Journal
CURRENT OPINION IN LIPIDOLOGY
Volume 25, Issue 1, Pages 8-19Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOL.0000000000000042
Keywords
cardiometabolic risk; sugars; systematic review and meta-analysis; trials
Funding
- Canadian Institutes of health Research (CIHR)
- Calorie Control Council
- The Coca-Cola Company
- Pulse Canada
- The International Tree Nut Council Nutrition Research & Education Foundation
- American Heart Association (AHA)
- American College of Physicians (ACP)
- American Society for Nutrition (ASN)
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH)
- Canadian Diabetes Association (CDA)
- Canadian Nutrition Society (CNS)
- Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD)
- International Life Sciences Institute (ILSI) North America
- International Life Sciences Institute (ILSI) Brazil
- University of South Carolina
- Canadian Sugar Institute
- Abbott Laboratories
- Canadian Institutes of Health Research (CIHR) Knowledge Synthesis grant [102078]
- Province of Ontario Graduate Scholarships
- Canadian Institutes of Health Research (CIHR)-Fredrick Banting and Charles Best Canada Graduate Scholarship
- Banting and Best Diabetes Centre (BBDC)-Novo Nordisk Studentship
- CIHR
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Purpose of reviewFructose is seen as uniquely contributing to the pandemics of obesity and its cardiometabolic complications. Much of the evidence for this view derives from the unique biochemical, metabolic, and endocrine responses that differentiate fructose from glucose. To understand whether these proposed mechanisms result in clinically meaningful modification of cardiovascular risk in humans, we update a series of systematic reviews and meta-analyses of controlled feeding trials to assess the cardiometabolic effects of fructose in isocaloric replacement for glucose.Recent findingsA total of 20 controlled feeding trials (n=344) have investigated the effect of fructose in/on cardiometabolic endpoints. Pooled analyses show that although fructose may increase total cholesterol, uric acid, and postprandial triglycerides in isocaloric replacement for glucose, it does not appear to be any worse than glucose in its effects on other aspects of the lipid profile, insulin, or markers of nonalcoholic fatty liver disease. It may also have important advantages over glucose for body weight, glycemic control, and blood pressure.SummaryDepending on the cardiometabolic endpoint in question, fructose has variable effects when replacing glucose. In the absence of clear evidence of net harm, there is no justification to replace fructose with glucose in the diet.
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