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Am Fam Physician. 2006;74(3):498-499

Soft drinks contribute 10 to 11 percent of calories to the diets of U.S. adolescents. They have been thought to promote obesity, but there are few trials examining their decreased consumption and demonstrable weight loss. Higher daily intake of sugar-sweetened beverages has been associated with obesity in observational studies, but decreasing consumption may facilitate long-term weight control. Ebbeling and colleagues attempted to determine if an environmental intervention can reduce sugar-sweetened beverage consumption and result in lower body mass index (BMI).

The study enrolled 103 adolescents 13 to 18 years of age with a BMI above the 25th percentile. Qualified participants had to drink at least one sugar-sweetened beverage daily (excluding 100 percent fruit juice) and reside in a single household. Each household received free noncaloric beverages for 25 weeks: four servings per day for participants and two servings for each additional family member per day. The individuals in the intervention group were asked to only consume these beverages while at home and to avoid sugar-sweetened beverages outside the home. The control group was instructed to continue usual beverage consumption. Instructions were reinforced with written materials and an initial telephone call. Monthly follow-up calls were conducted for the 25-week study, with the end point defined as change in BMI from baseline.

There was an 82 percent decrease in energy intake from sugar-sweetened beverages in the intervention group, but there was no change in the control group. BMI change was 0.07 ± 0.14 kg per m2 in the intervention group compared with 0.21 ± 0.15 kg per m2 in the control group. That difference was not significant, but there was a trend toward greater weight loss in participants within the intervention group who had a higher BMI and in patients with a BMI greater than 30 kg per m2. This effect was statistically significant. Additionally, participants with a BMI in the upper third at tertile (25.6 kg per m2 or higher) had a BMI change of −0.63 ± 0.23 kg per m2 compared with +0.12 ± 0.26 kg per m2 in the control groups.

Decreasing consumption of sugar-sweetened beverages affected body weight beneficially, which was strongly linked to baseline BMI, but BMI changes did not differ significantly in participants with lower base-line body weight. However, this effect was greater in patients who consumed more of these beverages. The authors suggest that, pending completion of larger studies that apply these findings, physicians and other public health professionals should continue to recommend limiting consumption of sugar-sweetened beverages.

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