A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight

Abstract

BACKGROUND: Consumption of sugar-sweetened beverages may cause excessive weight gain. We aimed to assess the effect on weight gain of an intervention that included the provi- sion of noncaloric beverages at home for overweight and obese adolescents. METHODS: We randomly assigned 224 overweight and obese adolescents who regularly con- sumed sugar-sweetened beverages to experimental and control groups. The experi- mental group received a 1-year intervention designed to decrease consumption of sugar-sweetened beverages, with follow-up for an additional year without interven- tion. We hypothesized that the experimental group would gain weight at a slower rate than the control group. RESULTS: Retention rates were 97% at 1 year and 93% at 2 years. Reported consumption of sugar-sweetened beverages was similar at baseline in the experimental and control groups (1.7 servings per day), declined to nearly 0 in the experimental group at 1 year, and remained lower in the experimental group than in the control group at 2 years. The primary outcome, the change in mean body-mass index (BMI, the weight in ki- lograms divided by the square of the height in meters) at 2 years, did not differ sig- nificantly between the two groups (change in experimental group minus change in control group, −0.3; P = 0.46). At 1 year, however, there were significant between- group differences for changes in BMI (−0.57, P = 0.045) and weight (−1.9 kg, P = 0.04). We found evidence of effect modification according to ethnic group at 1 year (P = 0.04) and 2 years (P = 0.01). In a prespecified analysis according to ethnic group, among Hispanic participants (27 in the experimental group and 19 in the control group), there was a significant between-group difference in the change in BMI at 1 year (−1.79, P = 0.007) and 2 years (−2.35, P = 0.01), but not among non-Hispanic partici- pants (P>0.35 at years 1 and 2). The change in body fat as a percentage of total weight did not differ significantly between groups at 2 years (−0.5%, P = 0.40). There were no adverse events related to study participation.CONCLUSION Among overweight and obese adolescents, the increase in BMI was smaller in the experimental group than in the control group after a 1-year intervention designed to reduce consumption of sugar-sweetened beverages, but not at the 2-year follow- up (the prespecified primary outcome). (Funded by the National Institute of Diabe- tes and Digestive and Kidney Diseases and others; ClinicalTrials.gov number, NCT00381160.) n