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Composition, Production, Consumption, and Health Effects of Added Sugars

  • Chapter
Preventive Nutrition

Part of the book series: Nutrition and Health ((NH))

Abstract

Added sugars, particularly those containing fructose—high fructose corn syrup (HFCS), sucrose, honey, fruit juice concentrates, agave nectar, and crystalline fructose—have been blamed for a variety of adverse health consequences. Fructose containing sugars are among the most misunderstood nutrients in all of nutrition. While the consumption of added sugars has increased in the last 40 years in the American diet, the increase in sugars has not been disproportionate compared to flour and grain products. In fact, of the increase of over 450 cal in the overall diet in the USA between 1970 and 2010 only 34 cal came from all added sugars combined. Over this same time period, fructose consumption has changed very little. In this chapter we begin with an historical perspective on the manufacture of sugar and high fructose corn syrup including their production, consumption, and functionality. We then examine the modern scientific literature related to added sugars and their potential interaction with a variety of health related issues such as obesity, cardiovascular disease, diabetes, the metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD). We then summarize emerging evidence on the interaction between sugars and the brain. Based on contemporary scientific research we conclude there is not a unique relationship between sugar consumption and changes in energy regulating hormones, obesity, diabetes, NAFLD or risk factors for cardiovascular disease, and that HFCS and sucrose are not nutritionally distinct.

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References

  1. Rippe JM, Angelopoulos TJ. Sucrose, high-fructose corn syrup, and fructose, their metabolism and potential health effects: what do we really know? Adv Nutr. 2013;4(2):236–45.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  2. Rippe J. The metabolic and endocrine response and health implications of consuming sweetened beverages: findings from recent, randomized, controlled trials. Adv Nutr. 2013;4:677–86.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Kahn R, Sievenpiper JL. Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes?: we have, but the pox on sugar is overwrought and overworked. Diabetes Care. 2014;37(4):957–62.

    Article  PubMed  CAS  Google Scholar 

  4. Bray GA, Popkin BM. Dietary sugar and body weight: have we reached a crisis in the epidemic of obesity and diabetes?: health be damned! Pour on the sugar. Diabetes Care. 2014;37(4):950–6.

    Article  PubMed  CAS  Google Scholar 

  5. Klurfeld DM, Foreyt J, Angelopoulos TJ, Rippe JM. Lack of evidence for high fructose corn syrup as the cause of the obesity epidemic. Int J Obes (Lond). 2012;27(6):771–3.

    Google Scholar 

  6. Bray GA, Nielsen SJ, Popkin BM. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr. 2004;79:537–43.

    PubMed  CAS  Google Scholar 

  7. Lustig RH. Fructose: metabolic, hedonic, and societal parallels with ethanol. J Am Diet Assoc. 2010;110(9):1307–21.

    Article  PubMed  CAS  Google Scholar 

  8. Lustig RH, Schmidt LA, Brindis CD. Public health: the toxic truth about sugar. Nature. 2012;482(7383):27–9.

    Article  PubMed  CAS  Google Scholar 

  9. Bray G. Fructose: pure, white, and deadly? Fructose, by any other name, is a health hazard. J Diabetes Sci Technol. 2010;4(4):1003–7.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Rippe JM. The health implications of sucrose, high-fructose corn syrup, and fructose: what do we really know? J Diabetes Sci Technol. 2010;4(4):1008–11.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Sievenpiper JL, de Souza RJ, Kendall CW, Jenkins DJ. Is fructose a story of mice but not men? J Am Diet Assoc. 2011;111(2):219–20; author reply 220–2.

    Article  PubMed  Google Scholar 

  12. van Buul V, Tappy L, Brouns F. Misconceptions about fructose-containing sugars and their role in the obesity epidemic. Nutr Res Rev. 2014;27(1):119–30.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. White J. Straight talk about high-fructose corn syrup: what it is and what it ain’t. Am J Clin Nutr. 2008;88:1716S–21.

    Article  PubMed  CAS  Google Scholar 

  14. White JS. Challenging the fructose hypothesis: new perspectives on fructose consumption and metabolism. Adv Nutr. 2013;4(2):246–56.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Teff KL, Grudziak J, Townsend RR, Dunn TN, Grant RW, Adams SH. Endocrine and metabolic effects of consuming fructose- and glucose-sweetened beverages with meals in obese men and women: influence of insulin resistance on plasma triglyceride responses. J Clin Endocrinol Metab. 2009;94:1562–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  16. Stanhope K, Griffen S, Keim N, Ai M, Otokozawa S, Nakajimak SE, Havel PJ. Consumption of fructose-, but not glucose-sweetened beverages produces an atherogenic lipid profile in overweight/obese men and women. Diabetes. 2007;56 Suppl 1:A16.

