Department of Health Sciences, EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.
N Engl J Med. 2012 Oct 11;367(15):1397-406. doi: 10.1056/NEJMoa1203034. Epub 2012 Sep 21.
The consumption of beverages that contain sugar is associated with overweight, possibly because liquid sugars do not lead to a sense of satiety, so the consumption of other foods is not reduced. However, data are lacking to show that the replacement of sugar-containing beverages with noncaloric beverages diminishes weight gain.
We conducted an 18-month trial involving 641 primarily normal-weight children from 4 years 10 months to 11 years 11 months of age. Participants were randomly assigned to receive 250 ml (8 oz) per day of a sugar-free, artificially sweetened beverage (sugar-free group) or a similar sugar-containing beverage that provided 104 kcal (sugar group). Beverages were distributed through schools. At 18 months, 26% of the children had stopped consuming the beverages; the data from children who did not complete the study were imputed.
The z score for the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) increased on average by 0.02 SD units in the sugar-free group and by 0.15 SD units in the sugar group; the 95% confidence interval (CI) of the difference was -0.21 to -0.05. Weight increased by 6.35 kg in the sugar-free group as compared with 7.37 kg in the sugar group (95% CI for the difference, -1.54 to -0.48). The skinfold-thickness measurements, waist-to-height ratio, and fat mass also increased significantly less in the sugar-free group. Adverse events were minor. When we combined measurements at 18 months in 136 children who had discontinued the study with those in 477 children who completed the study, the BMI z score increased by 0.06 SD units in the sugar-free group and by 0.12 SD units in the sugar group (P=0.06).
Masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children. (Funded by the Netherlands Organization for Health Research and Development and others; DRINK ClinicalTrials.gov number, NCT00893529.).
含糖饮料的消费与超重有关，这可能是因为液体糖不会让人产生饱腹感，因此不会减少其他食物的摄入。然而，目前还没有数据表明用无热量饮料代替含糖饮料会减少体重增加。
我们进行了一项为期 18 个月的试验，涉及 641 名主要为正常体重的儿童，年龄在 4 岁 10 个月至 11 岁 11 个月之间。参与者被随机分配每天饮用 250 毫升（8 盎司）无糖、人工甜味的饮料（无糖组）或类似的含糖饮料，提供 104 千卡热量（糖组）。饮料通过学校分发。18 个月时，26%的儿童停止饮用饮料；未完成研究的儿童的数据被推断。
无糖组的体重指数（BMI，体重以千克为单位除以身高以米为单位的平方）平均增加 0.02 个标准差单位，糖组增加 0.15 个标准差单位；差异的 95%置信区间（CI）为-0.21 至-0.05。无糖组体重增加 6.35 公斤，糖组增加 7.37 公斤（差异的 95%CI，-1.54 至-0.48）。皮褶厚度、腰高比和体脂也明显减少。不良事件轻微。当我们将 136 名停止研究的儿童的 18 个月测量值与完成研究的 477 名儿童的测量值合并时，无糖组的 BMI z 评分增加了 0.06 个标准差单位，糖组增加了 0.12 个标准差单位（P=0.06）。
用无热量饮料代替含糖饮料可以减少正常体重儿童的体重增加和脂肪堆积。（由荷兰健康研究与发展组织和其他组织资助；DRINK 临床试验.gov 编号，NCT00893529）。
