Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial
Open accessAbstract
Background Replacement of caloric beverages with noncaloric beverages may be a simple strategy for promoting modest weight reduction; however, the effectiveness of this strategy is not known.Objective We compared the replacement of caloric beverages with water or diet beverages (DBs) as a method of weight loss over 6 mo in adults and attention controls (ACs).Design Overweight and obese adults [n = 318; BMI (in kg/m(2)): 36.3 ± 5.9; 84% female; age (mean ± SD): 42 ± 10.7 y; 54% black] substituted noncaloric beverages (water or DBs) for caloric beverages (≥200 kcal/d) or made dietary changes of their choosing (AC) for 6 mo.Results In an intent-to-treat analysis, a significant reduction in weight and waist circumference and an improvement in systolic blood pressure were observed from 0 to 6 mo.Mean ((±SEM) weight losses at 6 mo were -2.5 ± 0.45% in the DB group, -2.03 ± 0.40% in the water group, and -1.76 ± 0.35% in the AC group; there were no significant differences between groups [corrected]. The chance of achieving a 5% weight loss at 6 mo was greater in the DB group than in the AC group (OR: 2.29; 95% CI: 1.05, 5.01; P = 0.04). A significant reduction in fasting glucose at 6 mo (P = 0.019) and improved hydration at 3 (P = 0.0017) and 6 (P = 0.049) mo was observed in the Water group relative to the AC group. In a combined analysis, participants assigned to beverage replacement were 2 times as likely to have achieved a 5% weight loss (OR: 2.07; 95% CI: 1.02, 4.22; P = 0.04) than were the AC participants.Conclusions Replacement of caloric beverages with noncaloric beverages as a weight-loss strategy resulted in average weight losses of 2% to 2.5%. This strategy could have public health significance and is a simple, straightforward message. This trial was registered at clinicaltrials.gov as NCT01017783.
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These previous studies had a different design in terms of not including any weight-loss plan or had only cognitive behavioral therapy for weight loss during a short period of 12 wk.
“However, it should be noted that these previous studies had a different design in terms of not including any weight-loss plan (16) or had only CBT for weight loss during a short period of 12 wk (17).”
From Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial (2015) · cites this paper as [16]
The Subjects and Methods (Interventions; page unavailable) describes a weight-loss strategy: participants were encouraged to replace caloric beverages with water or diet beverages and received monthly behavioral counseling. The Discussion (page unavailable) identifies the trial as a six-month weight-control intervention, not a 12-week course of CBT alone. Thus, neither design description in the claim fits this source. (LLM, conf=0.87)
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Experimental — accuracy not yet measuredThe results do not appear to support the claim that both diet beverages and water would be effective weight-loss strategies.
“However, the results do not appear to support these claims (16).”
From Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial (2015) · cites this paper as [16]
The Abstract (page unavailable) reports no significant difference in mean weight loss between groups, and the Results, ‘Criterion measures of weight loss’ (page unavailable), report no significant advantage for water over control in achieving 5% weight loss. But diet beverages did show a significant advantage on that measure, and the paper concludes that replacing caloric beverages with noncaloric ones produced modest weight loss. Thus, the blanket statement that the results do not support either strategy overstates the findings. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThat study failed to indicate any significant differences in weight loss during 3- and 6-mo interventions when replacing DBs or water for SSBs compared with the control group.
“Nonetheless, this study failed to indicate any significant differences in weight loss during 3-and 6-mo interventions when replacing DBs or water for SSBs compared with the control group.”
From Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial (2015) · cites this paper as [16]
A recent study claimed that replacement of energy-containing beverages with DBs resulted in mean weight losses of 2-2.5% without any weight-loss diet program.
“A recent study (16) has claimed that replacement of energy-containing beverages with DBs resulted in mean weight losses of 2-2.5% without any weight-loss diet program.”
From Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial (2015) · cites this paper as [16]
In that study, fasting blood glucose was only significantly reduced in the water group, not in the DB group, compared with control.
“However, fasting blood glucose was only significantly reduced in the water group, not in the DB group, compared with control.”
From Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial (2015) · cites this paper as [16]
Our results are contradictory with some other studies that showed no significant difference in effects on weight loss between water and diet beverages or reported a superior impact on weight loss with diet beverages compared with water.
“On the other hand, our results are contradictory with some other studies that showed no significant difference in effects on weight loss (16) between water and DBs or reported a superior impact on weight loss with DBs compared with water (17).”
From Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial (2015) · cites this paper as [16]
The volume of beverage and the time of drinking water and beverage were different in these studies.
“Furthermore, the volume of beverage and the time of drinking water and beverage were different in these studies.”
From Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial (2015) · cites this paper as [16]
It has been claimed, based on the results of previous studies on replacement of energy-containing beverages with either water or diet beverages, that both diet beverages and water would be effective weight-loss strategies.
“It has been claimed, based on the results of previous studies on replacement of energy-containing beverages with either water or DBs, that both DBs and water would be effective weight-loss strategies.”
From Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial (2015) · cites this paper as [16]
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References 51 · Cited by 345
Research works printed but not linked: 1
- [30]ACSM American College of Sports Medicine's guidelines for exercise testing and prescription. 6th ed New York, NY: Lippincott, Williams, & Wilkins, 2000
- Authors
- Tate, D. F., Turner-McGrievy, G., Lyons, E., Stevens, J., Erickson, K., Polzien, K., Diamond, M., Wang, X., & Popkin, B.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Tate, Deborah F
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 95
- Issue
- 3
- Pages
- 555-563
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC3632875
- OpenAlex
- W2165702513
- Cited by
- 345
- References
- 51
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 8 · 2023: 18 · 2022: 14 · 2021: 21 · 2020: 22 · 2019: 23 · 2018: 24 · 2017: 35 · 2016: 40 · 2015: 36 · 2014: 28 · 2013: 38 · 2012: 16
- FWCI
- 36.44
- Type
- journal article
- Language
- en
- Update notices
- erratum (2013-12-01)
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute
- National Institutes of Health
- 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 › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- caloric beverages, diet beverages, water, weight loss, obesity, overweight adults, waist circumference, systolic blood pressure, fasting blood glucose, hydration, dietary change, CHOICE trial, attentional control, public health communication, racial and ethnic differences, Black women, menopause, hormone replacement therapy, menopausal symptoms, sleep duration
- MeSH terms
- Adult, Beverages, Blood Glucose, Blood Pressure, Energy Intake, Choice Behavior, Diet, Diet, Reducing, Fasting, Feeding Behavior, Female, Follow-Up Studies, Humans, Interviews as Topic, Male, Middle Aged, Obesity, Patient Compliance, Surveys and Questionnaires, Water, Weight Loss, Logistic Models, Single-Blind Method
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