    Google Scholar 

  17. Havel P. Dietary fructose: implications for dysregulation of energy homeostasis and lipid/carbohydrate metabolism. Nutr Rev. 2005;63:133–57.

    Article  PubMed  Google Scholar 

  18. Basu S, Yoffe P, Hills N, Lustig RH. The relationship of sugar to population-level diabetes prevalence: an econometric analysis of repeated cross-sectional data. PLoS One. 2013;8:e57873.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  19. Goran MI, Ulijaszek SJ, Ventura EE. High fructose corn syrup and diabetes prevalence: a global perspective. Glob Public Health. 2013;8:55–64.

    Article  PubMed  Google Scholar 

  20. Johnson R, Segal M, Sautin Y, Nakagawa T, Feig D, Kang D, Gersch M, Benner S, Sanchez-Lozada L. Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. Am J Clin Nutr. 2007;86:899–906.

    PubMed  CAS  Google Scholar 

  21. Dhingra R, Sullivan L, Jacques PF, Wang TJ, Fox CS, Meigs JB, D’Agostino RB, Gaziano JM, Vasan RS. Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation. 2007;116:480–8.

    Article  PubMed  Google Scholar 

  22. Page KA, Luo S, Romero A, Adam T, Hu HH. Fructose compared to glucose ingestion preferentially activates brain reward regions in response to high-calorie food cues in young, obese Hispanic females. Endocrinol Rev. 2012;33.

    Google Scholar 

  23. Purnell JQ, Klopfenstein BA, Stevens AA, Havel PJ, Adams SH, Dunn TN, Krisky C, Rooney WD. Brain functional magnetic resonance imaging response to glucose and fructose infusions in humans. Diabetes Obes Metab. 2011;13(3):229–34.

    Article  PubMed  CAS  Google Scholar 

  24. Benton D. The plausibility of sugar addiction and its role in obesity and eating disorders. Clin Nutr. 2010;29(3):288–303.

    Article  PubMed  CAS  Google Scholar 

  25. Ziauddeen H, Farooqi I, Fletcher P. Obesity and the brain: how convincing is the addiction model? Nat Rev. 2012;13:279.

    Article  CAS  Google Scholar 

  26. Corwin LW, Hayes JE. Are the sugars addictive? Perspectives for practitioners. In: Rippe JM, editor. Fructose, high fructose corn syrup, sucrose and health. New York: Springer; 2014. p. 199–215.

    Chapter  Google Scholar 

  27. Johnson R, Appel L, Brands M, Howard B, Lefevre M, Lustig R, Sacks F, Steffen L, Wylie-Rosett J, American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity, Metabolism and the Council on Epidemiology and Prevention. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2009;120:1011–20.

    Article  PubMed  CAS  Google Scholar 

  28. World Health Organization (WHO). Draft guideline: sugars intake for adults and children. Online public consultation open: 5–31 Mar 2014. http://www.who.int/mediacentre/news/notes/2014/consultation-sugar-guideline/en/. Accessed 17 Sept 2014.

  29. Scientific Advisory Committee on Nutrition. Draft carbohydrates and health report. 2014. (http://www.sacn.gov.uk/). Accessed 26 June–1 Sept 2014.

  30. Center for Nutrition Policy and Promotion. Report of the dietary guidelines advisory committee on the dietary guidelines for Americans. Washington, DC: US Department of Agriculture; 2010. http://www.nutriwatch.org/05Guidelines/dga_advisory_2010.pdf.

  31. Institute of Medicine of the National Academies. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. Washington, DC: National Academies Press; 2005.

    Google Scholar 

  32. Clark K, Rippe J. Flavored milk, dietary quality and childhood nutrition. In: Rippe JM, editor. Fructose, high fructose corn syrup, sucrose and health. New York: Springer; 2014. p. 229–46.

    Chapter  Google Scholar 

  33. Clemens R. Sweetening public policy—evidence or emotion? Adv Nutr. 2015 (in press).

    Google Scholar 

  34. Brownell KD, Gold M. Food and addiction: a comprehensive handbook. Oxford: Oxford University Press; 2012.

    Book  Google Scholar 

  35. de Koning L, Malik VS, Kellogg MD, Rim EB, Willett WC, Hu FB. Sweetened beverage consumption, incident coronary heart disease and biomarkers of risk in men. Circulation. 2012;125:1735–41.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  36. Fung T, Malik V, Rexrode K, Manson JE, Willett WC, Hu FB. Sweetened beverage consumption and risk of coronary heart disease in women. Am J Clin Nutr. 2009;89(4):1037–42.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  37. Raben A, Vasilaras T, Møller A, Astrup A. Sucrose compared with artificial sweeteners: different effects on ad libitum food intake and body weight after 10 wk of supplementation in overweight subjects. Am J Clin Nutr. 2002;76:721–9.

