Department of Pediatrics, The Saban Research Institute, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA 90027, USA.
Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
Nutrients. 2023 Jul 27;15(15):3338. doi: 10.3390/nu15153338.
Pediatric obesity and cardiometabolic disease disproportionately impact minority communities. Sugar reduction is a promising prevention strategy with consistent cross-sectional associations of increased sugar consumption with unfavorable biomarkers of cardiometabolic disease. Few trials have tested the efficacy of pediatric sugar reduction interventions. Therefore, in a parallel-design trial, we randomized Latino youth with obesity (BMI ≥ 95th percentile) [ = 105; 14.8 years] to control (standard diet advice) or sugar reduction (clinical intervention with a goal of ≤10% of calories from free sugar) for 12-weeks. Outcomes included changes in glucose tolerance and its determinants as assessed by a 2-h frequently sample oral glucose tolerance test, fasting serum lipid profile (total cholesterol, HDL, LDL, triglycerides, cholesterol:HDL), and inflammatory markers (CRP, IL-6, TNF-α). Free sugar intake decreased in the intervention group compared to the control group [11.5% to 7.3% vs. 13.9% to 10.7% (% Energy), respectively, = 0.02], but there were no effects on any outcome of interest ( > 0.07). However, an exploratory analysis revealed that sugar reduction, independent of randomization, was associated with an improved Oral-disposition index ( < 0.001), triglycerides ( = 0.049), and TNF-α ( = 0.02). Dietary sugar reduction may have the potential to reduce chronic disease risks through improvements in beta-cell function, serum triglycerides, and inflammatory markers in Latino adolescents with obesity.
儿科肥胖和心血管代谢疾病不成比例地影响少数族裔社区。减少糖的摄入量是一种有前途的预防策略,有一致的横断面研究表明,增加糖的摄入量与心血管代谢疾病的不利生物标志物有关。很少有试验测试过儿科减少糖摄入量干预的效果。因此,在一项平行设计的试验中,我们将肥胖的拉丁裔青少年(BMI≥第 95 百分位数)[=105;14.8 岁]随机分为对照组(标准饮食建议)或糖摄入量减少组(临床干预,目标是使来自游离糖的卡路里摄入量≤10%),干预时间为 12 周。结果包括通过 2 小时频繁采样口服葡萄糖耐量试验评估的葡萄糖耐量及其决定因素的变化、空腹血清脂质谱(总胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三酯、胆固醇:高密度脂蛋白)和炎症标志物(CRP、IL-6、TNF-α)。与对照组相比,干预组的游离糖摄入量减少[分别从 11.5%降至 7.3%和从 13.9%降至 10.7%(占能量的百分比), = 0.02],但对任何感兴趣的结果均无影响( > 0.07)。然而,一项探索性分析表明,无论是否随机分组,减少糖的摄入量都与改善口服处置指数( < 0.001)、甘油三酯( = 0.049)和 TNF-α( = 0.02)有关。在肥胖的拉丁裔青少年中,减少膳食中的糖摄入量可能通过改善β细胞功能、血清甘油三酯和炎症标志物来降低慢性病风险。