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Br J Nutr. 2016 Jun;115(11):2057-66. doi: 10.1017/S0007114516001136. Epub 2016 Apr 4.

Changes in water and sugar-containing beverage consumption and body weight outcomes in children.

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1Institute of Public Health,Charité - Universitätsmedizin Berlin,Seestr. 73,13347 Berlin,Germany.
2Department of Social and Behavioral Sciences,Harvard T.H. Chan School of Public Health,677 Huntington Avenue, Boston, MA 02115,USA.
3Department of Child and Adolescent Psychiatry,University Hospital Essen,University of Duisburg-Essen,Virchowstr. 174, 45147 Essen,Germany.
5Research Institute of Child Nutrition,University of Bonn,Heinstück 11,44225 Dortmund,Germany.
6Center of Excellence for Nutrition,Hofer Str. 20,95326 Kulmbach,Germany.


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.


BMI; Children; Juices; Overweight and Obesity; Soft drinks; Water consumption

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