Myassignment.live is not sponsored or endorsed by this college or university
Type 2 diabetes is a global health issue that is highly prevalent in developed countries. For instance, in the US, over 100 million people are diabetic with over 1.5 million new cases being reported each year (CDC, 2017). The article by Liu et al. (2000) forms the basis of this critique. The specific areas of critique include the general overview of the paper, internal and external validity, and the underlying relation between the exposure and outcome.
The study purposed to assess the association between the intake of whole-grain against refined grains and the risk of being diagnosed with type 2 diabetes mellitus among women in the United States. The study objectives have clearly been stated. Type 2 diabetes is a chronic illness and a global public health problem that is the leading cause of mortality (Ogurtsova et al., 2017). Furthermore, the US is among the developed countries with a high rates of type 2 diabetes. Over 100 million people are diabetic in the US with an increasing rate of over 1.5 million new cases reported each year (CDC, 2017). Multiple studies have reported a direct association between type 2 diabetes mellitus and diet. Insulin resistance is increased by high-fat, low fibre diets thus increasing the development of type 2 diabetes (Miller, Kristeller, Headings, Nagaraja, & Miser, 2012; Asif, 2014). Furthermore, a high frequency of type 2 diabetes mellitus has been observed in populations with high consumption of fats such as the US (Asif, 2014). Hence, the current study is important because the outcomes will help reduce the incidences of the disorder and improve the quality of life of the US women who have a significant influence on the family diet and wellbeing.
The study used a prospective cohort study design. The intervention consisted of the consumption of whole-grain against refined grains among women. The authors found out that the consumption of whole-grain instead of processed grain reduced the possibility of developing the disease. The study population comprised of US women aged 38 to 63 years. The outcomes are presented under appropriate headings and summary tables for easy reading and comparison (Von Elm et al., 2014). The authors do not recommend further studies or expressly state the implications of the findings in nursing practice.
The study found out a positive association between the intake of whole grains and the minimal possibility of being diagnosed with type 2 diabetes. However, this association can also be ascribed to other non-causal factors such as family history and unhealthy lifestyle choices such as inactivity, obesity/overweight among others (Asif, 2014). The results are most likely to be influenced by chance variation. For instance, there exist multiple alternative explanations for the reported positive association such as other healthy lifestyle factors associated with high consumption of whole grains. Additionally, subclinical conditions may result in diet changes thus affecting the reported positive association.
The outcomes are likely to be affected by some few biases. Observer bias is likely to occur due to the previous knowledge of the researcher about the hypothesis of the association between the study variables i.e. prior knowledge of one’s exposure to risk factors for type 2 diabetes (Sedgwick, 2015). Potential biases may also be caused by subclinical diseases which may demand changes in diet thus distorting the observed causal association. The strongest confounding factor identified in the research was BMI. Other possible confounding factors not addressed in the study include family history and other unhealthy lifestyles such as physical inactivity. These confounding factors influence both the dependent (type 2 diabetes) and independent (intake of whole grains vs refined grains) variables. The consumption of whole grains and the decrease in the danger of type 2 diabetes might be affected by BMI, family history and other unhealthy lifestyles thus distorting the association (Midhet, Al-Mohaimeed, & Sharaf, 2010).
Sub-group analysis was performed. The sub-group consisted of 1475 cases of type 2 diabetes women with a BMI of 25 and above. The relation between the proportion of processed grain to whole grain consumption and the possibility of being diagnosed with the disease among women of BMI > 25 was examined because BMI was the main confounding factor. Any possible biases due to subclinical illness were dealt with by excluding those diagnosed with the condition in the first four years of follow-up.
The causal link between the intake of whole grains and reduced risk of type 2 diabetes is plausible. Overall a significant association between the study groups was found and thus the intervention program was proved to be more effective in reducing the risk of developing type 2 diabetes. The exclusion of type 2 diabetes mellitus within the initial four years of follow-up reduced potential biases due to subclinical disease. Furthermore, controlling for the confounding factor of BMI, and the reduction of potential recall bias by conducting dietary evaluations contributed to the true effects of the study.
