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Keep your kids thin with sugar-free beverages

Robin Wulffson MD's picture
obesity, children, sugary beverages, artifical sweeteners, sugar-free

The consumption of sugar-containing beverages is associated with obesity; this may be due to the fact that liquid sugars do not produce a sense of satiety; thus, the consumption of other foods is not reduced. A new study noted that data are lacking to show that the replacement of sugar-containing beverages with noncaloric beverages diminishes weight gain. Therefore, researchers affiliated with VU University Amsterdam, Amsterdam, The Netherlands conducted a study addressing this issue. Their results were published on October 11, in The New England Journal of Medicine.

The investigators conducted an 18-month trial involving 641 primarily normal-weight children from ranging in age from 4 years 10 months to 11 years 11 months. The children 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 calories (sugar group). The 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 also evaluated.

The researcher found that 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 standard deviation (SD) units in the sugar-free group and by 0.15 SD units in the sugar group. (Z scores inform whether a particular score is equal to the mean, below the mean or above the mean of a bunch of scores. They can also inform how far a particular score is away from the mean (i.e., is a particular score close to the mean or far away?).

Weight increased by 6.35 kg in the sugar-free group, compared with 7.37 kg in the sugar group. 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 the measurements were combined 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.

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The researchers concluded that masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children.

Take Home Message:
Artificial sweeteners are synthetic sugar substitutes; however, they may be derived from naturally occurring substances, including herbs or sugar itself. Artificial sweeteners are also known as intense sweeteners because they are many times sweeter than regular sugar. Some leave an aftertaste that some individuals deem unpleasant.

As the study noted, a benefit of artificial sweeteners is that they are helpful in weight control. Other possible benefits are that they do not contribute to tooth decay and cavities and are a healthy alternative to sugar for diabetics who must regulate glucose ingestion. However, artificial sweeteners have been the subject of intense scrutiny for decades. Critics of artificial sweeteners note that they cause a variety of health problems, including cancer. The cancer risk is derived from studies conducted as far back as the 1970s that linked saccharin to bladder cancer in laboratory rats. Because of those studies, saccharin once carried a warning label that it may be hazardous to one’s health. However, the National Cancer Institute and other health agencies assert that there is no sound scientific evidence that any of the artificial sweeteners approved for use in the US cause cancer or other serious health problems. Furthermore, a number of studies confirm that artificial sweeteners are generally safe in limited quantities, even for pregnant women. Despite the low health risk of artificial sweeteners, the healthiest alternative to a sugary beverage is a cold glass of water. Another healthy alternative is a piece of fresh fruit. The contained sugar is absorbed more slowly and fruit contains roughage, which appeases the appetite.

Reference: The New England Journal of Medicine

See also:
Trick or (healthy) treat
Chemical BPA in food linked to childhood obesity
CDC releases sad statistics regarding obesity in the US