Fructose Intake From Fruit Juice and Sugar-Sweetened Beverages Is Associated With Higher Intrahepatic Lipid Content: The Maastricht Study
Research Design and Methods: We used cross-sectional data from The Maastricht Study, a population-based cohort (n=3,981;60±9years;50%women). We assessed the relationship between fructose intake (assessed by a food frequency questionnaire) – total and derived from fruit, fruit juice and sugar-sweetened beverages (SSB) – and IHL (quantified by 3T-Dixon-MRI) with adjustment for age, sex, type 2 diabetes, education, smoking status, physical activity, and intakes of total energy, alcohol, saturated fat, protein, vitamin E, and dietary fiber.
Results: Energy-adjusted total fructose intake and energy-adjusted fructose from fruit was not associated with IHL in the fully adjusted model (p=0.647 and p=0.767).
In contrast, energy-adjusted intake of fructose from fruit juice and SSB was associated with higher IHL in the fully adjusted models (p=0.019 and p=0.009). Individuals in the highest tertile of energy-adjusted intake of fructose from fruit juice and SSB had a 1.04-fold (95%CI: 0.99;1.11) and 1.09-fold (95%CI: 1.03;1.16) higher IHL, respectively, when compared to the lowest tertile in the fully adjusted model. Finally, the association for fructose from fruit juice was stronger in individuals with type 2 diabetes (p for interaction=0.071).
Conclusions: Fructose from fruit juice and SSB is independently associated with higher IHL. These cross-sectional findings contribute to current knowledge in support of measures to reduce the intake of fructose-containing beverages as a means to prevent non-alcoholic fatty liver disease at the population level.