Effects of pure sugar vs. mixed starch fructose loads on food intake Effect of glucose, sucrose and fructose on plasma glucose and insulin responses in normal humans: comparison with white bread The glycaemic index of foods containing sugars: comparison of foods with naturally-occurring v. added sugars. The Effects of Physiologic Amounts of Simple Sugars on Lipoprotein, Glucose, and Insulin Levels in Normal Subjects Effects of dietary fructose on plasma lipids in healthy subjects. Sugars and risk of mortality in the NIH-AARP Diet and Health Study. No difference in ad libitum energy intake in healthy men and women consuming beverages sweetened with fructose, glucose, or high-fructose corn syrup: a randomized trial. Replacement of glycaemic carbohydrates by inulin-type fructans from chicory (oligofructose, inulin) reduces the postprandial blood glucose and insulin response to foods: report of two double-blind, randomized, controlled trials Refined sugar intake in Australian children. Fructose ingestion acutely elevates blood pressure in healthy young humans. Appetite hormones and energy intake in obese men after consumption of fructose, glucose and whey protein beverages Effects of Two Energy-Restricted Diets Containing Different Fruit Amounts on Body Weight Loss and Macronutrient Oxidation Effects of Liquid Preloads with Different Fructose/Fibre Concentrations of Subsequent Food Intake and Ratings of Hunger in Women The ingestion of a fructose-containing beverage combined with fat cream exacerbates postprandial lipidemia in young healthy women. Glycaemic index, glycaemic load and ovarian cancer risk: a prospective cohort study. The addition of raspberries and blueberries to a starch-based food does not alter the glycaemic response. No Effect of Added Sugar Consumed at Median American Intake Level on Glucose Tolerance or Insulin Resistance Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study Weight loss in overweight subjects following low-sucrose or sucrose-containing diets Effects of meals with high soluble fibre, high amylose barley variant on glucose, insulin, satiety and thermic effect of food in healthy lean women Fructose-rich beverages and risk of gout in women. Sugars in diet and risk of cancer in the NIH‐AARP Diet and Health Study Brain functional magnetic resonance imaging response to glucose and fructose infusions in humans. Acute effects of feeding fructose, glucose and sucrose on blood lipid levels and systemic inflammation The Effect of Normally Consumed Amounts of Sucrose or High Fructose Corn Syrup on Lipid Profiles, Body Composition and Related Parameters in Overweight/Obese Subjects Calcium and fructose intake in relation to risk of prostate cancer. Effect of drinking soda sweetened with aspartame or high-fructose corn syrup on food intake and body weight. Sugar and dietary fibre composition influence, by different hormonal response, the satiating capacity of a fruit-based and a β-glucan-enriched beverage. Added thermogenic and satiety effects of a mixed nutrient vs a sugar-only beverage A prospective study of sugar intake and risk of type 2 diabetes in women. Effect of sugars in solutions on subjective appetite and short-term food intake in 9- to 14-year-old normal weight boys 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 Energy compensation following consumption of sugar-reduced products: a randomized controlled trial High-fructose corn syrup and sucrose have equivalent effects on energy-regulating hormones at normal human consumption levels. Glycaemic index methodology. The effects of four hypocaloric diets containing different levels of sucrose or high fructose corn syrup on weight loss and related parameters Dietary glycemic load, carbohydrate, sugar, and colorectal cancer risk in men and women. Child-directed and nutrition-focused marketing cues on food packaging: links to nutritional content. Acute effects of fructose and glucose ingestion with and without caffeine in young and old humans. Effect of Meal Dilution on the Postprandial Glycemic Response: Implications for glycemic testing Total dietary carbohydrate, sugar, starch and fibre intakes in the European Prospective Investigation into Cancer and Nutrition The glycaemic index values of Vietnamese foods Liquid meal replacements and glycemic control in obese type 2 diabetes patients. Reducing the use of sugar in public schools: a randomized cluster trial. Macronutrient disposal during controlled overfeeding with glucose, fructose, sucrose, or fat in lean and obese women. Association of Sweetened Beverage Intake with Incident Hypertension Fructose consumption and the risk of kidney stones. Effect of drinking compared with eating sugars or whey protein on short-term appetite and food intake Mechanisms for the acute effect of fructose on postprandial lipemia. Intake of macronutrients as predictors of 5-y changes in waist circumference. The problem of accuracy in dietary surveys. Analysis of the over 65 UK National Diet and Nutrition Survey Reducing Retail Merchandising of Discretionary Food and Beverages in Remote Indigenous Community Stores: Protocol for a Randomized Controlled Trial Differential effects of fructose versus glucose on brain and appetitive responses to food cues and decisions for food rewards Effects of high-fructose corn syrup and sucrose consumption on circulating glucose, insulin, leptin, and ghrelin and on appetite in normal-weight women.
