Influence of repeated consumption of beverages containing sucrose or intense sweeteners on food intake

Drinking water is associated with weight loss in overweight dieting women independent of diet and activity

BACKGROUND

Data from short-term experiments suggest that drinking water may promote weight loss by lowering total energy intake and/or altering metabolism. The long-term effects of drinking water on change in body weight and composition are unknown, however.

OBJECTIVE

This study tested for associations between absolute and relative increases in drinking water and weight loss over 12 months.

METHODS AND PROCEDURES

Secondary analyses were conducted on data from the Stanford A TO Z weight loss intervention on 173 premenopausal overweight women (aged 25-50 years) who reported <1 l/day drinking water at baseline. Diet, physical activity, body weight, percent body fat (dual-energy X-ray absorptiometry), and waist circumference were assessed at baseline, 2, 6, and 12 months. At each time point, mean daily intakes of drinking water, noncaloric, unsweetened caloric (e.g., 100% fruit juice, milk) and sweetened caloric beverages, and food energy and nutrients were estimated using three unannounced 24-h diet recalls. Beverage intake was expressed in absolute (g) and relative terms (% of beverages). Mixed models were used to test for effects of absolute and relative increases in drinking water on changes in weight and body composition, controlling for baseline status, diet group, and changes in other beverage intake, the amount and composition of foods consumed and physical activity.

RESULTS

Absolute and relative increases in drinking water were associated with significant loss of body weight and fat over time, independent of covariates.

DISCUSSION

The results suggest that drinking water may promote weight loss in overweight dieting women.

A short history of beverages and how our body treats them

Numerous studies have demonstrated that beverages containing sugar, high fructose corn syrup (HFCS) or alcohol are handled differently by the body than when sugar or HFCS are incorporated in solid foods and as a result the overall caloric intake from solid food does not adjust to account for the calories in these beverages. A consideration of our evolutionary history may help to explain our poor compensatory response to calories from fluids. This paper reviews the history of eight important beverages: milk, beer, wine, tea, coffee, distilled alcoholic beverages, juice and soft drinks. We arrive at two hypotheses. First, humans may lack a physiological basis for processing carbohydrate or alcoholic calories in beverage because only breast milk and water were available for the vast majority of our evolutionary history. Alternatives to those two beverages appeared in the human diet no more than 11,000 years ago, but Homo sapiens evolved between 100,000 and 200,000 years ago. Second, carbohydrate and alcohol-containing beverages may produce an incomplete satiation sequence which prevents us from becoming satiated on these beverages.

Replacing sweetened caloric beverages with drinking water is associated with lower energy intake

OBJECTIVE

Reduced intake of sweetened caloric beverages (SCBs) is recommended to lower total energy intake. Replacing SCBs with non-caloric diet beverages does not automatically lower energy intake, however. Compensatory increases in other food or beverages reportedly negate benefits of diet beverages. The purpose of this study was to evaluate drinking water as an alternative to SCBs.

RESEARCH METHODS AND PROCEDURES

Secondary analysis of data from the Stanford A TO Z intervention evaluated change in beverage pattern and total energy intake in 118 overweight women (25 to 50 years) who regularly consumed SCBs (>12 ounces/d) at baseline. At baseline and 2, 6, and 12 months, mean daily beverage intake (SCBs, drinking water, non-caloric diet beverages, and nutritious caloric beverages), food composition (macronutrient, water, and fiber content), and total energy intake were estimated using three 24-hour diet recalls. Beverage intake was expressed in relative terms (percentage of beverages).

RESULTS

In fixed effects models that controlled for total beverage intake, non-caloric and nutritious caloric beverage intake (percentage of beverages), food composition, and energy expenditure [metabolic equivalent (MET)], replacing SCBs with drinking water was associated with significant decreases in total energy intake that were sustained over time. The caloric deficit attributable to replacing SCBs with water was not negated by compensatory increases in other food or beverages. Replacing all SCBs with drinking water was associated with a predicted mean decrease in total energy of 200 kcal/d over 12 months.

DISCUSSION

The results suggest that replacing SCBs with drinking water can help lower total energy intake in overweight consumers of SCBs motivated to diet.

Habitual high and low consumers of artificially-sweetened beverages: Effects of sweet taste and energy on short-term appetite

This study investigated the effects of sweet taste and energy on subsequent short-term appetite in female habitual high and low consumers of artificially-sweetened beverages. The study was based on the proposal that effects of sweet taste on appetite may differ as a result of the habitual experience of sweetness with or without energy. Following a repeated measures design, 10 female habitual high and 10 female habitual low consumers of artificially-sweetened beverages consumed a non-sweet/low-energy, sweet/low-energy, and sweet/high-energy preload, and cumulative test meal intake (gram, kJ.), cumulative total intake (gram, kJ.), and subjective perceptions of appetite were subsequently assessed. Different effects of sweet taste were found in habitual high and low consumers of artificially-sweetened beverages. Low consumers of artificially-sweetened beverages demonstrated an increase in appetite in response to sweet taste, whereas high consumers did not. Effects of energy on appetite did not differ between consumers. The effects of energy are unsurprising. The effects of sweet taste, however, are of interest. The lack of response to sweet taste in high consumers of artificially-sweetened beverages can be explained as a result of the repeated experience of sweetness without energy by these consumers. This lack of response suggests an adaptation to sweet taste as a result of the habitual dietary pattern of these consumers.

Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community

BACKGROUND

Consumption of soft drinks has been linked to obesity in children and adolescents, but it is unclear whether it increases metabolic risk in middle-aged individuals.

METHODS AND RESULTS

We related the incidence of metabolic syndrome and its components to soft drink consumption in participants in the Framingham Heart Study (6039 person-observations, 3470 in women; mean age 52.9 years) who were free of baseline metabolic syndrome. Metabolic syndrome was defined as the presence of > or = 3 of the following: waist circumference > or = 35 inches (women) or > or = 40 inches (men); fasting blood glucose > or = 100 mg/dL; serum triglycerides > or = 150 mg/dL; blood pressure > or = 135/85 mm Hg; and high-density lipoprotein cholesterol < 40 mg/dL (men) or < 50 mg/dL (women). Multivariable models included adjustments for age, sex, physical activity, smoking, dietary intake of saturated fat, trans fat, fiber, magnesium, total calories, and glycemic index. Cross-sectionally, individuals consuming > or = 1 soft drink per day had a higher prevalence of metabolic syndrome (odds ratio [OR], 1.48; 95% CI, 1.30 to 1.69) than those consuming < 1 drink per day. On follow-up (mean of 4 years), new-onset metabolic syndrome developed in 717 of 4033 participants (17.8%) consuming < 1 drink/day and in 433 of 2006 persons (21.6%) [corrected] consuming > or = 1 soft drink/day [corrected] Consumption of > or = 1 soft drink per day was associated with increased odds of developing metabolic syndrome (OR, 1.44; 95% CI, 1.20 to 1.74), obesity (OR, 1.31; 95% CI, 1.02 to 1.68), increased waist circumference (OR, 1.30; 95% CI, 1.09 to 1.56), impaired fasting glucose (OR, 1.25; 95% CI, 1.05 to 1.48), higher blood pressure (OR, 1.18; 95% CI, 0.96 to 1.44), hypertriglyceridemia (OR, 1.25; 95% CI, 1.04 to 1.51), and low high-density lipoprotein cholesterol (OR, 1.32; 95% CI 1.06 to 1.64).

CONCLUSIONS

In middle-aged adults, soft drink consumption is associated with a higher prevalence and incidence of multiple metabolic risk factors.

Liquid calories, sugar, and body weight

The consumption of sugar-sweetened beverages has been linked to rising rates of obesity in the United States. The standard explanation is that energy-containing liquids are less satiating than are solid foods. However, purely physiologic mechanisms do not fully account for the proposed links between liquid sugar energy and body weight change. First, a reevaluation of published epidemiologic studies of consumption of sweetened beverages and overweight shows that most such studies either are cross-sectional or are based on passive surveillance of temporal trends and thus permit no conclusions about causal links. Second, research evidence comparing the short-term satiating power of different types of liquids and of solids remains inconclusive. Numerous clinical studies have shown that sugar-containing liquids, when consumed in place of usual meals, can lead to a significant and sustained weight loss. The principal ingredient of liquid meal replacement shakes is sugar, often high-fructose corn syrup, which is present in amounts comparable to those in soft drinks. Far from suppressing satiety, one such liquid shake is marketed on the grounds that it helps control hunger and prevents hunger longer when consumed for the purpose of weight loss. These inconsistencies raise the question whether the issue of sugars and body weight should continue to be framed purely in metabolic or physiologic terms. The effect of sugar consumption on body weight can also depend on behavioral intent, context, and the mode of use, availability, and cost of sweetened liquids.

Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis

In a meta-analysis of 88 studies, we examined the association between soft drink consumption and nutrition and health outcomes. We found clear associations of soft drink intake with increased energy intake and body weight. Soft drink intake also was associated with lower intakes of milk, calcium, and other nutrients and with an increased risk of several medical problems (e.g., diabetes). Study design significantly influenced results: larger effect sizes were observed in studies with stronger methods (longitudinal and experimental vs cross-sectional studies). Several other factors also moderated effect sizes (e.g., gender, age, beverage type). Finally, studies funded by the food industry reported significantly smaller effects than did non-industry-funded studies. Recommendations to reduce population soft drink consumption are strongly supported by the available science.

Intense sweeteners, energy intake and the control of body weight

Replacing sugar with low-calorie sweeteners is a common strategy for facilitating weight control. By providing sweet taste without calories, intense sweeteners help lower energy density of beverages and some foods. Reduced dietary energy density should result in lower energy intakes--but are the energy reduction goals, in fact, achieved? The uncoupling of sweetness and energy, afforded by intense sweeteners, has been the focus of numerous studies over the past two decades. There are recurring arguments that intense sweeteners increase appetite for sweet foods, promote overeating, and may even lead to weight gain. Does reducing energy density of sweet beverages and foods have a measurable impact on appetite and energy intakes, as examined both in short-term studies and over a longer period? Can reductions in dietary energy density achieved with intense sweeteners really affect body weight control? This paper reviews evidence from laboratory, clinical and epidemiological studies in the context of current research on energy density, satiety and the control of food intake.

