Background: The role of sugar-sweetened beverages (SSBs) in increasing obesity is of great scientific, clinical, and public health interest. Many reviews have been published on this topic in recent years with very different conclusions. Objective: We sought to assess the scientific quality and other characteristics that may be associated with the conclusions of reviews regarding the causal relation between SSB consumption and body weight. Design: A systematic search of reviews in English languagepublished peer-reviewed journals in 2006-2013 was performed. Their methodologic quality was assessed by 2 judges using 2 scoring systems: the Assessment of Multiple Systematic Reviews and the American Dietetic Association Quality Criteria Checklist. The conclusions were blindly assessed by 11 independent readers using a Likert scale ranging from a position score of 0 = no evidence of a causal relation to 5 = strong evidence of a causal relation. Results: Twenty reviews were identified: 5 meta-analyses, 3 qualitative systematic reviews, and 12 qualitative nonsystematic reviews. Four received funding from the food industry. Quality scores were neither correlated with the readers' perception of conclusions nor with the source of funding. However, industry-funded reviews were more likely to suggest that evidence supporting a causal relation between SSB consumption and weight gain was weak (mean position score = 1.78), whereas evidence was generally considered well-founded in other reviews (mean position score = 3.39; P # 0.01). Conclusions: For a complex and controversial scientific issue, it is important to minimize perceived or actual threats to scientific objectivity and methodologic quality. More refined tools are needed to better assess their scientific quality and to identify factors and mechanisms that may influence authors' conclusions.
The purpose of the research was to explore the associations between the characteristics of schools' vicinity and the risk of sugar sweetened beverage (SSB) consumption in elementary students. Findings exposed an important variation in student's SSB consumption between schools. Schools with a lower socioeconomic status or in a densely built environment tend to have higher proportion of regular SSB drinkers. These characteristics of the school's vicinity partly explained the variation observed between them. We estimated that a student moving to a school with a higher proportion of SSB drinkers may increase his/her chances by 52% of becoming a daily consumer. Important changes in dietary preferences can occur when children are in contact with a new social environment. Findings also support the idea that dietary behaviors among children result from the complex interactions between biological, social, and environmental factors.
Background:The aim of this study was to explore the population-wide distribution in the practice of leisure-time physical activity among Canadian youth and how physical activity level is influenced by contextual features of the environment.
Methods:We studied the self-reported leisure-time physical activity of 54 832 Canadians aged 12 to 17 years. Observations were structured according to a 4-level geographic hierarchy. The outcome studied was a dichotomous indicator that referred to achieving (or not) the recommended daily level of leisure-time physical activity. To investigate the influence of the contextual features, we conducted multilevel logistic regressions.Results: For both girls and boys, significant variations were observed between health regions and between neighbourhoods within the provinces. Girls who lived in an urban setting showed lower odds of achieving the recommended physical activity level, as did those surveyed during the winter. Boys surveyed during the winter also showed lower odds of achieving the recommended level, but living in an urban setting had no effect on activity levels. Analysis of province-level residuals showed that girls living in Quebec were less likely to achieve the recommended activity level as compared with the national mean, and girls living in Ontario and British Columbia were more likely to achieve that threshold. Boys living in Ontario were more likely to achieve the recommended activity level as compared with the national mean. Youth had up to a 17% increased chance of achieving the recommended physical activity level if they lived in a context with a higher activity achievement level.Interpretation: Leisure-time physical activity was associated with environmental factors at multiple geographic scales among Canadian youth. The variation was more important at the neighbourhood level. The results provide rationale for further investigation into how leisure-time physical activity is promoted in different contexts.
Abstract
ResearchResearch CMAJ OPEN CMAJ OPEN, 4(3) E437
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