ESPE Abstracts (2016) 86 P-P2-497

Cardiometabolic Effect of Sugar-Sweetened Beverages Reduction in Obese Children

Júlia Galhardoa, Catarina Diamantinob, Anabela Alonsoa & Lurdes Lopesa

aDiabetes and Paediatric Endocrinology Unit, Centro Hospitalar de Lisboa Central – Hospital de Dona Estefânia, Lisbon, Portugal; bPaediatrics Department, Centro Hospitalar de Lisboa Central – Hospital de Dona Estefânia, Lisbon, Portugal

Background: The excessive consumption of sucrose, primarily used in sweetened beverages, has been considered an important inducer of cardiometabolic diseases. Besides the association between metabolic syndrome and fructose found in animal models, literature is lacking prospective studies in humans, especially in paediatric ages.

Objective and hypotheses: We assessed the effect of sugar-sweetened beverages reduction on markers of metabolic syndrome in obese children.

Method: This was a prospective analysis of the first 200 pre-pubertal patients admitted to our hospital-based obesity clinic, during 2015 (mean BMI z-score 3.41±0.54). To access dietary intake, children were asked to make a three 24 h-recall weekly. Sugar-added beverages were quantified as number of servings, and sucrose intake was calculated. During the first 4 weeks, patients had their usual diet. For the next 24 weeks, they were asked to restrict sugar-added beverages to one serving a week, keeping everything else as previously.

Results: At baseline, mean daily sucrose intake was 219±62 g, of which 144±14 g (about 66%) from sugar-sweetened beverages; mean systolic and diastolic BP z-scores were 1.8±0.6 and 1.7±0.4 respectively; median HOMA-IR was 3.57 (1.34–6.43); mean uric acid was 4.1±1.9 mg/dl; median triglycerides was 132 (72–201) mg/dl. After adjustment for potential confounders, the reduction of beverages to one serving a week was associated to a decrease of: 0.5 (95% CI, 0.3–0.7) and 0.4 (95% CI, 0.2–0.6) in systolic and diastolic BP z-scores correspondingly; 1.7 mg/dl (95% CI, 1.0–2.2) in uric acid; 44 mg/dl (95% CI, 21–55) in triglycerides; 19 mg/dl in apolipoprotein B (95% CI, 13–25); 41.9 μUI/ml (95% CI, 27.3–56.5) in insulin at 30′ of OGTT; 2.2 ng/ml (95% CI, 1.3–3.1) in leptin. No association was found for HOMA-IR.

Conclusion: Our results provide additional evidence supporting a positive relationship between sugar-sweetened beverages reduction and the improvement of important markers of metabolic syndrome. Therefore, controlling its consumption by children is an efficient and urgent measure of public health worldwide.

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