Washington University researchers found sorbitol can reach the liver and convert into fructose 1-phosphate when sorbitol-degrading gut bacteria are absent or overwhelmed, potentially driving MASLD.
Zebrafish experiments showed intestinal cells turn dietary glucose into sorbitol; with depleted microbiota, that sorbitol accumulated in the liver, boosted glycolysis and caused fat buildup characteristic of steatotic liver disease.
High sorbitol doses directly triggered hepatic steatosis in zebrafish, while reintroducing sorbitol-degrading Aeromonas strains reduced those effects, pointing to a protective role for gut microbes.
The findings challenge the view of sugar alcohols as metabolically inert, though the authors said more research is needed to confirm whether the same mechanism operates in humans.
Is the sorbitol in your 'sugar-free' diet secretly contributing to fatty liver disease?
Could your gut health determine if common low-calorie sweeteners are safe for your liver?