Fructose and hepatic insulin resistance

Plant-based antioxidant peptides: impact on oxidative stress and gut microbiota

Plant-based peptides can be obtained from natural and climate-friendly sources. These peptides show various bioactivities including antioxidant activity. Oxidative stress has an impact on the gut microbiota causing inflammation, insulin resistance, osteoporosis, cancer, and several chronic diseases like type 2 diabetes, arthritis, hypertension, and atherosclerosis. Therefore, antioxidant peptides may significantly affect oxidative stress as a potential alternative to conventional medication. The production of antioxidant peptides from plant-based protein sources through conventional and innovative approaches may provide promising strategies to improve gut microbiota. Recent studies in plant-based antioxidant peptides (PBAP) focus on their advanced identification and characterization techniques, structure-activity relationship, improvement of extraction and purification, cellular and molecular mechanisms, specific health applications in preventing and managing conditions with gut microbiota, and commercial applications in nutraceuticals. Short-chain fatty acids and reactive sulfur species are specific gut-derived metabolites that can improve metabolic function by modulating oxidative stress and the immune system. This review highlights the influence of food oxidants on the gut microbiota and PBAP-induced modulation of gut microbiota. Moreover, the production of PBAP and the challenges in their application will be discussed.

Fructose-Induced Impairment of Liver and Skeletal Muscle Metabolism Is Prevented by Administration of Shouchella clausii Spores by Preserving Mitochondrial Function and Insulin Sensitivity

The objective of the study was to evaluate the efficacy of S. clausii spores (SF174) in counteracting the deleterious effects of dietary fructose. Thirty-days old male Wistar rats were treated for 6 weeks: control group: 0.5 mL of 10% sucrose solution (without probiotics); fructose group: 0.5 mL of 10% sucrose solution + high-fructose diet (without probiotics); SF174 group: 0.5 mL of 10% sucrose solution containing SF174 (5 × 10⁹ CFU) + high-fructose diet. Fructose intake induced an increase in proinflammatory cytokines in portal plasma, liver, and skeletal muscle, a decrease in insulin sensitivity in both tissues and a condition of hepatic steatosis. An increase in the mitochondrial activity in the liver and a decrease in skeletal muscle were evidenced, together with an increase in the thiobarbituric acid reactive substances (TBARS) levels and a decrease in the antioxidant enzyme activity. All the above alterations were counteracted by probiotic administration. We here demonstrate for the first time that S. clausii SF174 counteracts low-grade inflammation and insulin resistance induced by fructose, protects mitochondria from changes in oxidative capacity, and maintains unaltered the oxidative balance. Therefore, S. clausii SF174 administration can be an effective strategy to prevent the unhealthy consequences of dietary fructose.

Long-Term Exposure to Environmentally Realistic Doses of Starch-Based Microplastics Suggests Widespread Health Effects

There is a growing consensus on addressing the global plastic pollution problem by advocating for bioplastics. While starch-based plastics are prevalent, the potential health implications of starch-based microplastics (SMPs) remain largely unexplored. This is particularly concerning given their potential for accidental ingestion and subsequent interference with blood glucose metabolism. Our research provides the first investigation into the distribution and adverse effects of long-term exposure to environmentally relevant doses of SMPs in female mice, approximately 14-81 particles per mouse per day. After three months of exposure, SMPs were found to infiltrate the liver, intestine, and ovarian tissues, causing microstructural lesions. Exposure to SMPs also resulted in elevated blood glucose levels, increased hepatic oxidative stress, and disrupted lipid metabolism. A multiomics analysis further uncovered abnormalities in gene expression and microbiota, as well as enriched pathways related to insulin regulation and circadian rhythms in the exposed mice. Our results indicate that prolonged exposure to environmentally relevant doses of SMPs can have widespread health effects in mice, potentially disrupting circadian rhythms by inducing insulin resistance. This suggests that the safety of bioplastics requires further evaluation before their large-scale application in food packages.

The effect of Helicobacter pylori-derived extracellular vesicles on glucose metabolism and induction of insulin resistance in HepG2 cells

Helicobacter pylori infection has been associated with the development of insulin resistance (IR). This study aimed to examine the effect of H. pylori-derived extracellular vesicles (EVs) on IR induction. EVs were derived from two H. pylori strains, and characterised by transmission electron microscopy and dynamic light scattering. Different concentrations of insulin were added to HepG2 cells to induce IR model. HepG2 cells were exposed to various concentrations of H. pylori-derived EVs to assess IR development. The gene expression of IRS1, AKT2, GLUT2, IL-6, SOCS3, c-Jun and miR-140 was examined using RT-qPCR. Glucose uptake analysis revealed insulin at 5 × 10 -7 mol/l and EVs at 50 µg/ml induced IR model in HepG2 cells. H. pylori-derived EVs downregulated the expression level of IRS1, AKT2, and GLUT2, and upregulated IL-6, SOCS3, c-Jun, and miR-140 expression in HepG2 cells. In conclusion, our findings propose a novel mechanism by which H. pylori-derived EVs could potentially induce IR.

Can Iron Absorption in Molasses Be Increased with Probiotic Additives? "Molasses with Increased Bioavailability"

Introduction: There are many studies on the chemical and enzymatic interactions of probiotics, and the effects of Lactobacillus plantarum 299v on iron absorption have been clearly shown. The aim of this study was to investigate the effect of probiotics on the absorption of iron in molasses. Material and method: Wistar rats (n = 46) were taken four weeks after birth and divided into seven groups. Iron deficiency anemia was induced by giving "iron purified pellet" to the groups except the control group for four weeks and then the groups were given nutrients for eight weeks. In addition to iron deficiency anemia tests, immunohistochemical markers such as SCL11a, IRE1, Wnt2, and CD71 were examined. Results: The mean weight of the subjects was 309.5 ± 63.9 (226-424) g and no significant difference was observed in the laboratory values of metabolic data. When the laboratory values of iron deficiency anemia were examined, a statistically significant difference was found between the mean ferritin (p = 0.03) and hepcidin (p = 0.02) values of the groups. Discussion: Iron absorption analysis values were generally higher in the group receiving Fe3+ as expected. However, when the groups receiving molasses and additives were compared, the highest plasma iron level and Hb value were found in the Lactobacillus plantarum 299v group, and the highest ferritin and hepcidin levels were found in the Multiprobiotic group. No difference was observed between the body weights and fasting serum glucose levels of the groups despite daily molasses consumption, indicating the metabolic proactive effects of probiotics. Conclusions: Although no significant difference was detected between the groups receiving probiotics, iron absorption in molasses was increased with probiotic supplementation.

The correlation between serum fructose levels and pregnancy outcomes in IVF patients with and without PCOS: a case-control study

BACKGROUND

Excessive fructose intake can impact pregnancy health. Additionally, Polycystic ovary syndrome (PCOS) is associated with both elevated fructose levels and adverse pregnancy outcomes. Therefore, it is significant to investigate whether serum fructose levels influence pregnancy outcomes in patients with or without PCOS.

METHODS

This case-control study included 270 participants (PCOS, n = 135; non-PCOS, n = 135). The serum fructose levels of consecutively treated women undergoing in vitro fertilization - embryo transfer treatment at the Center of reproductive medicine in Shengjing hospital of China Medical University, from June 2020 to June 2021, were measured. Pregnancies were monitored until the ultimate outcome was determined. The antenatal, delivery, and neonatal outcomes were extracted from hospital records.

RESULTS

In patients with PCOS, those who experienced miscarriage had significantly higher serum fructose levels (P = 0.011). The incidence of miscarriage increased as the serum fructose quartiles increased in patients with PCOS (P = 0.010). There was a significant correlation between serum fructose levels and miscarriage (r = 0.258, P = 0.002). The results of multivariate logistic regression analysis remain consistent (odd ratio [OR] = 10.138, P = 0.005). Conversely, in women without PCOS, those who prematurely delivered had significantly higher serum fructose levels (P = 0.001). The incidence of preterm delivery increased as the serum fructose quartiles increased in patients without PCOS (P < 0.001). There was a significant correlation between serum fructose levels and preterm delivery (r = 0.311, P < 0.001) in non-PCOS group. The multivariate logistic regression analysis indicated the identical results (OR = 18.359, P = 0.008). The area under the curve for fructose-mediated prediction of miscarriage in PCOS was 0.686, while for prediction of preterm birth in non-PCOS individuals, the area under the curve was 0.731.

CONCLUSIONS

Serum fructose levels are positively associated with miscarriage risk in patients with PCOS. Within the non-PCOS cohort, fructose levels are linked to preterm birth. Further investigation is warranted to comprehensively elucidate the underlying mechanisms, thus enhancing our profound understanding.

Ultra-processed foods and risk of declined renal function: a dose-response meta-analysis of 786,216 participants

OBJECTIVES

Earlier investigations have documented an association between elevated consumption of Ultra-Processed Foods (UPFs) and adverse renal outcomes. To explore this relationship further, we executed a comprehensive dose-response meta-analysis to examine the link between UPFs intake and the risk of declined renal function.

SETTING

A systematic search was completed utilizing the ISI Web of Science, Scopus, Embase as well as PubMed/MEDLINE databases (without any restrictions), up until September 5, 2024. Effect sizes of declined renal function were recalculated by applying a random effects model. The GRADE tool was adopted to assess the certainty of the evidence, while study quality and potential publication bias were examined via validated methods such as the Newcastle-Ottawa Scale, Egger's regression asymmetry and Begg's rank correlation test.

