Sugars and risk of mortality in the NIH-AARP Diet and Health Study. The Effect of Normally Consumed Amounts of Sucrose or High Fructose Corn Syrup on Lipid Profiles, Body Composition and Related Parameters in Overweight/Obese Subjects Effects of weight loss vs aerobic exercise training on risk factors for coronary disease in healthy, obese, middle-aged and older men. A randomized controlled trial. The Effects of Physiologic Amounts of Simple Sugars on Lipoprotein, Glucose, and Insulin Levels in Normal Subjects Sugars in diet and risk of cancer in the NIH‐AARP Diet and Health Study The influence of obesity-related factors in the etiology of renal cell carcinoma—A mendelian randomization study Effects of a classroom-based weight-control intervention on cardiovascular disease in elementary-school obese children. Fasting glucose is a risk factor for breast cancer: a prospective study. Do sugar-sweetened beverages cause adverse health outcomes in children? A systematic review protocol The Association between Carbohydrate-Rich Foods and Risk of Cardiovascular Disease Is Not Modified by Genetic Susceptibility to Dyslipidemia as Determined by 80 Validated Variants Randomized, controlled trial promotes physical activity and reduces consumption of sweets and sodium among overweight and obese adults. Reduction in risk factors for type 2 diabetes mellitus in response to a low-sugar, high-fiber dietary intervention in overweight Latino adolescents. Effects of diet and exercise on common cardiovascular disease risk factors in moderately obese older women. Energy compensation following consumption of sugar-reduced products: a randomized controlled trial Effect of obesity intervention programs on adipokines, insulin resistance, lipid profile, and low-grade inflammation in 3- to 5-y-old children Liquid meal replacements and glycemic control in obese type 2 diabetes patients. Low-fat diet: effect on anthropometrics, blood pressure, glucose, and insulin in older women.
BACKGROUND Although previous studies have linked intake of sugars with incidence of cancer and other chronic diseases , its association with mortality remains unknown . OBJECTIVE We investigated the association of total sugars , added sugars , total fructose , added fructose , sucrose , and added sucrose with the risk of all-cause , cardiovascular disease , cancer , and other-cause mortality  in the NIH-AARP Diet and Health Study . DESIGN The participants ( n = 353,751 ) , aged 50 - 71 y , were followed for up to 13 y. Intake of individual sugars over the previous 12 mo was assessed at baseline by using a 124-item NIH Diet History Question naire . RESULTS In fully adjusted models ( fifth quartile compared with first quartile ) , all-cause mortality was positively associated with the intake of total sugars [ HR ( 95 % CI ) : 1.13 ( 1.06 , 1.20 ) ; P-trend < 0.0001 ] , total fructose [ 1.10 ( 1.04 , 1.17 ) ; P-trend < 0.0001 ] , and added fructose [ 1.07 ( 1.01 , 1.13 ) ; P-trend = 0.005 ) in women and total fructose [ 1.06 ( 1.01 , 1.10 ) ; P-trend = 0.002 ] in men . In men , a weak inverse association was found between other-cause mortality and dietary added sugars  ( P-trend = 0.04 ) , sucrose ( P-trend = 0.03 ) , and added sucrose ( P-trend = 0.006 ) . Investigation of consumption of sugars by source showed that the positive association with mortality risk was confined only to sugars from beverages , whereas the inverse association was confined to sugars from solid foods . CONCLUSIONS In this large prospect i ve study , total fructose intake was weakly positively associated with  all-cause mortality in both women and men , whereas added sugar , sucrose , and added sucrose intakes were inversely associated with other-cause mortality in men . In our analyses , intake of added sugars was not associated with an increased risk of mortality . The NIH-AARP Diet and Health Study was registered at clinical trials.gov as NCT00340015 The American Heart Association ( AHA ) has advocated that women and men not consume more than 100 and 150 kcal/day , respectively , from added sugars . These levels are currently exceeded by over 90 % of the adult population in the United States . Few data exist on longer-term metabolic effects when sucrose and High Fructose Corn Syrup ( HFCS ) , the principal sources of added dietary sugars , are consumed at levels typical of the general population . Sixty five overweight and obese individuals were placed on a eucaloric ( weight stable ) diet for 10-weeks , which