The Effect of Sugar-Free Versus Sugar-Sweetened Beverages on Satiety,Liking and Wanting: An 18 Month Randomized Double-Blind Trial in Children

Background

Substituting sugar-free for sugar-sweetened beverages reduces weight gain. A possible explanation is that sugar-containing and sugar-free beverages cause the same degree of satiety. However, this has not been tested in long-term trials.

Methods

We randomized 203 children aged 7-11 years to receive 250 mL per day of an artificially sweetened sugar-free beverage or a similarly looking and tasting sugar-sweetened beverage. We measured satiety on a 5-point scale by questionnaire at 0, 6, 12 and 18 months. We calculated the change in satiety from before intake to 1 minute after intake and 15 minutes after intake. We then calculated the odds ratio that satiety increased by 1 point in the sugar-group versus the sugar-free group. We also investigated how much the children liked and wanted the beverages.

Results

146 children or 72% completed the study. We found no statistically significant difference in satiety between the sugar-free and sugar-sweetened group; the adjusted odds ratio for a 1 point increase in satiety in the sugar group versus the sugar-free group was 0.77 at 1 minute (95% confidence interval, 0.46 to 1.29), and 1.44 at 15 minutes after intake (95% CI, 0.86 to 2.40). The sugar-group liked and wanted their beverage slightly more than the sugar-free group, adjusted odds ratio 1.63 (95% CI 1.05 to 2.54) and 1.65 (95% CI 1.07 to 2.55), respectively.

Conclusions

Sugar-sweetened and sugar-free beverages produced similar satiety. Therefore when children are given sugar-free instead of sugar-containing drinks they might not make up the missing calories from other sources. This may explain our previous observation that children in the sugar-free group accumulated less body fat than those in the sugar group.

Trial Registration

ClinicalTrials.gov NCT00893529 http://clinicaltrials.gov/show/NCT00893529     

Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages

Introduction

Type 2 diabetes poses an increasing public health burden in South Africa (SA) with obesity as the main driver of the epidemic. Consumption of sugar sweetened beverages (SSBs) is linked to weight gain and reducing SSB consumption may significantly impact the prevalence of obesity and related diseases. We estimated the effect of a 20% SSB tax on the burden of diabetes in SA.

Methods and Findings

We constructed a life table-based model in Microsoft Excel (2010). Consumption data from the 2012 SA National Health and Nutrition Examination Survey, previously published own- and cross-price elasticities of SSBs and energy balance equations were used to estimate changes in daily energy intake and its projected impact on BMI arising from increased SSB prices. Diabetes relative risk and prevalent years lived with disability estimates from the Global Burden of Disease Study and modelled disease epidemiology estimates from a previous study were used to estimate the effect of the BMI changes on diabetes burden. Diabetes cost estimates were obtained from the South African Council for Medical Schemes. Over 20 years, a 20% SSB tax could reduce diabetes incident cases by 106 000 in women (95% uncertainty interval (UI) 70 000–142 000) and by 54 000 in men (95% UI: 33 000–80 000); and prevalence in all adults by 4.0% (95% UI: 2.7%-5.3%). Cumulatively over twenty years, approximately 21 000 (95% UI: 14 000–29 000) adult T2DM-related deaths, 374 000 DALYs attributed to T2DM (95% UI: 299 000–463 000) and over ZAR10 billion T2DM healthcare costs (95% UI: ZAR6.8–14.0 billion) equivalent to USD860 million (95% UI: USD570 million–USD1.2 billion) may be averted.

Conclusion

Fiscal policy on SSBs has the potential to mitigate the diabetes epidemic in South Africa and contribute to the National Department of Health goals stated in the National NCD strategic plan.     

The Potential Impact of a 20% Tax on Sugar-Sweetened Beverages on Obesity in South African Adults: A Mathematical Model

Background/Objectives

The prevalence of obesity in South Africa has risen sharply, as has the consumption of sugar-sweetened beverages (SSBs). Research shows that consumption of SSBs leads to weight gain in both adults and children, and reducing SSBs will significantly impact the prevalence of obesity and its related diseases. We estimated the effect of a 20% tax on SSBs on the prevalence of and obesity among adults in South Africa.

