Prospective associations and population impact of sweet beverage intake and type 2 diabetes, and effects of substitutions with alternative beverages Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort. The relative reinforcing value of sweet versus savory snack foods after consumption of sugar- or non-nutritive sweetened beverages Effects of Decreasing Sugar-Sweetened Beverage Consumption on Body Weight in Adolescents: A Randomized, Controlled Pilot Study Sweetened beverage consumption and risk of coronary heart disease in women. Effects on uric acid, body mass index and blood pressure in adolescents of consuming beverages sweetened with high-fructose corn syrup Beverage Intake Among Preschool Children and Its Effect on Weight Status Modeling the Effect of Replacing Sugar-Sweetened Beverage Consumption with Water on Energy Intake, HBI Score, and Obesity Prevalence A mHealth randomized controlled trial to reduce sugar‐sweetened beverage intake in preschool‐aged children Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial. A Multicomponent Intervention Helped Reduce Sugar-Sweetened Beverage Intake in Economically Disadvantaged Hispanic Children Reduced availability of sugar-sweetened beverages and diet soda has a limited impact on beverage consumption patterns in Maine high school youth. Sweetened Beverage Consumption, Incident Coronary Heart Disease, and Biomarkers of Risk in Men Association of Sweetened Beverage Intake with Incident Hypertension Need for specific sugar-sweetened beverage lessons for fourth- and fifth-graders. Effects of replacing the habitual consumption of sugar-sweetened beverages with milk in Chilean children. The impact of a population-level school food and nutrition policy on dietary intake and body weights of Canadian children☆
Aims /hypothesisThis study aim ed to evaluate the association of types of sugar-sweetened beverages ( SSB ) ( soft drinks , sweetened-milk beverages , sweetened tea/coffee ) , artificially sweetened beverages ( ASB ) and fruit juice with incident type 2 diabetes and determine the effects of substituting non-SSB for SSB and the population -attributable fraction of type 2 diabetes due to total sweet beverages . Methods Beverage consumption of 25,639 UK-resident adults without diabetes at baseline ( 1993–1997 ) in the European Prospect i ve Investigation into Cancer and Nutrition (EPIC)-Norfolk study was assessed using 7-day food diaries . During 10.8 years of follow-up 847 incident type 2 diabetes cases were verified . Results In adjusted Cox regression analyses there were positive associations ( HR [ 95 % CI ] per serving/day ] ) for soft drinks 1.21 ( 1.05 , 1.39 ) , sweetened-milk beverages 1.22 ( 1.05 , 1.43 ) and ASB 1.22 ( 1.11 , 1.33 ) , but not for sweetened tea/coffee 0.98 ( 0.94 , 1.02 ) or fruit juice 1.01 ( 0.88 , 1.15 ) . Further adjustment for adiposity attenuated the association of ASB , HR 1.06 ( 0.93 , 1.20 ) . There was a positive dose – response relationship with total sweet beverages : HR per 5 % energy 1.18 ( 1.11 , 1.26 ) . Substituting ASB for any SSB did not reduce the incidence in analyses accounting for energy intake and adiposity . Substituting one serving/day of water or unsweetened tea/coffee for soft drinks and for sweetened-milk beverages reduced the incidence by 14%–25 % . If sweet beverage consumers reduced intake to below 2 % energy , 15 % of incident diabetes might be prevented . Conclusions /interpretationThe consumption of soft drinks , sweetened-milk beverages and energy from total sweet beverages was associated with higher type 2 diabetes risk independently of adiposity . Water or unsweetened tea/coffee appear to be suitable alternatives to SSB for diabetes prevention . These findings support the implementation of population -based interventions to reduce SSB consumption and increase the consumption of suitable alternatives BACKGROUND It has been extensively shown , mainly in US population s , that sugar-sweetened beverages ( SSBs ) are associated with increased risk of type 2 diabetes ( T2D ) , but less is known about the effects of artificially sweetened beverages ( ASBs ) . OBJECTIVE We evaluated the association between self-reported SSB , ASB , and 100 % fruit juice consumption and T2D risk over 14 y of follow-up in the French prospect i ve Etude Epidémiologique auprès des femmes de la Mutuelle Générale de l'Education Nationale-European Prospect i ve Investigation into Cancer and Nutrition cohort . DESIGN A total of 66,118 women were followed from 1993 , and 1369 incident cases of T2D were diagnosed during the follow-up . Cox regression models were used to estimate HRs and 95 % CIs for T2D risk . RESULTS The average consumption of sweetened beverages in consumers was 328 and 568 mL/wk for SSBs and ASBs , respectively . Compared with nonconsumers , women in the highest quartiles of SSB