Statement Regarding “Consumption of low‐calorie sweetened beverages is associated with higher total energy and sugar intake among children, NHANES 2011–2016”Allison C. Sylvetsky, Janet Figueroa, Talia Zimmerman, Susan E. Swithers, Jean A. Welsh
Pediatric Obesity Pediatric Obesity
ATLANTA — The Calorie Control Council (CCC) recommends careful interpretation of the findings of a recent observational study that looked to compare calorie and added-sugar consumption in children and adolescents who consumed low-calorie sweetened beverages (LCSB), sugar-sweetened beverages (SSB) or water. While researchers looked to compare calorie intake among the three groups, this study did not take into account two key factors – changes in body weight and overall calorie intake over time – making the authors’ conclusions inappropriate. Therefore, these results do not challenge the existing evidence that LCSB are one of many helpful tools in weight management and overall calorie reduction.
There are a lot of unknowns in this study – too many to allow specific conclusions. As a clinician of over 30 years, I have had many parents ask if LCSB can be helpful to their kids, I tell them of course, but these are just one tool of many available, and to get the best use of them, you have to maximize their potential. LCSB can help you consume fewer calories from added sugars and they can help make a lower calorie diet more palatable so you can adapt to it more comfortably. Even if weight loss isn’t necessary, a lower sugar diet that still tastes good is a win-win.Dr. Keith Ayoob, Associate Clinical Professor Emeritus of Pediatrics, Albert Einstein College of Medicine and Scientific Advisor for the Calorie Control Council
Keri Peterson, MD, medical advisor for the Calorie Control Council notes, “This study reflects caloric intake over one single 24 hour period. To exert that this represents a person’s overall dietary pattern is a gross extrapolation. Additionally the study did not examine body weight fluctuations over time. Thus, it is not able to accurately make any comments on the use of LCSB in weight management. While water is the recommended beverage of choice, consumption of LCSB remains a valid means for weight control.”
As this study is observational, researchers are unable to prove a causal relationship between increased calorie intake and LCSB consumption. Observational data can be used to make associations, but is not intended to be used to draw conclusions about any variables or health outcomes. While the authors do admit this within the discussion section, their overall conclusions suggest otherwise.
This study did not review the diet quality or any of the other foods consumed by the population groups over time. LCSB consumers actually had lower added sugar intake compared to SSB consumers, which is a positive outcome. The authors’ conclusion that drinking LCSB was associated with consuming 15 more calories of added sugar than water drinkers is clinically insignificant.
study results were dependent on self-reported data assessed via in-person
dietary recall with participants, aged 2-17. Such recall is subject to
misreporting, especially among younger participants, which can result in
inaccurate data collection. Additionally, the collected data was not validated
via other assessment measures in this study.