    PubMed  CAS  Google Scholar 

  38. Brown CM, Dulloo AG, Yepuri G, Montani JP. Fructose ingestion acutely elevates blood pressure in healthy young humans. Am J Physiol Regul Integr Comp Physiol. 2008;294:R730–7.

    Article  PubMed  CAS  Google Scholar 

  39. Kaiser KA, Shikany JM, Keating KD, Allison DB. Will reducing sugar-sweetened beverage consumption reduce obesity? Evidence supporting conjecture is strong, but evidence when testing effect is weak. Obes Rev. 2013;14:620–33.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  40. Te Morenga L, Mallard S, Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ. 2013;346:e7492.

    Article  Google Scholar 

  41. Malik VS, Pan A, Willett WC, Hu FB. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr. 2013;98:1084–102.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  42. Rippe J, editor. Fructose, high fructose corn syrup, sucrose and health. New York: Springer; 2014.

    Google Scholar 

  43. Benítez RA. The repeating island: the Caribbean and the postmodern perspective. Durham: Duke University Press; 1992.

    Google Scholar 

  44. Galloway JH. History of sugar—domestication to the 17th century. Ann Assoc Am Geogr. 1996;86(4):682–706.

    Article  Google Scholar 

  45. Ponting C. World history: a new perspective. London: Chatto & Windus; 2000.

    Google Scholar 

  46. Adas M, American Historical Association. Agricultural and pastoral societies in ancient and classical history. Philadelphia: Temple University Press; 2001.

    Google Scholar 

  47. Parker M. Sugar barons: family, corruption, empire and war. London: Hutchinson; 2011.

    Google Scholar 

  48. Takasaki Y, Tanabe O. Enzyme method for converting glucose in glucose syrups to fructose US patent 3,616,221. Agency of Industrial Science and Technology, Tokyo. 1971.

    Google Scholar 

  49. Hanover LM. Crystalline fructose: production, properties, and applications. In: Schenck FW, Hebeda RE, editors. Starch hydrolysis products: worldwide technology, production, and application. New York: VCH; 1992. p. 201–31.

    Google Scholar 

  50. Hanover LM, White JS. Manufacturing, composition, and applications of fructose. Am J Clin Nutr. 1993;58(5 Suppl):724S–32.

    PubMed  CAS  Google Scholar 

  51. Schwartz D, Whistler RL. History and future of starch. In: BeMiller JN, Whistler RL, editors. Starch: chemistry and technology, Food science and technology: International series. 3rd ed. Burlington: Academic; 2009. p. 1–10.

    Chapter  Google Scholar 

  52. USDA-ERS. Table 6—U.S. retail refined sugar price, monthly, quarterly, and by calendar and fiscal year. Updated 24 Oct 2014. http://www.ers.usda.gov/data-products/sugar-and-sweeteners-yearbook-tables.aspx-25456. Accessed 10 Nov 2014.

  53. Buck AW. High fructose corn syrup. In: Nabors LO, editor. Alternative sweeteners. 4th ed. Boca Raton: CRC Press; 2012.

    Google Scholar 

  54. Chen JCP, Chou C-C. Chen–Chou cane sugar handbook: a manual for cane sugar manufacturers and their chemists. 12th ed. New York: Wiley; 1993.

    Google Scholar 

  55. Clarke MA. Cane sugar. In: Kroschwitz JI, editor. Kirk–Othmer concise encyclopedia of chemical technology. 4th ed. New York: Wiley; 1999. p. 1915–7.

    Google Scholar 

  56. Hull P. Glucose syrups: technology and applications. Chichester: Wiley-Blackwell; 2010.

    Book  Google Scholar 

  57. White JS. Misconceptions about high-fructose corn syrup: is it uniquely responsible for obesity, reactive dicarbonyl compounds, and advanced glycation endproducts? J Nutr. 2009;139(6):1219S–27.

    Article  PubMed  CAS  Google Scholar 

  58. Salomonsson I. Shelf life: sucrose hydrolysis. Copenhagen: Danisco Sugar A/S; 2005. http://www.danisco.com/cms/resources/file/eb241b041a6ed65/Shelflife.pdf. Accessed 15 Mar 2007.

