{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T15:48:46Z","timestamp":1788191326011,"version":"build-2803163510"},"reference-count":38,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T00:00:00Z","timestamp":1690416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R01 MD010358"],"award-info":[{"award-number":["R01 MD010358"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["MD017344"],"award-info":[{"award-number":["MD017344"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Pediatric obesity and cardiometabolic disease disproportionately impact minority communities. Sugar reduction is a promising prevention strategy with consistent cross-sectional associations of increased sugar consumption with unfavorable biomarkers of cardiometabolic disease. Few trials have tested the efficacy of pediatric sugar reduction interventions. Therefore, in a parallel-design trial, we randomized Latino youth with obesity (BMI \u2265 95th percentile) [n = 105; 14.8 years] to control (standard diet advice) or sugar reduction (clinical intervention with a goal of \u226410% of calories from free sugar) for 12-weeks. Outcomes included changes in glucose tolerance and its determinants as assessed by a 2-h frequently sample oral glucose tolerance test, fasting serum lipid profile (total cholesterol, HDL, LDL, triglycerides, cholesterol:HDL), and inflammatory markers (CRP, IL-6, TNF-\u03b1). Free sugar intake decreased in the intervention group compared to the control group [11.5% to 7.3% vs. 13.9% to 10.7% (% Energy), respectively, p = 0.02], but there were no effects on any outcome of interest (pall &gt; 0.07). However, an exploratory analysis revealed that sugar reduction, independent of randomization, was associated with an improved Oral-disposition index (p &lt; 0.001), triglycerides (p = 0.049), and TNF-\u03b1 (p = 0.02). Dietary sugar reduction may have the potential to reduce chronic disease risks through improvements in beta-cell function, serum triglycerides, and inflammatory markers in Latino adolescents with obesity.<\/jats:p>","DOI":"10.3390\/nu15153338","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T02:08:00Z","timestamp":1690510080000},"page":"3338","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Dietary Sugar Reduction on Biomarkers of Cardiometabolic Health in Latino Youth: Secondary Analyses from a Randomized Controlled Trial"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9916-1634","authenticated-orcid":false,"given":"Kelsey A.","family":"Schmidt","sequence":"first","affiliation":[{"name":"Department of Pediatrics, The Saban Research Institute, Children\u2019s Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA 90027, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pari","family":"Mokhtari","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Saban Research Institute, Children\u2019s Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA 90027, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1773-0099","authenticated-orcid":false,"given":"Elizabeth A.","family":"Holzhausen","sequence":"additional","affiliation":[{"name":"Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7751-9543","authenticated-orcid":false,"given":"Tanya L.","family":"Alderete","sequence":"additional","affiliation":[{"name":"Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2384-5239","authenticated-orcid":false,"given":"Hooman","family":"Allayee","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5735-3550","authenticated-orcid":false,"given":"Krishna S.","family":"Nayak","sequence":"additional","affiliation":[{"name":"Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA 90089, USA"},{"name":"Alfred E. Mann Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank R.","family":"Sinatra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2281-641X","authenticated-orcid":false,"given":"Trevor A.","family":"Pickering","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2474-7921","authenticated-orcid":false,"given":"Wendy","family":"Mack","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Kohli","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Pediatrics, Children\u2019s Hospital Los Angeles, Los Angeles, CA 90027, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6897-6961","authenticated-orcid":false,"given":"Michael I.","family":"Goran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Saban Research Institute, Children\u2019s Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA 90027, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e20173459","DOI":"10.1542\/peds.2017-3459","article-title":"Prevalence of Obesity and Severe Obesity in US Children, 1999\u20132016","volume":"141","author":"Skinner","year":"2018","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1515\/jpem-2019-0369","article-title":"Prevalence of metabolic syndrome and its associated factors in overweight and obese adolescents","volume":"33","author":"Dejavitte","year":"2020","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2184","DOI":"10.2337\/diacare.25.12.2184","article-title":"Insulin resistance and associated compensatory responses in african-american and Hispanic children","volume":"25","author":"Goran","year":"2002","journal-title":"Diabetes Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"81","DOI":"10.3945\/jn.113.182519","article-title":"Consumption of added sugars from liquid but not solid sources predicts impaired glucose homeostasis and insulin resistance among youth at risk of obesity","volume":"144","author":"Wang","year":"2014","journal-title":"J. Nutr."