Effect of Plain Versus Sugar‐Sweetened Breakfast on Energy Balance and Metabolic Health: A Randomized Crossover Trial

Abstract

Objective This study investigated the effect of 3 weeks of high‐sugar (“Sweet”) versus low‐sugar (“Plain”) breakfast on energy balance, metabolic health, and appetite. Methods A total of 29 healthy adults (22 women) completed this randomized crossover study. Participants had pre‐ and postintervention appetite, health, and body mass outcomes measured, and they recorded diet, appetite (visual analogue scales), and physical activity for 8 days during each intervention. Interventions were 3 weeks of isoenergetic Sweet (30% by weight added sugar; average 32 g of sugar) versus Plain (no added sugar; average 8 g of sugar) porridge‐based breakfasts. Results Pre‐ to postintervention changes in body mass were similar between Plain (Δ 0.1 kg; 95% CI: −0.3 to 0.5 kg) and Sweet (Δ 0.2 kg; 95% CI: −0.2 to 0.5 kg), as were pre‐ to postintervention changes for biomarkers of health (all P ≥ 0.101) and psychological appetite (all P ≥ 0.152). Energy, fat, and protein intake was not statistically different between conditions. Total carbohydrate intake was higher during Sweet (287 ± 82 g/d vs. 256 ± 73 g/d; P = 0.009), driven more by higher sugar intake at breakfast (116 ± 46 g/d vs. 88 ± 38 g/d; P < 0.001) than post‐breakfast sugar intake (Sweet 84 ± 42 g/d vs. Plain 80 ± 37 g/d; P = 0.552). Participants reported reduced sweet desire immediately after Sweet but not Plain breakfasts (trial × time P < 0.001). Conclusions Energy balance, health markers, and appetite did not respond differently to 3 weeks of high‐ or low‐sugar breakfasts.

No effects of sweet taste exposure at breakfast for 3 weeks on pleasantness, desire for, sweetness or intake of other sweet foods: a randomised controlled trial

“…The strength of the evidence provided by the rating measures is an important finding of this study. These results confirm the findings of previous short-term studies (7)(8)(9)(10)12) , and conclusions based on longer time-frames (4) . The evidence for a lack of effect in the intake measures was inconsistent, ranging from weak to very strong.…”

Effect of plain versus sugar‐sweetened breakfast on energy balance and metabolic health: A secondary data analysis stratified by participant-defined sweet preference

“…Our finding that sweet preference may moderate the blood lipid response to sugar ingestion is worthy of future investigation on two counts. Firstly, as posited in the original paper (in the supplementary file) it may be that sugar mitigates the cholesterol lowering effect of oat beta glucan (Carroll et al, 2020a). This has implications for cholesterol-lowering health claims on high-fibre but also high-sugar breakfast cereals.…”

“…Such a difference may be due to the overall higher fasted plasma fibroblast growth factor 21 concentrations in those with a sweet tooth compared to those without a sweet tooth (regardless of the intervention) with research typically showing lower BMI and mixed findings on waist:hip ratio (Frayling et al, 2018;Søberg et al, 2017). Inferences on fibroblast growth factor 21 should be made with added caution as these were only taken in a subgroup of the original study sample (though sweet preference was included as a randomisation strata when selecting these samples; Carroll et al, 2020a). Fibroblast growth factor 21 has been implicated in glucoregulatory health, and sweet preference and intake (Søberg et al, 2017;Weng et al, 2015).…”

“…It was infeasible based on sample size to further split our data by sex or BMI status. Lastly in regards to sample size, some variables had missing data, such as physical activity energy expenditure, and all blood measures, but particularly fibroblast growth factor 21 which was only measured in a random subsample in the original study; randomisation was stratified by sweet preference for fibroblast growth factor 21, however (Carroll et al, 2020a). Secondly, as with any unplanned post hoc secondary subanalyses, causality cannot be inferred, particularly considering the lack of sweet preference randomisation strata.…”

“…Understanding this may proffer clues towards the role of sweet preference in disease progression, and may offer ideas towards tailoring diets or guidelines in order to increase adherence. We recently conducted a randomised crossover study investigating the role of a plain porridge breakfast versus an equicaloric high-sugar breakfast over three weeks in healthy adults who were body mass index (BMI)-defined as being lean or having overweight/obesity (Carroll et al, 2020a). Overall, this study found no differential effect of the breakfasts in nearly every health and appetite marker measured.…”