Assessing the impact of concurrent high-fructose and high-saturated fat diets on pediatric metabolic syndrome: A review

Abstract

High-saturated fat (HF) or high-fructose (HFr) consumption in children predispose them to metabolic syndrome (MetS). In rodent models of MetS, diets containing individually HF or HFr lead to a variable degree of MetS. Nevertheless, simultaneous intake of HF plus HFr have synergistic effects, worsening MetS outcomes. In children, the effects of HF or HFr intake usually have been addressed individually. Therefore, we have reviewed the outcomes of HF or HFr diets in children, and we compare them with the effects reported in rodents. In humans, HFr intake causes increased lipogenesis, hypertriglyceridemia, obesity and insulin resistance. On the other hand, HF diets promote low grade-inflammation, obesity, insulin resistance. Despite the deleterious effects of simultaneous HF plus HFr intake on MetS development in rodents, there is little information about the combined effects of HF plus HFr intake in children. The aim of this review is to warn about this issue, as individually addressing the effects produced by HF or HFr may underestimate the severity of the outcomes of Western diet intake in the pediatric population. We consider that this is an alarming issue that needs to be assessed, as the simultaneous intake of HF plus HFr is common on fast food menus.

Keywords: Fructose, Saturated fat, Metabolic syndrome, Insulin resistance, Type 2 diabetes, Ultra processed foods, Children, Obesity, Dyslipidemia, Non-alcoholic fatty liver disease

Core Tip: High-fructose (HFr) or high-fat (HF) intake favors metabolic syndrome (MetS) development by different mechanisms. When combined, HFr exacerbates the effects of HF, leading to a faster and more severe MetS development. Combined HF + HFr is usually present in ultra-processed foods. However, there is a lack of studies in the pediatric population evaluating the impact of restricting the combined intake of carbohydrates and fat in MetS. We reviewed the mechanisms by which HF + HFr produces more severe MetS to support the need for studies targeting the combined intake of HF + HFr in pediatric population to improve the outcomes of different interventions against MetS.