incorporated sucrose- or HFCS-sweetened , low-fat milk at 10 % or 20 % of calories in a r and omized , double-blinded study . All groups responded similarly ( interaction p > 0.05 ) . There was no change in body weight in any of the groups over the 10-week study , or in systolic or diastolic blood pressure . Likewise , there were no changes in total cholesterol , triglycerides , low-density lipoprotein ( LDL ) , or apolipoprotein B ( Apo B ) . We conclude that ( 1 ) when consumed as part of a eucaloric diet fructose — when given with glucose ( as normally consumed ) does not promote weight gain or an atherogenic lipid profile even when consumed at two to four times the level recently recommended by the AHA . ( 2 ) There were no differences between HFCS and sucrose on these parameters OBJECTIVE To compare the effects of weight loss vs aerobic exercise training on coronary artery disease risk factors in healthy sedentary , obese , middle-aged and older men . DESIGN R and omized controlled trial . SUBJECTS A total of 170 obese ( body mass index , 30 + /- 1 kg/m2 [ mean + /- SEM ] ) , middle-aged and older ( 61 + /- 1 years ) men . INTERVENTIONS A 9-month diet-induced weight loss interventions , 9-month aerobic exercise training program , and a weight-maintenance control group . MAIN OUTCOME MEASURES Change in body composition , maximal aerobic capacity ( V02 max ) , blood pressure , lipoprotein concentrations , and glucose tolerance . RESULTS Forty-four of 73 men r and omized to weight loss completed the intervention and had a 10 % mean reduction in weight ( - 9.5 + /- 0.7 kg ; P < .001 ) , with no 22 change in VO2 max . Forty-nine of 71 men r and omized to aerobic exercise completed the intervention , increased their VO2 max by a mean of 17 % ( P < .001 ) , and did not change their weight , whereas the 18 men who completed in the control group had no significant changes in body composition or VO2 max . Weight loss decreased fasting glucose concentrations by 2 % , insulin by 18 % , and glucose and insulin areas during the oral glucose tolerance test ( OGTT ) by 8 % and 26 % , respectively ( P < .01 ) . By contrast , aerobic exercise did not improve fasting glucose or insulin concentrations or glucose responses during the OGTT but decreased insulin areas by 17 % ( P < .001 ) . In analysis of variance , the decrement in fasting glucose and insulin levels and glucose areas with intervention differed between weight loss and aerobic exercise when compared with the control group ( P < .05 ) . Similarly , weight loss but not aerobic exercise increased high-density lipoprotein cholesterol levels ( + 13 % ) and decreased blood pressure compared with the control group . In multiple regression analyses , the improvement in lipoprotein and glucose metabolism was related primarily to the reduction in obesity . CONCLUSIONS These results suggest that weight loss is the preferred treatment to improve coronary artery disease risk factors in overweight , middle-aged and older men Using a crossover design , eight healthy volunteers r and omly received physiologic amounts ( ⅓ of each subject 's total carbohydrate intake ) of either fructose or sucrose as the primary source of simple sugar , incorporated into isocaloric diets comprised of typical American foods . After 7 and 14 days of consuming either of the two sugars , no change occurred in fasting glucose or insulin levels . In addition , total triglyceride , totalcholesterol , low-density-lipoprotein ( LDL ) cholesterol , and high-density-lipoprotein ( HDL ) cholesterol concentrations were unaltered . Since our study used conventional foods in normal eating patterns rather than contrived formulas or excessive amounts of simple sugar , our data indicate that there is no difference between sucrose or fructose on various lipid components or glucose and fasting insulin levels in the “ real world ” innormal subjects Prospect i ve epidemiologic data on the effects of different types of dietary sugars on cancer incidence have been limited . In this report , we investigated the association of total sugars , sucrose , fructose , added sugars , added sucrose and added fructose in the diet with risk of 24 malignancies . Participants ( n = 435,674 ) aged 50–71 years from the NIH‐AARP Diet and Health Study were followed for 7.2 years . The intake of individual sugars was assessed using a 124‐item food frequency question naire ( FFQ ) . Cox proportional hazards regression was used to estimate hazard ratios ( HR ) and 95 % confidence intervals ( CI ) in multivariable models adjusted for confounding factors pertinent to individual cancers . We identified 29,099 cancer cases in men and 13,355 cases in women . In gender‐combined analyses , added sugars were positively associated with risk of esophageal adenocarcinoma ( HRQ5 vs. Q1 : 1.62 , 95 % CI : 1.07–2.45 ; ptrend = 0.01 ) , added fructose was associated with risk of small intestine cancer ( HRQ5 vs. Q1 : 2.20 , 95 % CI : 1.16–4.16 ; ptrend = 0.009 ) and all investigated sugars were associated with increased risk of pleural cancer . In women , all investigated sugars were inversely associated with ovarian cancer . We found no association between dietary sugars and risk of colorectal or any other major cancer . Measurement error in FFQ‐reported dietary sugars may have limited our ability to obtain more conclusive findings . Statistically significant associations observed for the rare cancers are of interest and warrant further investigation Background Several obesity-related factors have been associated with renal cell carcinoma ( RCC ) , but it is unclear which individual factors directly influence risk . We addressed this question using genetic markers as proxies for putative risk factors and evaluated their relation to RCC risk in a mendelian r and omization ( MR ) framework . This methodology limits bias due to confounding and is not affected by reverse causation . Methods and findings Genetic markers associated with obesity measures , blood pressure , lipids , type 2 diabetes , insulin , and glucose were initially identified as instrumental variables , and their association with RCC risk was subsequently evaluated in a genome-wide association study ( GWAS ) of 10,784 RCC patients and 20,406 control participants in a 2- sample MR framework . The effect on RCC risk was estimated by calculating odds ratios ( ORSD ) for a st and ard deviation ( SD ) increment in each risk factor . The MR analysis indicated that higher body mass index increases the risk of RCC ( ORSD : 1.56 , 95 % confidence interval [ CI ] 1.44–1.70 ) , with comparable results for waist-to-hip ratio ( ORSD : 1.63 , 95 % CI 1.40–1.90 ) and body fat percentage ( ORSD : 1.66 , 95 % CI 1.44–1.90 ) . This analysis further indicated that higher fasting insulin ( ORSD : 1.82 , 95 % CI 1.30–2.55 ) and diastolic blood pressure ( DBP ; ORSD : 1.28 , 95 % CI 1.11–1.47 ) , but not systolic blood pressure ( ORSD : 0.98 , 95 % CI 0.84–1.14 ) , increase the risk for RCC . No association with RCC risk was seen for lipids , overall type 2 diabetes , or fasting glucose . Conclusions This study provides novel evidence for an etiological role of insulin in RCC , as well as confirmatory evidence that obesity and DBP influence RCC risk BACKGROUND Childhood obesity has become a growing public health issue in Taiwan . Obese children have risk factors for type 2 diabetes and cardiovascular disease . In this prospect i ve study , we investigated the effect of a twelve-week heart health education and physical activity program on body weight and risk factors for type 2 diabetes and cardiovascular disease . METHODS Subjects were 120 obese fifth grade rs ( 65 boys and 55 girls , aged 10 - 13 years ( mean 10.6 yrs ) , body mass index ( BMI ) at the 95th percentile or more ) and were r and omly assigned to an intervention group ( n=60 ) or control group ( n=60 ) . The intervention group received a twelve-week heart health education and physical activity program , while the control group did not . In both groups , a series of examinations were done at baseline and post-test , including height , weight , BMI , body fat , blood pressure ( BP ) , physical fitness ( 800-meter running test ) , heart health knowledge , and serum biochemistry . Differences for baseline and post-test data were compared between both groups . RESULTS Mean changes in the intervention group versus control group were significant for weight ( P = 0.024 ) , BMI ( P = 0.047 ) , percentage body fat ( P = 0.008 ) , physical fitness ( 800-meter running test ) ( P = 0.025 ) , heart health knowledge ( P = 0.006 ) , total cholesterol ( P = 0.027 ) , triglycerides ( P = 0.018 ) , high-density lipoprotein cholesterol ( HDL-C ) ( P = 0.009 ) , low-density lipoprotein cholesterol ( LDL-C ) ( P = 0.041 ) , sugar ( P = 0.035 ) , insulin ( P = 0.007 ) , and insulin resistance ( HOMA-IR ) ( P = 0.028 ) . At post-test , weight , BMI , body fat , total cholesterol , triglycerides , LDL-C , sugar , insulin and HOMA-IR