Evidence map›Paper›PMID 24569542›Full record

SynthesisEuropean journal of clinical nutrition2014

Effect of fructose on markers of non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of controlled feeding trials.

S Chiu, J L Sievenpiper, R J de Souza, A I Cozma, A Mirrahimi, A J Carleton, V Ha, M Di Buono, A L Jenkins, L A Leiter and 5 more

Registry-linked trialOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of clinical nutrition, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02716870 (Effect of Important Food Sources of Fructose-containing Sugars on Cardiometabolic Risk Factors), which is not on this map. Cited by 130 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
130citing papers in PubMed, 16 pooled it
19.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02716870 unknown statusnot on this mapstarted 2015, after this paper: background citation

Effect of Important Food Sources of Fructose-containing Sugars on Cardiometabolic Risk Factors: A Series of Systematic Reviews and Meta-analyses of Controlled Trials to Inform Dietary Guidelines, Public Health Policy, and Future Trial Design

TypeobservationalSponsorUniversity of TorontoRan2015 to 2020Enrolled1ConditionsDyslipidemia, Diabetes, Prediabetes, DysglycemiaArmsFructose-containing Sugars
3 · Its place in the literature

Who cites it

130 citing papers in PubMed, 16 syntheses or guidelines pooled it, 315 citations in OpenAlex.

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  11. ESPEN guideline on clinical nutrition in liver disease.Clinical nutrition (Edinburgh, Scotland) · 2019
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  14. Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017
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70 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 6 institutions in 2 countries.

S Chiu1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Department of Human Biology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
J L Sievenpiper1] Department of Pathology and Molecular Medicine, Faculty of Health Sciences, Hamilton, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] The Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
R J de Souza1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
A I Cozma1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada.
A Mirrahimi1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada.
A J Carleton1] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [2] Department of Undergraduate Medical Education (MD Program), Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
V Ha1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada.
M Di Buono1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Heart and Stroke Foundation of Ontario, Toronto, ON, Canada [3] American Heart Association, Dallas, TX, USA.
A L Jenkins1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada.
L A Leiter1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] Keenan Research Center of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada [4] Division of Endocrinology, St Michael's Hospital, Toronto, ON, Canada [5] Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
T M S Wolever1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] Keenan Research Center of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada [4] Division of Endocrinology, St Michael's Hospital, Toronto, ON, Canada [5] Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
A C Don-Wauchope1] Department of Pathology and Molecular Medicine, Faculty of Health Sciences, Hamilton, ON, Canada [2] Division of Clinical Chemistry and Immunology, Hamilton Regional Laboratory Medicine Program, Hamilton, ON, Canada.
J Beyene1] Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada [2] The Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [3] Child Health Evaluative Sciences (CHES), The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
C W C Kendall1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
D J A Jenkins1] Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada [2] Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, ON, Canada [3] Keenan Research Center of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada [4] Division of Endocrinology, St Michael's Hospital, Toronto, ON, Canada [5] Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
University of Toronto · CASt. Michael's Hospital · CAAmerican Heart Association · USHamilton Health Sciences · CAMcMaster University · CAUniversity of Saskatchewan · CA

Funding

Canadian Institutes of Health Research 102078
6 · The paper itself

Abstract

BACKGROUND/

objectivesIn the absence of consistent clinical evidence, there are concerns that fructose contributes to non-alcoholic fatty liver disease (NAFLD). To determine the effect of fructose on markers of NAFLD, we conducted a systematic review and meta-analysis of controlled feeding trials. SUBJECTS/

methodsWe searched MEDLINE, EMBASE, CINAHL and the Cochrane Library (through 3 September 2013). We included relevant trials that involved a follow-up of ≥ 7 days. Two reviewers independently extracted relevant data. Data were pooled by the generic inverse variance method using random effects models and expressed as standardized mean difference (SMD) for intrahepatocellular lipids (IHCL) and mean difference (MD) for alanine aminotransferase (ALT). Inter-study heterogeneity was assessed (Cochran Q statistic) and quantified (I(2) statistic).

resultsEligibility criteria were met by eight reports containing 13 trials in 260 healthy participants: seven isocaloric trials, in which fructose was exchanged isocalorically for other carbohydrates, and six hypercaloric trials, in which the diet was supplemented with excess energy (+21-35% energy) from high-dose fructose (+104-220 g/day). Although there was no effect of fructose in isocaloric trials, fructose in hypercaloric trials increased both IHCL (SMD=0.45 (95% confidence interval (CI): 0.18, 0.72)) and ALT (MD=4.94 U/l (95% CI: 0.03, 9.85)). LIMITATIONS: Few trials were available for inclusion, most of which were small, short (≤ 4 weeks), and of poor quality.

conclusionsIsocaloric exchange of fructose for other carbohydrates does not induce NAFLD changes in healthy participants. Fructose providing excess energy at extreme doses, however, does raise IHCL and ALT, an effect that may be more attributable to excess energy than fructose. Larger, longer and higher-quality trials of the effect of fructose on histopathological NAFLD changes are required.

Indexed as

Alanine TransaminaseDatabases, FactualFructoseHumansNon-alcoholic Fatty Liver DiseaseObservational Studies as TopicRandomized Controlled Trials as TopicAlanine TransaminaseFructose

Identifiers

PMID24569542
PMCPMC3975811
OpenAlexW2055736494

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.