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Cited by 49Obesity, Physical Activity, DietNutrition, Health and Food BehaviorBiochemical Analysis and Sensing Techniques

Effects on weight loss in adults of replacing diet beverages with water during a hypoenergetic diet: a randomized, 24-wk clinical trial

Open access
Madjd, Ameneh, Taylor, Moira A, Delavari, Alireza, Malekzadeh, Reza, Macdonald, Ian A, Farshchi, Hamid R·2015·The American Journal of Clinical Nutrition
DOI 10.3945/ajcn.115.109397
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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. Design 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 Conclusions Replacement of DBs with water after the main meal may lead to greater weight reduction during a weight-loss prog…

AI snapshot

Written from the paper’s full text.

TL;DR

In overweight and obese women who habitually drank diet beverages and followed a 24-week hypoenergetic weight-loss program, replacing diet beverages with water after lunch led to modestly greater weight loss and larger improvements in some insulin-related measures. Both groups lost weight and improved cardiometabolic markers over time.

Key findings

  • Weight loss was greater in the water group than in the diet-beverage group: the paper reports a 1.2 kg difference favoring water, or 13.6% greater weight loss, with a significant time × group interaction (P = 0.015). BMI also showed a significant interaction favoring water (P = 0.002), while waist circumference decreased in both groups without a significant between-group interaction (P = 0.35).
  • The water group had greater reductions in fasting insulin (2.84 vs 1.78 mU/L; P < 0.001), HOMA-IR (0.097 vs 0.057; P < 0.001), and 2-hour postprandial glucose (1.02 vs 0.72 mmol/L; P < 0.001). Fasting plasma glucose and HbA1c did not differ significantly between groups over time (P = 0.143 and P = 0.066, respectively).
  • Lipid profiles improved in both groups over 24 weeks, but there were no significant group × time differences for total cholesterol, HDL cholesterol, LDL cholesterol, or triglycerides (P = 0.268, 0.912, 0.761, and 0.994, respectively).
  • Total energy intake fell in both groups, with a greater reduction in the water group (interaction P = 0.015), and the water group had a larger carbohydrate deficit (P = 0.001).

Methods

  • Two-arm, single-blind randomized clinical trial conducted at the NovinDiet Clinic in Tehran. Participants were overweight or obese women aged 18–50 years with BMI 27–40 who habitually consumed diet beverages. Of 89 recruited, 71 were randomized (35 to water, 36 to diet beverages), and 62 completed the 24-week trial (30 water, 32 diet beverages).
  • The water group replaced habitual diet beverages with 250 mL water after lunch; the diet-beverage group drank 250 mL diet beverages after lunch 5 days per week and water on the remaining days. Both groups followed a hypoenergetic NovinDiet diet designed to create a 500–1000 kcal deficit, with a macronutrient pattern of 17% protein, 23% fat, and 60% carbohydrate, plus a physical activity goal of 60 minutes of moderate activity 5 days per week.
  • Measurements were taken at baseline, 12 weeks, and 24 weeks, with blood samples at baseline and 24 weeks. Analyses used repeated-measures two-factor ANOVA for group × time effects, unpaired t tests, and Pearson correlations, with significance set at P ≤ 0.05.

Limitations

  • The paper states that there was no long-term follow-up, so it is unknown whether participants could maintain water-only beverage habits or whether the benefits would persist; longer-term studies are needed, including in prediabetic and diabetic patients.
  • Evident from the text: participants were not blinded to their beverage assignment despite the single-blind design, and dietary intake and adherence were self-reported.
  • The sample was limited to overweight or obese women at one clinic, which restricts generalizability, and dropout was substantial relative to the originally recruited group (62 of 89 completed).

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3945/ajcn.115.109397

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

21 of 29 cited sources checked · 11 supported · 3 flagged · accuracy not yet measured

  • Premisecitation

    Energy restriction, activity monitoring, and frequent patient visits and consultation in the clinic are more consistently effective than others recommending small but theoretically sustainable lifestyle modifications that can be made to improve health.

