\nOnline Courses: Contact us at seminars@crossfit.com \nCrossFit Games Support: Reach out to support@crossfitgames.com \nFor T-Shirt Purchase: Check your inbox for instructions from customer@trackorder.site
\n","orderHistoryHeadlineText":"Order History","orderHistoryLabelText":"Order History","viewOrderDetailsText":"View order details"},"resourcesKickerText":"Resources","rulebookLabelText":"Rulebook","rulebookLinkUrl":"https://games.crossfit.com/rules","preferenceCenter":{"checkAllText":"Check All","emailCommunicationBodyText":"Select which lists you would like to receive communication from","emailCommunicationHeadlineText":"Email Communication","newsletters":[{"bodyText":"Every day since 2001, CrossFit has published a Workout of the Day for new CrossFit athletes, seasoned veterans, and anyone in between. Subscribe to Workout of the Day emails, and you'll receive CrossFit programming in a three-days-on, one-day-off, two-days-on, one-day-off cadence.","brazeGroupId":"d68551b9-ac7e-437e-bfd2-d225702413cc","headlineText":"Workout of the Day"},{"bodyText":"Get inspired with the latest and/or trending articles, stories, videos, and podcasts focused on the CrossFit community and methodology.","brazeGroupId":"1bfd806e-efe3-404d-9980-c8f38c39490b","headlineText":"What's Trending"},{"bodyText":"Be the first to know when official updates and announcements are released from CrossFit HQ.","brazeGroupId":"cb28cb07-ca09-4739-b73b-7413f95a4892","headlineText":"Updates and Announcements from CrossFit HQ"},{"bodyText":"This subscription is for those interested in announcements, updates, and stories about the CrossFit Games season and its competitors. ","brazeGroupId":"e56abfcc-c940-482d-879c-eed93958cbbe","headlineText":"CrossFit Games"},{"bodyText":"This monthly newsletter includes important CrossFit Games competition season updates, resources, and tips. It is intended for competitive athletes but is open to anyone interested in learning more about the CrossFit Games season.","brazeGroupId":"fce49890-9b3c-4e1f-9e06-1bd06cd696a3","headlineText":"The Hopper"},{"bodyText":"The Professional Coach provides a wealth of articles, media, and webinar opportunities that cover all aspects of coaching, including best practices, real-world coaching application, scaling, methodology, nutrition, CEU opportunities, and more. With contributions from experts inside and outside the CrossFit space, this twice-monthly newsletter is the ultimate tool for any coach looking to improve their skills and knowledge. This newsletter is exclusively available to those who hold a Level 1 Certificate or higher. ","brazeGroupId":"653207fb-9734-44c9-a988-23eb18142529","headlineText":"The Professional Coach"},{"bodyText":"The Affiliate Update is a newsletter for CrossFit affiliate owners and includes upcoming event details, business and marketing resources, and general updates from CrossFit HQ. The Affiliate Update is only available to licensees of record (LOR).","brazeGroupId":"1d3e4c63-f03f-4b61-8453-1fbb186ae27e","headlineText":"CrossFit Affiliate Update"},{"bodyText":"An email series for learning what it takes to open and run a successful CrossFit gym","brazeGroupId":"6ab8a53a-167c-4c74-b5ea-3a06cb857068","headlineText":"Interested in Affiliation"},{"bodyText":"CAP is a weekly email available exclusively to affiliate owners that provides comprehensive class plans, resources, and educational tips to help coaches deliver an exceptional experience to their members.","brazeGroupId":"ba7e977e-ec76-41e3-8465-158d38167ed6","headlineText":"CrossFit Affiliate Programming (CAP)"},{"bodyText":"CrossFit Health serves as a vital bridge connecting the realms of fitness and healthcare. Committed to delivering valuable insights, CrossFit Health harnesses the expertise of renowned professionals from the health, wellness, and CrossFit communities. Our mission is to educate individuals on the transformative potential of CrossFit as a powerful lifestyle intervention, ultimately optimizing health outcomes.","brazeGroupId":"a9c5a8a4-df0a-4b0c-acb6-e9b4631fc00c","headlineText":"CrossFit Health"},{"bodyText":"Be the first to know when new products are added to the Official CrossFit Store and receive special offers and discounts conveniently delivered directly to your inbox.","brazeGroupId":"905db0be-a3c8-4f5b-8903-536a04cb0a40","headlineText":"The CrossFit Store"},{"bodyText":"This subscription is for companies interested in on-site event activations and vendor booths at the CrossFit Games and other events hosted by