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. 2012 Mar;95(3):555-63. doi: 10.3945/ajcn.111.026278. Epub 2012 Feb 1.

Abstract

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Beverages*
  • Blood Glucose / analysis
  • Blood Pressure
  • Choice Behavior
  • Diet
  • Diet, Reducing / methods*
  • Energy Intake
  • Fasting / blood
  • Feeding Behavior*
  • Female
  • Follow-Up Studies
  • Humans
  • Interviews as Topic
  • Logistic Models
  • Male
  • Middle Aged
  • Obesity / diet therapy*
  • Patient Compliance
  • Single-Blind Method
  • Surveys and Questionnaires
  • Water
  • Weight Loss*

Substances

  • Blood Glucose
  • Water

Associated data

  • ClinicalTrials.gov/NCT01017783