title: Replacing sweetened caloric beverages with drinking water is associated with lower energy intake.
abstract: OBJECTIVE
  Reduced intake of sweetened caloric beverages (SCBs) is recommended to lower total energy intake. Replacing SCBs with non-caloric diet beverages does not automatically lower energy intake, however. Compensatory increases in other food or beverages reportedly negate benefits of diet beverages. The purpose of this study was to evaluate drinking water as an alternative to SCBs.
  
  
  METHODS
  Secondary analysis of data from the Stanford A TO Z intervention evaluated change in beverage pattern and total energy intake in 118 overweight women (25 to 50 years) who regularly consumed SCBs (>12 ounces/d) at baseline. At baseline and 2, 6, and 12 months, mean daily beverage intake (SCBs, drinking water, non-caloric diet beverages, and nutritious caloric beverages), food composition (macronutrient, water, and fiber content), and total energy intake were estimated using three 24-hour diet recalls. Beverage intake was expressed in relative terms (percentage of beverages).
  
  
  RESULTS
  In fixed effects models that controlled for total beverage intake, non-caloric and nutritious caloric beverage intake (percentage of beverages), food composition, and energy expenditure [metabolic equivalent (MET)], replacing SCBs with drinking water was associated with significant decreases in total energy intake that were sustained over time. The caloric deficit attributable to replacing SCBs with water was not negated by compensatory increases in other food or beverages. Replacing all SCBs with drinking water was associated with a predicted mean decrease in total energy of 200 kcal/d over 12 months.
  
  
  CONCLUSIONS
  The results suggest that replacing SCBs with drinking water can help lower total energy intake in overweight consumers of SCBs motivated to diet.
authors.affiliation: Children's Hospital Oakland Research Institute, 5700 Martin Luther King Jr. Way, Oakland, CA 94609, USA. jstookey@chori.org
authors.forename: Jodi D
authors.initials: JD
authors.lastname: Stookey
authors.forename: Florence
authors.initials: F
authors.lastname: Constant
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Gardner
authors.forename: Barry M
authors.initials: BM
authors.lastname: Popkin
mesh_terms: D000328:Adult; D001628:Beverages; D002149:Energy Intake / Q000187:drug effects* / Q000502:physiology*; D004734:Energy Metabolism / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D050177:Overweight / Q000503:physiopathology; D012044:Regression Analysis; D013549:Sweetening Agents / Q000494:pharmacology*; D013997:Time Factors; D014867:Water / Q000494:pharmacology*
chemical_list: D013549:Sweetening Agents; D014867:Water