CrossFit.","brazeGroupId":"92fa7fe8-262a-4d6a-9b0d-9fcc8cc17e7d","headlineText":"Interested in On-Site Event Activations / Vendor Booths"},{"bodyText":"Get alerted for upcoming courses. CrossFit courses and certifications are open to individuals and trainers seeking to improve their health and fitness through effective training and nutritional strategies.","brazeGroupId":"dd1ee7a4-2ef5-477b-affb-77347ce81684","headlineText":"Interested in Finding a Course Near You"}],"preferenceCenterHeadlineText":"Newsletter Preferences","preferenceCenterLabelText":"Newsletter Preferences","uncheckAllText":"Uncheck All"}}},"pages":{"breadcrumbs":{"links":[{"text":"Essentials","url":"/essentials"},{"text":"Role of Dietary Fructose and Hepatic De Novo Lipogenesis In Fatty Liver Disease","url":"#"}]},"contentPublishDate":"20190315","contentType":"article","commentTopics":[{"title":"Role of Dietary Fructose and Hepatic De Novo Lipogenesis In Fatty Liver Disease","topicId":"article.20190313090304517"}],"title":"Role of Dietary Fructose and Hepatic De Novo Lipogenesis In Fatty Liver Disease","topicId":"article.20190313090304517","socialMetaData":{"title":"Role of Dietary Fructose and Hepatic De Novo Lipogenesis In Fatty Liver Disease"},"path":"/essentials/role-of-dietary-fructose-and-hepatic-de-novo-lipogenesis-in-fatty-liver-disease","components":[{"name":"ArticleHeader","props":{"topicId":"article.20190313090304517","date":"20190315","articleDate":"20190315","authorName":"CrossFit ","bylineText":"By","headlineText":"Role of Dietary Fructose and Hepatic De Novo Lipogenesis In Fatty Liver Disease"}},{"name":"TextBlock","props":{"children":"
Hepatic de novo lipogenesis refers to the liver’s synthesis of new fat from other substances, often carbohydrate and specifically fructose. This review summarizes the role of hepatic de novo lipogenesis (DNL)—and thus the role of fructose—in the development and progression of fatty liver disease.
\n
Nonalcoholic fatty liver disease, the most common cause of elevated liver enzymes and among the most common indications for liver transplantation, is characterized by a liver fat concentration of more than 5 percent (by weight). Hepatic fat accumulates in the liver from three sources: (i) dietary lipids, (ii) esterification of plasma free fatty acids (FFAs), and (iii) the production of dietary fat by the liver, or hepatic de novo lipogenesis. In hepatic DNL, dietary carbohydrates are broken down to pyruvate, converted to citrate, and used to synthesize long-chain fatty acids.
\n
Figure 2 from Role of Dietary Fructose and Hepatic de novo Lipogenesis in Fatty Liver Disease. Lambert et al., used isotope analysis to compare de novo lipogenesis and fatty acid flux in obese subjects with and without NAFLD. The proportion of hepatic triglycerides deriving from the evening meal was not different, 5% versus 5%, at the end of the study. The proportion of triglycerides synthesized from plasma FFA in low liver-fat group (52%), was significantly higher than in high liver-fat group (38%). By contrast, triglycerides synthesized via de novo lipogenesis was significantly higher in high liver-fat group (23%), compared to low liver-fat group (10%).
\n
Early studies suggested hepatic DNL was a minor contributor to liver fat stores, but these studies were done in fasting subjects; more recent research has shown that in obese patients with NAFLD, 26 percent of liver fat is derived from DNL (60 percent is from free fatty acids, 15 percent is from dietary fat). The share of liver triglycerides derived from hepatic DNL is higher in subjects with high liver fat, which suggests enhanced hepatic DNL is the primary defect in NAFLD. This has been supported by studies showing diets higher in carbohydrate promote DNL to a greater extent than diets lower in carbohydrate. Carbohydrate overfeeding, in particular, can lead to a rapid increase in liver fat.
\n
Fructose uniquely promotes DNL, and thus uniquely promotes fatty liver disease. A variety of studies in both humans and animals have shown that increased fructose consumption is associated with greater risk of NAFLD and fructose restriction leads to NAFLD improvement. Fructose, once absorbed through the intestine, goes straight to the liver (unlike other macronutrients), where it upregulates multiple steps of the DNL process. While insulin promotes hepatic DNL in most cases, fructose (unlike glucose) does not require insulin to be metabolized. Finally, fructose may further increase metabolism through a variety of indirect mechanisms, including uric acid promotion and reactive oxygen species accumulation.
