1. Introduction
obesity, decreases in fasting glucose, SSBs, cardiometabolic disease, Sugar reduction, sugar reduction
OBESITY, INFLAMMATION, INSULIN SENSITIVITY
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 ≥ 95th percentile) [Pediatric obesity continues to rise, with rates disproportionately impacting Latino children [Reducing the consumption of added sugars, particularly in the form of sugar sweetened beverages (SSBs), has been identified as one modifiable dietary factor that has the potential to improve the metabolic profile in children and adolescents. Cross-sectional studies in adolescents consistently find associations between sugar consumption and markers of glucose tolerance and insulin sensitivity [While few randomized controlled trials (RCTs) have tested the efficacy of sugar reduction as a strategy to improve blood pressure, serum lipid profile, or glucose tolerance and its determinants in children and adolescents, the trials show promise. In a school-based intervention in Brazilian 9–12-year-olds, children attending schools randomized to receive education that discouraged soft drink intake had significant decreases in fasting glucose and total cholesterol compared to children at control schools [To further explore whether a dietary intervention focused on sugar reduction impacts the cardiometabolic profile, we randomized Latino adolescents with obesity to either a control group receiving standard dietary advice or an intervention group that received dietary counseling focused on sugar reduction and home-delivery of bottled water with a goal of reducing added sugar intake to 10% or less of their total calories. Outcomes of interest included measures of glucose tolerance and its determinants, the fasting serum lipid profile, and markers of inflammation. We hypothesized that participants in the intervention group would have greater improvements in cardiometabolic health. 