Dietary fructose reduction improves markers of cardiovascular disease risk in Hispanic-American adolescents with NAFLD

Ran Jin, Jean A Welsh, Ngoc-Anh Le, Jeffrey Holzberg, Puneet Sharma, Diego R Martin, Miriam B Vos, Ran Jin, Jean A Welsh, Ngoc-Anh Le, Jeffrey Holzberg, Puneet Sharma, Diego R Martin, Miriam B Vos

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.

Figures

Figure 1
Figure 1
Study design for the randomized controlled beverage trial.
Figure 2
Figure 2
4-week percent changes of plasma hs-CRP (A); adipose IR index (B); and large VLDL particle numbers (C) in both fructose and glucose beverage groups among adolescents with hepatic steatosis. Error bars stand for SE.

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