Using a within-subject design , we gave subjects three different 520 - 530 kcal preloads in the form of puddings in a r and omized fashion at weekly intervals . The puddings contained either 50 g of fructose or glucose as the sole carbohydrate source in a protein and fat mixture , or 50 g fructose plus 15 g of starch .  Food intake was assessed 2.25 h after the preload was completed . Blood was drawn throughout and assayed for concentrations of glucose and insulin . When the preload contained fructose alone as the sole source of carbohydrate , subjects ate significantly fewer calories and less fat than when the preload contained glucose alone . When starch was added to the fructose preload , there was no significant reduction in calorie and fat intake . Effects on food intake paralleled the rise in plasma insulin levels produced by the different preloads . Implication s for use of fructose as an adjunct to weight control efforts are discussed Objective : To determine the plasma glucose and insulin responses of various doses of glucose , sucrose , fructose and white bread in normal human subjects . Design : Plasma glucose and insulin were measured before and at various times after 8 subjects ate 13 different test meals in r and omized order on separate days after an overnight fast . Test meals consisted of 500 ml of tea or water to which was added either nothing , 25 , 50 , or 100 g of glucose or sucrose , 25 or 50 g fructose , 50 g glucose plus 50 g fructose , or a 25 , 50 or 100 g carbohydrate portion of white bread . The glycaemic ( GI ) and insulinaemic index ( II ) values of the sugars were calculated by expressing the incremental areas under the plasma glucose and insulin curves ( AUC ) after glucose , sucrose and fructose as a percentage of the respective AUC after white bread containing the same amount of carbohydrate . Setting : University teaching hospital clinical nutrition centre . Subjects : Lean , normal subjects ( 4 male , 4 female ) 21–33 y of age . Results : Plasma insulin responses increased nearly linearly as carbohydrate intake increased from 0 to 100 g , but glycaemic responses increased by only 68 % and 38 % as carbohydrate intake increased from 25 to 50 g and 50 to 100 g , respectively . The GI and II values of glucose , 149±16 and 147±18 , respectively , were significantly greater than those of bread ( 100 ; P<0.05 ) , while the values for fructose , 16±4 and 22±3 were significantly less than those of bread ( P<0.001 ) . GI values did not differ significantly from II values . Conclusions : It is concluded that , in normal subjects , as carbohydrate intake is increased from 0 to 100 g , plasma insulin responses increase at a greater rate than plasma glucose responses . The insulinaemic responses elicited by glucose , sucrose or fructose are similar to those that would be expected from a starchy food with the same glycaemic index . Descriptors The primary aim of the present study was to exp and the glycaemic index ( GI ) data base by determining the GI and insulin index values of thirty-nine foods containing sugars  in healthy adults . The second aim was to examine the hypothesis that glycaemic and insulin responses to foods which contain added sugar(s ) are higher than responses to foods containing naturally-occurring sugars . Eight healthy subjects drawn from a pool of eighteen consumed 50 g carbohydrate portions ( except 25 g carbohydrate portions for fruits ) of the test foods . The GI and insulin index were determined according to st and ardized methodology and expressed on a scale on which glucose = 100 . The median GI and insulin index values of all foods tested were 56 ( range 14 to 80 ) and 56 ( range 24 to 124 ) respectively . The median GI of the foods containing added sugars was similar to that of foods containing naturally-occurring sugars ( 58 v. 53 respectively , P = 0.08 ) . Likewise , the median insulin index of the foods containing added sugars was not significantly different from that of foods containing naturally-occurring sugars ( 61 v. 56 respectively , P = 0.16 ) . There was no evidence of ' rebound hypoglycaemia ' or excessive insulin secretion relative to the glucose response . We conclude that most foods containing sugars do not have a high GI . In addition , there is often no difference in responses between foods containing added sugars and those containing naturally-occurring sugars Using a