Cutting Sugary Drinks at Home Helped Teens Shed Pounds
By Judith Groch , MedPage Today Staff Writer
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.
Source News Article: BBC News
MedPage Today Action Points
When talking with parents or teenagers, explain that the ready availability of high-calorie beverages in the home undermines educational efforts to curb their consumption.
Remind patients that the American Academy of Pediatrics guidelines recommend that teenagers limit consumption of sugar-sweetened beverages, which have no nutritional value and can contribute to weight gain.
Review
BOSTON, March 6 - Evicting sugar-sweetened beverages from the home can help overweight teenagers drop nearly a pound a month, according to researchers here.
Replacing sugar-sweetened beverages with noncaloric drinks in the home helped teenagers cut consumption of high-calorie drinks by more than 80%, according to a randomized pilot study reported in the March issue of Pediatrics.
This emerged in a six-month intervention program in which noncaloric drinks were delivered to teens at home, said David Ludwig, M.D., Ph.D., of Children's Hospital here and colleagues.
In a controlled trial, 103 teenagers (47 male and 56 female), ages 13 to 18, were randomly assigned to an intervention program or a control group. At the outset, all participants reported consuming at least one 12-ounce serving a day of a sugar-sweetened drink -- soda, sports drink, high-calorie fruit or tea drink, the researchers said.
For 25 weeks, teens in the intervention group received a home delivery of noncaloric beverages of their own choosing -- bottled water and artificially sweetened drinks -- and were taught how to choose noncaloric drinks outside the home. Those in the control group were asked to continue their usual eating and drinking habits.
"Although access to soft drinks from many sources has increased over the last two decades, adolescents still obtain nearly 50% of their beverages at home," Dr. Ludwig's team wrote.
Consumption of sugar-sweetened drinks decreased by 82% (P< 0.0001) in the intervention group but did not change for the controls, the researchers reported. The change in BMI for the two groups, 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 controls. The net difference (-0.14 ± 0.21 kg/ m2 ) was not significant overall, they said.
However, significant changes were seen when the teenagers were stratified by baseline body mass index. For those in the upper BMI tertile (more than 25.6 kg/m2), the change in BMI differed markedly between the intervention and control groups. The no-calorie group had a definite decrease in BMI (-0.63 kg/ m2 ± 0.23 kg/ m2), whereas the controls had a slight increase (+0.12 ± 0.26 kg/ m2).
The net effect was -0.75 ± 0. 34 kg/ m2 (P=0.03), a "group-to-group difference of almost a pound a month," the investigators concluded.
By contrast, no significant group difference was seen for the teens in the middle or lower-weight tertiles.
The interaction between weight change and baseline BMI was not the result of baseline consumption of sugar-sweetened beverages, the researchers reported. Also, the results were not affected by gender, race, ethnicity, age, or household income. Other factors that affect obesity, exercise or television viewing, did not change in either group, the researchers said.
Cara Ebbeling, Ph.D., a co-author, noted that a single 12-ounce sugar-sweetened beverage per day, would translate to about a pound of weight gain over three to four weeks. "Sugary beverages" she said, "seem to make a huge contribution to weight gain."
The researchers agreed that their intervention was expensive, but they suggested that schools could make noncaloric beverages available by purchasing large quantities at low cost.
Limitations of the study noted by the authors included a relatively small sample size and short intervention period. Large-scale trials are needed to assess the value of decreasing sugary drinks as a strategy in the treatment of overweight adolescents, Dr. Ludwig's team wrote.
Pending completion of such trials, the investigators said, the current study supports the American Academy of Pediatrics guidelines that recommend limiting sugar-sweetened beverages, which have no nutritional value. Pediatricians and public health professional, they said, are well positioned to publicize and implement these guidelines.
Primary source: Pediatrics 2006, 117, No. 3
Source reference:
Ebbeling, Cara B., "Effects of Decreasing Sugar-Sweetened Beverage Consumption on Body Weight in Adolescents: A Randomized Controlled Pilot Study"
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