Abstract
(1) Background: High sugar intake is prevalent among children and is associated with non-alcoholic fatty liver disease (NAFLD). The purpose of this study is to determine if a high intake of free sugars and sugary beverages (SB) in childhood is associated with NAFLD in adulthood; (2) Methods: At 24 years, 3095 participants were assessed for severe hepatic steatosis (controlled attenuation parameter >280 dB/m) and had dietary data collected via a food frequency questionnaire at age three years. Multiple logistic regression models adjusted for total energy intake, potential confounders, and a mediator (offspring body mass index (BMI) at 24 years); (3) Results: Per quintile increase of free sugar intake association with severe hepatic steatosis at 24 years after adjusting for total energy was odds ratio (OR):1.07 (95% CL: 0.99–1.17). Comparing the lowest vs. the highest free sugar consumers, the association was OR:1.28 (95% CL: 0.88–1.85) and 1.14 (0.72, 1.82) after full adjustment. The OR for high SB consumption (>2/day) compared to <1/day was 1.23 (95% CL: 0.82–1.84) and OR: 0.98 (95% CL: 0.60–1.60) after full adjustment; (4) Conclusions: High free sugar and SB intake at three years were positively but weakly associated with severe hepatic steatosis at 24 years. These associations were completely attenuated after adjusting for confounders and 24-year BMI.
Highlights
The prevalence of non-alcoholic fatty liver disease (NAFLD), signified by elevated liver fat, has increased in parallel with the rise of obesity in children over recent decades, but has not received similar attention [1]
The World Health Organization (WHO) dietary guidelines for children and adults recommend limiting free sugar intake to less than 10% of daily energy to reduce the risk of overweight and obesity, and a further reduction to below 5% for additional health benefits [6]
When the oldest children were seven years of age, attempts were made to increase the initial sample by recruiting from children that would have been eligible to enroll in the original study but did not join at the time, resulting in a new total of 15,454 pregnancies and 14,901 children
Summary
The prevalence of non-alcoholic fatty liver disease (NAFLD), signified by elevated liver fat, has increased in parallel with the rise of obesity in children over recent decades, but has not received similar attention [1]. Male sex, obesity, and high sugar diets are some established risk factors for NAFLD [5]. Free sugars, which include sugars that are naturally present in honey, syrups, fruit juices and fruit juice concentrate, are the primary sugars of public health concern because of their high prevalence in human diets [6]. The World Health Organization (WHO) dietary guidelines for children and adults recommend limiting free sugar intake to less than 10% of daily energy to reduce the risk of overweight and obesity, and a further reduction to below 5% for additional health benefits [6].
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