Hydration and Physical Activity
To compare, under resting conditions, the plasma D2O accumulation profiles of water, and 4 CES differing in percentage (^, 8, 10%) and type (simple sugars, maltodextrins) of carbohydrate.
Healthy, informed consent
none mentioned
Recruitment not mentioned
Design randomized crossover, 5 beverage conditions, each containig D2O:
water, 6% maltodextrin, 6%, 8%, 10% glucose-fructose
All CES contained 20 mmol/l Na, 3 mmol/l K
Blinding used (if applicable)
Double-blind, counterbalanced assignment of conditions to subjects.
Intervention (if applicable)
5 beverage conditions, each containig D2O:
water, 6% maltodextrin, 6%, 8%, 10% glucose-fructose
All CES contained 20 mmol/l Na, 3 mmol/l K
Statistical Analysis
No statistical analysis section of paper (no analysis plan stated).
Timing of Measurements
12 h fast prior to 5 experimental sessions (1 week washout); catheter inserted for blood sampling;
Ingestion of 275 ml (within 60 sec) of 1 of 5 beverage conditions during rest (sitting quietly).
Blood samples taken before testing, and at 10, 20, 30, 40, 60, 90, 120, 180 min after ingestion.
Dependent Variables
- D2O accumulation (method not mentioned)
- Insulin (method not mentioned)
- glucose (glucose analyzer)
Independent Variables
5 beverage conditions (275 ml), each containig 20 ml (22.1 g) of 99.8 atom D2O:
water, 6% maltodextrin, 6%, 8%, 10% glucose-fructose
All CES contained 20 mmol/l Na, 3 mmol/l K
Control Variables
All subjects at rest; amt of beverage ingested; no others mentioned.
Initial N: N=8 M
Attrition (final N):N=8 M
Age: college-aged (no range or mean±SEM given)
Ethnicity: noty mentioned
Other relevant demographics: none mentioned
Anthropometrics (e.g., were groups same or different on important measures) None mentioned
Location: Exercise Biochemistry Lab, Dept Exercise Science, school of Public Health, Univ SC, Columbia, SC
*No mean±SEM tabular data given - all data in 3 figures*
Other Findings
Plasma D2O concentration and insulin not significantly different between the 5 drink conditions.
Changes in plasma glucose: plasma cglu increased after ingestion of the CES, peaking at 20 min for 8% GF, and 30 min for % and 10% GF. PLasma glu higher with ingestion of CES than water at 20 and 30 min (P<0.05) and returned to baseline (6% M and GF) or below (8%, 10% GF) (P<0.05). No differences found among the drinks at or after 90 min.
2.5-10% CES beverages, regardlesss if maltodextrin or simple sugars, are not likely to enter the vascular system more slowly than water, and therefore will not compromise fluid replenishment.
| University/Hospital: | University of South Carolina |
Conclusions that can be made from this study are limited.
No statistical plan was described (or P values expected for the sample size, i.e. effect size).
No subject characteristics/anthrompometrics/demographics described for this small, limited sample. no info re: body weight/ht, activity level, etc
Much information missing from methods (drink temp, subjective feelings, environmental conditions, analysis of plasma measures, hydration status).
Could have done much more with respect to measures obtained.
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Quality Criteria Checklist: Primary Research
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| Relevance Questions | |||
| 1. | Would implementing the studied intervention or procedure (if found successful) result in improved outcomes for the patients/clients/population group? (Not Applicable for some epidemiological studies) | ??? | |
| 2. | Did the authors study an outcome (dependent variable) or topic that the patients/clients/population group would care about? | Yes | |
| 3. | Is the focus of the intervention or procedure (independent variable) or topic of study a common issue of concern to dieteticspractice? | Yes | |
| 4. | Is the intervention or procedure feasible? (NA for some epidemiological studies) | Yes | |
| Validity Questions | |||
| 1. | Was the research question clearly stated? | Yes | |
| 1.1. | Was (were) the specific intervention(s) or procedure(s) [independent variable(s)] identified? | Yes | |
| 1.2. | Was (were) the outcome(s) [dependent variable(s)] clearly indicated? | Yes | |
| 1.3. | Were the target population and setting specified? | ??? | |
| 2. | Was the selection of study subjects/patients free from bias? | No | |
| 2.1. | Were inclusion/exclusion criteria specified (e.g., risk, point in disease progression, diagnostic or prognosis criteria), and with sufficient detail and without omitting criteria critical to the study? | No | |
| 2.2. | Were criteria applied equally to all study groups? | N/A | |
| 2.3. | Were health, demographics, and other characteristics of subjects described? | No | |
| 2.4. | Were the subjects/patients a representative sample of the relevant population? | ??? | |
| 3. | Were study groups comparable? | ??? | |
| 3.1. | Was the method of assigning subjects/patients to groups described and unbiased? (Method of randomization identified if RCT) | Yes | |
| 3.2. | Were distribution of disease status, prognostic factors, and other factors (e.g., demographics) similar across study groups at baseline? | ??? | |
