GW Research: No Difference in Calorie Intake in Children Who Drink Low-Calorie or Sugary Beverages

A new Milken SPH study shows low-calorie sweetened beverage consumers also take in extra calories compared to children and teens who drink water.

May 2, 2019

low-calorie sweetened beverage

U.S. children who consumed low-calorie or zero-calorie sweetened beverages took in about 200 extra calories on a given day compared to those who drank water, according to a new GW study.

U.S. children who consumed low-calorie or zero-calorie sweetened beverages took in about 200 extra calories on a given day compared to those who drank water, and they took in about the same number of calories as youth who consumed sugary beverages, according to a recent study published by a Milken Institute School of Public Health researcher.

“These results challenge the utility of diet or low-calorie sweetened beverages when it comes to cutting calories and weight management,” said Allison Sylvetsky, lead author of the study and an assistant professor of exercise and nutrition sciences at Milken Institute SPH. “Our findings suggest that water should be recommended as the best choice for kids and teens.”

A 2017 study by Dr. Sylvetsky and colleagues found that children and teens frequently consume low-calorie sweeteners, not only in diet sodas but also in a variety of reduced calorie juice and sports drinks, as well as food and snack items.

Consumption of low-calorie sweeteners jumped by 200 percent in children and teens from 1999 to 2012, according to the study. Yet despite the rise in popularity, researchers still do not know how these sweeteners affect total energy intake or if they are helpful for weight management as they are intended to be.

Dr. Sylvetsky and her colleagues looked at dietary recalls collected from more than 7,000 children and teens enrolled in the National Health and Nutrition Examination Survey from 2011 until 2016 to find out more. Children and teens reported what they ate and drank during a 24-hour period. The research team zeroed in on the reported consumption of sweetened beverages—those with low-calorie sweeteners and those with sugar.

Young people who reported drinking low-calorie sweetened beverages, such as a diet soda, not only ingested extra calories compared to water consumers, but they also took in more calories from added sugars in foods and beverages compared to water consumers, the team found.

Other key findings from the study included:

  • After adjusting for body weight, consumption of low-calorie sweetened beverages, sugary beverages and combined consumption of both was associated with 196, 312 and 450 higher total calorie intake compared to youth who consumed predominantly water.
  • consumers of low-calorie sweetened drinks, sugary beverages and consumers of both took in 15, 39 and 46 more grams of added sugar, which translates to 60, 156 and 184 extra calories from added sugar--as compared to water consumers.
  • No differences in calorie intake were observed between consumers of low-calorie sweetened beverages and sugary beverages.
  • The highest calorie intakes were reported in children and teens that consumed both low-calorie sweetened beverages and sugary beverages.

These findings are particularly important because nearly 1 in 3 children in the United States is overweight or has obesity, which puts them at increased risk of Type 2 diabetes and other serious health conditions.

This study was not designed to show that drinking low or zero-calorie beverages causes unhealthy weight gain, Dr. Sylvetsky said. Rather, the study findings suggest a link between consuming sweetened beverages that contain sugar and/or low-calorie sweeteners and higher intakes of both calories and sugar.

While the role of diet beverages in weight management remains controversial, experts have weighed in with some practical advice for parents and children. For example, an American Heart Association science advisory group recently advised, “against prolonged consumption of low-calorie sweetened beverages by children.”

Dr. Sylvetsky agrees with that conclusion. She says children and teens, like people of all ages, should follow the federal government’s guidelines for a healthy diet. A healthy diet emphasizes water instead of soft drinks, plenty of fruits and veggies and whole grains.

The study, “Consumption of Low-calorie Sweetened Beverages Is Associated with Higher Total Energy and Sugar Intake Among Children, NHANES 2011-2016,” was published Thursday in the journal Pediatric Obesity. Co-authors of the study include Jean Welsh and Janet Figueroa at Emory University and Susan Swithers at Purdue University. Talia Zimmerman, a research assistant at GW and an undergraduate student at Georgetown University, also contributed to the study.

The Sumner M. Redstone Global Center for Prevention and Wellness at the Milken Institute SPH funded the research.