This discovery might leave a bad taste in your mouth.
A new study found that a popular low-calorie sweetener commonly used in sugar-free gum, candies and diet-friendly baked goods may increase your risk of developing a serious liver disease.
The chronic illness already affects 1 in 3 American adults and is rising fast among children, putting millions at higher risk for serious health problems, including heart disease.
For the study, scientists from Washington University in St. Louis gave adult zebrafish antibiotics to wipe out most of the bacteria in their guts.
Then they tracked how the fish processed glucose on their regular diet, focusing specifically on whether their intestines produced sorbitol.
Sorbitol is a sugar alcohol naturally found in several fruits.
It’s also commercially produced for sugar-free, low-calorie and diabetic-friendly products, as it’s about 60% as sweet as sugar but contains 35% fewer calories per gram.
The body can produce sorbitol as well.
Research shows that gut enzymes make sorbitol when glucose levels rise, which is why it has mostly been associated with diabetes, a condition where blood sugar can spike.
The new study suggests that even in healthy people, glucose levels can rise high enough after a meal to trigger sorbitol production.
Normally, bacteria in the gut breaks down modest amounts of sorbitol — like what you’d get from fruit — into a harmless byproduct.
“However, if you don’t have the right bacteria, that’s when it becomes problematic,” biochemist Gary Patti, whose lab conducted the study, said in a statement.
When that happens, sorbitol accumulates faster than gut microbes can handle. This can occur if you consume too much glucose, too much sorbitol or both.
Once sorbitol levels get too high, the gut can’t break it down and it gets passed onto the liver. There, the body converts it into a form of fructose.
Fructose is already known to fuel metabolic dysfunction-associated steatotic liver disease (MASLD) — formerly called nonalcoholic fatty liver disease — because the liver turns excess fructose into fat.
That fat builds up in liver cells, causing inflammation, scarring and potentially permanent damage.
Not everyone is convinced by the latest findings.
“This study has several limitations, including relying on research on fish, which cannot be directly applied to humans,” Carla Saunders, president of the Calorie Control Council, the lobbying group representing the low- and reduced-calorie food and beverage industry, told The Post.
“Sorbitol, which naturally occurs in fruits like apples, pears, peaches and prunes, has been repeatedly confirmed as safe by global authorities for decades, which is why it’s a trusted, popular choice in more than 53,000 products worldwide,” she continued.
Silent but serious
Although MASLD is widespread in the US, experts say many people don’t realize they have it because it often causes no symptoms in the early stages.
“Some may feel more tired than usual or notice vague discomfort or a feeling of fullness on the upper right side of the abdomen, but these signs are nonspecific and easy to overlook,” Dr. Leana Wen, an emergency physician and medical analyst, told CNN Health.
One study found that among nearly 3 million adults with MASLD, less than 1% had a prior diagnosis.
Doctors typically detect the condition when routine blood tests show mildly abnormal liver enzymes or when imaging for another reason, such as an abdominal ultrasound.
“Because most people don’t have symptoms, the diagnosis depends on health care providers putting together these clues and checking for metabolic risk factors — namely excess weight, diabetes or prediabetes, high blood pressure and high cholesterol,” Wen explained.
Caught early, MASLD can often be improved and in some cases even reversed. Treatment usually focuses on lifestyle changes, including weight loss, regular exercise and managing related conditions like diabetes.
While no medications are specifically approved for MASLD, two drugs address metabolic dysfunction–associated steatohepatitis, or MASH — the more advanced form of the condition.
“These two medicines, Rezdiffra (resmetirom) and Wegovy (semaglutide), are meant to be used along with, not instead of, lifestyle changes,” Wen noted.
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