AN ingredient found in a variety of products has been linked to a deadly disease.
Scientists have warned that a sweetener found in sugar-free products could increase the risk of liver issues.
The concerning research suggests that ingesting this common sweetener could result in a build up of sorbitol, which can cause a worrying amount of fat to build up in the liver.
This could potentially lead to metabolic dysfunction-associated steatotic liver disease (MASLD).
MASLD, formerly known as non-alcoholic fatty liver disease, now effects up to one in five people in the UK, according to the British Liver Trust.
However, experts have warned the true figure could be as high as 40% of the UK population, around 80% of those affected remaining undiagnosed.
Scientific study
The study, published in the journal Science Signalling, examined the gut microbiome of zebrafish.
This gut microbiome is a natural ecosystem made up of billions of “friendly” bacteria, which aids with the break down, digestion, and absorption of food.
The researchers found that a depletion in gut microbiome contributed to the development of liver disease, even when the fish were being fed a normal diet.
As part of the natural digestion process, the body converts glucose into fructose by converting it into sorbitol in the intestine, and normally, bacteria in the microbiome break down this sorbitol, preventing harm.
However, when gut bacteria were removed with antibiotics, sorbitol built up, travelled to the liver, and caused fatty liver.
Researchers concluded that gut bacteria protects against sugar-related liver disease and that sorbitol, which is used as a common sweetener, may increase the risk of fatty liver.
Sugar-free products
According to the experts, the findings suggest that “sugar free” alternatives could be just as harmful, if not more so, to liver health than once thought.
Dr Gary Patti, a professor of chemistry, genetics and medicine at Washington University, previously wrote about sorbitol in relation to fructose.
He concluded that sorbitol is essentially “one transformation away from fructose”, which has previously been shown to supercharge cancer cells and contribute to steatotic liver disease.
While most of the research on how the body processes sorbitol has focused on its production due to glucose overload, Dr Patti said sorbitol can actually be produced by the gut after eating.
But, for this to happen, blood glucose levels have to be high, which is why liver disease is often linked with diabetes.
Symptoms of MASLD
The lower diagnosis rate of MASLD may be a result of non-obvious symptoms or symptoms that are mistaken for less serious problems.
In most cases, it’s only spotted during routine blood tests or liver function tests carried out for unrelated issues.
According to healht experts, people who develop the condition are often overweight or have diabetes.
Fatigue, a dull pain in the upper right abdomen, and general unwellness are common symptoms.
More advanced stages of the disease can cause jaundice, abdominal swelling, easy bruising, and confusion.
“Sorbitol can be produced in the body at significant levels. But if you have the right bacteria, turns out it doesn’t matter,” Dr Patti explained.
“If you don’t have the right bacteria, that’s when it becomes problematic.
“Because in those conditions, sorbitol doesn’t get degraded and as a result, it is passed on to the liver.”
This depletion in gut bacteria can occur when excessive amounts of sugar or sorbitol are consumed in the diet, meaning the “sugar-free” option can be just as harmful for your liver.
Even if someone has the right “friendly” bacteria to process glucose and sorbitol into a harmless byproduct, higher quantities of these can still overwhelm gut microbes, passing the job on to the liver.
And once in the liver, it is converted into a derivative of fructose, leading to an increase of fat in the organ.
“Together, these findings show that sorbitol-degrading bacteria in the gut protect against steatotic liver disease and suggest that excessive intake of dietary sorbitol may pose a risk for the development of MASLD,” researchers concluded.
While more research needs to be carried out, the experts cautioned that the basic idea that these “healthier’” alternatives are harmless for the body may not hold true.
However, experts also pointed out that the potential risks of artificial sweeteners are overblown compared to the sugar they have replaced.
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