Giussani Marco, Lieti Giulia, Orlando Antonina, Parati Gianfranco, Genovesi Simonetta
Cardiologic Unit, Istituto Auxologico Italiano, Istituto Ricovero Cura Carattere Scientifico (IRCCS), Milan, Italy.
School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Front Med (Lausanne). 2022 Apr 12;9:792949. doi: 10.3389/fmed.2022.792949. eCollection 2022.
Arterial hypertension, dyslipidemia, alterations in glucose metabolism and fatty liver, either alone or in association, are frequently observed in obese children and may seriously jeopardize their health. For obesity to develop, an excessive intake of energy-bearing macronutrients is required; however, ample evidence suggests that fructose may promote the development of obesity and/or metabolic alterations, independently of its energy intake. Fructose consumption is particularly high among children, because they do not have the perception, and more importantly, neither do their parents, that high fructose intake is potentially dangerous. In fact, while this sugar is erroneously viewed favorably as a natural nutrient, its excessive intake can actually cause adverse cardio-metabolic alterations. Fructose induces the release of pro-inflammatory cytokines, and reduces the production of anti-atherosclerotic cytokines, such as adiponectin. Furthermore, by interacting with hunger and satiety control systems, particularly by inducing leptin resistance, it leads to increased caloric intake. Fructose, directly or through its metabolites, promotes the development of obesity, arterial hypertension, dyslipidemia, glucose intolerance and fatty liver. This review aims to highlight the mechanisms by which the early and excessive consumption of fructose may contribute to the development of a variety of cardiometabolic risk factors in children, thus representing a potential danger to their health. It will also describe the main clinical trials performed in children and adolescents that have evaluated the clinical effects of excessive intake of fructose-containing drinks and food, with particular attention to the effects on blood pressure. Finally, we will discuss the effectiveness of measures that can be taken to reduce the intake of this sugar.
动脉高血压、血脂异常、糖代谢改变和脂肪肝，单独或合并出现时，在肥胖儿童中经常可见，可能严重危害他们的健康。肥胖的发生需要摄入过量的含能量宏量营养素；然而，大量证据表明，果糖可能促进肥胖和/或代谢改变的发展，与其能量摄入量无关。儿童中果糖的摄入量特别高，因为他们没有意识到，更重要的是，他们的父母也没有意识到高果糖摄入有潜在危险。事实上，虽然这种糖被错误地视为一种天然营养素而受到青睐，但其过量摄入实际上会导致不良的心脏代谢改变。果糖会诱导促炎细胞因子的释放，并减少抗动脉粥样硬化细胞因子如脂联素的产生。此外，通过与饥饿和饱腹感控制系统相互作用，特别是通过诱导瘦素抵抗，它会导致热量摄入增加。果糖直接或通过其代谢产物，促进肥胖、动脉高血压、血脂异常、葡萄糖不耐受和脂肪肝的发展。这篇综述旨在强调早期过量摄入果糖可能导致儿童出现多种心脏代谢危险因素的机制，从而对他们的健康构成潜在危险。它还将描述在儿童和青少年中进行的主要临床试验，这些试验评估了过量摄入含果糖饮料和食物的临床效果，特别关注对血压的影响。最后，我们将讨论可以采取哪些措施来减少这种糖的摄入量。
