Volume 153, Issue 3, Pages 743-752 (September 2017) Effects of Dietary Fructose Restriction on Liver Fat, De Novo Lipogenesis, and Insulin Kinetics in Children With Obesity  Jean-Marc Schwarz, Susan M. Noworolski, Ayca Erkin-Cakmak, Natalie J. Korn, Michael J. Wen, Viva W. Tai, Grace M. Jones, Sergiu P. Palii, Moises Velasco-Alin, Karen Pan, Bruce W. Patterson, Alejandro Gugliucci, Robert H. Lustig, Kathleen Mulligan  Gastroenterology  Volume 153, Issue 3, Pages 743-752 (September 2017) DOI: 10.1053/j.gastro.2017.05.043 Copyright © 2017 AGA Institute Terms and Conditions

Figure 1 Clinical research design and procedures on day 0 and day 10, depicting the time of OGTT, MR studies, and sodium [1-13C]-acetate administration via liquid meals (shakes) to determine rate of DNL. Gastroenterology 2017 153, 743-752DOI: (10.1053/j.gastro.2017.05.043) Copyright © 2017 AGA Institute Terms and Conditions

Figure 2 Changes in individual fat compartments in obese children (A−D) before and after 9 days of isocaloric fructose restriction, and in the subset of 9 children who did not lose weight (E−H) during fructose restriction. (A, E) Mean ± SEM in liver fat as determined by MR, and VAT and subcutaneous SAT fat as determined by MR in the entire cohort (A) and the subgroup of 9 participants who did not lose weight (E). (B, F) Individual serial measures of liver fat in the entire cohort (B) and the subgroup of 9 participants who did not lose weight (F). (C, G) Individual serial measures of VAT. (D, H) Individual serial measures of SAT in the entire cohort (D) and the subgroup of 9 participants who did not lose weight (H). Open and closed circles to the left and right of the day 0 and day 10 individual plots depict median and IQR (B, F) or mean ± SEM (C, D, G, H). Decreases in liver fat and VAT were statistically significant in the group as a whole (P < .001 in both cases). In the subgroup who did not lose weight, change in liver fat was statistically significant (P = .02). Gastroenterology 2017 153, 743-752DOI: (10.1053/j.gastro.2017.05.043) Copyright © 2017 AGA Institute Terms and Conditions

Figure 3 Changes in postprandial fractional DNL (percent of palmitate in circulating triglyceride that was synthesized de novo) and the integrated DNL-AUC on days 0 (open circles) and 10 (closed circles) after isocaloric fructose restriction in 40 obese children (A, B) and in the subgroup of 9 children who did not lose weight (C, D) during fructose restriction. On both study days, after an overnight fast, and after the OGTT was complete, participants consumed liquid meals every 20 minutes for 6 hours, starting at 10:30 am. Blood samples were obtained hourly during this period. (A, C) Fractional DNL (mean ± SEM) for all subjects (A) and the subgroup of 9 participants who did not lose weight (C). (B, D) Individual serial measures of DNL-AUC in the group as a whole (B) and the subgroup that did not lose weight (D). Decreases in DNL-AUC were statistically significant in the group as a whole (P < .001), as well as the subgroup who did not lose weight (P = .006). Gastroenterology 2017 153, 743-752DOI: (10.1053/j.gastro.2017.05.043) Copyright © 2017 AGA Institute Terms and Conditions