RESULTS

Thirty-three studies (comprising 786,216 participants) were incorporated in the quantitative analysis. The results demonstrated that a greater UPFs intake was significantly associated with an enhanced risk of declined renal function (RR = 1.16; 95% CI: 1.09, 1.23; I2 = 68.8%; p < 0.001; n = 37). Additionally, we observed that each 1-serving-per-day increase in UPFs consumption was associated to a 5% greater risk of reduced renal function (RR = 1.05; 95% CI: 1.02, 1.09; I2 = 80.9%; p = 0.013; n = 9). A positive, linear association between UPF intake and the risk of declined renal function (Pnonlinearity = 0.107, Pdose-response < 0.001) was further displayed in the non-linear dose-response analysis.

CONCLUSION

Greater exposure to UPFs is positively associated with the risk of declined renal function. The information emphasizes the importance of considering UPFs in the prevention and management of adverse renal outcomes.

Aldose reductase, fructose and fat production in the liver

There is an increasing interest in the role of fructose as a major driver of non-alcoholic fatty liver disease (NAFLD), and it is linked closely with the intake of sugar. However, there has also been the recognition that fructose can be produced directly from intracellular glucose via the evolutionarily conserved polyol pathway whose access is governed by aldose reductase (AR). The purpose of this article is to review the biochemistry of AR and the role of the polyol pathway in opening fructose metabolism. This article provides a new perspective about AR and the other key enzymes surrounding the decision to divert glucose into the polyol pathway which suggests that the production of endogenous fructose may be of much greater significance than historically viewed. There are important aspects of the regulation of the polyol pathway and its committal step catalyzed by AR, which supports the notion that fructose-uric acid pathway is activated by elevated glucose with the downstream consequence of NAFLD and perhaps other chronic metabolic diseases.

Indian lychee honey ameliorates hepatic glucose uptake by regulating the ChREBP/Glut4 axis under insulin-resistant conditions

Many traditional treatments include honey owing to its magnificent health beneficiary effects. Recent studies have demonstrated the potent anti-diabetic activity of honey. However, its actual mechanism of action remains elusive. Moreover, being rich in sugar (75%-80%), its role in maintaining glucose homeostasis remains questionable. Although the polyphenol content of honey aids its hypoglycaemic activity, the small quantity of bioactive compounds in honey (0.5%-1.0%) may not be solely responsible for this. In the current study, an attempt was made to understand the role of Indian lychee honey (LyH) in regulating blood glucose levels under diabetic conditions. This study investigated whether LyH, although rich in sugars, can be used as an alternative to regulate glucose and lipid homeostasis under insulin-resistant conditions by regulating the ChREBP/Glut4 signalling pathway. This study was first performed in vitro in palmitic acid-induced insulin-resistant HepG2 cells. Various assays, such as FACS, GCMS, qRT-PCR, immunoblot and ChIP-qPCR, were performed to establish the anti-hyperglycaemic role of LyH in vitro. The in vitro results were subsequently confirmed in vivo using a high-fat diet-induced diabetic C57BL/6 mice model. The in vivo study was supported by several experiments, such as examining blood parameters, histopathology, double-immunohistochemistry and ELISA. Finally, the finding was validated by comparing it with a couple of GEO datasets from the NCBI database. This study found that LyH is an excellent choice for regulating blood sugar levels under diabetic conditions without significant harmful side effects. Moreover, LyH showed excellent hepatic glucose uptake activity in an insulin-independent manner. This activity is mainly governed by sugars as its main ingredient. LyH treatment also regulates hepatic lipid homeostasis by maintaining a balance between saturated and unsaturated fatty acids in insulin-resistant HepG2 cells. Further, sugar, when supplemented individually, caused severe inflammation, which was validated through histopathology, ELISA and IHC. Collectively, the findings of this study indicate that Indian LyH provides a better food matrix (the right proportion of sugars and different bioactive compounds), which significantly improves hyperglycemia and inflammation under diabetic conditions by regulating the hepatic ChREBP/Glut4 axis.

Apigenin Ameliorates Insulin Resistance in 3T3-L1 Adipocytes: Establishment of a New Insulin Resistance Model Induced by Combined Treatments

Adipose tissue dysfunction due to insulin resistance (IR) plays a central role in the development of metabolic diseases. Obesity-associated IR greatly attributes to low-grade inflammation and high circulating levels of FFAs and sugar. 3T3-L1 adipocytes exposed to a mixture of TNF-α, fructose, and palmitate acid for 24 h were validated as a model to simulate the pathogenesis of IR in obese people under a high-fat-fructose diet. Results show that the combined induction medium (CIM) successfully induced IR in 3T3-L1 adipocytes by impairing insulin signaling pathway. In the meantime, MAPK (JNK, ERK) pathway and NFκB p65 were activated, which are signs of inflammation response. Moreover, CIM caused mitochondrial dysfunction and oxidative stress. In addition, endoplasmic reticulum stress (ER stress) was evoked by CIM through activating IRE1α/XBP1s, eIF2α, and ATF6. Apigenin could efficiently relieve IR in adipocytes through sensitizing insulin signaling pathway, exerting antioxidant activity, blocking the NFκB pathway, and suppressing ER stress. The present study may provide new tools in discovering preventive and intervention strategies for IR caused by low-grade inflammation and high-fat-fructose diets and provide a basis for the application of apigenin in IR and other IR-related diseases.

The impact of high-intensity interval training on insulin sensitivity and quality of life in women with overweight polycystic ovary syndrome

BackgroundPolycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age, characterized by menstrual irregularities, hyperandrogenism, and polycystic ovaries. Insulin resistance is central to its pathophysiology, contributing to metabolic disturbances and increased cardiometabolic risks. High-Intensity Interval Training (HIIT) has emerged as a promising intervention to improve metabolic health.ObjectiveThis study aimed to investigate the specific effects of HIIT on insulin sensitivity, body composition, metabolic profile, and quality of life in women with overweight PCOS.MethodsA retrospective analysis was conducted on 107 female patients with overweight PCOS who were divided into two groups: the Regular Interval Training Group (n = 54) and the HIIT Group (n = 53). Baseline data, including insulin sensitivity, glucose metabolism, body composition, metabolic profile, and quality of life, were measured and compared between the two groups.ResultsThe HIIT Group demonstrated significantly improved insulin sensitivity, reduced fasting glucose levels, lower HOMA-IR index, lower body fat percentage, decreased waist and hip circumferences, improved favorable changes in metabolic profile, and significant improvements in quality of life compared to the Regular Interval Training Group. These findings suggest that HIIT led to beneficial outcomes across various metabolic and clinical parameters in women with overweight PCOS.ConclusionThe findings of this study highlight the potential of personalized exercise prescriptions, such as HIIT, in optimizing health outcomes in women with overweight PCOS. The observed improvements in insulin sensitivity, body composition, metabolic profile, and quality of life underscore the promising role of HIIT in addressing the multifaceted implications of PCOS and its associated metabolic and reproductive implications.

The Association of Fructose Metabolism With Anesthesia/Surgery-Induced Lactate Production

BACKGROUND

In elderly individuals, excessive lactate levels in the brain may be associated with the development of cognitive impairment after surgery, including delayed neurocognitive recovery (dNCR). Since the origin of this increased lactate is unknown, here we assessed associations between metabolic pathways and postoperative dNCR.

METHODS

This study included 43 patients (≥60 years old) who had surgery under general anesthesia. We also used a mouse model in which 20-month-old mice were exposed to sevoflurane to induce postoperative dNCR, while control mice were exposed to 40% oxygen. Mice in the control group and anesthesia/surgery group were injected with fructose or glucose intracerebroventricularly, or fructose metabolism inhibitor intraperitoneally. Barnes maze test and Y maze were used to measure cognitive function in mice. Metabolomics was used to measure metabolites in the serum of patients and the brains of mice after anesthesia/surgery. Isotope labeling and metabolic flux were used to analyze flow and distribution of specific metabolites in metabolic pathways.

RESULTS

Among 43 patients, 17 developed dNCR. Metabolomics showed significantly decreased postoperative serum fructose 1-phosphate levels in dNCR compared to nondNCR patients (mean difference [×10 4 ] = -0.164 ± 0.070; P = .024). Similar results were found in the brains of mice (mean difference = -1.669 ± 0.555; * P = .014). Isotope labeling and metabolic flux experiments in mice showed fructose but not glucose entered glycolysis, increasing lactate levels in the brain after anesthesia/surgery ( P < .05). Administration of intraperitoneal fructose inhibitors to mice effectively inhibited increased lactate levels in the brain (mean difference =96.0 ± 4.36, P = .0237) and cognitive dysfunction after anesthesia/surgery (mean difference =69.0 ± 3.94, P = .0237). In a small subsample, we also found anesthesia/surgery increased interleukin-6 (IL-6) levels in the brains of mice (mean difference =88.3 ± 3.44, P = .0237) and that IL-6 may function upstream in fructose activation.

CONCLUSIONS

These results suggest that anesthesia/surgery activates fructose metabolism, producing excessive lactate in the brain that is associated with postoperative cognitive impairment. Fructose metabolism is thus a potential therapeutic target for dNCR.

