SYSTEMATIC REVIEW article
Front. Nutr.
Sec. Clinical Nutrition
This article is part of the Research TopicFunctional Foods for Metabolic Health - Volume IIView all articles
The Impact of High Fructose Corn Syrup on Liver Injury and Glucose Metabolism: A Systematic Review
Provisionally accepted
- 1Center for the History and Ethics of Public Health, Mailman School of Public Health, Columbia University, New York, United States
- 2Brown University Health, Providence, United States
- 3New York-Presbyterian/Columbia University Irving Medical Center, New York, United States
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Background: High fructose corn syrup (HFCS) is a dietary sweetener that is used in a substantial portion of food and beverages. Recent evidence has cited dietary HFCS as a risk factor in the development of obesity, metabolic syndrome, and liver disease. This systematic review provides a new evaluation of the potential hepatic and metabolic risks posed by HFCS to inform both clinical practice and public health policy. Methods: We conducted a systematic review of English-language, human studies of adults (≥18 years) with low to no alcohol intake using Covidence. Only quantitative studies that specified a link supported by direct evidence between HFCS and markers of liver injury or glucose metabolism in the setting of MASLD or NAFLD were included. Results: The literature search yielded 23,006 studies. After removing duplicates, 16,955 studies were screened and 16,930 were excluded after abstract screening. 20 texts were reviewed in full; 19 were excluded. 1 study was included after study selection. Conclusion: This review identifies and critically appraises the methodological strengths and limitations of the sole study meeting eligibility criteria. The 2022 study by Sigala et al. involved a non-randomized, controlled dietary intervention examining the dose-response effects of high-fructose corn syrup (HFCS) on hepatic lipid accumulation and insulin sensitivity in healthy adults. The identification of only a single eligible study emphasizes a stark absence of focused investigations in this area. Given the increasingly widespread consumption of HFCS and its prevalence in the modern food supply, this scarcity of research is concerning. Further research in this area should focus on clinical studies of longer duration, comparative studies of HFCS and other sugars, and incorporate greater demographic and geographic diversity.
Keywords: liver injury, Liver disease, High fructose corn syrup, Metabolic health, MASLD
Received: 13 Oct 2025; Accepted: 13 Nov 2025.
Copyright: © 2025 Yu, Varahala, Lim, Marenah and Wattacheril. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Julia Wattacheril, jjw2151@cumc.columbia.edu
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