Editors' ChoiceMETABOLIC DISORDERS

The Liver Speaks Up in the Sugar Debate

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Science Translational Medicine  14 May 2014:
Vol. 6, Issue 236, pp. 236ec85
DOI: 10.1126/scitranslmed.3009308

The dramatically rising prevalence of type 2 diabetes and obesity has coincided with an equally dramatic rise in the consumption of fructose-sweetened beverages. Is there a connection? Although fructose has been shown to cause abnormal metabolic responses, many of these results have been obtained with concentrations of fructose higher than those usually consumed. Hochuli et al. provide interesting data for consideration in this debate. These authors identify deleterious effects of fructose on the physiological function of the liver in young healthy males, even when only low or moderate amounts are consumed.

Hochuli et al. recruited young normal-weight males and determined their responses to fructose, sucrose, and glucose. The subjects drank one of several sugar-sweetened beverages with their meals in the trial: a medium-fructose beverage (equivalent to a 12-oz U.S. soda), a high-fructose beverage (24-oz U.S. soda), a high-sucrose beverage, (12-oz U.S. soda), or a high-glucose beverage (same calories as a 24-oz U.S. soda without fructose). As a surrogate measure of liver function during lipid metabolism, the authors determined the effects of each beverage on de novo lipogenesis. Both high- and medium-fructose–sweetened beverages clearly increased fatty acid synthesis more than did the sucrose- or glucose-containing drinks.

This study strengthens the link between fructose consumption and the current increase in cardiometabolic dysfunction. Although small in size, it had a robust crossover design that provided adequate statistical power to detect alterations in metabolism. The liver now serves as an active battleground in the debate whether sugars in beverages are influencing the rising trends of cardiometabolic disorders.

M. Hochuli et al., Sugar-sweetened beverages with moderate amounts of fructose, but not sucrose, induce fatty acid synthesis in healthy young men: A randomized crossover study, J. Clin. Endocrinol. Metab. 10.1210/jc.2013-3856 (2014). [Abstract]

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