Background: The relation between sugar-sweetened beverages
(SSBs) and body weight remains controversial.
Objective: We conducted a systematic review and meta-analysis to
summarize the evidence in children and adults.
Design: We searched PubMed, EMBASE, and Cochrane databases
through March 2013 for prospective cohort studies and randomized
controlled trials (RCTs) that evaluated the SSB-weight relation.
Separate meta-analyses were conducted in children and adults and
for cohorts and RCTs by using random- and fixed-effects models.
Results: Thirty-two original articles were included in our meta-analyses:
20 in children (15 cohort studies, n = 25,745; 5 trials, n = 2772) and
12 in adults (7 cohort studies, n = 174,252; 5 trials, n = 292). In cohort
studies, one daily serving increment of SSBs was associated with a 0.06
(95% CI: 0.02, 0.10) and 0.05 (95% CI: 0.03, 0.07)-unit increase in
BMI in children and 0.22 kg (95% CI: 0.09, 0.34 kg) and 0.12 kg (95%
CI: 0.10, 0.14 kg) weight gain in adults over 1 y in random- and fixedeffects
models, respectively. RCTs in children showed reductions in
BMI gain when SSBs were reduced [random- and fixed-effects:
20.17 (95% CI: 20.39, 0.05 kg) and 20.12 (95% CI: 20.22, 20.2
kg)], whereas RCTs in adults showed increases in body weight when
SSBs were added (random- and fixed-effects: 0.85 kg; 95% CI: 0.50,
1.20 kg). Sensitivity analyses of RCTs in children showed more pronounced
benefits in preventing weight gain in SSB substitution trials
(compared with school-based educational programs) and among overweight
children (compared with normal-weight children).
Conclusion: Our systematic review and meta-analysis of prospective
cohort studies and RCTs provides evidence that SSB consumption
promotes weight gain in children and adults.
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