  59. Wong DWS. Food enzymes: structure and mechanism. New York: Chapman & Hall; 1995.

    Book  Google Scholar 

  60. Chou C-C. Handbook of sugar refining: a manual for design and operation of sugar refining facilities. New York: Wiley; 2000.

    Google Scholar 

  61. White PJ, Johnson LA. Corn: chemistry and technology. 2nd ed. St. Paul: American Association of Cereal Chemists; 2003.

    Google Scholar 

  62. Corn Refiners Association. Manufacture: nutritive sweeteners from corn. 8th ed. Washington, DC: Corn Refiners Association; 2006.

    Google Scholar 

  63. Asadi M. Beet-sugar handbook. Hoboken: Wiley-Interscience; 2007.

    Google Scholar 

  64. Eggleston G, Monge A, Montes B, Stewart D. Application of dextranases in sugarcane factory: overcoming practical problems. Sugar Tech. 2009;11(2):135–41.

    Article  CAS  Google Scholar 

  65. Eggleston G, Montes B. Optimization of amylase application in raw sugar manufacture that directly concern refiners, #982. Sugar Industry Technologists Annual Meeting, New Orleans. 2009.

    Google Scholar 

  66. Ganter C. Production of thermostable, recombinant alpha-galactosidase suitable for raffinose elimination from sugar beet syrup. J Biotechnol. 1988;8(4):301–10.

    Article  CAS  Google Scholar 

  67. USDA-ERS. Food availability (per capita) data system: loss-adjusted food availability. Sugar and sweeteners (added). Updated 9 Sept 2014. http://www.ers.usda.gov/data-products/food-availability-(per-capita)-data-system.aspx-UvjuyUJdVOE. Accessed 10 Nov 2014.

  68. Welsh JA, Sharma AJ, Grellinger L, Vos MB. Consumption of added sugars is decreasing in the United States. Am J Clin Nutr. 2011;94(3):726–34.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  69. Marriott BP, Fink CJ, Krakower T. Worldwide consumption of sweeteners and recent trends. In: Rippe JM, editor. Fructose, high fructose corn syrup, sucrose and health. New York: Springer; 2014; Chapter 6.

    Google Scholar 

  70. Sun SZ, Empie MW. Fructose metabolism in humans—what isotopic tracer studies tell us. Nutr Metab (Lond). 2012;9(1):89.

    Article  CAS  Google Scholar 

  71. Tappy L, Le KA. Metabolic effects of fructose and the worldwide increase in obesity. Physiol Rev. 2010;90(1):23–46.

    Article  PubMed  CAS  Google Scholar 

  72. Rippe JM, Angelopoulos TJ. Sugars and Health Controversies. What does the Science Say? Adv Nutr 2015;6 (Suppl):493S–503S.

    Google Scholar 

  73. Elgi L, Tran C, Tappy L. Metabolism of nutritive sweeteners in humans. In: Rippe J, editor. Fructose, high fructose corn syrup, sucrose and health. New York: Springer; 2014.

    Google Scholar 

  74. Latulippe ME, Skoog SM. Fructose malabsorption and intolerance: effects of fructose with and without simultaneous glucose ingestion. Crit Rev Food Sci Nutr. 2011;51(7):583–92.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  75. Hellerstein MK, Schwarz JM, Neese RA. Regulation of hepatic de novo lipogenesis in humans. Annu Rev Nutr. 1996;16:523–57.

    Article  PubMed  CAS  Google Scholar 

  76. Bocarsly ME, Powell ES, Avena NM, Hoebel BG. High-fructose corn syrup causes characteristics of obesity in rats: increased body weight, body fat and triglyceride levels. Pharmacol Biochem Behav. 2010;97:101–6.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  77. Carden TJ, Carr TP. Food availability of glucose and fat, but not fructose, increased in the US between 1970 and 2009: analysis of the USDA food availability data system. Nutr J. 2013;12(1):130.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  78. Le MT, Frye RF, Rivard CJ, Cheng J, McFann KK, Segal MS, et al. Effects of high-fructose corn syrup and sucrose on the pharmacokinetics of fructose and acute metabolic and hemodynamic responses in healthy subjects. Metabolism. 2012;61(5):641–51.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  79. Light HR, Tsanzi E, Gigliotti J, Morgan K, Tou JC. The type of caloric sweetener added to water influences weight gain, fat mass, and reproduction in growing Sprague-Dawley female rats. Exp Biol Med (Maywood). 2009;234(6):651–61.

