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      SWEET MAPS: A Conceptualization of Low-Calorie Sweetener Consumption Among Young Adults

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          ABSTRACT

          Background

          The extent to which low-calorie sweeteners (LCSs) are helpful or harmful for weight management and metabolic health is unclear, because LCS effects may depend on the context in which they are consumed.

          Objective

          To develop a conceptual framework for LCS consumption.

          Methods

          Young adults ages 18–35 y, who reported LCS consumption, were recruited from a private, urban, university in the mid-Atlantic United States. Concept mapping, a mixed-method approach was used to identify, organize, and quantify determinants of LCS consumption. First, participants ( n = 68) identified reasons for their LCS consumption through brainstorming; content analysis of those reasons identified 37 specific determinants of LCS consumption. Second, participants ( n = 93) sorted all 37 determinants conceptually. Third, participants ( n = 97) rated the extent to which each of the 37 determinants was reflective of their own consumption. Similarity matrices, multidimensional scaling, and hierarchical cluster analysis produced a series of 2-dimensional concept maps (SWEET MAPS).

          Results

          The SWEET MAPS identified 37 determinants, organized within 8 factors reflective of 3 overarching motives: perceived health benefits, palatability, and accessibility of LCSs. At the determinant level, the most highly rated determinants that exceeded the boundary (rating >3.0) were: “I want something that tastes sweet,” “I am trying to maintain/control my weight,” “They contain fewer calories,” “They are available,” and “I want to save calories because I am eating a high-calorie meal.”

          Conclusions

          LCS consumption is a function of many inter-related determinants spanning biological, psychological, and social domains. The SWEET MAPS are an important and novel use of concept mapping methods that can be used to inform the design and interpretation of future studies evaluating LCS effects.

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          Most cited references37

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          Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study.

          The consumption of sucrose-sweetened soft drinks (SSSDs) has been associated with obesity, the metabolic syndrome, and cardiovascular disorders in observational and short-term intervention studies. Too few long-term intervention studies in humans have examined the effects of soft drinks. We compared the effects of SSSDs with those of isocaloric milk and a noncaloric soft drink on changes in total fat mass and ectopic fat deposition (in liver and muscle tissue). Overweight subjects (n = 47) were randomly assigned to 4 different test drinks (1 L/d for 6 mo): SSSD (regular cola), isocaloric semiskim milk, aspartame-sweetened diet cola, and water. The amount of intrahepatic fat and intramyocellular fat was measured with (1)H-magnetic resonance spectroscopy. Other endpoints were fat mass, fat distribution (dual-energy X-ray absorptiometry and magnetic resonance imaging), and metabolic risk factors. The relative changes between baseline and the end of 6-mo intervention were significantly higher in the regular cola group than in the 3 other groups for liver fat (132-143%, sex-adjusted mean; P < 0.01), skeletal muscle fat (117-221%; P < 0.05), visceral fat (24-31%; P < 0.05), blood triglycerides (32%; P < 0.01), and total cholesterol (11%; P < 0.01). Total fat mass was not significantly different between the 4 beverage groups. Milk and diet cola reduced systolic blood pressure by 10-15% compared with regular cola (P < 0.05). Otherwise, diet cola had effects similar to those of water. Daily intake of SSSDs for 6 mo increases ectopic fat accumulation and lipids compared with milk, diet cola, and water. Thus, daily intake of SSSDs is likely to enhance the risk of cardiovascular and metabolic diseases. This trial is registered at clinicaltrials.gov as NCT00777647.
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            Quality and rigor of the concept mapping methodology: a pooled study analysis.

            The use of concept mapping in research and evaluation has expanded dramatically over the past 20 years. Researchers in academic, organizational, and community-based settings have applied concept mapping successfully without the benefit of systematic analyses across studies to identify the features of a methodologically sound study. Quantitative characteristics and estimates of quality and rigor that may guide for future studies are lacking. To address this gap, we conducted a pooled analysis of 69 concept mapping studies to describe characteristics across study phases, generate specific indicators of validity and reliability, and examine the relationship between select study characteristics and quality indicators. Individual study characteristics and estimates were pooled and quantitatively summarized, describing the distribution, variation and parameters for each. In addition, variation in the concept mapping data collection in relation to characteristics and estimates was examined. Overall, results suggest concept mapping yields strong internal representational validity and very strong sorting and rating reliability estimates. Validity and reliability were consistently high despite variation in participation and task completion percentages across data collection modes. The implications of these findings as a practical reference to assess the quality and rigor for future concept mapping studies are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms.

              Nonnutritive sweeteners (NNS) are ecologically novel chemosensory signaling compounds that influence ingestive processes and behavior. Only about 15% of the US population aged >2 y ingest NNS, but the incidence is increasing. These sweeteners have the potential to moderate sugar and energy intakes while maintaining diet palatability, but their use has increased in concert with BMI in the population. This association may be coincidental or causal, and either mode of directionality is plausible. A critical review of the literature suggests that the addition of NNS to non-energy-yielding products may heighten appetite, but this is not observed under the more common condition in which NNS is ingested in conjunction with other energy sources. Substitution of NNS for a nutritive sweetener generally elicits incomplete energy compensation, but evidence of long-term efficacy for weight management is not available. The addition of NNS to diets poses no benefit for weight loss or reduced weight gain without energy restriction. There are long-standing and recent concerns that inclusion of NNS in the diet promotes energy intake and contributes to obesity. Most of the purported mechanisms by which this occurs are not supported by the available evidence, although some warrant further consideration. Resolution of this important issue will require long-term randomized controlled trials.
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                Author and article information

                Contributors
                Journal
                Curr Dev Nutr
                Curr Dev Nutr
                cdn
                Current Developments in Nutrition
                Oxford University Press
                2475-2991
                24 December 2018
                April 2019
                24 December 2018
                : 3
                : 4
                : nzy103
                Affiliations
                [1 ]Department of Exercise and Nutrition Sciences, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052
                [2 ]Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, DC 20052
                [3 ]Matthew Gfeller Sport-Related TBI Research Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
                Author notes
                Address correspondence to ACS (e-mail: asylvets@ 123456gwu.edu )
                Author information
                http://orcid.org/0000-0002-7032-2772
                http://orcid.org/0000-0003-1838-8245
                http://orcid.org/0000-0001-8582-2852
                http://orcid.org/0000-0003-0424-2798
                Article
                nzy103
                10.1093/cdn/nzy103
                6437264
                094a5a83-c8f5-4cf1-9e66-aa7546604981
                Copyright © American Society for Nutrition 2018.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@ 123456oup.com

                History
                : 21 December 2018
                : 02 October 2018
                : 13 November 2018
                Page count
                Pages: 11
                Funding
                Funded by: The George Washington University Food Institute
                Funded by: Department of Exercise and Nutrition Sciences
                Categories
                Original Research
                Eating Behavior and Qualitative Assessments

                artificial sweeteners,diet soda,obesity,concept mapping,non-nutritive sweetener

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