Lower Fructose Intake May Help Protect Against Development of Nonalcoholic Fatty Liver in Adolescents With Obesity

T.A. O'Sullivan, Wendy Oddy, Alexandra Bremner, Jill Sherriff, Oyekoya T. Ayonrinde, John Olynyk, Lawrence Beilin, Trevor Mori, Leon Adams

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Abstract

Objectives: Although obesity is a major risk factor for nonalcoholic fatty liver (NAFL), not all individuals with obesity develop the condition, suggesting that other factors such as diet may also contribute to NAFL development. We evaluated associations between fructose and total sugar intake and subsequent diagnosis of NAFL in adolescents with obesity and without obesity in a population-based cohort. Methods: Adolescents participating in the Western Australian Pregnancy Cohort (Raine) Study completed 3-day food records and body mass index measurement at age 14 years. At age 17 years, participants underwent abdominal ultrasound to determine NAFL status. Multivariable logistic regression models were used to analyse associations between energy-adjusted fructose and total sugar intake and NAFL status. Food diaries and liver assessments were completed for 592 adolescents. Results: The prevalence of NAFL at age 17 was 12.8% for the total group and 50% for adolescents with obesity. Fructose intake did not significantly differ between adolescents with or without NAFL in our cohort as a whole. Among adolescents with obesity, those without NAFL had significantly lower energy-adjusted fructose intake at age 14 years compared with those with NAFL (mean±standard deviation [SD] 38.8±19.8 g/day, vs 55.7±14.4 g/day, P=0.02). Energy-adjusted fructose intake was independently associated with NAFL in adolescents with obesity (OR [odds ratio] 1.09, 95% CI 1.01-1.19, P=0.03) after the adjustment for confounding factors. Energy-adjusted total sugar intake showed less significance (OR 1.03, 95% CI 0.999-1.07, P=0.06). No significant associations were observed in other body mass index categories. Conclusions: Lower fructose consumption in adolescents with obesity at 14 years is associated with a decreased risk of NAFL at 17 years. Fructose rather than overall sugar intake may be more physiologically relevant in this association. © 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Original languageEnglish
Pages (from-to)624-631
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume58
Issue number5
DOIs
Publication statusPublished - May 2014

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Pediatric Obesity
Fructose
Gastroenterology
Obesity
Body Mass Index
Non-alcoholic Fatty Liver Disease
Logistic Models
Pediatrics
Diet Records
Cohort Studies
Odds Ratio
Diet
Food
Pregnancy

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@article{67efa1c7c58c4b84b67062a7ff71ef4c,
title = "Lower Fructose Intake May Help Protect Against Development of Nonalcoholic Fatty Liver in Adolescents With Obesity",
abstract = "Objectives: Although obesity is a major risk factor for nonalcoholic fatty liver (NAFL), not all individuals with obesity develop the condition, suggesting that other factors such as diet may also contribute to NAFL development. We evaluated associations between fructose and total sugar intake and subsequent diagnosis of NAFL in adolescents with obesity and without obesity in a population-based cohort. Methods: Adolescents participating in the Western Australian Pregnancy Cohort (Raine) Study completed 3-day food records and body mass index measurement at age 14 years. At age 17 years, participants underwent abdominal ultrasound to determine NAFL status. Multivariable logistic regression models were used to analyse associations between energy-adjusted fructose and total sugar intake and NAFL status. Food diaries and liver assessments were completed for 592 adolescents. Results: The prevalence of NAFL at age 17 was 12.8{\%} for the total group and 50{\%} for adolescents with obesity. Fructose intake did not significantly differ between adolescents with or without NAFL in our cohort as a whole. Among adolescents with obesity, those without NAFL had significantly lower energy-adjusted fructose intake at age 14 years compared with those with NAFL (mean±standard deviation [SD] 38.8±19.8 g/day, vs 55.7±14.4 g/day, P=0.02). Energy-adjusted fructose intake was independently associated with NAFL in adolescents with obesity (OR [odds ratio] 1.09, 95{\%} CI 1.01-1.19, P=0.03) after the adjustment for confounding factors. Energy-adjusted total sugar intake showed less significance (OR 1.03, 95{\%} CI 0.999-1.07, P=0.06). No significant associations were observed in other body mass index categories. Conclusions: Lower fructose consumption in adolescents with obesity at 14 years is associated with a decreased risk of NAFL at 17 years. Fructose rather than overall sugar intake may be more physiologically relevant in this association. {\circledC} 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.",
author = "T.A. O'Sullivan and Wendy Oddy and Alexandra Bremner and Jill Sherriff and Ayonrinde, {Oyekoya T.} and John Olynyk and Lawrence Beilin and Trevor Mori and Leon Adams",
year = "2014",
month = "5",
doi = "10.1097/MPG.0000000000000267",
language = "English",
volume = "58",
pages = "624--631",
journal = "Journal of Pediatric Gastroenterology and Nutrition",
issn = "0277-2116",
publisher = "Lippincott Williams & Wilkins",
number = "5",