    Article  CAS  Google Scholar 

  80. Sanchez-Lozada LG, Mu W, Roncal C, Sautin YY, Abdelmalek M, Reungjui S, et al. Comparison of free fructose and glucose to sucrose in the ability to cause fatty liver. Eur J Nutr. 2010;49(1):1–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  81. Sheludiakova A, Rooney K, Boakes RA. Metabolic and behavioural effects of sucrose and fructose/glucose drinks in the rat. Eur J Nutr. 2012;51(4):445–54.

    Article  PubMed  CAS  Google Scholar 

  82. Tsanzi E, Light HR, Tou JC. The effect of feeding different sugar-sweetened beverages to growing female Sprague-Dawley rats on bone mass and strength. Bone. 2008;42(5):960–8.

    Article  PubMed  CAS  Google Scholar 

  83. Braden B. Methods and functions: breath tests. Best Pract Res Clin Gastroenterol. 2009;23(3):337–52.

    Article  PubMed  CAS  Google Scholar 

  84. Gibson PR, Newnham E, Barrett JS, Shepherd SJ, Muir JG. Review article: fructose malabsorption and the bigger picture. Aliment Pharmacol Ther. 2007;25(4):349–63.

    Article  PubMed  CAS  Google Scholar 

  85. Van den Berge G. Inborn errors of fructose metabolism. Annu Rev Nutr. 1994;14:41–58.

    Article  Google Scholar 

  86. Melanson K, Zukley L, Lowndes J, Nguyen V, Angelopoulos T, Rippe J. Effects of high-fructose corn syrup and sucrose consumption on circulating glucose, insulin, leptin, and ghrelin and on appetite in normal-weight women. Nutrition. 2007;23:103–12.

    Article  PubMed  CAS  Google Scholar 

  87. Melanson KJ, Summers A, Nguyen V, Brosnahan J, Lowndes J, Angelopoulos TJ, Rippe JM. Body composition, dietary composition, and components of metabolic syndrome in overweight and obese adults after a 12-week trial on dietary treatments focused on portion control, energy density, or glycemic index. Nutr J. 2012;11:57.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  88. Yu Z, Lowndes J, Rippe J. High-fructose corn syrup and sucrose have equivalent effects on energy-regulating hormones at normal human consumption levels. Nutr Res. 2013;33:1043–52.

    Article  PubMed  CAS  Google Scholar 

  89. Stanhope K, Havel P. Endocrine and metabolic effects of consuming beverages sweetened with fructose, glucose, sucrose or high-fructose corn syrup. Am J Clin Nutr. 2008;88:1733S–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  90. Dolan LC, Potter SM, Burdock GA. Evidence-based review on the effect of normal dietary consumption of fructose on development of hyperlipidemia and obesity in healthy, normal weight individuals. Crit Rev Food Sci Nutr. 2010;50(1):53–84.

    Article  PubMed  CAS  Google Scholar 

  91. Dolan LC, Potter SM, Burdock GA. Evidence-based review on the effect of normal dietary consumption of fructose on blood lipids and body weight of overweight and obese individuals. Crit Rev Food Sci Nutr. 2010;50(10):889–918.

    Article  PubMed  CAS  Google Scholar 

  92. Yudkin J. Pure, white, and deadly. HarperCollins Distribution Services; 1972.

    Google Scholar 

  93. Glinsmann WH, Bowman BA. The public health significance of dietary fructose. Am J Clin Nutr. 1993;58:820S–3.

    PubMed  CAS  Google Scholar 

  94. Soenen S, Westerterp-Plantenga MS. No differences in satiety or energy intake after high fructose corn syrup, sucrose, or milk preloads. Am J Clin Nutr. 2007;86:1586–94.

    PubMed  CAS  Google Scholar 

  95. Sievenpiper JL, de Souza RJ, Mirrahimi A, Yu ME, Carleton AJ, Beyene J, Chiavaroli L, Di Buono M, Jenkins AL, Leiter LA, Wolever TM, Kendall CW, Jenkins DJ. Effect of fructose on body weight in controlled feeding trials: a systematic review and meta-analysis. Ann Intern Med. 2012;156:291–304.

    Article  PubMed  Google Scholar 

  96. American Medical Association. Report 3 of the council on scientific and public health (A-08). The Health Effects of High Fructose Corn Syrup; 2008.

    Google Scholar 

  97. American Dietetic Association. Position of the Academy of Nutrition and Dietetics: use of nutritive and nonnutritive sweeteners. J Acad Nutr Diet. 2012;112:739–58.

    Article  Google Scholar 

  98. Hall KD, Heymsfield SB, Kemnitz JW, Klein S, Schoeller DA, Speakman J. Energy balance and its components: implications for body weight regulation. Am J Clin Nutr. 2012;95:989–94.