\n
In sum, fatty liver disease is primarily a defect of excessive hepatic de novo lipogenesis, and fructose specifically promotes DNL through multiple mechanisms. Given these and other factors that suggest fructose plays a role in NAFLD progression, targeting fructose metabolism or intake may support NAFLD management.
\n","hideText":"Hide","status":"active","type":"alert_banner","userCanHide":"no"},"header":{"desktopLinks":[{"below":[{"id":93961,"parent":"93960","target":"_self","text":"What is CrossFit?","url":"/what-is-crossfit"},{"id":93962,"parent":"93960","target":"_self","text":"Find a Gym","url":"/map"}],"id":93960,"parent":"0","target":"_self","text":"Getting Started","url":"/what-is-crossfit"},{"below":[{"id":93964,"parent":"93963","target":"_self","text":"About","url":"/education/about"},{"id":93966,"parent":"93963","target":"_self","text":"Level 1 Certificate Course","url":"/certificate-courses/level-1"},{"id":93965,"parent":"93963","target":"_self","text":"Explore All Courses","url":"/education/explore-courses"},{"id":109033,"parent":"93963","target":"_self","text":"Private Courses","url":"/private-course/"},{"id":109034,"parent":"93963","target":"_self","text":"Military Resources","url":"/army-ignited"},{"id":93967,"parent":"93963","target":"_self","text":"Coaching Resources","url":"/education/resources"}],"id":93963,"parent":"0","target":"_self","text":"Courses","url":"/education/about"},{"below":[{"id":95951,"parent":"93968","target":"_self","text":"Workout of the Day","url":"/wod"},{"id":93969,"parent":"93968","target":"_self","text":"Explore Workouts","url":"https://www.crossfit.com/workout"},{"id":101892,"parent":"93968","target":"_self","text":"Hero Workouts","url":"https://www.crossfit.com/heroes/"},{"id":93970,"parent":"93968","target":"_self","text":"Movements","url":"https://www.crossfit.com/crossfit-movements"}],"id":93968,"parent":"0","target":"_self","text":"Workouts","url":"https://www.crossfit.com/workout"},{"id":93971,"parent":"0","target":"_self","text":"Learn","url":"/media"},{"id":93972,"parent":"0","target":"_blank","text":"Games","url":"https://games.crossfit.com"},{"id":105467,"parent":"0","target":"_blank","text":"Store","url":"https://store.crossfit.com/?utm_source=owned&utm_medium=nav&utm_campaign=main"},{"id":106137,"parent":"0","target":"_self","text":"Open A Gym","url":"/open-crossfit-gym"}],"mobileLinks":[{"text":"Open a CrossFit Gym"},{"text":"Browse","links":[{"below":[{"id":93961,"parent":"93960","target":"_self","text":"What is CrossFit?","url":"/what-is-crossfit"},{"id":93962,"parent":"93960","target":"_self","text":"Find a Gym","url":"/map"}],"id":93960,"parent":"0","target":"_self","text":"Getting Started","url":"/what-is-crossfit"},{"below":[{"id":93964,"parent":"93963","target":"_self","text":"About","url":"/education/about"},{"id":93966,"parent":"93963","target":"_self","text":"Level 1 Certificate Course","url":"/certificate-courses/level-1"},{"id":93965,"parent":"93963","target":"_self","text":"Explore All Courses","url":"/education/explore-courses"},{"id":109033,"parent":"93963","target":"_self","text":"Private Courses","url":"/private-course/"},{"id":109034,"parent":"93963","target":"_self","text":"Military Resources","url":"/army-ignited"},{"id":93967,"parent":"93963","target":"_self","text":"Coaching Resources","url":"/education/resources"}],"id":93963,"parent":"0","target":"_self","text":"Courses","url":"/education/about"},{"below":[{"id":95951,"parent":"93968","target":"_self","text":"Workout of the Day","url":"/wod"},{"id":93969,"parent":"93968","target":"_self","text":"Explore Workouts","url":"https://www.crossfit.com/workout"},{"id":101892,"parent":"93968","target":"_self","text":"Hero Workouts","url":"https://www.crossfit.com/heroes/"},{"id":93970,"parent":"93968","target":"_self","text":"Movements","url":"https://www.crossfit.com/crossfit-movements"}],"id":93968,"parent":"0","target":"_self","text":"Workouts","url":"https://www.crossfit.com/workout"},{"id":93971,"parent":"0","target":"_self","text":"Learn","url":"/media"},{"id":93972,"parent":"0","target":"_blank","text":"Games","url":"https://games.crossfit.com"},{"id":105467,"parent":"0","target":"_blank","text":"Store","url":"https://store.crossfit.com/?utm_source=owned&utm_medium=nav&utm_campaign=main"},{"id":106137,"parent":"0","target":"_self","text":"Open