OBJECTIVE: The Dutch Obesity Intervention in Teenagers (DOiT) is a school-based randomised controlled trial that was effective in decreasing the consumption of sugar-sweetened beverages among adolescents. The present study examined, using mediation analysis, whether this decrease in consumption of sugar-sweetened beverages could be explained by an increase in the consumption of water or diet drinks. DESIGN: Participants completed a questionnaire about their beverage consumption at baseline and at 8 months (immediately post-intervention), 12- and 20-month follow-ups. A series of multi-level linear regression analyses were performed to examine water and diet drink consumption as potential mediators of the intervention effect on the consumption of sugar-sweetened beverages. SETTING:Eighteen Dutch secondary schools. SUBJECTS: A total of 747 adolescents (mean age: 12·7 years). RESULTS: In addition to the DoiT intervention effect of a reduction in the consumption of sugar-sweetened beverages at 8 months (-284 ml/d; 95 % CI -420, -148) and 12 months (-260 ml/d; 95 % CI -360, -160), there was also a significant reduction in diet drinks at 8 months (-52 ml/d; 95 % CI -89, -16). There was no significant difference in water consumption at any follow-up. The decrease in sugar-sweetened beverage consumption could not be explained by an increase in water or diet drink consumption at any time point. CONCLUSIONS: Interventions aimed at reducing sugar-sweetened beverage consumption may be effective without changing consumption of other beverages. Reducing sugar-sweetened beverages was, however, a main message of the DOiT intervention. It is possible that a concomitant promotion of water may have resulted in a greater increase in water intake and replacement of sugar-sweetened beverages with water.
RCT Entities:
OBJECTIVE: The Dutch Obesity Intervention in Teenagers (DOiT) is a school-based randomised controlled trial that was effective in decreasing the consumption of sugar-sweetened beverages among adolescents. The present study examined, using mediation analysis, whether this decrease in consumption of sugar-sweetened beverages could be explained by an increase in the consumption of water or diet drinks. DESIGN:Participants completed a questionnaire about their beverage consumption at baseline and at 8 months (immediately post-intervention), 12- and 20-month follow-ups. A series of multi-level linear regression analyses were performed to examine water and diet drink consumption as potential mediators of the intervention effect on the consumption of sugar-sweetened beverages. SETTING: Eighteen Dutch secondary schools. SUBJECTS: A total of 747 adolescents (mean age: 12·7 years). RESULTS: In addition to the DoiT intervention effect of a reduction in the consumption of sugar-sweetened beverages at 8 months (-284 ml/d; 95 % CI -420, -148) and 12 months (-260 ml/d; 95 % CI -360, -160), there was also a significant reduction in diet drinks at 8 months (-52 ml/d; 95 % CI -89, -16). There was no significant difference in water consumption at any follow-up. The decrease in sugar-sweetened beverage consumption could not be explained by an increase in water or diet drink consumption at any time point. CONCLUSIONS: Interventions aimed at reducing sugar-sweetened beverage consumption may be effective without changing consumption of other beverages. Reducing sugar-sweetened beverages was, however, a main message of the DOiT intervention. It is possible that a concomitant promotion of water may have resulted in a greater increase in water intake and replacement of sugar-sweetened beverages with water.
Authors: Sara M St George; Yaray Agosto; Lourdes M Rojas; Mary Soares; Monica Bahamon; Guillermo Prado; Justin D Smith Journal: Obes Rev Date: 2019-12-06 Impact factor: 10.867
Authors: Peter von Philipsborn; Jan M Stratil; Jacob Burns; Laura K Busert; Lisa M Pfadenhauer; Stephanie Polus; Christina Holzapfel; Hans Hauner; Eva Rehfuess Journal: Cochrane Database Syst Rev Date: 2019-06-12
Authors: Carmen B Franse; Mirte Boelens; Lisa R Fries; Florence Constant; Amy van Grieken; Hein Raat Journal: Obes Rev Date: 2020-03-13 Impact factor: 9.213
Authors: Maria A Cabrera Escobar; J Lennert Veerman; Stephen M Tollman; Melanie Y Bertram; Karen J Hofman Journal: BMC Public Health Date: 2013-11-13 Impact factor: 3.295