},{"key":"ref_5","first-page":"1669","article-title":"Intake of total dietary sugar and fibre is associated with insulin resistance among Danish 8\u201310- and 14\u201316-year-old girls but not boys","volume":"13","author":"Kynde","year":"2010","journal-title":"European Youth Heart Studies I and II. Public Health Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1111\/j.2047-6310.2012.00108.x","article-title":"Adiposity and glucose intolerance exacerbate components of metabolic syndrome in children consuming sugar-sweetened beverages: QUALITY cohort study","volume":"8","author":"Wang","year":"2013","journal-title":"Pediatr. Obes."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1743-7075-7-10","article-title":"Carbohydrate intake and cardiometabolic risk factors in high BMI African American children","volume":"7","author":"Sharma","year":"2010","journal-title":"Nutr. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1001\/archpediatrics.2009.21","article-title":"Relationship between insulin resistance-associated metabolic parameters and anthropometric measurements with sugar-sweetened beverage intake and physical activity levels in US adolescents: Findings from the 1999\u20132004 National Health and Nutrition Examination Survey","volume":"163","author":"Bremer","year":"2009","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1093\/ajcn\/82.5.1004","article-title":"The relation of sugar intake to beta cell function in overweight Latino children","volume":"82","author":"Davis","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e1017","DOI":"10.1161\/CIR.0000000000000439","article-title":"Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement from the American Heart Association","volume":"135","author":"Vos","year":"2017","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/j.jpeds.2009.01.015","article-title":"Sugar-sweetened beverages, serum uric acid, and blood pressure in adolescents","volume":"154","author":"Nguyen","year":"2009","journal-title":"J. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"46","DOI":"10.3945\/ajcn.113.076505","article-title":"Added sugars in the diet are positively associated with diastolic blood pressure and triglycerides in children","volume":"100","author":"Kell","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s00394-020-02229-w","article-title":"Influence of total sugar intake on metabolic blood markers at 8 years of age in the Childhood Obesity Project","volume":"60","author":"Aumueller","year":"2021","journal-title":"Eur. J. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.ypmed.2017.04.035","article-title":"Discouraging soft drink consumption reduces blood glucose and cholesterol of Brazilian elementary students: Secondary analysis of a randomized controlled trial","volume":"100","author":"Mediano","year":"2017","journal-title":"Prev. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1089\/met.2006.0038","article-title":"Reduction in added sugar intake and improvement in insulin secretion in overweight latina adolescents","volume":"5","author":"Davis","year":"2007","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1001\/archpediatrics.2009.11","article-title":"Reduction in risk factors for type 2 diabetes mellitus in response to a low-sugar, high-fiber dietary intervention in overweight Latino adolescents","volume":"163","author":"Ventura","year":"2009","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1542","DOI":"10.1038\/oby.2009.19","article-title":"Randomized control trial to improve adiposity and insulin resistance in overweight Latino adolescents","volume":"17","author":"Davis","year":"2009","journal-title":"Obesity"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1038\/oby.2010.343","article-title":"Randomized controlled trial to improve adiposity, inflammation, and insulin resistance in obese African-American and Latino youth","volume":"20","author":"Hasson","year":"2012","journal-title":"Obesity"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1093\/jn\/nxac046","article-title":"Clinical Intervention to Reduce Dietary Sugar Does Not Affect Liver Fat in Latino Youth, Regardless of PNPLA3 Genotype: A Randomized Controlled Trial","volume":"152","author":"Schmidt","year":"2022","journal-title":"J. Nutr."},{"key":"ref_20","unstructured":"(2023, June 18). U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2015\u20132020 Dietary Guidelines for Americans, 8th ed. December 2015, Available online: http:\/\/health.gov\/dietaryguidelines\/2015\/guidelines\/."