Abstract
Fructans are fructose-based oligo-and polysaccharides of natural origin. Fructan and fructose species are sometimes confused by the great public, although they clearly have different biochemical and physiological properties. This review discusses aspects of the use of fructose and fructans in foods in the context of human health, with possible differential effects on cellular autophagy in cells of the human body. Although there are uncertainties on the daily levels of ingested fructose to be considered harmful to human health, there is an emerging consensus on the benefits of the use of fructans in functional foods, sustaining health via direct immunomodulatory and antioxidant effects or through indirect, prebiotic mechanisms.
Similar content being viewed by others
Abbreviations
- AGEs:
-
Advanced glycation end products
- ATP III:
-
Adult Treatment Panel III
- ChREBP:
-
Carbohydrate-responsive element binding protein
- CVD:
-
Cardiovascular diseases
- DHAP:
-
Dihydroxyacetone phosphate
- eNOS:
-
Endothelial nitric oxide synthase
- ER:
-
Endoplasmic reticulum
- FA:
-
Fatty acid
- FOS:
-
Fructo-oligosaccharides
- GGT:
-
Gamma glutamyl transferase
- GI:
-
Glycemic index
- GLUT:
-
Glucose transporter
- Gr43a:
-
Gustatory receptor 43a
- HFCS:
-
High-fructose corn syrup
- IRS:
-
Insulin receptor substrate
- JNK:
-
c-jun N-terminal kinase
- NAFLD:
-
Non-alcoholic fatty liver disease
- PFK-1:
-
Phosphofructokinase 1
- PKC:
-
Protein kinase C
- RBP-4:
-
Retinol binding protein-4
- ROS:
-
Reactive oxygen species
- SCFAs:
-
Short chain fatty acids
- SREBP-1:
-
Sterol regulatory element-binding protein 1
- TG:
-
Triglyceride
- VLDL:
-
Very-low-density lipoproteins
References
Oser BL (1985) Highlights in the history of saccharin toxicology. Food Chem Toxicol 23:535–542
Gwak MJ, Chung SJ, Kim YJ, Lim CS (2012) Relative sweetness and sensory characteristics of bulk and intense sweeteners. Food Sci Biotechnol 21:889–894
Waldrop ME, Ross CF (2014) Sweetener blend optimization by using mixture design methodology and the electronic tongue. J Food Sci 79:S1782–S1794
Fuchs A (1991) Current and potential food and non-food applications of fructans. Biochem Soc Trans 19:555–560
Davis SN, Mann SL, Cherrington AD (2001) Acute fructose administration improves oral glucose tolerance in adults with type 2 diabetes. Diabetes Care 24:1882–1887
American Dietetic Association (2004) Use of nutritive and non-nutritive sweeteners. J Am Diet Assoc 104:255–275
Elliott SS, Keim NL, Stern JS, Teff K, Havel PJ (2002) Fructose, weight gain and the insulin resistance syndrome. Am J Clin Nutr 76:911–922
Niewoehner CB (1986) Metabolic effects of dietary versus parenteral fructose. J Am Coll Nutr 5:443–450
Levine R (1986) Monosaccharides in health and disease. Annu Rev Nutr 6:211–224
Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C (2004) American Heart Association, National Heart, Lung, and Blood Institute, Definition of Metabolic Syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition. Circulation 109:433–438
Bremer AA, Stanhope KL, Graham JL, Cummings BP, Wang W, Saville BR, Havel PJ (2011) Fructose-fed rhesus monkeys: a nonhuman primate model of insulin resistance, metabolic syndrome, and type 2. Clin Transl Sci 4:243–252
Barone S, Fussell SL, Singh AK, Lucas F, Xu J, Kim C, Wu X, Yu Y, Amlal H, Seidler U, Zuo J, Soleimani M (2009) Slc2a5 (Glut5) is essential for the absorption of fructose in the intestine and generation of fructose-induced hypertension. J Biol Chem 284:5056–5066
