最近几十年，肥胖率飞速攀升，肥胖和超重成为全球性问题。这与我们的饮食习惯和生活方式变化有很大关系。哈佛大学公共卫生学院的研究人员发现，含糖饮料确实与体重增加有关。 与此相关的三项研究发表在《新英格兰医学杂志》(NEJM)上。
“据我所知，在短短的时间内，没有其他类型的食物可以减肥，进行减肥的最有效的简单方法是减少饮用含糖饮料，”波士顿儿童医院的Ludwig说。Ludwig是参与研究肥胖和含糖饮料的研究员之一。
自20世纪70年代以来，美国饮用含糖饮料的数量和肥胖率都增加了一倍。第一项研究发现了含糖饮料和导致体重增加的遗传倾向之间的关系。
研究人员对长期参与健康研究的3万3千名肥胖男性和女性进行了遗传关系评估。他们发现，与受遗传因素影响的人相比，消耗大量含糖饮料的人更容易增加两倍的体重。这说明，虽然遗传因素容易导致人肥胖，但是含糖饮料更是加速了肥胖率的增长。
哈佛大学的Lu Qi说，研究结果支持对旨在减少含糖饮料的摄入量的立法，如像纽约市最近禁止出售超过16盎司的苏打水。
在Ludwig博士的领导的第二项研究中，研究人员发现，无热量饮料可以降低肥胖儿童的体重。在这项研究中，224名儿童被随机分配到喝无热量的饮料组或含糖饮料组。研究表明，供应健康食品可以降低儿童肥胖率。
在第三项研究中，来自丹麦一所学校的641名学生，被随机分配到含糖饮料组和无热量饮料组，研究持续了1年半的时间。为了不影响研究结果，饮料在外观和口感上都很相似。研究人员发现，与饮用普通含糖饮料的孩子相比，喝“蒙面饮料”（无热量饮料）的儿童1年后体重较轻。
Sugar-Sweetened Beverages and Genetic Risk of Obesity
Qibin Qi, Ph.D., Audrey Y. Chu, Ph.D., Jae H. Kang, Sc.D., Majken K. Jensen, Ph.D., Gary C. Curhan, M.D., Sc.D., Louis R. Pasquale, M.D., Paul M. Ridker, M.D., M.P.H., David J. Hunter, M.B., B.S., Sc.D., Walter C. Willett, M.D., Dr.P.H., Eric B. Rimm, Sc.D., Daniel I. Chasman, Ph.D., Frank B. Hu, M.D., Ph.D., and Lu Qi, M.D., Ph.D.
BACKGROUND: Temporal increases in the consumption of sugar-sweetened beverages have paralleled the rise in obesity prevalence, but whether the intake of such beverages interacts with the genetic predisposition to adiposity is unknown.
METHODS: We analyzed the interaction between genetic predisposition and the intake of sugar-sweetened beverages in relation to body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) and obesity risk in 6934 women from the Nurses' Health Study (NHS) and in 4423 men from the Health Professionals Follow-up Study (HPFS) and also in a replication cohort of 21,740 women from the Women's Genome Health Study (WGHS). The genetic-predisposition score was calculated on the basis of 32 BMI-associated loci. The intake of sugar-sweetened beverages was examined prospectively in relation to BMI.
RESULTS: In the NHS and HPFS cohorts, the genetic association with BMI was stronger among participants with higher intake of sugar-sweetened beverages than among those with lower intake. In the combined cohorts, the increases in BMI per increment of 10 risk alleles were 1.00 for an intake of less than one serving per month, 1.12 for one to four servings per month, 1.38 for two to six servings per week, and 1.78 for one or more servings per day (P<0.001 for interaction). For the same categories of intake, the relative risks of incident obesity per increment of 10 risk alleles were 1.19 (95% confidence interval [CI], 0.90 to 1.59), 1.67 (95% CI, 1.28 to 2.16), 1.58 (95% CI, 1.01 to 2.47), and 5.06 (95% CI, 1.66 to 15.5) (P=0.02 for interaction). In the WGHS cohort, the increases in BMI per increment of 10 risk alleles were 1.39, 1.64, 1.90, and 2.53 across the four categories of intake (P=0.001 for interaction); the relative risks for incident obesity were 1.40 (95% CI, 1.19 to 1.64), 1.50 (95% CI, 1.16 to 1.93), 1.54 (95% CI, 1.21 to 1.94), and 3.16 (95% CI, 2.03 to 4.92), respectively (P=0.007 for interaction).
