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


Address for correspondence: Professor K-P Zimmer, Department of Pediatrics and Neonatology, Justus-Liebig University Giessen, Feulgenstraße 12, 35392 Giessen, Germany. E-mail:



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


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


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.


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.


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