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).*

Participants in this study were from the Helsinki Birth Cohort Study (HBCS) which included 8,760 people born in one hospital between 1934 and 1944 and were still alive and living in Finland in 1971. In 2000, participants in the study were sent questionnaires and a random sample was asked to participate in a health exam. Researchers calculated a Fatty Liver Index (FLI) score for all participants, which was based on different factors such as waist circumference and body mass index (BMI). A FLI score >60 was defined as having NAFLD. Researchers also calculated a NALFD liver fat score for all participants to compare to the FLI score. The NALFD liver fat score was based on different factors such as diabetes and insulin levels. Blood samples were taken from each of the participants and each participant completed a food frequency questionnaire which measured diet over the past year.

Results of the FLI scores found that 44% of participants had NAFLD while results of the NAFLD liver fat scores found 46% of participants had NAFLD. The researchers also found that waist circumference tended to decrease with higher fructose intake and that those with the highest fructose consumption levels had higher intakes of fiber and vitamin E with lower fat intakes. Results of the study found that those in the highest fructose intake group were 28-44% less likely to have NAFLD as compared to those in the lowest intake group.

The researchers concluded, “Participants with higher fructose intake were significantly less likely to have a positive FLI score independently of the participants’ age, sex, lifestyle, and various nutrients. When NAFLD was assessed by using the NAFLD liver fat score, no association between intake of fructose and NAFLD emerged.” The researchers hypothesized that other factors may associated with development of NAFLD, concluding, “it seems that adverse changes related to fructose intake have been more due to excess caloric intake rather than sugar composition…Our results, which adjusted fructose intake for the intake of energy, also suggest that, in an energy-controlled situation, fructose does not associate with an increased prevalence of NAFLD.”

*Kanerva N, Sandboge S, Kaartinen NE, Männistö S, Eriksson JG. Higher fructose intake is inversely associated with risk of nonalcoholic fatty liver disease in older Finnish adults. Am J Clin Nutr, 2014; 100(4): 1133-1138.