Dyer J, Wood IS, Palejwala A, Ellis A, Shirazi-Beechey SP (2002) Expression of monosaccharide transporters in intestine of diabetic humans. Am J Physiol Gastrointest Liver Physiol 282:G241–G248
Douard V, Ferraris RP (2008) Regulation of the fructose transporter GLUT5 in health and disease. Am J Physiol Endocrinol Metab 295:E227–E237
Mayes PA (1993) Intermediary metabolism of fructose. Am J Clin Nutr 58:S754–S765
Mor I, Cheung EC, Vousden KH (2011) Control of glycolysis through regulation of PFK1: old friends and recent additions. Cold Spring Harb Symp Quant Biol 76:211–216
Bruynseels K, Bergans N, Gillis N, van Dorpen F, Van Hecke P, Stalmans W, Vanstapel F (1999) On the inhibition of hepatic glycogenolysis by fructose. A 31P-NMR study in perfused rat liver using the fructose analogue 2,5-anhydro-D-mannitol. NMR Biomed 12:145–156
Lanaspa MA, Sanchez-Lozada LG, Choi YJ, Cicerchi C, Kanbay M, Roncal-Jimenez CA, Ishimoto T, Li N, Marek G, Duranay M, Schreiner G, Rodriguez-Iturbe B, Nakagawa T, Kang DH, Sautin YY, Johnson JR (2012) Uric acid induces hepatic steatosis by generation of mitochondrial oxidative stress: potential role in fructose-dependent and -independent fatty liver. J Biol Chem 287:40732–40744
Sluijs I, Beulens JW, Van der A DL, Spijkerman AM, Schulze MB, Van der Schouw YT (2013) Plasma uric acid is associated with increased risk of type 2 diabetes independent of diet and metabolic risk factors. J Nutr 143:80–85
Cox CL, Stanhope KL, Schwarz JM, Graham JL, Hatcher B, Griffen SC, Bremer AA, Berglund L, McGahan JP, Keim NL, Havel PJ (2012) Consumption of fructose- but not glucose-sweetened beverages for 10 weeks increases circulating concentrations of uric acid, retinol binding protein-4, and gamma-glutamyl transferase activity in overweight/obese humans. Nutr Metab (Lond) 9:68
Terra X, Auguet T, Broch M, Sabench F, Hernández M, Pastor RM, Quesada IM, Luna A, Aguilar C, Del Castillo D, Richart C (2013) Retinol binding protein-4 circulating levels were higher in nonalcoholic fatty liver disease vs. histologically normal liver from morbidly obese women. Obesity (Silver Spring) 21:170–177
Baron AD, Steinberg HO, Chaker H, Leaming R, Johnson A, Brechtel G (1995) Insulin-mediated skeletal muscle vasodilation contributes to both insulin sensitivity and responsiveness in lean humans. J Clin Invest 96:786–792
Nakagawa T, Hu H, Zharikov S, Tuttle KR, Short RA, Glushakova O, Ouyang X, Feig DI, Block ER, Herrera-Acosta J, Patel JM, Johnson RJ (2006) A causal role for uric acid in fructose-induced metabolic syndrome. Am J Physiol Renal Physiol 290:F625–F631
Truswell AS (1992) Glycaemic index of foods. Eur J Clin Nutr 44(Suppl 2):S91–S101
Klok MD, Jakobsdottir S, Drent ML (2007) The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev 8:21–34
Anderson GH, Woodend D (2003) Effect of glycemic carbohydrates on short-term satiety and food intake. Nutr Rev 61:S17–S26
Shapiro A, Mu W, Roncal C, Cheng KY, Johnson RJ, Scarpace PJ (2008) Fructose-induced leptin resistance exacerbates weight gain in response to subsequent high-fat feeding. Am J Physiol Regul Integr Comp Physiol 295:R1370–R1375
Vila L, Roglans N, Alegret M, Sanchez RM, Vazquez-Carrera M, Laguna JC (2008) Suppressor of cytokine signaling-3 (SOCS-3) and a deficit of serine/threonine (Ser/Thr) phosphoproteins involved in leptin transduction mediate the effect of fructose on rat liver lipid metabolism. Hepatology 48:1506–1516
Stanhope KL, Griffen SC, Bremer AA, Vink RG, Schaefer EJ, Nakajima K, Schwarz JM, Beysen C, Berglund L, Keim N, Havel PJ (2011) 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 94:112–119
Faeh D, Minehira K, Schwarz JM, Periasamy R, Park S, Tappy L (2005) Effect of fructose overfeeding and fish oil administration on hepatic de novo lipogenesis and insulin sensitivity in healthy men. Diabetes 54:1907–1913
Wu T, Giovannucci E, Pischon T, Hankinson SE, Ma J, Rifai N, Rimm EB (2004) Fructose, glycemic load, and quantity and quality of carbohydrate in relation to plasma C-peptide concentrations in US women. Am J Clin Nutr 80:1043–1049
Corcoran MP, Lamon-Fava S, Fielding RA (2007) Skeletal muscle lipid deposition and insulin resistance: effect of dietary fatty acids and exercise. Am J Clin Nutr 85:662–677
Pagliassotti MJ, Kang J, Thresher JS, Sung CK, Bizeau ME (2002) Elevated basal PI 3-kinase activity and reduced insulin signaling in sucrose-induced hepatic insulin resistance. Am J Physiol Endocrinol Metab 282:E170–E176
Ueno M, Bezerra RM, Silva MS, Tavares DQ, Carvalho CR, Saad MJ (2000) A high-fructose diet induces changes in pp 185 phosphorylation in muscle and liver of rats. Braz J Med Biol Res 33:1421–1427
Samuel VT, Petersen KF, Shulman GI (2010) Lipid-induced insulin resistance: unravelling the mechanism. Lancet 375:2267–2277
Kim JK, Fillmore JJ, Sunshine MJ et al (2004) PKC-theta knockout mice are protected from fat-induced insulin resistance. J Clin Invest 114:823–827
Wei Y, Wang D, Topczewski F, Pagliassotti MJ (2007) Fructose-mediated stress signalling in the liver: implication for hepatic insulin resistance. J Nutr Biochem 18:1–9
Lim JS, Mietus-Snyder M, Valente A, Schwarz JM, Lustig RH (2010) The role of fructose in the pathogenesis of NAFLD and the metabolic syndrome. Nat Rev Gastroenterol Hepatol 7:251–264
Chong MF, Fielding BA, Frayn KN (2007) Mechanisms for the acute effect of fructose on postprandial lipemia. Am J Clin Nutr 85:1511–1520
Bar-On H, Stein Y (1968) Effect of glucose and fructose administration on lipid metabolism in the rat. J Nutr 94:95–105
Schwarz JM, Neese R, Shackleton C, Hellerstein MK (1993) De novo lipogenesis during fasting and oral fructose in lean and obese hyperinsulinemic subjects. Diabetes 42(Suppl):1–39A
McGarry JD, Brown NF (1997) The mitochondrial carnitine palmitoyltransferase system. From concept to molecular analysis. Eur J Biochem 244:1–14
Matsuzaka T, Shimano H, Yahagi N, Amemiya-Kudo M, Okazaki H, Tamura Y, Iizuka Y, Ohashi K, Tomita S, Sekiya M, Hasty A, Nakagawa Y, Sone H, Toyoshima H, Ishibashi S, Osuga J, Yamada N (2004) Insulin-independent induction of sterol regulatory element-binding protein-1c expression in the livers of streptozotocin-treated mice. Diabetes 53:560–569
Stanhope KL, Schwarz JM, Keim NL et al (2009) Consuming fructose-sweetened, not glucose- sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest 119:1322–1334
Rippe JM, Angelopoulos TJ (2013) Sucrose, high-fructose corn syrup, and fructose, their metabolism and potential health effects : what do we really know? Adv Nutr 4:236–245
White JS (2013) Challenging the fructose hypothesis: new perspectives on fructose consumption and metabolism. Adv Nutr 4:246–256
