title: Dietary fructose reduction improves markers of cardiovascular disease risk in Hispanic-American adolescents with NAFLD.
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.
authors.affiliation: Department of Pediatrics, School of Medicine, Emory University, 2015 Uppergate Drive NE, Atlanta, GA 30322, USA. rjin@emory.edu.
authors.forename: Ran
authors.initials: R
authors.lastname: Jin
authors.affiliation: Department of Pediatrics, School of Medicine, Emory University, 2015 Uppergate Drive NE, Atlanta, GA 30322, USA. jean.a.welsh@emory.edu.
authors.forename: Jean A
authors.initials: JA
authors.lastname: Welsh
authors.affiliation: Biomarker Core Laboratory, Atlanta Veterans Affairs Medical Center, Decatur, GA 30033, USA. anhleatcsl@gmail.com.
authors.forename: Ngoc-Anh
authors.initials: NA
authors.lastname: Le
authors.affiliation: Department of Pediatrics, School of Medicine, Emory University, 2015 Uppergate Drive NE, Atlanta, GA 30322, USA. jholzberg@gmail.com.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Holzberg
authors.affiliation: Department of Radiology, Emory University, Atlanta, GA 30322, USA. puneets@email.arizona.edu.
authors.forename: Puneet
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Radiology, Emory University, Atlanta, GA 30322, USA. dmartin@radiology.arizona.edu.
authors.forename: Diego R
authors.initials: DR
authors.lastname: Martin
authors.affiliation: Department of Pediatrics, School of Medicine, Emory University, 2015 Uppergate Drive NE, Atlanta, GA 30322, USA. mvos@emory.edu.
authors.forename: Miriam B
authors.initials: MB
authors.lastname: Vos
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000293:Adolescent; D001628:Beverages; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood; D066273:Diet, Western / Q000009:adverse effects; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004311:Double-Blind Method; D002149:Energy Intake; D005260:Female; D005632:Fructose / Q000008:administration & dosage*; D006630:Hispanic or Latino; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000150:complications; D050177:Overweight / Q000097:blood / Q000150:complications; D018384:Oxidative Stress / Q000187:drug effects; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D004040:Dietary Carbohydrates; D005632:Fructose; D002097:C-Reactive Protein
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