Effects of non‐nutritive sweetened beverages versus water after a 12‐week weight‐loss program: A randomized controlled trial

Abstract

Objective: The aim of this study was to compare non-nutritive sweetened (NNS) beverages versus water for weight loss after a 12-week behavioral weightmanagement program.Methods: This is an ongoing, 2-year, parallel-group, open-label, controlled equivalence trial; week-12 data are reported. Adults with BMI of 27 to 35 kg/m 2 who regularly drank cold beverages were randomized 1:1 to intention-to-treat water or NNS beverages while undergoing a weekly 12-week group behavioral weightmanagement program. Weight change to week 12 was the primary end point (equivalence: two-sided p > 0.05); changes in waist and hip circumference, blood pressure, glycemic control markers, fasting lipid profiles, liver function tests, hunger (visual analog scale), sugar and sweetener consumption, and activity levels were secondary end points.Results: Overall, 493 participants were randomized (water: n = 246; NNS beverages: n = 247); 24.1% were NNS beverage naïve. Weight change was equivalent with water versus NNS beverages (À5.6 vs. À5.8 kg; difference [90% CI]: À0.2 kg [À0.7 to 0.4]). There were no significant differences between groups for secondary end points except reductions in waist circumference (greater with NNS beverages vs. water), glycated hemoglobin, and consumption of any type of sweetener (both greater with water vs. NNS beverages).Conclusions: Weight loss was equivalent with NNS beverages and water following a 12-week behavioral weight-management program.

Non-nutritive sweetened beverages versus water after a 52-week weight management programme: a randomised controlled trial

“…The full eligibility criteria for the SWITCH trial have been reported previously [ 16 ]. Briefly, healthy adults aged 18–65 years with a BMI of 27–35 kg/m 2 who regularly consumed >3 cold beverages per week (water, or <2 l per day of NNS or sugar-sweetened beverage) from within a 50-mile radius of the county of Merseyside, England (of which Liverpool is the principal city) were included.…”

“…Full details on protocol amendments and approval, including ethical approval, have been reported elsewhere [ 15 , 16 ].…”

“…Participants were randomised to NNS beverages or water using a computer-generated sequence in blocks of 4 and 6 to ensure equal numbers in both groups (1:1). Randomisation was stratified by sex (male/female), age (18–35, 36–50 and 51–65 years), BMI (<30 and ≥30 kg/m 2 ) and NNS naïveté (categorised as naïve or non-naïve if NNS beverages constituted 0– ≤ 25% and >26–100%, respectively, of beverage choices in the 5 years before screening, assessed as part of the screening questionnaire on habitual consumption) to ensure a balance of characteristics between groups [ 16 ].…”

“…The Colorado/Temple trial found that NNS beverages were superior to water for weight loss (–6.2 vs. –2.5 kg, respectively) and for helping participants to better maintain their weight loss throughout the weight-maintenance phase at week 52 [ 14 ]. The effectS of non-nutritive sWeetened beverages on appetITe during aCtive weigHt loss (SWITCH) trial expanded on this by using a similar design but with an additional voluntary 52-week extension (after the 40-week assisted weight-maintenance phase) to investigate the effects during unassisted weight maintenance, as well as the inclusion of both NNS beverage-naïve and non-naïve participants [ 15 , 16 ]. At week 12 in the SWITCH trial, after the active weight-loss phase of the behavioural weight management programme, weight loss was equivalent for participants consuming either NNS beverages or water [ 16 ].…”

“…The effectS of non-nutritive sWeetened beverages on appetITe during aCtive weigHt loss (SWITCH) trial expanded on this by using a similar design but with an additional voluntary 52-week extension (after the 40-week assisted weight-maintenance phase) to investigate the effects during unassisted weight maintenance, as well as the inclusion of both NNS beverage-naïve and non-naïve participants [ 15 , 16 ]. At week 12 in the SWITCH trial, after the active weight-loss phase of the behavioural weight management programme, weight loss was equivalent for participants consuming either NNS beverages or water [ 16 ]. Here, we report the effect of water and NNS beverages on body weight at week 52 after completion of both the 12-week active weight loss and 40-week weight-maintenance phases of the SWITCH trial.…”