In the JournalsPerspective

Water as replacement for sugar-sweetened beverage reduces energy intake, body weight

Replacing one serving of a sugar-sweetened beverage with one serving of water decreased the percentage of energy intake in adults, a change that could lead to a decrease in body weight and obesity prevalence, according to an analysis of National Health and Nutrition Examination Survey data.

“Our findings provide further evidence that water replacement may be an effective strategy for adults concerned about excessive weight,” wrote Kiyah J. Duffey, PhD, of the department of human nutrition, foods and exercise at Virginia Tech, and Jennifer Poti, PhD, of the department of nutrition at the University of North Carolina at Chapel Hill. “The energy reduction associated with water replacement, we predict, would significantly lower the proportion of adults classified as obese from 35% down to 32% of the population.”

Duffey and Poti analyzed data from 16,429 U.S. adults participating in the 2007-2012 NHANES and What We Eat in America dietary intake potion of the NHANES dataset. Participants underwent a medical exam and completed an interviewer-administered 24-hour dietary recall. Beverages were classified according to the Healthy Beverage Index guidelines. Duffey and Poti determined baseline levels of beverage and macronutrient intake across age groups, as well as number of 8-oz servings of sugar-sweetened beverages consumed in 24 hours (< 1 serving, 1-2 servings or > 2 servings). They calculated total energy from all food and beverages and total energy from beverages alone to generate a measure of percent of energy from beverages.

Duffey and Poti applied observed changes in weight from previously published randomized controlled trials or intervention studies to the cohort across sugar-sweetened beverage consumption groups to predict the effect of replacing one sugar-sweetened beverage serving with water.

Among adults who reported consuming one sugar-sweetened beverage serving daily, replacing the beverage with water resulted in a 33% decrease in total energy, resulting in a lowering of the percent of energy from beverages to within the acceptable range of 10% to 14%, according to Duffey and Poti. In this group, they predicted that replacing the sugar-sweetened beverage with one serving of water would result in a weight change that ranged from –0.4 kg to –1.99 kg during 8 and 6 months’ intervention follow-up times, respectively.

“Using these new, predicted weight values and individual’s measured heights, we estimate a statistically significant reduction in the prevalence of obesity and a statistically significant increase in the prevalence of normal weight BMI among adults who replace one serving of [sugar-sweetened beverage] with one serving of water,” Duffey and Poti wrote. – by Regina Schaffer

Disclosure: Duffey reports receiving funding from the Drinking Water Research Foundation to conduct this study. Poti reports no relevant financial disclosures.

AUTHORS: Duffey KJ, Poti J

BACKGROUND: Sugar-sweetened beverages (SSB) contribute to excessive weight gain through added energy intake. Replacing SSB with water is one strategy that has shown promise in helping lower excessive energy intake. Using nationally representative data from US adults (n = 19,718) from NHANES 2007–2012 we examine the impact of replacing SSB with water on Healthy Beverage Index (HBI) scores and obesity prevalence ...

Replacing one serving of a sugar-sweetened beverage with one serving of water decreased the percentage of energy intake in adults, a change that could lead to a decrease in body weight and obesity prevalence, according to an analysis of National Health and Nutrition Examination Survey data.

“Our findings provide further evidence that water replacement may be an effective strategy for adults concerned about excessive weight,” wrote Kiyah J. Duffey, PhD, of the department of human nutrition, foods and exercise at Virginia Tech, and Jennifer Poti, PhD, of the department of nutrition at the University of North Carolina at Chapel Hill. “The energy reduction associated with water replacement, we predict, would significantly lower the proportion of adults classified as obese from 35% down to 32% of the population.”

Duffey and Poti analyzed data from 16,429 U.S. adults participating in the 2007-2012 NHANES and What We Eat in America dietary intake potion of the NHANES dataset. Participants underwent a medical exam and completed an interviewer-administered 24-hour dietary recall. Beverages were classified according to the Healthy Beverage Index guidelines. Duffey and Poti determined baseline levels of beverage and macronutrient intake across age groups, as well as number of 8-oz servings of sugar-sweetened beverages consumed in 24 hours (< 1 serving, 1-2 servings or > 2 servings). They calculated total energy from all food and beverages and total energy from beverages alone to generate a measure of percent of energy from beverages.

Duffey and Poti applied observed changes in weight from previously published randomized controlled trials or intervention studies to the cohort across sugar-sweetened beverage consumption groups to predict the effect of replacing one sugar-sweetened beverage serving with water.

Among adults who reported consuming one sugar-sweetened beverage serving daily, replacing the beverage with water resulted in a 33% decrease in total energy, resulting in a lowering of the percent of energy from beverages to within the acceptable range of 10% to 14%, according to Duffey and Poti. In this group, they predicted that replacing the sugar-sweetened beverage with one serving of water would result in a weight change that ranged from –0.4 kg to –1.99 kg during 8 and 6 months’ intervention follow-up times, respectively.

“Using these new, predicted weight values and individual’s measured heights, we estimate a statistically significant reduction in the prevalence of obesity and a statistically significant increase in the prevalence of normal weight BMI among adults who replace one serving of [sugar-sweetened beverage] with one serving of water,” Duffey and Poti wrote. – by Regina Schaffer

Disclosure: Duffey reports receiving funding from the Drinking Water Research Foundation to conduct this study. Poti reports no relevant financial disclosures.

AUTHORS: Duffey KJ, Poti J

BACKGROUND: Sugar-sweetened beverages (SSB) contribute to excessive weight gain through added energy intake. Replacing SSB with water is one strategy that has shown promise in helping lower excessive energy intake. Using nationally representative data from US adults (n = 19,718) from NHANES 2007–2012 we examine the impact of replacing SSB with water on Healthy Beverage Index (HBI) scores and obesity prevalence ...

    Perspective

    PERSPECTIVE
    Christina Roberto

    Christina A. Roberto

    These data suggest small dietary changes can be meaningful. And the message is simple: try replacing soda with water. It’s a great concrete step people can take toward healthier eating habits. 


    Christina A. Roberto, PhD
    Assistant professor of medical ethics and health policy, Perelman School of Medicine, University of Pennsylvania

    Disclosure: Roberto reports no relevant financial disclosures.