    Article  PubMed  PubMed Central  Google Scholar 

  99. International Diabetes Federation. IDF diabetes atlas. 2012. http://www.idf.org/diabetesatlas/5e/update2012.

  100. Hu FB. Globalization of diabetes: the role of diet, lifestyle and genes. Diabetes Care. 2011;34(6):1249–57.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Rippe J, Angelopoulos T. Preventing and managing obesity: the scope of the problem. In: Rippe J, Angelopoulos T, editors. Obesity: prevention and treatment. Boca Raton: CRC Press; 2012. p. 3–19.

    Chapter  Google Scholar 

  102. Shulman GI. Cellular mechanisms of insulin resistance. J Clin Invest. 2000;106:171–6.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  103. Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33:2477–83.

    Article  PubMed  PubMed Central  Google Scholar 

  104. Janket SJ, Manson JE, Sesso H, Buring JE, Liu S. A prospective study of sugar intake and risk of type 2 diabetes in women. Diabetes Care. 2003;26(4):1008–15.

    Article  PubMed  Google Scholar 

  105. Barclay AW, Brand-Miller J. The Australian paradox: a substantial decline in sugars intake over the same timeframe that overweight and obesity have increased. Nutrients. 2011;3:491–504; Correction: Nutrients. 2014; 6(2):663–4.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Hodge AM, English DR, O’Dea K, Giles DD. Glycemic index and dietary fiber and the risk of type 2 diabetes. Diabetes Care. 2004;27(11):2701–6.

    Article  PubMed  Google Scholar 

  107. Colditz GA, Manson JE, Stampfer MJ, Rosner B, Willett WC, Speizer FE. Diet and risk of clinical diabetes in women. Am J Clin Nutr. 1992;55(5):1018–23.

    PubMed  CAS  Google Scholar 

  108. Meyer KA, Kushi LH, Jacobs Jr DR, Slavin J, Sellers TA, Folson AR. Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am J Clin Nutr. 2000;71(4):921–30.

    PubMed  CAS  Google Scholar 

  109. Cozma AI, Sievenpiper JL, de Souza RJ, et al. Effect of fructose on glycemic control in diabetes: a systematic review and meta-analysis of controlled feeding trials. Diabetes Care. 2012;35(7):1611–20.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  110. Teff K, Elliott S, Tschop M, Kieffer TJ, Rader D, Heiman M, Townsend RR, Keim NL, D’Alessio D, Havel PJ. Dietary fructose reduces circulating insulin and leptin, attenuates postprandial suppression of ghrelin, and increases triglycerides in women. J Clin Endocrinol Metab. 2004;89:2963–72.

    Article  PubMed  CAS  Google Scholar 

  111. Aeberli I, Gerber PA, Hochuli M, Kohler S, Haile SR, Gouni-Berthold I, Berthold HK, Spinas GA, Berneis K. Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. Am J Clin Nutr. 2011;94(2):479–85.

    Article  PubMed  CAS  Google Scholar 

  112. Aeberli I, Hochuli M, Gerber PA, Sze L, Murer SB, Tappy L, Spinas GA, Berneis K. Moderate amounts of fructose consumption impair insulin sensitivity in healthy young men: a randomized controlled trial. Diabetes Care. 2013;36(1):150–6.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  113. Stanhope KL, Griffen SC, Bremer AA, et al. Metabolic responses to prolonged consumption of glucose- and fructose-sweetened beverages are not associated with postprandial or 24-h glucose and insulin excursions. Am J Clin Nutr. 2011;94(1):112–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  114. Beck-Nielsen H, Pedersen O, Lindskov HO. Impaired cellular insulin binding and insulin sensitivity induced by high-fructose feeding in normal subjects. Am J Clin Nutr. 1980;33(2):273–8.

    PubMed  CAS  Google Scholar 

  115. Clark JM. The epidemiology of nonalcoholic fatty liver disease in adults. J Clin Gastroenterol. 2006;40:S5–10.

    PubMed  Google Scholar 

  116. Ouyang X, Cirillo P, Sautin Y, McCall S, Bruchette JL, Diehl AM, Johnson RJ, Abdelmalek MF. Fructose consumption as a risk factor for non-alcoholic fatty liver disease. J Hepatol. 2008;48(6):993–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  117. Thuy S, Ladurner R, Volynets V, Wagner S, Strahl S, Konigsrainer A, Maier KP, Bischoff SC, Bergheim I. Nonalcoholic fatty liver disease in humans is associated with increased plasma endotoxin and plasminogen activator inhibitor 1 concentrations and with fructose intake. J Nutr. 2008;138(8):1452–5.

