1. In this randomized controlled trial, a low free sugar diet resulted in reduced hepatic steatosis compared to a usual diet in adolescents males with Non-Alcoholic Fatty Liver Disease (NAFLD)
2. A low free sugar diet led to greater reduction in alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transpeptidase levels.
Evidence Rating Level: 1 (Excellent)
Study Rundown: The prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) has increased among children, becoming one of the most common diseases in this population. While pediatric guidelines recommend lifestyle modification and exercise, there is no specific diet recommended. In this randomized controlled trial of adolescent boys with NAFLD, a low free sugar diet led to greater improvements in hepatic steatosis at 8 weeks compared to diet as usual. In addition, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transpeptidase levels were also reduced by a low free sugar diet.
While this study shows promising results for sugar restriction as treatment in adolescent NAFLD, the study has several limitations, including a small number of participants. Demographically, the study results are difficult to generalize due to exclusion of girls and a largely homogeneous Hispanic population. In addition, calorie-intake was lower in the low free sugar group, confounding whether sugar or calorie restriction was the main driver of results. Finally, it is unclear how the pathological and clinical endpoints in this study relate to morbidity and mortality.
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