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.

In the review, researchers considered evidence from 27 observation and intervention studies that considered the association between fructose (including that from high-fructose corn syrup (HFCS), sugar and honey) and different factors indicative of liver health and NALFD, such as liver fat and liver enzyme levels. Review of the observational studies, which cannot prove cause and effect, found insufficient evidence for any link between fructose and liver health outcomes, such as NAFLD. Review of the intervention studies considered trials in which participants consumed high levels of fructose as well as those in which participants consumed fructose in replacement of glucose. In both cases, the researchers concluded that there was limited evidence to show any association between fructose intake and poor liver health.

The researchers concluded that, “the apparent association between indexes of liver health and fructose or sucrose intake appear to be confounded by excessive energy intake.” Further, they concluded, “Current evidence does not allow us to discern the intertwined associations between excess body weight, monosaccharide fructose or sucrose intake, and NAFLD. Therefore, we concluded that, overall, the available evidence is not sufficiently robust to draw conclusions regarding effects of fructose, HFCS, or sucrose consumption on NAFLD.”

Lowndes J, Sinnett S, Yu Z, Rippe J. The effects of fructose-containing sugars on weight, body composition and cardiometabolic risk factors when consumed at up to the 90th percentile population consumption level for fructose. Nutrients, 2014; 6: 3153-3168.