In an outpatient study
13 in obese Latino and African American children with features of metabolic syndrome (eg, elevated triglycerides, insulin resistance, hypertension) who reported high levels of sugar intake, 9 days of fructose restriction with isocaloric substitution of complex carbohydrates resulted in reductions in fasting glucose and insulin levels, improved glucose tolerance,
41 and less atherogenic lipoprotein profiles.
42 Importantly, these same participants had a 56% decrease in DNL during feeding (n=40).
13 Although the children in this study were not selected for the presence of liver fat concentration, approximately two-thirds of them had elevated liver fat concentration (>5% liver fat fraction by magnetic resonance spectroscopy). Overall, liver fat concentration decreased by 22% during fructose restriction.
13 This study provides further evidence that carbohydrate quality, specifically fructose, plays an important role in liver fat accumulation and hypertriglyceridemia and that DNL is an important factor in these processes.