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Consumption of Low-Calorie Sweetened Beverages Compared to Water Is Associated with Reduced Intake of Carbohydrates and Sugar, with No Adverse Relationships to Glycemic Responses: Results from the 2001–2012 National Health and Nutrition Examination Surveys

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Food, Nutrition and Policy Consultant, Fort Myers Beach, FL 33931, USA
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Dr. Pepper Snapple Group, 5301 Legacy Drive, Plano, TX 75024, USA
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Nutrition Impact, LLC, 9725 D Drive North, Battle Creek, MI 49014, USA
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Author to whom correspondence should be addressed.
Nutrients 2017, 9(9), 928; https://doi.org/10.3390/nu9090928
Received: 25 July 2017 / Revised: 8 August 2017 / Accepted: 22 August 2017 / Published: 24 August 2017
Although the 2015 Dietary Guidelines Advisory Committee concluded that there was moderate evidence that substituting sugar-containing sweeteners with low-calorie sweeteners (LCS) reduces calorie intake and weight, dietary recommendations encourage substituting only water for sugar-sweetened beverages during weight management. This cross-sectional study evaluated the relation of water and no- and low-calorie sweetened beverage (LCSB) intake with nutrient intakes and prediabetes criteria using data from the National Health and Nutrition Examination Survey (NHANES) 2001–2012 in 25,817 adults that were free of diabetes. Although linear trends were observed with both beverages, higher LCSB intake was associated with significantly lower consumption of carbohydrates (−9.1 g/day vs. −1.4 g/day), total sugars (−10.9 g/day vs. −2.2 g/day), and added sugars (−2.0 tsp eq vs. −0.8 tsp eq) than those associated with higher water intake. Higher intake of both beverages was significantly associated with lower insulin levels (p < 0.01); however, higher intake of LCSB was also associated with lower hemoglobin A1c (HbA1c) and lower homeostatic model assessment of insulin resistance (HOMA-IR) (p < 0.01). We observed lower odds ratios for elevated HbA1c (adjusted odds ratio [OR] 0.79, 95% CI 0.64–0.98), HOMA-IR (0.68, 0.53–0.87), and insulin levels (0.63, 0.49–0.80) in LCSB among the higher (2+ servings) intake group compared to the lowest (<1 serving) intake group. Contrary to conventional wisdom, LCSB consumption was associated with equal, if not better, dietary intake and glycemic response than water consumption. Although observational in nature, these results contribute to the growing body of evidence from human studies suggesting that in addition to water, LCSBs can also be sensible choices for reducing sugars and carbohydrate intake, with no adverse associations to measures of glycemic response. View Full-Text
Keywords: diet drinks; beverages; low-calorie sweeteners; prediabetes; National Health and Nutrition Examination Survey diet drinks; beverages; low-calorie sweeteners; prediabetes; National Health and Nutrition Examination Survey
MDPI and ACS Style

Leahy, M.; Ratliff, J.C.; Riedt, C.S.; Fulgoni, V.L., III. Consumption of Low-Calorie Sweetened Beverages Compared to Water Is Associated with Reduced Intake of Carbohydrates and Sugar, with No Adverse Relationships to Glycemic Responses: Results from the 2001–2012 National Health and Nutrition Examination Surveys. Nutrients 2017, 9, 928. https://doi.org/10.3390/nu9090928

AMA Style

Leahy M, Ratliff JC, Riedt CS, Fulgoni VL III. Consumption of Low-Calorie Sweetened Beverages Compared to Water Is Associated with Reduced Intake of Carbohydrates and Sugar, with No Adverse Relationships to Glycemic Responses: Results from the 2001–2012 National Health and Nutrition Examination Surveys. Nutrients. 2017; 9(9):928. https://doi.org/10.3390/nu9090928

Chicago/Turabian Style

Leahy, Marge, Joseph C. Ratliff, Claudia S. Riedt, and Victor L. Fulgoni III. 2017. "Consumption of Low-Calorie Sweetened Beverages Compared to Water Is Associated with Reduced Intake of Carbohydrates and Sugar, with No Adverse Relationships to Glycemic Responses: Results from the 2001–2012 National Health and Nutrition Examination Surveys" Nutrients 9, no. 9: 928. https://doi.org/10.3390/nu9090928

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