Diabetes

According to the Center for Disease Control (CDC), more than 9 percent of the United States population currently suffers from diabetes and an additional 27 percent of people live with undiagnosed diabetes. Previous scientific research has focused on behaviors and dietary patterns that contribute to the development of diabetes and has identified excessive energy intake as a risk factor. Additionally, research suggests that excessive energy intake may be associated with poor health outcomes and co-morbidities such as high cholesterol, high blood pressure, and more.

Researchers have also investigated if intake of specific sugar types increases the risk for diabetes. Research has not proven that fructose, in particular, can promote the development of diabetes.

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In another study regarding an adolescent population conducted by Heden (2014) suggested that, “collectively, the data suggest that fructose or glucose consumption per se is not detrimental to an adolescent’s health, and perhaps factors other than fructose intake (obesity, physical activity levels) should be targeted to prevent chronic disease in this population.”

Overall, the current body of science agrees that fructose consumption does not contribute to metabolic disorders such as diabetes and/or obesity. Rather, a variety of factors may promote the development of the disease and total caloric intake and lifestyle habits should be of greatest concern.

Research Study Summaries

Fructose Consumption Contributes to Hyperinsulinemia in Adolescents With Obesity Through a GLP-1–Mediated Mechanism

J Clin Endocrinol Metab. 2019 Aug 1;104(8):3481-3490. doi: 10.1210/jc.2019-00161 Galderisi A, Giannini C, van Name M, et al. Download Research Study PDF Objective To test the hypothesis that that the ingestion of glucose and fructose may differentially stimulate GLP-1 and insulin response in lean adolescents and adolescents with obesity. Background The consumption of high-fructose beverages […]

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Fructose and metabolic health: governed by hepatic glycogen status?

J Physiol 597.14 (2019) pp 3573–3585 Hengist A, Koumanov F and Gonzalez JT. Download Research Study PDF Objective To present the hypothesis that hepatic glycogen stores may regulate metabolic responses to fructose ingestion and could therefore be a target to prevent or mitigate the negative metabolic effects of fructose intake. Background Fructose is a commonly […]

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The negative and detrimental effects of high fructose on the liver, with special reference to metabolic disorders

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2019:12 821–826 Brandon H. Mai and Liang-Jun Yan. Download Research Study PDF Objective This review focuses the discussion on the hepatic manifestations of high fructose-implicated liver metabolic disorders such as insulin resistance, obesity due to enhanced lipogenesis, non-alcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), and type […]

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The role of dietary sugars in health: molecular composition or just calories?

J Clin Nutr 2019; //doi.org/10.1038/s41430-019-0407-z — Philip Prinz Eur — Download Research Study PDF — Objective: To conduct a review highlighting current literature to discuss the question of whether dietary sugars per se have an unfavorable health effect or if it is just the amount of calories that matters in the development of noncommunicable diseases […]

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The effect of a new mixture of sugar and sugar-alcohols compared to sucrose and glucose on blood glucose increase and the possible adverse reactions: A phase I double-blind, three-way randomized cross-over clinical trial

Endocrinol Diabetes Nutr. 2019. //doi.org/10.1016/j.endinu.2018.12.008 — Mohsenpour MA, Kaseb F, Nazemian R, et al. — Download Research Study PDF — Objective: To examine the effect of a new mixture of sugars and sugar alcohol on the postprandial blood glucose levels and its possible gastrointestinal (GI) adverse reactions in human adults. Background: Various compounds such as […]

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Consuming glucose-sweetened, not fructose-sweetened, beverages increases fasting insulin in healthy humans

Eur J Clin Nutr 2018 Aug 11; //doi.org/10.1038/s41430-018-0297-5 — Kuzma JN, Comer G, Hagman DK, et al. — Download Research Study PDF —  Objective To conduct a secondary analysis to determine whether consuming beverages sweetened with fructose vs. HFCS vs. glucose differentially affected fasting glucose, insulin, and the homeostasis model assessment index of insulin resistance […]

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Glycaemic, uricaemic and blood pressure response to beverages with partial fructose replacement of sucrose

