A Trial of Sugar-free or Sugar-Sweetened Beverages and Body Weight in Children

Ruyter, J.C. de; Olthof, Margreet R.; Seidell, Jacob C.; Katan, Martijn B.

doi:10.1056/nejmoa1203034

Cited by 719 publications

(629 citation statements)

References 49 publications

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“…Explanation (2) could be supported by previous observational studies suggesting an association between non-caloric sweeteners and consumption of artificially sweetened beverages and weight gain [25,26], although recent randomised trials conducted in children and adolescents do not support this hypothesis [27,28].…”

Section: Discussionmentioning

confidence: 99%

Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct

et al. 2013

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Aims/hypothesis Consumption of sugar-sweetened beverages has been shown, largely in American populations, to increase type 2 diabetes incidence. We aimed to evaluate the association of consumption of sweet beverages (juices and nectars, sugarsweetened soft drinks and artificially sweetened soft drinks) with type 2 diabetes incidence in European adults. Methods We established a case-cohort study including 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 participants selected from eight European cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. After exclusions, the final sample size included 11,684 incident cases and a subcohort of 15,374 participants. Cox proportional hazards regression models (modified for the case-cohort design) and random-effects meta-analyses were used to estimate the association between sweet beverage consumption (obtained from validated dietary questionnaires) and type 2 diabetes incidence.Results In adjusted models, one 336 g (12 oz) daily increment in sugar-sweetened and artificially sweetened soft drink consumption was associated with HRs for type 2 diabetes of 1.22 (95% CI 1.09, 1.38) and 1.52 (95% CI 1.26, 1.83), respectively. After further adjustment for energy intake and BMI, the association of sugar-sweetened soft drinks with type 2 diabetes persisted (HR 1.18, 95% CI 1.06, 1.32), but the association of artificially sweetened soft drinks became statistically not significant (HR 1.11, 95% CI 0.95, 1.31). Juice and nectar consumption was not associated with type 2 diabetes incidence. Conclusions/interpretation This study corroborates the association between increased incidence of type 2 diabetes and high consumption of sugar-sweetened soft drinks in European adults.

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Section: Discussionmentioning

confidence: 99%

Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct

et al. 2013

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“…These results are in line with those from several longitudinal studies conducted in children from developed countries that have demonstrated a link between soda consumption and BMI (9,(37)(38)(39)(40) . A recent randomized trial among school-age children showed that sugar-sweetened beverages caused greater gains in BMI and WC compared with unsweetened beverages (41) . Soda consumption contributes to increasing total energy intake as children fail to compensate for kilojoules from liquids by reduced consumption of solid foods at subsequent meals (42) .…”

Section: Discussionmentioning

confidence: 99%

Adherence to a snacking dietary pattern and soda intake are related to the development of adiposity: a prospective study in school-age children

Shroff

Perng

Baylin

et al. 2013

Public Health Nutr.

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Objective: Snacking has been related to increased prevalence of overweight among school-age children in cross-sectional studies. It is uncertain, however, whether snacking influences the development of adiposity over time. Design: We examined whether adherence to a snacking dietary pattern was associated with greater increases in children's BMI, subscapular:triceps skinfold thickness ratio and waist circumference over a median 2?5-year follow-up. Dietary patterns were identified through principal component analysis of an FFQ administered at recruitment in 2006. Anthropometric follow-up was conducted annually. Linear mixed-effects models were used to estimate rates of change in each indicator according to quartiles of adherence to the snacking pattern. We also examined change in BMI, subscapular:triceps skinfold thickness ratio and waist circumference in relation to intake of the food items in the snacking pattern. Subjects: Children (n 961) 5-12 years of age. Setting: Public schools in Bogotá, Colombia. Results: After adjustment for age, sex, total energy intake and socio-economic status, children in the highest quartile of adherence to the snacking pattern had a 0?09 kg/m 2 per year higher BMI gain than children in the lowest quartile (P trend 5 0?05). A similar association was observed for mean change in subscapular:triceps skinfold thickness ratio (highest v. lowest quartile difference 5 0?012/year; P 5 0?03). Of the food items in the snacking pattern, soda intake was positively and significantly associated with change in BMI (P trend 5 0?01) and waist circumference (P trend 5 0?04) in multivariable analysis. Conclusions: Our results indicate that snacking and soda intake are associated with development of adiposity in school-age children.

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“…Moreover, the long-term efficacy of using LCS in place of non-milk extrinsic sugars as a weight management tool has yet to be conclusively established (19)(20)(21)(22)(23)(24)(25) . A recent meta-analysis of randomised controlled trials and prospective cohort studies into the effects of LCS consumption on weight status, reported that in prospective cohort studies, a small positive association was observed between LCS consumption and increased BMI (0·03 kg/m 2 ) but not body weight or fat mass.…”

Section: Health Effects Of Low-calorie Sweeteners Intakementioning

confidence: 99%

The potential application of a biomarker approach for the investigation of low-calorie sweetener exposure

et al. 2016

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Low-calorie sweeteners (LCS) are commonly used as sugar substitutes in the diet to provide a desired sweet taste without increased energy intake. The number of LCS available on the market has increased considerably over the years and despite extensive evaluation of their safety prior to approval, debate continues around the effects of consumption on health. In Europe, Member States are obligated to monitor exposure to LCS and methods currently used tend to rely on self-reported dietary intake data alongside LCS concentrations in products. However, the acquisition of accurate data can be costly in terms of resources and time and are inherently imprecise. Although LCS are intensely sweet, they are chemically diverse and a limitation of many studies investigating the health effects of consumption is that they often fail to discern intakes of individual LCS. An approach which objectively assesses intakes of individual LCS would therefore allow robust investigations of their possible effects on health. Biomarker approaches have been utilised for the objective investigation of intakes of a range of dietary components and the feasibility of any such approach depends upon its validity as well as its applicability within the target population. This review aims to provide an overview of current understanding of LCS intake and explore the possibility of implementing a biomarker approach to enhance such understanding. Several commonly used LCS, once absorbed into the body, are excreted via the kidneys; therefore a urinary biomarker approach may be possible for the investigation of short-term exposure to these compounds.

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A Trial of Sugar-free or Sugar-Sweetened Beverages and Body Weight in Children

Cited by 719 publications

References 49 publications

Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct

Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct

Adherence to a snacking dietary pattern and soda intake are related to the development of adiposity: a prospective study in school-age children

The potential application of a biomarker approach for the investigation of low-calorie sweetener exposure

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