Soda consumption in adolescents has been linked to poorer metabolic outcomes. We tested whether replacing soda with reduced fat milk would improve features of atherogenic dyslipidemia and other cardiometabolic risk factors. Thirty overweight and obese adolescent boys who were habitual consumers of sugar-sweetened beverages were randomly assigned to consume 24 oz/day of sugar-sweetened soda or an energy equivalent of reduced fat (2%) milk for 3 weeks with crossover to the alternate beverage after a ≥ 2 weeks washout. Plasma lipids and lipoproteins and other laboratory measures were assessed after each beverage period. Lipid and lipoprotein measurements, C-reactive protein, and serum transaminases did not differ significantly between the soda and milk phases of the study. Systolic blood pressure z-score and uric acid concentration were significantly lower after consuming milk compared to soda. Milk consumption also significantly decreased plasma glucosyl ceramide (d18:1/C16:0) and lactosylceramides (d18:1/C16:0 and d18:1/C18:0). While no effects of replacing soda with milk on lipid and lipoprotein measurements were observed in these normolipidemic weight-stable adolescent boys, decreases in systolic blood pressure, uric acid, and glycosphingolipids suggest that an overall favorable effect on cardiometabolic risk can be achieved following a short-term dietary intervention.

Almonds have been shown to lower LDL cholesterol but there is limited information regarding their effects on the dyslipidemia characterized by increased levels of very low density lipoproteins (VLDL) and small, dense low-density lipoprotein (LDL) particles that is associated with abdominal adiposity and high carbohydrate intake. The objective of the present study was to test whether substitution of almonds for other foods attenuates carbohydrate-induced increases in small, dense LDL in individuals with increased abdominal adiposity. This was a randomized cross-over study of three 3wk diets, separated by 2wk washouts: a higher-carbohydrate (CHO) reference diet (CHOhigh), a higher-CHO diet with isocaloric substitution of 20% kcal (E) from almonds (CHOhigh + almonds), and a lower-CHO reference diet (CHOlow) in 9 men and 15 women who were overweight or obese. The two CHOhigh diets contained 50% carbohydrate, 15% protein, 35% fat (6% saturated, 21% monounsaturated, 8% polyunsaturated), while the CHOlow diet contained 25% carbohydrate, 28% protein, 47% fat (8% saturated, 28% monounsaturated, 8% polyunsaturated). Lipoprotein subfraction concentrations were measured by ion mobility. Relative to the CHOlow diet: 1) the CHOhigh + almonds diet significantly increased small, dense LDLIIIa (mean difference ± SE: 28.6 ± 10.4 nmol/L, P = 0.008), and reduced LDL-peak diameter (− 1.7 ± 0.6 Å, P = 0.008); 2) the CHOhigh diet significantly increased medium-sized LDLIIb (24.8 ± 11.4 nmol/L, P = 0.04) and large VLDL (3.7 ± 1.8 nmol/L, P = 0.05). Relative to CHOlow, the effects of CHOhigh on LDLIIIa (17.7 ± 10.6 nmol/L) and LDL-peak diameter (− 1.1 ± 0.6 Å) were consistent with those of CHOhigh + almonds, and the effects of CHOhigh + almonds on LDLIIb (21.0 ± 11.2 nmol/L) and large VLDL (2.8 ± 1.8 nmol/L) were consistent with those of CHOhigh, but did not achieve statistical significance (P > 0.05). None of the variables examined showed a significant difference between the CHOhigh + almonds and CHOhigh diets (P > 0.05). Our analyses provided no evidence that deriving 20% E from almonds significantly modifies increases in levels of small, dense LDL or other plasma lipoprotein changes induced by a higher carbohydrate low saturated fat diet in individuals with increased abdominal adiposity. Clinicaltrials.gov NCT01792648 .