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High-fructose corn syrup consumption may push fatty livers to the brink

March 18, 2010 |  6:12 pm

Nonalcoholic fatty liver disease is one of the many consequences of obesity, as fat accumulates not only across the body and around the visceral organs, but inside the organ that helps break down fats, filter toxins from the bloodstream and create useable fuel from the food we eat.  About 3 in 10 American adults suffer from nonalcoholic fatty liver. But it's a population of patients that's grown so fast, there isn't a lot  known about their risks, and what factors aggravate those risks.

Researchers know those with nonalcoholic fatty liver are more likely than those without such fatty deposits to develop cirrhosis, liver cancer and liver failure requiring transplant. Still, a minority of those patients will do so, and doctors wish they could identify what factors may push those with fatty liver toward those outcomes.

The development of tough scar tissue in the liver can be a sign that liver failure may lie ahead. For heavy alcohol consumers, an alcoholic bender can cause scarring, or fibrosis, and lead to trouble. That's why those with signs of alcoholic fatty liver are urged to stop drinking alcohol.

A new study suggests that for those with nonalcoholic fatty liver, drinking a lot of beverages sweetened with fructose may do the same thing as liquor.

The study, published in the journal Hepatology, tracked 427 patients with fatty liver disease to see whether consumption of fructose made a difference in the progression of fatty liver to the organ's failure. The Duke University researchers asked subjects only about how many fructose-sweetened beverages a week they drank, including fruit juices and soft drinks sweetened with high-fructose corn syrup -- yielding a conservative accounting, since the stuff is also used in baking and other processed foods. Though only 19% of the fatty liver patients consumed few or no fructose sweetened beverages, 28% drank at least one a day.

Best represented among the heavy fructose consumers were subjects who were younger, male and Latino, and who had a higher BMI.

Compared to subjects who drank the least fructose beverages, those who drank the most were significantly more likely to have the hepatic scarring that will more often progress to cirrhosis or liver cancer. And older subjects who regularly consumed fructose beverages showed more signs of liver inflammation. After they stripped out the effects of age, gender and body-mass index, the researchers also found that the heavy fructose drinkers also have lower levels of HDL (or "good") cholesterol.

Duke University hepatologist Dr. Manal Abdelmalek said in a news release that high-fructose corn syrup, which was first introduced into the human diet in the 1970s and has accounted for an average of 10% of Americans' caloric intake over the last decade, "may not be as benign as we previously thought." While researchers have demonstrated clearly that the stuff has "fueled the fire of the obesity epidemic," added Abdelmalek, "untill now, no one has ever suggested it contributes to liver disease and/or liver injury."

--Melissa Healy

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Comments (11)

I allways known this. FDA kills us.

That is not really what the study said. No it is not just fat people. Are you being paid by Corn Refiners Association? I am just asking- not stating. I was wondering what the new spin would be. This is the title of the study:

High Fructose Corn Syrup Linked to Liver Scarring
Here is the link:

It is not that there is a new problem with bad people doing bad things. It is that we no longer have journalists to tell us about it because they are too concerned about advertising profits. Has every journalist sold out? Kids are drinking this stuff. Do you have no shame? Just asking.

Actually, several scientists have previously found that fructose and HCFS especially contribute to liver disease.

In 2005, Davail studied ducks, and showed they suffered liver damage when fed HFCS.

In 2008, Tetri showed liver cell damage in mice exposed to HFCS

Last year, Collison et al called NAFLD "Diabetes of the liver", pinpointed HFCS as the cause, and described its mechanisms in the lab.

And in my own ChefMD's Big Book of Culinary Medicine (Crown, 2008), we cited studies like these. I advise eaters to avoid foods which include HFCS, and none of my recipes contain products that contain it. Trans fats are also excluded.

Non-alcoholic fatty liver disease (NAFLD) is now more common than alcohol-induced damage and virus (e.g., hepatitis) induced damage. If your liver tests are out of whack, there's a 30% chance it is NAFLD. And HFCS might just be the reason why.

why did you state "High-fructose corn syrup consumption" in the title, when the study was about fructose in general?