had decreased , but HDL-C had increased in the intervention group . CONCLUSIONS A classroom-based weight-control intervention provides educational programs to promote cardiovascular health in children . This intervention is simple , practical , and beneficial for elementary school children There is some evidence that glucose and other factors related to glucose metabolism , such as insulin and insulin-like growth-factors ( IGFs ) may contribute to breast cancer development . The present study analyzed the hypothesis that serum glucose , insulin levels , and IGF-I pattern are associated with breast cancer using a nested case-control study . Between 1987 and 1992 , 10,786 women ages 35 - 69 were recruited in a prospect i ve study in Italy . Women with history of cancer and on hormone therapy were excluded at baseline . At recruitment ,  blood sample s were collected after a 12-h fast between 7:30 and 9:00 a.m. from all of the study participants . After 5.5 years , 144 breast cancer cases were identified among the participants of the cohort . Four matched controls were chosen for each breast cancer case from members of the cohort who did not develop breast cancer during the follow-up period . In premenopausal women , glucose was associated with breast cancer risk : the age , body mass index , and reproductive variable adjusted relative risk ( RR ) for the highest quartile of serum glucose versus the lowest was 2.8 [ 95 % confidence interval ( CI ) , 1.2 - 6.5 ] , and P for trend was 0.02 . Insulin showed a weaker association with breast cancer , the adjusted RR of the highest quartile versus the lowest was 1.7 ( 95 % CI , 0.7 - 4.1 ) , and P for trend was 0.14 , whereas the adjusted RR of the highest quartile of IGF-I was 3.1 ( 95 % CI , 1.1 - 8.6 ) , and P for trend was 0.01 . Increased levels of insulin-like growth factor binding protein-3 (IGFBP)-3 were related to breast cancer risk : the adjusted RR for the highest quartile was 2.1 ( 95 % CI , 0.95 - 4.75 ) , and P for trend was 0.02 . In postmenopausal women , the associations of glucose , insulin , and IGF-1 pattern were associated with breast cancer risk in heavier subjects characterized by a body mass index higher than 26 . These results indicate that chronic alteration of glucose metabolism is related to breast cancer development Background Cardiovascular disease and type 2 diabetes are examples of chronic diseases that impose significant morbidity and mortality in the general population worldwide . Most chronic diseases are associated with underlying preventable risk factors , such as elevated blood pressure , high blood glucose or glucose intolerance , high lipid levels , physical inactivity , excessive sedentary behaviours , and overweight/obesity . The occurrence of intermediate outcomes during childhood increases the risk of disease in adulthood . Sugar-sweetened beverages are known to be significant sources of additional caloric intake , and given recent attention to their contribution in the development of chronic diseases , a systematic review is warranted . We will assess whether the consumption of sugar-sweetened beverages in children is associated with adverse health outcomes and what the potential moderating factors are . Methods / Design Of interest are studies addressing sugar-sweetened beverage consumption , taking a broad perspective . Both direct consumption studies as well as those evaluating interventions that influence consumption ( e.g. school policy , educational ) will be relevant . Non-specific or multi-faceted behavioural , educational , or policy interventions may also be included subject to the level of evidence that exists for the other interventions /exposures . Comparisons of interest and endpoints of interest are pre-specified . We will include r and omized controlled trials , controlled clinical trials , interrupted time series studies , controlled before-after studies , prospect i ve and retrospective comparative cohort studies , case – control studies , and nested case – control design s. The MEDLINE ® , Embase , The Cochrane Library , CINAHL , ERIC , and PsycINFO ® data bases and grey literature sources will be search ed . The processes for selecting studies , abstract ing data , and resolving conflicts are described . We will assess risk of bias using design -specific tools . To determine sets of confounding variables that should be adjusted for , we have developed causal directed acyclic graphs and will use those to inform our risk of bias