Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial

Abstract

Background: Consumption of liquid calories from beverages has increased in parallel with the obesity epidemic in the US population, but their causal relation remains unclear.

Objective: The objective of this study was to examine how changes in beverage consumption affect weight change among adults.

Design: This was a prospective study of 810 adults participating in the PREMIER trial, an 18-mo randomized, controlled, behavioral intervention trial. Measurements (weight, height, and 24-h dietary recall) were made at baseline, 6 mo, and 18 mo.

Results: Baseline mean intake of liquid calories was 356 kcal/d (19% of total energy intake). After potential confounders and intervention assignment were controlled for, a reduction in liquid calorie intake of 100 kcal/d was associated with a weight loss of 0.25 kg (95% CI: 0.11, 0.39; P < 0.001) at 6 mo and of 0.24 kg (95% CI: 0.06, 0.41; P = 0.008) at 18 mo. A reduction in liquid calorie intake had a stronger effect than did a reduction in solid calorie intake on weight loss. Of the individual beverages, only intake of sugar-sweetened beverages (SSBs) was significantly associated with weight change. A reduction in SSB intake of 1 serving/d was associated with a weight loss of 0.49 kg (95% CI: 0.11, 0.82; P = 0.006) at 6 mo and of 0.65 kg (95% CI: 0.22, 1.09; P = 0.003) at 18 mo.

Conclusions: These data support recommendations to limit liquid calorie intake among adults and to reduce SSB consumption as a means to accomplish weight loss or avoid excess weight gain. This trial was registered at clinicaltrials.gov as NCT00000616.

FIGURE 1

Model-adjusted mean weight change and 95% CIs (6 mo − baseline) by tertile of 6-mo liquid calorie intake change and 18-mo weight change (18 mo – baseline) by tertile of 18-mo liquid calorie intake change. At 6 mo, the median change in liquid calorie intake was −271 kcal/d in the first tertile, −47 kcal/d in the second tertile, and 169 kcal/d in the third tertile. At 18 mo, the corresponding change in liquid calorie intake in each tertile was −267, −48, and 138 kcal/d, respectively. Models were adjusted for baseline age, sex, race, education, income, BMI status, intervention groups, concurrent change in fitness, physical activity, and solid calorie intake (test for trend was conducted by Wilcoxon's rank-sum test).

FIGURE 2

Model-adjusted mean 6-mo weight change and 95% Cls (6 mo – baseline) by tertile of 6-mo sugar-sweetened beverage (SSB) intake change and 18-mo weight change (18 mo – baseline) by tertile of 18-mo SSB intake change. At 6 mo, the median change in SSB intake was −479.0 mL/d in the first tertile, 0 mL/d in the second tertile, and 260.2 mL/d in the third tertile. At 18 mo, the median change in SSB intake in each tertile was −366.7, 0, and 248.3 mL/d, respectively. Models were adjusted for baseline age, sex, race, education, income, BMI status, intervention group, current change in physical activity, fitness, other beverages intake, and total calorie intake (test for trend was conducted by Wilcoxon's rank-sum test).