Scientists from the University of California San Diego found that excessive consumption of fructose—a sweetener ubiquitous in the American diet—can result in non-alcoholic fatty liver disease (NAFLD).
They also found that fructose only adversely affects the liver after it reaches the intestines, where the sugar disrupts the barrier protecting internal organs from bacterial toxins in the gut.
Developing treatments that prevent intestinal barrier disruption could protect the liver from NAFLD, a condition that affects one in three Americans.
The research is published in Nature Metabolism and was conducted by Michael Karin et al.
NAFLD is the most common cause of chronic liver disease in the world. It can progress to more serious conditions, such as cirrhosis, liver cancer, liver failure and death.
Fructose consumption in the U.S. has skyrocketed since the 1970s and the introduction of high fructose corn syrup (HFCS), a cheaper sugar substitute that is broadly used in processed and packaged foods, from cereals and baked goods to soft drinks.
In the study, the team defines a specific role and risk for HFCS in the development of fatty liver disease.
The ability of fructose, which is plentiful in dried figs and dates, to induce fatty liver was known to the ancient Egyptians, who fed ducks and geese dried fruit to make their version of foie gras.
The team found that fructose is two to three times more potent than glucose in increasing liver fat, a condition that triggers NAFLD.
And the increased consumption of soft drinks containing HFCS corresponds with the explosive growth in NAFLD incidence.
The team also found that excessive fructose metabolism in intestinal cells reduces the production of proteins that maintain the gut barrier.
Thus, by deteriorating the barrier and increasing its permeability, excessive fructose consumption can result in a chronic inflammatory condition, which has been in NAFLD patients.
Interestingly, the research team found that when fructose intake was reduced below a certain threshold, no adverse effects were observed in mice.
This suggests only excessive and long-term fructose consumption represents a health risk. Moderate fructose intake through normal eating of fruits is well-tolerated.
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