A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight
Open accessAbstract
BACKGROUND: Consumption of sugar-sweetened beverages may cause excessive weight gain. We aimed to assess the effect on weight gain of an intervention that included the provision of noncaloric beverages at home for overweight and obese adolescents. METHODS: We randomly assigned 224 overweight and obese adolescents who regularly consumed sugar-sweetened beverages to experimental and control groups. The experimental group received a 1-year intervention designed to decrease consumption of sugar-sweetened beverages, with follow-up for an additional year without intervention. We hypothesized that the experimental group would gain weight at a slower rate than the control group. RESULTS: Retention rates were 97% at 1 year and 93% at 2 years. Reported consumption of sugar-sweetened beverages was similar at baseline in the experimental and control groups (1.7 servings per day), declined to nearly 0 in the experimental group at 1 year, and remained lower in the experimental group than in the control group at 2 years. The primary outcome, the change in mean body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) at 2 years, did not differ significantly between the two groups (change in experimental group minus change in control group, -0.3; P=0.46). At 1 year, however, there were significant between-group differences for changes in BMI (-0.57, P=0.045) and weight (-1.9 kg, P=0.04). We found evidence of effect modification according to ethnic group at 1 year (P=0.04) and 2 years (P=0.01). In a prespecified analysis according to ethnic group, among Hispanic participants (27 in the experimental group and 19 in the control group), there was a significant between-group difference in the change in BMI at 1 year (-1.79, P=0.007) and 2 years (-2.35, P=0.01), but not among non-Hispanic participants (P>0.35 at years 1 and 2). The change in body fat as a percentage of total weight did not differ significantly between groups at 2 years (-0.5%, P=0.40). There were no adverse events related to study participation. CONCLUSIONS: Among overweight and obese adolescents, the increase in BMI was smaller in the experimental group than in the control group after a 1-year intervention designed to reduce consumption of sugar-sweetened beverages, but not at the 2-year follow-up (the prespecified primary outcome). (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; ClinicalTrials.gov number, NCT00381160.).
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In a randomized trial of 224 overweight and obese American adolescents who regularly consumed SSBs, at the end of the 1-year intervention, those in the intervention group had beneficial changes in BMI and weight compared to those who did not receive the intervention, but these differences were no longer significant at additional 1-year follow-up.
“The second study randomized 224 overweight and obese American adolescents who regularly consumed SSBs to either participate in a program to reduce SSB consumption or receive no intervention [59].”
From The negative impact of sugar-sweetened beverages on children’s health: an update of the literature (2018) · cites this paper as [59]
In a pre-planned subgroup analysis of Hispanic participants in the adolescent SSB-reduction trial, there were significant differences in BMI between groups at both follow-up periods.
“However, in a pre-planned subgroup analysis of Hispanic participants, there were significant differences in BMI between groups at both follow-up periods.”
From The negative impact of sugar-sweetened beverages on children’s health: an update of the literature (2018) · cites this paper as [59]
One of the more promising gene-diet interactions, notable in Hispanic populations, involves PNPLA3 and sugar consumption in relation to obesity and liver fat accumulation.
“One of the more promising gene-diet interactions, notable in Hispanic populations, involves PNPLA3 and sugar consumption in relation to obesity and liver fat accumulation;84-86”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [86]
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- Authors
- Ebbeling, C. B., Feldman, H. A., Chomitz, V. R., Antonelli, T. A., Gortmaker, S. L., Osganian, S. K., & Ludwig, D. S.
- Affiliations
- Boston Children's Hospital (US)
- Harvard University (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2012-10-11
- Volume
- 367
- Issue
- 15
- Pages
- 1407-1416
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC3494993
- OpenAlex
- W2126423118
- Cited by
- 699
- References
- 30
- Citations by year
- 2026: 10 · 2025: 20 · 2024: 20 · 2023: 51 · 2022: 40 · 2021: 41 · 2020: 48 · 2019: 54 · 2018: 53 · 2017: 53 · 2016: 58 · 2015: 66 · 2014: 99 · 2013: 71 · 2012: 13
- FWCI
- 76.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01hd030780-03)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK073025, K24DK082730)
- National Center for Research Resources (M01-RR02172, UL1RR025758, M01RR002172)
- National Center for Chronic Disease Prevention and Health Promotion (U48 DP001946, 1U48DP001946)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD 30780)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- sugar-sweetened beverages, adolescent obesity, adolescent overweight, weight gain, body mass index, body fat percentage, Latino youth, dietary intervention, childhood obesity prevention, weight loss maintenance, follow-up retention, adverse events, participant burden
- MeSH terms
- Adolescent, Beverages, Energy Intake, Female, Follow-Up Studies, Humans, Male, Obesity, Weight Gain, Body Mass Index, Dietary Sucrose, Overweight
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