In our sugar-laden modern diet, fructose is one harmful culprit that is getting overlooked. While this natural sugar found in fruit doesn't seem so sinister, the excessive amounts of added sugars weigh heavily on our livers. But we have the power to make healthier dietary choices and protect our liver health.
When you think of liver disease, alcohol abuse likely comes to mind first. But fructose gets metabolised by the liver in a disturbingly similar way to alcohol. And just like alcohol overload, flooding the liver with large quantities of fructose can lead to severe liver damage over time.
The Fructose Overload
Consuming fructose from whole fruit causes no issues for most people - it's packaged with fibre, nutrients, and natural portion control. The problems start when you consume excessive amounts of added sugars and refined sweeteners laden with fructose.
Here's what happens: Fructose-Fatty Liver Connection
Step 1) The liver cells rapidly convert the fructose into fatty compounds like triglycerides. When you consume excessive amounts of fructose, far beyond what the liver can handle from fruit alone, it overwhelms the normal pathways for fructose metabolism. Normally, fructose gets converted to glucose and glycogen for energy.
But with a fructose onslaught, it gets shunted into a separate pathway, producing fatty acids and triglycerides. This de novo lipogenesis process happens rapidly in the liver - creating a backup of fat molecules within the liver cells themselves. Unable to be exported elsewhere, these fats need somewhere to go but accumulate inside the liver.
Step 2) Those lipids have nowhere to go but accumulate in the liver itself. Under normal conditions, the liver can export triglycerides out through the bloodstream as VLDL particles for use or storage elsewhere in the body.
But when you chronically overload the liver with fructose, it creates a bottleneck where triglyceride production far exceeds export capacity.
The end result is a build-up and droplet accumulation of these lipids within the hepatocytes (liver cells). Over months and years, more and more fat inundates the liver cells in a toxic spillover effect.
Step 3) The buildup of hepatic fat causes inflammation, oxidative stress, and injury to the liver cells over time. This extended exposure of the liver cells to high levels of lipids and fatty acids becomes so damaging. The fat accumulation triggers a chain reaction:
First, it leads to cellular injury and death of hepatocytes through a process called lipotoxicity.
Second, it promotes mitochondrial dysfunction and oxidative stress, further harming the liver cells.
Third, it activates an inflammatory response within the liver as the body tries to fight off the perceived toxin exposure.
This sustained injury, oxidation, and inflammation within the liver sets up a vicious cycle. More liver cells die, scar tissue accumulates, and inflammation perpetuates the problem. If left unchecked, it can progress to the irreversible scarring and dysfunction of cirrhosis.
By overloading the liver with fructose from added sugars, the snowball quickly rolls into full-blown fatty liver disease for many people. Reducing fructose consumption is crucial to breaking this damaging cycle.
Here's the flowchart with even more details on the fructose-fatty liver disease pathway:
The average American now consumes around 55 grams of fructose daily, mainly from foods and beverages with added sugars. That far exceeds the liver's capacity to process it.
Protecting Your Liver's
The primary line of treatment is cutting out added sugars, refined carbs and high fructose Foods as much as possible. That means limiting or avoiding:
Sugary beverages like soda, fruit juices, sports/energy drinks 🥤
Baked goods, candies, syrups, and other sweets 🍰
Processed foods with added sugars like cereals, granola bars, condiments 🥨
High fructose corn syrup and agave nectar 🌽
Maintaining a healthy weight through diet and exercise can also help reduce liver fat accumulation. But the first critical step is drastically cutting your fructose consumption, especially from added sugars and refined sweeteners.
Don't let this silent liver disease sneak up on you. Ditch the added sugars and fructose bombs - your liver will thank you.
References:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3649103/ [2] https://www.gastroenterologylive.com/view/nonalcoholic-fatty-liver-disease-review
an eye opener, thanks