A Gym","url":"/open-crossfit-gym"}]}],"brandLinks":[{"id":93974,"parent":"0","target":"_self","text":"Open a CrossFit Gym","url":"/open-crossfit-gym"}],"loggedInMenu":[{"id":72863,"parent":"0","target":"_self","text":"Manage Account","url":"https://www.crossfit.com/dashboard"},{"id":72864,"parent":"0","target":"_self","text":"Competition Dashboard","url":"https://games.crossfit.com/manage-competition/athlete"}]},"footer":{"mainLinks":[{"below":[{"id":9764,"parent":"511","target":"_self","text":"What Is CrossFit?","url":"/what-is-crossfit"},{"id":9765,"parent":"511","target":"_self","text":"Get Started","url":"/get-started"},{"id":45861,"parent":"511","target":"_self","text":"Workouts","url":"/workout/"},{"id":45862,"parent":"511","target":"_self","text":"Movements","url":"/essentials/movements"},{"id":1741,"parent":"511","target":"_self","text":"FAQ","url":"/faq"},{"id":90183,"parent":"511","target":"_self","text":"Help Center","url":"https://crossfit.my.site.com/Support/s/"},{"id":45103,"parent":"511","target":"_self","text":"Careers","url":"/careers/"}],"id":511,"parent":"0","target":"_self","text":"About CrossFit","url":"#"},{"below":[{"id":45864,"parent":"45863","target":"_self","text":"Courses Near You","url":"/courses-near-you/"},{"id":45865,"parent":"45863","target":"_self","text":"Certificate Courses","url":"/certificate-courses/"},{"id":45866,"parent":"45863","target":"_self","text":"Certifications","url":"/certifications/"},{"id":45868,"parent":"45863","target":"_self","text":"Online Courses","url":"https://www.crossfit.com/online-courses"}],"id":45863,"parent":"0","target":"_self","text":"Education","url":"#"},{"below":[{"id":45870,"parent":"45871","target":"_self","text":"Open a CrossFit Gym","url":"/open-crossfit-gym"},{"id":45884,"parent":"45871","target":"_self","text":"Field Leaders","url":"/field-leaders"},{"id":90935,"parent":"45871","target":"_self","text":"Global Mentor Program","url":"/global-mentor-program/"},{"id":93982,"parent":"45871","target":"_self","text":"Affiliate Portal","url":"https://affiliate.crossfit.com/tools/"}],"id":45871,"parent":"0","target":"_self","text":"Affiliates","url":"#"},{"below":[{"id":16638,"parent":"45875","target":"_self","text":"Find a Trainer","url":"https://trainerdirectory.crossfit.com/"},{"id":45876,"parent":"45875","target":"_self","text":"Scholarship Program","url":"/scholarship-program-inquiry"},{"id":45877,"parent":"45875","target":"_self","text":"Foundation","url":"/foundation"},{"id":104122,"parent":"45875","target":"_self","text":"CrossFit Medical Society","url":"https://www.crossfitmedicalsociety.com/"}],"id":45875,"parent":"0","target":"_self","text":"Community","url":"#"},{"below":[{"id":45881,"parent":"45879","target":"_self","text":"About the Games","url":"https://games.crossfit.com/"},{"id":45880,"parent":"45879","target":"_self","text":"Leaderboard","url":"https://games.crossfit.com/leaderboard/games/2022?division=2"},{"id":45882,"parent":"45879","target":"_self","text":"Schedule","url":"https://games.crossfit.com/games/schedule?_ga=2.142929340.802559833.1690817966-401013740.1685640771"},{"id":91727,"parent":"45879","target":"_self","text":"Workouts","url":"https://games.crossfit.com/workouts/games/2023"}],"id":45879,"parent":"0","target":"_self","text":"The CrossFit Games","url":"#"}],"brandLinks":[],"socialLinks":[{"id":66715,"parent":"0","target":"_self","text":"facebook","url":"https://www.facebook.com/crossfit"},{"id":66716,"parent":"0","target":"_self","text":"twitter","url":"https://twitter.com/CrossFit"},{"id":66717,"parent":"0","target":"_self","text":"instagram","url":"https://www.instagram.com/crossfit/"},{"id":66718,"parent":"0","target":"_self","text":"youtube","url":"https://www.youtube.com/channel/UCtcQ6TPwXAYgZ1Mcl3M1vng"}],"contactLinks":[{"id":531,"target":"_self","text":"Careers","url":"https://www.crossfit.com/jobs"},{"id":532,"target":"_self","text":"Contact