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Emily Ventura, MPH; Jaimie Davis, PhD, RD; Courtney Byrd-Williams; Katharine Alexander, MS; Arianna McClain; Christianne Joy Lane, MS; Donna Spruijt-Metz, PhD; Marc Weigensberg, MD; Michael Goran, PhD

Arch Pediatr Adolesc Med. 2009;163(4):320-327.

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 Identifier: NCT00697580

Author Affiliations: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles (Mss Ventura, Byrd-Williams, Alexander, McClain, and Lane and Drs Davis, Spruijt-Metz, and Goran); and Department of Pediatrics, Los Angeles County–University of Southern California Medical Center (Dr Weigensberg).

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