fys23.pdf - Obesity Original Article CLINICAL TRIALS...

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The Effects of Water and Non-Nutritive Sweetened Beverages on Weight Loss During a 12-week Weight Loss Treatment Program John C. Peters 1 , Holly R. Wyatt 1 , Gary D. Foster 2 , Zhaoxing Pan 1 , Alexis C. Wojtanowski 2 , Stephanie S. Vander Veur 2 , Sharon J. Herring 2 , Carrie Brill 1 and James O. Hill 1 Objective: To compare the efficacy of non-nutritive sweetened beverages (NNS) or water for weight loss during a 12-week behavioral weight loss treatment program. Methods: An equivalence trial design with water or NNS beverages as the main factor in a prospective randomized trial among 303 men and women was employed. All participants participated in a behavioral weight loss treatment program. The results of the weight loss phase (12 weeks) of an ongoing trial (1 year) that is also evaluating the effects of these two treatments on weight loss maintenance were reported. Results: The two treatments were not equivalent with the NNS beverage treatment group losing signifi- cantly more weight compared to the water group (5.95 kg versus 4.09 kg; P < 0.0001) after 12 weeks. Participants in the NNS beverage group reported significantly greater reductions in subjective feelings of hunger than those in the water group during 12 weeks. Conclusion: These results show that water is not superior to NNS beverages for weight loss during a comprehensive behavioral weight loss program. Obesity (2014) 22 , 1415–1421. doi:10.1002/oby.20737 Introduction Beverage consumption recommendations (1) suggest water as the gold-standard beverage for optimal health. The US Dietary Guide- lines (2) suggest that while beverages with non-nutritive sweeteners (NNS) are preferable to those with caloric sweeteners, there is still a question about whether they are beneficial for weight management. While numerous clinical trials have examined the effects of nutritive sugar sweetened beverages (NS) compared to NNS beverages on weight loss, few studies have directly compared water and NNS beverages on weight loss using an equivalence trial design. NNS were introduced into the food supply over 50 years ago and are being used in hundreds of different food and beverage products. Despite the long history of usage there continues to be considerable controversy concerning their role in the diet, particularly whether they are a useful tool as an aid in weight loss and weight loss main- tenance (3-6). NNS provide sweetness equivalent to NS but contrib- ute essentially zero energy. Since the 1980s a number of short-term experimental studies have compared NNS to NS and several com- prehensive reviews have concluded that the evidence supports either a beneficial effect or no effect of NNS on appetite and energy intake (7-11). Other studies have reported findings of increased hunger with consumption of NNS (11) but generally without an accompany- ing increase in caloric intake.
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