Us","url":"https://www.crossfit.com/contact-us"}],"legalLinks":[{"id":533,"parent":"0","target":"_self","text":"Terms & Conditions","url":"https://www.crossfit.com/terms-and-conditions"},{"id":534,"parent":"0","target":"_self","text":"Privacy Policy","url":"https://www.crossfit.com/privacy-policy"},{"id":10717,"parent":"0","target":"_self","text":"Cookie Policy","url":"https://www.crossfit.com/cookie-policy"},{"id":57312,"parent":"0","target":"_self","text":"Disclaimer","url":"https://www.crossfit.com/disclaimer"},{"id":10883,"parent":"0","target":"_self","text":"Contact Us","url":"https://www.crossfit.com/contact-us"},{"id":45883,"parent":"0","target":"_self","text":"Report IP Theft","url":"https://www.crossfit.com/iptheft"}]},"locationPages":{"simpleTiles":{"cards":[{"bodyText":"CrossFit offers a results-based, community-driven approach to functional training that helps you build strength and improve your health—over your lifetime.","headlineText":"Functional Fitness for Everyday Life","icon":{"alt":"Lifting Icon","url":"https://www.crossfit.com/wp-content/uploads/2024/04/26123658/crossfit-icon-workout-barbell-overhead-press.svg"}},{"bodyText":"Stay motivated with our community of coaches and members, who support your goals through approachable group training classes, helping you stay accountable and excited for each session.","headlineText":"Community Support and Motivation","icon":{"alt":"Heart Icon","url":"https://www.crossfit.com/wp-content/uploads/2024/04/26123700/crossfit-icon-heart.svg"}},{"bodyText":"Coaches scale class workouts to your fitness level to help you achieve your strength building goals.","headlineText":"Tailored to Your Fitness Levels","icon":{"alt":"Graph Icon","url":"https://www.crossfit.com/wp-content/uploads/2024/04/26123649/crossfit-icon-levels.svg"}},{"bodyText":"CrossFit coaches are experienced and trained to provide well-rounded and personalized guidance to individuals with varying fitness levels and goals.","headlineText":"Industry Certified Coaches","icon":{"alt":"Certification Icon","url":"https://www.crossfit.com/wp-content/uploads/2024/04/26123656/crossfit-icon-check-badge.svg"}}],"headlineText":"Build Strength for a Fuller Life"},"gymFinderPromo":{"bodyText":"Contact CrossFit to start your fitness journey. We’ll connect you to the closest gym in your area.","headlineText":"Get Started today","image":{"alt":"Man Lifting Barbell","sizes":{"1536x1536":"https://www.crossfit.com/wp-content/uploads/2018/12/13135656/aa6daff2983e555e3688654515568d25-1-768x512-1.jpeg","1536x1536Height":512,"1536x1536Width":768,"2048x2048":"https://www.crossfit.com/wp-content/uploads/2018/12/13135656/aa6daff2983e555e3688654515568d25-1-768x512-1.jpeg","2048x2048Height":512,"2048x2048Width":768,"hero":"https://www.crossfit.com/wp-content/uploads/2018/12/13135656/aa6daff2983e555e3688654515568d25-1-768x512-1.jpeg","heroHeight":512,"heroWidth":768,"heroLarge":"https://www.crossfit.com/wp-content/uploads/2018/12/13135656/aa6daff2983e555e3688654515568d25-1-768x512-1.jpeg","heroLargeHeight":512,"heroLargeWidth":768,"large":"https://www.crossfit.com/wp-content/uploads/2018/12/13135656/aa6daff2983e555e3688654515568d25-1-768x512-1.jpeg","largeHeight":512,"largeWidth":768,"medium":"https://www.crossfit.com/wp-content/uploads/2018/12/13135656/aa6daff2983e555e3688654515568d25-1-768x512-1.jpeg","mediumHeight":512,"mediumWidth":768,"mediumLarge":"https://www.crossfit.com/wp-content/uploads/2018/12/13135656/aa6daff2983e555e3688654515568d25-1-768x512-1.jpeg","mediumLargeHeight":512,"mediumLargeWidth":768,"small":"https://www.crossfit.com/wp-content/uploads/2018/12/13135656/aa6daff2983e555e3688654515568d25-1-768x512-1-300x200.jpeg","smallHeight":200,"smallWidth":300,"thumbnail":"https://www.crossfit.com/wp-content/uploads/2018/12/13135656/aa6daff2983e555e3688654515568d25-1-768x512-1-150x150.jpeg","thumbnailHeight":150,"thumbnailWidth":150}},"links":[{"link":{"priority":"primary","text":"Find a