Multi-tissue network analysis reveals the effect of JNK inhibition on dietary sucrose-induced metabolic dysfunction in rats

Excessive consumption of sucrose, in the form of sugar-sweetened beverages, has been implicated in the pathogenesis of metabolic dysfunction-associated fatty liver disease (MAFLD) and other related metabolic syndromes. The c-Jun N-terminal kinase (JNK) pathway plays a crucial role in response to dietary stressors, and it was demonstrated that the inhibition of the JNK pathway could potentially be used in the treatment of MAFLD. However, the intricate mechanisms underlying these interventions remain incompletely understood given their multifaceted effects across multiple tissues. In this study, we challenged rats with sucrose-sweetened water and investigated the potential effects of JNK inhibition by employing network analysis based on the transcriptome profiling obtained from hepatic and extrahepatic tissues, including visceral white adipose tissue, skeletal muscle, and brain. Our data demonstrate that JNK inhibition by JNK-IN-5A effectively reduces the circulating triglyceride accumulation and inflammation in rats subjected to sucrose consumption. Coexpression analysis and genome-scale metabolic modeling reveal that sucrose overconsumption primarily induces transcriptional dysfunction related to fatty acid and oxidative metabolism in the liver and adipose tissues, which are largely rectified after JNK inhibition at a clinically relevant dose. Skeletal muscle exhibited minimal transcriptional changes to sucrose overconsumption but underwent substantial metabolic adaptation following the JNK inhibition. Overall, our data provides novel insights into the molecular basis by which JNK inhibition exerts its metabolic effect in the metabolically active tissues. Furthermore, our findings underpin the critical role of extrahepatic metabolism in the development of diet-induced steatosis, offering valuable guidance for future studies focused on JNK-targeting for effective treatment of MAFLD.

Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) and mortality among survivors of liver cirrhosis: a prospective cohort study

BACKGROUND

Cirrhosis is a medical condition marked by persistent liver damage, which leads to the development of fibrous tissue and compromised liver function. In the present study, we decided to investigate the possibility of a connection between the consumption of fermentable olig-, di-, monosaccharides, and polyols (FODMAPs) and mortality rates in cirrhotic patients by utilizing data obtained from a prospective cohort study.

METHODS

This cohort study enrolled 166 ambulatory patients from two hospitals in Tehran, Iran, between 2016 and 2018, and followed them up for 5 48 months until April 30, 2022. During the 3,955 person-months of follow-up, 43 fatalities were recorded (36 men and 7 women). The study classified participants into three groups based on their FODMAPs consumption and assessed the risk of mortality using Cox proportional hazards regression models.

RESULTS

Total FODMAPs intake was associated with increased overall mortality risk (T3 vs. T1, HR = 3.5; 95%CI: 1.05, 11.7; P-trend = 0.036). This significant trend was also observed for total fructans (T3 vs. T1, HR = 5.15; 95% CI: 1.15, 23.2; P-trend = 0.006) and fructose (T3 vs. T1, HR = 5.55; 95% CI: 0.54, 57.14; P-trend = 0.018). Mortality risk was U-shaped with galactooligosaccharide intake, a lower mortality risk was observed with lactose intake and a higher mortality risk with polyols intake, although these associations did not reach statistical significance.

CONCLUSION

In conclusion, this study highlights a higher risk of mortality with higher intake of fructans, excess fructose and total FODMAPs.

Types of dietary sugars and carbohydrates, cardiometabolic risk factors, and risk of diabetes: a cohort study from the general Danish population

BACKGROUND

The role of carbohydrates in diabetes risk is of particular interest due to conflicting results. This study aims to examine the prospective association between types of dietary carbohydrates (fiber, starch, total sugar, glucose, fructose, lactose, maltose, and added sugar) and the risk of diabetes. Further, this study examines the cross-sectional associations between these nutrients and cardiometabolic risk factors.

METHODS

Danish Health Examination Survey (2007-2008) investigated 76,484 Danes in a representative sample using online questionnaires. Dietary information using a food frequency questionnaire was obtained from 42,836 participants. Information on incident cases of diabetes was obtained from the Danish National Diabetes Register. Cox proportional hazard models were used to estimate Hazard Ratios (95% CI). Multiple linear regression analyses were used to assess the associations between carbohydrate types and cardiometabolic risk factors measured in a subsample of 12,977 participants.

RESULTS

During a median follow-up of 4.9 years, 970 participants developed diabetes. A higher consumption of fructose, but a lower consumption of glucose was associated with a lower risk of diabetes. In subgroup analyses, these associations were only significant among individuals with other risk factors, such as older age, obesity, low fiber consumption, sedentary behavior, smoking status, and hypertension. Participants with a higher intake of fiber tend to have a lower risk of diabetes and healthier anthropometric parameters compared to those with a lower intake.

CONCLUSIONS

Our findings suggest that a higher intake of dietary fiber and fructose is associated with a lower risk of diabetes and healthier metabolic status, while higher glucose intake is associated with a higher diabetes risk.

Dietary Interventions and Physical Activity as Crucial Factors in the Prevention and Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and affects nearly 30% of the adult population and 10% of the pediatric population. It is estimated that this number will double by 2030. MASLD is one of the leading causes of hepatocellular carcinoma, cirrhosis, and liver transplantation, as well as a significant risk factor for cardiovascular disease and mortality. Due to the ever-increasing number of patients, the long-term asymptomatic course of the disease, serious complications, and lack of preventive programs, as well as insufficient awareness of the disease among patients and doctors themselves, MASLD is a growing interdisciplinary problem and a real challenge for modern medicine. The main cause of MASLD is an inappropriate lifestyle-inadequate nutrition and insufficient physical activity, which lead to various components of metabolic syndrome. Lifestyle changes-appropriate diet, weight reduction, and systematic physical activity-are also the basis for the prevention and treatment of MASLD. Hence, in recent years, so much importance has been attached to lifestyle medicine, to non-pharmacological treatment as prevention of lifestyle diseases. The narrative review presents possible therapeutic options for non-pharmacological management in the prevention and treatment of MASLD. The best documented and available diets used in MASLD were discussed, focusing on the benefits and drawbacks of the Mediterranean, high-protein, ketogenic, and intermittent fasting diets. In addition, the most recent recommendations regarding physical activity are summarized.

Fructose catabolism and its metabolic effects: Exploring host-microbiota interactions and the impact of ethnicity

Important health disparities are observed in the prevalence of obesity and associated non-communicable diseases (NCDs), including type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD) among ethnic groups. Yet, the underlying factors accounting for these disparities remain poorly understood. Fructose has been widely proposed as a potential mediator of these NCDs, given that hepatic fructose catabolism can result in deleterious metabolic effects, including insulin resistance and hepatic steatosis. Moreover, the fermentation of fructose by the gut microbiota can produce metabolites such as ethanol and acetate, both which serve as potential substrates for de novo lipogenesis (DNL) and could therefore contribute to the development of these metabolic conditions. Significant inter-ethnic differences in gut microbiota composition have been observed. Moreover, fructose consumption varies across ethnic groups, and fructose intake has been demonstrated to significantly alter gut microbiota composition, which can influence its fermenting properties and metabolic effects. Therefore, ethnic differences in gut microbiota composition, which may be influenced by variations in fructose consumption, could contribute to the observed health disparities. This review provides an overview of the complex interactions between host and microbial fructose catabolism, the role of ethnicity in shaping these metabolic processes and their impact on host health. Understanding these interactions could provide insights into the mechanisms driving ethnic health disparities to improve personalized nutrition strategies. KEY POINTS: Dietary fructose consumption has increased substantially over recent decades, which has been associated with the rising prevalence of obesity and non-communicable diseases (NCDs) such as type 2 diabetes and metabolic dysfunction-associated steatotic liver disease. Pronounced disparities among different ethnic groups in NCD prevalence and dietary fructose consumption underscore the need to elucidate the underlying mechanisms of fructose catabolism and its health effects. Together with the well-known toxic effects of hepatic fructose catabolism, emerging evidence highlights a role for the small intestinal microbiota in fermenting sugars like fructose into various bacterial products with potential deleterious metabolic effects. There are significant ethnic differences in gut microbiota composition that, combined with varying fructose consumption, could mediate the observed health disparities. To comprehensively understand the role of the gut microbiota in mediating fructose-induced adverse metabolic effects, future research should focus on the small intestinal microbiota. Future research on fructose - microbiota - host interactions should account for ethnic differences in dietary habits and microbial composition to elucidate the potential role of the gut microbiota in driving the mentioned health disparities.

Nutritional Strategies for Battling Obesity-Linked Liver Disease: the Role of Medical Nutritional Therapy in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Management

PURPOSE OF REVIEW

This narrative review explores the role of Medical Nutritional Therapy (MNT) in managing Metabolic-Associated Steatotic Liver Disease (MASLD), previously known as nonalcoholic fatty liver disease. It aims to examine the effectiveness of specific nutritional strategies in preventing and treating this obesity-linked liver disease.

RECENT FINDINGS

Emerging evidence underscores the benefits of the Mediterranean diet, low-carbohydrate diets, and intermittent fasting in reducing liver fat, improving insulin sensitivity, and mitigating inflammation. Supplementing with vitamin E, omega-3 fatty acids, and silymarin can potentially reduce liver fibrosis and promote liver health. MNT is a key intervention for MASLD management, emphasizing dietary patterns, caloric restriction, and nutraceutical supplementation. Integrating these strategies with lifestyle modifications, including regular physical activity, offers a comprehensive approach to improving metabolic and liver outcomes in patients with MASLD. Further research is needed to refine and personalize these therapeutic interventions.

Leisure activity engagement attenuates the risks of cognitive impairment induced by unhealthy plant-based diets: a nationwide cohort study

OBJECTIVE

We intended to reveal the joint effects between LAE and uPDI on cognition in Chinese older adults.

