Department of Health Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, Netherlands, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands.
Contemp Clin Trials. 2012 Jan;33(1):247-57. doi: 10.1016/j.cct.2011.10.007. Epub 2011 Oct 25.
Intake of sugar-sweetened beverages is associated with overweight in observational studies. A possible explanation is that liquid sugars do not satiate and that their intake is not compensated by reduced caloric intake from other foods. However, evidence from intervention studies for this hypothesis is inconclusive because previous studies were not blinded. Hence results may have been influenced by expectations and behavioral cues rather than by physiological mechanisms.
We designed the Double-blind, Randomized INtervention study in Kids (DRINK) to examine the effect on body weight of covertly replacing sugar-sweetened by sugar-free beverages. Children were only eligible if they habitually drank sugar-sweetened beverages. We recruited 642 healthy children (mean age 8.2, range 4.8-11.9). We designed, tested and produced custom-made beverages containing 10% sugar and sugar-free beverages with the same sweet taste and look. Children receive one 250 mL can of study beverage daily for 18 months. We perform body measurements at 0, 6, 12 and 18 months. The primary outcome is the z-score of BMI for age. The maximum predicted difference in this score between groups is 0.72, which corresponds with a difference in body weight of 2.3 kg.
The double-blind design eliminates behavioral factors that affect body weight. If children gain less body fat when drinking sugar-free than when drinking sugar-sweetened beverages that would show that liquid sugar indeed bypasses biological satiation mechanisms. It would also suggest that a reduction in liquid sugars could decrease body fat more effectively than reduction of other calorie sources.
观察性研究表明，摄入含糖饮料与超重有关。一种可能的解释是，液体糖不会让人感到满足，而且它们的摄入不会被其他食物减少的热量摄入所补偿。然而，由于先前的研究没有设盲，干预研究对此假设的证据尚无定论。因此，结果可能受到预期和行为线索的影响，而不是生理机制的影响。
我们设计了双盲、随机干预儿童饮料研究（DRINK），以检验暗中用无糖饮料替代含糖饮料对体重的影响。只有习惯性饮用含糖饮料的儿童才有资格参加。我们招募了 642 名健康儿童（平均年龄 8.2 岁，范围 4.8-11.9 岁）。我们设计、测试并生产了含有 10%糖的特制饮料和具有相同甜味和外观的无糖饮料。儿童每天接受 250 毫升研究饮料，持续 18 个月。我们在 0、6、12 和 18 个月时进行身体测量。主要结局是体重指数年龄的 z 评分。两组之间该评分的最大预测差异为 0.72，这对应于体重的差异为 2.3 公斤。
双盲设计消除了影响体重的行为因素。如果儿童饮用无糖饮料比饮用含糖饮料时体重增加较少，这将表明液体糖确实绕过了生物饱腹感机制。这也表明，减少液体糖可能比减少其他热量来源更有效地减少体脂肪。
