Lustig Robert H, Mulligan Kathleen, Noworolski Susan M, Tai Viva W, Wen Michael J, Erkin-Cakmak Ayca, Gugliucci Alejandro, Schwarz Jean-Marc
Department of Pediatrics, University of California, San Francisco, California, USA.
Department of Medicine, University of California, San Francisco, California, USA.
Obesity (Silver Spring). 2016 Feb;24(2):453-60. doi: 10.1002/oby.21371. Epub 2015 Oct 26.
Dietary fructose is implicated in metabolic syndrome, but intervention studies are confounded by positive caloric balance, changes in adiposity, or artifactually high amounts. This study determined whether isocaloric substitution of starch for sugar would improve metabolic parameters in Latino (n = 27) and African-American (n = 16) children with obesity and metabolic syndrome.
Participants consumed a diet for 9 days to deliver comparable percentages of protein, fat, and carbohydrate as their self-reported diet; however, dietary sugar was reduced from 28% to 10% and substituted with starch. Participants recorded daily weights, with calories adjusted for weight maintenance. Participants underwent dual-energy X-ray absorptiometry and oral glucose tolerance testing on Days 0 and 10. Biochemical analyses were controlled for weight change by repeated measures ANCOVA.
Reductions in diastolic blood pressure (-5 mmHg; P = 0.002), lactate (-0.3 mmol/L; P < 0.001), triglyceride, and LDL-cholesterol (-46% and -0.3 mmol/L; P < 0.001) were noted. Glucose tolerance and hyperinsulinemia improved (P < 0.001). Weight reduced by 0.9 ± 0.2 kg (P < 0.001) and fat-free mass by 0.6 kg (P = 0.04). Post hoc sensitivity analysis demonstrates that results in the subcohort that did not lose weight (n = 10) were directionally consistent.
Isocaloric fructose restriction improved surrogate metabolic parameters in children with obesity and metabolic syndrome irrespective of weight change.
膳食果糖与代谢综合征有关，但干预研究因热量摄入呈正平衡、肥胖程度改变或人为造成的高摄入量而受到干扰。本研究旨在确定用淀粉等热量替代糖类是否能改善患有肥胖症和代谢综合征的拉丁裔儿童（n = 27）和非裔美国儿童（n = 16）的代谢参数。
参与者按照自身报告的饮食模式摄入9天的饮食，以提供相同比例的蛋白质、脂肪和碳水化合物；然而，膳食中的糖含量从28%降至10%，并用淀粉替代。参与者记录每日体重，并根据维持体重情况调整热量摄入。参与者在第0天和第10天接受双能X线吸收测定法和口服葡萄糖耐量测试。通过重复测量协方差分析对体重变化进行生化分析控制。
观察到舒张压降低（-5 mmHg；P = 0.002）、乳酸降低（-0.3 mmol/L；P < 0.001）、甘油三酯和低密度脂蛋白胆固醇降低（-46%和-0.3 mmol/L；P < 0.001）。葡萄糖耐量和高胰岛素血症得到改善（P < 0.001）。体重减轻了0.9±0.2 kg（P < 0.001），去脂体重减轻了0.6 kg（P = 0.04）。事后敏感性分析表明，在未减重的亚组（n = 10）中，结果在方向上是一致的。
等热量果糖限制改善了肥胖和代谢综合征儿童的替代代谢参数，与体重变化无关。