CONCLUSIONS: The genetic association with adiposity appeared to be more pronounced with greater intake of sugar-sweetened beverages. (Funded by the National Institutes of Health and others.)
文献链接：Sugar-Sweetened Beverages and Genetic Risk of Obesity
A Trial of Sugar-free or Sugar-Sweetened Beverages and Body Weight in Children
Janne C. de Ruyter, M.Sc., Margreet R. Olthof, Ph.D., Jacob C. Seidell, Ph.D., and Martijn B. Katan, Ph.D.
The consumption of beverages that contain sugar is associated with overweight, possibly because liquid sugars do not lead to a sense of satiety, so the consumption of other foods is not reduced. However, data are lacking to show that the replacement of sugar-containing beverages with noncaloric beverages diminishes weight gain.
METHODS: We conducted an 18-month trial involving 641 primarily normal-weight children from 4 years 10 months to 11 years 11 months of age. Participants were randomly assigned to receive 250 ml (8 oz) per day of a sugar-free, artificially sweetened beverage (sugar-free group) or a similar sugar-containing beverage that provided 104 kcal (sugar group). Beverages were distributed through schools. At 18 months, 26% of the children had stopped consuming the beverages; the data from children who did not complete the study were imputed.
RESULTS: The z score for the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) increased on average by 0.02 SD units in the sugar-free group and by 0.15 SD units in the sugar group; the 95% confidence interval (CI) of the difference was −0.21 to −0.05. Weight increased by 6.35 kg in the sugar-free group as compared with 7.37 kg in the sugar group (95% CI for the difference, −1.54 to −0.48). The skinfold-thickness measurements, waist-to-height ratio, and fat mass also increased significantly less in the sugar-free group. Adverse events were minor. When we combined measurements at 18 months in 136 children who had discontinued the study with those in 477 children who completed the study, the BMI z score increased by 0.06 SD units in the sugar-free group and by 0.12 SD units in the sugar group (P=0.06).
CONCLUSIONS: Masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children. (Funded by the Netherlands Organization for Health Research and Development and others; DRINK ClinicalTrials.gov number, NCT00893529.)
文献链接：A Trial of Sugar-free or Sugar-Sweetened Beverages and Body Weight in Children
A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight
Cara B. Ebbeling, Ph.D., Henry A. Feldman, Ph.D., Virginia R. Chomitz, Ph.D., Tracy A. Antonelli, M.P.H., Steven L. Gortmaker, Ph.D., Stavroula K. Osganian, M.D., Sc.D., and David S. Ludwig, M.D., Ph.D.Consumption of sugar-sweetened beverages may cause excessive weight gain. We aimed to assess the effect on weight gain of an intervention that included the provision of noncaloric beverages at home for overweight and obese adolescents.
METHODS: We randomly assigned 224 overweight and obese adolescents who regularly consumed sugar-sweetened beverages to experimental and control groups. The experimental group received a 1-year intervention designed to decrease consumption of sugar-sweetened beverages, with follow-up for an additional year without intervention. We hypothesized that the experimental group would gain weight at a slower rate than the control group.
RESULTS: Retention rates were 97% at 1 year and 93% at 2 years. Reported consumption of sugar-sweetened beverages was similar at baseline in the experimental and control groups (1.7 servings per day), declined to nearly 0 in the experimental group at 1 year, and remained lower in the experimental group than in the control group at 2 years. The primary outcome, the change in mean body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) at 2 years, did not differ significantly between the two groups (change in experimental group minus change in control group, −0.3; P=0.46). At 1 year, however, there were significant between-group differences for changes in BMI (−0.57, P=0.045) and weight (−1.9 kg, P=0.04). We found evidence of effect modification according to ethnic group at 1 year (P=0.04) and 2 years (P=0.01). In a prespecified analysis according to ethnic group, among Hispanic participants (27 in the experimental group and 19 in the control group), there was a significant between-group difference in the change in BMI at 1 year (−1.79, P=0.007) and 2 years (−2.35, P=0.01), but not among non-Hispanic participants (P>0.35 at years 1 and 2). The change in body fat as a percentage of total weight did not differ significantly between groups at 2 years (−0.5%, P=0.40). There were no adverse events related to study participation.
CONCLUSIONS: Among overweight and obese adolescents, the increase in BMI was smaller in the experimental group than in the control group after a 1-year intervention designed to reduce consumption of sugar-sweetened beverages, but not at the 2-year follow-up (the prespecified primary outcome). (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; ClinicalTrials.gov number, NCT00381160.)
文献链接：A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight
