(13-04-15) Restricting Fructose Cuts Liver Fat in Kids

Substituting complex carbs for simple sugars over just 10 days shows meaningful results.


SAN DIEGO -- In just 10 days, restricting the amount of fructose children consumed through sugary drinks and juices resulted in "dramatic" reductions in liver fat, researchers reported here.
During the intervention, the conversion of sugar to fat in the 40 children in the study declined by 56% (P=0.001) and the liver fat declined by more than 20% (P=0.001), said Jean-Marc Schwarz, PhD, of Touro University California in Vallejo, and colleagues.
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There were no calorie differences in the diets as the meals prepared for the study participants had simple sugars replaced with complex carbohydrates, Schwarz explained in a presentation at The Endocrine Society annual meeting.
"We did some studies first in adults and showed that high fructose consumption is associated with liver fat accumulation, hypertriglyceridemia, and increased conversion of sugar to fat in the liver known as hepatic de novo lipogenesis," he told MedPage Today.
Schwarz and colleagues wanted to see if changes in diet would have an impact on both hepatic de novo lipogenesis and concentrations of fat in the liver.
"When we ingest fructose in large quantities, such as in fruit juices or in sodas, it caused almost a tsunami in the liver, forcing it to produce more fat," Schwarz said. "We wanted to do an intervention study to see what would happen if we changed the fructose intake. We wanted to see if there were some benefits that could be seen in the short term."
They recruited 25 Latino children (15 girls, 11 boys) and 15 African-American children (12 girls, three boys) with a median age of 13. The children had a median weight of 89.1 kg (196 lbs) and body mass index z-score of 2.3. The median height was 162 cm (about 5'3"). The median percent fat by dual emission x-ray absorptiometry was 47.3%. The median fasting glucose was 98 mg/dL and the median fasting insulin was 29.7 mcIU/mL.
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The first meal on day 0 was based on the child's habitual fructose intake. During the next 9 days, the patients were fed meals that contained the same relative energy and macronutrient content of their normal diet, but with high-fructose products replaced with vegetables, breads, or pasta.
"These results suggest that hepatic de novo lipogenesis is an important mechanism contributing to liver fat accumulation in children, which can be reversed by short-term fructose restriction," the group stated. "Our data support public health efforts to reduce sugar consumption."
Schwarz acknowledged that the study was short, but pointed out that it was "an intervention that goes on beyond just correlation ... [it was a] very intensive study. We saw that in 10 days there was this dramatic change that suggests benefits for cardiovascular disease."
The authors reported no differences in the reduction of de novo lipogenesis between the two study groups nor did they observe any significant weight loss in the 10-day period.
"When you have a 12-year-old who has 50% of fat in the liver, that is not a good thing. If you have that at 12, it is going to have a lot of impact," Schwarz said. "This is also correlated with fat in the blood and that puts one at higher risk for cardiovascular disease. The earlier you can prevent that, the earlier you can avoid those issues, and, I think, the better off you are."
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In commenting on the study, press conference moderator Ann Nardulli, PhD, professor of molecular and integrative physiology at the University of Illinois at Urbana-Champaign, pointed out that the results may not be applicable to adults.
However, she told MedPage Today that "the study does give us points of interest to try to follow up on."
The study was supported by grants from the NIH, National Center for Advancing Translational Sciences, and Touro University California.
Schwarz and co-authors disclosured no relevant relationships with industry.
Reviewed by Henry A. Solomon, MD, FACP, FACC Clinical Associate Professor, Weill Cornell Medical College and Dorothy Caputo, MA, BSN, RN, Nurse Planner
last updated 03.10.2015
Primary Source
The Endocrine Society
Source Reference: Schwarz J-M, et al "Isocaloric fructose restriction for 10 days reduces

SOURCE: http://www.medpagetoday.com/MeetingCoverage/ENDO/50396

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