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This in turn leads to excessive storage of underutilized glucose in the liver (glycogenesis), the potential for developing fatty liver (ie, nonalcoholic steatohepatitis), and conversion of excess carbohydrates to fatty acids and triglycerides, with subsequent storage in adipose tissue

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In addition, exposure to sweeteners has been shown to alter fermentation profiles and metabolism in vitro, indicating a connection between sweetener exposure and modifications in both microbiota composition and microbial metabolic processes (Vamanu et al, 2019)