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Note : the study selected children who were considered to be "particularly high risk of diabetes and related disorders. All the subjects were black or Hispanic

by sgt101 11y ago

Note : the study selected children who were considered to be "particularly high risk of diabetes and related disorders. All the subjects were black or Hispanic and obese, and had at least one or more symptoms of metabolic syndrome, a cluster of risk factors that includes hypertension, high blood sugar, abnormal cholesterol and excess body fat around the waist." I did not read that there was a control group.

hyperpape 11y ago
Wait, the original study didn't mention a control group, or the NYTimes didn't mention it? Those are very different.
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cryoshon 11y ago
Great catch. It's possible that participating in a study of high risk people has a subtle influence on eating behavior such that these biomarkers might be altered over a 10 day time course anyway. I'm pretty sure that this change wouldn't be as large as the experimental group's results, but you never know.
cle 11y ago
The paper discusses this: However, there are some limitations to our paradigm. Athough inclusion of a separate external control group would have been optimal, it would have presented novel challenges of its own, such as: 1) if subjects under- or over-estimated their baseline fructose consumption, then providing them their reported daily fructose content would be problematic; 2) altering each subject's diet while trying to maintain the baseline fructose content would require changes in liquid versus solid, which may also result in caloric change, altered absorption, and altered satiety; and 3) our participants were all patients in an obesity program. We did not believe that maintaining fructose at the same level, even within a study, is commensurate with the message that the change in macronutrient composition is important for their health, and in order to use the study as an “educational moment.” Furthermore, others have looked longitudinally at children with obesity over time without any intervention, but still within the confines of a study, and had seen no changes in metabolic outcomes [39]. Rather, each participant served as his or her own control. Our paradigm of dietary sugar and fructose restriction, which included mid-study dietary adjustments to compensate for weight loss, resulted in a 4% decrease in percentage of calories from carbohydrate, a 2% increase in percentage of calories from protein, and a small increase in dietary fiber, which could have reduced macronutrient absorption [18], flux of fructose to the liver, and also increased satiety. Recognizing that consumption data by recall is routinely underestimated [24], we made every effort to maintain our participants' baseline weight throughout the 10-day study interval, and even increased the caloric allotment partway through the cohort, yet a decline of 0.9 ± 0.2 kg was noted during the 10 days.
- gus_massa 11y ago
  I'll quote part of your quote, because it's interesting: > We did not believe that maintaining fructose at the same level, even within a study, is commensurate with the message that the change in macronutrient composition is important for their health, and in order to use the study as an “educational moment.” This is a very bad excuse to avoid a control group. There are many unknown factors that are difficult to estimate. For example: Did the children also change the fat consumption because a doctor was going to examine them in a few days? Did they change some habits, like walking to medical center instead of no walking? I can invent a few more, because it's very difficult to guess the baseline and the changes in the subjects. To be sure that "the change in macronutrient composition is important for their health" you need a scientific study. And to be sure that the study is reliable you need a control group.
Retric 11y ago
You don't always need a control group for short term studies like this. If for example you want to know what altitude people pass out then having people stick around at sea level is pointless.
jonlucc 11y ago
Actually, I am a bit unimpressed by the body weight data. You can see clearly in their individual data that there are a ton of errors in readings, and while the SEM is low by the final day, I'm not sure you can make much of that information when so many of the individuals had daily swings >1kg. It does look like OGTT changes are dependent on weight change (post-hoc weight-gaining group did not see the same benefit as the total cohort). To me, the diastolic BP, baseline fasting insulin, and OGTT AUC are the real stars here.

by sgt101 11y ago

hyperpape 11y ago

Wait, the original study didn't mention a control group, or the NYTimes didn't mention it? Those are very different.

deleted 11y ago

[deleted]

deleted 11y ago

[deleted]

cryoshon 11y ago

Great catch. It's possible that participating in a study of high risk people has a subtle influence on eating behavior such that these biomarkers might be altered over a 10 day time course anyway. I'm pretty sure that this change wouldn't be as large as the experimental group's results, but you never know.

cle 11y ago

The paper discusses this: However, there are some limitations to our paradigm. Athough inclusion of a separate external control group would have been optimal, it would have presented novel challenges of its own, such as: 1) if subjects under- or over-estimated their baseline fructose consumption, then providing them their reported daily fructose content would be problematic; 2) altering each subject's diet while trying to maintain the baseline fructose content would require changes in liquid versus solid, which may also result in caloric change, altered absorption, and altered satiety; and 3) our participants were all patients in an obesity program. We did not believe that maintaining fructose at the same level, even within a study, is commensurate with the message that the change in macronutrient composition is important for their health, and in order to use the study as an “educational moment.” Furthermore, others have looked longitudinally at children with obesity over time without any intervention, but still within the confines of a study, and had seen no changes in metabolic outcomes [39]. Rather, each participant served as his or her own control. Our paradigm of dietary sugar and fructose restriction, which included mid-study dietary adjustments to compensate for weight loss, resulted in a 4% decrease in percentage of calories from carbohydrate, a 2% increase in percentage of calories from protein, and a small increase in dietary fiber, which could have reduced macronutrient absorption [18], flux of fructose to the liver, and also increased satiety. Recognizing that consumption data by recall is routinely underestimated [24], we made every effort to maintain our participants' baseline weight throughout the 10-day study interval, and even increased the caloric allotment partway through the cohort, yet a decline of 0.9 ± 0.2 kg was noted during the 10 days.

gus_massa 11y ago
I'll quote part of your quote, because it's interesting: > We did not believe that maintaining fructose at the same level, even within a study, is commensurate with the message that the change in macronutrient composition is important for their health, and in order to use the study as an “educational moment.” This is a very bad excuse to avoid a control group. There are many unknown factors that are difficult to estimate. For example: Did the children also change the fat consumption because a doctor was going to examine them in a few days? Did they change some habits, like walking to medical center instead of no walking? I can invent a few more, because it's very difficult to guess the baseline and the changes in the subjects. To be sure that "the change in macronutrient composition is important for their health" you need a scientific study. And to be sure that the study is reliable you need a control group.

Retric 11y ago

You don't always need a control group for short term studies like this. If for example you want to know what altitude people pass out then having people stick around at sea level is pointless.

jonlucc 11y ago

Actually, I am a bit unimpressed by the body weight data. You can see clearly in their individual data that there are a ton of errors in readings, and while the SEM is low by the final day, I'm not sure you can make much of that information when so many of the individuals had daily swings >1kg. It does look like OGTT changes are dependent on weight change (post-hoc weight-gaining group did not see the same benefit as the total cohort). To me, the diastolic BP, baseline fasting insulin, and OGTT AUC are the real stars here.