and ASB consumers were at increased risk of T2D with HRs ( 95 % CIs ) of 1.34 ( 1.05 , 1.71 ) and 2.21 ( 1.56 , 3.14 ) for women who consumed > 359 and > 603 mL/wk of SSBs and ASBs , respectively . Strong positive trends in T2D risk were also observed across quartiles of consumption for both types of beverage ( P = 0.0088 and P < 0.0001 , respectively ) . In sensitivity analyses , associations were partly mediated by BMI , although there was still a strong significant independent effect . No association was observed for 100 % fruit juice consumption . CONCLUSIONS Both SSB consumption and ASB consumption were associated with increased T2D risk . We can not rule out that factors other than ASB consumption that we did not control for are responsible for the association with diabetes , and r and omized trials are required to prove a causal link between ASB consumption and T2D The effects of sugar-sweetened ( SSB ) and non-nutritive sweetened ( NSB ) beverages on the regulation of appetite , energy intake and body weight regulation remain controversial . Using a behavioral choice paradigm , we sought to determine the effects of consuming a SSB or NSB on appetite and the reinforcing value of sweet relative to salty/savory snack foods . In a r and omized crossover study , 21 healthy weight adults consumed 360 ml of SSB ( sucrose ; 31 g ) or NSB ( sucralose ; 4 g ) with a st and ardized meal . Hedonic ratings for the sweet and salty/savory snack foods used for the reinforcement task were assessed prior to the start of the study . Satiety and the desire to eat foods with a specific taste profile were assessed before and every 30 min post-meal for 4 h. The relative reinforcing value of the snack foods was assessed using a computer-based choice task ( operant responding with concurrent schedules of reinforcement ) 4 h post-meal . Hedonic ratings did not differ between the most highly liked sweet and salty/savory snack foods . Beverage type did not influence measures of satiety or the desire to eat foods with a specific taste . However , sweet snacks were more ( p < 0.05 ) reinforcing relative to salty/savory snack foods after consuming a NSB than after a SSB . In conclusion , this is the first study to demonstrate that NSB can increase the motivation to gain access to sweet snacks relative to salty/savory snack foods later in the day OBJECTIVE . The role of sugar-sweetened beverages ( SSBs ) in promoting obesity is controversial . Observational data link SSB consumption with excessive weight gain ; however , r and omized , controlled trials are lacking and necessary to resolve the debate . We conducted a pilot study to examine the effect of decreasing SSB consumption on body weight . METHODS . We r and omly assigned 103 adolescents aged 13 to 18 years who regularly consumed SSBs to intervention and control groups . The intervention , 25 weeks in duration , relied largely on home deliveries of noncaloric beverages to displace SSBs and thereby decrease consumption . Change in  SSB consumption was the main process measure , and change in body mass index ( BMI ) was the primary end point . RESULTS . All of the r and omly assigned subjects completed the study . Consumption of SSBs  decreased by 82 % in the intervention group and did not change in the control group . Change in BMI , adjusted for gender and age , was 0.07 ± 0.14 kg/m2 ( mean ± SE ) for the intervention group and 0.21 ± 0.15 kg/m2 for the control group . The net difference , −0.14 ± 0.21 kg/m2 , was not significant overall . However , baseline BMI was a significant effect modifier . Among the subjects in the upper baseline- BMI tertile , BMI change differed significantly between the intervention ( −0.63 ± 0.23 kg/m2 ) and control ( + 0.12 ± 0.26 kg/m2 ) groups , a net effect of −0.75 ± 0.34 kg/m2 . The interaction between weight change and baseline BMI was not attributable to baseline consumption of SSBs . CONCLUSIONS . A simple environmental intervention almost completely eliminated SSB consumption in a diverse group of adolescents . The beneficial effect on body weight of reducing SSB consumption increased with increasing baseline body weight , offering additional support for American Academy of Pediatrics guidelines to limit SSB consumption BACKGROUND Previous studies have linked full-calorie sugar-sweetened beverages ( SSBs ) with greater weight gain and an increased risk of type 2 diabetes . OBJECTIVE We prospect ively examined the association between consumption of SSBs and the risk of coronary heart disease ( CHD ) in women . DESIGN Women ( n = 88,520 ) from the Nurses ' Health Study aged 34 - 59 y , without previously diagnosed coronary heart disease ( CHD ) , stroke , or diabetes in 1980 , were followed from 1980 to 2004 . Consumption of SSBs was derived from 7 repeated food-frequency question naires administered between 1980 