    “It has been shown that these approaches are more consistently effective than others recommending small but theoretically sustainable lifestyle modifications that can be made to improve health (30).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [30] Stroebele, 2009, A small-changes approach reduces energy intake in free-living humans, J Am Coll Nutr source

      The Conclusion says weight-management recommendations might be more effective with small changes than with intensive temporary exercise and diet programs—the opposite of the attributed comparison. The Discussion likewise describes small changes as potentially more feasible than rigorous diet restrictions. Our copy does not establish that approaches involving frequent clinic visits are more consistently effective. (LLM, conf=0.89)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Premisecitation

    Epidemiologic studies suggest that energy intake is significantly lower in water drinkers than in non-water drinkers.

    “Epidemiologic studies suggest that energy intake is significantly lower in water drinkers than in non-water drinkers (14), which may contribute to weight gain.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [14] Popkin, 2005, Water and food consumption patterns of US adults from 1999 to 2001, Obes Res source
  • Premisecitation

    That 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.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [16] Tate, 2012, 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, Am J Clin Nutr source
  • Interpretationreasoning

    These results are consistent with the outcome of the study by Dennis et al.

    “These results are consistent with the outcome of the study by Dennis et al.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [15] Dennis, 2010, Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults, Obesity (Silver Spring) source

      The Results (Intervention; page unavailable) report a 44% greater rate of weight loss in the water group than in the nonwater group. The citing sentence does not identify what “these results” are, so their consistency with Dennis et al.’s outcome cannot be assessed. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
  • Interpretationcitation

    The 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).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [16] Tate, 2012, 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, Am J Clin Nutr source

      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 measured
  • May combine two claims. 19
  • Classified as probably not a substantial claim. 23
  • The quote only partly states this claim. 4

  • May combine two claims.

    Premisecitation

    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).”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [16] Tate, 2012, 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, Am J Clin Nutr source

      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)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites [17] Peters, 2014, The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program, Obesity (Silver Spring) source

      The Intervention section says participants received a comprehensive cognitive-behavioral weight-loss intervention with 12 weekly meetings. But “only CBT” omits the assigned water or non-nutritive-sweetened beverage treatments, and the Study design section says the 12-week weight-loss phase was followed by nine months of weight maintenance. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Study design and conductcitation

    Subjects wished to lose weight and included middle-aged overweight and obese women who were able to comply with a weight-loss plan; hence, they demonstrated that they were motivated to adhere to the weight-loss diet protocol.

    “Second, subjects wished to lose weight and included middleaged overweight and obese women who were able to comply with a weight-loss plan; hence, they demonstrated that they were motivated to adhere to the weight-loss diet protocol (34).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [34] Kraschnewski, 2010, Long-term weight loss maintenance in the United States, Int J Obes source

      The Results report that the sample included both men and women in nearly equal numbers, and that losing weight was a current goal for only one-third of participants. The Subjects and methods describe an analysis of NHANES weight histories, not a group of women selected for their ability to follow a weight-loss diet protocol. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Premisecitation

    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.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [16] Tate, 2012, 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, Am J Clin Nutr source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    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.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [16] Tate, 2012, 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, Am J Clin Nutr source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Low-energy sweeteners offer sweet taste without the extra energy delivered from foods and drinks containing sugar.

    “Low-energy sweeteners are of interest as a dietary tool (6), because they offer sweet taste without the extra energy delivered from foods and drinks containing sugar (7)(8)(9)(10)(11)(12).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [6] Benton, 2005, Can artificial sweeteners help control body weight and prevent obesity?, Nutr Res Rev source
    • cites (7)(8)(9)(10)(11)(12)

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In an interventional study, premeal water consumption in subjects after a weight-loss diet may cause them to lose more weight than control subjects.

