Background: Emerging studies indicate that replacing sugar-sweetened beverages (SSB) with beverage alternatives may be a feasible way of reducing SSB consumption and combating obesity prevalence. However, evidence as to the impact of beverage substitution on obesity is limited. This study aimed to investigate the associations between SSB consumption, its substitution with beverage alternatives, and obesity outcomes among the Australian population.
Methods: Data from adults participating in the 2011-12 National Nutrition and Physical Activity Survey (NNPAS) were used. Multivariate linear regression with adjustment for covariates was used to examine the associations between SSB consumption and body mass index (BMI) and waist circumference (WC), and substitution modelling was used to contemplate the effects of replacing SSB with water, coffee/tea, diet drinks, fruit juice, and milk on obesity outcomes.
Results: SSB intake (100g/day) was associated with higher BMI (β= 0.07kg/m2, P<0.001) and WC (β=0.25cm, P<0.001). In models not assuming a linear dose-response trend, adults who consumed greater than one serve/day of SSB had higher BMI (β= 0.61kg/m2, P<0.001) and WC (β= 1.7cm, P<0.001) than those who consumed less than one serve/day. Replacing 100g SSB with 100g water was inversely associated with BMI (β= -0.07kg/m2, P<0.001) and WC (β= -0.26cm, P<0.001). Similarly, every 100g substitution of SSB with coffee/tea predicted 0.07 kg/m2 decrease in BMI and 0.24cm decrease in WC (P<0.001). BMI and WC decreased by 0.09kg/m2 and 0.25cm, respectively, when milk was substituted for SSB (P=0.001).
Conclusion: Our results suggest that SSB consumption is a significant predictor of obesity. Water, coffee/tea, and milk were better alternatives for SSB pertaining to obesity. The findings of this study underline the role of SSB consumption in promoting obesity, and will facilitate health researchers and policy makers to deliver sound recommendations towards SSB consumption and suitable alternatives.