Sugar Restriction Leads to Increased Ad Libitum Sugar Intake by Overweight Adolescents in an Experimental Test Meal Setting

Background The impact of sugar restriction on subsequent sugar intake by overweight adolescents is unknown. Objective Our aim was to examine the effect of sugar restriction on subsequent ad libitum sugar intake by overweight adolescents and whether habitual sugar intake and impulsivity influence the effect of sugar restriction on subsequent sugar intake. Design This was an in-laboratory crossover feeding trial with sugar-exposure and sugar-restriction conditions. Participants/setting Eighty-seven overweight Latino and African-American adolescents underwent both meal conditions in two separate 8-hour in-laboratory visits. Intervention Participants had access to ad libitum snack trays for 3 hours after the condition-specific meals. Main outcome measures Ad libitum sugar intake during the snack period was measured at each visit. Habitual sugar intake and impulsivity were assessed at baseline. Statistical analyses performed Repeated measures analysis of covariance was used to examine the within-person effect of meal condition on ad libitum sugar intake. Mixed models were used to examine the moderating effects of habitual sugar intake and impulsivity on the meal condition ad libitum sugar intake relationship. Results Participants consumed more ad libitum sugar during the snack period in the sugar-restriction condition than in the sugar-exposure condition (sugar restriction=78.63 +/- 38.84 g, sugar exposure=70.86 +/- 37.73 g; F=9.64, P=0.002). There was no relationship between habitual sugar intake and how much ad libitum sugar participants consumed during either condition. Higher impulsivity was associated with greater ad libitum sugar intake during both conditions (sugar restriction: b=.029, standard error=.01, P<0.05; sugar exposure: b=.034, standard error=.01, P<0.05). Conclusions Findings suggest that overweight adolescents restricted from sugar intake consume greater amounts of sugar when they are later given access to high-sugar foods. Overweight adolescents with higher impulsivity appear to consume greater amounts of sugar regardless of previous levels of sugar consumption. Compensatory sugar intake and trait impulsivity may have implications for dietary interventions in this population.