Laughlin MR (2014) Normal roles for dietary fructose in carbohydrate metabolism. Nutrients 6:3117–3129
Livesey G, Taylor R (2008) Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am J Clin Nutr 88:1419–1437
Aeberli I, Hochuli M, Gerber P (2013) Moderate amounts of fructose consumption impair insulin sensitivity in healthy young men. A randomized controlled trial. Diabetes Care 36:150–156
Valluru R, Van den Ende W (2008) Plant fructans in stress environments: emerging concepts and future prospects. J Exp Bot 59:2905–2916
Di Bartolomeo F, Startek JB, Van den Ende W (2013) Prebiotics to fight diseases: reality or fiction? Phytother Res 27:1457–1473
López MG, Urías-Silvas JE (2007) Agave fructans as prebiotics. Recent Advances in Fructooligosaccharides. Eds Shiomi, N., Benkeblia, N. and Onodera. Pp 297–310
Tamura K, Kawakami A, Sanada Y, Tase K, Komatsu T, Yoshida M (2009) Cloning and functional analysis of a fructosyltransferase cDNA for synthesis of highly polymerized levans in timothy (Phleum pratense L.). J Exp Bot 60:893–905
Incoll, LD, Bonnett GD (1993). The occurrence of fructan in food plants. In: Inulin and Inulin-containing Crops. Ed. A Fuchs. Pp 309–322
Lammens W, Le Roy K, Schroeven L, Van Laere A, Rabijns A, Van den Ende W (2009) Structural insights into glycoside hydrolase family 32 and 68 enzymes: functional implications. J Exp Bot 60:727–740
Delgado GTC, da Silva Cunha Tamashiro WM, Maróstica MRJ, Pastore GM (2013) Yacon (Smallanthus sonchifolius): a functional food. Plant Foods Hum Nutr 68:222–228
Kelly G (2008) Inulin-type prebiotics—a review: part 1. Alter Med Rev 13:315–329
Peshev D, Van den Ende W (2014) Fructans: prebiotics and immunomodulators. J Funct Foods 8:384–357
Van Loo J, Coussement P, De Leenheer L, Hoebregs H, Smits G (1995) On the presence of inulin and oligofructose as natural ingredients in the Western diet. Crit Rev Food Sci Nutr 35:525–552
Allsopp P, Possemiers S, Campbell D, Oyarzábal IS, Gill C, Rowland I (2013) An exploratory study into the putative prebiotic activity of fructans isolated from Agave angustifolia and the associated anticancer activity. Anaerobe 22:38–44
Tarini J, Wolever TMS (2010) The fermentable fibre inulin increases postprandial serum short-chain fatty acids and reduces free-fatty acids and ghrelin in healthy subjects. Appl Physiol Nutr Metab 35:9–16
Kleessen B, Sykura B, Zunft HJ, Blaut M (1997) Effects of inulin and lactose on faecal microflora, microbial activity and bowel habit in elderly constipated persons. Am J Clin Nutr 65:1397–1402
Rumessen JJ, Bode S, Hamberg O, Hoyer EG (1990) Fructans of Jerusalem artichoke: intestinal transport, absorption, fermentation and influence on blood glucose, insulin and C-peptide responses in healthy subjects. Am J Clin Nutr 52:675–680
Scholz-Ahrens KE, Schrezenmeir J (2007) Inulin and oligofructose and mineral metabolism: the evidence from animal trials. J Nutr 137:2513S
Rendon-Huerta JA, Juarez-Flores B, Pinos-Rodriguez JM, Aguirre-Rivera JR, Delgado-Portales RE (2012) Effect of different sources of fructans on body weight, blood metabolites and fecal bacteria in normal and obese non-diabetic and diabetic rats. Plant Foods Hum Nutr 67:64–70
Sauer J, Richter KK, Pool-Zobel BL (2007) Physiological concentrations of butyrate favourably modulates genes of oxidative and metabolic stress in primary human colon cells. J Nutr Biochem 18:736–745