crossover design , eight healthy volunteers r and omly received physiologic amounts ( ⅓ of each subject 's total carbohydrate intake ) of either fructose or sucrose as the primary source of simple sugar , incorporated into isocaloric diets comprised of typical American foods . After 7 and 14 days of consuming either of the two sugars , no change occurred in fasting glucose or insulin levels . In addition , total triglyceride , totalcholesterol , low-density-lipoprotein ( LDL ) cholesterol , and high-density-lipoprotein ( HDL ) cholesterol concentrations were unaltered . Since our study used conventional foods in normal eating patterns rather than contrived formulas or excessive amounts of simple sugar , our data indicate that there is no difference between sucrose or fructose on various lipid components or glucose and fasting insulin levels in the “ real world ” innormal subjects BACKGROUND About 9 % of average dietary energy intake in the United States comes from fructose . Such a high consumption raises concern about the metabolic effects of this sugar . OBJECTIVE The objective of this study was to determine the effect of dietary fructose on plasma lipids . DESIGN The study was conducted in the General Clinical Research Center at Fairview-University of Minnesota Medical Center . The participants were 24 healthy adult volunteers ( 12 men and 12 women ; 6 of each sex were aged < 40 y and 6 of each sex were aged > /=40 y ) . All subjects received 2 isoenergetic study diets assigned by using a r and omized , balanced crossover design . One diet provided 17 % of energy as fructose . The other diet was sweetened with glucose and was nearly devoid of fructose . Each diet was fed for 6 wk . Both diets were composed of common foods and contained nearly identical amounts of carbohydrate , protein , fat , fiber , cholesterol , and saturated , monounsaturated , and polyunsaturated fatty acids . All meals were prepared in the metabolic kitchen of the General Clinical Research Center . RESULTS The responses to the study diets differed by sex . In men , the fructose diet produced significantly higher fasting , postpr and ial , and daylong plasma triacylglycerol concentrations than did the glucose diet . The daylong plasma triacylglycerol concentration after 6 wk of the fructose diet was 32 % greater in men than the corresponding concentration during the glucose diet ( P : < 0.001 ) . The fructose diet had no significant effect on fasting or postpr and ial plasma triacylglycerol concentrations in women . The fructose diet also had no persistent effect on fasting plasma cholesterol , HDL cholesterol , or LDL cholesterol in either men or women . CONCLUSIONS Dietary fructose was associated with increased fasting and postpr and ial plasma triacylglycerol concentrations in men . Diets high in added fructose may be undesirable , particularly for men . Glucose may be a suitable replacement sugar BACKGROUND Although previous studies have linked intake of sugars with incidence of cancer and other chronic diseases , its association with mortality remains unknown . OBJECTIVE We investigated the association of total sugars , added sugars , total fructose , added fructose , sucrose , and added sucrose with the risk of all-cause , cardiovascular disease , cancer , and other-cause mortality  in the NIH-AARP Diet and Health Study . DESIGN The participants ( n = 353,751 ) , aged 50 - 71 y , were followed for up to 13 y. Intake of individual sugars over the previous 12 mo was assessed at baseline by using a 124-item NIH Diet History Question naire . RESULTS In fully adjusted models ( fifth quartile compared with first quartile ) , all-cause mortality was positively associated with the intake of total sugars [ HR ( 95 % CI ) : 1.13 ( 1.06 , 1.20 ) ; P-trend < 0.0001 ] , total fructose [ 1.10 ( 1.04 , 1.17 ) ; P-trend < 0.0001 ] , and added fructose [ 1.07 ( 1.01 , 1.13 ) ; P-trend = 0.005 ) in women and total fructose [ 1.06 ( 1.01 , 1.10 ) ; P-trend = 0.002 ] in men . In men , a weak inverse association was found between other-cause mortality and dietary added sugars  ( P-trend = 0.04 ) , sucrose ( P-trend = 0.03 ) , and added sucrose ( P-trend = 0.006 ) . Investigation of consumption of sugars by source showed that the positive association with mortality risk was confined only to sugars from beverages , whereas the inverse association was confined to sugars from solid foods . CONCLUSIONS In this large prospect i ve study , total fructose intake was weakly positively associated with  all-cause mortality in both women and men , whereas added sugar , sucrose , and added sucrose intakes were inversely associated with other-cause mortality in men . In our analyses , intake of added sugars was not associated with an increased risk of mortality . The NIH-AARP Diet and Health Study was registered at clinical trials.gov as NCT00340015 BACKGROUND Increased energy intake is consistently