Public Health and Primary CareReview Article

Conversion of Sugar to Fat: Is Hepatic de Novo Lipogenesis Leading to Metabolic Syndrome and Associated Chronic Diseases?

Jean-Marc Schwarz, PhD; Michael Clearfield, DO; and Kathleen Mulligan, PhD
Notes and Affiliations
Notes and Affiliations

Received: November 18, 2016

Accepted: January 11, 2017

Published: August 1, 2017

J Osteopath Med; 117(8): 520-527
Abstract

Epidemiologic studies suggest a link between excess sugar consumption and obesity, fatty liver disease, metabolic syndrome, and type 2 diabetes mellitus. One important pathway that may link these metabolic diseases to sugar consumption is hepatic conversion of sugar to fat, a process known as de novo lipogenesis (DNL). Mechanistic studies have shown that diets high in simple sugars increase both DNL and liver fat. Importantly, removal of sugar from diets of children with obesity for only 9 days consistently reduced DNL and liver fat and improved glucose and lipid metabolism. Although the sugar and beverage industries continue to question the scientific evidence linking high-sugar diets to metabolic diseases, major health organizations now make evidence-based recommendations to limit consumption of simple sugars to no more than 5% to 10% of daily intake. Clear recommendations about moderating sugar intake to patients may be an important nonpharmacologic tool to include in clinical practice.

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