METHODS

Data were collected from the Chinese Longitudinal Healthy Longevity Survey. In total, 10,617 individuals aged 65 years and above without cognitive impairment or dementia at baseline were enrolled in 2008 and followed up in 2011, 2014, and 2018. The uPDI and the scores of LAE were derived from survey responses, and both were categorized into three groups (low, intermediate, and high). Individuals with a Mini-Mental State Examination (MMSE) score lower than 18 were considered to have cognitive impairment. Cox proportional hazards models were employed to explore the joint association of uPDI and LAE on cognitive impairment, followed by restricted cubic spline (RCS) to observe the effects of the continuous-type variable of uPDI and the scores of LAE on the risk of cognitive impairment. Stratified analysis was applied to examine the association of LAE with cognitive impairment in uPDI groups (high uPDI vs. low uPDI).

RESULTS

Compared to participants maintained low scores of LAE and high uPDI, those who maintained high scores of LAE and low uPDI had a decreased risk of cognitive impairment (HR = 0.52, 95% CI, 0.43-0.62). The findings of the stratified analysis demonstrated that the protective effects of high scores of LAE on cognition was pronounced in individuals with low uPDI (HR = 0.61, 95% CI: 0.47-0.79) and those with high uPDI (HR = 0.63, 95% CI: 0.51-0.78).

CONCLUSIONS

In this cohort study, a higher score of uPDI, which indicated higher intake of salt-preserved vegetables, sugars, and refined grains, was associated with an increased risk of cognitive impairment, whereas this association may be mitigated by regular engagement in leisure activities.

The possible protective effect of luteolin on cardiovascular and hepatic changes in metabolic syndrome rat model

The metabolic syndrome, or MetS, is currently a global health concern. The anti-inflammatory, anti-proliferative, and antioxidant properties of luteolin are some of its advantageous pharmacological characteristics. This research was designed to establish a MetS rat model and investigate the possible protective effect of luteolin on cardiovascular, hepatic, and metabolic changes in diet-induced metabolic syndrome in rats. Forty adult male albino rats were split into four groups: a negative control group, a group treated with luteolin, a group induced MetS (fed 20% fructose), and a group treated with luteolin (fed 20% fructose and given luteolin). Following the experiment after 8 weeks, biochemical, histological (light and electron), and immunohistochemistry analyses were performed on liver and heart tissues. Serum levels of cTnI, CK-MB, and LDH were significantly elevated in response to the cardiovascular effect of MetS. Furthermore, compared to the negative control group, the MetS group showed a marked increase in lipid peroxidation in the cardiac and hepatic tissues, as evidenced by elevated levels of MDA and a decline in the antioxidant defense system, as demonstrated by lower activities of GSH and SOD. The fatty liver-induced group exhibited histological alterations, including disrupted hepatic architecture, dilated and congested central veins, blood sinusoids, and portal veins. In addition to nuclear structural alterations, most hepatocytes displayed varying degrees of cytoplasmic vacuolation, mitochondrial alterations, and endoplasmic reticulum dilatation. These alterations were linked to inflammatory cellular infiltrations, collagen fiber deposition, active hepatic stellate cells, and scattered hypertrophied Kupffer cells, as demonstrated by electron microscopy and validated by immunohistochemical analysis. It is interesting to note that eosinophils were seen between the liver cells and in dilated blood sinusoids. Moreover, the biochemical (hepatic and cardiac) and histological (liver) changes were significantly less severe in luteolin-treated rat on a high-fructose diet. These results suggested that luteolin protects against a type of metabolic syndrome that is produced experimentally.

Fructose intake, endogenous biomarkers and latent metabolic construct in adolescents: Exploring path associations and mediating effects

BACKGROUND

Uric acid (UA) and homeostatic model assessment of insulin resistance (HOMA-IR) are endogenous biomarkers implicated in metabolic disorders and dysfunction.

OBJECTIVES

To investigate the structural associations between sugar-sweetened beverage intake (SSB), UA, HOMA-IR and adolescent latent MetS construct (MetsC) representing paediatric metabolic syndrome (MetS).

METHODS

A population-based representative adolescent cohort (n = 1454) was evaluated for risk profiles of MetS. Structural equation modelling was performed to identify multifactor structural associations between study parameters and evaluate mediating effects.

RESULTS

Adolescents had a single-factor latent construct representing MetS. Increased SSB intake was associated with higher UA and HOMA-IR levels, and the two biomarkers were positively associated with the MetsC score. UA and HOMA-IR exerted three mediating effects on the association between fructose-rich tea beverage (FTB) intake of >500 mL/day and MetsC: adjusted standardized coefficient and mediating effect (%), FTB → UA → MetsC: 0.071, 23.1%; FTB → HOMA-IR → MetsC: 0.034, 11.0%; FTB → UA → HOMA-IR → MetsC: 0.010, 3.1%. The UA-associated pathways accounted for 31.1% of the overall mediation on the association between bottled sugar-containing beverage intake and MetsC. After accounting for the UA- and HOMA-IR-derived detrimental effects, the fructose-rich tea beverage intake of >500 mL/day had a tea-related beneficial effect on MetsC, with an adjusted standardized coefficient of -0.103.

CONCLUSIONS

UA and HOMA-IR individually and jointly mediate the adverse effects of high fructose-rich SSB intake on the mechanisms underlying paediatric MetS. Fructose-free tea-based beverages may have a beneficial effect on latent MetS structure in adolescents.

Rodent model of metabolic dysfunction-associated fatty liver disease: a systematic review

Although significant progress has been made in developing preclinical models for metabolic dysfunction-associated steatotic liver disease (MASLD), few have encapsulated the essential biological and clinical outcome elements reflective of the human condition. We conducted a comprehensive literature review of English-language original research articles published from 1990 to 2023, sourced from PubMed, Embase, and Web of Science, aiming to collate studies that provided a comparative analysis of physiological, metabolic, and hepatic histological characteristics between MASLD models and control groups. The establishment of a robust metabolic dysfunction-associated steatotic liver rodent model hinges on various factors, including animal species and strains, sex, induction agents and methodologies, and the duration of induction. Through this review, we aim to guide researchers in selecting suitable induction methods and animal species for constructing preclinical models aligned with their specific research objectives and laboratory conditions. Future studies should strive to develop simple, reliable, and reproducible models, considering the model's sensitivity to factors such as light-dark cycles, housing conditions, and environmental temperature. Additionally, the potential of diverse in vitro models, including 3D models and liver organ technology, warrants further exploration as valuable tools for unraveling the cellular mechanisms underlying fatty liver disease.

Knockdown of ketohexokinase versus inhibition of its kinase activity exert divergent effects on fructose metabolism

Excessive fructose intake is a risk factor for the development of obesity and its complications. Targeting ketohexokinase (KHK), the first enzyme of fructose metabolism, has been investigated for the management of metabolic dysfunction-associated steatotic liver disease (MASLD). We compared the effects of systemic, small molecule inhibitor of KHK enzymatic activity with hepatocyte-specific, N-acetylgalactosamine siRNA-mediated knockdown of KHK in mice on an HFD. We measured KHK enzymatic activity, extensively quantified glycogen accumulation, performed RNA-Seq analysis, and enumerated hepatic metabolites using mass spectrometry. Both KHK siRNA and KHK inhibitor led to an improvement in liver steatosis; however, via substantially different mechanisms, KHK knockdown decreased the de novo lipogenesis pathway, whereas the inhibitor increased the fatty acid oxidation pathway. Moreover, KHK knockdown completely prevented hepatic fructolysis and improved glucose tolerance. Conversely, the KHK inhibitor only partially reduced fructolysis, but it also targeted triokinase, mediating the third step of fructolysis. This led to the accumulation of fructose-1 phosphate, resulting in glycogen accumulation, hepatomegaly, and impaired glucose tolerance. Overexpression of wild-type, but not kinase-dead, KHK in cultured hepatocytes increased hepatocyte injury and glycogen accumulation after treatment with fructose. The differences between KHK inhibition and knockdown are, in part, explained by the kinase-dependent and -independent effects of KHK on hepatic metabolism.

Diabetes risk reduction diet and risk of liver cancer and chronic liver disease mortality: A prospective cohort study

BACKGROUND

We aimed to prospectively evaluate the association between a diabetes risk reduction diet (DRRD) score and the risk of liver cancer development and chronic liver disease-specific mortality.

METHODS

We included 98,786 postmenopausal women from the Women's Health Initiative-Observational Study and the usual diet arm of the Diet Modification trial. The DRRD score was derived from eight factors: high intakes of dietary fiber, coffee, nuts, polyunsaturated fatty acids, low intakes of red and processed meat, foods with high glycemic index, sugar-sweetened beverages (SSBs), and trans fat based on a validated Food-Frequency Questionnaire administered at baseline (1993-1998). Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for liver cancer incidence and chronic liver disease mortality were estimated using Cox proportional hazards regression models.

RESULTS AND CONCLUSION

After a median follow-up of 22.0 years, 216 incident liver cancer cases and 153 chronic liver disease deaths were confirmed. A higher DRRD score was significantly associated with a reduced risk of developing liver cancer (HRTertile 3 vs. Tertile 1 = 0.69; 95% CI: 0.49-0.97; Ptrend = 0.03) and chronic liver disease mortality (HRT3 vs. T1 = 0.54; 95% CI: 0.35-0.82; Ptrend = 0.003). We further found inverse associations with dietary fiber and coffee, and positive associations with dietary glycemic index, SSBs, and trans fat. A higher DRRD score was associated with reduced risk of developing liver cancer and chronic liver disease mortality among postmenopausal women.

