title: Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial.
abstract: BACKGROUND
  Obese people believe that drinking diet beverages (DBs) may be a simple strategy to achieve weight loss. However, nutritionists advise drinking water when attempting to lose weight. It is unclear how important drinking water instead of DBs is during a weight-loss program.
  
  
  OBJECTIVE
  In this study, we compared the effect on weight loss of either replacing DBs with water or continuing to consume DBs in adults during a 24-wk weight-loss program.
  
  
  METHODS
  Overweight and obese women [n = 89; body mass index (BMI; in kg/m(2)): 27-40; age: 18-50 y] who usually consumed DBs in their diet were asked to either substitute water for DBs (water group) or continue drinking DBs 5 times/wk after their lunch for 24 wk (DB group) while on a weight-loss program.
  
  
  RESULTS
  Sixty-two participants (71%) completed the trial (32 in the DB group, 30 in the water group). Baseline variables were not statistically significantly different between groups. A statistically significant reduction in anthropometric measurements and statistically significant improvements in cardiometabolic risk characteristics were observed over 24 wk in both groups. Compared with the DB group, the water group had a greater decrease in weight (mean ± SD: water: -8.8 ± 1.9 kg; DBs: -7.6 ± 2.1 kg; P = 0.015, time × group), fasting insulin (mean ± SD: water: -2.84 ± 0.77 mU/L; DBs: -1.78 ± 1.25 mU/L, P < 0.001), homeostasis model assessment of insulin resistance (mean ± SD: water: -0.097 ± 0.049; DBs: -0.057 ± 0.042, P < 0.001), and 2-h postprandial glucose (mean ± SD: water: -1.02 ± 0.25 mmol/L; DBs: -0.72 ± 0.27 mmol/L; P < 0.001) over the 24 wk. However, there was no significant time × group interaction for waist circumference, fasting plasma glucose, and lipid profiles within both groups over 24 wk.
  
  
  CONCLUSIONS
  Replacement of DBs with water after the main meal may lead to greater weight reduction during a weight-loss program. It may also offer clinical benefits to improve insulin resistance. This trial was registered at www.irct.ir/ as IRCT201402177754N5.
authors.affiliation: School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom; NovinDiet Clinic, Tehran, Iran; and.
authors.forename: Ameneh
authors.initials: A
authors.lastname: Madjd
authors.affiliation: School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom;
authors.forename: Moira A
authors.initials: MA
authors.lastname: Taylor
authors.affiliation: Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Delavari
authors.affiliation: Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
authors.affiliation: School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom;
authors.forename: Ian A
authors.initials: IA
authors.lastname: Macdonald
authors.affiliation: School of Life Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom; NovinDiet Clinic, Tehran, Iran; and hamid.farshchi@nottingham.ac.uk.
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Farshchi
mesh_terms: D000293:Adolescent; D000328:Adult; D001628:Beverages / Q000009:adverse effects; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D003131:Combined Modality Therapy; D004038:Diet, Reducing; D004326:Drinking; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D007492:Iran / Q000453:epidemiology; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D050177:Overweight / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D011236:Prediabetic State / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D016037:Single-Blind Method; D055815:Young Adult
keywords: diet beverages; insulin resistance; obesity; water; weight loss