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.