Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain.
We have examined the relationship between artificially sweetened beverage (ASB) consumption and long-term weight gain in the San Antonio Heart Study. From 1979 to 1988, height, weight, and ASB consumption were measured among 5,158 adult residents of San Antonio, Texas. Seven to eight years later, 3,682 participants (74% of survivors) were re-examined. Outcome measures were incidence of overweight/obesity (OW/OB(inc)) and obesity (OB(inc)) (BMI > or = 25 and > or = 30 kg/m(2), respectively), and BMI change by follow-up (DeltaBMI, kg/m(2)). A significant positive dose-response relationship emerged between baseline ASB consumption and all outcome measures, adjusted for baseline BMI and demographic/behavioral characteristics. Consuming >21 ASBs/week (vs. none) was associated with almost-doubled risk of OW/OB (odds ratio (OR) = 1.93, P = 0.007) among 1,250 baseline normal-weight (NW) individuals, and doubled risk of obesity (OR = 2.03, P = 0.0005) among 2,571 individuals with baseline BMIs <30 kg/m(2). Compared with nonusers (+1.01 kg/m(2)), DeltaBMIs were significantly higher for ASB quartiles 2-4: +1.46 (P = 0.003), +1.50 (P = 0.002), and +1.78 kg/m(2) (P < 0.0001), respectively. Overall, adjusted DeltaBMIs were 47% greater among artificial sweetener (AS) users than nonusers (+1.48 kg/m(2) vs. +1.01 kg/m(2), respectively, P < 0.0001). In separate analyses--stratified by gender; ethnicity; baseline weight category, dieting, or diabetes status; or exercise-change category--DeltaBMIs were consistently greater among AS users. These differences, though not significant among exercise increasers, or those with baseline diabetes or BMI >30 kg/m(2) (P = 0.069), were significant in all 13 remaining strata. These findings raise the question whether AS use might be fueling--rather than fighting--our escalating obesity epidemic.
Department of Medicine, Division of Clinical Epidemiology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA. fowlers@uthscsa.edu
Sharon P
SP
Fowler
Ken
K
Williams
Roy G
RG
Resendez
Kelly J
KJ
Hunt
Helen P
HP
Hazuda
Michael P
MP
Stern
D000328:Adult; D001628:Beverages / Q000009:adverse effects*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D017058:Mexican Americans / Q000208:ethnology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D013549:Sweetening Agents / Q000009:adverse effects* / Q000494:pharmacology*; D013781:Texas / Q000453:epidemiology; D015430:Weight Gain / Q000187:drug effects*; D044465:White People / Q000208:ethnology
D013549:Sweetening Agents