(P23-059-23) The Effect of Substituting Water for Diet Beverages on Diet Quality in People With Type 2 Diabetes: The Study of Drinks With Artificial Sweeteners (SODAS), a Randomized Trial

Objectives: Diet beverages are the single largest contributor to artificial sweetener intake in the U.S. diet. People with diabetes are the highest consumers of diet beverages, tending to consume them as a replacement for dietary sources of sugar, especially sugar-sweetened beverages. This behavior has been endorsed by dietetic and scientific organizations, and diet beverages are marketed as being synonymous with better health, suitable for weight loss, and thus advantageous for diabetes control. However, there are few data to support or refute the benefit or harm of habitual diet beverage consumption by people with diabetes. To inform this topic we conducted a randomized trial.

Methods: The SODAS study is a two-arm parallel trial with a run-in period of 2 weeks and an active intervention period of 24 weeks that randomized 181 adults with type 2 diabetes, age 35+ years, who were usual consumers of commercial diet beverages to receive and consume either: 1) A commercial diet beverage (DB) of choice (24 oz. daily); or 2) Unflavored bottled water of choice (sparkling or plain) (H2O) (24 oz. daily). Outcomes include clinical diabetes control measures, and measures of mechanisms that may alter clinical risk. Here we report preliminary results on diet quality from 122 participants with dietary data collected via 7, unannounced 24-hour recalls. We calculated HEI-2015 scores at baseline (2 run in period recalls), week 12 (2-3 recalls conducted during weeks 1-12), and week 24 (2-3 recalls during weeks 13-24) and compared the HEI-2015 scores and reported energy intake between arms at the end of the study.

Results: 179 participants will have provided complete data when study finishes collection in March 2023, and we anticipate being able to report full results in summer 2023 related to dietary intake. Among the 122 completers to date (mean age 58, 55% men), mean 24-week HEI-2015 for DB was 53.5 (SD 12.1) v. 53.3 (SD 14.0) for H2O, (P=0.92). There was no difference in total energy intake either, 1972 kcal/day (SD 613) DB v. 1992 kcal/day (SD 548) H2O (P=0.87).

Conclusions: Preliminarily, in people with type 2 diabetes who habitually consumed diet beverages, there were no significant differences in diet quality or energy intake when substituting water intake for diet beverages.

Funding Sources: NIH/NIDDK