    “In an interventional study (15), researchers showed that premeal water consumption in subjects after a weight-loss diet may cause them to lose more weight than control subjects.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [15] Dennis, 2010, Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults, Obesity (Silver Spring) source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The sample-size calculation used a power of 0.85, alpha = 0.05, an expected weight-loss difference of 2.0 ± 2.5 kg, a targeted final sample size of 56, and a 20% dropout rate, giving a required sample size of 67.

    “The power calculation was based on that described by Dennis et al. (15), except we chose a power of 0.85 (a = 0.05), which was performed based on expected differences in weight loss between weight loss diet groups (mean 6 SD: 2.0 6 2.5 kg) to determine the targeted final sample size (n = 56).Considering a dropout rate of 20%, the sample size required was 67.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Dennis et al. (15) Dennis, 2010, Water consumption increases weight loss during a hypocaloric diet intervention in middle-aged and older adults, Obesity (Silver Spring) source

  • Classified as probably not a substantial claim.

    Premisecitation

    A recently published study claimed that obese people drinking DBs lost significantly more weight than the water group while they were on a cognitive behavioral therapy weight-loss plan without any personalized detailed dietary recommendations for 12 wk.

    “Concurrent with the present study, a recently published study (17) claimed that obese people drinking DBs lost significantly more weight than the water group while they were on a cognitive behavioral therapy (CBT) weightloss plan without any personalized detailed dietary recommendations for 12 wk.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [17] Peters, 2014, The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program, Obesity (Silver Spring) source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    In the recent study with opposite results compared with the present study, subjects received only cognitive behavioral therapy, and the intervention period was as short as 12 wk.

    “In the recent study (17) with the opposite results compared with the present study, subjects received only CBT, and the intervention period was as short as 12 wk.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [17] Peters, 2014, The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program, Obesity (Silver Spring) source

      The Intervention section reports that all participants received cognitive-behavioral weight-loss treatment for 12 weeks. But 'only CBT' omits the assigned water or non-nutritive-sweetened beverage treatments and the physical-activity goals. The Study design section also specifies that 12 weeks was the weight-loss phase of a planned one-year trial, not the entire intervention period (page numbers unavailable). (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In that recent study, participants had at least 3 diet beverages during the week, with no limitation on other beverage consumption, whereas subjects in the present study habitually drank diet beverages before the study.

    “In addition, participants had at least 3 DBs during the week, with no limitation on other beverage consumption, whereas subjects in the present study habitually drank DBs before the study.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [17] Peters, 2014, The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program, Obesity (Silver Spring) source

      The Participants section says eligibility required consuming at least three non-nutritive-sweetened beverages per week before enrollment, not that participants were instructed to drink three during treatment. The NSS beverage group section says water was unrestricted for that group, but the water group was prohibited from drinking those beverages, so the claim of no beverage limitations is too broad. The comparison with the citing authors’ present study is not attributed to Peters et al. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S1 (asserted).

    Premisecitation

    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.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [16] Tate, 2012, 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, Am J Clin Nutr source

  • May combine two claims.

    Premisecitation

    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).”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [16] Tate, 2012, 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, Am J Clin Nutr source
    • cites [17] Peters, 2014, The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program, Obesity (Silver Spring) source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    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.”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [16] Tate, 2012, 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, Am J Clin Nutr source
    • cites [17] Peters, 2014, The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program, Obesity (Silver Spring) source

      The NSS beverage group section (page unavailable) specifies at least 24 fluid ounces per day for both the NNS-beverage and water groups, supporting a description of this study’s beverage volume. It does not specify when participants drank them or establish that volume or timing differed across the studies the citing sentence refers to. (LLM, conf=0.77)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    Between-group differences over 24 wk were significant only for fasting insulin, 2-h postprandial glucose, and HOMA-IR.

    “However, between-groups differences were significant only for insulin, 2hpp, and HOMA-IR (Table 2).”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    The water group had a greater decrease in 2-h postprandial glucose than the DB group over 24 wk (mean -1.02 ± 0.25 mmol/L vs -0.72 ± 0.27 mmol/L; P < 0.001).

