Fructose consumption in pregnancy and associations with maternal and offspring hepatic and whole-body adiposity: a scoping review.

BackgroundFructose is a major component in the Western diet, and its increased intake has been linked to adverse metabolic health, including impaired hepatic function and increased adiposity. The early life period, including preconceptionally, pregnancy and the newborn period, are critical periods in determining later metabolic health. However, the impact of excess fructose intake during this time on maternal, fetal, and offspring hepatic and whole-body adiposity, are ill defined. ObjectivesTo understand the effects of maternal fructose consumption pre- and during pregnancy on maternal, fetal and offspring hepatic and whole-body adiposity. MethodsA systematic search of MEDLINE, EMBASE, and CENTRAL was performed up to August 23, 2022, to identify studies that focused on maternal fructose consumption pre- and during pregnancy on hepatic and whole-body adiposity in the mother, fetus, and offspring. Citations, abstracts, and full texts were screened in duplicate. Hepatic adiposity was defined as elevated hepatic triglycerides or overall hepatic fat accumulation. Whole-body adiposity was defined as increased adipose tissue or adipocyte hypertrophy. ResultsAfter screening 2334 citations, 33 experimental studies reporting maternal fructose consumption pre- and during pregnancy in rodents were included. Prenatal fructose exposure was associated with maternal (9 out of 12) and offspring (6 out of 10) whole-body adiposity. A high proportion of studies (13 out of 14) supported the association between fructose during pregnancy and increased maternal hepatic adiposity. Fetal hepatic adiposity and elevated expression of hepatic lipogenic proteins were noted in four studies. Offspring hepatic adiposity was supported in 14 of the 17 articles that discussed hepatic results, with five studies demonstrating more severe effects in female offspring. ConclusionsFructose consumption during pregnancy in rodent models is associated with maternal, fetal, and offspring hepatic, whole-body adiposity and underlying sex-specific effects. There are no human fructose studies and its effects in the early life period. Registration numberH8F26 on Open Science Framework