Reduced prevalence of obesity in children with primary fructose malabsorption: a multicentre, retrospective cohort study.

Background: Studies in animals and in man have demonstrated that excessive consumption of fructose can cause all components of the metabolic syndrome.

Objective: To investigate the impact of a condition resulting in decreased absorption of fructose, on obesity.

Methods: In a multicentre study, we analyzed a cohort of paediatric patients with suspected primary fructose malabsorption (FM). Patients with chronic intestinal diseases were excluded. The final cohort comprised 628 patients.

Results: 302 patients were diagnosed with primary FM (48.1%). The proportion of obese patients was lower among FM patients, compared to non-FM patients (2.3 vs. 6.1%, P = 0.029). Logistic regression analysis with inclusion of various covariates showed that FM was negatively associated with obesity (OR 0.35, 95% CI [0.13; 0.97]). We discuss several mechanisms involving the metabolic, endocrine and gastrointestinal system.

Conclusions: Our data indicate that primary FM is negatively associated with childhood obesity.