Reduction in risk factors for type 2 diabetes mellitus in response to a low-sugar, high-fiber dietary intervention in overweight Latino adolescents

Arch Pediatr Adolesc Med. 2009 Apr;163(4):320-7. doi: 10.1001/archpediatrics.2009.11.

Abstract

Objective: To examine if reductions in added sugar intake or increases in fiber intake in response to a 16-week intervention were related to improvements in metabolic outcomes related to type 2 diabetes mellitus risk.

Design: Secondary analysis of a randomized control trial.

Setting: Intervention classes at a lifestyle laboratory and metabolic measures at the General Clinical Research Center.

Participants: Fifty-four overweight Latino adolescents (mean [SD] age, 15.5 [1] years). Intervention Sixteen-week study with 3 groups: control, nutrition, or nutrition plus strength training.

Main outcome measures: Body composition by dual-energy x-ray absorptiometry; visceral adipose tissue by magnetic resonance imaging; glucose and insulin incremental area under the curve by oral glucose tolerance test; insulin sensitivity, acute insulin response, and disposition index by intravenous glucose tolerance test; and dietary intake by 3-day records.

Results: Fifty-five percent of all participants decreased added sugar intake (mean decrease, 47 g/d) and 59% increased fiber intake (mean increase, 5 g/d), and percentages were similar in all intervention groups, including controls. Those who decreased added sugar intake had an improvement in glucose incremental area under the curve (-15% vs +3%; P = .049) and insulin incremental area under the curve (-33% vs -9%; P = .02). Those who increased fiber intake had an improvement in body mass index (-2% vs +2%; P = .01) and visceral adipose tissue (-10% vs no change; P = .03).

Conclusions: Individuals who reduced added sugar intake by the equivalent of 1 can of soda per day or increased fiber intake by the equivalent of a cup of beans showed improvements in key risk factors for type 2 diabetes, specifically in insulin secretion and visceral fat. Improvements occurred independent of group assignment and were equally likely to occur in control group participants.

Trial registration: ClinicalTrials.gov NCT00697580.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Anthropometry
  • Blood Glucose / analysis
  • Body Composition
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diet, Diabetic / methods*
  • Dietary Carbohydrates
  • Dietary Fiber / administration & dosage*
  • Female
  • Glucose Tolerance Test
  • Glycemic Index
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Male
  • Multivariate Analysis
  • Obesity / diet therapy*
  • Obesity / ethnology
  • Obesity / prevention & control*
  • Primary Prevention / methods
  • Probability
  • Prognosis
  • Reference Values
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Blood Glucose
  • Dietary Carbohydrates
  • Dietary Fiber

Associated data

  • ClinicalTrials.gov/NCT00697580