observed in individuals consuming sugar-sweetened beverages ( SSBs )  , likely mainly because of an inadequate satiety response to liquid calories . However , SSBs have a high content of fructose , the consumption of which acutely fails to trigger responses in key signals involved in energy homeostasis . It is unclear whether the fructose content of SSBs contributes to the increased energy intake in individuals drinking SSBs . OBJECTIVE We investigated whether the relative amounts of fructose and glucose in SSBs modifies ad libitum energy intake over 8 d in healthy adults without fructose malabsorption . DESIGN We conducted 2 r and omized , controlled , double-blind crossover studies to compare the effects of consuming 4 servings/d of a fructose- , glucose- , or aspartame-sweetened beverage  ( study A ; n = 9 )  or a fructose- , glucose- , or high-fructose corn syrup (HFCS)-sweetened beverage  ( study B ; n = 24 ) for 8 d on overall energy intake . SSBs were provided at 25 % of estimated energy requirement , or an equivalent volume of the aspartame-sweetened beverage , and consumption was m and atory . All solid foods were provided at 125 % of estimated energy requirements and were consumed ad libitum . RESULTS In study A , ad libitum energy intake was 120 % ± 10 % , 117 % ± 12 % , and 102 % ± 15 % of estimated energy requirements when subjects consumed the fructose- , glucose- , and aspartame-sweetened beverages . Energy intake was significantly higher in the fructose and glucose phases than in the aspartame phase ( P < 0.003 for each ) , with no difference between the fructose and glucose phases ( P = 0.462 ) . In study B , total energy intake during the fructose , HFCS , and glucose phases was 116 % ± 14 % , 116 % ± 16 % , and 116 % ± 16 % of the subject 's estimated total energy requirements ( P = 0.880 ) . CONCLUSIONS In healthy adults , total 8-d ad libitum energy intake was increased in individuals consuming SSBs compared with aspartame-sweetened beverages . The energy overconsumption observed in individuals consuming SSBs occurred independently of the relative amounts of fructose and glucose in the beverages . These trials were registered at clinical trials.gov as NCT00475475 and NCT01424306 Purpose Inulin-type fructans are recognized as prebiotic dietary fibres and classified as non-digestible carbohydrates that do not contribute to glycaemia . The aim of the present studies was to investigate the glycaemic response ( GR ) and insulinaemic response ( IR ) to foods in which sucrose was partially replaced by inulin or oligofructose from chicory . Methods In a double-blind , r and omized , controlled cross-over design , 40–42 healthy adults consumed a yogurt drink containing oligofructose or fruit jelly containing inulin and the respective full-sugar variants .  Capillary blood glucose and insulin were measured in fasted participants and at 15 , 30 , 45 , 60 , 90 , and 120 min after starting to drink/eat . For each test food , the incremental area under the curve ( iAUC ) for glucose and insulin was calculated and the GR and IR determined . Results Consumption of a yogurt drink with oligofructose which was 20 % reduced in sugars significantly lowered the glycaemic response compared to the full-sugar reference ( iAUC120min 31.9 and 37.3 mmol/L/min , respectively ; p < 0.05 ) . A fruit jelly made with inulin and containing 30 % less sugars than the full-sugar variant likewise result ed in a significantly reduced blood glucose response ( iAUC120min 53.7 and 63.7 mmol/L/min , respectively ; p < 0.05 ) . In both studies , the postpr and ial insulin response was lowered in parallel ( p < 0.05 ) . The reduction of postpr and ial glycaemia was positively correlated to the proportion of sugars replaced by inulin-type fructans ( p < 0.001 ) . Conclusions In conclusion , the studies confirmed that substitution of glycaemic sugars by inulin or oligofructose from chicory may be an effective strategy to reduce the postpr and ial blood glucose response to foods OBJECTIVE To estimate the intake of refined sugar in Australian children and adolescents , aged 2 - 18 years . DESIGN Foods contributing to total sugar intake were identified using data from the National Nutrition Survey 1995 ( NNS95 ) , the most recent national dietary survey of the Australian population . The top 100 foods represented means of 85 % ( range 79 - 91 % ) and 82 % ( range 78 - 85 % ) of total sugar intake for boys and girls , respectively . Using published Australian food composition data ( NUTTAB95 ) , the proportion of total sugar being refined sugar was estimated for each food . Where published food composition data were not available , calculations from ingredients and manufacturer 's information were used . SUBJECTS The NNS95 assessed the dietary intake  of a r and om sample of the Australian population , aged 2 - 18 years ( n=3007 ) . RESULTS Mean daily intakes of