Q3 for October
Q3. a) What are some potential pitfalls with using such products as the sterol margarine?
b) Can you indentify some flaws with the first study?
posted by Nisa M. @ 1:33 PM
13 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
Wednesday, October 04, 2006
b) Can you indentify some flaws with the first study?
13 Comments:
a) Patients may not like benecol and other sterol margarines and therefore not use them. Also, patients may need to comsume two or more tablespoons a day in order to see benefits, this amount may be unattainable for many patients especially over a long time period. Sterol margaine contains fat and calories, over consumption can lead to weight gain.
b) The first study used a small sample size of only 20 patients. The study also had a short follow-up time. Furthermore, the patients were not randomly selected because many patients did not want to participate because of the duration of the study and the number of visits to the hospital. The consumption of benecol was measured by patients turning in the empty containers. I do not feel that this is a accurate way to measure intake. It is possible that the containers could have been emptied without the contents being consumed.
a)Some potential pitfalls of using these products include that they are expensive. Not everyone is going to want to spend that much more for margarine products. They also taste a lot different than other margarines and have a different texture. It could take someone awhile to get used to them. Also they are also very concentrated in fat and calories. Over-consumption of these spreads will easily lead to more weight gain, especially if they are not used as a subsitute for other fats.
b) The first study had a pretty small sample size. The two groups were also given different education from the RDs. The treatment group was given pretty specific instruction, and were motivated by the RDs to improve habits, while the control group was given handout and had time for questions. It would be a stronger studied if the long term effects were studiend. I also think that there could have been some deviation in triglyceride levels since they were self-measured. There could have easily been some differences in how careful persons were to wash hands, and adhere to the fasting periods. Also they were not told to avoid measuring levels after consuming alcohol which would skew their levels significantly.
Lisa & Mary Ellen: I also agree that overconsumption of these products could possibly lead to weight gain. This is true if the margarine is not a dietary replacement but rather a new addition. I am glad you both were able to pick up on the small sample size of the study. This may have had an impact on the study.
Individuals using sterol margarine must make diet choices that allow them to control their daily caloric intake. In addition, these products are typically more expensive. The limitations of the study include its small size and short follow-up. In addition, the researchers used a convenience sample, limiting the study’s ability to promote the findings to other representative groups.
A) The rate of absorption is pretty low. As Lisa said above, the portion sizes would have to be increased resulting in the encouragement of margarine. Also, phytosterol rich margarines are more costly. And I doubt products like Benecol taste similar to butter and probably doesn't do well in high temperatures. People may find it difficult to see the benefits of spending more on butter-imitators.
B) There were several areas througout the research that had room for error. Pts were recruited and some were even reported as having previous experience with consuming margarines high in phytosterols. Drawing the conclusion that they may already have a diet consistent with healthier eating.
Breine and Susie, I also think that these margarines are very expensive for some people. In the store they are around $3-$4 for a pound or so.
Has anyone tasted these margarines?
If so what did you think?
Nisa - I have only used the SmartBalance. I enjoy the taste, although I do recall having a bit of trouble spreading one of the SmartBalane brands awhile back. The product may have improved since then.
Products like benecol are more expensive so for a pt who does not have lots of money they would not be able to afford it. It would be important to let the person know that with adding a product like benecol to foods they eat it may add an additional 150 calories so try to limit food else where to not gain weight. People may be unsure of how to add this additional amount of benencol to their diets. One suggestion is to check out the benecol website because they have some recipes and usage suggestions. Some flaws in the first study include having such a small sample size and the study was only over 6 months. It would be intersting to see the results from a study that included more people and was for a longer time period.
Breine: I also tried the SmartBalance. I think there were two options- a regular and a ‘light’ version. The regular I remember was very hard to spread, but the light was much softer. As for the taste, Nisa, I really did not notice a significant difference between SmartBalance and regular margarine….except the cost!
Julie,
I personally like the regular kind of Smart-balance. I think it is because it the most butter-like margarine spread that I have tried. So while it is harder to spread I think it has a better taste. I would probably recommed it to someone who is used to regular butter as an alternative.
I feel that in most cases even though the sterol margarines do cost more most people who could afford it would at least give it a try. Many people have probably tried so many medications and if using margarine has been proven to help lower cholesterol than they would try it and see if it helps them.
Yes, even if it costs a few dollars more, sometimes things like a Benecol have more benefits than side effects...which may be worth the few extra dollars to some people.
Brittany,
I think you made a good suggestion about having patients look at the benecol website for tips on how to use the margarine. I think this would help keep the client from getting bored with the product and also help them get the amount they need to reep the benefits from it.
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