    PubMed  CAS  Google Scholar 

  118. Parks EJ, Skokan LE, Timlin MT, Dingfelder CS. Dietary sugars stimulate fatty acid synthesis in adults. J Nutr. 2008;138(6):1039–46.

    PubMed  PubMed Central  CAS  Google Scholar 

  119. Stanhope K, Schwarz J, Keim N, Griffen S, Bremer A, Graham J, Hatcher B, Cox C, Dyachenko A, Zhang W, McGahan J, Seibert A, Krauss R, Chiu S, Schaefer E, Ai M, Otokozawa S, Nakajima K, Nakano R, Beysen C, Hellerstein M, Berglund L, Havel P. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest. 2009;119:1322–34.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  120. Le KA, Ith M, Kreis R, Faeh D, Bortolotti M, Tran C, Boesch C, Tappy L. Fructose overconsumption causes dyslipidemia and ectopic lipid deposition in healthy subjects with and without a family history of type 2 diabetes. Am J Clin Nutr. 2009;89(6):1760–5.

    Article  PubMed  CAS  Google Scholar 

  121. Silbernagel G, Machann J, Unmuth S, Schick F, Stefan N, Haring HU, Fritsche A. Effects of 4-week very-high-fructose/glucose diets on insulin sensitivity, visceral fat and intrahepatic lipids: an exploratory trial. Br J Nutr. 2011;106(1):79–86.

    Article  PubMed  CAS  Google Scholar 

  122. Bravo S, Lowndes J, Sinnett S, Yu Z, Rippe J. Consumption of sucrose and high-fructose corn syrup does not increase liver fat or ectopic fat deposition in muscles. Appl Physiol Nutr Metab. 2013;38(6):681–8.

    Article  PubMed  CAS  Google Scholar 

  123. Chiu S, Sievenpiper JL, de Souza RJ, Cozma AI, Mirrahimi A, Carleton AJ, Ha V, Di Buono M, Jenkins AL, Leiter LA, Wolever TM, Don-Wauchope AC, Beyene J, Kendall CW, Jenkins DJ. Effect of fructose on markers of non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of controlled feeding trials. Eur J Clin Nutr. 2014;68(4):416–23.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  124. Chung M, Ma J, Patel K, Berger S, Lau J, Lichtenstein AH. Fructose, high-fructose corn syrup, sucrose, and nonalcoholic fatty liver disease or indexes of liver health: a systematic review and meta-analysis. Am J Clin Nutr. 2014;100:833–49.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  125. Eshak ES, Iso H, Kokubo Y, Saito I, Yamagishi K, Inoue M, Tsugane S. Soft drink intake in relation to incident ischemic heart disease, stroke, and stroke subtypes in Japanese men and women: the Japan public health centre-based study cohort. Am J Clin Nutr. 2012;96:1390–7.

    Article  PubMed  CAS  Google Scholar 

  126. Gross LS, Li L, Ford ES, Liu S. Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the united states: an ecologic assessment. Am J Clin Nutr. 2004;79:774–9.

    PubMed  CAS  Google Scholar 

  127. Miller M, Stone N, Ballantye C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2292–333.

    Article  PubMed  Google Scholar 

  128. Chiavaroli L, Mirrahimi A, De Souza RJ, Cozma A, Ha V, Wang DD, Yu ME, Carleton AJ, Beyene J, Kendall CWC, Jenkins DJA, Sievenpiper JL. Does fructose consumption elicit a dose-response effect on fasting triglycerides? A systematic review and meta-regression of controlled feeding trials. Can J Diabetes. 2012;36(5):S37.

    Article  Google Scholar 

  129. Wang DD, Sievenpiper JL, de Souza RJ, et al. Effect of fructose on postprandial triglycerides: a systematic review and meta-analysis of controlled feeding trials. Atherosclerosis. 2014;232(1):125–33.

    Article  CAS  Google Scholar 

  130. Zhang Y, An T, Zhang R, Zhou Q, Huang Y, Zhang J. Very high fructose intake increases serum LDL-cholesterol and total cholesterol: a meta-analysis of controlled feeding trials. J Nutr. 2013;143(9):1391–8.

