Substituting sugar-sweetened beverages with water or milk is inversely associated with body fatness development from childhood to adolescence

Objective
The aim of this study was to examine the association between different types of beverage intake and substitution of sugar-sweetened beverages (SSBs) by water, milk, or 100% fruit juice in relation to 6-y change in body fatness.

Methods
A cohort of 9-y-old children (N = 358) who participated in the Danish part of the European Youth Heart Study was followed for development of body fatness over 6 y. Multivariate linear regression was used to examine the associations between beverage intake at baseline and change in body fatness (body mass index z score [BMIz]), waist circumference (WC), and sum of four skinfolds (Σ4SF) over 6 y with adjustment for potential confounders. Substitution models were used to evaluate various beverages as alternatives to SSBs.

Results
SSB intake at age 9 y, but not intake of other beverages, was directly associated with subsequent 6-y changes in BMIz (β = 0.05; P = 0.02) and Σ4SF (β = 0.86; P = 0.02). Daily substitution of 100 g water for 100 g SSB was inversely associated with changes in BMIz (β = −0.04; P = 0.02), WC (β =−0.29; P = 0.04), and Σ4SF (β = −0.91; P = 0.02) over 6 y. Daily substitution of 100 g milk for 100 g SSB was also inversely associated with changes in BMIz (β = −0.05; P = 0.02), WC (β = −0.33; P = 0.046), and Σ4SF (β = −0.79; P = 0.06). No effect was observed for substitution of SSB by 100% fruit juice.

Conclusion
Our results suggest that SSB intake is associated with long-term changes in body fatness in children, and replacing SSBs with water or milk, but not 100% fruit juice, is inversely associated with body fatness development.