}

Lower Fructose Intake May Help Protect Against Development of Nonalcoholic Fatty Liver in Adolescents With Obesity. / O'Sullivan, T.A.; Oddy, Wendy; Bremner, Alexandra; Sherriff, Jill; Ayonrinde, Oyekoya T.; Olynyk, John; Beilin, Lawrence; Mori, Trevor; Adams, Leon.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 58, No. 5, 05.2014, p. 624-631.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Lower Fructose Intake May Help Protect Against Development of Nonalcoholic Fatty Liver in Adolescents With Obesity

AU - O'Sullivan, T.A.

AU - Oddy, Wendy

AU - Bremner, Alexandra

AU - Sherriff, Jill

AU - Ayonrinde, Oyekoya T.

AU - Olynyk, John

AU - Beilin, Lawrence

AU - Mori, Trevor

AU - Adams, Leon

PY - 2014/5

Y1 - 2014/5

N2 - Objectives: Although obesity is a major risk factor for nonalcoholic fatty liver (NAFL), not all individuals with obesity develop the condition, suggesting that other factors such as diet may also contribute to NAFL development. We evaluated associations between fructose and total sugar intake and subsequent diagnosis of NAFL in adolescents with obesity and without obesity in a population-based cohort. Methods: Adolescents participating in the Western Australian Pregnancy Cohort (Raine) Study completed 3-day food records and body mass index measurement at age 14 years. At age 17 years, participants underwent abdominal ultrasound to determine NAFL status. Multivariable logistic regression models were used to analyse associations between energy-adjusted fructose and total sugar intake and NAFL status. Food diaries and liver assessments were completed for 592 adolescents. Results: The prevalence of NAFL at age 17 was 12.8% for the total group and 50% for adolescents with obesity. Fructose intake did not significantly differ between adolescents with or without NAFL in our cohort as a whole. Among adolescents with obesity, those without NAFL had significantly lower energy-adjusted fructose intake at age 14 years compared with those with NAFL (mean±standard deviation [SD] 38.8±19.8 g/day, vs 55.7±14.4 g/day, P=0.02). Energy-adjusted fructose intake was independently associated with NAFL in adolescents with obesity (OR [odds ratio] 1.09, 95% CI 1.01-1.19, P=0.03) after the adjustment for confounding factors. Energy-adjusted total sugar intake showed less significance (OR 1.03, 95% CI 0.999-1.07, P=0.06). No significant associations were observed in other body mass index categories. Conclusions: Lower fructose consumption in adolescents with obesity at 14 years is associated with a decreased risk of NAFL at 17 years. Fructose rather than overall sugar intake may be more physiologically relevant in this association. © 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

AB - Objectives: Although obesity is a major risk factor for nonalcoholic fatty liver (NAFL), not all individuals with obesity develop the condition, suggesting that other factors such as diet may also contribute to NAFL development. We evaluated associations between fructose and total sugar intake and subsequent diagnosis of NAFL in adolescents with obesity and without obesity in a population-based cohort. Methods: Adolescents participating in the Western Australian Pregnancy Cohort (Raine) Study completed 3-day food records and body mass index measurement at age 14 years. At age 17 years, participants underwent abdominal ultrasound to determine NAFL status. Multivariable logistic regression models were used to analyse associations between energy-adjusted fructose and total sugar intake and NAFL status. Food diaries and liver assessments were completed for 592 adolescents. Results: The prevalence of NAFL at age 17 was 12.8% for the total group and 50% for adolescents with obesity. Fructose intake did not significantly differ between adolescents with or without NAFL in our cohort as a whole. Among adolescents with obesity, those without NAFL had significantly lower energy-adjusted fructose intake at age 14 years compared with those with NAFL (mean±standard deviation [SD] 38.8±19.8 g/day, vs 55.7±14.4 g/day, P=0.02). Energy-adjusted fructose intake was independently associated with NAFL in adolescents with obesity (OR [odds ratio] 1.09, 95% CI 1.01-1.19, P=0.03) after the adjustment for confounding factors. Energy-adjusted total sugar intake showed less significance (OR 1.03, 95% CI 0.999-1.07, P=0.06). No significant associations were observed in other body mass index categories. Conclusions: Lower fructose consumption in adolescents with obesity at 14 years is associated with a decreased risk of NAFL at 17 years. Fructose rather than overall sugar intake may be more physiologically relevant in this association. © 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

U2 - 10.1097/MPG.0000000000000267

DO - 10.1097/MPG.0000000000000267

M3 - Article

VL - 58

SP - 624

EP - 631

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

SN - 0277-2116

IS - 5

ER -