assessment s. Meta- analysis will be conducted where appropriate ; parameters for exploring statistical heterogeneity and effect modifiers are pre-specified . The Grading of Recommendations Assessment , Development and Evaluation ( GRADE ) approach will be used to determine the quality of evidence for outcomes . Systematic review registration PROSPERO CRD42014009641 Background It is still unclear whether carbohydrate consumption is associated with cardiovascular disease ( CVD ) risk . Genetic susceptibility might modify the associations between dietary intakes and disease risk . Objectives The aim was to examine the association between the consumption of carbohydrate-rich foods ( vegetables , fruits and berries , juice , potatoes , whole grains , refined grains , cookies and cakes , sugar and sweets , and sugar-sweetened beverages ) and the risk of incident ischemic CVD ( iCVD ; coronary events and ischemic stroke ) , and whether these associations differ depending on genetic susceptibility to dyslipidemia . Methods Among 26,445 individuals ( 44–74 years ; 62 % females ) from the Malmö Diet and Cancer Study cohort , 2,921 experienced an iCVD event during a mean follow-up time of 14 years . At baseline , dietary data were collected using a modified diet history method , and clinical risk factors were measured in 4,535 subjects . We combined 80 vali date d genetic variants associated with triglycerides and HDL-C or LDL-C , into genetic risk scores and examined the interactions between dietary intakes and genetic risk scores on the incidence of iCVD . Results Subjects in the highest intake quintile for whole grains had a 13 % ( 95 % CI : 3–23 % ; p-trend : 0.002 ) lower risk for iCVD compared to the lowest quintile . A higher consumption of foods rich in added sugar ( sugar and sweets , and sugar-sweetened beverages ) had a significant cross-sectional association with higher triglyceride concentrations and lower HDL-C concentrations . A stronger positive association between a high consumption of sugar and sweets on iCVD risk was observed among those with low genetic risk score for triglycerides ( p-interaction=0.05 ) . Conclusion In this prospect i ve cohort study that examined food sources of carbohydrates , individuals with a high consumption of whole grains had a decreased risk of iCVD . No convincing evidence of an interaction between genetic susceptibility for dyslipidemia , measured as genetic risk scores of dyslipidemia-associated variants , and the consumption of carbohydrate-rich foods on iCVD risk was observed The present study sought to assess the impact of an intervention to reduce weight and control risk factors of noncommunicable chronic diseases in overweight or obese adults who are users of primary and secondary healthcare units of the public health system of Pelotas , Brazil . We hypothesized that individuals who received an educational intervention regarding how to lose weight and prevent other noncommunicable chronic disease risk factors through nutrition would lose weight and acquire active habits during leisure time more frequently than individuals under regular care . Two hundred forty-one participants from the Nutrition Outpatient Clinic of the Medical Teaching Hospital of the Federal University of Pelotas , Brazil , aged 20 years or older and classified as overweight or obese were r and omly allocated to either the intervention group ( IG ; n = 120 ) or control group ( CG ; n = 121 ) . The IG received individualized nutritional care for 6 months , and the CG received individualized usual care of the health services . Intention-to-treat analyses showed that at 6 months , mean fasting glycemia and daily consumption of sweet foods and sodium were reduced , and the time spent on physical leisure activity was increased in IG . Analysis of adherence to the protocol of the study revealed that individuals from IG had lost more in body weight , waist circumference , and fasting glucose compared to the CG . Leisure time physical activity increased in IG . Individuals adhered equally to the dietetic recommendations , irrespective of the nutrition approach that was used 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 r and omized 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 Diet and exercise studies of premenopausal women have shown reductions in obesity and other cardiovascular disease ( CVD ) risk factors . Forty-one healthy , moderately obese ( 120 - 140 % of ideal body weight , LBW ) , postmenopausal women ( 65.6 + /- 3.3 y ) participating in 24-wk diet or diet + exercise programs  were studied to determine whether similar CVD risk reduction would occur . Daily energy need ( DEN ) was estimated from basal energy expenditure and self-reported activity . The diet + exercise group ( n = 16 ) reduced their daily energy intake ( DEI ) by 2092 kJ from their DEN and expended 837 kJ/d in walking and resistance exercise . The two diet-only groups ( n = 13 and n = 12 ) reduced their DEI by 2092 and 2929 kJ from their DEN , respectively . Body weight , waist-to-hip and subscapula-to-triceps ratios , blood lipids ( total , low-density-lipoprotein , and high-density-lipoprotein cholesterol , and triacylglycerols ) , glucose , and insulin concentrations were measured at baseline and after 12 and 24 wk of diet and diet + exercise . Data were analyzed by using analysis of variance with repeated measures ( P < or = 0.05 ) and Tukey 's post hoc test . Loss of body weight was significant for all groups between baseline and 12 and 24 wk ( baseline : 79.3 + /- 7.6 kg ; 12 wk ; 75.1 + /- 7.7 kg ; 24 wk ; 72.8 + /- 8.0 kg ) but did not differ among groups . No significant time or treatment effects were observed between baseline and 24 wk for changes in mean blood lipid , glucose , and fasting insulin concentrations or measures of body fat distribution . Although 24 wk of diet or diet+exercise significantly reduced body weight in this group , this loss in body weight was not accompanied by a reduction of other commonly accepted CVD risks Purpose Consumption of sugar-reformulated products ( commercially available foods and beverages that have been reduced in sugar content through reformulation ) is a potential strategy for lowering sugar intake at a population level . The impact of sugar-reformulated products on body weight , energy balance ( EB ) dynamics and cardiovascular disease risk indicators has yet to be established . The REFORMulated foods ( REFORM ) study examined the impact of an 8-week sugar-reformulated product exchange on body weight , EB dynamics , blood pressure , arterial stiffness , glycemia and lipemia . Methods A r and omized , controlled , double-blind , crossover dietary intervention study was performed with fifty healthy normal to overweight men and women ( age 32.0 ± 9.8 year , BMI 23.5 ± 3.0 kg/m2 ) who were r and omly assigned to consume either regular sugar or sugar-reduced foods and beverages for 8 weeks , separated by 4-week washout period . Body weight , energy intake ( EI ) , energy expenditure and vascular markers were assessed at baseline and after both interventions . Results We found that carbohydrate ( P < 0.001 ) , total sugars ( P < 0.001 ) and non-milk extrinsic sugars ( P < 0.001 ) ( % EI ) were lower , whereas fat ( P = 0.001 ) and protein ( P = 0.038 ) intakes ( % EI ) were higher on the sugar-reduced than the regular diet . No effects on body weight , blood pressure , arterial stiffness , fasting glycemia or lipemia were observed . Conclusions Consumption of sugar-reduced products , as part of a blinded dietary exchange for an 8-week period , result ed in a significant reduction in sugar intake . Body weight did not change significantly , which we propose was due to energy compensation Background : Childhood obesity can cause the development of cardiovascular risk factors . We assessed the effect of a multidisciplinary intervention program on cardiovascular risk factors and compared this effect with a usual-care program in 3- to 5-y-old overweight or obese children . Methods : Seventy-five children were r and omly assigned to a multidisciplinary intervention or a usual-care program . Anthropometry , body composition , and abdominal adipose tissue were assessed at the start and end of a 16-wk program . Concurrently , fasting concentrations of serum lipids , glucose , insulin , HbA1c , leptin , adiponectin , high-sensitive C-reactive protein ( hsCRP ) , tumor necrosis factor (TNF)-α , and interleukin (IL)-6 were determined . Results : In both groups , insulin sensitivity improved , demonstrated by decreased insulin concentrations and a decreased HOMA2-IR . In the multidisciplinary intervention group , there was also a decrease of HbA1c and TNF-α . In the usual-care group , an increase in glucose concentrations was found . Comparing both groups , changes over time were not different , besides trends in the decrease in total cholesterol and TNF-α , in favor of the multidisciplinary intervention group . Combining the results of