Obesity Clinical Trial
Official title:
The Effects of Non-Nutritive Sweeteners on Energy Intake
The use of non-nutritive sweeteners (NNS) in replacement of nutritive sweeteners (NS) could
be a potential weight loss strategy as it may reduce energy intake. One concern with the
replacement of NS with NNS is the risk of caloric compensation after consumption of NNS. Most
studies have examined the effect of NNS foods and beverages on energy intake in the
short-term (one-day or less), with results suggesting lack of compensation in the very
short-term (less than one day), and then compensation, or over compensation, when the NNS
products are consumed on one day with measures of energy intake taken over 1 to 2 days (Anton
et al., 2010; Lavin et al., 1997; Overduin et al., 2016; Appleton et al., 2007; Piernas et
al., 2013). Given these mixed results, it is still not clear if NNS foods and beverages are a
beneficial strategy for decreasing energy intake. However most studies have been in lab-based
settings, in which participants are consuming provided food at specific times. No study has
reported on the effect of NNS foods or beverages consumed over several days and energy intake
on these days when participants are in free-living situations.
Therefore, the purpose of this investigation is to evaluate how NNS beverage consumption
affects energy intake in free-living situations over a span of three days. Through a 3x4
mixed design, participants will be randomized into one of three groups: NNS beverage, NS
beverage, or carbonated water (control). Participants will be encouraged to go about their
normal daily activities and not change any other aspect except for drink consumption. One
baseline and three, 24-hour dietary recalls will be collected over the course of the study to
analyze energy intake. The specific aim of this investigation is to determine if caloric
compensation occurs during 3-day exposure to NNS beverages.
At the completion of the phone screen, eligible participants will be scheduled to come to the
Healthy Eating and Activity Laboratory for the start of their baseline assessment.
The first session will occur the week prior to the test days. At this appointment, informed
consent will be obtained, a demographic questionnaire completed, a beverage questionnaire
(BEVQ-15) completed, and an appropriate time and preferred mode of contact (text message or
e-mail) will be collected. Participant's height and weight will be collected through an
electronic scale for weight and a stadiometer for height using standard procedures (Lohman,
et al., 1988). Next, participants will be given the SenseWear armband. Participants will be
instructed to start wearing the armband upon awakening on Monday morning and to wear the arm
band on their upper right arm until going to sleep Monday night (wear time should be at least
10 hours per day). Participants will be instructed to continue wearing the armband, in an
identical manner as on Monday, on Tuesday, Wednesday, and Thursday. Participants will be
instructed to not alter their physical activity from their normal routine from Monday to
Thursday.
Participants will be randomized to one of the three groups, Coke (NS), Diet Coke (NNS), or
carbonated water (control) using a random numbers table. For this investigation, Coke and
Diet Coke will be used due to Coke and Diet Coke ranked number one and two as the most
popular beverages in the U.S. from 2010 to 2018 ("Sweet! America's top 10 brands of soda,"
2011; "Top 10 Best Selling Soft Drink Brands in The World," 2016). Next, participants will
receive twelve, 12-ounce cans of a beverage that represents their assigned condition.
Participants will be instructed to drink their assigned beverages Tuesday through Thursday,
and to consume one beverage at 12pm, the second at 3pm, and the third at 6pm. Participants
will be instructed that the beverages need to be consumed within +/- 30 minutes of the
instructed time. Participants will be instructed that any other beverage consumed on Tuesday
through Thursday should be water. Next, instructions will be provided to participants on how
to complete the 24-hour dietary recalls and a two-dimensional visual aid will be provided to
help participants in estimating portion sizes. Participants will also be given a detailed
schedule about their study participation.
Participants will be called on Tuesday, Wednesday, and Thursday to complete 24-hour dietary
recalls. Participants will be sent daily reminders regarding their recalls and wearing the
armband via text or e-mail (participant preferred mode of contact).
A final appointment will be completed on Friday in the HEAL lab. The armband will be returned
and downloaded, the final recall will be completed, and participants will be debriefed about
the purpose of the study. Participants will not be responsible for paying for the SenseWear
Armband if they lose it or damage it. Once all data are collected, participants will be given
a $25 gift card for their participation. If a participant cannot come to the lab on the
Friday of their final appointment, then the last recall will be collected via phone and the
appointment will be rescheduled in order to collect the armband.
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