Update on Toxins Harming the Liver

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Keeping Food Sweet With Liver Disease


By looking at the facts about artificial sweeteners, high fructose corn syrup and table sugar, those with liver disease can make informed choices about how to best eat their sweets.

The debate regarding which form of sugar is the healthiest has been going on for quite some time. The many different types of sugar are especially confusing for those who must be vigilant about nutrition – like people with liver disease. Whether siding with artificial sweeteners, high fructose corn syrup (HFCS) or raw, cane sugar, each industry will have you believe that their sweetener is superior. All three of these sweet additives have their own health caveats; however, two of them are particularly conducive to worsening liver disease.

Liver Disease
Any person with chronic liver disease – including hepatitis, fatty liver and liver cancer – has an added burden on his or her blood purification system. One of the liver’s primary responsibilities is to detoxify the blood. When the liver is operating below optimal functioning level, its ability to cleanse the blood diminishes. Not being able to keep up with the daily detoxification demand leads to a buildup of toxins in the blood that are more likely to cause liver damage.

In the face of liver disease, the ideal way to prevent the liver from becoming overloaded and consequently shutting down is to reduce the load of toxins it must process. Thus, being able to identify potential ingestible toxins so they can be minimized in the diet is an important, common sense step to reduce the liver’s daily toxic onslaught.

Experts have not yet pinpointed why, but an estimated 30 percent of Americans are believed to have a fatty liver. Fatty liver disease is the likely culmination of a variety of factors, although obesity definitely plays a role in fat’s accumulation in the liver. While a fatty liver in and of itself is not a dangerous condition, repeated liver inflammation and scarring can easily cause a fatty liver to progress to advanced liver disease.

Artificial Sweeteners
Also referred to as sugar substitutes or low-calorie sweeteners, artificial sweeteners offer a way to enjoy food with fewer calories than sugar. Besides their common use as part of a weight-loss plan or to control weight gain, people with diabetes may use artificial sweeteners because they make food taste sweet without raising blood sugar levels as much as regular sugar.

Commonly known by the names Aspartame®, Splenda®, sucralose, acesulfame K, NutraSweet®, saccharin and Equal®, these substances are all chemically manufactured sweeteners capable of creating toxic reactions in the human body. The government cautions children and pregnant women against the use of any artificial sweeteners. Due to the additional burden of detoxifying artificial sweetener byproducts, people with liver disease are typically advised to avoid this type of sweetener.

High Fructose Corn Syrup
Instead of sucrose (natural sugar), the sugar contained in most soft drinks and many processed foods is high fructose corn syrup. Made from cornstarch, high fructose corn syrup is a thick liquid that contains two basic sugar building blocks: fructose and glucose. Many claims of health woes (especially the promotion of obesity) have been associated with HFCS. In HFCS’s defense, the Corn Refiners Association maintains that high fructose corn syrup is the same as table sugar nutritionally, and it launched a national TV campaign to educate consumers about their stance.

Despite its proponents claiming that HFCS is similar to sugar, recent research from Duke University Medical Center claims that high fructose corn syrup may be harmful to the liver. This confirms the proposed association between high fructose corn syrup and non-alcoholic fatty liver disease that was published in the Journal of Hepatology in 2008.

Upon examining the dietary habits and liver biopsies of over 400 adults, the Duke researchers found that an increased consumption of fructose appears to correlate with an increase in liver fibrosis in those with non-alcoholic fatty liver disease (NAFLD). According to Manal Abdelmalek, MD, MPH, associate professor of medicine in the Division of Gastroenterology/Hepatology at Duke University Medical Center, “We found that increased consumption of high fructose corn syrup was associated with scarring in the liver, or fibrosis, among patients with non-alcoholic fatty liver disease.”

For more information about the chemistry of high fructose corn syrup and how it is harmful to the liver, read Soda and Your Liver.

When evaluating artificial sweeteners and high fructose corn syrup for those with liver disease, regular table sugar may seem like a logical choice. However, most of us know that table sugar is far from a healthful food. Devoid of nutritional value, large amounts of sugar can be consumed without a feeling of fullness. Thus, it is easy to overindulge in sugar and suffer from its many consequences – including depressed immunity and weight gain. Especially a concern to those with fatty liver disease, weight gain can lead to liver inflammation and increased liver damage.

Enjoying a sweet beverage or dessert often means consuming artificial sweeteners, high fructose corn syrup or sugar. Obviously, none of these choices are particularly liver friendly – although artificial sweeteners and HFCS seem to elicit more concern to an ailing liver than sugar. Nonetheless, even sugar consumption can fan liver inflammation and fat accumulation. While sugar may be a better choice than artificial sweeteners or HFCS, living healthfully with liver disease means choosing your sweets carefully – and always with moderation in mind., What is High-Fructose Corn Syrup (HFCS)?, Dr. Michael Roizen, Retrieved March 27, 2010, ShareCare, Inc., 2010., High Fructose Corn Syrup vs. Sugar: Are they Nutritionally Similar?, Retrieved March 27, 2010,, 2010., Soda and Your Liver, Nicole Cutler, L.Ac., MTCM, Retrieved March 27, 2010, Natural Wellness, 2010., 5 Surprisingly Toxic Items to Your Liver, Nicole Cutler, L.Ac., MTCM, Natural Wellness, 2010., Artificial sweeteners: A safe alternative to sugar?, Retrieved March 28, 2010, Mayo Foundation for Medical Education and Research, 2010., High Fructose Corn Syrup Linked to Liver Scarring, March 27, 2010,, 2010., Fructose consumption as a risk factor for non-alcoholic fatty liver disease, Ouyang X, et al, Journal of Hepatology, June 2008., Breakthrough CBS News Health Report: “High Fructose Corn Syrup - It’s Just Sugar”, Retrieved March 27, 2010,, 2010.

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About the Author

Nicole Cutler, L.Ac., MTCM, Dipl. Ac. (NCCAOM)®

Nicole Cutler, L.Ac., MTCM is a long time advocate of integrating perspectives on health. With a Bachelor's degree in Neuroscience from the University of Rochester and a Master's degree in Traditional Chinese Medicine from Five Branches Institute, Nicole has been a licensed acupuncturist since 2000. She has gathered acupuncture licenses in the states of California and New York, is a certified specialist with the National Acupuncture Detoxification Association, has earned diplomat status with the National Commission of Chinese and Oriental Medicine in Acupuncture and Chinese Herbology and is a member of the Society for Integrative Oncology. In addition to her acupuncture practice that focuses on stress and pain relief, digestion, immunity and oncology, Nicole contributes to the integration of healthcare by writing articles for professional massage therapists and people living with liver disease.

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