Dose-response and substitution analyzes of sweet beverage consumption and body weight in Dutch adults: The Lifelines Cohort Study

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  • Marion E C Buso
  • Elske M Brouwer-Brolsma
  • Novita D Naomi
  • Joanne A Harrold
  • Jason C G Halford
  • Raben, Anne
  • Edith J M Feskens

Background/Methods: Prospective studies investigating sweet beverages and body weight associations show inconsistent results. Within the SWEET project, we examined prospective dose-response associations of sugar-sweetened beverages (SSB), low/no-calorie beverages (LNCB), and fruit juice with body weight-related outcomes among 78,286 Dutch adults followed for ~4 years. Baseline intakes were assessed using a validated food-frequency questionnaire (FFQ) with 150 ml representing a standard serving. Outcome variables were body weight change, waist circumference change, overweight/obesity, and abdominal obesity. Associations were investigated by using linear and non-linear dose-response analysis, as well as substitution models while adjusting for multiple socio-demographic, lifestyle, health, and dietary variables. 

Results: Participants were 46 ± 13 (mean ± SD) years old and 60% were women. Adjusted dose-response analyzes indicated an association between SSB and LNCB, and both body weight (+0.02 kg/year; SE 0.01 and +0.06 kg/year; SE 0.01) and waist circumference changes (+0.04 cm/year; SE: 0.01 and +0.11 cm/year; SE: 0.01). Associations for overweight/obesity and abdominal obesity incidence were +3% (95%CI: 1.00–1.06) and +2% (95%CI: 0.99–1.06) for SSB and +8% (95%CI: 1.06–1.11) and +5% (95%CI: 1.03–1.07) for LNCB, respectively. Substitution of SSB with LNCB was associated with higher weight change (+0.04 kg/year), waist circumference change (+0.09 cm/year), overweight/obesity incidence (+6%), but not abdominal obesity incidence. For fruit juice, we observed beneficial associations for intake levels below ~1 serving/day with weight, waist circumference change, and overweight/obesity incidence, and no association with abdominal obesity. Subsequent substitution analyzes indicated a small beneficial association for the replacement of SSB with fruit juice on weight (−0.04 kg/year) and waist circumference (−0.04 cm/year), but not with other outcomes. 

Conclusions: Overall, our results suggest that habitual consumption of both SSB and LNCB may adversely affect weight-related outcomes. In contrast, fruit juice consumption <150 ml may be beneficial with respect to weight and waist circumference.

TidsskriftFrontiers in Nutrition
Antal sider13
StatusUdgivet - 2022

Bibliografisk note

CURIS 2022 NEXS 196

Funding Information:
This EU-project under the acronym SWEET has received funding from the European Union's Horizon 2020 research and innovation programme, grant agreement No. 774293.

Funding Information:
JHal is on the International Sweeteners and Mars Scientific Advisory Boards and together with JHar and AR have received honorariums from the international Sweeteners association. JHal and JHar are also conducting the SWITCH trial funded by the American Beverage Association. AR has received an honorarium from Unilever. EF has received an unrestricted grant from Friesland Campina and European Beer Institute and conducted a study on added sugar and individual sugars partly funded by Kenniscentrum Suiker en Gezondheid. MB, NN, and EB-B report no conflict of interest. The funding sponsors had no role in the design of the study; in the collection, analyzes, interpretation of data, writing of the manuscript, and nor in the decision to publish the results.

Publisher Copyright:
Copyright © 2022 Buso, Brouwer-Brolsma, Naomi, Harrold, Halford, Raben and Feskens.

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