Gym","url":"/map"}},{"link":{"priority":"secondary","text":"What Is CrossFit?","url":"/what-is-crossfit"}}]},"locationCourseCards":{"courseLinkText":"Register Now","findCourseLink":{"text":"Find More Courses","url":"https://www.crossfit.com/courses-near-you"},"headerText":"Courses Near You","seminarType":["level-one","level-two"]},"socialSharing":{"facebook":{"description":"Jump into CrossFit in [City Name]! Our certified coach led group training and fitness classes feature strength, conditioning, and functional workouts.","title":"CrossFit Gyms in [State] | Functional Fitness Classes & Group Training"}}}},"user":{},"coachCertifications":{}}
Role of Dietary Fructose and Hepatic De Novo Lipogenesis In Fatty Liver Disease
ByCrossFit March 15, 2019
Hepatic de novo lipogenesis refers to the liver’s synthesis of new fat from other substances, often carbohydrate and specifically fructose. This review summarizes the role of hepatic de novo lipogenesis (DNL)—and thus the role of fructose—in the development and progression of fatty liver disease.
Nonalcoholic fatty liver disease, the most common cause of elevated liver enzymes and among the most common indications for liver transplantation, is characterized by a liver fat concentration of more than 5 percent (by weight). Hepatic fat accumulates in the liver from three sources: (i) dietary lipids, (ii) esterification of plasma free fatty acids (FFAs), and (iii) the production of dietary fat by the liver, or hepatic de novo lipogenesis. In hepatic DNL, dietary carbohydrates are broken down to pyruvate, converted to citrate, and used to synthesize long-chain fatty acids.
Figure 2 from Role of Dietary Fructose and Hepatic de novo Lipogenesis in Fatty Liver Disease. Lambert et al., used isotope analysis to compare de novo lipogenesis and fatty acid flux in obese subjects with and without NAFLD. The proportion of hepatic triglycerides deriving from the evening meal was not different, 5% versus 5%, at the end of the study. The proportion of triglycerides synthesized from plasma FFA in low liver-fat group (52%), was significantly higher than in high liver-fat group (38%). By contrast, triglycerides synthesized via de novo lipogenesis was significantly higher in high liver-fat group (23%), compared to low liver-fat group (10%).
Early studies suggested hepatic DNL was a minor contributor to liver fat stores, but these studies were done in fasting subjects; more recent research has shown that in obese patients with NAFLD, 26 percent of liver fat is derived from DNL (60 percent is from free fatty acids, 15 percent is from dietary fat). The share of liver triglycerides derived from hepatic DNL is higher in subjects with high liver fat, which suggests enhanced hepatic DNL is the primary defect in NAFLD. This has been supported by studies showing diets higher in carbohydrate promote DNL to a greater extent than diets lower in carbohydrate. Carbohydrate overfeeding, in particular, can lead to a rapid increase in liver fat.
Fructose uniquely promotes DNL, and thus uniquely promotes fatty liver disease. A variety of studies in both humans and animals have shown that increased fructose consumption is associated with greater risk of NAFLD and fructose restriction leads to NAFLD improvement. Fructose, once absorbed through the intestine, goes straight to the liver (unlike other macronutrients), where it upregulates multiple steps of the DNL process. While insulin promotes hepatic DNL in most cases, fructose (unlike glucose) does not require insulin to be metabolized. Finally, fructose may further increase metabolism through a variety of indirect mechanisms, including uric acid promotion and reactive oxygen species accumulation.
In sum, fatty liver disease is primarily a defect of excessive hepatic de novo lipogenesis, and fructose specifically promotes DNL through multiple mechanisms. Given these and other factors that suggest fructose plays a role in NAFLD progression, targeting fructose metabolism or intake may support NAFLD management.
Role of Dietary Fructose and Hepatic De Novo Lipogenesis In Fatty Liver Disease