Liver disease in kids linked to fructose

Recent research has found the following:

  • Dietary fructose intake may increase serum uric acid concentrations
  • Both uric acid concentration and fructose consumption may be increased in individuals with non-alcoholic fatty liver disease (NAFLD)

Investigators have now established that both dietary fructose consumption and serum uric acid concentrations are independently associated with non-alcoholic steatohepatitis (NASH).

What is non-alcoholic fatty liver disease (NAFLD)?

NAFLD, the accumulation of extra fat in liver cells in people who drink little or no alcohol, is recognised as the fastest growing cause of liver disease in both Western and developing countries.

Non-alcoholic fatty liver disease affects up to 9.6% of all children and 38% of obese children.

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It is estimated to affect up to 30% of the general population in Western countries and, up to 9.6% of all children and 38% of obese children across a spectrum of liver disease, including NASH

What is non-alcoholic steatohepatitis (NASH)?

NASH is defined as steatosis, hepatocyte ballooning and inflammation. Although it is a less aggressive form of NAFLD, it can progress to severe fibrosis and cirrhosis, with development of hepatocellular carcinoma (a common type of liver cancer) in adults.

Obese children studied

A team of researchers in Italy and the UK studied 271 obese children and adolescents with NAFLD who underwent liver biopsy. All the children completed a food frequency questionnaire.

Put that soda down

Major sources of fructose among children and adolescents are sodas and other sweetened beverages.

Several countries have already launched campaigns to ban soda vending machines in schools

According to the questionnaire answers, nearly 90% reported drinking sodas and soft drinks one or more times a week. Almost 95% of patients regularly consumed morning and afternoon snacks consisting of crackers, pizza and salty food, biscuits, yoghurt, or other snacks.

In the group of patients studied, 37.6% of patients had NASH and 47% of patients with NASH had high uric acid compared with 29.7% of patients who did not have NASH. Fructose consumption was independently associated with high uric acid, which occurred more frequently in patients with NASH than in not-NASH patients.

Affecting life expectancy

“In this study, we show for the first time that uric acid concentrations and dietary fructose consumption are independently and positively associated with NASH,” said senior investigator Valerio Nobili, MD, Chief of the Hepatometabolic Unit Liver Diseases Laboratory, Bambino Gesù Hospital, IRCCS, Rome, Italy.

The development of NASH may markedly affect life expectancy and quality of life in affected individuals and therefore it is crucial to understand the risk factors for NASH in children and adolescents in order to design effective interventions which can be used safely to treat this young group of patients.”

Ban school soda vending machines

Efforts geared towards behaviour modification, nutrition education, and limiting access to soda and other sweetened beverages could potentially reduce fructose consumption in this particular population. In fact, several countries have already launched campaigns to ban soda vending machines in schools.

Source: Elsevier Health Sciences via

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