Non-Caloric Sweetener Reduces Signs Of Fatty Liver Disease: Study

In a first-of-its-kind study, Dr. Kohli addressed and answered the question: Can non-caloric sweeteners improve signs of fatty liver disease?

According to a pre-clinical research published in the journal Scientific Reports, stevia extract can reduce markers of fatty liver disease. The pre-clinical research has been led by Rohit Kohli, MBBS, MS.

“Sugary foods and drinks can cause scarring in the liver,” says Dr. Kohli, “but we don’t know how non-caloric sweeteners may affect liver disease.” In a first-of-its-kind study, Dr. Kohli addressed and answered the question: Can non-caloric sweeteners improve signs of fatty liver disease?

Using a preclinical model, he tested two non-caloric sweeteners, sucralose and stevia extract. Both are widely available and appear in many sweetened foods and drinks. “We were interested in those two compounds because they are the newest and least studied in the context of liver disease and obesity,” says Dr. Kohli.

The results were striking. “We compared these sweeteners head to head with sugar,” he says. “Stevia extract lowers glucose levels and improves markers of fatty liver disease.” These markers include fibrosis and fat levels in the liver. The study also uncovered some potential mechanisms that could be responsible for reversing these markers of fatty liver disease. “We saw a decrease in signs of cellular stress and some changes in the gut microbiome,” says Dr. Kohli, “but there is more work to do in order for us to understand the clinical relevance.”

The preclinical study was funded by the Stanley W. Ekstrom Foundation. The results led Dr. Kohli’s team directly into a clinical trial – also funded by the Stanley W. Ekstrom Foundation – to test the effects of stevia in pediatric patients.

Fatty liver disease is condition involving excess fat buildup in the liver. The disease presents with vague symptoms such as fatigue, lethargy and sudden attacks of right-sided abdominal pain. When found in people who do not consume alcohol, it is called NAFLD (non-alcoholic fatty liver disease).

All patients of fatty liver have some common indices. They are obese with a BMI of 30 or more, a waist measurement more than 35 inches in women and 40 inches in men. They may be prediabetic, with blood sugar values higher than normal. The HBA1c values are high. The lipid profile shows elevated triglycerides. An ultrasound shows an enlarged liver with fat deposits.

There is a genetic predisposition to the disease and it tends to run in families. This may also be because habits such as overeating and a sedentary lifestyle also run in families. Girls with fatty liver in childhood often develop menstrual irregularities. They tend to develop PCOD (polycystic ovarian disease).

In some people, NAFLD progresses to inflammation in the liver. This heals by scarring and fibrosis. It is called NASH (non-alcoholic steatohepatitis). The liver enzymes become elevated and jaundice may occur. The liver heals by scarring, distorting its normal anatomy. Cirrhosis and eventually liver failure or cancer can occur. Alcoholics are those who have withdrawal symptoms if denied their daily quota of drinks. Their liver damage can follow the same sequence of events as NASH, at an accelerated pace.

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