Discovery of BI-9787, a potent zwitterionic ketohexokinase inhibitor with oral bioavailability

Fructose metabolism by ketohexokinase (KHK) is implicated in a variety of metabolic disorders. KHK inhibition is a potential therapeutic strategy for the treatment of diseases including diabetes, non-alcoholic fatty liver disease, and non-alcoholic steatohepatitis. The first small-molecule KHK-inhibitors have entered clinical trials, but it remains unclear if systemic inhibition of KHK by small-molecules will eventually benefit patients. Here we report the discovery of BI-9787, a potent, zwitterionic KHK inhibitor characterized by high permeability and favorable oral rat pharmacokinetics. BI-9787 was identified by optimizing chemical starting points generated via a ligand-based virtual screening of Boehringer's virtual library of synthetically accessible compounds (BICLAIM). It serves as a high-quality in vitro and in vivo tool compound for investigating the role of fructose metabolism in disease.

Characterization of obesity-related diseases and inflammation using single cell immunophenotyping in two different diet-induced obesity models

BACKGROUND

Obesity is a growing problem worldwide and a major risk factor for many chronic diseases. The accumulation of adipose tissue leads to the release of significant amounts of pro-inflammatory cytokines and adipokines, resulting in a low-grade systemic inflammation. However, the mechanisms behind the development of obesity-related diseases are not fully understood. Therefore, our study aimed to investigate the pathological changes and inflammatory processes at systemic level and in individual organs in two different diet-induced mouse obesity models.

METHODS

Male C57BL6/J mice were fed by high-fat diet (HFD), high-fat/high-fructose diet (HFD + FR) or normal chow for 21 weeks starting at 3 months of age (n = 15 animals/group). Insulin resistance was tested by oral glucose tolerance test. Pathological changes were investigated on hematoxylin-eosin-stained liver and brown adipose tissue sections. The gene expression levels of adipokines and cytokines were analyzed by qPCR in adipose tissues, whereas serum protein concentrations were determined by multiplex immunoassays. Immunophenotyping of isolated blood, bone marrow and spleen cells was performed by single-cell mass cytometry.

RESULTS

Weight gain, glucose intolerance and hepatic steatosis were more severe in the HFD + FR group than in the control and HFD groups. This was accompanied by a higher level of systemic inflammation, as indicated by increased expression of pro-inflammatory genes in visceral white adipose tissue and by a higher serum TNFα level. In addition, immunophenotyping revealed the increase of the surface expressions of CD44 and CD69 on various cell types, such as CD8+ and CD4 + T-cells, B-cells and macrophages, in animals with obesity.

CONCLUSIONS

The combination of HFD with fructose supplementation promotes more properly the symptoms of metabolic syndrome. Therefore, the combined high-fat/high-fructose nutrition can be a more suitable model of the Western diet. However, despite these differences, both models showed immunophenotypic changes that may be associated with increased risk of obesity-related cancer.

Synergistic Effects of Fructose and Food Preservatives on Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): From Gut Microbiome Alterations to Hepatic Gene Expression

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health problem closely linked to dietary habits, particularly high fructose consumption. This study investigates the combined effects of fructose and common food preservatives (sodium benzoate, sodium nitrite, and potassium sorbate) on the development and progression of MASLD. Methods: We utilized a human microbiota-associated mouse model, administering 10% fructose with or without preservatives for 11 weeks. Liver histology, hepatic gene expression (microarray analysis), biochemical markers, cytokine profiles, intestinal permeability, and gut microbiome composition (16S rRNA and Internal Transcribed Spacer (ITS) sequencing) were evaluated. Results: Fructose and potassium sorbate synergistically induced liver pathology characterized by increased steatosis, inflammation and fibrosis. These histological changes were associated with elevated liver function markers and altered lipid profiles. The treatments also induced significant changes in both the bacterial and fungal communities and disrupted intestinal barrier function, leading to increased pro-inflammatory responses in the mesenteric lymph nodes. Liver gene expression analysis revealed a wide range of transcriptional changes induced by fructose and modulated by the preservative. Key genes involved in lipid metabolism, oxidative stress, and inflammatory responses were affected. Conclusions: Our findings highlight the complex interactions between dietary components, gut microbiota, and host metabolism in the development of MASLD. The study identifies potential risks associated with the combined consumption of fructose and preservatives, particularly potassium sorbate. Our data reveal new mechanisms that are involved in the development of MASLD and open up a new avenue for the prevention and treatment of MASLD through dietary interventions and the modulation of the microbiome.

Host-diet-microbiota interplay in intestinal nutrition and health

The intestine is populated by a complex and dynamic assortment of microbes, collectively called gut microbiota, that interact with the host and contribute to its metabolism and physiology. Diet is considered a key regulator of intestinal microbiota, as ingested nutrients interact with and shape the resident microbiota composition. Furthermore, recent studies underscore the interplay of dietary and microbiota-derived nutrients, which directly impinge on intestinal stem cells regulating their turnover to ensure a healthy gut barrier. Although advanced sequencing methodologies have allowed the characterization of the human gut microbiome, mechanistic studies assessing diet-microbiota-host interactions depend on the use of genetically tractable models, such as Drosophila melanogaster. In this review, we first discuss the similarities between the human and fly intestines and then we focus on the effects of diet and microbiota on nutrient-sensing signaling cascades controlling intestinal stem cell self-renewal and differentiation, as well as disease. Finally, we underline the use of the Drosophila model in assessing the role of microbiota in gut-related pathologies and in understanding the mechanisms that mediate different whole-body manifestations of gut dysfunction.

Healthy beverage index is associated with metabolic syndrome: insights from the Ravansar non-communicable disease (RaNCD) cohort study

BACKGROUND

Dietary patterns play a crucial role in the development and management of metabolic syndrome (MetS). The Healthy Beverage Index (HBI) is a novel tool that assesses the quality of beverage choices in the diet and provides insights into their potential impact on metabolic health. The aim of this study was to investigate the association between the HBI and the MetS.

METHODS

This cross-sectional study was conducted using data collected at baseline from the Ravansar Noncommunicable Disease Cohort Study. A total of 9,025 participants aged 35 to 65 years were included in the analysis. HBI was calculated using food items from the Food Frequency Questionnaire (FFQ). MetS status was defined according to established criteria, and logistic regression analysis was performed to assess the association between HBI scores and MetS, adjusting for potential confounding variables.

RESULTS

In our study, 41.13% of the population was found to have MetS, with a significant association between MetS and tertiles of HBI. Furthermore, the logistic regression model showed a significant inverse association between HBI scores and the odds of developing a MetS (OR = 0.90; 95% CI: 0.86, 0.94), even after adjusting for confounding factors, emphasizing the potential protective effect of higher HBI scores.

CONCLUSION

Increased HBI scores were associated with lower risk of MetS, emphasizing the importance of choosing health-promoting beverages in controlling MetS. These findings support the association between dietary habits and metabolic health and provide practical guidance for individuals and public health initiatives aimed at improving metabolic outcomes.

Soft drink consumption and increased risk of nonalcoholic fatty liver disease: Results from the health workers cohort study

INTRODUCTION AND OBJECTIVES

Nonalcoholic fatty liver disease (NAFLD) is a common clinical condition and an important public health problem. Some epidemiological studies have suggested that soft drinks (SD) intake is associated with NAFLD. However, the evidence is inconsistent. Our objective was to assess the association between SD consumption and the risk of NAFLD in a Mexican adult population.

MATERIALS AND METHODS

A total of 1,759 participants from the Health Workers Cohort Study (HWCS) were included in the analyses. SD intake was measured using a validated food frequency questionnaire. We classified SD consumption as follows: a) less than 1 serving per week, b) 1 to less than 3.5 servings per week, and c) 3.5 or more servings per week. Hepatic steatosis index (HSI) was calculated based on sex, BMI, and blood transaminase levels, and was categorized as NAFLD ≥ 36. To assess the relation between SD and NAFLD, we followed two approaches: fixed effects logistic regression and generalized estimating equations.

RESULTS

After adjusting for demographic characteristics, lifestyle factors, and dietary intake, the odds ratio (OR) and 95 % confidence interval (95 % CI) for NAFLD were 1.26 (95 % CI: 1.08, 1.48) for 1 to less than 3.5 servings per week and 1.42 (95 % CI: 1.19, 1.69) for ≥3.5 servings/week category in both sexes. When stratifying the analysis by sex, we observed that the association tended to be greater in men than in women.

CONCLUSIONS

The results from our prospective study indicate that SD consumption is associated with an increased risk of NAFLD.

Dietary fructose: from uric acid to a metabolic switch in pediatric metabolic dysfunction-associated steatotic liver disease

Fructose consumption in pediatric subjects is rising, as the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH). Despite increasing evidence supporting the detrimental effects of fructose in the development of Metabolic Syndrome (MetS) and its related comorbidities, the association between fructose intake and liver disease remains unclear, mainly in youths. The current narrative review aims to illustrate the correlation between fructose metabolism and liver functions besides its impact on obesity and MASLD in pediatrics. Fructose metabolism is involved in the liver through the classical lipogenic pathway via de novo lipogenesis (DNL) or in the alternative pathway via uric acid accumulation. Hyperuricemia is one of the main features of MALSD patients, underlining how uric acid is growing interest as a new marker of disease. Observational and interventional studies conducted in children and adolescents, who consumed large amounts of fructose and glucose in their diet, were included. Most of these studies emphasized the association between high fructose intake and weight gain, dyslipidemia, insulin resistance, and MASLD/MASH, even in normal-weight children. Conversely, reducing fructose intake ameliorates liver fat accumulation, lipid profile, and weight. In conclusion, fructose seems a potent inducer of both insulin resistance and hepatic fat accumulation.

