Health Implications of Fructose Consumption: A Review of Recent Data

A recent paper posted on MedScape reviews evidence in the context of current research linking dietary fructose to health risk markers and I learned a lot reviewing it. Here are some of the details.

Fructose intake has recently received considerable media attention, most of which has been negative. The assertion has been that dietary fructose is less satiating and more lipogenic than other sugars.

However, no fully relevant data have been presented to account for a direct link between dietary fructose intake and health risk markers such as obesity, triglyceride accumulation, and insulin resistance in humans. Here’s what we do know:

  • First: a re-evaluation of published epidemiological studies concerning the consumption of dietary fructose or mainly high fructose corn syrup shows that most of such studies have been cross-sectional or based on passive inaccurate surveillance, especially in children and adolescents, and thus have not established direct causal links.
  • Second: research evidence of the short or acute term satiating power or increasing food intake after fructose consumption as compared to that resulting from normal patterns of sugar consumption, such as sucrose, remains inconclusive.
  • Third: the results of longer-term intervention studies depend mainly on the type of sugar used for comparison. Typically aspartame, glucose, or sucrose is used and no negative effects are found when sucrose is used as a control group.
  • Negative conclusions have been drawn from studies in rodents or in humans attempting to elucidate the mechanisms and biological pathways underlying fructose consumption by using unrealistically high fructose amounts.

The issue of dietary fructose and health is linked to the quantity consumed, which is the same issue for any macro- or micro nutrients. It has been considered that moderate fructose consumption of ≤50g/day or ~10% of energy has no deleterious effect on lipid and glucose control and of ≤100g/day does not influence body weight.

The final conclusion of the review is this: “No fully relevant data account for a direct link between moderate dietary fructose intake and health risk markers.”

Nevertheless, until there is more data, my guess is the less fructose (and less sugar) you ingest the better.

By the way, here’s what I posted in 2008 on the topic The Truth About 7 Common Food Additives under the heading of “High fructose corn syrup:”

What it is

High fructose corn syrup is a sweetener made from corn. It’s sweeter and cheaper than sucrose, which is the form of sugar made from sugar cane.

Foods that have it

High fructose corn syrup is a common additive in many kinds of processed foods, not just sweets. Most non-diet soft drinks are sweetened with high fructose corn syrup.

Why it’s controversial

Some experts have proposed that people metabolize high fructose corn syrup in a way that raises the risk of obesity and type 2 diabetes more than sugar made from sugar cane. Much of the controversy stems from the observation that obesity in the United States and consumption of high fructose corn syrup increased at the same time.

What the research shows

“It’s just sugar,” says Marion Nestle, PhD, a professor of nutrition and public health at New York University. “Biochemically, there’s no difference.”

The high fructose corn syrups commonly used to sweeten foods and drinks are 55-58% fructose and 42-45% gluose. Sucrose (cane sugar) is a double sugar made of fructose and glucose. Digestion quickly breaks down cane sugar and high fructose corn syrup into fructose and glucose.

“There’s a little bit more fructose in high fructose corn syrup, but not a lot,” Nestle says. “It doesn’t really make any difference. The body can’t tell them apart.”

The American Medical Association recently stated that there is scant evidence to support the idea that high fructose corn syrup is any worse than cane sugar and that consuming too much sugar of either kind is unhealthy.

How you find it on the label

High fructose corn syrup can be found in the list of ingredients on a food label.

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