    “2-h postprandial glucose (mean 6 SD: water: 21.02 6 0.25 mmol/L; DBs: 20.72 6 0.27 mmol/L; P , 0.001)”
    • Also stated in: § Glucose metabolism measurement · plain
      “In terms of 2hpp differences during the 24 wk of intervention, the mean reduction of 2hpp was -1.024 6 0.254 mmol/L (water) and 20.719 6 0.275 mmol/L (DBs).”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    The water group had a greater decrease in fasting insulin than the DB group over 24 wk (mean -2.84 ± 0.77 mU/L vs -1.78 ± 1.25 mU/L; P < 0.001).

    “fasting insulin (mean 6 SD: water: 22.84 6 0.77 mU/L; DBs: 21.78 6 1.25 mU/L, P , 0.001)”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    Compared with the DB group, the water group had a greater decrease in body weight over 24 wk (mean -8.8 ± 1.9 kg vs -7.6 ± 2.1 kg; P = 0.015 for time × group).

    “As shown in Figure 2, there was a significant group 3 time interaction for weight loss over 24 wk (P = 0.015).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Fasting serum insulin concentrations decreased significantly over time, with differences between the water and diet beverage groups (P < 0.001).

    “Fasting serum insulin concentrations decreased significantly over time, with differences between the 2 groups (P , 0.001).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    In the current study, major reductions in waist circumference and significant improvements in cardiometabolic risk characteristics were observed in both groups over 24 wk, as would be expected given the weight loss observed.

    “In the current study, major reductions in WC and significant improvements in cardiometabolic risk characteristics were observed in both groups over 24 wk, as would be expected given the weight loss observed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Subjects in the water group consumed 250 mL water after their lunch over 24 wk and lost 1.2 kg more (13.6% greater weight loss) than those in the diet beverage group.

    “Subjects in the water group of our study consumed 250 mL water after their lunch over 24 wk, and they lost 1.2 kg more (13.6%greater weight loss) than those in the DB group.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Retention rates at week 12 were 97% for the DB group and 91% for the water group, and at week 24 they were 89% for DBs and 86% for water.

    “At week 12, the retention rates were 97% for the DB group and 91% for the water group, and at week 24, those rates were 89% for DBs and 86% for water.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Retention rates did not differ between groups.

    “Because 2 subjects in the water group were eliminated because of one unexpected pregnancy and the other diagnosed with asthma, it could be said that the retention rates did not differ between groups.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Eligible participants were randomly assigned after baseline measures by using a computer-generated random-numbers method, with allocation concealed from participants and dietitians until randomization was revealed.

    “Eligible participants were randomly assigned after baseline measures by using a computer-generated random-numbers method by the project coordinator with allocation concealed from the participants and dietitians until randomization was revealed to the study participants at the initial intervention clinic appointment.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Study design and conductown data

    Sixty-two of 89 participants (71%) completed the 24-wk trial (32 in the DB group, 30 in the water group).

    “Sixty-two participants (71%) completed the trial (32 in the DB group, 30 in the water group).”
    • Also stated in: § Baseline characteristics · plain
      “Of 89 obese and overweight subjects recruited, 62 completed the 24-wk intervention (71% of the original population, Figure 1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The trial was registered at www.irct.ir as IRCT201402177754N5.

    “This trial was registered at www.irct.ir/as IRCT201402177754N5.”
    • Also stated in: § Subjects · plain
      “This trial was registered at www.irct.iras IRCT201402177754N5.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Drinking water may lead to more weight loss and a greater improvement in insulin sensitivity (measured by HOMA-IR and 2 h postprandial glucose concentrations) than drinking diet beverages after the main meal in overweight and obese female adults.

