Dietary Fructose Reduction Improves Markers of Cardiovascular Disease Risk in Hispanic-American Adolescents with NAFLD

• Type of Material: Article
• Authors: Ran Jin, Emory University; Jean A. Welsh, Emory University; Ngoc-Anh Le, Emory University; Jeffrey Holzberg, Emory University; Puneet Sharma, Emory University; Diego R. Martin, Emory University; Miriam Vos, Emory University
• Language: English
• Date: 2014-08-08
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2014 by the authors; licensee MDPI, Basel, Switzerland.
• License: Creative Commons Attribution 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.3390/nu6083187
• Title of Journal or Parent Work: Nutrients
• ISSN: 2072-6643
• Volume: 6
• Issue: 8
• Start Page: 3187
• End Page: 3201
• Grant/Funding Information: NIH K23 DK080953(Vos), North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) Foundation Nestle Young Investigator Award (Vos), also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR000454. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
• Keywords: hepatic steatosis; sugar; obesity; cardiovascular risk; fructose; nonalcoholic fatty liver disease; children and adolescents
• Research Categories: Health Sciences, General; Health Sciences, Epidemiology; Health Sciences, Nutrition

Abstract

Nonalcoholic fatty liver disease (NAFLD) is now thought to be the most common liver disease worldwide. Cardiovascular complications are a leading cause of mortality in NAFLD. Fructose, a common nutrient in the westernized diet, has been reported to be associated with increased cardiovascular risk, but its impact on adolescents with NAFLD is not well understood. We designed a 4-week randomized, controlled, double-blinded beverage intervention study. Twenty-four overweight Hispanic-American adolescents who had hepatic fat >8% on imaging and who were regular consumers of sweet beverages were enrolled and randomized to calorie-matched study-provided fructose only or glucose only beverages. After 4 weeks, there was no significant change in hepatic fat or body weight in either group. In the glucose beverage group there was significantly improved adipose insulin sensitivity, high sensitivity C-reactive protein (hs-CRP), and low-density lipoprotein (LDL) oxidation. These findings demonstrate that reduction of fructose improves several important factors related to cardiovascular disease despite a lack of measurable improvement in hepatic steatosis. Reducing dietary fructose may be an effective intervention to blunt atherosclerosis progression among NAFLD patients and should be evaluated in longer term clinical trials.