1. ^*Children's Hospital Oakland Research Institute, Oakland, California
2. ^†Nestle Waters, Issy les Moulineaux, France
3. ^‡Stanford Prevention Research Center, Stanford, California
4. ^§Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina

Correspondence: Jodi Dunmeyer Stookey Children's Hospital Oakland Research Institute, 5700 Martin Luther King Jr. Way, Oakland, CA 94609. E-mail: jstookey@chori.org

^**The costs of publication of this article were defrayed, in part, by the payment of page charges. This article must, therefore, be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Received 8 November 2006; Accepted 15 April 2007.

Abstract

Objective: Reduced intake of sweetened caloric beverages (SCBs) is recommended to lower total energy intake. Replacing SCBs with non-caloric diet beverages does not automatically lower energy intake, however. Compensatory increases in other food or beverages reportedly negate benefits of diet beverages. The purpose of this study was to evaluate drinking water as an alternative to SCBs.

Research Methods and Procedures: Secondary analysis of data from the Stanford A TO Z intervention evaluated change in beverage pattern and total energy intake in 118 overweight women (25 to 50 years) who regularly consumed SCBs (>12 ounces/d) at baseline. At baseline and 2, 6, and 12 months, mean daily beverage intake (SCBs, drinking water, non-caloric diet beverages, and nutritious caloric beverages), food composition (macronutrient, water, and fiber content), and total energy intake were estimated using three 24-hour diet recalls. Beverage intake was expressed in relative terms (percentage of beverages).

Results: In fixed effects models that controlled for total beverage intake, non-caloric and nutritious caloric beverage intake (percentage of beverages), food composition, and energy expenditure [ metabolic equivalent (MET)] , replacing SCBs with drinking water was associated with significant decreases in total energy intake that were sustained over time. The caloric deficit attributable to replacing SCBs with water was not negated by compensatory increases in other food or beverages. Replacing all SCBs with drinking water was associated with a predicted mean decrease in total energy of 200 kcal/d over 12 months.

Discussion: The results suggest that replacing SCBs with drinking water can help lower total energy intake in overweight consumers of SCBs motivated to diet.