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      Applying Multi-Theory Model (MTM) of Health Behavior Change to Predict Water Consumption Instead of Sugar-Sweetened Beverages

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          Abstract

          Background: A substantial proportion of college students to not drink enough water and consume sugar-sweetened beverages (SSBs). Consumption of SSBs is associated with weight gain, obesity, type 2 diabetes mellitus, dental carries, and increased risk for cardiovascular disease. Hence, the purpose of this study was to use the multi-theory model (MTM) in predicting initiation and sustenance of plain water consumption instead of sugar-sweetened beverages among college students.

          Study design: A cross-sectional study.

          Methods: In this cross-sectional study, a 37-item valid and reliable MTM-based survey was administered to college students in 2016 via Qualtrics at a large public university in the Southeastern United States. Overall, 410 students responded to the survey; of those, 174 were eligible for the study and completed it.

          Results: Stepwise multiple regression analysis revealed that 61.8% of the variance in the initiation of drinking plain water instead of SSBs was explained by behavioral confidence ( P<0.001) and changes in the physical environment ( P<0.001). Further, 58.3% of the variance in the sustenance of drinking plain water instead of SSBs was explained by emotional transformation ( P<0.001) and practice for change ( P=0.001).

          Conclusions: Multi-theory model of health behavior change is a robust theory for predicting plain water consumption instead of SSBs in college students. Interventions should be developed based on this theory for this target population.

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          Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction

          Fumiaki Imamura, Laura O’Connor, Zheng Ye … (2015)
          Objectives To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom. Design Systematic review and meta-analysis. Data sources and eligibility PubMed, Embase, Ovid, and Web of Knowledge for prospective studies of adults without diabetes, published until February 2014. The population attributable fraction was estimated in national surveys in the USA, 2009-10 (n=4729 representing 189.1 million adults without diabetes) and the UK, 2008-12 (n=1932 representing 44.7 million). Synthesis methods Random effects meta-analysis and survey analysis for population attributable fraction associated with consumption of sugar sweetened beverages. Results Prespecified information was extracted from 17 cohorts (38 253 cases/10 126 754 person years). Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, by 18% per one serving/day (95% confidence interval 9% to 28%, I2 for heterogeneity=89%) and 13% (6% to 21%, I2=79%) before and after adjustment for adiposity; for artificially sweetened beverages, 25% (18% to 33%, I2=70%) and 8% (2% to 15%, I2=64%); and for fruit juice, 5% (−1% to 11%, I2=58%) and 7% (1% to 14%, I2=51%). Potential sources of heterogeneity or bias were not evident for sugar sweetened beverages. For artificially sweetened beverages, publication bias and residual confounding were indicated. For fruit juice the finding was non-significant in studies ascertaining type 2 diabetes objectively (P for heterogeneity=0.008). Under specified assumptions for population attributable fraction, of 20.9 million events of type 2 diabetes predicted to occur over 10 years in the USA (absolute event rate 11.0%), 1.8 million would be attributable to consumption of sugar sweetened beverages (population attributable fraction 8.7%, 95% confidence interval 3.9% to 12.9%); and of 2.6 million events in the UK (absolute event rate 5.8%), 79 000 would be attributable to consumption of sugar sweetened beverages (population attributable fraction 3.6%, 1.7% to 5.6%). Conclusions Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. Although artificially sweetened beverages and fruit juice also showd positive associations with incidence of type 2 diabetes, the findings were likely to involve bias. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.
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            Effectiveness of interventions targeting physical activity, nutrition and healthy weight for university and college students: a systematic review and meta-analysis

            Ronald Plotnikoff, Sarah Costigan, Rebecca L Williams-Karnesky … (2015)
            To examine the effectiveness of interventions aimed at improving physical activity, diet, and/or weight-related behaviors amongst university/college students. Five online databases were searched (January 1970 to April 2014). Experimental study designs were eligible for inclusion. Data extraction was performed by one reviewer using a standardized form developed by the researchers and checked by a second reviewer. Data were described in a narrative synthesis and meta-analyses were conducted when appropriate. Study quality was also established. Forty-one studies were included; of these, 34 reported significant improvements in one of the key outcomes. Of the studies examining physical activity 18/29 yielded significant results, with meta-analysis demonstrating significant increases in moderate physical activity in intervention groups compared to control. Of the studies examining nutrition, 12/24 reported significantly improved outcomes; only 4/12 assessing weight loss outcomes found significant weight reduction. This appears to be the first systematic review of physical activity, diet and weight loss interventions targeting university and college students. Tertiary institutions are appropriate settings for implementing and evaluating lifestyle interventions, however more research is needed to improve such strategies. Electronic supplementary material The online version of this article (doi:10.1186/s12966-015-0203-7) contains supplementary material, which is available to authorized users.
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              Sugar-sweetened beverages and dental caries in adults: a 4-year prospective study.

              Eduardo Bernabé, Miira M. Vehkalahti, Aubrey Sheiham … (2014)
              To explore the association between frequency of consumption of sugar-sweetened beverages (SSB) and caries increment over 4 years in adults. A second objective was to explore whether the association between frequency of SSB consumption and caries increment varied by socio-demographic characteristics and use of fluoride toothpaste.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Res Health Sci
                Journal ID (iso-abbrev): J Res Health Sci
                Journal ID (publisher-id): J Res Health Sci
                Journal ID (pmc): J Res Health Sci
                Journal ID (publisher-id): JRHS
                Title: Journal of Research in Health Sciences
                Publisher: Hamadan University of Medical Sciences
                ISSN (Print): 2228-7795
                ISSN (Electronic): 2228-7809
                Publication date Collection: Winter 2017
                Publication date (Electronic): 25 February 2017
                Volume: 17
                Issue: 1
                Page: 370
                Affiliations
                1 Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA
                2 Public Health Studies, School of Health and Applied Human Sciences, University of North Carolina Wilmington, Wilmington, NC, USA
                3 Department of Health, Physical Education, and Exercise Science, Lincoln Memorial University, Harrogate, TN, USA
                4 Department of Management, School of Business Administration, University of Mississippi, MS, USA
                5 Department of Health, Exercise Science & Recreation Management, School of Applied Sciences, University of Mississippi, MS, USA
                Author notes
                [* ] Correspondence Vinayak K Nahar (MD, PhD) Tel: +662 638-5126 Email: naharvinayak@ 123456gmail.com
                Article
                PMC ID: 7191014
                PubMed ID: 28413165
                SO-VID: 6833bbe1-a2e2-44c3-ade2-e232f5df9c24
                Copyright © © 2017 The Author(s); Published by Hamadan University of Medical Sciences.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 12 November 2016
                Date revision received : 16 January 2017
                Date accepted : 18 February 2017
                Page count
                Tables: 4, References: 24, Pages: 6
                Categories
                Subject: Original Article

                Keywords: water consumption,water intake,health behavior,theoretical model
                Data availability:
                Keywords: water consumption, water intake, health behavior, theoretical model

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