    “We found that drinking water may lead to more weight loss and a greater improvement in insulin sensitivity, measured by HOMA-IR and 2 hpp glucose concentrations, than may drinking DBs after the main meal in overweight and obese female adults.”
    • Also stated in: § TABLE 3 · hedged
      “In conclusion, replacing DBs with water consumption would appear to have a beneficial impact on weight loss and insulin sensitivity in overweight and obese subjects adhering to a weight-loss diet.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Some studies presented an opposing outcome on energy intake and body weight.

    “However, some studies presented an opposing outcome on energy intake and body weight (13).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Fowler, 2008, Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain, Obesity (Silver Spring) source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The study was a 2-arm, single-blind, randomized clinical trial.

    “The study was a 2-arm, single-blind, randomized clinical trial.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The principal strength of this study is that it was a randomized, outpatient clinical trial while subjects were on a comprehensive diet plan for weight control in a long-term intervention (i.e., 24 wk).

    “The principal strength of this study is that it was a randomized, outpatient clinical trial while subjects were on a comprehensive diet plan for weight control in a long-term intervention (i.e., 24 wk).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Stookey and colleagues reported a 2-kg greater weight loss in water consumers (drinking ≥1 L water/d) on a hypoenergetic diet than in those who consumed less water.

    “Stookey and colleagues (31) reported a 2-kg greater weight loss in water consumers (drinking $1 L water/d) on a hypoenergetic diet than in those who consumed less water.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] Stookey, 2008, Drinking water is associated with weight loss in overweight dieting women independent of diet and activity, Obesity (Silver Spring) source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Nutritionists and popular weight-loss programs usually advise individuals who are keen to lose weight to increase their water consumption.

    “Nutritionists and popular weight-loss programs usually advise individuals who are keen to lose weight to increase their water consumption (32,33).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [32] Atkins, 1992

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [33] Sears, 1995

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Without long-term follow-up, it is not known whether subjects could comply with only water as the beverage or whether the beneficial effects would be sustained in the longer term.

    “On the other hand, without long-term follow-up, it is not known whether subjects could comply with only water as the beverage or whether the beneficial effects would be sustained in the longer term.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The greater weight loss in the water group might be explained by a greater reduction in energy intake in this group than in the diet beverage group.

    “The greater weight loss in the water group might be explained by a greater reduction in energy intake in this group than in the DB group.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Providing the diet beverages for the diet beverage group and water for the water group was an incentive for regular biweekly visits with the dietitian when compliance could be encouraged in both groups.

    “Third, providing the DBs for the DBs group and water for the water group was an incentive for regular biweekly visits with the dietitian when compliance could be encouraged in both groups.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    In our study, subjects in both groups had either water or diet beverages after their meal rather than before the meal, which is more representative of normal behavior in this group.

    “However, in our study, subjects in both groups had either water or DBs after their meal rather than before the meal, which is more representative of normal behavior in this group.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    In our study, the effect of substitution of diet beverages with water on weight loss may reflect better adherence to the weight-loss diet in the water group.

    “In our study, the effect of substitution of DBs with water on weight loss may reflect better adherence to the weight-loss diet in the water group.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The current study showed a significant interaction between beverage use and time for weight loss, suggesting a benefit from water compared with diet beverage consumption.

    “The current study showed a significant interaction between beverage use and time for weight loss, suggesting a benefit from water compared with DB consumption.”
    Quote in the paperSubstantial claim
37 of 37

  • The paper relies on this without support.

    No study has compared the effects of replacing DBs with water on weight-loss management in obese people who usually drank DBs after a comprehensive weight-loss diet program for 24 wk.

    “However, to our knowledge, no study has compared the effects of replacing DBs with water on weight-loss management in obese people who usually drank DBs after a comprehensive weight-loss diet program for 24 wk.”

  • The paper relies on this without support.

    It is unclear how important drinking water instead of DBs is during a weight-loss program.

    “It is unclear how important drinking water instead of DBs is during a weight-loss program.”

  • The paper relies on this without support.

    Increasing daily water drinking is generally recognized as a weight-loss strategy by the general public, but few data are available to support this practice.