refined sugar  ranged from 26.9 to 78.3 g for 2 - 18-year-old girls , representing 6.6 - 14.8 % of total energy intake . Corresponding figures for boys were 27.0 to 81.6 g and 8.0 - 14.0 % , respectively . Of the 10 highest sources of refined sugar for each age group , sweetened beverages , especially cola-type beverages , were the most prominent . CONCLUSION Refined sugar is an important contributor to dietary energy in Australian children . Sweetened beverages such as soft drinks and cordials were substantial sources of refined sugar and represent a potential target for campaigns to reduce refined sugar intake . Better access to information on the amounts of sugar added to processed food is essential for appropriate monitoring of this important energy source Overconsumption of fructose , particularly in the form of soft drinks , is increasingly recognized as a public health concern . The acute cardiovascular responses to ingesting fructose have not , however , been well-studied in humans . In this r and omized crossover study , we compared cardiovascular autonomic regulation after ingesting water and drinks containing either glucose or fructose in 15 healthy volunteers ( aged 21 - 33 yr ) . The total volume of each drink was 500 ml , and the sugar content 60 g. For 30 min before and 2 h after each drink , we recorded beat-to-beat heart rate , arterial blood pressure , and cardiac output . Energy expenditure was determined on a minute-by-minute basis . Ingesting the fructose drink significantly increased blood pressure , heart rate , and cardiac output but not total peripheral resistance . Glucose ingestion result ed in a significantly greater increase in cardiac output than fructose but no change in blood pressure and a concomitant decrease in total peripheral resistance . Ingesting glucose and fructose , but not water , significantly increased blood pressure variability and decreased cardiovagal baroreflex sensitivity . Energy expenditure increased by a similar amount after glucose and fructose ingestion , but fructose elicited a significantly greater increase in respiratory quotient . These results show that ingestion of glucose and fructose drinks is characterized by specific hemodynamic responses . In particular , fructose ingestion elicits an increase in blood pressure that is probably mediated by an increase in cardiac output without compensatory peripheral vasodilatation Objective : To investigate appetite responses over 4 h to fructose beverages in obese men , relative to glucose and whey protein . Second , to investigate the effect of combining whey and fructose on postpr and ial appetite hormones . Design : R and omized , double-blind crossover study of four beverages ( 1.1 MJ ) containing 50 g of whey , fructose , glucose or 25 g whey+25 g fructose . Blood sample s and appetite ratings were collected for 4 h then a buffet meal was offered . Subjects : Twenty-eight obese men ( age : 57.0±1.6 years , body mass index : 32.5±0.6 kg/m2 )  Measurements : Plasma ghrelin ( total ) , glucagon-like peptide-1 ( GLP-1 7–36 ) , cholecystokinin-8 , glucose , insulin and appetite ratings were assessed at baseline and 30 , 45 , 60 , 90 , 120 , 180 , 240 min after beverages , followed by measurement of ad libitum energy intake . Results : Fructose  produced lower glycaemia and insulinaemia compared to the glucose treatment ( P<0.0001 ) ; whereas postpr and ial ghrelin , GLP-1 and cholecystokinin responses were similar after both treatments . Whey protein produced a prolonged ( 2–4 h ) suppression of ghrelin ( P=0.001 ) and elevation of GLP-1 ( P=0.002 ) and cholecystokinin ( P=0.003 ) that were reduced when combined with fructose , while glucose and insulin responses were similar . Energy intake after 4 h was independent of beverage type ( glucose 4.7±0.2 MJ ; fructose 4.9±0.3 MJ ; whey 4.6±0.3 MJ ; whey/fructose 4.8±0.3 MJ ; P>0.05 ) . Conclusion : In obese men  , fructose- and glucose-based beverages had similar effects on appetite and associated regulatory hormones , independent of the differing glycaemic and insulinaemic responses . The contrasting profile of plasma ghrelin , GLP-1 and cholecystokinin after whey protein consumption did not impact on ad libitum intake 4 h later and was attenuated when 50 % of whey was replaced with fructose The consumption of specific foods in energy-restricted diets may affect the weight loss process . The purpose of this research was to evaluate whether obese women following two hypocaloric diets with distinct fruit content differ in weight loss and metabolic responses .  