Non-Alcoholic Fatty Liver Disease

Excessive fructose, glucose, and insulin cause the liver to produce fat faster than it can export, resulting in the fat being stored and accumulated in the liver. Fatty liver is the hallmark of insulin resistance and type 2 diabetes. The fattier the liver, the higher the insulin resistance. Therefore, to understand insulin resistance and resulting type 2 diabetes, we must first understand how fatty liver develops.

Fructose

When you ingest glucose, it is dispersed through your body to be utilized as energy by all organs, muscles, and tissues, which take up 80% of the incoming glucose, leaving 20 % for the liver to be converted into glycogen for later use. Glucose goes into the bloodstream and is metabolized by the entire body. You can test and control the level of glucose (blood sugar level) by the glycemic index, a number between 1 – 100.

Fructose, however, is largely metabolized by the liver. It's not absorbed into the bloodstream, which makes it have a very low glycemic index. It is hidden. Your doctor cannot track it with the glycemic index. That is why, the blood sugar level being in the normal range is by far not reliable to diagnose (pre-) type 2 diabetes. Since the liver glycogen is full, the incoming fructose is turned into fat and stored in the liver, resulting in fatty liver. Therefore, you need to ask your doctor for a fatty liver test.

Another bit of truth about fructose is that it doesn’t stimulate the "satiety hormone” leptin, which signals to the brain that we are full when we’ve eaten enough. Since fructose doesn’t turn this hormone “on,” we keep on eating more and more. This was beneficial for the monkeys in ancient times that needed to store up fat for the winter, but not for us now.

The sources of fructose are:

• Table sugar, 50% fructose, and 50% glucose

• High fructose corn syrup (HFCS), 55% fructose, and 45% glucose

• Naturally found in fruits

• Honey

You find HFCS in all processed foods such as soda, ice cream, breakfast cereals, cereal bars, sweetened yogurt, coffee creamer, candy, salad dressing, energy drinks, nutrition bars, frozen junk food, TV dinners, packed pizzas, donuts, canned fruit, jams and jellies, granola bars, cookies and cakes, sauces, ketchup, snack food, processed flavored oatmeal, peanut butter, flavored milk, mayo look like, canned soup, canned tomatoes, canned pickles, midnight snack. If you want to prevent or heal fatty liver and type 2 diabetes, you want to avoid those junk foods.

The Link Between Fructose and Insulin Resistance

HFCS and white crystal sugar both consist of 50% glucose and 50% fructose having a fattening effect in two ways:.

1. Fructose is chiefly responsible for fatty liver as it is metabolized by the liver solely and limitlessly.

2. Glucose raises the levels of blood glucose and insulin.

When you eat HFCS or sugar, fifty percent of that (fructose) goes directly into the liver, filling up the glycogen, and the rest is turned into fat, causing fatty liver. [1a] Another fifty percent (glucose) combined with refined carbs we eat in the day elevates the blood glucose. Then insulin tries to push the excess glucose from the bloodstream into the liver, already crammed full with fat . The liver resists. The pancreas releases more insulin to force the glucose into the liver, causing insulin resistance. [2b] Fructose accelerates fat production (de novo lipogenesis) by five times. [3b]

Insulin resistance promotes higher insulin levels. A high level of insulin creates an excess amount of fat in the liver, which in turn requires more insulin to push the surplus glucose into the fatty liver. Vicious circle.

Refined carbohydrates and food containing HFCS are the culprits of developing fatty liver because they have created far less of a satiety effect, as since their protein, fiber, and fat have been taken away. So, we have to eat more, the limited capacity of glycogen is reached, the blood glucose rises, and insulin spikes. Complex carbohydrates and whole- food, on the other hand, stimulate less insulin based on for two reasons. First, the fat and protein in them have caused more of the satiety effect, thus we eat less. Second, the fiber in them slows down the absorption of glucose. That is why you want to eat the whole food.

When we don't eat, the level of insulin drops, and the liver starts to release glucose and fat into circulation. The liver can use the time we don't eat to empty the glycogen and release some fat. However, we don't allow the liver to do so, as we eat over and over again. In the presence of insulin and glucose in the bloodstream, there is no way for the liver to get rid of fat. How can doctors and nutritionists advise “eat six times a day" and prescribe exogenous insulin? Or even worse, not communicate toting with patients the very underlying cause of diabetes, namely excessive HFCS consumption and fatty liver.

Multiple studies show that fatty liver is completely reversible by cutting back sugar, fructose, and refined carbohydrate. [4d] The main driver of fatty liver is sugar and fructose. [5e] Eating fructose and refined carbohydrate increases the production and accumulation of fat in the liver by ten 10 times. [4d] Studies have shown that dietary fat consumption and a low carbohydrate intake does not result in hepatic fat production. [4d] Therefore, it is crucial to shift your macros from carbs to healthy fat and fast intermittently, if you are to reverse and heal the fatty liver and type 2 diabetes.

Eating healthy fat combined with intermittent fasting results in a very low insulin level, which allows a catabolic hormone namely called glucagon to gain dominance. In such an environment, the body reorganizes the metabolism from storing to burning. When you eat fat and fast (in the absence of insulin influence), you set the body in a catabolic mode, meaning burning it will burn down the stored energy. You start to burn away all sugar and fat deposits.

The Key Takeaway. How to reverse a fatty liver?:

1. Fructose is metabolized almost entirely by the liver. Stop eating sugar, HFCS, fructose in fruit, and honey, because you want to inhibit the fat accumulation in the liver.

2. Eat fatty meat and other healthy fats followed by intermittent fasting. This way you make the liver get rid of fat.

Scientific References

[1a] Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK. Moore JB, Gunn PJ, Fielding BA. Nutrients. 2014 Dec 10;6(12):5679-703. doi: 10.3390/nu6125679. Review. PMID: 25514388. The physiological Society, Fructose and metabolic health: governed by hepatic glycogen status? 05 April 2019. Aaron Hengist, Francoise Koumanov, Javier T. Gonzales, Department for Health, University of Bath, Bath, UK.

[2b] Fabbrini E, et al. Intrahepatic fat, not visceral fat, is linked with metabolic complications of obesity. Proc Natl Acad Sci USA 2009; 106(36): 15430-15435; D'’Adamo E, Caprio S. Type 2 diabetes in youth: epidemiology and pathophysiology. Diabetes Care. 2011; 34(Suppl 2): S161-S165.

[3c] Faeh D, et al. Effect of rei overfeeding and fish oil administration on hepatic de novo lipogenesis and insulin sensitivity in healthy men. Diabetes. 2005; 54(7): 1907-1913.

[4d] Schwarz JM, et al. Short-term alterations in carbohydrate energy intake in humans. Striking effects on hepatic glucose production, de novo lipogenesis, lipolysis, and whole-body fuel selection. J Clin Invest. 1995; 96(6): 2735-2743; Softic S, et al. Role of dietary fructose and hepatic de novo lipogenesis in fatty liver disease. Dig Dis Sci. 2016 May; 61(5): 1282-1293.

[5e] Chong MF, et al. Mechanisms for the acute effect of fructose on postprandial lipemia. Am J Clin Nutr. 2007; 85(6): 1511-1520.