Eur J Clin Nutr (2018) 72:1717-1723; //doi.org/10.1038/s41430-018-0134-x — Rodrigues N, Peng M, Oey I, and Venn BJ. — Download PDF — Objective To assess the effects of partial replacement of sucrose with fructose on serum glucose, uric acid and blood pressure. Background Fructose has been shown to adversely affect plasma lipids and may predispose excessive […]

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Effects of fructose consumption on postprandial TAG: an update on systematic reviews with meta-analysis

Br J Nutr. 2018 Aug; 120(4):364-372. doi: 10.1017/S0007114518001538  — Macedo RCO, Vieira AF, Moritz CEJ, and Reischak-Oliveira A. — Download PDF — Objective: To re-examine the chronic effect (>7 days) of fructose consumption on postprandial TAG, in adolescents and adults. Background: Exaggerated elevation of TAG in the postprandial period represents an abnormal metabolism response and […]

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Study Summary – Chronic Fructose Substitution Has Little Effect on Blood Glucose, Insulin, Triglycerides

An article entitled “Chronic fructose substitution for glucose or sucrose in food or beverages has little effect on fasting blood glucose, insulin, or triglycerides: a systematic review and meta-analysis” by Evans et al. was recently published in the American Journal of Clinical Nutrition. The systematic review addressed the effect of isoenergetic fructose replacement of other […]

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Meta-Analysis of Sugar and Type 2 diabetes Published

Tsilas et al., present research findings of a systematic review and meta-analysis in the article “Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies” published in the Canadian Medical Association Journal. The authors evaluated data from 9 publications reporting results of 15 cohort […]

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Study Summary of “Adverse effects of fructose on cardiometabolic risk factors and hepatic lipid metabolism in subjects with abdominal obesity”

For your information, a study entitled “Adverse effects of fructose on cardiometabolic risk factors and hepatic lipid metabolism in subjects with abdominal obesity” was recently published in the Journal of Internal Medicine. The purpose of this study by Taskinen et al. was to determine the effects of fructose on liver fat development, body composition, dietary […]

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Fructose intervention for 12 weeks does not impair glycemic control for incretin hormone responses during oral glucose or mixed meal tests in obese men

A study entitled “Fructose intervention for 12 weeks does not impair glycemic control for incretin hormone responses during oral glucose or mixed meal tests in obese men” by Matikainen et al. was recently published in Nutrition, Metabolism & Cardiovascular Diseases. The purpose of the study was to determine if habitual fructose consumption (75g/d for 12 […]

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Associations of Dietary Glucose, Fructose, and Sucrose with Beta-cell Function, Insulin Sensitivity and T2DM Study Summary

For your information, a study entitled “Associations of Dietary Glucose, Fructose, and Sucrose with β–cell Function, Insulin Sensitivity, and Type 2 Diabetes in the Maastricht Study” by den Biggelaar et al. was recently published in Nutrients. The purpose of the study was to determine associations between glucose, fructose, and sucrose intakes with β–cell Function (BCF), […]

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Sugar Sweetened Beverages but Not Diet Soda Consumption is Positively Associated with Insulin Resistance

A longitudinal study examining the association between intake of sugar-sweetened beverages (SSB) and diet sodas on insulin resistance and incidence of prediabetes was published in November issue of The Journal of Nutrition. Researchers used a subsample of participants from the Framingham Heart Study’s Offspring cohort (n=1685). Data from 126-item food frequency questionnaires (FFQ) collected from […]

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Early Life Fructose Exposure and Its Implications for Long-Term Cardiometabolic Health in Offspring

A review was recently published in Nutrients which examined the relationship between early life exposure to fructose and cardiometabolic outcomes in offspring. Reviewers cited a number studies which associated fructose intake with various health outcomes such as insulin resistance, elevated low density lipoprotein cholesterol, elevated triglycerides, obesity, type 2 diabetes, cardiovascular disease, non-fatal myocardial infarction, and […]

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Review of Fructose on Insulin Sensitivity in Non-Diabetic Subjects

A new systematic review and meta-analysis examining the effects of fructose on insulin sensitivity in non-diabetic subjects was published in the American Journal of Clinical Nutrition. Researchers specifically looked at controlled clinical trials with normal weight, overweight, and obese non-diabetic participants. All studies used in the analysis were assessed and provided a Heyland methodological quality […]

