Dietary Sugars, Feeding Behavior, Insulin Resistance, Obesity, Adolescent, Taste Perception
Conditions
Keywords
Obesity, Adolescent, Sugar-Sweetened Beverages, Taste Perception, Insulin Resistance, Sweet Taste Preference, Latine Youth, African American Youth, Dietary Intervention, Beverage Replacement, Sugar Reduction, Sensory Evaluation, Randomized Controlled Trial
Brief summary
The goal of this clinical trial is to test whether replacing sugary sodas with unsweetened, flavored sparkling waters can reduce added sugar intake and improve health in Black/African American and Latine adolescents with obesity who prefer sweet-tasting beverages. The main questions it aims to answer are: * Does replacing sugary sodas with water change liking for sugary drinks, and water? * Do shifts in liking for sweetness lead to improved diet quality and cardiometabolic health? Researchers will compare replacing sugary sodas with one of three alternative beverages: unsweetened sparkling water, plain water, and beverages with gradually reduced sugar to determine which strategy is most effective. Participants will: * Replace sugary sodas with study drinks for 4 weeks * Complete taste tests to measure their liking for and sensory experience of sweetness over 8-weeks * Provide dietary recalls, body measurements, and blood samples over 8-weeks
Detailed description
This randomized controlled trial aims to evaluate the effects of replacing sugar-sweetened sodas with unsweetened, flavored sparkling waters, progressively sugar-reduced sodas, or plain water in adolescents who are classified as "sweet-likers"-individuals who prefer higher concentrations of sugar in beverages. The study focuses on a high-risk group: adolescents ages 12-18 who self-identify as Black/African American or Latine and have obesity (BMI \>95th percentile). 63 adolescents who are classified as sweet-likers and meet additional inclusion criteria will be enrolled in a randomized 3-arm intervention for 4 weeks, with an additional 4-week follow-up period. Participants will be randomized into one of the following groups: USW (Unsweetened Sparkling Water): Replaces sodas with flavored, unsweetened carbonated water. PRS (Progressively Reduced Sugar): Replaces sodas with carbonated beverages with decreasing sugar concentrations, ending with unsweetened carbonated water. PW (Plain Water - Control): Replaces sodas with still, plain water. Participants will replace all typical sugary sodas with study beverages during the 4-week intervention. Study assessments include sensory testing for liking, sweetness intensity, and "just about right" level of sweetness in sparkling and plain water at baseline, week 2, week 4, and week 8. Additionally, dietary intake (via 24-hour dietary recalls), anthropometrics (height, weight, waist circumference), blood pressure, and blood biomarkers (fasting glucose, insulin, triglycerides) will be measured at baseline, week 4, and week 8. The primary hypothesis is that exposure to unsweetened beverages (especially in the USW and PRS groups) will reduce participants' liking for higher concentrations of sugar in beverages and increasing liking for lower concentrations of sugar in beverages. It is also hypothesized that these changes may correspond with improvements in cardiometabolic markers, particularly serum triglycerides. Insulin resistance (HOMA-IR), blood pressure, and body weight will also be measured but are less likely to shift in the relatively short time period (8 weeks). This trial addresses the persistent challenge of high SSB consumption in racial and ethnic minority adolescents-a group that faces disproportionate risk of obesity, prediabetes, and cardiometabolic disease. By integrating sensory science with behavior change, this intervention seeks to develop more effective strategies to support reduced sugar intake in adolescents who have strong preferences for sweetness.
Interventions
BEHAVIORALUnsweetened Sparkling Water Replacement
Participants replace all sugar-sweetened sodas with flavored, unsweetened sparkling waters for 4 weeks.
BEHAVIORALProgressively Reduced Sugar Beverage Replacement
Participants replace sugary sodas with beverages containing gradually decreasing sugar concentrations (weekly), ending with unsweetened sparkling water.
BEHAVIORALPlain Water Replacement
Participants replace all sugar-sweetened sodas with plain, still water for 4 weeks. This serves as a comparator to evaluate sensory and metabolic changes.
Sponsors
Nana Gletsu Miller
Purdue University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Masking description
Not applicable. This is an open-label study; no parties are masked.
Intervention model description
Participants are randomly assigned to one of three parallel intervention arms for 4 weeks: (1) replacement of sugary sodas with unsweetened, flavored sparkling water (USW), (2) replacement with sodas containing progressively reduced sugar levels (PRS), or (3) replacement with plain water (PW). All participants are followed for an additional 4-week period to assess maintenance of changes.
Eligibility
Sex/Gender
ALL
Age
12 Years to 18 Years
Healthy volunteers
Yes
Inclusion criteria
* Adolescents ages 12 to 18 who display a "sweet-liker" pattern, characterized by a preference for higher concentrations of sugar in beverages, specifically identifying 0.3M (10.3% sucrose) or above as their most liked sample. * Adolescents consumes sugar-sweetened soda greater than or equal to 2 times per week. Adolescents must also indicate a willingness to drink study beverages; not currently dieting/changing diet.
Exclusion criteria
* Adolescent participant is pregnant, since pregnancy affects taste perception * Participant is allergic or intolerant to the items we are testing. * Adolescent with type 1 or type 2 diabetes (self-declared or detected at screening visit through fasting glucose) * Use of GLP-1 receptor agonists intended for weight loss.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Liking ratings changes for sugar concentrations over time | Baseline, Week 2, Week 4, Week 8 | Our primary outcome is the interaction of time with liking for different sugar concentrations. We expect to observe a significant Time\*Sugar Concentration interaction effect for these liking ratings. We expect the interaction term to show that higher concentrations of sugar had lower liking ratings by weeks 4 and 8 (compared to baseline), but that lower concentrations of sugar had higher liking ratings by weeks 4 and 8. Liking ratings are collected on a scale from -110 to 110, with internal markings at -100 Worst ever, -50 Dislike, 0 Neutral, 50 Like, 100 Best ever. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diet quality changes over time | Baseline, Week 4, Week 8 | We will use the ASA24 method to gather data on food intake. We will apply the Healthy Eating Index method to calculate diet quality. We expect to see improvements in diet quality at weeks 4 and 8 compared to baseline. |
| Serum triglyceride changes over time | Baseline, Week 4, Week 8 | A secondary outcome is the main effect of time on serum triglycerides. We expect to observe significant decreases in serum triglycerides at weeks 4 and 8 compared to baseline. |
| Change in fasting glucose over time | Baseline, Week 4, Week 8 | We will also evaluate fasting glucose by serum analysis. |
| Change in insulin resistance over time | Baseline, Week 4, Week 8 | We will also evaluate insulin resistance (HOMA-IR), which is a measure of fasting glucose multiplied by fasting insulin. |
| Change in BMI (body mass index) z-score | Baseline, Week 4, Week 8 | We will also evaluate BMI z-score for changes over time |
| Beverage Consumption Compliance | Baseline, Week 4, Week 8 | Participants report their beverage consumption and compliance will be assessed. |
| Change in Systolic Blood Pressure | Baseline, Week 4, Week 8 | Systolic Blood Pressure change over time will be evaluated. |
| Change in Diastolic Blood Pressure | Baseline, Week 4, Week 8 | Diastolic Blood Pressure change over time will be evaluated. |
| Change in Waist Circumference | Baseline, Week 4, Week 8 | Waist circumference will be evaluated over time. |
| Number of Participants experiencing tooth sensitivity or gastrointestinal symptoms | Week 4 | — |
Countries
United States
Contacts
CONTACTNana Gletsu Miller, PhD
Outcome results
None listed