Consumo de frutose natural ou adicionada e sua relação com marcadores hepáticos em adolescentes com excesso de peso

Abstract

In cases of non-alcoholic fatty liver disease (NAFLD), there is an increase in the concentrations of liver transaminases, with a focus on alanine aminotransferase (ALT). Inadequate food intake has been considered one of the causal factors for the development of this condition, especially fructose from unnatural sources. type of food processing, with liver markers and other metabolic parameters in overweight adolescents. This is a cross-sectional study with adolescents aged 10 to 19 years old, diagnosed with overweight or obesity. Anthropometric data (height, weight and waist circumference), biochemical data (lipid and glucose profile and ALT, AST, GGT and alkaline phosphatase concentrations) were collected; and two 24-hour recalls were applied to analyze food consumption. Habitual food consumption was estimated using the Multiple Source Method (MSM). To quantify the fructose consumed, the foods present in the recalls were matched with those in the Food Standards Australia New Zealand table, and classified according to the food groups of the NOVA classification. in natura and minimally processed) or added (processed and ultra-processed foods). To verify the association between fructose consumption and the nutritional and metabolic profile, linear regression analyzes were performed for continuous variables and logistic regression for categorical variables, with a significance level of p <0.05. In the population of 174 overweight adolescents, 91 were boys. We found changes in ALT in 55.1% of boys and 44.9% of girls; for TG, in 51.3% in boys and 48.7% in girls and in HDL-c, 56% in boys and 44% in girls with values below the recommended level. Boys had a higher level of physical activity (p=0.032), higher dietary energy intake (p=0.011), higher serum AST (p=0.003) and phosphatase (p<0.001). The foods that most contributed to the average amount of fructose were bananas, in the natural fructose group, and soft drinks in the added fructose group. Consumption of added fructose was associated with a higher risk of increased triglycerides (B= 1546; 95%CI: 2144), being up to 54.6%, regardless of adjustment. There was no association with the other variables. We showed that the consumption of added fructose from the processed and ultra-processed food groups was related to an increase in TG concentrations in overweight adolescents, however, we found no association with changes in ALT concentrations