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Comment & Response
June 25, 2019

Low Free Sugar Diet in Adolescents With Nonalcoholic Fatty Liver Disease—Reply

Author Affiliations
  • 1Department of Pediatrics, University of California, San Diego, School of Medicine, La Jolla
  • 2Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
JAMA. 2019;321(24):2469. doi:10.1001/jama.2019.5153

In Reply Messrs Tang and Gao raise 2 questions regarding our study of dietary sugar in pediatric nonalcoholic fatty liver disease.1 They suggest that the effect observed in our trial may have been solely a function of weight loss. The study was not designed to promote weight loss; participants ate without calorie or macronutrient restriction. In support of the argument for a weight loss effect, Tang and Gao reference practice guidelines that were written primarily for adults with nonalcoholic fatty liver disease and recommend weight loss of 5% to 10% of body weight.2

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