How Does Fructose Affect Your Liver?

While fructose does occur naturally in fruits, it is often consumed in much larger quantities from added sugars in processed foods and sugary beverages. High fructose corn syrup (HFCS) is a significant source of fructose in the modern diet which has been associated with an increased risk for developing certain chronic health issues, such as type 2 diabetes, obesity and metabolic liver disease.^1,2 

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One key mechanism linking fructose to fatty liver disease is the process of de novo lipogenesis (DNL) which is the making of new fat molecules from non-fat sources, such as carbohydrates (like fructose). High fructose intake can lead to increased DNL in the liver, resulting in the accumulation of fat within liver cells. 

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Fructose consumption can also lead to insulin resistance, a condition in which the body's cells become less responsive to the hormone insulin. Insulin resistance contributes to the development and progression of metabolic liver disease.³ 

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Some studies suggest that high fructose intake can promote inflammation in the liver, which can further exacerbate fatty liver disease. Chronic inflammation in the liver can lead to MASH, a more severe form of metabolic liver disease.⁴ 

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Finally, excess consumption of fructose, especially in the form of sugary beverages and processed foods, can contribute to weight gain, a well-established risk factor for metabolic liver disease. One reason this may occur is that fructose consumption appears to increase the release of appetite stimulating hormones, and thus increase hunger.⁵

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How Can I Avoid Excess Fructose? 

It's important to note that not all fructose consumption is harmful. In moderation and as part of a balanced diet, natural sources of fructose from whole fruits can be part of a healthy lifestyle. The concern arises when there is excessive consumption of added sugars, particularly from processed and high-fructose corn syrup-containing foods and drinks.

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You can find a lot of permanent alternatives for these foods that support balanced nutrition. First, it helps to know how to find HFCS on a nutrition facts label and what common foods might have it as an ingredient.

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Reading Nutrition Labels to Identify HFCS

The first thing to do is to flip over to the ingredients section of the nutrition facts label. Look for: high fructose corn syrup, corn syrup, natural corn syrup, maize syrup, isolated fructose, glucose-fructose syrup, and tapioca syrup. If you see any of these listed, the product contains HFCS and should be limited or avoided.

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Looking for Common Products that Contain HFCS

While this is not meant to be an exhaustive list, below are some common food products that contain HFCS (in red) and helpful substitutions (in green) for those products. It also never hurts to double check your refrigerator and pantry to see if any of the similar food items you own contain this ingredient.

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Condiments

1. Ketchup - Avoid Heinz and Del Monte and instead pick up Amy’s Organic, Heniz “organic” or “simply,” Hunt's 100% Natural
2. Jelly - Get rid of the generic jellies, Smucker’s and Welch’s and instead look for brands labeled “organic”. 
3. Sauces - It’s time to break up with Sweet Baby Ray’s BBQ sauce and instead give Stubbs Original BBQ sauce. 
4. Maple syrup - It’s time to toss Aunt Jemima, Smucker’s, or Log Cabin. Give 100% Pure Maple Syrup, like Kirkland Organic Maple Syrup or Maple Grove 100% Pure Maple Syrup a try to sweeten up those morning meals. 

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Beverages

1. Sodas - Continue avoiding the obvious culprits like Coca Cola, Pepsi, and Sprite. But, when you do get a craving for some carbonation, try Unsweetened Sparkling Water from brands like La Croix, Topo Chico, Waterloo, Kirkland brand. You could even throw in some fruit pieces for some added natural flavor! 
2. Sweetened Juices (includes frozen concentrate) - Get rid of the Hawaiian Punch and Minute Maid and if you’ve got to do a juice, try Juicy Juice 100% juice or Honest Kids. You could even try making your own fresh, cold pressed juice at home! 

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Snacks

1. Sweets - It’s no surprise your childhood favorites Oreos, Hostess, Little Debbie’s, Baby Ruth, and Skittles have high HCFS contents. So next time you’re craving something sweet or maybe just even a little nostalgia, try a dupe from Annie’s! 
2. Crackers - Who knew your salty favorite would have HCFS?! Say goodbye to the Ritz and Keebler Club Crackers and instead opt for Mary’s Gone Crackers, Simple Mills, Ak-Mak Sesame Crackers, or Nut Thins

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Canned Goods

1. Applesauce - Avoid Mott’s Original Applesauce and other generic brands (read those labels!) and to keep it simple, opt for unsweetened applesauce instead.
2. Canned fruits - Any brand of canned fruit packed in syrup automatically means HCFS, so instead, just look for those packed in 100% juice. (But, be sure to read those labels to avoid additives!)

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Breakfast Cereals

Instead of starting your morning off with a big ol’ bowl of HCFS like you would with some Lucky Charms, Cocoa Puffs, or Trix, fill your morning with Cheerios, some Kashi Cereals, Life, Shredded Wheat, or Barbara’s Cereal.

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Bread

Repeat after me: NO to Wonderbread, Sara Lee, or Pepperidge Farms and YES Ezekiel Bread (and other sprouted grain bread brands), Dave’s Killer Bread, Canyon Bakehouse (GF)

*References available with PDF download*