Non-alcoholic fatty liver disease (NAFLD) affects an estimated 30% of adults in the United States, and there currently is no therapy for the disease. Noting that he rising incidence of obesity and diabetes coincides with a marked increase in fructose consumption, and that fructose consumption is higher in individuals with NAFLD than in people of comparable age and weight, Manal F. Abdelmalek, from Duke University Medical Center (North Carolina, USA), and colleagues studied the relationship between fructose consumption and disease severity in NAFLD.  The team tracked 427 adults, enrolled in the NASH Clinical Research Network, collecting data on daily foods consumed and conducting a liver biopsy.  The researchers found that only 19% of adults with NAFLD reported no intake of fructose-containing beverages, while 52 % consumed between one and six servings a week and 29% consumed fructose-containing beverages on a daily basis. Correlating the increased consumption of fructose appeared to increased liver fibrosis (scarring) in patients with NAFLD, the team concludes that: “These results identify a readily modifiable environmental risk factor that may ameliorate disease progression in patients with NAFLD.”