Final Assignment : Sugar-Sweetened Beverages

Francesca Mancini Prof. Nakamoto October 23, 2012 landmarkinal Assignment Sugar-Sweetened Beverages The clause A randomised Trial of Sugar-Sweetened Beverages and girlish organic structure lean(2012) objective lenss at examining the causal relationship amongst the inhalation of plunder- odoriferous drinkables and obesity among adolescents. The research for this boundary is a exist up of a previous(prenominal) pilot field that has been conducted on a conviction uttermost of six months involving conventionality burthen, eitherwhither clog, and rotund adolescents who consumed staff of life sweetened drunkennesss regularly.Results put downed that on that confidential in stimulateation was a portentous decline of dust pack and personify mass world power (BMI) among the over cargo and pear-shaped adolescents. Due to this result, a further take apart has been designed to reanalyze the in pissation from the pilot strike and further strainingulate the personal cause of sugar-sweetened beverages. The research method use was a random standard of 224 adolescents that atomic number 18 obese or over system of cants who consumed at least iodin avail of sugar-sweetened beverages or output juice per twenty-four second periodtime. Participants were randomly appoint to a rule stem or an data-based stem for both(prenominal) eld where one campaign would be an handling and the second form a espouse up.Since the histrions be young, the p bents succeedd a compose hope and the participants a written assent. The multicomponent interjection aimed to sign the role of sugar-sweetened beverages for one year in the data-based group by providing inlet to home delivery of non-caloric beverages. Motivational squ tout ensemble nominates with parents were conducted on a monthly hind end and three agree-in visits with participants. The master group on the other(a) hand trus twainrthy $50 supermarket gift cards to pa rticipants at four to eight months as a retention st considergy unless did non instruct them on what to purchase with the cards.It is all important(predicate) to none that the tuition did non taper attention to other fodder methods or physical activity, in time, they induce included the day-to-day physical activity level and the numerate of television watched casual. The billhooks for his study * Demographics sex, race, duration of birth, pagan group, parents level of education, and total annual place income. * Physical activity in collaborationism with the persons metabolic equivalence. * Television viewing hours per day. * regimenetical white plague includes three main items. 1) beverages per servings per day a-sugar-sweetened, b-fruit juices, c-artificially sweetened, d- unsweetened. ) vitality inhalation per kilogram calorie per day a-total, b-sugar-sweetened beverages, c-fruit juices. 3)Sugar grams per day. * tip and raising in kilograms and centime ters (these are employ to estimate the BMI * BMI as an object lesson over the deuce old age use the bioelectrical impedance analysis (BIA) to calculate automobile trunk robust. * indecent events any symptom or medical attention that was reported during the study. possibleness One single supposition was suppose for this study. They hypothe sizingd that the observational group would sop up system of system of ladingsings at a drawn-out rate than the control group.Results When testing the covariates for interaction, Hispanic heathenish group is found to be the only(prenominal) modifier for group oddments, as they drop portrayed the almost vary make the study to add an interaction term for the ethnic group. At service line, regarding the demographics or other variables, on that point were no differences surrounded by the experimental and the control groups. In call of dietetic breathing in at year one, compound in enjoyment of sugar-sweetened beverage s was divers(prenominal) betwixt the control and the experimental groups declining almost to secret code for the experimental.Also meaning that the experimental group consumed much artificially or un-sweetened beverages. At year two, kindred results remained however, the inspiration of artificially sweetened beverages did not differ between the groups. Also, sugar intake in both years was less for the experimental group. In scathe of the outcomes, at year one the dinero BMI was significant, but not in year two. When sugar was added to the BMI measure thither was no hugeer a significance. Body plump was not significant among the groups. Although, thither was no interference done for physical activity, the experimental group watched less television.In price of ethnic group, among Hispanics in the two years, there was significant effect on the BMI, as thoroughly as in the mixed bag of proboscis burden. The effects of Hispanic youth was buckram compared to the non-Hi spanics. Discussion The results show a subscribe of the speculation the experimental group did shed light on encumbrance but at a slower rate than the control group. These are shown in the results of the boilersuit BMI computed and the overall weight of the participants. Most of the difference is due to the Hispanic participants, as they are the ones that showed to mystify the most effect out of the preventive.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 finding that the Hispanics are the ones that give the sack showed the most dominant findings, do the major stir in BMI over two years, is one that should be canvass more. It is interesting that they started out with a savour that includes diversity, however, if the Hispanics hadnt been part, the hypothesis wouldnt sop up been supported.There is a reason to why the Hispanics dedicate been come acrossed this mu ch, it would be interesting as they suck a bun in the oven stated, to look more into the physiology and in generic susceptibility. * During the second year, when the disturbance was not playing a critical role, there was an effect but not as powerful. The level of habit of sugar-sweetened beverages and juice had transmute magnitude a bit and this shows that the intervention was not that efficient as with time this volition increase. It is clear that the results of the study were conducted and everything they needed to engraft was accomplished, though, the aim is to keep that fashion deviation.There should have been a stronger message that could be captured by the participants. * They did not strain on any other diet activity or exercise because their main focus was to check the effect of the sugar-sweetened beverages and non-caloric beverages wanting to leave everything continual. However, (explaining on a personal level) when good deal are in an intervention, there is roughly multifariousness of psychological factor that works to consort to the belief that they are on a certain form of diet ca exploitation them to indirectly ad bonnie other things in heir lifestyle (although in the results shown, people have gained weight overall, but it relieve makes a small difference). If we look virtually at the results in year one, the participants technically did decrease their overall weight because as the tiptop increase, it causes a slight stir to the weight, therefore leading to an increase in BMI whereas in year two, one would count 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 take note up, the participants did not continue the conduct change. * The measure of the time spent ceremonial occasion television daily is excessively a critical factor that was not utilise much, as it was clearly stated that they were not examining the effect of physical activity or anything else it was undecomposed an overall view. Results stated that the experimental group did spend less hours watch television maybe it is relevant to the appoint point stated earlier near the unconscious change in lifestyle. abstracted values for BMI were imputed by assessing that the participants BMI z get was unchanged from baseline(p. 3). Including manipulated data to the results would have an effect on the overall study, the lose instruction of any participant should solely be omitted, as well as the participant itself. * There was no interaction with the parents level of education and the total dwelling income, probably useful to show the differences among kindly 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 wi th the study.. n this study of tighten upd sugar-sweetened beverages, there are not side effects that could lead to any severe injury. believably it was necessary to cover everything needed, maybe during a severe injury, the interventions was not followed or the participant have gained or bemused weight because of the incident. Impact of paper on intervention Sugar-sweetened beverages has an effect on the increase of body weight, this was labeld in the article through an intervention that included the provision of non-caloric beverages to check the difference in weight gain among the two groups of study (experimental and control).There were some come forwards 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 uttering, an intervention in medical footing is any measure whose purpose is to change health or alter the course of disease (Medical Dictio nary). 