},{"key":"ref_21","unstructured":"Center for Nutrition Policy and Promotion (U.S.) (2023, June 18). Getting Started with MyPlate: ChooseMyPlate.gov, Available online: https:\/\/www.myplate.gov\/."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.2337\/diacare.22.9.1462","article-title":"Insulin sensitivity indices obtained from oral glucose tolerance testing: Comparison with the euglycemic insulin clamp","volume":"22","author":"Matsuda","year":"1999","journal-title":"Diabetes Care"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Herzberg-Sch\u00e4fer, S.A., Staiger, H., Heni, M., Ketterer, C., Guthoff, M., Kantartzis, K., Machicao, F., Stefan, N., Haring, H., and Fritsche, A. (2010). Evaluation of fasting state-\/oral glucose tolerance test-derived measures of insulin release for the detection of genetically impaired \u03b2-cell function. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0014194"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"E1159","DOI":"10.1152\/ajpendo.00093.2002","article-title":"Meal and oral glucose tests for assessment of beta -cell function: Modeling analysis in normal subjects","volume":"283","author":"Mari","year":"2002","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_25","unstructured":"National Health and Nutrition Examination Survey (U.S.), National Center for Health Statistics (U.S.), and Westat (2023, June 18). National Health and Nutrition Examination Survey III: Body Measurements (Anthropometry) Manual, Available online: https:\/\/stacks.cdc.gov\/view\/cdc\/53134."},{"key":"ref_26","unstructured":"Lohman, G.T., Roche, A.F., and Martorell, R. (1988). Anthropometric Standardization Reference Manual, Human Kinetics Books."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1097\/00005768-199701000-00020","article-title":"Validation of an Instrument for Measurement of Physical Activity in Youth","volume":"29","author":"Weston","year":"1997","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_28","unstructured":"R Core Team, R. (2021). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing."},{"key":"ref_29","unstructured":"Team, R (2021). RStudio: Integrated Development Environment for R, PBC."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.ijsu.2011.10.001","article-title":"CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials","volume":"10","author":"Moher","year":"2012","journal-title":"Int. J. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"335","DOI":"10.2337\/dc08-1478","article-title":"Oral disposition index predicts the development of future diabetes above and beyond fasting and 2-h glucose levels","volume":"32","author":"Utzschneider","year":"2009","journal-title":"Diabetes Care"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2796","DOI":"10.2337\/diabetes.51.9.2796","article-title":"Preservation of pancreatic beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk hispanic women","volume":"51","author":"Buchanan","year":"2002","journal-title":"Diabetes"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1542\/peds.105.3.671","article-title":"Type 2 diabetes in children and adolescents. American Diabetes Association","volume":"105","author":"Association","year":"2000","journal-title":"Pediatrics"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1161\/CIRCULATIONAHA.110.972166","article-title":"Consumption of added sugars and indicators of cardiovascular disease risk among US adolescents","volume":"123","author":"Welsh","year":"2011","journal-title":"Circulation"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.jand.2012.10.020","article-title":"The relationships between sugar-sweetened beverage intake and cardiometabolic markers in young children","volume":"113","author":"Kosova","year":"2013","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1089\/jmf.2017.0126","article-title":"Limiting Dietary Sugar Improves Pediatric Sinonasal Symptoms and Reduces Inflammation","volume":"21","author":"Sawani","year":"2018","journal-title":"J. Med. Food"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1001\/jama.2021.5469","article-title":"The Leading Causes of Death in the US for 2020","volume":"325","author":"Ahmad","year":"2021","journal-title":"JAMA"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e7492","DOI":"10.1136\/bmj.e7492","article-title":"Dietary sugars and body weight: Systematic review and meta-analyses of randomised controlled trials and cohort studies","volume":"346","author":"Mallard","year":"2012","journal-title":"BMJ"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/15\/3338\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:20:34Z","timestamp":1760127634000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/15\/3338"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,27]]},"references-count":38,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["nu15153338"],"URL":"https:\/\/doi.org\/10.3390\/nu15153338","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,27]]}}}