How fructose is
the gateway to diabetes, obesity, and Non-Alcoholic
Fatty Liver Disease (NAFLD)
At the bottom is this article is my addition on what
been left out. If you wish to understand
the essentials of the obesity and diabetes epidemics then read this
commentary. It explains why eating the
current high amount of sugar alone won’t cause fatty liver--except for a few
who are genetically susceptible. The
other main causal part for fatty liver is eating a large amount of
carbohydrates with a high insulin response, namely foods such as rice, white
potatoes, and highly processed grains. These
foods in quantity will cause a high insulin response by the pancreas to lower
the high blood glucose level—click on link for tables on glucose levels
and insulin response. The consequences
of the two take years to become clinically significant. Such
diet overloads the body’s systems for clearing the liver of excess fat.
For the sake of completeness I include an article (bottom
page) on how trans-fat and polyunsaturated fats are another major causal factor
for NAFLD. Polyunsaturated fats are
subject to rancidification and make their role equivalent to trans-fats in the
production of NAFLD and associated comorbidities. For more on this click on
these two links.
One last comment, the cat has gotten out of the bag
the health consequences of a high-sugar diet.
For example, England, Canada, and Australia have done documentaries on
this problem—see video page for
links. But the powerful food
manufactures operating though the developed-world governments has got them to
support the high carb diet such as through farm-subsides and to oppose efforts
to warn the public repeatedly of the role of foods with a high insulin/glycemic
The article below, an important statement of the how
fructose causes fatty liver disease, this article is based mainly upon a 2009
article-- http://www.jci.org/articles/view/37385. A edited version is at the bottom of the
of fructose not good for the liver, heart
Harvard Heart Letter
Harvard Medical school September 1, 2011
reason to avoid foods made with a lot of sugar.
The human body handles
glucose and fructose — the most abundant sugars in our diet — in different
ways. Virtually every cell in the body can break down glucose for energy. About
the only ones that can handle fructose are liver cells. What the liver does
with fructose, especially when there is too much in the diet, has potentially
dangerous consequences for the liver, the arteries, and the heart.
Fructose, also called
fruit sugar, was once a minor part of our diet. In the early 1900s, the average American took in about 15 grams of
fructose a day (about half an ounce), most of it from eating fruits and
vegetables. Today we average four or five times that amount, almost all of it from the refined sugars
used to make breakfast cereals, pastries, sodas, fruit drinks, and other sweet
foods and beverages. Refined sugar,
called sucrose, is half glucose and half fructose. High-fructose corn syrup is
about 55% fructose and 45% glucose [42% glucose & 3% other sugars].
From fructose to fat
The entry of fructose
into the liver kicks off a series of complex chemical transformations. (You can
see a diagram of these at health.harvard.edu/172.) One remarkable change is that the liver uses fructose, a carbohydrate, to create
fat. This process is
called lipogenesis. Give the liver enough fructose, and tiny fat droplets begin
to accumulate in liver cells (see figure). This buildup is called nonalcoholic
fatty liver disease, because it looks just like what happens in the livers of
people who drink too much alcohol.
Virtually unknown before
1980, nonalcoholic fatty liver disease now affects up to 30% of adults in the
United States and other developed countries, and between 70% and 90% of those
who are obese or who have diabetes.
Early on, nonalcoholic
fatty liver disease is reversible. At some point, though,
the liver can become inflamed. This can cause the low-grade damage known as
nonalcoholic steatohepatitis (steato meaning fat and hepatitis meaning
liver inflammation). If the inflammation
becomes severe, it can lead to cirrhosis — an accumulation of scar tissue and
the subsequent degeneration of liver function.
fat expands the
hepatocytes up to
70%. The normal 3 lb.
weighs 5 lb.]
Beyond the liver
The breakdown of fructose in
the liver does more than lead to the buildup of fat. It also:
harmful LDL (so-called
promotes the buildup of fat around organs (visceral fat)
increases blood pressure
makes tissues insulin-resistant, a precursor to diabetes
increases the production of free radicals,
that can damage DNA
[Has 7.5 times the rate of glycation compared to fructose, and
its clearance from the blood is slower
Fructose accumulates in the liver where it is metabolized]
None of these changes are good for
the arteries and the heart.
Researchers have begun looking
at connections between fructose, fatty liver disease, and cardiovascular
disease. The early results are in line with changes listed above due to the
metabolism of fructose.
article published in 2010 in The
New England Journal of Medicine [NEJM] indicated that people with nonalcoholic fatty liver disease
more likely than those without it to
have buildups of
cholesterol-filled plaque in their arteries. They are also more likely to
develop cardiovascular disease or die from it. In fact, people with
nonalcoholic fatty liver disease are far more likely to die of cardiovascular
disease than liver disease.
report from the Framingham Heart Study has linked nonalcoholic fatty
liver disease with metabolic syndrome, a constellation of changes that is
strongly associated with cardiovascular disease. Other studies have linked
fructose intake with high blood pressure.
Experts still have a long way
to go to connect the dots between fructose and nonalcoholic fatty liver
disease, obesity, diabetes, and heart disease. Higher intakes of fructose are associated with
these conditions, but clinical
trials have yet to show that it causes them.
Still, it’s worth cutting back
on fructose. But don’t do it by giving up fruit. Fruit is good for you and is a
minor source of fructose for most people. The big sources are refined sugar and
high-fructose corn syrup [and fruit juices—one glass of apple juice
requires five apples, but without the fiber].
The American Heart Association [AHA]
recommends limiting the amount of sugar you get from sugar-sweetened drinks,
pastries, desserts, breakfast cereals, and more, mainly to avoid gaining
weight. The same strategy could also protect your liver and your arteries.
[the World Health Organization in 2014 recommendation is 9 teaspoon a day for
men, and 6 for woman, which was then
adopted by the AHA.]
cause of the
inflammatory process which causes cardiovascular disease: Though it is beyond
dispute and accepted
in medical text books that atherosclerosis results from an immune response, tobacco
science ignores the role of pathogens
within the artery walls and blames oxidized LDL. Though the role of pathogens
established nearly 100-years ago through the examination of atheroma from those
who died of heart attacks, this and other definitive evidence has been ignored
due to the rule of pharma upon the information systems and research. A review
of the evidence for pathogens is
found at these two links. With the development of
metabolic dysfunction from a fatty liver the rate of formation of plaque is
Major industries can effectively manipulate the information
concerning their products for financial gain.
To prevent atherosclerosis would entail preventing its comorbidities of
hypertension, myocardial infarction, and most cases of arrhythmia. It would
also entail conceding that treatment
of hypercholesterolemia lacks benefits. The
role of diet in causing fatty liver could be easily be prevented with a
healthful diet which would be low in fructose and polyunsaturated vegetable
oils—see second article. This would
reduce their sales of drugs for diabetes.
Thus pharma wants us to chase symptoms rather than causes of
cardiovascular disease. Prevention is
not on their financial horizon.
 Approximately 20 to 30% of adults in the
general population in Western countries have nonalcoholic fatty liver disease,
and its prevalence increase to 70 to 90% among persons who are obese or have
diabetes;… a strong association between nonalcoholic fatty liver disease and
the risk of cardiovascular disease…. Strongly associated with increased
carotid-artery intimal medial thickness and an increase prevalence of carotid
atherosclerosis plaques…. 2006 study.