Kiritimati is an isolated coral atoll in the Pacific Ocean, and is one of 32 islands that comprise the Republic of Kiribati. Obesity and type 2 diabetes rates are high in Kiribati, but the causes and rates of childhood obesity/diabetes are unknown. However, it has been hypothesized that high consumption of sugar-sweetened beverages on Kiritimati may be a contributing factor. The investigators therefore conducted a study in Kiritimati in September 2018 with the aim of 1) quantifying obesity and diabetes rates amongst children on Kiritimati and 2) testing the feasibility of a sugar-reduction intervention in Kiritimati schools. The investigators randomized the two high schools on the island to either the control group or the intervention group. The investigators measured height/weight, continuous blood glucose (using flash glucose monitoring), and diet (using 24-hour diet recalls). One week into the study, the intervention school received an intervention, which consisted of installation of a water filter at the school, the provision of water bottles to each student at the school, and a 30-minute educational presentation on the link between sugar consumption and type 2 diabetes. The investigators then measured how blood glucose and diet changed the week following the intervention, and compared this to the control school.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
63
The intervention consisted of a) installation of a water filter at the school. b) each participant received a metal water bottle. c) a registered dietitian gave a 30-minute presentation on sugar reduction for the purposes of type 2 diabetes prevention
University of Southern California
Los Angeles, California, United States
Kiritimati
London, Kiribati
Change in mean blood glucose (mg/dL)
A continuous glucose monitor was attached to all participants, which collected data for 2 weeks. Mean blood glucose was calculated for each participant using GlyCulator, an online tool for analyzing CGM data.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in mean amplitude of glycemic variability (MAGE) (mg/dL)
A continuous glucose monitor was attached to all participants, which collected data for 2 weeks. Glycemic variability (mean amplitude of glycemic excursions) was calculated for each participant using GlyCulator, an online tool for analyzing CGM data.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in standard deviation (mg/dL) of continuous glucose monitor data
A continuous glucose monitor was attached to all participants, which collected data for 2 weeks. Glycemic variability (standard deviation) was calculated for each participant using GlyCulator, an online tool for analyzing CGM data.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in coefficient of variation (percent) of continuous glucose monitor data
A continuous glucose monitor was attached to all participants, which collected data for 2 weeks. Glycemic variability (coefficient of variation (percent) was calculated for each participant using GlyCulator, an online tool for analyzing CGM data.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in J-index of continuous glucose monitor data
A continuous glucose monitor was attached to all participants, which collected data for 2 weeks. Glycemic variability (J-index) was calculated for each participant using GlyCulator, an online tool for analyzing CGM data.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in area under the curve of continuous glucose monitor data
A continuous glucose monitor was attached to all participants, which collected data for 2 weeks. Glycemic variability (area under the curve) was calculated for each participant using GlyCulator, an online tool for analyzing CGM data.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in total sugar consumption (g/day) using 24-hour dietary recalls
The investigators conducted 24-hour diet recalls and entered data into the NDSR database for comparison of change in total sugar intake between the control and intervention schools (time x group interaction).
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in added sugar consumption (g/day) using 24-hour dietary recalls
The investigators conducted 24-hour diet recalls and entered data into the NDSR database for comparison of change in added sugar intake between the control and intervention schools (time x group interaction).
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in total water consumption (g/day) using 24-hour dietary recalls
The investigators conducted 24-hour diet recalls and entered data into the NDSR database for comparison of change in total water intake between the control and intervention schools (time x group interaction).
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in unsweetened water consumption (servings/day) using 24-hour dietary recalls
The investigators conducted 24-hour diet recalls and entered data into the NDSR database for comparison of change in unsweetened water intake between the control and intervention schools (time x group interaction).
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in energy (kcal/day) consumption using 24-hour dietary recalls
The investigators conducted 24-hour diet recalls and entered data into the NDSR database for comparison of change in energy (kcal) intake between the control and intervention schools (time x group interaction).
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in total carbohydrate (g/day) consumption using 24-hour dietary recalls
The investigators conducted 24-hour diet recalls and entered data into the NDSR database for comparison of change in total carbohydrate intake between the control and intervention schools (time x group interaction).
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in percent calories from carbohydrate consumption using 24-hour dietary recalls
The investigators conducted 24-hour diet recalls and entered data into the NDSR database for comparison of change in % calories from carbohydrate intake between the control and intervention schools (time x group interaction).
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in percent calories from total sugars consumption using 24-hour dietary recalls
The investigators conducted 24-hour diet recalls and entered data into the NDSR database for comparison of change in % calories from total sugars intake between the control and intervention schools (time x group interaction).
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in percent calories from added sugars consumption using 24-hour dietary recalls
The investigators conducted 24-hour diet recalls and entered data into the NDSR database for comparison of change in % calories from added sugars intake between the control and intervention schools (time x group interaction).
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in sugary beverage (tioka) consumption using beverage frequency questionnaires
The investigators conducted beverage frequency questionnaires which asked about consumption of popular beverages on Kiritimati (specifically: "how many days per week do you typically drink this drink?" and "how much each day?") then compared change pre-and post-intervention between the two groups (time x group interaction) in servings/day.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in sugary beverage (tang) consumption using beverage frequency questionnaires
The investigators conducted beverage frequency questionnaires which asked about consumption of popular beverages on Kiritimati (specifically: "how many days per week do you typically drink this drink?" and "how much each day?") then compared change pre-and post-intervention between the two groups (time x group interaction) in servings/day.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in sugary beverage (toddy) consumption using beverage frequency questionnaires
The investigators conducted beverage frequency questionnaires which asked about consumption of popular beverages on Kiritimati (specifically: "how many days per week do you typically drink this drink?" and "how much each day?") then compared change pre-and post-intervention between the two groups (time x group interaction) in servings/day.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in sugary beverage (ice block) consumption using beverage frequency questionnaires
The investigators conducted beverage frequency questionnaires which asked about consumption of popular beverages on Kiritimati (specifically: "how many days per week do you typically drink this drink?" and "how much each day?") then compared change pre-and post-intervention between the two groups (time x group interaction) in servings/day.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in sugary beverage (soda) consumption using beverage frequency questionnaires
The investigators conducted beverage frequency questionnaires which asked about consumption of popular beverages on Kiritimati (specifically: "how many days per week do you typically drink this drink?" and "how much each day?") then compared change pre-and post-intervention between the two groups (time x group interaction) in servings/day.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in sugary beverage (juice) consumption using beverage frequency questionnaires
The investigators conducted beverage frequency questionnaires which asked about consumption of popular beverages on Kiritimati (specifically: "how many days per week do you typically drink this drink?" and "how much each day?") then compared change pre-and post-intervention between the two groups (time x group interaction) in servings/day.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in sugary beverage (fruit drinks) consumption using beverage frequency questionnaires
The investigators conducted beverage frequency questionnaires which asked about consumption of popular beverages on Kiritimati (specifically: "how many days per week do you typically drink this drink?" and "how much each day?") then compared change pre-and post-intervention between the two groups (time x group interaction) in servings/day.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
Change in sugary beverage (coffee/tea) consumption using beverage frequency questionnaires
The investigators conducted beverage frequency questionnaires which asked about consumption of popular beverages on Kiritimati (specifically: "how many days per week do you typically drink this drink?" and "how much each day?") then compared change pre-and post-intervention between the two groups (time x group interaction) in servings/day.
Time frame: 2 weeks (1 week pre- and 1 week post-intervention)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.