Beneficial Effects of the Ketogenic Diet on Nonalcoholic Fatty Liver Disease (NAFLD/MAFLD)

The prevalence of nonalcoholic fatty liver disease (NAFLD) is likely to be approaching 38% of the world's population. It is predicted to become worse and is the main cause of morbidity and mortality due to hepatic pathologies. It is particularly worrying that NAFLD is increasingly diagnosed in children and is closely related, among other conditions, to insulin resistance and metabolic syndrome. Against this background is the concern that the awareness of patients with NAFLD is low; in one study, almost 96% of adult patients with NAFLD in the USA were not aware of their disease. Thus, studies on the therapeutic tools used to treat NAFLD are extremely important. One promising treatment is a well-formulated ketogenic diet (KD). The aim of this paper is to present a review of the available publications and the current state of knowledge of the effect of the KD on NAFLD. This paper includes characteristics of the key factors (from the point of view of NAFLD regression), on which ketogenic diet exerts its effects, i.e., reduction in insulin resistance and body weight, elimination of fructose and monosaccharides, limitation of the total carbohydrate intake, anti-inflammatory ketosis state, or modulation of gut microbiome and metabolome. In the context of the evidence for the effectiveness of the KD in the regression of NAFLD, this paper also suggests the important role of taking responsibility for one's own health through increasing self-monitoring and self-education.

Associations of five dietary indices with metabolic dysfunction-associated steatotic liver disease and liver fibrosis among the United States population

Background and aims

The role of dietary factors in metabolic dysfunction-associated steatotic liver disease (MASLD)-which represents a new definition of liver steatosis and metabolic dysfunction- remains unclear. This study aimed to explore the relationships between dietary indices and MASLD.

Methods

We analyzed data from the United States National Health and Nutrition Examination Survey (NHANES) 2017-2020 cycle, including 4,690 participants with complete vibration-controlled transient elastography (VCTE) data. Multivariate logistic regression models adjusted for covariates were used to assess the association between dietary indices, MASLD, and MASLD-associated liver fibrosis (MASLD-LF). Restricted cubic spline (RCS) models and subgroup analyses were also performed.

Results

The Alternative Healthy Eating Index (AHEI), Healthy Eating Index-2020 (HEI-2020), Dietary Approaches to Stop Hypertension Index (DASHI), and Mediterranean Diet Index (MEDI) were found to be negatively associated with MASLD risk, while the Dietary Inflammatory Index (DII) had a positive association. The highest quartile of MEDI was linked to a 44% reduction in MASLD risk [Q1 vs. Q4 odds ratio (OR): 0.56; 95% confidence interval (CI): 0.34-0.94, P for trend: 0.012]. DASHI was uniquely associated with a reduced risk of MASLD-LF (continuous OR: 0.79; 95% CI: 0.64-0.97; p for trend: 0.003). Our RCS curves indicated a nonlinear association with DASHI-MASLD (p-overall: 0.0001, p-nonlinear: 0.0066). Subgroup analyses showed robust associations among the non-Hispanic White and highly educated populations.

Conclusion

Specific dietary patterns were associated with reduced risks of MASLD and MASLD-LF. The DASHI, in particular, showed a significant protective effect against MASLD-LF. These findings suggest potential dietary interventions for managing MASLD and MASLD-LF, although large-scale randomized controlled trials are warranted to validate these findings.

Fructose vs. glucose: modulating stem cell growth and function through sugar supplementation

In multicellular organisms, stem cells are impacted by microenvironmental resources such as nutrient availability and oxygen tension for their survival, growth, and differentiation. However, the accessibility of these resources in the pericellular environment greatly varies from organ to organ. This divergence in resource availability leads to variations in the potency and differentiation potential of stem cells. This study aimed to explore the distinct effects of glucose and fructose, as well as different oxygen tensions, on the growth dynamics, cytokine production, and differentiation of stem cells. We showed that replacing glucose with fructose subjected stem cells to stress, resulting in increased Hif1α expression and stability, which in turn led to a reduction in cell proliferation, and alterations in cytokine production. However, fructose failed to induce differentiation of human mesenchymal stem cells (hMSCs) as well as mouse fibroblasts into mature adipocytes compared to glucose, despite the upregulation of key markers of adipogenesis, including C/EBPβ, and PPARγ. Conversely, we showed that fructose induced undifferentiated mouse fibroblasts to release cytokines associated with senescence, including IL1α1, IL6, IL8, MCP1, and TNF1α, suggesting that these cells were undergoing lipolysis. Taken together, our results suggest that altering the culture conditions through changes in hexose levels and oxygen tension places considerable stress on stem cells. Additional research is required to further characterize the mechanisms governing stem cell response to their microenvironments.

Pomegranate supplementation alleviates dyslipidemia and the onset of non-alcoholic fatty liver disease in Wistar rats by shifting microbiota and producing urolithin-like microbial metabolites

Non-alcoholic fatty liver disease (NAFLD), obesity and related chronic diseases are major non-communicable diseases with high mortality rates worldwide. While dietary sugars are known to be responsible for insulin resistance and metabolic syndrome (MetS), the underlying pathophysiological effects of sustained fructose consumption require further elucidation. We hypothesize that certain bioactive compounds (i.e. punicalagin and ellagic acid) from dietary pomegranate could counteract the harmful effects of sustained fructose consumption in terms of obesity and liver damage. The present study aimed to elucidate both the molecular mechanisms involved in the pathophysiology associated with fructose intake and the effect of a punicalagin-rich commercial pomegranate dietary supplement (P) used as a nutritional strategy to alleviate fructose-induced metabolic impairments. Thus, nineteen Wistar rats fed on a basal commercial feed were supplemented with either 30% (w/v) fructose in drinking water (F; n = 7) or 30% (w/v) fructose solution plus 0.2% (w/v) P (F + P; n = 6) for 10 weeks. The results were compared to those from a control group fed on the basal diet and provided with drinking water (C; n = 6). Body weight and energy intake were registered weekly. P supplementation decreased fat depots, counteracted the dyslipidemia caused by F and improved markers of liver injury including steatosis. The study of the microbiota by metagenomics and urine by untargeted MS-based metabolomics revealed microbial metabolites from P that may be responsible for these health benefits.

The Therapeutic Potential of the Specific Intestinal Microbiome (SIM) Diet on Metabolic Diseases

Exploring the intricate crosstalk between dietary prebiotics and the specific intestinal microbiome (SIM) is intriguing in explaining the mechanisms of current successful dietary interventions, including the Mediterranean diet and high-fiber diet. This knowledge forms a robust basis for developing a new natural food therapy. The SIM diet can be measured and evaluated to establish a reliable basis for the management of metabolic diseases, such as diabetes, metabolic (dysfunction)-associated fatty liver disease (MAFLD), obesity, and metabolic cardiovascular disease. This review aims to delve into the existing body of research to shed light on the promising developments of possible dietary prebiotics in this field and explore the implications for clinical practice. The exciting part is the crosstalk of diet, microbiota, and gut-organ interactions facilitated by producing short-chain fatty acids, bile acids, and subsequent metabolite production. These metabolic-related microorganisms include Butyricicoccus, Akkermansia, and Phascolarctobacterium. The SIM diet, rather than supplementation, holds the promise of significant health consequences via the prolonged reaction with the gut microbiome. Most importantly, the literature consistently reports no adverse effects, providing a strong foundation for the safety of this dietary therapy.

John Yudkin's hypothesis: sugar is a major dietary culprit in the development of cardiovascular disease

To date, the risk of developing atherosclerosis has extended beyond Western countries and now affecting individuals from various ethnic backgrounds and age groups. Traditional risk factors of atherosclerosis, such as hypercholesterolemia, has been better controlled than before due to highly effective and inexpensive therapies at lowering plasma cholesterol levels. However, the role of reducing dietary cholesterol intake, as a public healthy strategy, in preventing the occurrence of cardiovascular mortalities has been recently challenged. Indeed, despite our continuous decline of dietary cholesterol intake within the last 50 years, the incidence of cardiovascular mortalities has continued to rise, thus raising the possibility that other dietary factors, such as fructose-containing sugars, are the major culprit. In the 1970s, John Yudkin first proposed that sugar was the predominant dietary factor that underlies the majority of cardiovascular mortalities, yet his hypothesis was dismissed. However, over the last 25 years substantial scientific evidence has been accumulated to support Yudkin's hypothesis. The objectives of this review are to highlight Yudkin's significant contribution to nutritional science by reviewing his hypothesis and summarizing the recent advances in our understanding of fructose metabolism. The metabolic consequences of fructose metabolism, such as fructose-induced uricemia, insulin resistance, lipoprotein hyperproduction and chronic inflammation, and how they are linked to atherosclerosis as risk factors will be discussed. Finally, the review will explore areas that warrant future research and raise important considerations that we need to evaluate when designing future studies.

