title: Changes in water and beverage intake and long-term weight changes: results from three prospective cohort studies.
abstract: OBJECTIVE
  To examine the long-term relationship between changes in water and beverage intake and weight change.
  
  
  METHODS
  Prospective cohort studies of 50013 women aged 40-64 years in the Nurses' Health Study (NHS, 1986-2006), 52987 women aged 27-44 years in the NHS II (1991-2007) and 21988 men aged 40-64 years in the Health Professionals Follow-up Study (1986-2006) without obesity and chronic diseases at baseline.
  
  
  METHODS
  We assessed the association of weight change within each 4-year interval, with changes in beverage intakes and other lifestyle behaviors during the same period. Multivariate linear regression with robust variance and accounting for within-person repeated measures were used to evaluate the association. Results across the three cohorts were pooled by an inverse-variance-weighted meta-analysis.
  
  
  RESULTS
  Participants gained an average of 1.45 kg (5th to 95th percentile: -1.87 to 5.46) within each 4-year period. After controlling for age, baseline body mass index and changes in other lifestyle behaviors (diet, smoking habits, exercise, alcohol, sleep duration, TV watching), each 1 cup per day increment of water intake was inversely associated with weight gain within each 4-year period (-0.13 kg; 95% confidence interval (CI): -0.17 to -0.08). The associations for other beverages were: sugar-sweetened beverages (SSBs) (0.36 kg; 95% CI: 0.24-0.48), fruit juice (0.22 kg; 95% CI: 0.15-0.28), coffee (-0.14 kg; 95% CI: -0.19 to -0.09), tea (-0.03 kg; 95% CI: -0.05 to -0.01), diet beverages (-0.10 kg; 95% CI: -0.14 to -0.06), low-fat milk (0.02 kg; 95% CI: -0.04 to 0.09) and whole milk (0.02 kg; 95% CI: -0.06 to 0.10). We estimated that replacement of 1 serving per day of SSBs by 1 cup per day of water was associated with 0.49 kg (95% CI: 0.32-0.65) less weight gain over each 4-year period, and the replacement estimate of fruit juices by water was 0.35 kg (95% CI: 0.23-0.46). Substitution of SSBs or fruit juices by other beverages (coffee, tea, diet beverages, low-fat and whole milk) were all significantly and inversely associated with weight gain.
  
  
  CONCLUSIONS
  Our results suggest that increasing water intake in place of SSBs or fruit juices is associated with lower long-term weight gain.
authors: 1] Department of Nutrition, Harvard School of Public Health, Boston, MA, USA [2] Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore.
authors: A
authors: A
authors: Pan
authors: V S
authors: VS
authors: Malik
authors: T
authors: T
authors: Hao
authors: W C
authors: WC
authors: Willett
authors: D
authors: D
authors: Mozaffarian
authors: F B
authors: FB
authors: Hu
mesh_terms: D000328:Adult; D001628:Beverages; D015992:Body Mass Index; D004032:Diet; D019422:Dietary Sucrose / Q000009:adverse effects*; D004326:Drinking; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D013549:Sweetening Agents / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology; D015430:Weight Gain
chemical_list: D019422:Dietary Sucrose; D013549:Sweetening Agents