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Replacing Diet Beverages With Water Leads to Increased Weight Loss
TAKE-HOME MESSAGE
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Now that obesity has become an epidemic all over the world, clinicians are frantically searching for tools that can help turn back the tide. One such tool that has been proposed is the replacement of drinks that contain concentrated sugar for drinks that contain artificial no-calorie sweeteners to help with weight loss. Although these "diet" drinks have led to weight loss in some studies, they have also led to paradoxical weight gain in others. The alternative to these no-calorie beverages is, of course, good old-fashioned water. This study included 71 overweight or obese women who were otherwise healthy. Of these, 35 were randomized to the water group, in which participants substituted habitual intake of diet beverages with a glass of water (250 mL) after the main meal (lunch), and to the diet drink group, in which participants were instructed to drink diet drinks (250 mL) once a day after their main meal (lunch) five times a week and then water only after the main meal (lunch) on the remaining days of the week. This dietary intervention was combined with monthly weight-loss group therapy for a total of 53 weeks. Additional weight loss occurred in the water group compared with the diet drink group after 12 months. In addition, BMI decreased more in the water group than in the diet drink group, and there was a greater reduction in 2-hour postprandial glucose levels.
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This was a fairly large randomized trial that aimed to answer a long-standing question of whether diet beverages or water were better for weight loss and insulin sensitivity. The answer to this question seems to be that water is the better option. This is very important for clinicians to understand because we often make diet and lifestyle recommendations for patients with obesity and/or type 2 diabetes that can influence their treatment outcomes. Based on this study, the recommendation should be to drink more water instead of diet beverages if the goal is weight loss and improved postprandial glucose levels.
– Jason Sloane, MD
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Beneficial effects of replacing diet beverages (DBs) with water on weight loss, during a 24-week hypoenergetic diet were previously observed. However, it is not known whether this difference is sustained during a subsequent 12-month weight maintenance period.
OBJECTIVE
To evaluate effects of replacing DBs with water on body weight maintenance over a 12-month period in participants who undertook a 6-month weight loss plan.
DESIGN
Seventy-one obese and overweight adult women (body mass index (BMI): 27-40 kg m-2; age: 18-50 years) who usually consumed DBs in their diet were randomly assigned to either substitute water for DBs (water group: 35) or continue drinking DBs five times per week (DBs group: 36) after their lunch for the 6-month weight loss intervention and subsequent 12-month weight maintenance program.
RESULTS
A total of 71 participants who were randomly assigned were included in the study by using an intention-to-treat analysis. Greater additional weight loss (mean±s.d.) in the water group was observed compared with the DBs group after the 12-month follow-up period (-1.7±2.8 vs -0.1±2.7 kg, P=0.001). BMI decreased more in the water group than in the DBs group (-0.7±1 vs -0.05±1.1 kg m-2, P=0.003). There was also a greater reduction in fasting insulin levels (-0.5±1.4 vs -0.02±1.5 mmol l-1, P=0.023), better improvement in homeostasis model assessment of insulin resistance (-0.2±0.4 vs -0.1±0.3, P=0.013) and a greater decrease in 2-h postprandial plasma glucose (-0.2±0.3 vs -0.1±0.3 mmol l-1, P<0.001) in the water group compared with the DBs over the 12-month weight maintenance period.
CONCLUSIONS
Replacement of DBs with water after the main meal in women who were regular users of DBs may cause further weight reduction during a 12-month weight maintenance program. It may also offer benefits in carbohydrate metabolism including improvement of insulin resistance over the long-term weight maintenance period.
Additional Info
Disclosure statements are available on the authors' profiles:
Effects of Replacing Diet Beverages With Water on Weight Loss and Weight Maintenance: 18-Month Follow-up, Randomized Clinical Trial
Int J Obes (Lond) 2018 Apr 01;42(4)835-840, A Madjd, MA Taylor, A Delavari, R Malekzadeh, IA Macdonald, HR FarshchiFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This study examined the effects of replacing artificially sweetened diet drinks with water on the weight of women attending a weight-loss clinic in Iran. After 18 months of dieting and maintenance, the women who replaced diet drinks with water consumed less energy, lost more weight, and showed greater improvement in insulin responses than the women who continued to consume diet drinks. But, in theory, diet drinks and water ought to have the same effect on weight loss; neither has calories. Thus, this study supports previous research indicating that diet drinks do not usually help people lose weight.1 It has been difficult to settle this question, in part because studies that do suggest weight-loss benefits of diet drinks are often sponsored by companies with a vested interest in their outcome.2 The reasons why diet drinks don’t help remain speculative; perhaps they reinforce the desire for sweet foods or encourage overeating. While waiting for further research, drink water.
References