and 2002 . Relative risks ( RRs ) for CHD were calculated by using Cox proportional hazards models and adjusted for known cardiovascular disease risk factors . RESULTS During 24 y of follow-up , we ascertained 3105 incident cases of CHD  ( nonfatal myocardial infa rct ion and fatal CHD ) . After st and ard and dietary risk factors were adjusted for , the RRs ( and 95 % CIs ) of CHD according to categories of cumulative average of SSB consumption ( < 1/mo , 1 - 4/mo , 2 - 6/wk , 1/d , and > or = 2 servings/d ) were 1.0 , 0.96 ( 0.87 , 1.06 ) , 1.04 ( 0.95 , 1.14 ) , 1.23 ( 1.06 , 1.43 ) , and 1.35 ( 1.07 , 1.69 ) ( P for trend < 0.001 ) . Additional adjustment for body mass index , energy intake , and incident diabetes attenuated the associations , but they remained significant . Artificially sweetened beverages were not associated with CHD . CONCLUSION Regular consumption of SSBs is associated with a higher  risk of CHD in women , even after other unhealthful lifestyle or dietary factors are accounted for Objective : The dietary intake of fructose-rich sugar-sweetened beverages ( SSB ) may have a significant role in raising serum uric acid ( SUA ) levels as well as the risk of contracting gout and cardiovascular risk factors . Our objective was to investigate the impact of SSB intake on SUA , body mass index ( BMI ) and systolic blood pressure ( SBP ) among adolescents in Taiwan . Methods : We evaluated data from 2727 representative adolescents who were multistage sample d from 36 Junior High schools in Taiwan . We cross-sectionally collected demographic , physical , dietary and anthropometric variables , and prospect ively measured clinical outcomes . Data were analyzed using multiple regression and logistic models adjusted for covariates . Results : We found that 87.7 % of adolescents were SSB drinkers , with 25.1 % drinking > 500 ml per day of such beverages . Increased SSB intake was associated with increased waist and hip circumferences , body fat , BMI , SBP and SUA . As compared with non-drinkers , SSB drinkers had a 3.2–4.9 elevated risk of obesity . The prevalence of hyperuricemia in heavy SSB  users ( 40.2–49.4 % ) was appreciably greater than that for non-users ( 24.2 % ) . Adolescents who consumed > 500 ml per day of heavy high-fructose corn syrup ( HFCS ) containing beverages had a 0.42 mg dl−1 higher SUA level and a 2.0–2.1 increased risk of developing hyperuricemia than non-drinkers . The consumption of HFCS-rich beverages was also found to interact with obesity in determining higher levels of SUA ( 2.2–2.4 mg dl−1 increases ) . Conclusion : High SSB consumption has a notable effect on increased levels of BMI and SUA . The intake of HFCS-rich beverages and BMI were likely to interactively strengthen SUA levels among obese adolescents OBJECTIVE . The obesity epidemic in the United States continues to increase . Because obesity tends to track over time , the increase in overweight among young children is of significant concern . A number of eating patterns have been associated with overweight among preschool-aged children . Recently , 100 % fruit juice and sweetened fruit drinks have received considerable attention as potential sources of high-energy beverages that could be related to the prevalence of obesity among young children . Our aim was to evaluate the beverage intake among preschool children who participated in the National Health and Nutrition Examination Survey 1999–2002 and investigate associations between types and amounts of beverages consumed and weight status in preschool-aged children . METHODS . We performed a secondary analysis of the data from the National Health and Nutrition Examination Survey 1999–2002 , which is a continuous , cross-sectional survey of a nationally representative sample of the noninstitutionalized population of the United State . It included the collection of parent reported demographic descriptors , a  24-hour dietary recall  , a  measure of physical activity  , and a st and ardized physical examination .  The 24-hour dietary recall was obtained in person by a trained interviewer and reflected the foods and beverages that were consumed by the participant the previous day . The National Health and Nutrition Examination Survey food groups were classified on the basis of the US Department of Agriculture 's Food and Nutrient Data base for Dietary Studies . We review ed the main food descriptors used and classified all beverages listed . One hundred percent fruit juice was classified as only beverages that contained 100 % fruit juice , without sweetener . Fruit drinks included any sweetened fruit juice , fruit-flavored drink ( natural or artificial ) , or drink that contained fruit juice in part . Milk included any type of cow milk and then was subcategorized by percentage of milk fat . Any sweetened soft drink , caffeinated or