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High-Fructose Diet Linked to Liver Disease in Children and Teens

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A recent study suggests that obese youth who have a buildup of fats in their liver and a diet that is high in fructose are at an increased risk of developing serious chronic liver damage common in adult alcoholics.

Having fat in the liver is not the end of the world, in fact, most people do have a little bit of fat present. Fatty liver disease is diagnosed when more than 5 percent of the liver (by weight) consists of fat. When this is caused by excessive drinking, which can also cause fat to accumulate, it is known as alcoholic fatty liver disease.

However, if you don’t drink much, it doesn’t mean that you are out of the woods, for people can still develop non-alcoholic fatty liver disease (NAFLD), which is associated with obesity and certain poor eating habits.

NAFLD is the most common liver disease in western children, the authors write in Journal of Hepatology. And it is now recognized as the liver’s “manifestation” of metabolic syndrome – a constellation of traits and symptoms that raise a person’s risk for diabetes and heart disease – they add.

“Cells don’t use fructose for energy, so 100 percent of the fructose you eat is metabolized in your liver,” said study co-author Dr. Valerio Nobili of Bambino Gesu Children’s Hospital in Rome. So what happens to it?

Since the body doesn’t use fructose, it converts it into fatty acids, the “bad” kind of cholesterol, and triglycerides, which are stored as body fat, Nobili said. “That’s why excess fructose going into the liver is followed by the formation of fatty liver,” Nobili added.

From the study, which examined 271 obese children and teens, about 38 percent of them, or 102 participants, had more extensive liver damage known as nonalcoholic steatohepatitis (NASH) that happens when fat buildup leads to swelling in the liver and impairs liver function.

Furthermore, 47 patients with NASH had high uric acid, compared with 30 percent of participants without NASH, the study also found.

The youth with NASH had a significantly higher diet consisting of fructose, about 70 grams daily. Those without NASH had an average consumption of about 53 grams a day.

“Our understanding of the role of fructose in fatty liver is still evolving,” said Dr. Jeffrey Schwimmer, a researcher at the University of California, San Diego and director of the Fatty Liver Clinic at Rady Children’s Hospital.

“We don’t think that the impact of fructose from fruit is the same as fructose from drinks,” Schwimmer, who wasn’t involved in the study, said via interview.

So what can be done about this potential epidemic? For parents, the advice is simple. “Limit added sugars while further research is done to better understand” how fructose impacts the liver.

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