Artificially-Sweetened Beverage Substitution Linked to Long-Term Weight Loss

The replacement of sugar-sweetened beverages with non-caloric or artificially-sweetened beverages is associated with long-term body mass index (BMI) reductions among children and adults, according to study findings published in Obesity Reviews. 

Although previous research findings suggest an association between sugar-sweetened beverage consumption and weight gain, scarce evidence shows long-term weight changes from substituting sugar-sweetened with artificially-sweetened beverages.

To determine whether replacement of sugar-sweetened beverages with non-caloric beverages results in long-term body weight reduction, researchers conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) using PubMed and EMBASE. Inclusion criteria were an intervention duration of at least 6 months, sugar-sweetened beverages as the major difference between intervention and study groups, and participants with an existing intake of sugar-sweetened beverages.

The primary effect measure was the mean between-group difference in BMI from baseline to the end of the intervention period. The researchers conducted subgroup analyses according to intervention duration, participant age and baseline BMI.

The study included a total of 1729 participants from 6 studies, of which 4 were from the United States, 1 was from Mexico, and 1 was from the Netherlands. The study intervention arms were continuous sugar-sweetened beverage consumption and non-caloric beverage consumption, which included artificially-sweetened beverages and water.

The researchers calculated the smallest and largest mean BMI reductions as 0.28 kg/m² (95% CI, 0.14-0.42) and 0.31 kg/m² (95% CI, 0.17-0.44), respectively. These BMI reductions were calculated as weight loss values of approximately 0.5 kg and 1.0 kg among children and adults, respectively. 

In subgroup analyses, the researchers noted mean BMI reductions of:

• 0.36 kg/m² (95% CI, 0.2-0.53; longer duration studies);
• 0.19 kg/m² (95% CI, -0.04 to 0.43; shorter duration studies);
• 0.34 kg/m² (95% CI, 0.18-0.50; studies with children only);
• 0.22 kg/m² (95% CI, 0.04-0.47; studies with adults only);
• 0.29 kg/m² (95% CI, 0.04-0.55; baseline BMI >30); and,
• 0.31 kg/m² (95% CI, 0.15-0.47; all baseline BMIs).

Among the studies that assessed sugar-sweetened beverage intake at baseline and follow-up, substitution of sugar-sweetened beverages with non-caloric alternatives yielded a mean energy intake reduction of 240.1 kcal/day. 

Study limitations include the small number of eligible trials and subgroup analyses with less than 10 trials.

The researchers concluded, “Replacing [sugar-sweetened beverage]-consumption with non-caloric drinks resulted in a small but statistically significant long-term (as long at the interventions lasted) reduction in body weight of approximately 0.3 BMI units equivalent to approximately 0.5 and 1 kg in normal weight in children and adults, respectively.”

This article originally appeared on Endocrinology Advisor