Study shows low-sugar diet is effective in boys with non-alcoholic fatty liver disease

Researchers from the University of California San Diego School of Medicine and the Emory University School of Medicine discovered that a diet low in free sugars (added to foods and beverages) and present naturally in fruit juices) resulted in a significant improvement in non-alcoholic fatty liver disease in adolescent boys.

The study published in the January 22 issue of JAMA.

NAFLD is the most common liver disease in children and is badociated with type 2 diabetes, end-stage liver disease, liver cancer and cardiovascular disease. "With more than five million children with NAFLD, it is a much more widespread and serious disease than most people know it – effective treatment is crucial for long-term health." term, "said lead author Jeffrey Schwimmer, MD, professor of clinical pediatrics at UC San Diego School of Medicine. "Although diet is controversial, we know that sugar can play an important role in the development of liver fat." Our study focused on free sugar based on a combination of NAFLD biology and practicalities. of a real, feasible diet that could be an effective treatment. "

The study included 40 boys aged 11 to 16 years with diagnosed hepatic steatosis. Participants were randomized into two groups. Half of the boys, as well as their families, received a diet low in free sugars (less than three percent of daily calorie intake) and half ate their usual diet for eight weeks. The reduction of sugars in the diet involves the reduction of glucose, fructose and sucrose commonly consumed in sweetened foods and beverages and in naturally sweetened fruit juices.

The researchers interviewed the participants and their families, drew up the food inventory at home and removed those who did not meet the requirements of the study. The research team helped families plan meals, shop groceries, cook and prepare meals. The diet was intended for the whole family and was designed to be as similar as possible to their usual diet, minus the sugar.

"Although pediatric recommendations for the management of NAFLD recommend a healthy diet, targeted reduction of beverages and sugary foods was an unproven treatment," said lead author Miriam Vos, MD. professor of pediatrics at Emory.

The study was designed to measure changes in liver fat at the beginning and after eight weeks of treatment, based on magnetic resonance imaging-measured fat fraction measurement – a state-of-the-art method for the quantification of lipids in the liver developed by UC San Diego. The researchers found that the reduction in liver fat was an average of 31% for boys in the low-sugar diet group, while those in the typical diet group showed no improvement. Blood tests performed on liver inflammation also revealed a significant improvement in children in the low free-sugar group compared to the typical diet group.

"The substantial improvement seen in just eight weeks leads us to believe that a diet low in free sugars could be a clinically relevant treatment," Schwimmer said. "The next step will be to build on what we have learned and test this approach to empower families to control their own diet for long enough to see if we can effectively treat NAFLD and prevent it. cirrhosis, insufficiency and liver cancer. "

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Co-authors include: Patricia Ugalde-Nicalo, Jorge Angeles, Janis Durelle, Cynthia Knott, Michael Middleton, Claude Sirlin, all of UC San Diego; Kathryn Harlow, Kimberly Newton, UC San Diego and San Diego Children's Rady Hospital; Jean Welsh, Maria Cordero, Rebecca Cleeton, Juna Konomi, Curtis Travers, Albert Hernandez, Ahlia Sekkarie, Emory University and Children & # 39; s Healthcare of Atlanta; Adina Alazraki, Jack Knight-Scott, Atlanta Children's Health Care; and Courtney McCracken, Children's Healthcare Atlanta and Emory University.