Fructose Consumption is Associated with Non-Alcoholic Fatty Liver Disease Risk: A Case-Control Study from Iran

Objectives: This study aimed is to evaluate the association between dietary fructose intake and risk of nonalcoholic fatty liver disease (NAFLD). Methods: Newly diagnosed patients with NAFLD and age matched controls were asked about their dietary intakes. Fructose consumption was assessed using a reliable and valid food frequency questionnaire and fructose intake was calculated using food composition table. Results: In the crude model, subjects in the highest quartile had more than 3.08 times higher risk of NAFLD in comparison to those in the lowest quartile of the fructose intake (OR: 3.08; 95 percent CI: 1.87 - 5.06), (P < 0.001). Also, adjustment for age, sex, physical activity (MET-h/wk), body mass index (kg/m2 ), energy intake (kcal/d) and simple sugar strengthened this association (OR: 3.54; 95 percent CI: 1.81 - 6.93) (P = 0.003). Conclusions: Our results indicate that higher intake of fructose is significantly associated with the higher risk of NAFLD; this association remained significant after adjustment for known confounding factors. Further studies are required to find the cut point for safe daily fructose consumption alone or in combination with dietary fiber sources.