Wow, this is interesting research, I hope it is investigated further. Many nutrition professionals of late have been reporting that HFCS is no worse than sugar. This type of finding may challenge that argument.

I'm not sure I understand how it can be said that "until now no one has suggested that fructose contributes to liver disease/injury."

Gary Taubes in his book 'Good Calories, Bad Calories' refers to fructose-induced lipogenesis, researched by Peter Mayes at King's College Medical School in London; by Eleazar Shafrir at Hebrew University-Hadassah Medical School in Jerusalem; and by Sheldon Reiser and others at USDA Carbohydrate Nutrition Laboratory in Maryland. This research has been conducted since the late 1960s so it's hardly anything new.

The reason fructose is causing liver disease is that where cells can take glucose (e.g. table sugar is half fructose, half glucose) directly from the bloodstream and use it as energy, fructose on the other hand passes directly to the liver where it is metabolized. And the way liver responds to fructose is by converting it into triglycerides - the storage form of fat.

In other words, the more fructose in your diet the more strain you're putting on your liver, and the higher your triglyceride levels in blood.


I think this article represents a misleading interpretation of the actual findings in the _Hepatology_ paper. The question that is being publicly debated is whether high-fructose corn syrup (HFCS) is more unhealthy than sucrose (table sugar). This paper did not compare the health effects of the two sugars. It simply correlated liver pathology with intake of HFCS. It is quite possible that if sucrose were substituted as a sweetening agent, the effect on the liver would be the same (or even worse). That study has yet to be done, and until it is, the demonization of HFCS will have to wait. In the meantime, we all need to recognize that Americans eat way too much sugar and other refined carbohydrates. So, whatever type of sugar is in our food and drink, we need much less of it.

High Fructose Corn Syrup and plain Fructose are not the same thing. HFCS contains between 45-55% Fructose, while cane sugar contains 50% Fructose.
Instead of people getting emotionally involved with some fad, how about people do their own unbiased research instead of reading headlines from people getting paid to get you attention.

Sugar has about 2000 years of research behind it. It's good. Unfortunately the FDA allows these companies to quietly put new chemicals into our food. Now we find out that it can be damaging. Where is the process of food approval like they have for medicine? Why is this stuff there to begin with? Why is our government subsidizing it? Now we have genetically modified food everywhere and the same "experts" say it is safe. There is something that is fundamentally wrong with the FDA. Recently we found that the USDA (Bush) was illegally allowing GM food to be planted without environmental studies. The court said it was bad, but what's done is done and allowed the Sugar Beets to be planted this year. Now we will have 50% of our sugar genetically modified.

It has be recently discovered that genes have more than one trait. The introduction of the gene into food supports the purpose but we will not know what else it does until people start getting sick in 20 years, then the people that have built an industry around it with have a web site telling everyone it is safe.

Technology is getting smarter. People are getting dumber. There will be a tipping point where there will be no return and we may almost be there. 95% soybeans, 80% corn are GM.

Duke University incorrectly singled out high fructose corn syrup as being responsible for scarring in the liver and other liver diseases, when the underlying study reviewed dietary intake of fructose containing beverages – not high fructose corn syrup.

Fructose has not been proven to be a cause of NAFLD in humans, and NAFLD subjects are compromised individuals with significant health problems which have very little to do with fructose intake.

This study unnecessarily confuses consumers about the impact of dietary fructose, let alone high fructose corn syrup. Fructose, or “fruit sugar,” is safe and is commonly found in fruits, vegetables, fruit juices, table sugar, honey, high fructose corn syrup, and maple syrup.

For more information, please visit

Audrae Erickson, Corn Refiners Association

Audrae, dear Audrae....You're desperate. Nobody can in good faith continue to argue that HFCS is the same as sugar. The Duke and Princeton studies are just the latest of dozens of studies performed in the last decade. I don't know why the media ignored the others, but better late than never. Audrae, I continue to remind you, that the tidal wave against HFCS and the Corn Refiners is growing.


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