Methods

A mathematical simulation model was constructed to estimate the effect of a 20% SSB tax on the prevalence of obesity. We used consumption data from the 2012 SA National Health and Nutrition Examination Survey and a previous meta-analysis of studies on own- and cross-price elasticities of SSBs to estimate the shift in daily energy consumption expected of increased prices of SSBs, and energy balance equations to estimate shifts in body mass index. The population distribution of BMI by age and sex was modelled by fitting measured data from the SA National Income Dynamics Survey 2012 to the lognormal distribution and shifting the mean values. Uncertainty was assessed with Monte Carlo simulations.

Results

A 20% tax is predicted to reduce energy intake by about 36kJ per day (95% CI: 9-68kJ). Obesity is projected to reduce by 3.8% (95% CI: 0.6%–7.1%) in men and 2.4% (95% CI: 0.4%–4.4%) in women. The number of obese adults would decrease by over 220 000 (95% CI: 24 197–411 759).

Conclusions

Taxing SSBs could impact the burden of obesity in South Africa particularly in young adults, as one component of a multi-faceted effort to prevent obesity.     

Global,Regional, and National Consumption of Sugar-Sweetened Beverages,Fruit Juices,and Milk: A Systematic Assessment of Beverage Intake in 187 Countries

Background

Sugar-sweetened beverages (SSBs), fruit juice, and milk are components of diet of major public health interest. To-date, assessment of their global distributions and health impacts has been limited by insufficient comparable and reliable data by country, age, and sex.

Objective

To quantify global, regional, and national levels of SSB, fruit juice, and milk intake by age and sex in adults over age 20 in 2010.

Methods

We identified, obtained, and assessed data on intakes of these beverages in adults, by age and sex, from 193 nationally- or subnationally-representative diet surveys worldwide, representing over half the world’s population. We also extracted data relevant to milk, fruit juice, and SSB availability for 187 countries from annual food balance information collected by the United Nations Food and Agriculture Organization. We developed a hierarchical Bayesian model to account for measurement incomparability, study representativeness, and sampling and modeling uncertainty, and to combine and harmonize nationally representative dietary survey data and food availability data.

Results

In 2010, global average intakes were 0.58 (95%UI: 0.37, 0.89) 8 oz servings/day for SSBs, 0.16 (0.10, 0.26) for fruit juice, and 0.57 (0.39, 0.83) for milk. There was significant heterogeneity in consumption of each beverage by region and age. Intakes of SSB were highest in the Caribbean (1.9 servings/day; 1.2, 3.0); fruit juice consumption was highest in Australia and New Zealand (0.66; 0.35, 1.13); and milk intake was highest in Central Latin America and parts of Europe (1.06; 0.68, 1.59). Intakes of all three beverages were lowest in East Asia and Oceania. Globally and within regions, SSB consumption was highest in younger adults; fruit juice consumption showed little relation with age; and milk intakes were highest in older adults.

Conclusions

Our analysis highlights the enormous spectrum of beverage intakes worldwide, by country, age, and sex. These data are valuable for highlighting gaps in dietary surveillance, determining the impacts of these beverages on global health, and targeting dietary policy.     

Replication Protein A (RPA): The Eukaryotic SSB

Replication protein A (RPA) is a heterotrimeric single-stranded DNA-binding protein that is highly conserved in eukaryotes. RPA plays essential roles in many aspects of nucleic acid metabolism, including DNA replication, nucleotide excision repair, and homologous recombination. In this review, we provide a comprehensive overview of RPA structure and function and highlight the more recent developments in these areas. The last few years have seen major advances in our understanding of the mechanism of RPA binding to DNA, including the structural characterization of the primary DNA-binding domains (DBD) and the identification of two secondary DBDs. Moreover, evidence indicates that RPA utilizes a multistep pathway to bind single-stranded DNA involving a particular molecular polarity of RPA, a mechanism that is apparently used to facilitate origin denaturation. In addition to its mechanistic roles, RPA interacts with many key factors in nucleic acid metabolism, and we discuss the critical nature of many of these interactions to DNA metabolism. RPA is a phosphorylation target for DNA-dependent protein kinase (DNA-PK) and likely the ataxia telangiectasia-mutated gene (ATM) protein kinase, and recent observations are described that suggest that RPA phosphorylation plays a significant modulatory role in the cellular response to DNA damage.     

