title: Changes in water and sugar-containing beverage consumption and body weight outcomes in children.
abstract: An intervention study showed that promoting water consumption in schoolchildren prevented overweight, but a mechanism linking water consumption to overweight was not substantiated. We investigated whether increased water consumption replaced sugar-containing beverages and whether changes in water or sugar-containing beverages influenced body weight outcomes. In a secondary analysis of the intervention study in Germany, we analysed combined longitudinal data from the intervention and control groups. Body weight and height were measured and beverage consumption was self-reported by a 24-h recall questionnaire at the beginning and end of the school year 2006/2007. The effect of a change in water consumption on change in sugar-containing beverage (soft drinks and juices) consumption, change in BMI (kg/m2) and prevalence of overweight and obesity at follow-up was analysed using regression analyses. Of 3220 enroled children, 1987 children (mean age 8·3 (sd 0·7) years) from thirty-two schools were analysed. Increased water consumption by 1 glass/d was associated with a reduced consumption of sugar-containing beverages by 0·12 glasses/d (95 % CI -0·16, -0·08) but was not associated with changes in BMI (P=0·63). Increased consumption of sugar-containing beverages by 1 glass/d was associated with an increased BMI by 0·02 (95 % CI 0·00, 0·03) kg/m2 and increased prevalence of obesity (OR 1·22; 95 % CI 1·04, 1·44) but not with overweight (P=0·83). In conclusion, an increase in water consumption can replace sugar-containing beverages. As sugar-containing beverages were associated with weight gain, this replacement might explain the prevention of obesity through the promotion of water consumption.
authors.affiliation: 1Institute of Public Health,Charité - Universitätsmedizin Berlin,Seestr. 73,13347 Berlin,Germany.
authors.forename: Rebecca
authors.identifier: 0000-0001-5979-2469
authors.initials: R
authors.lastname: Muckelbauer
authors.affiliation: 2Department of Social and Behavioral Sciences,Harvard T.H. Chan School of Public Health,677 Huntington Avenue, Boston, MA 02115,USA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Gortmaker
authors.affiliation: 3Department of Child and Adolescent Psychiatry,University Hospital Essen,University of Duisburg-Essen,Virchowstr. 174, 45147 Essen,Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Libuda
authors.affiliation: 5Research Institute of Child Nutrition,University of Bonn,Heinstück 11,44225 Dortmund,Germany.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Kersting
authors.affiliation: 6Center of Excellence for Nutrition,Hofer Str. 20,95326 Kulmbach,Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Clausen
authors.affiliation: 1Institute of Public Health,Charité - Universitätsmedizin Berlin,Seestr. 73,13347 Berlin,Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Adelberger
authors.affiliation: 1Institute of Public Health,Charité - Universitätsmedizin Berlin,Seestr. 73,13347 Berlin,Germany.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Müller-Nordhorn
mesh_terms: D001628:Beverages; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D019422:Dietary Sucrose / Q000008:administration & dosage*; D004326:Drinking; D002149:Energy Intake; D005260:Female; D005858:Germany; D006293:Health Promotion; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011939:Mental Recall; D009765:Obesity / Q000209:etiology / Q000517:prevention & control*; D050177:Overweight; D011795:Surveys and Questionnaires; D014867:Water / Q000008:administration & dosage*
chemical_list: D019422:Dietary Sucrose; D014867:Water
keywords: BMI; Children; Juices; Overweight and Obesity; Soft drinks; Water consumption