Inhibitory effects of nobiletin-mediated interfacial instability of bile salt emulsified oil droplets on lipid digestion

Previous lipase inhibitors studies mainly focus on the binding between inhibitors and lipase, ignoring the impact of inhibitors on the oil-water interface of lipid droplets. This study aimed to investigate the effect of nobiletin (NBT) from Citri Reticulatae Pericarpium on the oil-water interface properties and lipid digestion. Here, we found that NBT could destroy bile salt (BS)-stabilized lipid droplets and thus inhibited free fatty acid release, owing to the interaction between NBT and BS at the oil-water interface, and reducing the stability of the oil-water interface (the stability index decreased from 91.15 ± 2.6 % to 66.5 ± 3.6 %). Further, the molecular dynamics simulation and isothermal titration calorimetry revealed that NBT could combine with BS at oil-water interface through intermolecular interactions, including hydrogen bonds, Van der Waals force, and steric hindrance. These results suggest that the interfacial instability of NBT mediated BS emulsified oil droplets may be another pathway to inhibit lipid digestion.

Longitudinal association between soft drink consumption and handgrip strength in adults: a prospective analysis from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort study

Soft drink consumption has become a highly controversial public health issue. Given the pattern of consumption in China, sugar-sweetened beverage is the main type of soft drink consumed. Due to containing high levels of fructose, a soft drink may have a deleterious effect on handgrip strength (HGS) due to oxidative stress, inflammation and insulin resistance. However, few studies show an association between soft drink consumption and HGS in adults. We aimed to investigate the association between soft drink consumption and longitudinal changes in HGS among a Chinese adult population. A longitudinal population-based cohort study (5-year follow-up, median: 3·66 years) was conducted in Tianjin, China. A total of 11 125 participants (56·7 % men) were enrolled. HGS was measured using a handheld digital dynamometer. Soft drink consumption (mainly sugar-containing carbonated beverages) was measured at baseline using a validated FFQ. ANCOVA was used to evaluate the association between soft drink consumption and annual change in HGS or weight-adjusted HGS. After adjusting for multiple confounding factors, the least square means (95 % CI) of annual change in HGS across soft drink consumption frequencies were -0·70 (-2·49, 1·09) for rarely drinks, -0·82 (-2·62, 0·97) for < 1 cup/week and -0·86 (-2·66, 0·93) for ≥ 1 cup/week (Pfor trend < 0·05). Likewise, a similar association was observed between soft drink consumption and annual change in weight-adjusted HGS. The results indicate that higher soft drink consumption was associated with faster HGS decline in Chinese adults.

Transcriptomic insights into the lipotoxicity of high-fat high-fructose diet in rat and mouse

Along with the increasing prevalence of obesity worldwide, the deleterious effects of high-calorie diet are gradually recognized through more and more epidemiological studies. However, the concealed and chronic causality whitewashes its unhealthy character. Given an ingenious mechanism orchestrates the metabolic adaptation to high-fat high-fructose (HFF) diet and connive its lipotoxicity, in this study, an experimental rat/mouse model of obesity was induced and a comparative transcriptomic analysis was performed to probe the mystery. Our results demonstrated that HFF diet consumption altered the transcriptomic pattern as well as different high-calorie diet fed rat/mouse manifested distinct hepatic transcriptome. Validation with RT-qPCR and Western blotting confirmed that SREBP1-FASN involved in de novo lipogenesis partly mediated metabolic self-adaption. Moreover, hepatic ACSL1-CPT1A-CPT2 pathway involved in fatty acids β-oxidation, played a key role in the metabolic adaption to HFF. Collectively, our findings enrich the knowledge of the chronic adaptation mechanisms and also shed light on future investigations. Meanwhile, our results also suggest that efforts to restore the fatty acids metabolic fate could be a promising avenue to fight against obesity and associated steatosis and insulin resistance challenged by HFF diet.

Safety assessment of high fructose corn syrup and fructose used as sweeteners in foods

High Fructose Corn Syrup (HFCS) and Fructose (FR) are widely used sweeteners in many foods and beverages. This study aimed at investigating the cytotoxic effects of HFCS (5%-30%) and FR (62.5-2000 μg/mL) using MTT assay in Human Hepatocellular Carcinoma (HepG2) cells, and genotoxic effects of using Chromosome Aberrations (CAs), Sister Chromatid Exchanges (SCEs), Micronuclei (MN) and comet assays in human lymphocytes. HFCS significantly reduced the cell viability in HepG2 cells at between 7.5% and 30% for 24 and 48 h. 30% HFCS caused a very significant toxic effect. FR had a cytotoxic effect in HepG2 cells at all treatments. However, as fructose concentration decreased, the cell viability decreased. HFCS (10%-20%) and FR (250-2000 μg/mL) decreased the mitotic index at higher concentrations. IC50 value was found to be a 15% for 48 h. IC50 value of FR was detected as 62.5 μg/mL for 24 h and 48 h. HFCS significantly increased CAs frequency at 15% and 20%. FR significantly increased the frequency of CAs at 250, 1000, and 2000 μg/mL for 48 h. Both sweeteners increased the frequency of SCEs at all concentrations. HFCS (15% and 20%) and FR (250, 1000, and 2000 μg/mL) induced MN frequency at higher concentrations. HFCS caused DNA damage in comet assay at 10% -30%. FR increased tail intensity and moment at 125-2000 μg/mL and tail length at 62.5, 250 and 500 μg/mL. Therefore, HFCS and FR are clearly seen to be cytotoxic and genotoxic, especially at higher concentrations.

Effects of dietary sugar restriction on hepatic fat in youth with obesity

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in children. Like adults, children can develop the progressive form of NAFLD, nonalcoholic steatohepatitis (NASH), which is characterized by hepatic inflammation, often in the presence of fibrosis. Children with NAFLD are at higher risk of liver-related complications, metabolic dysfunction, and cardiovascular disease in adulthood. Many factors contribute to the escalating prevalence of NAFLD in the pediatric population, among which are an array of dietary patterns such as overnutrition, poor diet quality, and heavy consumption of fat and sugar, including fructose. Findings from an increasing number of epidemiological studies support a connection between high habitual sugar consumption and NAFLD, especially within the context of obesity, but these studies are not able to demonstrate whether sugar is a contributing factor or instead an indicator of an overall poor diet (or lifestyle) quality. To date, only four randomized controlled dietary interventions assessing the effects of sucrose/fructose restriction on hepatic fat fraction in youth with obesity have been published. The objectives of this review are to summarize the key findings from these dietary interventions to achieve a better understanding of the strength of the relationship between dietary sugar restriction and liver fat reduction, despite their inherent limitations, and to discuss the potential impact of weight loss and fat mass reduction on improvement in hepatic steatosis.

TEAD1, MYO7A and NDUFC2 are novel functional genes associated with glucose metabolism in BXD recombinant inbred population

AIM

The liver is an important metabolic organ that governs glucolipid metabolism, and its dysfunction may cause non-alcoholic fatty liver disease, type 2 diabetes mellitus, dyslipidaemia, etc. We aimed to systematic investigate the key factors related to hepatic glucose metabolism, which may be beneficial for understanding the underlying pathogenic mechanisms for obesity and diabetes mellitus.

MATERIALS AND METHODS

Oral glucose tolerance test (OGTT) phenotypes and liver transcriptomes of BXD mice under chow and high-fat diet conditions were collected from GeneNetwork. QTL mapping was conducted to pinpoint genomic regions associated with glucose homeostasis. Candidate genes were further nominated using a multi-criteria approach and validated to confirm their functional relevance in vitro.

RESULTS

Our results demonstrated that plasma glucose levels in OGTT were significantly affected by both diet and genetic background, with six genetic regulating loci were mapped on chromosomes 1, 4, and 7. Moreover, TEAD1, MYO7A and NDUFC2 were identified as the candidate genes. Functionally, siRNA-mediated TEAD1, MYO7A and NDUFC2 knockdown significantly decreased the glucose uptake and inhibited the transcription of genes related to insulin and glucose metabolism pathways.

CONCLUSIONS

Our study contributes novel insights to the understanding of hepatic glucose metabolism, demonstrating the impact of TEAD1, MYO7A and NDUFC2 on mitochondrial function in the liver and their regulatory role in maintaining in glucose homeostasis.

Empagliflozin alone and in combination with metformin mitigates diabetes-associated renal complications

Diabetes mellitus is a major public health concern, often leading to undiagnosed micro- and macrovascular complications, even in patients with controlled blood glucose levels. Recent evidence suggests that empagliflozin and metformin have renoprotective effects in addition to their hypoglycemic action. This study investigated the potential protective effect of empagliflozin and metformin on diabetic renal complications. Forty-two adult male Sprague Dawley rats were randomized into six groups: normal control, diabetic control, metformin (250 mg/kg), empagliflozin (10 mg/kg), and combination therapy groups. Type 2 diabetes was induced in rats by a single intraperitoneal injection of streptozotocin (40 mg/kg) following two weeks of 10% fructose solution in their drinking water. Blood glucose, creatinine, urea nitrogen, inflammatory markers (IL-6, TNF-α), and renal tissue caspase-3 were assessed after eight weeks. Blood glucose, urea, creatinine, serum IL-6, TNF-α, and tissue caspase-3 were significantly decreased in the treatment groups compared to the diabetic group. The histopathological findings revealed that treatment with empagliflozin and/or metformin improved the damage in the renal tissue caused by diabetes-induced nephropathy. Moreover, co-administration of empagliflozin and metformin resulted in even better outcomes. Our data revealed that empagliflozin and metformin could improve renal function and decrease inflammation and apoptosis in diabetic animals, delaying the progression of diabetic nephropathy. Combined treatment with metformin and empagliflozin proved to have an additive protective action on renal tissue.