Health Warnings on Alcoholic Beverages: Perceptions of the Health Risks and Intentions towards Alcohol Consumption

ObjectivesResearch has demonstrated that packaging which includes pictorial health warnings are more effective in altering smokers’ perceptions and intentions as well as changing smoking behaviours compared to text-only health warnings. However, very few studies have investigated the effectiveness of health warnings on alcoholic beveragesMethodsParticipants (N = 60) viewed alcoholic beverages presenting one of three health warnings (No health warning, Text-only, Pictorial) and then responded to questions relating to level of fear arousal and their perceptions toward alcohol use.ResultsWe found that pictorial health warnings were associated with significantly higher fear arousal, increased perceptions of the health risks of consuming alcohol as well as greater intentions to reduce and quit alcohol consumption compared to the control.ConclusionsThese novel findings suggest pictorial health warnings on alcoholic beverages may be an important way of making the public aware of the health risks of alcohol consumption.     

Financial Conflicts of Interest and Reporting Bias Regarding the Association between Sugar-Sweetened Beverages and Weight Gain: A Systematic Review of Systematic Reviews

Background

Industry sponsors'' financial interests might bias the conclusions of scientific research. We examined whether financial industry funding or the disclosure of potential conflicts of interest influenced the results of published systematic reviews (SRs) conducted in the field of sugar-sweetened beverages (SSBs) and weight gain or obesity.

Methods and Findings

We conducted a search of the PubMed, Cochrane Library, and Scopus databases to identify published SRs from the inception of the databases to August 31, 2013, on the association between SSB consumption and weight gain or obesity. SR conclusions were independently classified by two researchers into two groups: those that found a positive association and those that did not. These two reviewers were blinded with respect to the stated source of funding and the disclosure of conflicts of interest.We identified 17 SRs (with 18 conclusions). In six of the SRs a financial conflict of interest with some food industry was disclosed. Among those reviews without any reported conflict of interest, 83.3% of the conclusions (10/12) were that SSB consumption could be a potential risk factor for weight gain. In contrast, the same percentage of conclusions, 83.3% (5/6), of those SRs disclosing some financial conflict of interest with the food industry were that the scientific evidence was insufficient to support a positive association between SSB consumption and weight gain or obesity. Those reviews with conflicts of interest were five times more likely to present a conclusion of no positive association than those without them (relative risk: 5.0, 95% CI: 1.3–19.3).An important limitation of this study is the impossibility of ruling out the existence of publication bias among those studies not declaring any conflict of interest. However, the best large randomized trials also support a direct association between SSB consumption and weight gain or obesity.

Conclusions

Financial conflicts of interest may bias conclusions from SRs on SSB consumption and weight gain or obesity. Please see later in the article for the Editors'' Summary     

The Totora (Scirpus Californicus) in Ecuador and Peru

Economic Botany - The totora (also known as matara and merme),Scirpus californicus, is widely used in Ecuador and Peru for a number of purposes. Floats made from it are still found at L.ake San...     

Migration and Agricultural Change: The Case of Smallholder Agriculture in Highland Ecuador

A large and growing number of agricultural households in less developed countries are also engaged in international migration. Thousands of farmers from the highland provinces of Cañar and Azuay, Ecuador, have immigrated to metropolitan New York, where they work in menial jobs and remit, as a group, millions of dollars annually. This paper examines the effects of international migration on agricultural production and land-use in two regions of Cañar Province. An agricultural survey was administered in two communities to determine land-use and agricultural production of migrant and nonmigrant households. Contrary to most reports on the subject, migration has neither led to agricultural abandonment nor have remittances been dedicated to agricultural improvements. Semisubsistence agriculture remains an important riskaverse economic and cultural activity, but cultivation is a poor investment. A large investment in housing and land has converted much of the region into a peri-urban landscape of cultivated real estate.     

Loneliness,Social Integration and Consumption of Sugar-Containing Beverages: Testing the Social Baseline Theory

Objective

Social Baseline Theory (SBT) proposes that close relationships aid in metabolic resource management and that individuals without significant relationships may experience more demands on their own neural metabolic resources on a daily basis when solving problems, remaining vigilant against potential threats and regulating emotional responses. This study tests a hypothesised consequence derived from SBT: relative social isolation leads to increased levels of sugar intake.

Methods

Based on cross-sectional, self-reported data from the Norwegian Mother and Child Cohort Study (N = 90 084), information on social integration and the consumption of both sugar-sweetened and artificially sweetened sodas and juices was obtained from a large number of women in early pregnancy. Multiple regression analyses were conducted to assess whether loneliness, marital status, relationship satisfaction, advice from others than partner, and cohesion at work is associated with consumption of sodas and juices.

