Date: 05 Sep 2012
Fructose and Risk of Cardiometabolic Disease
- George A. Bray
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Fructose and glucose in soft drinks and fruit drinks account for just under 50 % of added sugars. Soft drinks intake has risen five-fold between 1950 and 2000, and this increase in intake of simple sugars has raised health concerns. The risks of cardiovascular disease, obesity and the metabolic syndrome have all been related to consumption of sugar-sweetened beverages in several, but not all meta-analyses. Fructose and sugar-sweetened beverages have also been related to the risk of gout in men, and to non-alcoholic fatty liver disease. Studies show that the calories in sugar-sweetened beverages do not produce an adequate reduction in the intake of other foods, leading to increased caloric intake. Plasma triglycerides are increased by sugar-sweetened beverages, and this increase appears to be due to fructose, rather than to glucose in sugar. Several 10-week to 26-week randomized trials of sugar-containing soft drinks show increases in triglycerides, body weight, and visceral adipose tissue; there were also increases in muscle fat and liver fat, which might lead to non-alcoholic-fatty liver disease.
Papers of particular interest, published recently, have been highlighted as:• Of importance •• Of major importance
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•• Sievenpiper JL, de Souza RJ, Mirrahimi A, et al. Effect of fructose on body weight in controlled feeding trials: a systematic review and meta-analysis. Ann Intern Med. 2012;156:291-304. Review This meta-analysis examines studies in which fructose itself replaced other carbohydrates in either isocaloric or hypercaloric diets. It showed that isocaloric replacement did not affect weight, but that hyperaloric replacement did – both of which would be expected from the concept of energy balance (see #4). However, this meta-analysis excluded the fructose which is contained in high fructose corn syrup or in sucrose, which represents the major source of fructose as “added sugars”. The free fructose as an “added sugar” is only a small part of the diet, thus this meta-analysis is tangential to the current review. Two other papers in this bibliography (# 40 and # 42) use the same data base but examine other responses to “free fructose” added to the diet in place of other carbohydrates. PubMed
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•• Maersk M, Belza A, Stødkilde-Jørgensen H, et al. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Am J Clin Nutr. 2012;95:283-9. This randomized parallel arm controlled trial compared ingesting 1 liter of one of four beverages over a 6month period. The beverages included a sugar-sweetened cola, milk, diet cola and water. Both the sugar containing cola and milk have “sugar” but only the sucrose in the cold has fructose – the milk sugar is composed of glucose and galactose. During the 6months when the equivalent of two 16oz beverages were ingested each day, the cola group showed increased visceral fat, liver fat, muscle fat, cholesterol and systolic blood pressure, in comparison with milk or all other groups combined. This suggests that within 6months, two 16oz sugar-containing beverages can mimic the metabolic syndrome. PubMedCrossRef
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- Fructose and Risk of Cardiometabolic Disease
Current Atherosclerosis Reports
Volume 14, Issue 6 , pp 570-578
- Cover Date
- Print ISSN
- Online ISSN
- Current Science Inc.
- Additional Links
- Metabolic syndrome
- Food intake
- Soft drinks
- Visceral fat
- Industry Sectors
- George A. Bray (1)
- Author Affiliations
- 1. Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA, 70808, USA