Liver Health

It is well established that excessive energy intake can lead to adverse liver health outcomes including nonalcoholic fatty liver disease (NAFLD). However, recent scientific literature shows that there is no association between fructose consumption and the development of NAFLD. Participants that consumed more fructose had smaller waist circumferences, lower dietary fat intake, and higher fiber and vitamin E intake in one observational study. Thus, the researchers concluded that the potentially adverse effects of fructose intake are instead from excess caloric intake overall rather than sugar consumption alone. A meta-analysis of studies using energy-controlled protocols show fructose was not found to be associated with an increased prevalence of NAFLD. Some of the controversy regarding fructose is due to studies that were conducted by feeding individuals excessive fructose or implying a causal relationship from observational studies that are not designed for such outcomes.

It is now generally accepted that glucose, fructose, HFCS and sucrose consumption results in similar responses over the range of human exposure to each carbohydrate. Fructose consumption does not play a unique role in the development of adverse liver health outcomes.

Research Study Summaries

Study Linking Fructose Intake to Nonalcoholic Fatty Liver Disease

A study entitled “Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents,” was recently published in the Journal of Hepatology. The purpose of the study was to identify the factors associated with non-alcoholic steatohepatitis (NASH) in children and adolescents with confirmed cases of non-alcoholic fatty liver disease (NAFLD). More […]


Nonalcoholic fatty liver disease is associated with excessive calorie intake rather than a distinctive dietary pattern

A study published in Medicine sought to characterize the dietary patterns of patients with nonalcoholic fatty liver disease (NAFLD) and to assess the efficacy of dietary interventions on NAFLD related outcomes. Researchers collected a total of 55 NAFLD patients and 88 controls to complete the study in northern Germany. All participants were subjected to a […]


Study Finds Fructose Not Associated with Nonalcoholic Fatty Liver Disease

A new study of more than 1,600 people has concluded that fructose is not associated with the development of nonalcoholic fatty liver disease (NAFLD).


Review Finds Fructose Not Associated with NAFLD

Available scientific evidence does not support a link between fructose consumption and risk of nonalcoholic fatty liver disease (NALFD), according to a recent review published in The American Journal of Clinical Health.


Review Study: Fructose Does Not Cause NAFLD

A systematic review and meta-analysis by Chiu et al found that fructose does not cause non-alcoholic fatty liver disease (NAFLD).


Singling out fructose in liver and heart disease is not scientifically justified

A recent article published in Harvard Heart Letter recommended that readers cut back on fructose.


Calorie-sweetened beverages and fructose: what have we learned 10 years later

Calorie-sweetened beverages and fructose: what have we learned 10 years later. Pediatr Obes 2013.


High rates of fructose malabsorption are associated with reduced liver fat in obese African Americans

The aim of this study was to investigate the frequency of fructose malabsorption between obese Hispanic and African American young adults.


Calorie Control Council Response to Abdelmalek et al

Underpowered and unphysiologic design weakens fructose


Therapeutic Interventions for Fructose-Induced Fatty Liver Disease are Premature

In their recent article, Vos and McClain paint a grim picture of dietary fructose, likening its effect to alcohol-induced hepatic steatosis and liver injury and thereby ‘‘defining targets for therapeutic interventions.’’ The case for such interventions is unsupported, built as it is on inappropriate extrapolation of highly exaggerated diets to the human condition, and decidedly premature for two reasons.


Restraint urged in extrapolation of unphysiologic fructose experimentation to predictions of real-world outcomes

In their commentary accompanying the recent mechanistic paper from Peter Havel’s group, Hoffman & Tschöp (2) do not show the same restraint Havel does in extrapolating his admittedly unphysiologic results to typical human diets.


Calorie Control Council Response to Thuy et al

Nonalcoholic fatty liver disease in humans is associated with increased plasma endotoxin and plasminogen activator inhibitor 1 concentrations and with fructose intake