    “On the other hand, increasing daily water drinking is generally recognized as a weight-loss strategy by the general public, but few data are available to support this practice.”

  • The paper relies on this without support.

    The general population believes that DBs can help them to lose weight, and many obese people drink DBs, believing that this simple strategy would be helpful in reducing weight.

    “The general population believes that diet beverages (DBs) can help them to lose weight, and many obese people drink DBs, believing that this simple strategy would be helpful in reducing weight.”

  • The paper relies on this without support.

    This is the first randomized controlled trial investigating the effect on weight loss of either replacing diet beverages with water or continuing to consume diet beverages in overweight and obese women who regularly consume diet beverages with their meal while undertaking a voluntary integrated weight-reduction program for 24 wk.

    “To our knowledge, this is the first randomized controlled trial in which the effect on weight loss of either replacing DBs with water or continuing to consume DBs is investigated in overweight and obese women who regularly consume DBs with their meal while undertaking a voluntary integrated weight-reduction program for 24 wk.”

  • The paper relies on this without support.

    Most obese people believe that they can drink diet beverages during a low-caloric diet without any deleterious effects on their weight management.

    “On the other hand, most obese people believe that they can drink DBs during a low-caloric diet without any deleterious effects on their weight management.”
6 of 6

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Relative weight-loss advantage is calculated against the wrong group

    Minor

    The water group lost 1.2 kg more than the DB group's 7.6 kg loss. Relative to the DB group, that is 15.8% greater weight loss, not 13.6%; 13.6% uses the water group's 8.8 kg loss as the denominator.

    Reported 13.6 · recomputed 15.789474

  • Depression-screen exclusions differ between sections

    Minor

    The screening description says three subjects were excluded based on depression scores, while the results say two were excluded for that reason.

  • Completion percentage uses the wrong denominator or count

    Minor

    Sixty-two of 89 participants is 69.7%, which rounds to 70%, not 71%.

    Reported 71 · recomputed 69.662921

3 of 3

Cites

Flagged first, then by citations

1 of the 33 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Tate, 2012, 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, Am J Clin Nutr, 95, 555, 10.3945/ajcn.111.026278 · DOI · Paper page

Cited by

Sorted by citations

Related

Authors
Madjd, A., Taylor, M. A., Delavari, A., Malekzadeh, R., Macdonald, I. A., & Farshchi, H. R.
Affiliations
  • University of Nottingham (GB)
  • Digestive Disease Research Institute (IR)
Corresponding author
Farshchi, Hamid R
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2015-12
Volume
102
Issue
6
Pages
1305-1312
ISSN
0002-9165 (ISSN-L)
DOI
10.3945/ajcn.115.109397
OpenAlex
W2183023066
Cited by
49
References
33
Citations by year
2025: 4 · 2024: 4 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 8 · 2019: 9 · 2018: 5 · 2017: 8 · 2016: 4
FWCI
6.06
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
  • Repository@Nottingham (University of Nottingham) (submittedVersion)
Funders
  • School of Life Sciences, University of Nottingham
  • Digestive Disease Research Institute
  • Tehran University of Medical Sciences
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 › Nursing › Nutrition and Dietetics › Biochemical Analysis and Sensing Techniques
Keywords
diet beverages, water consumption, weight loss, hypocaloric diet, obesity, overweight women, insulin resistance, fasting insulin, postprandial blood glucose, cardiometabolic risk, waist circumference, lipid profile, fasting blood glucose, dietary substitution, energy intake, satiety, dietary habits
MeSH terms
Adolescent, Adult, Beverages, Energy Intake, Cardiovascular Diseases, Combined Modality Therapy, Diet, Reducing, Drinking, Female, Follow-Up Studies, Humans, Insulin Resistance, Iran, Middle Aged, Motor Activity, Obesity, Prediabetic State, Risk Factors, Body Mass Index, Single-Blind Method, Overweight, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-11.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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