    Article  PubMed  CAS  Google Scholar 

  131. Livesey G, Taylor R. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am J Clin Nutr. 2008;88(5):1419–37.

    PubMed  CAS  Google Scholar 

  132. Sievenpiper JL, Carleton AJ, Chatha S, Jiang HY, de Souza RJ, Beyene J, Kendall CW, Jenkins DJ. Heterogeneous effects of fructose on blood lipids in individuals with type 2 diabetes: systematic review and meta-analysis of experimental trials in humans. Diabetes Care. 2009;32(10):1930–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  133. Lowndes J, Sinnett S, Pardo S, Nguyen V, Melanson K, Yu Z, Lowther B, Rippe J. The effects of normally consumed amounts of sucrose or high fructose corn syrup on lipid profiles, body composition, and related parameters in overweight/obese subjects. Nutrients. 2014;6(3):1128–44.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  134. Lê K-A, Faeh D, Stettler R, Ith M, Kreis R, Vermathen P, Boesch C, Ravussin E, Tappy L. A 4-wk high-fructose diet alters lipid metabolism without affecting insulin sensitivity or ectopic lipids in healthy humans. Am J Clin Nutr. 2006;84:1374–9.

    PubMed  Google Scholar 

  135. Maersk M, Belza A, Stødkilde-Jørgensen H, Ringgaard S, Chabanova E, Thomsen H, Pedersen SB, Astrup A, Richelsen B. 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.

    Article  PubMed  CAS  Google Scholar 

  136. Ha V, Sievenpiper JL, de Souza RJ, Chiavaroli L, Wang DD, Cozma AI, Mirrahimi A, Matthew EY, Carleton AJ, Di Buono M. Effect of fructose on blood pressure a systematic review and meta-analysis of controlled feeding trials. Hypertension. 2012;59:787–95.

    Article  PubMed  CAS  Google Scholar 

  137. Lowndes J, Sinnett S, Yu Z, Rippe J. The effects of fructose-containing sugars on weight, body composition and cardiometabolic risk factors when consumed at up to the 90th percentile population consumption level for fructose. Nutrients. 2014;6:3153–68.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  138. Funari VA, Herrera VL, Freeman D, et al. Genes required for fructose metabolism are expressed in Purkinje cells in the cerebellum. Brain Res Mol Brain Res. 2005;142(2):115–22.

    Article  PubMed  CAS  Google Scholar 

  139. Lindqvist A, Mohapel P, Bouter B, Frielingsdorf H, Pizzo D, Brundin P, Erlanson-Albertsson C. High-fat diet impairs hippocampal neurogenesis in male rats. Eur J Neurol. 2006;13(12):1385–8.

    Article  PubMed  CAS  Google Scholar 

  140. Stice E, Burger KS, Yokum S. Relative ability of fat and sugar tastes to activate reward, gustatory, and somatosensory regions. Am J Clin Nutr. 2013;98(6):1377–84.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  141. Stice E, Yokum S, Blum K, Bohon C. Weight gain is associated with reduced striatal response to palatable food. J Neurosci. 2010;30:13105–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  142. Grabenhorst F, Rolls ET, Parris BA, d’Souza AA. How the brain represent the reward value of fat in the mouth. Cereb Cortex. 2010;20:1082–91.

    Article  PubMed  Google Scholar 

  143. Pena-Gomez C, Alonso-Alonso M, Bravo S, Magerowski G, Sinnett S, Blackburn G, Rippe J. Hypothalamic fMRI responses to different sugars under normal intake conditions: a pilot study. In Obesity Society Annual Scientific Meeting. 2013. T-729-P

    Google Scholar 

  144. Johnston CA, Foreyt JP. Sugar intake in children and adolescents and its effects on health. In: Rippe JM, editor. Fructose, high fructose corn syrup, sucrose and health. New York: Springer; 2014. p. 219–22.

    Chapter  Google Scholar 

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Authors and Affiliations

  1. Rippe Lifestyle Institute, 21 N. Quinsigamond Avenue, Shrewsbury, MA, 01545, USA

    James M. Rippe M.D.

  2. Rippe Lifestyle Institute, Celebration, FL, USA

    James M. Rippe M.D.

  3. Department of Biomedical Sciences, University of Central Florida, Orlando, FL, 32826, USA

    James M. Rippe M.D.

  4. White Technical Research, Argenta, IL, 62501, USA

    John S. White Ph.D.

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  1. James M. Rippe M.D.
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Correspondence to James M. Rippe M.D. .

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  1. Consultants in Consumer Healthcare, Morristown, New Jersey, USA

    Adrianne Bendich

  2. Columbia University Inst. Human Nutrition, New York, New York, USA

    Richard J. Deckelbaum

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Rippe, J.M., White, J.S. (2015). Composition, Production, Consumption, and Health Effects of Added Sugars. In: Bendich, A., Deckelbaum, R. (eds) Preventive Nutrition. Nutrition and Health. Springer, Cham. https://doi.org/10.1007/978-3-319-22431-2_24

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