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Fleming SA, Peregoy JA, Paul TL, Scott MO, Gaine PC. Charting the Chronology of Research on Added Sugars: A Scoping Review and Evidence Map. Nutrients 2023; 15:4974. [PMID: 38068831 PMCID: PMC10708429 DOI: 10.3390/nu15234974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/14/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
The objective of this study was to conduct a scoping review and produce a publicly available database characterizing the design and reporting elements of the literature on dietary added sugars and select health outcomes. Relevant studies published from 1990 to 2021 were identified to create a database containing information on study and population characteristics, reported added sugars source and concentrations, dietary energy balance, total energy intake, and outcome measures related to body composition, obesity, cardiovascular disease, and diabetes mellitus. There were 245 publications identified, 22% of which describe interventions, and 78% describe observational studies. Publications pertaining to added sugars have risen dramatically since 2010, led by studies primarily assessing body composition (36%) or cardiovascular health (32%), including adults (65%), measuring liquid-only sources of added sugars (56%). Over 65% of studies reported total energy intake, 61% controlled for total energy intake in the design and analysis, and fewer than 5% of studies reported the energy balance of subjects. There has been a significant increase in research on added sugars since 2010, with substantial heterogeneity across all facets of methodology-study designs, exposures and outcomes of interest, terminology, and reporting of dietary intake data-thus limiting the ability to synthesize evidence in this scope of the literature. This evidence map highlights gaps and important areas for improvement to strengthen the state of research and better inform future policies and dietary recommendations on added sugars.
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Affiliation(s)
- Stephen A. Fleming
- Traverse Science, 435 E Hawley Street #816, Mundelein, IL 60060, USA; (J.A.P.); (T.L.P.)
| | - Jennifer A. Peregoy
- Traverse Science, 435 E Hawley Street #816, Mundelein, IL 60060, USA; (J.A.P.); (T.L.P.)
| | - Tristen L. Paul
- Traverse Science, 435 E Hawley Street #816, Mundelein, IL 60060, USA; (J.A.P.); (T.L.P.)
| | - Maria O. Scott
- Sugar Association Inc., 1310 L Street, NW, Suite 400, Washington, DC 20005, USA; (M.O.S.); (P.C.G.)
| | - P. Courtney Gaine
- Sugar Association Inc., 1310 L Street, NW, Suite 400, Washington, DC 20005, USA; (M.O.S.); (P.C.G.)
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Garcidueñas-Fimbres TE, Paz-Graniel I, Gómez-Martínez C, Jurado-Castro JM, Leis R, Escribano J, Moreno LA, Navas-Carretero S, Portoles O, Pérez-Vega KA, Gil-Campos M, López-Rubio A, Rey-Reñones C, De Miguel-Etayo P, Martínez JA, Flores-Rojas K, Vázquez-Cobela R, Luque V, Miguel-Berges ML, Pastor-Villaescusa B, Llorente-Cantarero FJ, Salas-Salvadó J, Babio N. Associations Between Eating Speed, Diet Quality, Adiposity, and Cardiometabolic Risk Factors. J Pediatr 2023; 252:31-39.e1. [PMID: 36027978 DOI: 10.1016/j.jpeds.2022.08.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the associations between eating speed, adiposity, cardiometabolic risk factors, and diet quality in a cohort of Spanish preschool-children. STUDY DESIGN A cross-sectional study in 1371 preschool age children (49% girls; mean age, 4.8 ± 1.0 years) from the Childhood Obesity Risk Assessment Longitudinal Study (CORALS) cohort was conducted. After exclusions, 956 participants were included in the analyses. The eating speed was estimated by summing the total minutes used in each of the 3 main meals and then categorized into slow, moderate, or fast. Multiple linear and logistic regression models were fitted to assess the β-coefficient, or OR and 95% CI, between eating speed and body mass index, waist circumference, fat mass index (FMI), blood pressure, fasting plasma glucose, and lipid profile. RESULTS Compared with participants in the slow-eating category, those in the fast-eating category had a higher prevalence risk of overweight/obesity (OR, 2.9; 95% CI, 1.8-4.4; P < .01); larger waist circumference (β, 2.6 cm; 95% CI, 1.5-3.8 cm); and greater FMI (β, 0.3 kg/m2; 95% CI, 0.1-0.5 kg/m2), systolic blood pressure (β, 2.8 mmHg; 95% CI, 0.6-4.9 mmHg), and fasting plasma glucose levels (β, 2.7 mg/dL, 95% CI, 1.2-4.2 mg/dL) but lower adherence to the Mediterranean diet (β, -0.5 points; 95% CI, -0.9 to -0.1 points). CONCLUSIONS Eating fast is associated with higher adiposity, certain cardiometabolic risk factors, and lower adherence to a Mediterranean diet. Further long-term and interventional studies are warranted to confirm these associations.
