May's Article Summary

Article: Substitution of Sugar-Sweetened Beverages with Other Beverage Alternatives: A Review of Long-Term Health Outcomes

Zheng, Miaobing. Et al. Journal of the Academy of Nutrition and Dietetics, Volume 115, Issue 4, 767-779.

Article Link: http://www.andjrnl.org/article/S2212-2672(15)00112-4/pdf

There is a large number of evidence supporting the association between sugar-sweetened beverages (SSBs) and an increase in caloric intake and weight gain. Past literature has also shown a link between the consumption of SSBs and type 2 diabetes, metabolic syndrome, and cardiovascular diseases. The review defines SSBs as the following: calorie containing carbonated drinks, fruit-flavored drinks, energy drinks, sports drinks, and vitamin water drinks. SSBs exclude 100% juices. Considering the health concerns that have been linked to SSB consumption, some cities have even passed soda taxes as an effort to deter consumers from purchasing the caloric dense beverages. In the past, alternatives to SSBs have been recommended as a way of consuming less calories. Proposed as alternatives are water, artificially sweetened beverages (ASBs), coffee, tea, 100% fruit juices, and milk. While these seem like logical replacements, the long-term health outcomes are unclear, thus, the reason for this review of the literature.

The research article for this month is a review of the long-term health outcomes of substitutions of SSBs. The study included six prospective cohort studies and four randomized control trials. Studies that included modification of multiple health behaviors and education programs on reducing SSBs alone were excluded from the study to help prevent bias. After analyzing the ten articles included, the study outcomes were divided into: total energy intake, body weight and composition, type 2 diabetes, stroke, and other health outcomes.

Both a cohort and a RCT study examined the replacement of SSB with the total energy intake. Over a 12-month period, the replacement with water or low-calorie beverages showed a mean decrease in calories/day of 140-200 kcals. However, there was no significant difference in energy consumption when replacing SSB with milk and 100% juices. When looking at body weight and composition, two cohort studies and four RCTs evaluated those variables. The replacement of SSBs with water or low-calorie beverages was associated with weight loss over a 12 month period. In fact, it was predicted that replacement of all SSBs with water would produce a 3.0 kg weight loss, 3.4 cm waist circumference loss, and a decrease of 1.9% in waist circumference over 12 months. Two cohort studies also showed beneficial effects of substation of SSB on risk of T2DM. Similarly, there were beneficial effects on the incidence of stroke when substituting SSBs.

Overall, there may be beneficial health outcomes when substituting SSB with water and low-calorie beverages in the diet. The outcomes are not as significant when milk and 100% fruit juices are used as replacements.

Since the review study excluded education impacts, a supplemental article examining the impacts of providing caloric information on SSBs was included. The target of the study were low-income Black neighborhoods in Baltimore and the data was collected on Black adolescents. Signs were posted indicating the number of calories, teaspoons of sugar, and number of minutes/miles needed to run to burn off the drink. The results showed that adolescents of this study significantly reduced their purchasing of the highlighted drinks.

Additional article:

Bleich, S. N., Barry, C. L., Gary-Webb, T. L., & Herring, B. J. (2014). Reducing sugar-sweetened beverage consumption by providing caloric information: how black adolescents alter their purchases and whether the effects persist. American Journal of Public Health, 104(12), 2417.

Link: http://eds.a.ebscohost.com.libproxy.lib.ilstu.edu/eds/pdfviewer/pdfviewer?sid=2402f7de-f5b3-44c1-815d-2e0f0b821eea%40sessionmgr4002&vid=8&hid=4202