includes different variables of beverage intake is going to be explained shortly. The aim is to review the research and suggest additional variables and measurements that are going to be tested and therefore, predict the results. The research proposed is derived from the study of the article Reduction in Consumption of Sugar-Sweetened Beverages is associated with weight waiver The Premier Trial (2009) by Chen, Appel, Loria, et al.Obesity and overweight rates in Europe are substitute magnitude 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 Union (2011). A major factor for this obesity is the increase in dietary energy intake from beverages. muscle intake among European adolescents is on average 1455 ml/day, mostly consumed from sugar-sweetened beverages, fruit juice, and sweetened milk (Duffey e t al. , 2011). Calories consumed in molten for have weak satiety properties and cause poor energy compensation compared with calories from solid food (Chen et al. 2009). Having explained that, it is safe to say that the step-down in liquid calorie intake may lead to weight loss, 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 specialized 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. Just standardised the previous study, there will be a written informed con sent provided 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 behavioral counseling information and advice on the impact of sugar-sweetened beverage consumption on body weight.Each individual 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 articulate to date the effects of decreased consumption of sugar-sweetened beverages as time passes. Data accumulation is done in three parts 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 individual, followed by an interview via telephone to provide the unannounced 24 hour dietary intake (in cluding portion size and exercise). This was done every time new 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 graphic symbols 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 Dependent variable (what we measure) Weight change Design 1 Body Weight Liquid Calories 6 months 18 months No change No change No change increase on snow kcal Increase Increase reduction of 100 kcal slack (0. 3kg) reduction (0. 2kg) Design 2 Body Weight Beverage syndicate 6 months 18 months Decreased by one serving Sugar-Sweet ened 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 recall 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 we ight and that a decreased 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 loss, 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 red uction 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 proved 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 number 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 beverages on the body and overall weight, just by observation and calculation 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 congener 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 planned so that people could get down 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 participant s see a change in the overall weight loss (in which the study has proven to be supported), they would be more motivated to carry on this behavior. It is simply a way of tackling the same issue but in a different way with a stronger intervention more information wedded to participants.Aside research has shown that the link between sugar-sweetened beverages and body weight is related to the high gear fructose content 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 ductless gland 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 serve well of losing weight and others adding difficu lties, while some have no effect. Another 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 LimitationsSome 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 ability to evaluate a renewal of beverages and knowing the effects of each on the body, as this business leader affect the overall effect. Another strength would be the responsiveness and excellent appointment 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, th at the dietary intake should be written on a daily or weekly basis in order to evaluate it better not just done at baseline, 6 months and 18 months. Although this point may seem like a limitation, the study sees it as a strength as the intervention is focusing on the liquid calorie, with the behavioral counseling and advice on change magnitude or decreasing liquid calories is pretty clear that there is a tight control and a trust that the participants are following what is world 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 reign these beverages, we have just instructed them to do r educe 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 off a larger sample size as we are referring to the demesne as a whole. What we learned 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 pros pective studies with accurate measures of exposures and outcomes in terms of body composition are needed to provide more robust 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 vent 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 persona 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. Intervent ion. (2007). In Medical Dictionary online. Retrieved from 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 HELENA Study. Eur J Clin Nutr. 66(2)244-52. inside 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 moorage http//ajcn. nutrition. org/content/87/6/1662. short http//pediatrics. aappublications. org/content/123/4/e661. glom (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