Effect of Fructose on Non-Alcoholic Fatty Liver Disease Markers: Isocaloric Exchange vs. Hypercaloric Excess (Meta-Analysis of Controlled Feeding Trials)
Chiu S, Sievenpiper JL, de Souza RJ, Cozma AI, Mirrahimi A, Carleton AJ, Ha V, Di Buono M, Jenkins AL, Leiter LA, Wolever TM, Beyene J, Jenkins DJ
Evidence is still building up
Summary
A meta-analysis of 8 reports (13 controlled feeding trials, 260 healthy participants). Isocaloric fructose-exchange trials (7 trials) showed no change in liver fat markers, while hypercaloric trials providing excess fructose (6 trials, +104-220 g/day, +21-35% energy) significantly increased intrahepatocellular lipids and ALT. The authors concluded the effect may be more attributable to excess energy than to fructose per se.
Key findings
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Pooled 8 reports (13 controlled feeding trials, 260 healthy participants)
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Isocaloric exchange trials (7 trials) showed no significant effect on fatty liver markers
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Hypercaloric trials (6 trials, +104-220 g/day, +21-35% energy) significantly increased intrahepatocellular lipids (SMD 0.45) and ALT (+4.94 U/L)
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The authors interpreted the effect as more attributable to excess energy than to fructose itself
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