Effects of sugar-sweetened soda on plasma saturated and monounsaturated fatty acids in individuals with obesity: A randomized study

Mohammed Fahad Bajahzer, Jens Meldgaard Bruun, Fredrik Rosqvist, Matti Marklund, Bjørn Richelsen, Ulf Risérus, Mohammed Fahad Bajahzer, Jens Meldgaard Bruun, Fredrik Rosqvist, Matti Marklund, Bjørn Richelsen, Ulf Risérus

Abstract

Background: High carbohydrate, i.e., sugars, intake potentially drives the liver into a lipogenic state leading to elevated plasma fatty acids. Excessive intake of saturated fat and sugar-sweetened soda induces liver fat accumulation, but studying the effect of high intake from sugar-sweetened soda on the de novo lipogenesis (DNL) fatty acids in long-term randomized trials is lacking.

Objective: To study the effect of consuming 1 L/day of sugar-sweetened soda, semi-skimmed milk (milk), aspartame-sweetened soda or water over 24 weeks on DNL-derived fatty acids (i.e., palmitate (primary outcome) and other saturated and monounsaturated fatty acids), and markers of stearoyl-CoA desaturase activity (SCD1) in plasma phospholipids (PL), cholesteryl esters (CE), and triglycerides (TG).

Design and methods: A randomized parallel study was conducted simultaneously at Aarhus University Hospital and Copenhagen University, Denmark, including (n = 41) individuals aged 20-50 years, with BMI of 26-40 kg/m2, and without diabetes. The groups consisted of 9 individuals in the sugar-sweetened soda, 10 in the milk, 11 in the aspartame-sweetened soda, and 11 in the water. The change at 24 weeks was assessed and compared across the groups using ANCOVA and mixed-effects models. Correlations of fatty acid changes with liver fat accumulation (magnetic resonance imaging) were explored.

Results: After 24 weeks, the groups differed in palmitate proportions in PL, oleate in CE and PL, and palmitoleate and SCD1 in all fractions (p < 0.05). Compared with water, the relative proportion of palmitate in PL increased by approximately 1% during both sugar-sweetened soda (p = 0.011) and milk (p = 0.006), whereas oleate and palmitoleate increased only during sugar-sweetened soda (CE 2.77%, p < 0.001; PL 1.51%, p = 0.002 and CE 1.46%, PL 0.24%, TG 1.31%, all p < 0.001, respectively). Liver fat accumulation correlated consistently with changes in palmitoleate, whereas correlations with palmitate and oleate were inconsistent across lipid fractions.

Conclusions: Although both sugar-sweetened soda and milk increased palmitate in PL, only excess intake of sugar-sweetened soda increased palmitoleate in all lipid fractions and correlated with liver fat. In contrast, isocaloric milk intake did not increase plasma monounsaturated fatty acids.

Clinical trial registration: [https://ichgcp.net/clinical-trials-registry/NCT00777647], identifier [NCT00777647].

Keywords: biomarkers; carbohydrate intake; de novo lipogenesis; liver fat; monounsaturated; plasma fatty acid composition; saturated; sugar-sweetened beverages.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Bajahzer, Bruun, Rosqvist, Marklund, Richelsen and Risérus.

Figures

FIGURE 1
FIGURE 1
The consort flow diagram. Seventy-seven subjects were screened for eligibility to enroll in the study and 60 subjects were randomized.
FIGURE 2
FIGURE 2
Data are differences in the relative changes of plasma fatty acids comparing water with each of the test beverages. Percentages of the relative changes as indicated by the mixed effects model, with each individual fatty acid as the dependent variable; individual as a random intercept; group, time, weight, sex, and age as fixed effects; and an interaction term of group and time. (A) Palmitate (16:0), (B) palmitoleate (16:1n7), and (C) oleate (18:1n9). The columns in the charts exhibit the mean values of relative change (the baseline values were subtracted from the 24 weeks values) in the levels of each one of the included fatty acids in each plasma lipid fraction for the included test beverage, in comparison to water. The distinct columns exhibit three test beverages; the diagonal pattern columns represent sugar-sweetened soda, the white columns represent semi-skimmed milk, and the gray columns represent aspartame-sweetened soda.
FIGURE 3
FIGURE 3
(A–C) Scatterplots of correlation of the relative changes (i.e., percentage points) in plasma palmitate (16:0), palmitoleate (16:1n7), oleate (18:1n9) in phospholipids (PL), cholesteryl esters (CE), and triglycerides (TG) lipid fractions with the relative changes in liver fat content after 24 weeks intervention in the whole population. The correlation of relative changes in plasma (16:0, 16:1n7, and 18:1n9) in the CE fraction with relative changes in liver fat content (A), The correlation of relative changes in plasma (16:0, 16:1n7, and 18:1n9) in the PL fraction with relative changes in liver fat content (B), and the correlation of relative changes in plasma (16:0, 16:1n7, and 18:1n9) in the TG fraction with relative changes in liver fat content (C).

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