Important Food Sources of Fructose-Containing Sugars and Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Controlled Trials

作者：Danielle Lee, Laura Chiavaroli, Sabrina Ayoub‐Charette, Tauseef Ahmad Khan, Andreea Zurbau, Fei Au‐Yeung, Annette Cheung, Qi Liu, Xinye Qi, Amna Ahmed, Vivian L. Choo, Sonia Blanco Mejía, Vasanti Malik, Ahmed El‐Sohemy, Russell J. de Souza, Thomas M. S. Wolever, Lawrence A. Leiter, Cyril W.C. Kendall, David J.A. Jenkins, John L. Sievenpiper · 发表于：Nutrients · 年份：2022 · DOI：10.3390/nu14142846 · 被引用次数：59 · 研究领域：Diet, Metabolism, and Disease、Liver Disease Diagnosis and Treatment、Diet and metabolism studies

Background: Fructose providing excess calories in the form of sugar sweetened beverages (SSBs) increases markers of non-alcoholic fatty liver disease (NAFLD). Whether this effect holds for other important food sources of fructose-containing sugars is unclear. To investigate the role of food source and energy, we conducted a systematic review and meta-analysis of controlled trials of the effect of fructose-containing sugars by food source at different levels of energy control on non-alcoholic fatty liver disease (NAFLD) markers. Methods and Findings: MEDLINE, Embase, and the Cochrane Library were searched through 7 January 2022 for controlled trials ≥7-days. Four trial designs were prespecified: substitution (energy-matched substitution of sugars for other macronutrients); addition (excess energy from sugars added to diets); subtraction (excess energy from sugars subtracted from diets); and ad libitum (energy from sugars freely replaced by other macronutrients). The primary outcome was intrahepatocellular lipid (IHCL). Secondary outcomes were alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Independent reviewers extracted data and assessed risk of bias. The certainty of evidence was assessed using GRADE. We included 51 trials (75 trial comparisons, n = 2059) of 10 food sources (sugar-sweetened beverages (SSBs); sweetened dairy alternative; 100% fruit juice; fruit; dried fruit; mixed fruit sources; sweets and desserts; added nutritive sweetener; honey; and m...