[HTML][HTML] A trial of sugar-free or sugar-sweetened beverages and body weight in children

JC de Ruyter, MR Olthof, JC Seidell… - New England Journal …, 2012 - Mass Medical Soc
JC de Ruyter, MR Olthof, JC Seidell, MB Katan
New England Journal of Medicine, 2012Mass Medical Soc
Background The consumption of beverages that contain sugar is associated with
overweight, possibly because liquid sugars do not lead to a sense of satiety, so the
consumption of other foods is not reduced. However, data are lacking to show that the
replacement of sugar-containing beverages with noncaloric beverages diminishes weight
gain. Methods We conducted an 18-month trial involving 641 primarily normal-weight
children from 4 years 10 months to 11 years 11 months of age. Participants were randomly …
Background
The consumption of beverages that contain sugar is associated with overweight, possibly because liquid sugars do not lead to a sense of satiety, so the consumption of other foods is not reduced. However, data are lacking to show that the replacement of sugar-containing beverages with noncaloric beverages diminishes weight gain.
Methods
We conducted an 18-month trial involving 641 primarily normal-weight children from 4 years 10 months to 11 years 11 months of age. Participants were randomly assigned to receive 250 ml (8 oz) per day of a sugar-free, artificially sweetened beverage (sugar-free group) or a similar sugar-containing beverage that provided 104 kcal (sugar group). Beverages were distributed through schools. At 18 months, 26% of the children had stopped consuming the beverages; the data from children who did not complete the study were imputed.
Results
The z score for the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) increased on average by 0.02 SD units in the sugar-free group and by 0.15 SD units in the sugar group; the 95% confidence interval (CI) of the difference was −0.21 to −0.05. Weight increased by 6.35 kg in the sugar-free group as compared with 7.37 kg in the sugar group (95% CI for the difference, −1.54 to −0.48). The skinfold-thickness measurements, waist-to-height ratio, and fat mass also increased significantly less in the sugar-free group. Adverse events were minor. When we combined measurements at 18 months in 136 children who had discontinued the study with those in 477 children who completed the study, the BMI z score increased by 0.06 SD units in the sugar-free group and by 0.12 SD units in the sugar group (P=0.06).
Conclusions
Masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children. (Funded by the Netherlands Organization for Health Research and Development and others; DRINK ClinicalTrials.gov number, NCT00893529.)
The New England Journal Of Medicine