Beverages and positive energy balance: the menace is the medium

Energy-containing beverages have been implicated in the increasing incidence and prevalence of overweight and obesity. This association has been challenged based on some conflicting evidence and questions about a plausible mechanism. However, the preponderance of epidemiological data indicates that caloric beverage consumption is positively associated with energy intake and body mass index, and this is supported by most intervention trials. Mechanistic questions remain largely unresolved, but there is compelling evidence that caloric beverages elicit weak satiety and compensatory dietary responses. Some attribute this to the components of beverages ( e. g., carbohydrate form), but the totality of evidence indicates that the limited appetitive and dietary responses hold across beverage types. This suggests that the fluid medium rather than energy form or nutrient composition is responsible. If true, this hypothesis holds implications for recommendations to the moderate consumption of energy from beverages for example, substitution of one energy-yielding beverage for another may be less effective than reducing intake or switching to lower or non-energy sources.