Elsevier

Nutrition

Volumes 39–40, July–August 2017, Pages 71-75
Nutrition

Applied nutritional investigation
A modeling study of beverage substitution and obesity outcomes among Australian adults

https://doi.org/10.1016/j.nut.2017.03.010Get rights and content

Highlights

  • •

    Sugar-sweetened beverage consumption was associated with obesity.

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    Energy intake played a partial role in this association.

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    Water, coffee/tea, and milk were good alternatives for sugar-sweetened beverages.

Abstract

Objective

The aim of this study was to investigate the cross-sectional associations among sugar-sweetened beverage (SSB) consumption, its substitution with beverage alternatives, and obesity outcomes in an Australian population.

Methods

We used data from 9341 adults ages ≥19 y from the 2011–2012 Australian National Nutrition and Physical Activity Survey. Multivariate linear regression with adjustment for covariates was used to examine the associations between SSB consumption and body mass index (BMI) and waist circumference (WC). Substitution modeling was used to simulate the effect of replacing SSB with water, coffee/tea, fruit juice, and milk.

Results

SSB intake (100 g/d) was associated with higher BMI (β = 0.06 kg/m2; P = 0.001) and WC (β = 0.19 cm; P < 0.001). A linear trend with BMI and WC also was seen when SSB intake was examined as categories of servings per day (Ptrend ≤ 0.001). Replacing SSB with water, coffee/tea, or milk was inversely associated with BMI (β = −0.07 to −0.09 kg/m2; P < 0.001) and WC (β = −0.25 to −0.28 cm; P < 0.001).

Conclusions

The results of the present study suggested that SSB intake is associated with obesity and that coffee/tea, water, and milk may be good alternatives for SSB. Further longitudinal and intervention studies are warranted to examine the effects of beverage substitution on obesity.

Introduction

In light of the health and social consequences of obesity prevalence, obesity has become a worldwide concern [1]. In Australia, >60% of adults are overweight or obese, and obesity is one of the leading contributing factors to the Australian national burden of disease [2]. A concomitant increase in sugar-sweetened beverage (SSB) consumption has been reported, and Australia has been ranked as one of the countries with the highest per capita SSB consumption worldwide [3].

Considerable evidence has associated SSB consumption with obesity outcomes [4], [5], [6]. SSBs are defined as sweetened beverages such as soft drinks, fruit drinks, cordials, sports/energy drinks, and vitamin water drinks that contain sucrose or high-fructose corn syrup [7]. The mechanism through which SSB intake affects obesity remains unclear. It has been suggested that energy in liquid form is not well compensated, resulting in excess energy intake and body weight gain in the long term [8]. Other evidence suggests that the high glycemic load of large amounts of readily absorbable sugar in SSB may exacerbate a high insulin response and increase obesity risk [9]. Furthermore, SSB consumption may interrelate with other unhealthy dietary and lifestyle behaviors that have been implicated in obesity [10].

Limiting SSB consumption has been targeted in policies and strategies in many countries to combat the increasing prevalence of obesity. Replacing SSB consumption with beverage alternatives may be a promising approach to reduce SSB consumption and mitigate the obesity epidemic. Beverages with lower sugar content or higher nutritional value may be good alternatives to SSB in terms of maintaining or reducing body weight [11], [12]. The aim of this study was to investigate the associations between SSB consumption and obesity outcomes as well as the association of beverage substitution in relation to obesity outcomes in an Australian national representative sample.

Section snippets

Respondents and dietary data collection

Data from 9341 adults ≥19 y of age from the 2011–2012 Australian National Nutrition and Physical Activity Survey were used. The survey was conducted throughout Australia from May 2011 to June 2012. A multistage sampling was used for sample selection and demographic, dietary, and physical activity information was collected from 9500 private households. Dietary intake was collected by an automated multiple-pass, 24-h, face-to-face dietary recall followed by a telephone 24-h recall that was

Results

The characteristics of respondents by SSB intake categories are presented in Table 1. Higher SSB intake was associated with younger age, male sex, lower physical activity, higher sedentary behavior, and shorter sleep duration. A greater proportion of respondents in the highest SSB intake category (>2 servings/d) were Australian born, current smokers, single, and from a lower socioeconomic status group. Respondents in the highest SSB intake category had the lowest intakes of water, coffee/tea,

Discussion

In a national representative sample of Australian adults, SSB consumption was a significant predictor of BMI and WC, and linear dose–response trends were found. Replacing SSB with water, coffee/tea, 100% fruit juice, or milk using substitution modeling was associated with lower BMI and WC.

The majority of studies on SSB consumption and obesity have been conducted in the United States among children and adolescents; studies among adults are somewhat limited [17]. The positive associations of SSB

Conclusions

The present study resulted in our finding that SSB consumption was significantly associated with obesity outcomes. Water, coffee/tea, and milk may be good alternatives for SSB pertaining to body weight management. The findings of this study have the potential to inform future obesity interventions, dietary guidelines, and policies. However, more research is warranted to gain further insights regarding beverage intake and obesity.

Acknowledgment

The authors acknowledge the Australian Bureau of Statistics for providing data and all those involved in the Australian Health Survey 2011–2012.

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    The authors have no conflicts of interest to declare.

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