The Impact and Burden of Dietary Sugars on the Liver

• Type of Material: Article
• Authors: Helaina Huneault, Emory University; Ana Ramirez Tovar, Emory University; Cristian Julian Sanchez-Torres, Emory University; Jean Welsh, Emory University; Miriam Benedicta Vos, Emory University
• Language: English
• Date: 2023-11-06
• Publisher: Wolters Kluwer Health, Inc.
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Author(s).
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.1097/HC9.0000000000000297
• Title of Journal or Parent Work: Hepatology Communications
• Volume: 7
• Issue: 11
• Start Page: e0297
• Grant/Funding Information: Supported by the National Institutes of Health (NIH) (grant numbers R01NR019083 and R01DK125701).
• Keywords: associated steatotic liver disease; Simple sugars; NAFLD; Dietary
• Research Categories: Health Sciences, Public Health; Health Sciences, Nutrition

Abstract

NAFLD, or metabolic dysfunction–associated steatotic liver disease, has increased in prevalence hand in hand with the rise in obesity and increased free sugars in the food supply. The causes of NAFLD are genetic in origin combined with environmental drivers of the disease phenotype. Dietary intake of added sugars has been shown to have a major role in the phenotypic onset and progression of the disease. Simple sugars are key drivers of steatosis, likely through fueling de novo lipogenesis, the conversion of excess carbohydrates into fatty acids, but also appear to upregulate lipogenic metabolism and trigger hyperinsulinemia, another driver. NAFLD carries a clinical burden as it is associated with obesity, type 2 diabetes, metabolic syndrome, and cardiovascular disease. Patient quality of life is also impacted, and there is an enormous economic burden due to healthcare use, which is likely to increase in the coming years. This review aims to discuss the role of dietary sugar in NAFLD pathogenesis, the health and economic burden, and the promising potential of sugar reduction to improve health outcomes for patients with this chronic liver disease.