uncaffeinated , was categorized as soda . Diet drinks included any fruit drink , tea , or soda that was sweetened by low-calorie sweetener . Several beverages were removed from the analysis because of low frequency of consumption among the sample . Water was not included in the analysis because it is not part of the US Department of Agriculture 's Food and Nutrient Data base categories . For the purpose s of this analysis , the beverages were converted and reported as ounces , rather than grams , as reported by the National Health and Nutrition Examination Survey , to make it more clinical ly relevant . The child 's BMI percentile for age and gender were calculated on the basis of Centers for Disease Control and Prevention criteria and used to identify children 's weight status as underweight ( < 5 % ) , normal weight ( 5 % to < 85 % ) , at risk for overweight ( 85 % to < 95 % ) , or overweight ( ≥95 % ) . Because of the small number of children in the underweight category , they were included in the normal-weight category for this analysis . Data were analyzed using SUDAAN 9.0.1 statistical software programs . SUDAAN allows for improved accuracy and validity of results by calculating test statistics for the stratified , multistage probability design of the National Health and Nutrition Examination Survey . Sample weights were applied to all analyses to account for unequal probability of selection from oversampling low-income children and black and Mexican American children . Descriptive and χ2 analyses and analysis of covariance , adjusting for age , gender , ethnicity , household income , energy intake , and physical activity , were conducted . RESULTS . All children who were aged 2 to 5 years were identified ( N = 1572 ) . Those with missing data were removed from additional analysis , result ing in a final sample of 1160 preschool children . Of the 1160 children analyzed , 579 ( 49.9 % ) were male . White children represented 35 % , black children represented 28.3 % , and Hispanic children represented 36.7 % of the sample . Twenty-four percent of the children were overweight or at risk for overweight ( BMI ≥85 % ) , and 10.7 % were overweight ( BMI ≥95 % ) . There were no statistically significant differences in BMI between boys and girls or among the ethnicities . Overweight children tended to be older ( mean age : 3.83 years ) compared with the normal-weight children ( mean age : 3.48 years ) . Eighty-three percent of children drank milk , 48 % drank 100 % fruit juice , 44 % drank fruit drink , and 39 % drank soda .  Whole milk was consumed by 46.5 % of the children , and 3.1 % and 5.5 % of the children consumed skim milk and 1 % milk , respectively . Preschool children consumed a mean total beverage volume of 26.93 oz/day , which included 12.32 oz of milk , 4.70 oz of 100 % fruit juice , 4.98 oz of fruit drinks , and 3.25 oz of soda . Weight status of the child had no association with the amount of total beverages , milk , 100 % fruit juice , fruit drink , or soda consumed . There was no clinical ly significant association between the types of milk ( percentage of fat ) consumed and weight status . In analysis of covariance , daily total energy intake increased with increased consumption of milk , 100 % fruit juice , fruit drinks , and soda . However , there was not a statistically significant increase in BMI on the basis of quantity of milk , 100 % fruit juice , fruit drink , or soda consumed . CONCLUSIONS . On average , preschool children drank less milk than the 2005 Dietary Guidelines for Americans recommendation of 16 oz/day . Only 8.6 % drank low-fat or skim milk , as recommended for children who are older than 2 years . On average , preschool children drank < 6 oz/day 100 % fruit juice . Increased beverage consumption was associated with an increase in the total energy intake of the children but not with their BMI . Prospect ively study ing preschool children beyond 2 to 5 years of age , through their adiposity rebound ( ∼5.5–6 years ) to determine whether there is a trajectory increase in their BMI , may help to clarify the role of beverage consumption in total energy intake and weight status 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 an 8-ounce serving of SSB with water lowered the percent of energy from beverages from 17 % to 11 % ( among those consuming 1 serving SSB/day ) . Reductions in the percent energy from beverages were observed across all SSB consumption groups ( 1–2 servings/day and > 2 servings/day ) . Among adults there was a 9 % to 21 % improvement in HBI score when one serving of water replaced one serving of SSB . Using previously published r and omized controlled trials ( RCT ) and meta-analyses of measured weight loss we also predicted a reduction in the prevalence of obesity ( observed : 35.2 % ; predicted 33.5%–34.9 % , p < 0.05 ) and