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Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome
Author(s) -
Lustig Robert H.,
Mulligan Kathleen,
Noworolski Susan M.,
Tai Viva W.,
Wen Michael J.,
ErkinCakmak Ayca,
Gugliucci Alejandro,
Schwarz JeanMarc
Publication year - 2016
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.21371
Subject(s) - medicine , endocrinology , metabolic syndrome , fructose , triglyceride , calorie , hyperinsulinemia , obesity , glucose tolerance test , blood pressure , weight loss , insulin resistance , cholesterol , food science , chemistry
Objective 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. Methods 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. Results 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. Conclusions Isocaloric fructose restriction improved surrogate metabolic parameters in children with obesity and metabolic syndrome irrespective of weight change.