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Cutting down on sodas, other sweet beverages may work better than eating less, study finds

When it comes to losing weight, cutting back on the calories in sugar-sweetened drinks, rather than food, may be most important.So say researchers who found that cutting back on calories from sugary beverages — by only one serving per day — accounted for nearly two-and-a-half pounds of lost weight over 18 months.

“Weight loss from liquid calories is greater than loss of calorie intake from solid food,” concluded lead researcher Dr. Liwei Chen, an assistant professor of epidemiology at the School of Public Health at the LSU Health Science Center in New Orleans.

One reason for this is that the body is able to self-regulate its intake of solid food. For example, if you eat too much solid food at lunch, you’ll tend to eat less at dinner. But the same self-regulation is not there for what you drink, experts say. Your body does not adjust to liquid calories, so over time, you gain more weight, Chen explained.

“If you reduce your intake of beverages, particularly sugar-containing beverages, it’s a simple but easy way to help you maintain your weight,” Chen said. “You can avoid additional weight gain, or if you are on a diet, it’s an easy, simple way to help you achieve your goals,” Chen added.

One dietitian said the finding wasn’t so surprising.

The study “supports what many have suspected — liquid calories don’t satisfy,” said Connie Diekman, director of university nutrition at Washington University in St. Louis. “In addition, the identification that [sugar-sweetened beverages] can impact weight gain more than other liquids is an important message as Americans continue to work to lower their calories.”

And if you get thirsty? “Drink water,” Chen said.

The report was published in the April 1 issue of the American Journal of Clinical Nutrition.

For the study, researchers studied the diets of 810 adults 25 to 79 years old who participated in the Lifestyle Interventions for Blood Pressure Control (PREMIER) trial. People in the trial, which lasted 18 months, were randomly assigned to one of three groups: advice about lowering blood pressure; lifestyle intervention (including dieting advice and exercise to lower blood pressure); or lifestyle intervention plus a specific diet that was rich in fruits and vegetables.

In the current study, researchers specifically looked at the weight of the participants and the beverages they drank. People in PREMIER had their weight measured at six and 18 months and were quizzed about their diet by unannounced phone interviews.

Beverages were placed into seven categories: sugar-sweetened beverages (including soft drinks, fruit drinks, fruit punch, or high-calorie beverages sweetened with sugar); diet drinks such as diet soda and other diet drinks that were artificially sweetened; milk (including whole milk, 2 percent milk, 1 percent and skim); 100 percent fruit and vegetable juice; coffee and tea with sugar; coffee and tea without sugar; alcoholic beverages.

The researchers found that sugar-sweetened drinks accounted for 37 percent of all the liquid calories people in the study consumed. Among beverages, sugar-sweetened beverages were the only type of beverage type significantly associated with weight change at both the 6 and 18 months, the researchers noted.

Drinking fewer sugary drinks was more important than eating less for losing weight, the researchers found. In fact, drinking one less serving of a soft drink was associated with just over one pound of weight loss at six months and an additional weight loss of more than 1.4 pounds at 18 months.

Diekman said the findings are a reminder that little things mean a lot when it comes to weight loss.

“If one small diet change can trigger a one-half- to one-pound weight loss in six months, adding other small changes or boosting activity even 15 minutes a day could make ‘healthy’ more attainable,” she said. “As a registered dietitian, this study indicates to me that helping people make gradual changes will help them comfortably achieve a healthier weight.”

Consuming liquid calories has increased along with the obesity epidemic, Chen’s group noted. In earlier studies, researchers found that 75 percent of U.S. adults could be overweight or obese by 2015, and they tied drinking sugar-sweetened beverages to the obesity epidemic.

In 2006, the nation’s major soft drink companies agreed to limit the sale of sodas in U.S. schools. That deal was brokered by the Alliance for a Healthier Generation, a joint effort of the American Heart Association and the President William J. Clinton Foundation.

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But researchers note that exact in-flight medical emergency numbers hard to find

More than half of the medical emergencies that occur on airplane flights involve fainting, a new study shows, but the researchers note that a lack of good data on such cases makes it hard to know how to best protect passengers in the future.Researchers requested in-flight emergency data from 32 European airlines, although only four of the airlines had the data, and only two of those participated in the study. What they discovered: 53.5 percent of incidents involved fainting; 9 percent dealt with gastrointestinal problems; and about 5 percent experienced cardiac events. Of the flights studied, 52 people died while on a plane, and two babies were born.

However, these numbers were hardly comprehensive, they added.

“There were very big differences between the airlines,” said study author Dr. Michael Sand, of the department of general and visceral surgery at the Augusta Krankenanstalt, Academic Teaching Hospital at Ruhr-University Bochum, in Germany. “Some were documenting very precisely, some very bad or not at all.”

The report was published in a recent issue of Critical Care.

“The problem with most of these studies is largely that the data is not recorded in any consistent form, and there’s no common definition of any of these medical conditions,” said Katherine Andrus, assistant general counsel of the Air Transport Association. “It makes it difficult to compare data across different airlines and across different countries.”

“I think airlines should think about documenting in-flight emergencies in a standardized manner to have better data in the future,” said Sand. “Based on this data, one could facilitate the design of in-flight emergency kits and give advice to chronically ill patients who are more likely to have an emergency while in the air.”

Meanwhile, the researchers and industry experts suggest that people, especially ones with preexisting medical conditions, take responsibility for themselves before boarding a plane.

“A chronically ill patient who already had some myocardial infarction should consult his doctor before a long distance flight,” Sand said. “Somebody who’s diabetic should be traveling with insulin.”

The good news is that when medical emergencies do happen mid-flight, the researchers found that medical professionals were often on board and willing to help.

“In 86 percent of the cases, we had a nurse, paramedic or a doctor on board who could assist in treating the patient,” said Sand. “Another possibility would be a bonus program for physicians who voluntarily register as a physician on board in case there will be an emergency.”

“This study, like the others that have been done, is actually pretty reassuring,” said Andrus. “If there is an emergency, they are probably better off than they would be in a lot of other public spaces.”

But more work remains to ensure consistency of emergency care among airplanes, the study authors noted.

“In fact, all flights have first-aid boxes. However, there are big differences regarding the contents. It would be favorable that every airline would carry emergency medical equipment so that a physician would have everything necessary for a reanimation or securing the airway or IV medication,” said Sand. “Currently, this is not the situation in every airplane.”

“The other limitation in terms of reporting anything is that we often don’t know the outcome or final diagnosis, particularly in the United States, where we have strict privacy laws,” said Sand. “The airlines appropriately do not have access to your medical records.”

“This study, like the others that have been done, is actually pretty reassuring,” said Andrus. “If there is an emergency, they are probably better off than they would be in a lot of other public spaces.”

Another report, published in the Feb. 19 issue of The Lancet, pointed to an increase in the number of medical emergencies on planes, a consequence of an aging population.

In-flight medical events are increasingly frequent, because a growing number of individuals with preexisting medical conditions travel by air, wrote the researchers from the Lahey Clinic Medical Center in Burlington, Mass. Fortunately, most of these emergencies were minor.

Passengers over age 70 had the highest rates of in-flight medical events, but the mean age of passengers with an in-flight medical event was 44 for men and 49 for women. Commercial aircraft have medical kits, including one enhanced medical kit, as required by aviation regulatory agencies. Emergency medical kits do vary from carrier to carrier and can be extensively complex. Most commercial flights also carry an automated external defibrillator.

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