First, let me ask you a simple question – do you know what’s non-alcoholic fatty liver? We can answer that for you – when your liver is composed of 5 to 10 percent fat by weight, you have non-alcoholic fatty liver disease (NAFLD). The function of the liver is to produce bile so the body can digest fats, break down hormones, cleanse the blood, and store vitamins and minerals.
Note: but, when you have fatty liver disease, the liver is unable to adequately break down the fats it has extracted from the blood. The fats accumulate and the liver becomes enlarged. You should also know that NAFLD is the most common liver disorder in the world. Causes and increased risk factors for NAFLD include:
- Alcohol consumption
- High cholesterol
- High triglycerides
- Poor diet and/or malnutrition
- Sedentary lifestyle
- Some medications
- Thyroid disorders
The medical experts say that when you have inflammation and cell damage in your liver in addition to NAFLD, you are diagnosed with non-alcoholic steatohepatitis, or NASH. Between 2 and 5 percent of Americans have NASH. According to the National Institute of Health, or NIH, the experts estimate that between 20 and 30 percent of adults in western countries are afflicted with NAFLD. Although the incidence is lower in eastern countries, it is on the rise. The incidence also rises with age, although it is increasingly more common at younger ages due to the high-fat diet consumed by most Americans.
Excess Fructose Is a Leading Cause of Non-Alcoholic Fatty Liver Disease
The best thing you can do to your body and your health in general is to eliminate fructose – the sugar found in everything from high-fructose corn syrup (HFCS) and fruit juice to agave syrup and honey. It’s harmful when consumed in excess – which is exactly what many (if not most) Americans do. You should also know that fructose is, in many ways, very similar to alcohol in the damage that it can do to your body, and your liver. Unlike glucose, which can be used by virtually every cell in your body, fructose can only be metabolized by your liver, because your liver is the only organ that has the transporter for it.
How this works – well, all fructose gets shuttled to your liver. So, if you eat a typical Western-style diet, you consume high amounts of this sugar, and fructose ends up taxing and damaging your liver in the same way alcohol and other toxins do. The medical experts say that fructose is virtually identical to alcohol with regard to the metabolic havoc it wreaks.
The famous Dr. Robert Lustig, a neuroendocrinologist in the Division of Endocrinology at the University of California, fructose is a “chronic, dose-dependent liver toxin.” And just like alcohol, fructose is metabolized directly into fat – not cellular energy, like glucose.
Dr. Lustig’s findings were published in the Journal of the Academy of Nutrition and Dietetics, where Dr. Lustig explained the three similarities between fructose and its fermentation byproduct, ethanol (alcohol):
- First, you should know that your liver’s metabolism of fructose is similar to alcohol, as they both serve as substrates for converting dietary carbohydrate into fat, which promotes insulin resistance, dyslipidemia (abnormal fat levels in the bloodstream), and fatty liver
- Fructose undergoes the Mallard reaction with proteins, leading to the formation of superoxide free radicals that can result in liver inflammation similar to acetaldehyde, an intermediary metabolite of ethanol
- And – by “stimulating the ‘hedonic pathway’ of the brain both directly and indirectly,” He said that fructose creates habituation, and possibly dependence; also paralleling ethanol.
One Sugary Drink Daily Increases Your Risk of NAFLD
We can easily say that sugary drinks, including not only soda but also fruit juice, lemonade, fruit punch, and the like, are a major source of fructose in the US diet.
A recent study from Tufts University has found that this could be putting your health at risk, as those who consumed at least one sugary drink daily had a higher risk of liver damage and NAFLD. The experts say that sugary drinks are likely one major factor in why even children are developing NAFLD at alarming rates. The longer you have NAFLD, the more likely it is to progress into more serious disease like liver fibrosis (accumulation of abnormal fibrous tissue), cirrhosis (accumulation of scar tissue), and NASH.
A recent study, conducted by researchers at the Hepatobiliary Surgery and Nutrition, has linked HFCS consumption to the severity of fibrosis in patients with NAFLD. Therefore, it’s very concerning that children are developing this so early in their lives. The following facts about pediatric NAFLD are disturbing:
- Almost 10 % of US children have NAFLD
- This includes 1 % of 2- to 4-year-olds and 17 percent of 15- to 19-year-olds
- More than 38 % of obese children have NAFLD
- Children with NAFLD are at particular risk of complications and poor prognosis, including the need for a liver transplant in adulthood
How Much Fructose Is Too Much?
Well, the real and ugly truth is that most overweight Americans have some degree of insulin and leptin resistance. This also includes people with diabetes, and many individuals with high blood pressure or high cholesterol (the same individuals at increased risk of NAFLD). Note: this means that you should be very careful, and if you fall into this category, it would be prudent for you to restrict your fructose consumption to about 15 grams of fructose per day from all sources. Remember, fructose isn’t only found in sugary beverages; it’s also found in many processed foods and even “healthy” sweeteners like agave.
People who are normal weight and relatively healthy may also benefit from reducing their intake of fructose to 25 grams a day, particularly from foods containing high-fructose corn syrup or sugar, as the effects of high sugar and HFCS intake may have effects that build up over time. We all know that fruits also have fructose but contain many beneficial nutrients and antioxidants. For someone who is obese or suffering from NAFLD, one has to be careful with eating fruits that have substantial fructose content.
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