Effects of dietary intervention on human diseases: molecular mechanisms and therapeutic potential

Diet, serving as a vital source of nutrients, exerts a profound influence on human health and disease progression. Recently, dietary interventions have emerged as promising adjunctive treatment strategies not only for cancer but also for neurodegenerative diseases, autoimmune diseases, cardiovascular diseases, and metabolic disorders. These interventions have demonstrated substantial potential in modulating metabolism, disease trajectory, and therapeutic responses. Metabolic reprogramming is a hallmark of malignant progression, and a deeper understanding of this phenomenon in tumors and its effects on immune regulation is a significant challenge that impedes cancer eradication. Dietary intake, as a key environmental factor, can influence tumor metabolism. Emerging evidence indicates that dietary interventions might affect the nutrient availability in tumors, thereby increasing the efficacy of cancer treatments. However, the intricate interplay between dietary interventions and the pathogenesis of cancer and other diseases is complex. Despite encouraging results, the mechanisms underlying diet-based therapeutic strategies remain largely unexplored, often resulting in underutilization in disease management. In this review, we aim to illuminate the potential effects of various dietary interventions, including calorie restriction, fasting-mimicking diet, ketogenic diet, protein restriction diet, high-salt diet, high-fat diet, and high-fiber diet, on cancer and the aforementioned diseases. We explore the multifaceted impacts of these dietary interventions, encompassing their immunomodulatory effects, other biological impacts, and underlying molecular mechanisms. This review offers valuable insights into the potential application of these dietary interventions as adjunctive therapies in disease management.

Sweetened Beverages, Genetic Susceptibility, and Incident Atrial Fibrillation: A Prospective Cohort Study

BACKGROUND

An association between sweetened beverages and several cardiometabolic diseases has been reported, but their association with atrial fibrillation (AF) is unclear. We aimed to investigate the associations between consumption of sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB), and pure fruit juice (PJ) and risk of consumption with AF risk and further evaluate whether genetic susceptibility modifies these associations.

METHODS

A total of 201 856 participants who were free of baseline AF, had genetic data available, and completed a 24-hour diet questionnaire were included. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

During a median follow-up of 9.9 years, 9362 incident AF cases were documented. Compared with nonconsumers, individuals who consumed >2 L/wk of SSB or ASB had an increased risk of AF (HR, 1.10 [95% CI, 1.01-1.20] and HR, 1.20 [95% CI, 1.10-1.31]) in the multivariable-adjusted model. A negative association was observed between the consumption of ≤1 L/wk of PJ and the risk of AF (HR, 0.92 [95% CI, 0.87-0.97]). The highest HRs (95% CIs) of AF were observed for participants at high genetic risk who consumed >2 L/wk of ASB (HR, 3.51 [95% CI, 2.94-4.19]), and the lowest HR were observed for those at low genetic risk who consumed ≤1 L/wk of PJ (HR, 0.77 [95% CI, 0.65-0.92]). No significant interactions were observed between the consumption of SSB, ASB, or PJ and genetic predisposition to AF.

CONCLUSIONS

Consumption of SSB and ASB at >2 L/wk was associated with an increased risk for AF. PJ consumption ≤1 L/wk was associated with a modestly lower risk for AF. The association between sweetened beverages and AF risk persisted after adjustment for genetic susceptibility to AF. This study does not demonstrate that consumption of SSB and ASB alters AF risk but rather that the consumption of SSB and ASB may predict AF risk beyond traditional risk factors.

Association between higher duodenal levels of the fructose carrier glucose transporter-5 and nonalcoholic fatty liver disease and liver fibrosis

BACKGROUND

An increased dietary fructose intake has been shown to exert several detrimental metabolic effects and contribute to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). An augmented intestinal abundance of the fructose carriers glucose transporter-5 (GLUT-5) and glucose transporter-2 (GLUT-2) has been found in subjects with obesity and type 2 diabetes. Herein, we investigated whether elevated intestinal levels of GLUT-5 and GLUT-2, resulting in a higher dietary fructose uptake, are associated with NAFLD and its severity.

METHODS

GLUT-5 and GLUT-2 protein levels were assessed on duodenal mucosa biopsies of 31 subjects divided into 2 groups based on ultrasound-defined NAFLD presence who underwent an upper gastrointestinal endoscopy.

RESULTS

Individuals with NAFLD exhibited increased duodenal GLUT-5 protein levels in comparison to those without NAFLD, independently of demographic and anthropometric confounders. Conversely, no difference in duodenal GLUT-2 abundance was observed amongst the two groups. Univariate correlation analyses showed that GLUT-5 protein levels were positively related with body mass index, waist circumference, fasting and 2 h post-load insulin concentrations, and insulin resistance (IR) degree estimated by homeostatic model assessment of IR (r = 0.44; p = 0.02) and liver IR (r = 0.46; p = 0.03) indexes. Furthermore, a positive relationship was observed between duodenal GLUT-5 abundance and serum uric acid concentrations (r = 0.40; p = 0.05), a product of fructose metabolism implicated in NAFLD progression. Importantly, duodenal levels of GLUT-5 were positively associated with liver fibrosis risk estimated by NAFLD fibrosis score.

CONCLUSION

Increased duodenal GLUT-5 levels are associated with NAFLD and liver fibrosis. Inhibition of intestinal GLUT-5-mediated fructose uptake may represent a strategy for prevention and treatment of NAFLD.

The effect of low-fructose diet on anthropometric and metabolic factors: A systematic review and meta-analysis

AIMS

In recent decades, there has been a rise in the consumption of sugars containing fructose, raising concerns about their association with metabolic disorders and obesity. We conducted a systematic review and meta-analysis of randomized controlled trials to assess the effects of a low-fructose diet on anthropometric and metabolic variables.

DATA SYNTHESIS

We conducted a systematic review and meta-analysis of randomized controlled trials to assess the effects of low-fructose diets on anthropometric and metabolic factors. Relevant studies were identified by searching electronic databases such as PubMed, Scopus, and Web of Science up to January 2023. The quality of the included studies was assessed using the Cochrane risk-of-bias tool. Ten trials with varying intervention durations (ranging from 4 to 24 weeks) and a total of 750 participants were included. The analysis revealed that a low-fructose diet had no significant effect on weight but did have a significant impact on body mass index (SMD = -0.2; 95 % CI: -0.37, -0.04, P = 0.017) and waist circumference (SMD = -0.48; 95 % CI: -0.67, -0.29, P < 0.0001). Furthermore, a low-fructose diet significantly affected systolic blood pressure (SMD = -0.24; 95 % CI: -0.39, -0.09, P = 0.002), fasting blood glucose (SMD = -0.23; 95 % CI: -0.40, -0.07, P = 0.005), hemoglobin A1c (SMD = -0.62; 95 % CI: -0.93, -0.31, P < 0.0001), and triglyceride levels (SMD = -0.17; 95 % CI: -0.33, -0.02, P = 0.028). However, it had no significant effect on diastolic blood pressure, insulin levels, or homeostatic model assessment of insulin resistance. Subgroup analysis indicated that a low-fructose diet had a greater effect on healthy participants aged over 50 years.

CONCLUSIONS

Meta-analysis results suggest that low-fructose diets significantly reduce body mass index, waist circumference, systolic blood pressure, fasting blood glucose, hemoglobin A1c, and triglyceride levels. Additionally, the results of the current study suggest that a low-fructose diet may be more effective in healthy individuals who are older than 50 years old compared to those younger than 50 years old.

Exogenous Melatonin Alleviates Atrazine-Induced Glucose Metabolism Disorders in Mice Liver via Suppressing Endoplasmic Reticulum Stress

Atrazine (ATZ) is a widely used herbicide that has toxic effects on animals. Melatonin (MLT) is a natural hormone with strong antioxidant properties. However, the effect of MLT on the glucose metabolism disorder caused by ATZ is still unclear. Mice were divided into four groups randomly and given 21 days of gavage: blank control group (Con), 5 mg/kg MLT group (MLT), 170 mg/kg ATZ group (ATZ), and 170 mg/kg ATZ and 5 mg/kg MLT group (ATZ + MLT). The results show that ATZ alters mRNA levels of metabolic enzymes related to glycogen synthesis and glycolysis and increased metabolites (glycogen, lactate, and pyruvate). ATZ causes abnormalities in glucose metabolism in mouse liver, interfering with glycemia regulation ability. MLT can regulate the endoplasmic reticulum to respond to disordered glucose metabolism in mice liver. This study suggested that MLT has the power to alleviate the ATZ-induced glycogen overdeposition and glycolytic deficit.

Acute Intake of Fructose Increases Arterial Pressure in Humans: A Meta-Analysis and Systematic Review

Hypertension is a major cardiac risk factor. Higher blood pressures are becoming more prevalent due to changing dietary habits. Here, we evaluated the impact on blood pressure in human subjects after acutely ingesting fructose using meta-analysis. A total of 89 studies were collected from four different electronic databases from 1 January 2008 to 1 August 2023. Of these studies, 10 were selected that fulfilled all the criteria for this meta-analysis. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), and blood glucose level were analyzed using the Cohen's d analysis or standardized mean difference at a confidence interval (CI) of 95%. The SBP, DBP, and MAP showed medium effect size; HR and glucose level displayed small effect size. The standardized mean difference of normal diet groups and fructose diet groups showed a significant increase in SBP (p = 0.04, REM = 2.30), and DBP (p = 0.03, REM = 1.48) with heterogeneity of 57% and 62%, respectively. Acute fructose ingestion contributes to an increase in arterial pressure in humans. The different parameters of arterial pressure in humans correlated with each other. These findings support further rigorous investigation, retrospective of necessity, into the effect of chronic dietary of fructose in humans in order to better understand the impact on long term arterial pressure.