Editorial
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Jun 7, 2010; 16(21): 2579-2588
Published online Jun 7, 2010. doi: 10.3748/wjg.v16.i21.2579
Soft drinks consumption and nonalcoholic fatty liver disease
William Nseir, Fares Nassar, Nimer Assy
William Nseir, Department of Internal Medicine, Holy Family Hospital, Nazareth, 16126, Israel
Fares Nassar, Department of Internal Medicine, Western Galilee Hospital, Nahariya, 22356, Israel
Nimer Assy, Liver Unit, Ziv Medical Center, Safed, 13100, Israel; Technion Institute, Haifa, 32000, Israel
Author contributions: Nseir W wrote the manuscript and participated in the design; Nassar F revised the manuscript and participated in the design; Assy N wrote the manuscript, and participated in the design, figures, tables, editing and polishing.
Correspondence to: Nimer Assy, MD, Liver Unit, Ziv Medical Center, PO Box 1008, Safed, 13100, Israel. assy.n@ziv.health.gov.il
Telephone: +972-4-6828441 Fax: +972-4-6828442
Received: January 7, 2010
Revised: February 20, 2010
Accepted: February 27, 2010
Published online: June 7, 2010
Abstract

Nonalcoholic fatty liver disease (NAFLD) is a common clinical condition which is associated with metabolic syndrome in 70% of cases. Inappropriate dietary fat intake, excessive intake of soft drinks, insulin resistance and increased oxidative stress combine to increase free fatty acid delivery to the liver, and increased hepatic triglyceride accumulation contributes to fatty liver. Regular soft drinks have high fructose corn syrup which contains basic sugar building blocks, fructose 55% and glucose 45%. Soft drinks are the leading source of added sugar worldwide, and have been linked to obesity, diabetes, and metabolic syndrome. The consumption of soft drinks can increase the prevalence of NAFLD independently of metabolic syndrome. During regular soft drinks consumption, fat accumulates in the liver by the primary effect of fructose which increases lipogenesis, and in the case of diet soft drinks, by the additional contribution of aspartame sweetener and caramel colorant which are rich in advanced glycation end products that potentially increase insulin resistance and inflammation. This review emphasizes some hard facts about soft drinks, reviews fructose metabolism, and explains how fructose contributes to the development of obesity, diabetes, metabolic syndrome, and NAFLD.

Keywords: Aspartame; Caramel; Carbonated beverage; Cola; Diabetes; Fatty liver; Fructose; Metabolic syndrome; Obesity; Soda; Soft drink; Sweetened beverage