Fructose
Not all sugars are equal. Fructose is metabolized almost exclusively in the liver—unlike glucose which every cell can use. This unique processing pathway can drive fatty liver, elevate uric acid, and contribute to metabolic dysfunction. The problem isn't fruit—it's the concentrated fructose in added sugars and sweeteners.
How Fructose Is Metabolized
Liver-Exclusive
Unlike glucose, fructose goes straight to liver. Only organ with fructokinase.
No Insulin Response
Doesn't trigger insulin directly. But liver converts to fat.
De Novo Lipogenesis
Liver makes fat from fructose. Drives fatty liver development.
ATP Depletion
Fructose metabolism uses ATP rapidly. Creates energy deficit in liver.
Uric Acid Production
Byproduct of fructose breakdown. Raises uric acid. Gout, hypertension link.
No Satiety Signal
Doesn't stimulate leptin well. Doesn't suppress ghrelin. Easy to overconsume.
Fructose Sources
High-Fructose Corn Syrup
55% fructose. In sodas, processed foods. Highly concentrated.
Table Sugar (Sucrose)
50% fructose, 50% glucose. Splits in digestion. Same metabolic effect.
Agave
Up to 90% fructose. Marketed as healthy. Actually worse than sugar.
Honey
About 40% fructose. Has benefits but still fructose load. Moderate.
Fruit Juice
Concentrated fructose without fiber. Equivalent to soda metabolically.
Whole Fruit
Fiber slows absorption. Nutrients offset. Lower fructose per serving. Generally fine.
Health Effects of Excess Fructose
Fatty Liver (NAFLD)
Primary driver. Liver fat accumulation. Can progress to NASH, cirrhosis.
Elevated Triglycerides
Liver exports fat as VLDL. Raises blood triglycerides. Heart risk.
Insulin Resistance
Liver fat causes hepatic insulin resistance. Systemic effects follow.
Gout
Uric acid elevation. Crystal formation in joints. Painful flares.
Hypertension
Uric acid and metabolic effects raise blood pressure. Often overlooked cause.
Visceral Fat
Promotes fat storage around organs. Metabolically dangerous location.