Vogt L, Ramasamy U, Meyer D, Pullens G, Venema K, Faas MM, Schols HA, de Vos P (2013) Immune modulation by different types of β2 → 1-fructans is toll-like receptor dependent. Plos ONE 8:7
Ortega-Gonzales M, Molina Santiago C, Lopez Posadas R, Pacheco D (2014) Fructooligosacharides reduce Pseudomonas aeruginosa PAO1 pathogenicity through distinct mechanisms. Plos ONE 9:1
Ten Bruggencate SJ, Bovee-Oudenhoven IM, Lettink-Wissink ML, Katan MB, van der Meer R (2006) Dietary fructooligosaccharides affect intestinal barrier function in healthy men. J Nutr 136:70–74
Keunen E, Peshev D, Vangronsveld J, Van den Ende W, Cuypers A (2013) Plant sugars are crucial players in the oxidative challenge during abiotic stress. Extending the traditional concept. Plant Cell Environ 36:1242–1255
Van den Ende W, Peshev D, De Gara L (2011) Disease prevention by natural antioxidants and prebiotics acting as ROS scavengers in the gastrointestinal tract. Trends Food Sci Technol 22:689–697
Pasqualetti V, Altomare A, Guarino MPL, Locato V, Cocca S, Cimini S, Palma R, Alloni R, De Gara L, Cicala L (2014) Antioxidant activity of inulin and its role in the prevention of human colonic muscle cell impairment induced by lipopolysaccharide mucosal exposure. Plos ONE 9, e9803
Arroyo DS, Gaviglio EA, Peralta Ramos JM, Bussi C, Rodriguez-Galan MC, Irribaren P (2014) Autophagy in inflammation, infection, neurodegeneration and cancer. Int Immunopharmacol 18:55–65
Van den Ende W (2013) Multifunctional fructans and raffinose family oligosaccharides. Front Plant Sci 4:247
Viollet B, Foretz M, Guigas B, Horman S, Dentin R, Bertrand L, Hue L (2006) Activation of AMP-activated protein kinase in the liver: a new strategy for the management of metabolic hepatic disorders. J Physiol 574:41–53
Kroemer G, Mariño G, Levine B (2010) Autophagy and the integrated stress response. Mol Cell 40:280–293
Peng L, Li Z, Green RS, Holzman IR, Lin J (2009) Butyrate enhances the intestinal barrier by facilitating tight junction assembly via activation of AMP-activated protein kinase in Caco-2 cell monolayers. J Nutr 139:1619–1625
Eiwegger T, Stahl B, Haidl P, Schmitt J, Boehm G, Dehlink E, Urbanek R, Szepfalusi Z (2010) Prebiotic oligosaccharides: in vitro evidence for gastrointestinal epithelial transfer and immunomodulatory properties. Pediatr Allergy Immunol 21:1179–1188
Higuchi T, Nishikawa J, Inoue H (2015) Sucrose induces vesicle accumulation and autophagy. J Cell Biochem 116:609–617
Kang Y-L, Saleem MA, Chan KW, Yung BY-M, Law HK-W (2014) Trehalose, an mTOR independent autophagy inducer, alleviates human podocyte injury after puromycin aminonucleoside treatment. PLoS ONE 9, e113520
Giordano S, Darley-Ismar V, Zhang J (2014) Autophagy as an essential cellular antioxidant pathway in neurodegenerative disease. Redox Biol 2:82–90
Acknowledgments
Wim Van den Ende is supported by funding from FWO Vlaanderen. The authors thank Lukasz Pawel Tarkowski for his assistance in drawing figures.
Conflict of Interest
This article does not contain any studies with human or animal subjects.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Di Bartolomeo, F., Van den Ende, W. Fructose and Fructans: Opposite Effects on Health?. Plant Foods Hum Nutr 70, 227–237 (2015). https://doi.org/10.1007/s11130-015-0485-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11130-015-0485-6