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Clinical Studies and Practice

Changes in water and beverage intake and long-term weight changes: results from three prospective cohort studies

International Journal of Obesity volume 37, pages 1378–1385 (2013)Cite this article

Subjects

Abstract

OBJECTIVE:

To examine the long-term relationship between changes in water and beverage intake and weight change.

SUBJECTS:

Prospective cohort studies of 50 013 women aged 40–64 years in the Nurses’ Health Study (NHS, 1986–2006), 52 987 women aged 27–44 years in the NHS II (1991–2007) and 21 988 men aged 40–64 years in the Health Professionals Follow-up Study (1986–2006) without obesity and chronic diseases at baseline.

MEASURES:

We assessed the association of weight change within each 4-year interval, with changes in beverage intakes and other lifestyle behaviors during the same period. Multivariate linear regression with robust variance and accounting for within-person repeated measures were used to evaluate the association. Results across the three cohorts were pooled by an inverse-variance-weighted meta-analysis.

RESULTS:

Participants gained an average of 1.45 kg (5th to 95th percentile: −1.87 to 5.46) within each 4-year period. After controlling for age, baseline body mass index and changes in other lifestyle behaviors (diet, smoking habits, exercise, alcohol, sleep duration, TV watching), each 1 cup per day increment of water intake was inversely associated with weight gain within each 4-year period (−0.13 kg; 95% confidence interval (CI): −0.17 to −0.08). The associations for other beverages were: sugar-sweetened beverages (SSBs) (0.36 kg; 95% CI: 0.24–0.48), fruit juice (0.22 kg; 95% CI: 0.15–0.28), coffee (−0.14 kg; 95% CI: −0.19 to −0.09), tea (−0.03 kg; 95% CI: −0.05 to −0.01), diet beverages (−0.10 kg; 95% CI: −0.14 to −0.06), low-fat milk (0.02 kg; 95% CI: −0.04 to 0.09) and whole milk (0.02 kg; 95% CI: −0.06 to 0.10). We estimated that replacement of 1 serving per day of SSBs by 1 cup per day of water was associated with 0.49 kg (95% CI: 0.32–0.65) less weight gain over each 4-year period, and the replacement estimate of fruit juices by water was 0.35 kg (95% CI: 0.23–0.46). Substitution of SSBs or fruit juices by other beverages (coffee, tea, diet beverages, low-fat and whole milk) were all significantly and inversely associated with weight gain.

CONCLUSION:

Our results suggest that increasing water intake in place of SSBs or fruit juices is associated with lower long-term weight gain.

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Acknowledgements

We are indebted to the participants in the Nurses’ Health Study, Nurses’ Health Study II and HPFS for their continuing outstanding support and colleagues working in these studies for their valuable help. The study was supported by the National Institutes of Health Grants (P01CA087969, R01CA050385, U19CA055075, R01DK058845, P30DK046200 and U54CA155626). The study sponsors were not involved in the study design and the collection, analysis and interpretation of data, nor the writing of the article or the decision to submit it for publication. The authors were independent from the study sponsors.

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Authors and Affiliations

  1. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

    A Pan, V S Malik, W C Willett, D Mozaffarian & F B Hu

  2. Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Republic of Singapore

    A Pan

  3. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    T Hao, W C Willett, D Mozaffarian & F B Hu

  4. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    W C Willett, D Mozaffarian & F B Hu

  5. Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    D Mozaffarian

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  1. A Pan
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Correspondence to A Pan or F B Hu.

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Pan, A., Malik, V., Hao, T. et al. Changes in water and beverage intake and long-term weight changes: results from three prospective cohort studies. Int J Obes 37, 1378–1385 (2013). https://doi.org/10.1038/ijo.2012.225

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