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Reducing Sugar Improves Metabolic Syndrome Markers in Obese Children

Benefits seen after nine days despite lack of weight loss.

A recent study suggests that reducing sugar intake in obese children improves their metabolic profiles – even with other aspects of their diets (e.g. caloric consumption) equal. This study is novel because previous studies implicating sugar in metabolic syndrome problems are confounded by improving other aspects of diet.

The study included 27 obese children of Latino descent and 16 obese children of African-American descent. Participants had to be between the ages of 8 and 18 years old and had to have at least one other metabolic syndrome comorbidity, such as hypertension, abnormal glucose metabolism, or hypertriglyceridemia. They were given 9 days of food by the clinicians that restricted added sugar, but substituted with other carbohydrates such as those in fruits and starchy products. The diets were individually formulated to ensure that the percentage of calories from carbohydrates was consistent with their baseline diets, but intake of sugar and fructose were reduced to 10% and 4% of calories. Diets were adjusted to maintain the patients’ baseline weights and caloric intake.

The results on day 10 showed numerous metabolic improvements. Diastolic blood pressure was reduced by an average of 5 mmHg (P = 0.0020) and serum lactate was reduced by 0.3 mmol/L (P < 0.001). Triglycerides were reduced by 46% (P < 0.001), and LDL-cholesterol was reduced by 0.3 mmol/L (P < 0.001). Glucose tolerance and hyperinsulinemia also improved (P < 0.001). Some patients lost weight; average loss was relatively minor at 0.9 ± 0.2 kg (P < 0.001) due to the study’s efforts to maintain the patient’s weights. The 10 patients who did not lose weight still saw the metabolic improvements.

The results of this study suggest that reducing added sugar and fructose – and doing little else about caloric intake, carbohydrate consumption, or other macronutrient profiles – can positively impact metabolic health in a short period of time, even absent weight loss. It further implicates added sugar and fructose in cardiovascular damage versus other carbohydrates. That is not to imply that patients only need to reduce added sugar; there are many dietary changes necessary to improve metabolic syndrome markers, such as losing weight and consuming less salt. However, reducing added sugar can be seen as an effective first step.

The study was limited by its small size and scope. It included fewer than 50 subjects.

Practice Pearls:

  • In obese children with metabolic syndrome, reducing added sugar consumption, but keeping calories and carbohydrate percentages the same results in metabolic syndrome improvements across the board in just 9 days of intervention.
  • These results suggest widespread and immediate benefits from reducing intake of added sugar and fructose in foods such as sodas and sweets.
  • Despite the positive results, lifestyle modifications to improve metabolic syndrome should be comprehensive and involve more than just limiting sugar intake, such as weight loss and salt intake reduction.

Lustig RH, Mulligan K, Noworolski SM, et al. Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome. Obesity (Silver Spring). 2015