Fructose: it's "alcohol without the buzz"

FAB RESEARCH COMMENT:

Dr Robert Lustig is a clinical expert in both pediatric obesity and neuroendocrinology, and has become one of the world's leading researchers on the impact of high intakes of sugar - and particularly fructose - on the development of obesity, diabetes and related metabolic conditions.

In this review, he makes clear the striking parallels between the metabolism of fructose, and of alcohol, within the body - detailing the mechanisms by which consumption of either of these in more than minimal amounts

1. selectively disrupts sensivitiy to insulin within the liver (which equivalent glucose consumption does not)
2. promotes the storage of excess energy as fat (rather than glycogen)
3. leads over time to almost exactly the same patterns of chronic metabolic disease

This account provides a compelling explanation for why the dramatic increase in added sugars in human diets over recent decades has been matched by an extraordinary increase in the incidence and prevalance of 'non-alcoholic fatty liver disease' (NAFLD), as well as both obesity and Type 2 diabetes, both of which NAFLD is very strongly associated with, and typically precedes.

Even 50 years ago, 'fatty liver disease' was almost never seen in children, and was relatively rare even in adults, and almost always associated with excessive consumption of alcohol and increasing age. Now, NAFLD affect 10-15% of US children and adolescents - and around 40% of those with obesity.

With respect to their effects on the brain, he also summmarises the evidence that chronic high doses of both alcohol and fructose (unlike glucose) can override the systems that normally lead to self-regulation of their intake, albeit via different mechanisms with respect to their effects on mood and behaviour.  And while alcohol is classically 'addictive', human studies remain inconclusive on this point with respect to fructose - although they do clearly show that it is habit-forming.