title: Reduced prevalence of obesity in children with primary fructose malabsorption: a multicentre, retrospective cohort study.
abstract: BACKGROUND
  Studies in animals and in man have demonstrated that excessive consumption of fructose can cause all components of the metabolic syndrome.
  
  
  OBJECTIVE
  To investigate the impact of a condition resulting in decreased absorption of fructose, on obesity.
  
  
  METHODS
  In a multicentre study, we analyzed a cohort of paediatric patients with suspected primary fructose malabsorption (FM). Patients with chronic intestinal diseases were excluded. The final cohort comprised 628 patients.
  
  
  RESULTS
  302 patients were diagnosed with primary FM (48.1%). The proportion of obese patients was lower among FM patients, compared to non-FM patients (2.3 vs. 6.1%, P = 0.029). Logistic regression analysis with inclusion of various covariates showed that FM was negatively associated with obesity (OR 0.35, 95% CI [0.13; 0.97]). We discuss several mechanisms involving the metabolic, endocrine and gastrointestinal system.
  
  
  CONCLUSIONS
  Our data indicate that primary FM is negatively associated with childhood obesity.
authors.affiliation: Department of Pediatrics, Justus-Liebig University Giessen, Giessen, Germany.
authors.forename: S C
authors.initials: SC
authors.lastname: Disse
authors.forename: A
authors.initials: A
authors.lastname: Buelow
authors.forename: R-H
authors.initials: RH
authors.lastname: Boedeker
authors.forename: K-M
authors.initials: KM
authors.lastname: Keller
authors.forename: H-S
authors.initials: HS
authors.lastname: Kim-Berger
authors.forename: S A
authors.initials: SA
authors.lastname: Wudy
authors.forename: K-P
authors.initials: KP
authors.lastname: Zimmer
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005632:Fructose / Q000378:metabolism*; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology; D016015:Logistic Models; D008286:Malabsorption Syndromes / Q000150:complications*; D008297:Male; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D005632:Fructose
keywords: Childhood obesity; fructose; fructose malabsorption; multicentre study