The effect of sugar-free versus sugar-sweetened beverages on satiety, liking and wanting: an 18 month randomized double-blind trial in children

PLoS One. 2013 Oct 22;8(10):e78039. doi: 10.1371/journal.pone.0078039. eCollection 2013.


Background: Substituting sugar-free for sugar-sweetened beverages reduces weight gain. A possible explanation is that sugar-containing and sugar-free beverages cause the same degree of satiety. However, this has not been tested in long-term trials.

Methods: We randomized 203 children aged 7-11 years to receive 250 mL per day of an artificially sweetened sugar-free beverage or a similarly looking and tasting sugar-sweetened beverage. We measured satiety on a 5-point scale by questionnaire at 0, 6, 12 and 18 months. We calculated the change in satiety from before intake to 1 minute after intake and 15 minutes after intake. We then calculated the odds ratio that satiety increased by 1 point in the sugar-group versus the sugar-free group. We also investigated how much the children liked and wanted the beverages.

Results: 146 children or 72% completed the study. We found no statistically significant difference in satiety between the sugar-free and sugar-sweetened group; the adjusted odds ratio for a 1 point increase in satiety in the sugar group versus the sugar-free group was 0.77 at 1 minute (95% confidence interval, 0.46 to 1.29), and 1.44 at 15 minutes after intake (95% CI, 0.86 to 2.40). The sugar-group liked and wanted their beverage slightly more than the sugar-free group, adjusted odds ratio 1.63 (95% CI 1.05 to 2.54) and 1.65 (95% CI 1.07 to 2.55), respectively.

Conclusions: Sugar-sweetened and sugar-free beverages produced similar satiety. Therefore when children are given sugar-free instead of sugar-containing drinks they might not make up the missing calories from other sources. This may explain our previous observation that children in the sugar-free group accumulated less body fat than those in the sugar group.

Trial registration: NCT00893529

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / physiology
  • Beverages*
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Female
  • Food Additives / administration & dosage*
  • Food Additives / adverse effects
  • Humans
  • Male
  • Satiety Response / drug effects*
  • Satiety Response / physiology
  • Sweetening Agents / administration & dosage*
  • Sweetening Agents / adverse effects
  • Time Factors


  • Food Additives
  • Sweetening Agents

Associated data


Grants and funding

Funding provided by ZonMW: grantnumber: 120520010, Dutch Heart Foundation: grantnumber: 2008B96 and Royal Netherlands Academy of Arts and Sciences: grantnumber: ISK/741/PAH The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.