increase in the prevalence of normal weight ( observed : 29.7 % ; high weight loss : 31.3 % , p < 0.05 ) . Our findings provide further epidemiologic evidence that water in the place of SSB can be used as a strategy to limit energy intake and help individuals meet beverage intake recommendations BACKGROUND Sugar-sweetened beverages and maternal weight are strong drivers of child obesity , but few studies have targeted these risk factors as an obesity prevention strategy in children . OBJECTIVE The objective of this study was to test the efficacy of a smartphone-delivered intervention to reduce parent-provided  sugar-sweetened beverage and juice ( SSB/juice ) consumption among children ages 3 - 5 and maternal weight . METHODS Mothers with overweight or obesity , who had a child ages 3 - 5 that consumed at least 12 fl . oz./day of SSB/juice ( N = 51 dyads ) were r and omized to the Smart Moms  group that received one group session , lessons on a mobile website , and text messages , or to a waitlist control group . Mothers self-monitored their children 's beverages in addition to their own beverages , high-calorie foods , and weight . Assessment s at baseline , 3 , and 6 months included dietary recalls to measure SSB/juice intake and objective ly measured maternal weight . RESULTS Using linear mixed models controlling for baseline values , child age and race , there was a greater reduction in child SSB/juice in Smart Moms compared with control at 6 months ( -9.7 oz./day vs. 1.7 oz./day , p < .01 ) . Mothers in Smart Moms lost 2.4 kg at 6 months compared with a 0.9-kg gain in the control group ( p < .01 ) . CONCLUSIONS An intervention delivered using mHealth technologies can target mothers to change child dietary behaviours and improve maternal weight , which suggests a novel approach to family-based obesity prevention 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 prospect i ve study of 810 adults participating in the PREMIER trial , an 18-mo r and omized , 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 clinical trials.gov as NCT00000616 Purpose . This study aim ed to examine the effect of a multicomponent intervention program on consumption of sugar-sweetened beverages ( SSBs ) , and lifestyle factors associated with SSB intake , in Hispanic children from low-income families . Design . A five-wave longitudinal study using a quasi-experimental design was conducted . Setting . Five elementary schools in West Texas served as the setting . Subjects . Participants included 555 predominantly Hispanic children ( ages 5–9 years ) from low-income families and their parents ( n = 525 ) . Intervention . A multicomponent intervention program was implemented . Measures . Children 's anthropometric measures were obtained . Their weight status was determined based on body mass index for age and gender . Parents responded to a demographic question naire , a shelf inventory , an acculturation scale , and a family survey . Analysis . Growth curve analyses were used to test differences between intervention and comparison participants ' SSB intake and to examine potential covariates . Results . Comparison group children 's daily SSB intake significantly increased over time ( B = 1.06 ± .40 ounces per month , p < .01 ) , but this linear increase of SSB was slowed down by the intervention ( B = −.29 ± .12 , p < .05 ) . More daily TV time , more fast food intake , and more types of SSBs available at home were associated with higher SSB intake . Conclusion . Risk factors of childhood obesity were associated with each other . The intervention program produced a modest reduction in SSB consumed by economically disadvantaged and predominantly Hispanic children OBJECTIVE To examine change in high school students ' beverage consumption patterns pre- and post-intervention of reduced availability of sugar-sweetened beverages ( SSB ) and diet soda in school food venues . DESIGN A prospect i ve , quasi-experimental , nonr and omized study design . SETTING Public high schools . PARTICIPANTS A convenience sample from control ( n = 221 ) and intervention ( n = 235 ) high schools . INTERVENTION Schools aim ed to reduce ( n = 4 ) or not change ( n = 3 ) availability of SSB and diet soda in food venues for 1 school year . MAIN OUTCOME MEASURES Subjects ' beverage servings/day was determined from a food frequency question naire pre- and post-intervention . ANALYSIS Two-by-two mixed analysis of variance model compared pre- to post-intervention servings/day between control and intervention subjects , stratified by gender . RESULTS Consumption of SSB decreased in both intervention and control boys ( F = 53.69 , P < .05 ) and girls ( F = 22.87 , P < .05 ) . Intervention girls decreased  diet soda consumption as compared to control girls ( F = 6.57 , P < .05 ) . CONCLUSION AND IMPLICATION S Reducing availability of SSB in schools did not result in a greater decrease in SSB consumption by intervention as compared to control subjects . The impact of reducing availability of SSB at school may be limited . A better underst and ing of beverage consumption patterns may be needed to determine the efficacy of school food policies on those youth susceptible to obesity Background — Sugar-sweetened beverage consumption is associated with weight gain and risk of type 2 diabetes mellitus .  