The association of fructose and fiber consumption and physical activity with non-alcoholic fatty liver disease in children and adolescents: a cross-sectional study
Camellia Akhgarjand,
Mahdieh Entezarian,
Simin Samavat,
Aryan Tavakoli,
Aliarash Anoushirvani,
Golaleh Asghari,
Emad Yusbashian,
Pooneh Dehghan,
Parvin mirmiran,
Hossein Imani
Affiliations
Camellia Akhgarjand
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences
Mahdieh Entezarian
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences
Simin Samavat
Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences
Aryan Tavakoli
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences
Aliarash Anoushirvani
Firoozabadi Clinical Research Development Unit (FACRDU), Department of Pediatrics, School of Medicine, Iran University of Medical Sciences
Golaleh Asghari
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences
Emad Yusbashian
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences
Pooneh Dehghan
Department of Imaging, Research Development Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences
Parvin mirmiran
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences
Hossein Imani
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences
Abstract Background Non-alcoholic fatty liver disease (NAFLD) is emerging as the most prevalent liver disease in overweight and obese children. While no cure exists, dietary and lifestyle modifications have been shown to improve the condition. This study investigates the relationship between fructose and fiber consumption, physical activity, and NAFLD in children. Methods A cross-sectional study was conducted on 378 overweight and obese children aged 6–13 years. NAFLD diagnosis was confirmed via ultrasound, and dietary intake was assessed using a 147-item food frequency questionnaire (FFQ). Physical activity was evaluated using the Modifiable Activity Questionnaire (MAQ). Multivariable logistic regression models were applied to determine the associations. Results After excluding 53 participants due to incomplete data, 325 were included in the final analysis. The mean age was 9.2 ± 1.7 years, and 35% had NAFLD. No significant association was found between fructose intake and NAFLD (OR: 0.67, 95% CI: 0.35–1.29, P = 0.221). However, higher intake of legume fiber (OR: 0.48, 95% CI: 0.26–0.90, P = 0.03) and nut fiber (OR: 0.52, 95% CI: 0.28–0.95, P = 0.04) was significantly associated with a reduced risk of NAFLD. Physical activity showed a trend towards reduced NAFLD risk but was not statistically significant after adjustments (OR: 0.53, 95% CI: 0.22–1.04, P = 0.07). Conclusions While fructose intake was not significantly linked to NAFLD in this population, fiber from legumes and nuts appeared protective. Further prospective studies are needed to confirm these findings and clarify the role of physical activity in NAFLD prevention.
