A nutrition policy advisor recommends policies to reduce population-level fructose consumption to lower non-alcoholic fatty liver disease (NAFLD) risk. Critically evaluate the biochemical rationale that supports this recommendation.

• A. The rationale is unsupported biochemically because fructose is converted directly into muscle glycogen and cannot be used for fat synthesis in the liver, so limiting fructose would not affect hepatic fat.
• B. The policy should target increasing sucrose consumption instead because sucrose contains fructose and glucose and is completely protective against NAFLD by promoting hepatic glycogen storage without lipid synthesis.
• C. The recommendation is unnecessary because only galactose, not fructose, is converted to triglycerides in the liver; fructose is excreted unchanged in urine and therefore harmless for the liver.
• D. The rationale is supported because dietary fructose is rapidly taken up and metabolized by the liver where it can be channeled into de novo lipogenesis and triglyceride synthesis; reducing high fructose intake could therefore plausibly decrease hepatic fat accumulation and NAFLD risk.

Answer: (D)