Few studies have tested for a relationship with coronary heart disease ( CHD ) or intermediate biomarkers . The role of artificially sweetened beverages is also unclear . Methods and Results — We performed an analysis of the Health Professionals Follow-Up Study , a prospect i ve cohort study including 42 883 men . Associations of cumulatively averaged sugar-sweetened ( eg , sodas ) and artificially sweetened ( eg , diet sodas ) beverage intake with incident fatal and nonfatal CHD ( myocardial infa rct ion ) were examined with proportional hazard models . There were 3683 CHD cases over 22 years of follow-up . Participants in the top quartile of sugar-sweetened beverage intake had a 20 % higher relative risk of CHD than those in the bottom quartile ( relative risk=1.20 ; 95 % confidence interval , 1.09–1.33 ; P for trend < 0.01 ) after adjustment for age , smoking , physical activity , alcohol , multivitamins , family history , diet quality , energy intake , body mass index , pre-enrollment weight change , and dieting . Artificially sweetened beverage consumption was not significantly associated with CHD ( multivariate relative risk=1.02 ; 95 % confidence interval , 0.93–1.12 ; P for trend=0.28 ) . Adjustment for self-reported high cholesterol , high triglycerides , high blood pressure , and diagnosed type 2 diabetes mellitus slightly attenuated these associations . Intake of sugar-sweetened but not artificially sweetened beverages was significantly associated with increased plasma triglycerides , C-reactive protein , interleukin-6 , and tumor necrosis factor receptors 1 and 2 and decreased high-density lipoprotein , lipoprotein(a ) , and leptin ( P<0.02 ) . Conclusions — Consumption of sugar-sweetened beverages was associated with increased risk of CHD and some adverse changes in lipids , inflammatory factors , and leptin . Artificially sweetened beverage intake was not associated with CHD risk or biomarkers BACKGROUND Consumption of sugar-sweetened beverages ( SSBs ) is associated with an increased risk of hypertension  in cross-sectional studies . However , prospect i ve data are limited . OBJECTIVE To examine the associations between SSBs and artificially sweetened beverages ( ASBs ) with incident hypertension . DESIGN AND SETTING Prospect i ve analysis using Cox proportional hazards regression to examine the association between SSBs and ASBs with incident hypertension in three large , prospect i ve cohorts , the Nurses ' Health Studies I ( n = 88,540 women ) and II ( n = 97,991 women ) and the Health Professionals ' Follow-Up Study ( n = 37,360 men ) . MEASUREMENTS Adjusted hazard ratios for incident clinical ly diagnosed hypertension . RESULTS Higher SSB  and ASB intake was associated with an increased risk of developing hypertension in all three cohorts . In a pooled analysis , participants who consumed at least one SSB daily had an adjusted HR for incident hypertension of 1.13 ( 95 % CI , 1.09–1.17 ) compared with those who did not consume SSBs ; for persons who drank at least one ASB daily , the adjusted HR was 1.14 ( 95 % CI , 1.09–1.18 ) . The association between sweetened beverage intake and hypertension was stronger for carbonated beverages versus non-carbonated beverages , and for cola-containing versus non-cola beverages in the NHS I and NHS II cohorts only . Higher fructose intake from SSBs as a percentage of daily calories was associated with increased hypertension risk in NHS I and NHS II ( p-trend = 0.001 in both groups ) , while higher fructose intake from sources other than SSBs was associated with a decrease in hypertension risk in NHS II participants ( p-trend = 0.006 ) . LIMITATIONS Residual confounding factors may interfere with the interpretation of results . CONCLUSIONS SSBs and ASBs are independently associated with an increased risk of incident hypertension after controlling for multiple potential confounders . These associations may be mediated by factors common to both SSBs and ASBs ( e.g. , carbonation or cola ) , but are unlikely to be due to fructose OBJECTIVE Consumption of sugar-sweetened beverages ( SSB ) is linked to obesity . The authors hypothesized that school-based nutrition education would decrease SSB consumption . DESIGN Self-selected interventional cohort with r and om selection for pre and post measurements . SETTING Arizona Supplemental Nutrition Assistance Program-Education