In the realm of nutrition and health, the impact of different sugars on the body has become a topic of increasing interest. Among these, the relationship between fructose and liver health has been a subject of scrutiny. While both fructose and sucrose are forms of sugar, in a recent tweet, Abby Philips who is known by the name 'TheLiverDoc' on Twitter shared, "Fructose is more damaging to the liver than sucrose."


In this regard, Dr. Sreenivass B J, who is a Medical Oncologist at HCG Cancer Hospital, Bangalore said, "The claim that fructose is more damaging to the liver than sucrose holds some truth but requires nuanced understanding. Both fructose and sucrose are sugars, but their metabolic pathways and effects on the body differ."


To know more, ABP Live sought the opinion of other experts who explained the reason behind it.


Why Does Fructose Pose A Greater Risk?


Dr. Sashwata Chatterjee, who is a consultant of Gastro Science at CMRI said, "Fully refined sugar is almost entirely sucrose. Sucrose is made up of glucose and fructose. It is broken down in the intestine. Glucose is broken down in cells all around the body and leads to increase in lipid content in blood and liver. It stimulates liver protein synthesis and a bit of fat in liver. Unlike sucrose, fructose is almost entirely metabolised in liver and promotes synthesis of fat in liver. 10 grams of sucrose contains 5 grams of fructose and 5 grams of glucose. Therefore, if a person consumes 10 grams of sucrose, 5 grams of fructose will reach liver. On the other hand, consumption of 10 grams of fructose will lead to 10 grams of fructose reaching liver. Therefore, if equal amounts (by weight) of sucrose and frustose are consumed, more amount of sugar will be metabolised in liver and more fat will accumulate in the liver. Therefore, fructose is more daging to the liver than sucrose."


What Are The Harmful Effects Of Fructose?


Fructose is a natural sugar found in various fruits, honey, and root vegetables. While it is a natural component of many foods, excessive consumption of fructose, especially in its isolated form as high-fructose corn syrup (HFCS), has raised concerns due to its potential adverse health effects.


Talking about this, Nupuur Patil who is a celebrity nutritionist certified from the Olympic Committee said, "One significant concern is its association with metabolic issues. Unlike glucose, which is metabolised throughout the body, fructose is primarily processed by the liver. Excessive fructose intake has been linked to non-alcoholic fatty liver disease (NAFLD), as it can contribute to fat accumulation in the liver, leading to inflammation and potentially more severe liver conditions."


"The impact of fructose on cardiovascular health is another area of concern. Studies suggest that increased fructose intake may contribute to elevated blood pressure, dyslipidemia, and an increased risk of cardiovascular diseases," she added.


Fructose Metabolism: A Unique Challenge For The Liver


The liver plays a central role in sugar metabolism. When we consume sugars, the liver acts as a processing center, regulating their conversion into energy or storage as fat. Glucose is readily utilized by the body's cells for energy. However, the liver's handling of fructose differs significantly from that of glucose.


To explain this, Dr. Tejeswini Deepak, who is an MBBS, MD - General Medicine, Fellow of American College of Endocrinology (FACE) and General Physician, Apollo Spectra Hospital, Bangalore listed the following points:



  • Insulin Resistance


Research indicates that excessive fructose consumption may contribute to insulin resistance, a condition in which the body's cells become less responsive to the effects of insulin. Insulin resistance is a precursor to conditions like type 2 diabetes and can exacerbate the impact of fructose on liver health.



  • Role in Inflammation


High levels of fructose have been associated with increased inflammation in the liver. Chronic inflammation is a known factor in the progression of liver diseases, including more severe conditions like cirrhosis.



  • Connection to Metabolic Syndrome


The unique metabolism of fructose is also linked to the development of metabolic syndrome, a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes. Components of metabolic syndrome, such as abdominal obesity and elevated blood pressure, often coincide with adverse effects on the liver.


In addition, Dr. Sajid Mairaj who is a senior consultant physician and Ddiabetologist at Prayag Hospitals Group said, "The liver converts fructose into triglycerides more efficiently than it does with glucose. High levels of triglycerides in the liver can contribute to the development of fatty liver disease. Additionally, fructose metabolism can lead to increased production of uric acid, which has been linked to insulin resistance and other metabolic disturbances."


How Much Fructose Should Be Consumed?


Dr. Sajid Mairaj said, "It's important to emphasise that moderate consumption of fructose from natural sources like fruits is generally considered part of a healthy diet. The issues arise when there is an excessive intake of added sugars, particularly in the form of HFCS, which is commonly found in many processed foods and sugary beverages."


"Excessive fructose consumption poses significant risks to health, contributing to the progression of metabolic syndrome and related conditions. Fructose metabolism increases uric acid production, linked to insulin resistance and gout risk, while also being associated with elevated blood pressure, a key component of metabolic syndrome and a cardiovascular disease risk factor," he added.


What Happens If Fructose Is Consumed In Excess?


In addition, Dr. Pramila Ramnis Baitha, who is the Additional Director of Internal Medicine at Fortis Hospital Greater Noida said, "The increased usage leads to predominant side effects like insulin resistance, obesity, leading to diabetes. Fructose-rich foods lead to the conversion of serum triglycerides and liver triglycerides. Consumption of fructose and sucrose must be in moderation to avoid such health complications."


"More often, nutritionists have two opinions and advise switching from sucrose to fructose. Both are simple sugars, but consumption of either of them in excess can lead to metabolic problems, insulin resistance, diabetes, and obesity," she added.


In the realm of sugar consumption and its impact on health, understanding the nuances of different sugars is crucial. While sucrose and fructose are molecular cousins, their distinct metabolic pathways in the liver set them apart in terms of potential harm. As we navigate the complexities of modern diets, it becomes imperative to strike a balance and be mindful of the types and amounts of sugars we consume. By fostering awareness of the unique challenges posed by fructose metabolism, individuals can make informed choices that promote not only liver health but overall well-being.