Background: Fructose consumption is associated with metabolic syndrome (MetS), including atherogenic dyslipidemia, cardiovascular disease, and type 2 diabetes. We recently showed that isocaloric fructose restriction improved fasting lipoprotein profiles. Others have suggested that postprandial changes in lipoproteins may be uniquely atherogenic. 

Objective: We measured the effects of an isocaloric fructose-restricted diet for 9 days on postprandial lipoprotein subclasses in children with obesity and MetS consuming a high sugar (>50 gm/d) diet. 

Design/Methods: Thirty-two children had all meals provided for 9 days with the same calorie and macronutrient composition as their standard diet (reducing sugar from 28 to 10%, fructose from 12% to 4% of total caloric intake, by substituting starch). An 8-hour continuous feeding study was undertaken before and 10 days after the intervention. Altogether, the meals provided 67% of estimated daily energy requirement (15% protein, 35% fat, 50% carbohydrate). Lipoprotein subclasses were analyzed using Lipoprint LDL and HDL from Quantimetrix. 

Results:  On day 10, VLDL peaked (12% over basal) at 3 h vs. day 0 peak (11% over basal) at 6 h. VLDL also cleared faster (11% over basal at 6 h on day 0 vs 5% on day 10 (*). Large buoyant LDL increased during feeding up to 6% (8 h) on day 10 vs 4% on day 0,  whereas intermediate LDL decreased by 40 % by 6 h, remaining 20% lower on day 10 vs day 0 (*). Fasting small dense LDL were 3 times higher on day 0 vs. day 10, and increased by 16% at 3 h during feeding on day 0, whereas they decreased by 60% on day 10 (**) Fasting large HDL was 20.1 % higher on day 10, and increased another 4.4% at 3h (**). Fasting small HDL were 22% higher on day 0 and peaked at  6 % over basal at 3 h, whereas they continually decreased upon feeding day 10 (**). * p<0.01, ** p<0.001.

Conclusions: Fructose restriction altered postprandial changes in VLDL, LDL, small dense LDL, and HDL subclasses, favoring profiles traditionally associated with lower atherogenicity.

01 - SHORT-TERM ISOCALORIC FRUCTOSE RESTRICTION IMPROVES POSTPRANDIAL LIPOPROTEIN SUBCLASS PROFILES