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Affiliation(s)
- Tany E Garcidueñas-Fimbres
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | - Indira Paz-Graniel
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | - Carlos Gómez-Martínez
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
| | - Jose Manuel Jurado-Castro
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Reina Sofia University Hospital, Maimónides Biomedical Research Institute of Cordoba., University of Córdoba, Córdoba, Spain
| | - Rosaura Leis
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Pediatric Nutrition Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain; Unit of Investigation in Human Nutrition, Growth and Development of Galicia, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Joaquin Escribano
- Institut d'Investigació Sanitària Pere Virgili, Reus, Spain; Pediatrics, Nutrition, and Development Research Unit, Universitat Rovira i Virgili, Reus, Spain
| | - Luis A Moreno
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Growth, Exercise, Nutrition and Development Research Group, Instituto Agroalimentario de Aragón, Instituto de Investigación Sanitaria Aragón, University of Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Santiago Navas-Carretero
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Center for Nutrition Research, University of Navarra, Pamplona, Spain; IdisNA Institute for Health Research, Pamplona, Spain
| | - Olga Portoles
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Valencia, Valencia, Spain
| | - Karla A Pérez-Vega
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Mercedes Gil-Campos
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Reina Sofia University Hospital, Maimónides Biomedical Research Institute of Cordoba., University of Córdoba, Córdoba, Spain
| | - Alicia López-Rubio
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Pediatric Nutrition Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain; Unit of Investigation in Human Nutrition, Growth and Development of Galicia, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristina Rey-Reñones
- Departament de Ciències Mèdiques Bàsiques, Facultat de Medicina, Universitat Rovira i Virgili, Reus, Spain; Unitat de Suport a la Recerca Camp de Tarragona, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Reus, Spain; Centre d'Atenció Primària St Pere, Direcció d'Atenció Primària Camp de Tarragona, Institut Català de la Salut, Reus, Spain
| | - Pilar De Miguel-Etayo
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Growth, Exercise, Nutrition and Development Research Group, Instituto Agroalimentario de Aragón, Instituto de Investigación Sanitaria Aragón, University of Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
| | | | - Katherine Flores-Rojas
- Reina Sofia University Hospital, Maimónides Biomedical Research Institute of Cordoba., University of Córdoba, Córdoba, Spain
| | - Rocío Vázquez-Cobela
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Service, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Pediatric Nutrition Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain; Unit of Investigation in Human Nutrition, Growth and Development of Galicia, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Verónica Luque
- Institut d'Investigació Sanitària Pere Virgili, Reus, Spain; Pediatrics, Nutrition, and Development Research Unit, Universitat Rovira i Virgili, Reus, Spain
| | - Maria Luisa Miguel-Berges
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Growth, Exercise, Nutrition and Development Research Group, Instituto Agroalimentario de Aragón, Instituto de Investigación Sanitaria Aragón, University of Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Belén Pastor-Villaescusa
- Reina Sofia University Hospital, Maimónides Biomedical Research Institute of Cordoba., University of Córdoba, Córdoba, Spain
| | - Francisco Jesus Llorente-Cantarero
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Department of Specific Didactics, Faculty of Education, University of Córdoba, Córdoba, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili, Reus, Spain.
| | - Nancy Babio
- Consorcio CIBER. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili, Reus, Spain.
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Nguyen CT, Luckett DJ, Kahkoska AR, Shearrer GE, Spruijt-Metz D, Davis JN, Kosorok MR. Estimating individualized treatment regimes from crossover designs. Biometrics 2020; 76:778-788. [PMID: 31743424 PMCID: PMC7234899 DOI: 10.1111/biom.13186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 10/03/2019] [Accepted: 10/29/2019] [Indexed: 11/27/2022]
Abstract
The field of precision medicine aims to tailor treatment based on patient-specific factors in a reproducible way. To this end, estimating an optimal individualized treatment regime (ITR) that recommends treatment decisions based on patient characteristics to maximize the mean of a prespecified outcome is of particular interest. Several methods have been proposed for estimating an optimal ITR from clinical trial data in the parallel group setting where each subject is randomized to a single intervention. However, little work has been done in the area of estimating the optimal ITR from crossover study designs. Such designs naturally lend themselves to precision medicine since they allow for observing the response to multiple treatments for each patient. In this paper, we introduce a method for estimating the optimal ITR using data from a 2 × 2 crossover study with or without carryover effects. The proposed method is similar to policy search methods such as outcome weighted learning; however, we take advantage of the crossover design by using the difference in responses under each treatment as the observed reward. We establish Fisher and global consistency, present numerical experiments, and analyze data from a feeding trial to demonstrate the improved performance of the proposed method compared to standard methods for a parallel study design.
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Affiliation(s)
- Crystal T. Nguyen
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, U.S.A
| | - Daniel J. Luckett
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, U.S.A
| | - Anna R. Kahkoska
- Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, U.S.A
| | - Grace E. Shearrer
- Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, U.S.A
| | - Donna Spruijt-Metz
- Center of Economic and Social Research, University of Southern California, Los Angeles, California, U.S.A
| | - Jaimie N. Davis
- Department of Nutrition, University of Texas at Austin, Austin, Texas, U.S.A
| | - Michael R. Kosorok
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, U.S.A
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