Results

Perceived loneliness was associated with elevated intake of all sugary beverages, while relationship satisfaction was negatively associated with all sugary beverages. Being married or cohabitating, having supportive friends, and having a sense of togetherness at work were associated with lower intake of two out of three sugar-containing beverages. These associations were significant, even after controlling for factors such as body mass index, weight related self-image, depression, physical activity, educational level, age and income. In comparison, a statistically significant relationship emerged between relationship satisfaction and artificially sweetened cola. No other predictor variables were significantly associated with any type of artificially sweetened beverage.

Conclusions

This study indicates that loneliness and social integration influence the level of consumption of sugary beverages. The results support the hypothesis derived from the Social Baseline Theory that relative social isolation leads to increased levels of sugar intake.     

Biological Invasions in the Amazonian Tropical Rain Forest: The Case of Drosophilidae (Insecta,Diptera) in Ecuador,South America

There have been few reports of invasions in continental rain forests, especially for exotic animals. This study provides original data concerning the potential of exotic drosophilid species to colonize the Amazonian tropical rain forest. To investigate if the structure of drosophilid assemblages differed in response to anthropogenic disturbance, we performed a taxonomic survey at six sites within the Yasuni National Park in Ecuadorian Amazonia along a disturbance gradient from pristine to clearcut artificial forest. A total of 7425 individuals from 34 species were collected of which seven species were exotic. There was significant variation in the assemblage composition along this disturbance gradient; 31 percent of which was explained by the presence of exotic species, particularly at the most disturbed sites, through nonmetric multidimensional scaling and SIMPER analyses. These results confirm the susceptibility of continental rain forests to invasion by exotic species. There is an urgent need to develop and implement monitoring systems, for example, based on drosophilid assemblage surveys, to detect exotic invasions in continental tropical forests.     

Detecting Stress at the Whole-Ecosystem Level: The Case of a Mountain Lake (Lake Santo, Italy)

Detecting the early signs of stress is imperative for the conservation of natural ecosystems. They may, however, go unrecognized because ecosystems, when disturbed, may act as sinks that absorb the external impact without showing any evident changes. This seems to be the case for Lake Santo, a small water body located in a mountainous area of northern Italy. Tourism activity in this area began to develop in the early 1970s and grew continuously over the following 20 years. This activity caused a continually increasing nutrient load into the waters, but surprisingly the lake has remained oligo-mesotrophic, as it was before human pressure became a stressor to the lake. To anticipate possible severe damage to the ecosystem, we searched for early signs of stress by carrying out a retrospective analysis based on a whole-ecosystem approach using trophic flow networks. Ecosystem properties of the lake as calculated from network analysis for the disturbed (year 1991) and unimpacted (year 1973) configurations were compared, with the support of sensitivity analysis and statistical tests. We found evidence that in the period 1970–90 nutrient enrichment did change the course of normal development as the observed increase in system throughput was accompanied by a drop in the level of mutual organization of flows, which instead would be expected to increase during the natural progression of the ecosystem. The scenario that emerged from the comparison of system-level indices, cycling activity, trophic structure, and trophic efficiency indicates that the ecosystem has been subjected to stress. In particular, the type of disturbance corresponds to a quantitative definition of eutrophication.     

Planorbidae, Lymnaeidae and Physidae of Ecuador (Mollusca: Basommatophora)

In the course of a trip to Ecuador I had the opportunity of collecting topotypic specimens of the following nominal species of pulmonate molluscs: Biomphalaria cousini Paraense, 1966; Planorbis equatorius Cousin, 1887; P. canonicus Cousin, 1887; Lymnaea cousini Jousseaume, 1887 and P. boetzkesi Miller, 1879. Additional findings were: Helisoma trivolvis (Say, 1817), Biomphalaria peregrina (Orbigny 1835), Drepanotrema anatinum (Orbigny, 1835), D. kermatoides (Orbigny, 1835), D. lucidum (Pfeiffer, 1839), D. surinamense (Clessin, 1884), Lymnaea columella Say, 1817 and Physa acuta Draparnaud, 1805. P. boetzkesi and P. canonicus are considered junior synonyms of Gyraulus hindsianus (Dunker, 1848) and Biomphalaria peregrina (Orbigny, 1835), respectively.     

