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Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome

In 43 Latino and African-American children with obesity and metabolic syndrome, nine days of isocaloric substitution of dietary sugar (28% to 10% of calories, replaced with starch) improved diastolic blood pressure, lipid fractions, and oral glucose tolerance with lower hyperinsulinemia despite modest mean weight change.

Design

Open feeding study with isocaloric macronutrient matching to baseline self-reported intake; dietary sugar reduced from ~28% to ~10% of calories with starch substitution (9 days on protocol; assessments Days 0 and 10).

Key outcomes (abstract)

  • DBP: −5 mmHg (P = 0.002)
  • LDL-C: −46% and −0.3 mmol/L (P < 0.001); triglycerides fell (P < 0.001); lactate −0.3 mmol/L (P < 0.001)
  • OGTT: glucose tolerance and hyperinsulinemia improved (P < 0.001)
  • Weight: mean −0.9 ± 0.2 kg (P < 0.001); FFM −0.6 kg (P = 0.04); post hoc n = 10 no-weight-loss subgroup remained directionally consistent

Evidence hygiene

Short, highly controlled feeding paradigm in a specific paediatric metabolic-syndrome phenotype—not a long-term ad libitum sugar policy trial; do not substitute for TRE/IF windows on other slugs.

Publication

Lustig RH, Mulligan K, Noworolski SM, et al. Obesity (Silver Spring). 2016 Feb;24(2):453-460. PMID 26499447.

Outcomes

  • Diastolic Blood Pressure
    -5
    mmHg (Millimetres of Mercury)
  • LDL cholesterol ~46% lower with parallel ~0.3 mmol/L absolute reduction (P < 0.001); glucose tolerance and hyperinsulinemia improved on OGTT (P < 0.001) despite small mean weight change.
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