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Diabetes Regulates Fructose Absorption through Thioredoxin-Interacting Protein

On October 11, a study published in eLife revealed the effects of thioredoxin-interacting protein (Txnip) on fructose absorption and metabolic disease progression in mice models. It has been established Txnip overexpression impairs glucose uptake in peripheral tissues whereas Txnip ablation results in increased glucose uptake.  Txnip is thought to regulate glucose uptake through increased expression […]

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Post-Exercise Appetite was Affected by Fructose Content but Not Glycemic Index of Pre-Exercise Meals

A study published in Appetite investigated the effect of glycemic index (GI) and fructose content in pre-exercise meals on appetite following moderate-intensity exercise. The study enrolled ten, healthy men with an average age of 21.7 years and average BMI of 20.9kg/m2. The three, isocaloric pre-exercise meals were classified as low GI breakfast without fructose (LGI), […]

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ChREBP Regulates Fructose-induced Glucose Production Independently of Insulin Signaling

In a study published in the Journal of Clinical Investigation (see attached), researchers suggest that ChREBP, a transcriptional activator of glycolytic and lipogenic genes, modulates selective liver insulin sensitivity.   Researchers believe that in insulin resistant states, where glucose is not readily taken up by peripheral tissues, glucose shunting to the liver activates ChREBP and promotes […]

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High Intake of Fructose Does Not Differentially Affect Health as Compared to Lower Intake Levels

According to a recent study, a high consumption level of fructose does not lead to high cholesterol or high blood pressure.

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Study Finds Moderate Intake of Fructose-Sweetened Beverages Does Not Lead to Poor Metabolic Health in Teenagers

Moderate consumption of fructose does not lead to adverse metabolic health in adolescents, according to a new study published in The American Journal of Clinical Nutrition.

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Sugar Should Not be Condemned as Primary Obesity or Diabetes Cause, Say Researchers

In a commentary featured in the April issue of Diabetes Care, researchers Kahn and Sievenpiper argue that blaming sugar, and specifically fructose, on the obesity and diabetes epidemics is misguided.

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Systematic Review Finds No Association between Fructose and Triglyceride Levels

According to a new study, swapping fructose for other carbohydrates does not impact triglycerides.

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Is there really a link between type 2 diabetes and fructose?

In a commentary featured in the September 2013 publication ofNutrition Bulletin, author Dr. Geoffrey Livesey dismisses the association between fructose consumption and type 2 diabetes.

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Research Shows No Harm at Typical Intake Levels

Fructose does not increase body weight, blood pressure, uric acid or insulin levels, and may improve glycemic control at normal consumption levels, according to research.

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Study on Sugar Availability DM Prevalence Should Be Interpreted with Caution

The findings in a study published on diabetes prevalence and sugar availability did not show that sugar causes diabetes.

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Fructose and Clinical Outcomes Study Speculative

Findings presented in a review study titled “A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes” examining the efficacy of sweeteners in relation to clinical outcomes is restrained with regards to positive findings and full of speculation, not supported by scientific evidence.

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Fructose study fails to show real world significance

It would be ill advised to base predictions of real world medical outcomes, formulate dietary advice or articulate public health policy on experiments with exposures so highly distorted from actual consumption patterns of fructose.

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Calorie Control Council Response to Manders et al

Prevalence of daily hyperglycemia in obese type 2 diabetic men compared with that in lean and obese normoglycemic men: effect of consumption of a sucrose-containing beverage.

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Fructose Consumption and Consequences for Glycation, Plasma Triacylglycerol, and Body Weight

Meta-Analyses and Meta-Regression Models of Intervention Studies

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Calorie Control Council Response to Couchepin et al

Markedly Blunted Metabolic Effects of Fructose in Healthy Young Female Subjects Compared with Male Subjects

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Calorie Control Council Response to Sanchez-Lozada et al.

How safe is fructose for persons with or without diabetes?

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Calorie Control Council Response to Lê et al

Fructose overconsumption causes dyslipidemia and ectopic lipid deposition in healthy subjects with and without a family history of type 2 diabetes

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Calorie Control Council Response to Stanhope/Havel, et al

Consumption of Fructose-, but not Glucose-Sweetened Beverages Produces an Atherogenic Lipid profile in Overweight/Obese Men and Women

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