Flavor-nutrient learning in restrained and unrestrained eaters

After we consume a novel food an association can form between its sensory characteristics (e.g., taste properties) and the effect it has on the body (rewarding). Associations of this kind underpin much of our everyday dietary behavior because they mediate both the affective quality of food (flavor-preference learning) and the amount that we choose to consume (learning satiation). Notwithstanding this fact, very few studies have successfully demonstrated the process of dietary learning in human adults. In addition, based on evidence from related research, we explored whether learning is less likely to occur in individuals who have high scores on a measure of dietary restraint. Female participants (N = 44) consumed two differently flavored desserts. Each was presented three times on separate days. One was formulated with a high-energy content (1882 kJ) and the other with a low-energy content (226 kJ). After training, we found little evidence for learned satiation. However, we did observe flavor-preference learning. Specifically, participants acquired a greater liking and desire-to-eat the dessert flavor that was paired with a higher energy density during training. Further analysis revealed that this effect on liking is qualified by dietary restraint. As predicted, unrestrained eaters demonstrated greater differential responding to the two desserts than did restrained eaters. These data provide further evidence for flavor-nutrient learning in adults and they highlight a hitherto unexplored and potentially important difference between restrained and unrestrained eaters.

[Household food availability in Brazil: distribution and trends (1974-2003)]

OBJECTIVE

Data from household food budget surveys were examined in order to describe the regional and socio-economic distribution of household food availability in Brazil in 2002-2003 and trends from 1974 to 2003.

METHODS

The study uses data from the "Pesquisa de Orçamento Familiar 2002-2003" budget survey conducted by the Brazilian Institute for Geography and Statistics (Instituto Brasileiro de Geografia e Estatística) from July 2002 to June 2003, including a national sample of 48,470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses with food and beverages for family consumption were registered. Crude weights of purchased foods were transformed into calories and nutrients with the use of food composition tables.

RESULTS

Adequate protein content and a high proportion of animal protein were found in all regions and income strata. These were the most important positive aspects identified in the household food availability in Brazil. On the other hand, all regions and socio-economic strata showed excess calories from sugar and little availability of fruits and vegetables. An excessive proportion of calories came from total and saturated fat in the more economically developed regions and in the urban milieu, as well as among higher-income families. Time-trends in metropolitan areas indicated a decline in the consumption of basic, traditional foods, such as rice and beans; notable increases (up to 400%) in the consumption of processed food items, such as cookies and soft drinks; maintenance of the excessive consumption of sugar; and a continuous increase in total fat and saturated fat content in the diet.

CONCLUSIONS

Patterns and trends regarding household food availability in Brazil are consistent with the increasing participation of chronic non-communicable diseases in morbidity and mortality and with the continuous increase in the prevalence of obesity.

Concept of fat balance in human obesity revisited with particular reference to de novo lipogenesis

The measurement of fat balance (fat input minus fat output) involves the accurate estimation of both metabolizable fat intake and total fat oxidation. This is possible mostly under laboratory conditions and not yet in free-living conditions. In the latter situation, net fat retention/mobilization can be estimated based on precise and accurate sequential body composition measurements. In case of positive balance, lipids stored in adipose tissue can originate from dietary (exogenous) lipids or from nonlipid precursors, mainly from carbohydrates (CHOs) but also from ethanol, through a process known as de novo lipogenesis (DNL). Basic equations are provided in this review to facilitate the interpretation of the different subcomponents of fat balance (endogenous vs exogenous) under different nutritional circumstances. One difficulty is methodological: total DNL is difficult to measure quantitatively in man; for example, indirect calorimetry only tracks net DNL, not total DNL. Although the numerous factors (mostly exogenous) influencing DNL have been studied, in particular the effect of CHO overfeeding, there is little information on the rate of DNL in habitual conditions of life, that is, large day-to-day fluctuations of CHO intakes, different types of CHO ingested with different glycemic indexes, alcohol combined with excess CHO intakes, etc. Three issues, which are still controversial today, will be addressed: (1) Is the increase of fat mass induced by CHO overfeeding explained by DNL only, or by decreased endogenous fat oxidation, or both? (2) Is DNL different in overweight and obese individuals as compared to their lean counterparts? (3) Does DNL occur both in the liver and in adipose tissue? Recent studies have demonstrated that acute CHO overfeeding influences adipose tissue lipogenic gene expression and that CHO may stimulate DNL in skeletal muscles, at least in vitro. The role of DNL and its importance in health and disease remain to be further clarified, in particular the putative effect of DNL on the control of energy intake and energy expenditure, as well as the occurrence of DNL in other tissues (such as in myocytes) in addition to hepatocytes and adipocytes.