A case Study on Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome

Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome


Fructose has been associated with increased blood pressure by; increasing the sympathetic activity, increasing the rate of sodium reabsorption and elevating the level of uric acid and also  reducing the rate of the rate sodium excretion in the kidney tubules. It has been a common assumption that dietary fructose can be associated with metabolic syndrome. There has been debates about the association of positive caloric balance and the adiposity. This paper seeks to determine if there is any change in the metabolic parameters following the substitution of starch for sugar. The study is conducted using a sample obtained from the populations of 27 Latino  and 16 African American obese children. The study evaluated the implication of short-term isocaloric restriction of fructose in the obese children to determine if metabolic syndrome would reduce metabolic disease.


For the study the participants of the study were selected following weight assessment of teenage children. The selection was limited to Latino children who are associated with a high risk of dyslipidemia and African American children. On the same accord the African American children are linked to a higher risk to type II diabetes mellitus and also hypertension. The study was also limited to those children who were recognized to have high fructose consumption. The exclusion criteria factors included; pregnancy, alcohol use and steroid and neural medication.

The participants of the study were advised to continue with the normal diets. Afterwards they were supposed to go  fasting to the clinical center on the day designated as day 0. on that day, the anthropometric parameters such as blood pressure, oral glucose tolerance rate  were taken. More so, the fat, bone, and the fat free mass measurements were ascertained using the DXA scanning. Subsequently all the participants were provided with a weight scale and advised to take weight measurements daily.

Additionally the participants were also instructed to prepare and store the study diet as well as monitor and record the dietary intake for the preceding 9 days. During the 9 days the participants were supposed to take food prepared  by the clinical research service. The food had predetermined caloric value: added sugar was restricted replaced with other carbohydrates obtained from fruits cereals and bread. The food was to be provided in and was provided in three installments. After the 9 days the participants returned for final measurement of the parameters. Biochemical tests were performed to measure; glucose and lactate levels, serum insulin concentration, fasting lipids as well as the high density lipoprotein cholesterol. the parameters of weight change were recorded on a daily basis.


A total of 52 participants were recruited of which 2 were found Ineligible. 5 others did not show up for day 0 assessment. The results of the biochemical tests were tabulated and  Individual curves of the participants were plotted and changes in the recorded parameters were determined. Fasting glucose levels and serum lipids increased. It was observed that fasting lactate and lactate decreased. The results indicated that the effects of sugar restriction were not as a result of the  modest weight loss that was recorded in the during the study. The 10 participants who did not loses weight were assessed in a separate sensitivity test and the results were found to be consistent as compared to all the participants.

Strengths and limitations

The strengths of the study were that  as an alternative of administration of high levels of fructose to normal participants, the assessment was done by observing restriction of the same in children with metabolic syndrome. The study was a positive assessment to determine whether the metabolic syndrome would be resolved. Furthermore, failure of compliance from the participants would not have made significant changes to the findings. The limitations of the study were that a control group was not included due to complication presented by the risks of the participants t estimate their dietary intake of fructose. Another limitation is that people may not find any significant changes in the metabolic outcomes. Furthermore, there was the concern than weight loss in a span of the 10 days could have been as a result of inadequate calories.


Numerous concerns have been raised regarding the role of amount of sugar consumption and the association with metabolic syndrome. Earlier studies have based their experiments on the administration of large amount of sugar to acquire the results. In this study however, utilizes a sample of children exhibiting metabolic syndrome to determine the association. The study seeks to regulate the caloric measure to determine the effect on the aspect of weight change. The objective of the study was to determine if the restriction of sugar only can have influence on metabolic syndrome in adults and also to ascertain whether the effects are long-lasting or short-lasting. The study concluded that the health risks that are caused by sugar consumption particularly fructose consumption are not associated with the caloric value as well as the effects on weight (Lustig et al., 2015).


Bantle, J. P. (2009). Dietary fructose and metabolic syndrome and diabetes. The Journal of

nutrition, 139(6), 1263S-1268S.

Nakagawa, T., Hu, H., Zharikov, S., Tuttle, K. R., Short, R. A., Glushakova, O., … & Johnson,

  1. J. (2006). A causal role for uric acid in fructose-induced metabolic syndrome. American Journal of Physiology-Renal Physiology, 290(3), F625-F631.

Lustig, R. H., Mulligan, K., Noworolski, S. M., Tai, V. W., Wen, M. J., Erkin‐Cakmak, A., … & Schwarz, J. M. (2015). Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome. Obesity.