| 3.3. | Were concurrent controls or comparisons used? (Concurrent preferred over historical control or comparison groups.) | ??? | |
| 3.4. | If cohort study or cross-sectional study, were groups comparable on important confounding factors and/or were preexisting differences accounted for by using appropriate adjustments in statistical analysis? | ??? | |
| 3.5. | If case control study, were potential confounding factors comparable for cases and controls? (If case series or trial with subjects serving as own control, this criterion is not applicable.) | N/A | |
| 3.6. | If diagnostic test, was there an independent blind comparison with an appropriate reference standard (e.g., "gold standard")? | N/A | |
| 4. | Was method of handling withdrawals described? | N/A | |
| 4.1. | Were follow-up methods described and the same for all groups? | N/A | |
| 4.2. | Was the number, characteristics of withdrawals (i.e., dropouts, lost to follow up, attrition rate) and/or response rate (cross-sectional studies) described for each group? (Follow up goal for a strong study is 80%.) | N/A | |
| 4.3. | Were all enrolled subjects/patients (in the original sample) accounted for? | Yes | |
| 4.4. | Were reasons for withdrawals similar across groups? | N/A | |
| 4.5. | If diagnostic test, was decision to perform reference test not dependent on results of test under study? | N/A | |
| 5. | Was blinding used to prevent introduction of bias? | Yes | |
| 5.1. | In intervention study, were subjects, clinicians/practitioners, and investigators blinded to treatment group, as appropriate? | Yes | |
| 5.2. | Were data collectors blinded for outcomes assessment? (If outcome is measured using an objective test, such as a lab value, this criterion is assumed to be met.) | N/A | |
| 5.3. | In cohort study or cross-sectional study, were measurements of outcomes and risk factors blinded? | N/A | |
| 5.4. | In case control study, was case definition explicit and case ascertainment not influenced by exposure status? | N/A | |
| 5.5. | In diagnostic study, were test results blinded to patient history and other test results? | N/A | |
| 6. | Were intervention/therapeutic regimens/exposure factor or procedure and any comparison(s) described in detail? Were interveningfactors described? | No | |
| 6.1. | In RCT or other intervention trial, were protocols described for all regimens studied? | No | |
| 6.2. | In observational study, were interventions, study settings, and clinicians/provider described? | No | |
| 6.3. | Was the intensity and duration of the intervention or exposure factor sufficient to produce a meaningful effect? | ??? | |
| 6.4. | Was the amount of exposure and, if relevant, subject/patient compliance measured? | ??? | |
| 6.5. | Were co-interventions (e.g., ancillary treatments, other therapies) described? | N/A | |
| 6.6. | Were extra or unplanned treatments described? | N/A | |
| 6.7. | Was the information for 6.4, 6.5, and 6.6 assessed the same way for all groups? | ??? | |
| 6.8. | In diagnostic study, were details of test administration and replication sufficient? | No | |
| 7. | Were outcomes clearly defined and the measurements valid and reliable? | ??? | |
| 7.1. | Were primary and secondary endpoints described and relevant to the question? | Yes | |
| 7.2. | Were nutrition measures appropriate to question and outcomes of concern? | Yes | |
| 7.3. | Was the period of follow-up long enough for important outcome(s) to occur? | ??? | |
| 7.4. | Were the observations and measurements based on standard, valid, and reliable data collection instruments/tests/procedures? | ??? | |
| 7.5. | Was the measurement of effect at an appropriate level of precision? | ??? | |
| 7.6. | Were other factors accounted for (measured) that could affect outcomes? | No | |
| 7.7. | Were the measurements conducted consistently across groups? | ??? | |
| 8. | Was the statistical analysis appropriate for the study design and type of outcome indicators? | ??? | |
| 8.1. | Were statistical analyses adequately described and the results reported appropriately? | No | |
| 8.2. | Were correct statistical tests used and assumptions of test not violated? | ??? | |
| 8.3. | Were statistics reported with levels of significance and/or confidence intervals? | No | |
| 8.4. | Was "intent to treat" analysis of outcomes done (and as appropriate, was there an analysis of outcomes for those maximally exposed or a dose-response analysis)? | N/A | |
| 8.5. | Were adequate adjustments made for effects of confounding factors that might have affected the outcomes (e.g., multivariate analyses)? | No | |
| 8.6. | Was clinical significance as well as statistical significance reported? | No | |
| 8.7. | If negative findings, was a power calculation reported to address type 2 error? | No | |
| 9. | Are conclusions supported by results with biases and limitations taken into consideration? | Yes | |
| 9.1. | Is there a discussion of findings? | Yes | |
| 9.2. | Are biases and study limitations identified and discussed? | ??? | |
| 10. | Is bias due to study's funding or sponsorship unlikely? | Yes | |
| 10.1. | Were sources of funding and investigators' affiliations described? | No | |
| 10.2. | Was the study free from apparent conflict of interest? | Yes | |