both groups , a correlation was found between the decrease in body fat percentage ( BF% ) , and both HOMA2-IR and triglyceride ( TG ) concentrations . Conclusion : In 3- to 5-y-old children , both obesity intervention programs improved insulin sensitivity , in parallel with a reduced BF% OBJECTIVE Although weight management is an important component in the treatment of type 2 diabetes , there has been concern about the use of liquid meal replacements ( MRs ) in treating obese patients with type 2 diabetes because of the sugar content of the MRs . The goal of this study was to evaluate the safety and feasibility of using MRs for weight loss in obese patients with type 2 diabetes . RESEARCH METHODS AND PROCEDURES Seventy-five subjects with type 2 diabetes , treated only with oral agents , were recruited for this 12-week clinical study . Subjects were r and omized into three groups using either a MR containing lactose , fructose , and sucrose , a MR in which fructose and sucrose were replaced with oligosaccharides ( sugar-free Slim-Fast ) , or an exchange diet plan ( EDP ) using the proportion of macronutrients recommended by the American Diabetes Association . RESULTS Fifty-seven patients ( 41 MR and 16 EDP ) finished the study . None developed serious adverse effects , including major hypoglycemic reactions . Weight losses in the MR 1 and MR 2 groups were comparable ( 6.4 % and 6.7 % , respectively ) and greater than the weight loss in the EDP group ( 4.9 % ) . Fasting glucose level was significantly reduced in the MR group compared with the EDP group ( p = 0.012 ) . There was a significant reduction in the MR group in total cholesterol and low-density lipoprotein cholesterol that was not seen in the EDP group . DISCUSSION We have shown that liquid MRs are a safe and effective weight loss tool for obese subjects with type 2 diabetes , and can result in improvements in body weight , glucose , insulin , hemoglobin A1c and lipid levels OBJECTIVE The Women 's Health Trial : Feasibility Study in Minority Population s ( WHT : FSMP ) documented that a low-fat diet was associated with a reduced fat intake in older women of diverse ethnic background s. The purpose of the current study was to examine the effect of the low-fat diet on anthropometric and biochemical variables . DESIGN R and omized clinical trial in 2,208 postmenopausal women , 50 to 79 years of age . RESULTS The decrease in fat intake correlated directly with a decrease in body weight ( r=.22 , P<.001 ) . After 6 months , the intervention group had an average weight loss of 1.8 kg . Body mass index decreased 0.7 kg/m2 . Waist circumference decreased 1.8 cm . All of these changes were statistically significant , compared to changes in the control group ( P<.01 ) . Changes in systolic ( -3.1 mm Hg ) and diastolic ( -1.1 mm Hg ) blood pressures ( BP ) occurred in the intervention group . The decrease in systolic BP reached statistical significance ( P=.02 ) , relative to the control group . Decreases in plasma glucose were small ( -0.2 mmol/L ) in the intervention group , although there was a trend for difference from the control group ( P=.11 ) . Decreases in serum insulin levels were small ( -0.5 microIU/mL ) in the intervention group , although there was , again , a trend for difference from the control group . CONCLUSIONS In older White , Black , and Hispanic women , a long-term low-fat dietary intervention was accompanied by modest , but statistically significant , decreases in body weight and anthropometric indices , without any particular attempt being made to reduce calories . Changes in glucose and insulin were small . The long-term biological significance of the glucose and insulin changes is unknown
Subgroup analyses showed the most marked relation between sugar intakes and lipids in studies in which efforts were made to ensure an energy balance and when no difference in weight change was reported .
CONCLUSIONS Dietary sugars  influence blood pressure and serum lipids .
The relation is independent of effects of  sugars on body weight .
BACKGROUND Dietary sugars have been suggested as a cause of obesity , several chronic diseases , and a range of cardiometabolic risk factors , but there is no convincing evidence of a causal relation between sugars and risk factors other than body weight .
OBJECTIVE We conducted a systematic review and meta- analysis of r and omized controlled trials that examined effects of the modification of dietary free sugars on blood pressure and lipids .