Dietary fructose: a metabolic switch in pediatric obesity-related diseases. Identification of nutritional, biological, omics and social determinants

The increase in childhood obesity is a multifactorial phenomenon influenced also by unhealthy diets. Children and adolescents are deviating to a “Western diet” richer in saturated fats, simple carbohydrates, and processed foods than traditional food habits. The risk of obesity is associated with specific foods and depends also on socio-economic status, weighting more on disadvantaged families. Among dietary components fructose, sugar widely used from food industry for low cost and high palatability, has been implicated in the development of obesity, metabolic disorders, including non-alcoholic fatty liver disease (NAFLD), impacting also on bone status. Although consistent data, population knowledge on healthy foods and the impact of excessive intake of some nutrients is still poor. The identification of social determinants in paediatrics relative to specific food ingredients as fructose is still lacking. A better understanding of the effect of fructose on molecular events that contribute to the obesity evolution represents one of the most rational approaches to deal with the clinical and social problems derived from the spreading of it in the paediatric age. From our preliminary data showing an interaction between diet, microbiota, the immune system, metabolic and bone functions in children with obesity and low adherence to the Mediterranean diet, this proposal aims: i) to generate new understanding on the mechanisms responsible for NAFLD and bone health by investigating the role of fructose in clinical setting as well as using translational in vitro ed in vivo animal models by exploring its role on immunity into the liver and osteoclastogenesis in the bone; ii) to recognize an omics signature of high intake of fructose to identify high risk subjects. Biological findings need to be translated in an efficacious message to the civil audience. Indeed, the study of social and cultural determinants in relation to clinical, omics and molecular results aims: i) to originate a more complete picture by the integration of scientific and social data; ii) to spread the findings in a tailored multi-level strategy for the promotion of lifestyle healthy habits; iii) to produce data and information that could be used and understood by the general population; iv) to elicit innovative information for stakeholders that drives further changes and prevention programs for the civil society identified at risk.