Meta-analysis of the association between major foods with added fructose and non-alcoholic fatty liver disease

• Published in: Food & function 2023-06, Vol.14 (12), p.5551-5561
• Main Authors: Liu, Wenqi, Zhai, Daokuan, Zhang, Tingjing, Mudoti, Nyasha Grace, Chang, Qing, Liu, Yashu, Zhao, Yuhong, Ding, Yang, Xia, Yang
• Format: Article
• Language: English
• Subjects: Adult; Beverages; Cross-Sectional Studies; Dairy products; Diet; Epidemiology; Fatty liver; Food; Food consumption; Food intake; Food sources; Fructose; Fructose - adverse effects; Heterogeneity; Humans; Ice cream; Liver; Liver diseases; Meta-analysis; Non-alcoholic Fatty Liver Disease - epidemiology; Non-alcoholic Fatty Liver Disease - etiology; Subgroups
• ISSN: 2042-6496; 2042-650X
• DOI: 10.1039/d3fo00882g

Objectives : The relationship between the consumption of foods with added fructose and non-alcoholic fatty liver disease (NAFLD) was inconsistent in previous epidemiological studies, and no meta-analysis has been performed on the pooled results. Hence, this study aims to assess the associations between the consumption of major foods with added fructose and NAFLD in a meta-analysis. Methods : Through PubMed and Web of Science, an extensive literature search of publications before July 2022 was conducted. We included studies that investigated the associations between the intake of ≥1 food sources with added fructose (biscuits and cookies, cake, sugar-sweetened beverages [SSBs], sweets, candies, chocolate, or ice cream) and NAFLD in a general adult population. Random- or fixed-effects models were used to pool odds ratios [ORs, 95% confidence intervals (95% CIs)] depending on the degree of heterogeneity. Results : A total of 15 studies with 65 149 participants were finally brought into the meta-analysis. Based on the results, it seems that the prevalence of NAFLD was higher among those who consumed foods with added fructose (OR = 1.31, 95% CI = 1.17-1.48). Subgroup analysis showed that consumption of foods with added fructose was associated with a greater prevalence of NAFLD in subgroups of cohort and cross-sectional studies, of SSBs, participants from Asia or North America, disease assessment using ultrasound, CT, or MRI, and exposure assessment using dietary recall and food frequency questionnaires. Conclusion : Our results indicated that major foods with added fructose intake have a positive association with the prevalence of NAFLD. Reduction of added fructose consumption may represent an early opportunity to mitigate or prevent NAFLD. The relationship between the consumption of foods with added fructose and non-alcoholic fatty liver disease (NAFLD) was inconsistent in previous epidemiological studies, and no meta-analysis has been performed on the pooled results.