The authors specify the target population to be women in the United States and the findings can be generalized to initial population. As initially indicated, the control for confounding factor and addressing potential biases implies that the study sample is much more likely to be similar to that of the general population. Thus, the outcomes are likely to apply to the general population for women are more prone to being diagnosed with the disease.
Moreover, the demographic profile of the participants is an indication of all-inclusivity of the target population. There were 1,875 diabetic cases out of 75,521 women aged 38 to 63 years and at a high risk of developing diabetes during the ten-year follow-up. This is a clear representation of any other dynamics of similar populations such as women of the same age bracket, living in the USA. The study can, therefore, be generally applied to other similar populations. However, it may not be generalized to a similar population but with varying socioeconomic position. This is because women in a lower SES are at a higher risk of becoming obese and overweight (which is a risk factor for type 2 diabetes) and have varying health needs compared to those in developed countries (Ghosh, Charlton, & Batterham, 2016; Bhurosy, & Jeewon, 2014).
Generally, the study found a significant relation between the intake of whole grain and the decline in the risk of developing type 2 diabetes among US women over 10 years. These outcomes are reliable because of the different measures in the study to address potential biases and control confounding factors thus increasing its internal and external validity. Additionally, the study can be generalized to a similar target population due to high representativeness of the sample, however, it's likely to be limited in application to similar populations with low SES.
Asif, M. (2014). The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern. Journal of education and health promotion, 3.
Bhurosy, T., & Jeewon, R. (2014). Overweight and obesity epidemic in developing countries: a problem with diet, physical activity, or socioeconomic status?. The Scientific World Journal, 2014.
Centre for Disease Control and Prevention (CDC). (2017). New CDC report: More than 100 million Americans have diabetes or prediabetes. Retrieved from https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html
Ghosh, A., Charlton, K. E., & Batterham, M. J. (2016). Socioeconomic disadvantage and its implications for population health planning of obesity and overweight, using cross-sectional data from general practices from a regional catchment in Australia. BMJ open, 6(5), e010405.
Liu, S., Manson, J. E., Stampfer, M. J., Hu, F. B., Giovannucci, E., Colditz, G. A., ... & Willett,
Midhet, F. M., Al-Mohaimeed, A. A., & Sharaf, F. K. (2010). Lifestyle related risk factors of type 2 diabetes mellitus in Saudi Arabia. Saudi Med J, 31(7), 768-774.
Miller, C. K., Kristeller, J. L., Headings, A., Nagaraja, H., & Miser, W. F. (2012). Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a pilot study. Journal of the Academy of Nutrition and Dietetics, 112(11), 1835-1842.
Ogurtsova, K., da Rocha Fernandes, J. D., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N.
H., ... & Makaroff, L. E. (2017). IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes research and clinical practice, 128, 40-50.
Sedgwick, P. (2015). Bias in observational study designs: cross sectional studies. Bmj, 350, h1286.
Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & Strobe Initiative. (2014). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. International journal of surgery, 12(12), 1495-1499.
To export a reference to this article please select a referencing stye below:
My Assignment Help. (2022). Accounting Principles II. Retrieved from https://myassignment.live/free-samples/acct2023-accounting-principles-ii/financial-statements-of-the-business-file-A1D39FE.html.
"Accounting Principles II." My Assignment Help, 2022, https://myassignment.live/free-samples/acct2023-accounting-principles-ii/financial-statements-of-the-business-file-A1D39FE.html.
My Assignment Help (2022) Accounting Principles II [Online]. Available from: https://myassignment.live/free-samples/acct2023-accounting-principles-ii/financial-statements-of-the-business-file-A1D39FE.html
[Accessed 06 September 2022].
My Assignment Help. 'Accounting Principles II' (My Assignment Help, 2022) < https://myassignment.live/free-samples/acct2023-accounting-principles-ii/financial-statements-of-the-business-file-A1D39FE.html> accessed 06 September 2022.
My Assignment Help. Accounting Principles II [Internet]. My Assignment Help. 2022 [cited 06 September 2022]. Available from: https://myassignment.live/free-samples/acct2023-accounting-principles-ii/financial-statements-of-the-business-file-A1D39FE.html.
Are you confident that you will achieve the grade?
Our best Expert will help you improve your grade
If you are the original writer of this content and no longer wish to have your work published on Myassignment.live then please raise the content removal request.