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Reduction in consumption of sugar-sweetened beverages is associated with weight loss: the PREMIER trial^1,2,3

¹ From the Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (LC and BC); the Department of Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD (LJA); the Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (CL); the Department of Medicine, Duke University Medical Center, Durham, NC (P-HL); the Pennington Biomedical Research Center, Baton Rouge, LA (CMC); the Kaiser Permanente Center for Health Research, Portland, OR (PJE); the Division of Clinical Nutrition & Dietetics, University of Alabama at Birmingham, Birmingham, AL (JDA); the Diet Assessment Center, Pennsylvania State University, University Park, PA (DM); and the Duke Hypertension Center, Duke University, Durham, NC (BCB and LPS).

² Supported by the National Heart, Lung, and Blood Institute; NIH grants UO1 HL60570, UO1 HL60571, UO1 HL60573, UO1 HL60574, and UO1 HL62828; the Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health; and the Eunice Kennedy Shriver National Institute of Child Health & Human Development.

³ Reprints not available. Address correspondence to B Caballero, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room 2041, Baltimore, MD 21205. E-mail: caballero{at}jhu.edu.

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.

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