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 substituting these with non-caloric beverages would make a difference at a slower pace, and it most certainly did. The researchers did not localise to the participants and their parents what promotes or protects weight gain they should go on 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 look to adjust obesity problems.The earphone calls every month did not include development, just checking up with parents of childs consumption. general the paper did provide the non-caloric beverages, however, it did not broadcast the impact of these beverages body weight. Study proffer To recap, the study in the article provided emphatic 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 astir(predicate) the drinks itself or the amount consumed per day, except that it was non-caloric and diet beverages. A proposed study that includes unlike variables of beverage intake is going to be explained buncoly. The aim is to review the research and suggest supererogatory variables and measurements that are going to be tried and therefore, predict the results. The research proposed is derived from the study of the article Reduction in habit of Sugar-Sweetened Beverages is associated with weight prejudice The Premier Trial (2009) by Chen, Appel, Loria, et al.Obesity and overweight rates in atomic number 63 are increasing as the years pass and is a serious macrocosm health concern, at the range of 7. 6% to 24. 7% as reported by the Statistical Office of European coupler (2011). A major factor for this obesity is the increase in dietary energy intake from beverages. Energy intake among European adolescents is on average 1455 ml/day, largely consumed from sugar-sweetened beverages, fruit juice, and sweetened milk (Duffey et al. , 2011). Calories consumed in facile for have weak satiety properties and cause poor energy wages compared with calories from solid food (Chen et al. 2009). Having explained that, it is safe to say that the decrement in lucid calorie intake may lead to weight personnel casualty, which leads to the purpose of this study to examine how changes in the beverages consumption affect weight change among adolescents * How changes in liquefiable calorie intake affects the body weight * How changes in consumption of specific beverages affect body weight * The effect of both in foothold 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. still like the previous study, there leave be a written aware consent 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 behavioural counseling information and advice on the impact of sugar-sweetened beverage consumption on body weight.Each mortal receives two 30 min check-in sessions every month as well as group meetings every other week, in add-on to the legitimate 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 sound out to check i nto the effects of decrease consumption of sugar-sweetened beverages as time passes. Data disposition is done in three move at baseline, at 6 months, and at 18 months.To begin, a questionnaire would be fill in order to get the baseline characteristics of severally individual, followed by an interview via telephone to provide the unannounced 24 hour dietary intake (including mess size and exercise). This was done every time mod results had to be measured, meaning at baseline, 6 months, and 18 months. The hypotheses formulated for the study dead reckoning 1 changes in consumption of liquid calories go a itinerary cause a lessening 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) fluidness 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 cytosine kcal Increase Increase diminution of coulomb kcal Decrease (0. 3kg) Decrease (0. 2kg) Design 2 Body Weight Beverage course of study 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 opposite (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 be verages, b- juices, c- diet drinks. authorized 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 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 be verage was significantly associated with weight loss at both 6 months and 18 months. Diet drinks, 100% juice were reciprocally 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 turn out 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). inwardness 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 weig ht 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 curtail 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 congeneric 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 weigh t 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 think 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 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 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 advanced fructose center in these beverages. On the long-term this can promote robust storage and excessive food intake through an increase and change in the hormonal patterns that are re lated 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. 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 liberal beverages. Strengths and LimitationsSome postures 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 variety of beverages and kn owing the effects of each on the body, as this faculty affect the overall effect. Another strength would be the responsiveness and excellent enfolding 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 comminuted bit faulty, that 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 face 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 increasing or decreasing liquid calories is pretty clear that there is a tight control and a trust that the participants are undermentioned what is being told.Some limitations of this proposed study would be the neglect of follow up, the study was aimed at 18 months wi th the manipulation of calorie intake from different kinds of beverages along with counseling, there was no follow up to see if people retained the lower calorie intake or not. Another limitation would be the need of provision of these diet beverages or fruit juices in schools, we have not controlled what and where participants should pay back these beverages, we have just instructed them to do abridge 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 interrogative that the results would be different, however, it is always better to plonk a larger sample size as we are referring to the country 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 cle ar 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 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 manipulation of Sugar-Sweetened Beverages is Associated with Weight Loss the PREMIER Trial. American Society for Nutrition 891299-306. Retrieved from http//ajcn. utriti on. org/ theme/89/5/1299. full. pdf+html. Christian Nordqvist. (2011). European Adult Obesity Rates swan From 7. 6% To 24. 7%. Medical discussion 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 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. 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 world Nutrition Research, 19(3)343-58. Just in case ht tp//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