Program-eligible schools . PARTICIPANTS R and omly selected ( 9 % ) fourth- and fifth- grade classroom students . INTERVENTION The  University of Arizona Nutrition Network provided general nutrition education training and material s to teachers , to be delivered to their students . The University of Arizona Nutrition Network administered behavioral question naires to students in both fall and spring . MAIN OUTCOME MEASURE(S ) Change in SSB consumption . ANALYSES Descriptive statistics were computed for student demographics and beverage consumption on the day before testing . Paired t tests evaluated change in classroom averages . Linear regression assessed potential correlates of SSB consumption . RESULTS Fall mean SSB consumption was 1.1 ( ± 0.2 ) times ; mean milk and water intake were 1.6 ( ± 0.2 ) and 5.2 ( ± 0.7 ) times , respectively . Beverage consumption increased ( 3.2 % ) in springtime , with increased SSBs ( 14.4 % ) accounting for the majority ( P = .006 ) . Change in SSB consumption was negatively associated with baseline SSB and water consumption but positively associated with baseline milk fat ( P ≤ .05 ) . CONCLUSIONS AND IMPLICATION S The results suggest the need for beverage-specific education to encourage children to consume more healthful beverages in warmer weather BACKGROUND During the nutrition transition in Chile , dietary changes were marked by increased consumption of high-energy , nutrient-poor products , including sugar-sweetened beverages ( SSBs ) . Obesity is now the primary nutritional problem in posttransitional Chile . OBJECTIVE We conducted a r and omized controlled trial to examine the effects on body composition of delivering milk beverages to the homes of overweight and obese children to displace SSBs . DESIGN We r and omly assigned 98 children aged 8 - 10 y who regularly consumed SSBs  to intervention and control groups . During a 16-wk intervention , children were instructed to drink 3 servings/d ( approximately 200 g per serving ) of the milk delivered to their homes and to not consume SSBs .  Body composition was measured by dual-energy X-ray absorptiometry . Data were analyzed by multiple regression analysis according to the intention-to-treat principle . RESULTS For the intervention group , milk consumption increased by a mean ( + /- SEM ) of 452.5 + /- 37.7 g/d ( P < 0.0001 ) , and consumption of SSBs  decreased by -711.0 + /- 33.7 g/d ( P < 0.0001 ) . For the control group , milk consumption did not change , and consumption of SSBs  increased by 71.9 + /- 33.6 g/d ( P = 0.04 ) . Changes in percentage body fat , the primary endpoint , did not differ between groups . Nevertheless , the mean ( + /- SE ) accretion of lean body mass was greater ( P = 0.04 ) in the intervention ( 0.92 + /- 0.10 kg ) than in the control ( 0.62 + /- 0.11 kg ) group . The increase in height was also greater ( P = 0.01 ) in the intervention group ( 2.50 + /- 0.21 cm ) than in the control group ( 1.77 + /- 0.20 cm ) for boys but not for girls . CONCLUSION Replacing habitual consumption of SSBs with milk may have beneficial effects on lean body mass and growth in children , despite no changes in percentage body fat . This trial was registered at clinical trials.gov as NCT00149695 Objective The objective of this study is to assess population -level trends in children 's dietary intake and weight status before and after the implementation of a  provincial school nutrition policy in the province of Nova Scotia , Canada . Method Self-reported dietary behavior and nutrient intake and measured body mass index were collected as part of a population -level study with grade 5 students in 2003 ( n = 5215 ) and 2011 ( 5508 ) , prior to and following implementation of the policy . We applied r and om effects regression methods to assess the effect of the policy on dietary and health outcomes . Results In 2011 , students reported consuming more milk products , while there was no difference in mean consumption of vegetables and fruits in adjusted models . Adjusted regression analysis revealed a statistically significant decrease in sugar-sweetened beverage consumption . Despite significant temporal decreases in dietary energy intake and increases in diet quality , prevalence rates of overweight and obesity continued to increase . Conclusion This population -level intervention research suggests a positive influence of school nutrition policies on diet quality , energy intake and healthy beverage consumption , and that more action beyond schools is needed to curb the increases in the prevalence of childhood obesity
The current evidence does not demonstrate conclusively that NSB consumption has uniquely contributed to obesity or that reducing NSB consumption will reduce BMI levels in general .
Nutritively sweetened beverages ( NSBs ) may play a role in the obesity epidemic .