The lichen genus Erioderma (Pannariaceae) in Ecuador and neighbouring countries

The lichen genus Erioderma is shown to be particularly species-rich in Ecuador, especially in the upper cloud forest (3000–3400m). Altogether seventeen species are recorded of which the following are new: E. barbellatum, E. cyathophorum, E. divisum, E. gloriosum, E. papyraceum, E. pycnidiferum, E. sinuatum , most of which also occur in the neighbouring countries. Two further taxa from these are described as new: E. latilobatum from Bolivia and E. peruvianum from Peru and Bolivia.     

The Holocene treeline in the northern Andes (Ecuador): First evidence from soil charcoal

Indications for the speed and timing of past altitudinal treeline shifts are often contradictory. Partly, this may be due to interpretation difficulties of pollen records, which are generally regional rather than local proxies. We used pedoanthracology, the identification and dating of macroscopic soil charcoal, to study vegetation history around the treeline in the northern Ecuadorian Andes. Pedoanthracology offers a complementary method to pollen-based vegetation reconstructions by providing records with high spatial detail on a local scale. The modern vegetation is tussock grass páramo (tropical alpine vegetation) and upper montane cloud forest, and the treeline is located at ca. 3600 m. Charcoal was collected from soils in the páramo (at 3890 and 3810 m) and in the forest (at 3540 m), and represents a sequence for the entire Holocene.The presence of páramo taxa throughout all three soil profiles, especially in combination with the absence of forest taxa, shows that the treeline in the study area has moved up to its present position only late in the Holocene (after ca. 5850 cal years BP). The treeline may have been situated between 3600 m and 3800 m at some time after ca. 4900 cal years BP, or it may never have been higher than it is today. The presence of charcoal throughout the profiles also shows that fires have occurred in this area at least since the beginning of the Holocene.These results contradict interpretations of palaeological data from Colombia, which suggest a rapid treeline rise at the Pleistocene–Holocene transition. They also contradict the hypothesis that man-made fires have destroyed large extents of forest above the modern treeline. Instead, páramo fires have probably contributed to the slowness of treeline rise during the Holocene.     

First Record of the Subfamily Psychodinae (Diptera: Psychodidae) from Ecuador

This is the first record for the subfamily Psychodinae from Ecuador and a new species belonging to genus Arisemus, A. triconnectus, is described.     

Negative cooperativity within individual tetramers of Escherichia coli single strand binding protein is responsible for the transition between the (SSB)35 and (SSB)56 DNA binding modes

We have examined the binding of the oligonucleotide dT (pT)34 to the Escherichia coli SSB protein as a function of NaCl and MgCl2 concentration (25 degrees C, pH 8.1) by monitoring the quenching of the intrinsic protein fluorescence. We find two binding sites for dT(pT)34 per single strand binding (SSB) protein tetramer, with each site possessing widely different affinities depending on the salt concentration. At 200 mM NaCl, we observe nearly stoichiometric binding of dT(pT)34 to both binding sites within the SSB tetramer, although a difference in the affinities is still apparent. However, when the NaCl concentration is lowered, the overall affinity of dT(pT)34 for the second site on the SSB tetramer decreases dramatically. At 1.5 mM NaCl, only a single molecule of dT(pT)34 can bind per SSB tetramer, even with a 10-fold molar excess of dT(pT)34. MgCl2 is effective at 100-fold lower concentrations than NaCl in promoting the binding of the second molecule of dT(pT)34. This binding behavior reflects an intrinsic property of the SSb tetramer, since it is also observed upon binding of smaller oligonucleotides, and the simplest explanation is that a salt-dependent negative cooperativity exists between DNA binding sites within the SSB tetramer. This phenomenon is also responsible for the transition between the two SSB-single strand (ss) polynucleotide binding modes that cover 35 and 56 nucleotides per tetramer [Bujalowski, W., & Lohman, T. M. (1986) Biochemistry 25, 7799-7802]. Extreme negative cooperativity stabilizes the (SSB)35 binding mode, in which the SSB tetramer binds tightly to ss DNA with only two of its subunits while the other two subunits remain unligated.(ABSTRACT TRUNCATED AT 250 WORDS)     

Helical Biography and the Historical Craft: The Case of Altruism and George Price

The life of George Price (1922–1975), the eccentric polymath genius and father of the Price equation, is used as a prism and counterpoint through which to consider an age-old evolutionary conundrum: the origins of altruism. This biographical project, and biography and history more generally, are considered in terms of the possibility of using form to convey content in particular ways. Closer to an art form than a science, this approach to scholarship presents both a unique challenge and promise.