RT Journal
A1 Wang Y, Ludwig DS, Sonneville K, Gortmaker SL
T1 IMpact of change in sweetened caloric beverage consumption on energy intake among children and adolescents
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2009
FD April 6
VO 163
IS 4
SP 336
OP 343
DO 10.1001/archpediatrics.2009.23
UL http://dx.doi.org/10.1001/archpediatrics.2009.23
AB Objective 
    To estimate the net caloric impact from replacing sugar-sweetened beverages (SSBs) with alternatives in children and adolescents in naturalistic settings.Design 
    Secondary analysis based on nationally representative cross-sectional study.Setting 
    Fixed-effect regression analysis of 2 nonconsecutive 24-hour dietary recalls from the 2003-2004 National Health and Nutrition Examination Survey data.Participants 
    Children and adolescents 2 to 19 years of age (N = 3098).Main Exposures 
    Within-person beverage consumption between 2 surveyed days.Main Outcome Measures 
    The association between changes in the consumption of SSBs and other beverages and changes in total energy intake (TEI) of the same individual.Results 
    Each additional serving (8 oz) of SSB corresponded to a net increase of 106 kcal/d (P < .001; 95% confidence interval [CI], 91 to 121 kcal/d), holding other beverages constant. Increases were also seen (all P < .001) for each additional serving of whole milk (169 kcal/d; 95% CI, 143 to 195 kcal/d), reduced-fat milk (145 kcal/d; 95% CI, 118 to 171 kcal/d), and 100% juice (123 kcal/d; 95% CI, 90 to 157 kcal/d). No net increases in TEI were seen for water (8 kcal/d; P = .27; 95% CI, −6 to 22 kcal/d) or diet drinks (47 kcal/d; P = .20; 95% CI, −23 to 117 kcal/d). Substituting SSBs with water was associated with a significant decrease in TEI, controlling for intake of other beverages, total beverage and nonbeverages, and fast-food and weekend effects. Each 1% of beverage replacement was associated with 6.6-kcal lower TEI, a reduction not negated by compensatory increases in other food or beverages. We estimate that replacing all SSBs with water could result in an average reduction of 235 kcal/d.Conclusion 
    Replacing SSB intake with water is associated with reductions in total calories for all groups studied.