Fructose intake and its association with relative telomere length: an exploratory study among healthy Lebanese adults

Nairie Messerlian; Nathalie Zgheib; Fatima Al Zahraa Chokor; Mona Nasrallah; Hani Tamim; Lara Nasreddine

doi:10.3389/fnut.2023.1270124

Fructose intake and its association with relative telomere length: an exploratory study among healthy Lebanese adults

Front Nutr. 2023 Oct 31:10:1270124. doi: 10.3389/fnut.2023.1270124. eCollection 2023.

Authors

Nairie Messerlian¹, Nathalie Zgheib², Fatima Al Zahraa Chokor³, Mona Nasrallah^{4

5}, Hani Tamim^{6

7}, Lara Nasreddine^{1

5}

Affiliations

¹ Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon.
² Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
³ Department of Public Health, College of Health Sciences, Qatar University Health, Qatar University, Doha, Qatar.
⁴ Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
⁵ Vascular Medicine Program, American University of Beirut Medical Center, Beirut, Lebanon.
⁶ Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
⁷ College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Abstract

Introduction: Shorter relative telomere length (RTL) has been associated with increased incidence of morbidity. Although still disputed, available evidence suggests that dietary factors, including sugar-sweetened beverages (SSB) may be linked with shorter RTL. It was argued that the link between SSB and RTL may be explained by the sugar content of these beverages, and specifically fructose given its impact on oxidative stress and the inflammatory response. However, none of the existing studies have examined the specific link between fructose intake and RTL. This exploratory study aimed at (1) assessing the intake of dietary fructose (total, added and natural) in Lebanese healthy adults and (2) examining dietary fructose as a predictor of short telomere length.

Methods: Following a cross-sectional design (n = 282), anthropometric and biochemical data were collected. RTL was assessed by utilizing real-time polymerase chain reaction (RT-qPCR) to amplify both telomere and single-copy gene segments. Dietary intake was evaluated using a culture-specific food frequency questionnaire (FFQ). Intakes of added fructose, naturally-occurring fructose, and total fructose were estimated.

Results: Mean intakes of added and natural fructose were of 39.03 ± 34.12 and 12.28 ± 8.59 g/day, respectively, representing 4.80 ± 3.56 and 1.78 ± 1.41% of total energy intake (EI). Mean total fructose intake was of 51.31 ± 35.55 g/day, contributing 6.58 ± 3.71% EI. Higher intakes of total and added fructose were significantly associated with shorter RTL 2nd RTL tertile as compared to the 3rd RTL tertile; relative risk ratio (RRR) = 3.10 [95% confidence interval (CI): 1.38, 6.94] and RRR = 2.33 (95% CI: 1.02, 5.36), respectively after adjustment for confounders identified using a directed acyclic graph (DAG).

Conclusion: In conclusion, although we could not observe a dose-dependent relation between fructose intakes and RTL shortening and although the study is limited by its small sample size, the findings suggest that total and added dietary fructose intakes may be associated with shorter RTL. Larger studies, of longitudinal nature, are needed to further confirm the study findings.

Keywords: Lebanon; adults; fructose; intake; relative telomere length.

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. This research was funded by different grants from the University Research Board (American University of Beirut), the Medical Practice Plan (American University of Beirut), the National Council for Scientific Research (LNCSR), the Munib Shahid Fund, and the Novo Nordisk development program.