Article Critique #2

Nicole Laws
Robin Tucker
FN4400-1001
23 Sep 2015

The public often has many questions pertaining to which fruits and vegetables
are more healthful in solid form or in beverage form, and which state is more likely to
produce weight gain. Houchins et al. produced a study called Beverage vs Solid Fruits
and Vegetables: Effects on Energy Intake and Body Weight to examine the effects of
high calorie beverages and weight gain (1). Researchers hypothesized that by providing
solid and beverage forms of fruits and vegetables that participants would gain weight
during the beverage arm, and see no change or weight loss during the solid arm (1).
Initially potential participants were screened for weight stability, low fruit and
vegetable consumption, not taking medications that alter appetite, and pre-existing
Diabetes mellitus (1). Out of the individuals assessed for the study, only 34 individuals
met the requirements out of 108 individuals (1). Participants selected for this study were
lean (n=15), overweight (n=19), and obese (n=5) (1). For 21 weeks in July 2005 and
March 2008, 34 participants took place in this study (1). Time was allotted so 1 week
was available for each arm of the study, 8 weeks of intervention followed by a 3 week
washout (1). Activity was measured via tri-axial accelerometers, caloric needs were
estimated using Harris Benedict, and nutrient intake was collected at each baseline for
analysis (1). Participants were told the study was to study the effects of fruit and
vegetable consumption on antioxidant status (1). Participants were provided with
400kcal of solid fruits and vegetables that were dried and fresh for the solid arm that
had to be eaten in 20 minutes (1). Additionally juice with wheat dextrin (added in place
of fiber) was available as a substitute for the dried or fresh fruit during the solid arm (1).
During the beverage arm apple and grape juice were available in 400kcal total, which
also had to be consumed within 20 minutes (1). Gas exchange was then collected for

several hours after finishing the meal (1). During the study, one week was dedicated to
the baseline, where the specifically just solids or beverages were monitored, and then
for 8 weeks the participants consumed randomly solids or beverages (1). No dietary
restrictions were in place outside eating the assigned 400 kcal, and no advice in regards
to diet or physical activity were provided (1). In order to measure compliance the
participants had to fast ten times and have blood drawn to measure ascorbic acid and
carotenoid concentrations (1). Results indicate overweight and obese participants
experience weight gain while ingesting solid foods in comparison with the lean
participants (1). Additional weight gains of 43% were discovered during the beverage
arm (1). In regards to statistics, researchers discovered there wasnt anything significant
for the effect of treatment, effect of order, or a correlation between treatment and BMI
(1). The approach used in this study was to implement randomized control trials (1).
Choosing to utilize randomized control trials as the approach was a major
strength to this study (1). Another strength was researchers discluding participants with
high fruit and vegetable consumption (1). By only allowing for individuals who have poor
intake of fruits and vegetables the study represents the general eating habits of the
United States (1). Another excellent choice was using a population that had a stable
weight with at most 5% difference in 3 months (1). Eliminating persons with any existing
conditions that impact appetite eliminated bias from illness, which was another good
choice the researchers made. The sheer attention to detail the researchers used in
obtaining ascorbic acid and carotenoids is extensive, and it allows for potential future
studies to replicate the testing used in this study. Additionally using the subsequent lab

values found to identify compliance was a stroke of brilliance, eliminating the candidates
from potentially misleading the researchers with fake dietary intake data.
Researchers failed entirely to specify exactly which energy-yielding
beverage(s) are related to weight gain, and in doing so this study is difficult to
understand (1). The researchers incorporated data from three participants that didnt
complete the program, which drastically skews data; only participants who finished
should have been included (1). Researchers grouped overweight and obese
participants together or individually seemingly when convenient, which is confusing and
misleading (1). Additionally this study doesnt adequately represent the obese
population, where there are 5 obese participants compared to 15 lean and 14
overweight (1). Another weakness is that researchers used Harris Benedict to calculate
the participants estimated needs individually (1). Harris Benedict isnt supported by
science and is known to overestimate needs in individuals with a BMI greater than or
equal to 25. A better option would have been using MSJ, which is more accurate in
estimating the needs of overweight and obese individuals.
Fruits and vegetables are among the lowest calorie foods and are promoted by
dietitians for the DASH diet, stabilizing blood sugars in persons with Diabetes Mellitus
type 2, and weight management just to name a few. While this study had excellent
intentions of seeing how fruits and vegetables in different states affect weight, there are
significant errors included in this study. The conclusion on the researchers
recommending that fruits and vegetable increase weight gain is very disheartening.
Dietitians everywhere should be thoroughly disappointed to read this study and wonder
how it managed to get funding from the NIH.

Bibliography

(1) Houchins JA, Burgess JR, Campbell WW, Daniel JR, Ferruzzi MG, McCabe GP, et
al. Beverage vs. solid fruits and vegetables: effects on energy intake and body weight.
Obesity 2012;20(9):1844-1850.