Fifteen obese women were included , who were r and omly assigned to follow a low or a high-fruit energy-restricted diet for 8 weeks . The main outcome variables were weight and fat losses . Metabolic measurements concerning macronutrient oxidation were also assessed by using 13C labelled fructose and indirect calorimetry . The induced weight loss was similar for both diets ( 6.9 ± 2 % vs. 6.6 ± 2 % , p = 0.785 ) . Both experimental diets similarly improved the lipid plasma profile in the participants , but the cholesterol fall was higher in obese subjects receiving the diet containing more fruit . No statistical differences in lipids carbohydrates and 13C labelled fructose utilisation were observed , but protein oxidation was differently affected by the experimental diets . The compensatory effects of the associated fibre/fructose intake may explain the lack of a specific effect of the fruit amount on hypocaloric diets design ed to weight loss , although the increased fibre content from enriched fruit diets may be involved in the favourable effects on cholesterol plasma levels Preloads ( 250 ml ) of 2 % or 10 % fructose containing 1 % soluble fibre and 1 % insoluble fibre or 10 % fructose with 3 % soluble fibre and 1 % insoluble were administered 60 min before lunch to 24 healthy women , who were slightly overweight and considerably weight concerned . The fibre consisted of guar gum , partly hydrolysed for the soluble form . The placebo consisted of a solution of sweeteners ( cyclamate and saccharin ) . After the experiment with three preload-types and a placebo , a r and om subset of 15 subjects returned for an experiment with one preload-type and a placebo , given 30 or 60 min before lunch . Food intake during the subsequent lunch was only significantly different from after the placebo in this subset of 15 subjects after the 10 % fructose/3 % soluble and 1 % insoluble fibre preload after intervals of 30 or 60 min . However , energy intake of preload and meal was significantly higher than energy intake of placebo and meal . At the 30-min delay , eating rate was significantly lower after the preload than after the placebo ; also , hunger ratings were lower after intake of a preload and meal than after intake of the placebo+meal , from immediately after lunch until 5 hours later . Energy intake over 24 h was not affected by administration of fructose/fibre or placebo 30 or 60 minutes before lunch in the 24 women AIM To investigate the acute effects of the ingestion of a fructose-containing beverage combined with fat on postpr and ial lipoprotein metabolism . METHODS Twelve young healthy Japanese women with apolipoprotein E phenotype 3/3 were enrolled in this study . At each of four sessions , the subjects ingested one of four sugar beverages containing fructose and /or glucose ( total : 0.5 g/kg body weight ) combined with OFTT cream ( 1 g/kg , 0.35 g/kg as fat ) in a r and omized crossover design . The four sugar beverages were as follows : 100 % ( w/w ) fructose ( F100 ) , 90 % fructose + 10 % glucose ( F90G10 ) , 55 % fructose + 45 % glucose ( F55G45 ) and 100 % glucose ( G100 ) . Venous blood sample s were obtained at baseline and 0.5 , one , two , four and six hours after ingestion . RESULTS The serum concentrations of TG in the F100 , F90G10 and F55G45 trials were significantly higher than each fasting value at two and four hours , and returned to baseline at six hours , except in the F100 trial . The concentrations at four hours and the incremental areas under the curve for the hepatic triglyceride-rich lipoprotein-triglyceride ( VLDL-TG(TM ) ) levels in the F100 and F90G10 trials were significantly higher and larger , respectively , than those observed in the G100 trial . Meanwhile , the concentrations of RLP-TG and apolipoprotein B-48 peaked at two hours in the G100 trial , versus four hours in the other trials , and did not return to baseline at six hours , except in the G100 trial . At four hours , the ⊿apoB48 tended to be higher in the F100 trial than in the G100 trial . CONCLUSIONS The ingestion of a high-fructose-containing beverage with fat cream delays the clearance of chylomicron and its remnant derived from the intestine and enhances the secretion of triglyceride-rich lipoprotein particles from the liver , thereby inducing postpr and ial lipidemia , even in young healthy women BACKGROUND There is some evidence that plasma insulin levels might influence ovarian cancer risk . Glycaemic index ( GI ) and glycaemic load ( GL ) are measures that allow the carbohydrate content of individual foods to be classified according to their postpr and ial glycaemic effects and hence their effects on circulating insulin levels . Therefore , we examined ovarian cancer risk in association with GI and GL , and intake of dietary carbohydrate and sugar . METHODS The study was conducted in a prospect i ve cohort of 49 613 Canadian women enrolled in the National Breast Screening Study ( NBSS ) who completed a self-administered food-frequency question naire ( FFQ ) between 1980 and 1985 . Linkages to national mortality and cancer data bases yielded data on deaths and cancer incidence , with follow-up ending between 1998 and 2000 . Data from the FFQ were used to estimate overall GI and GL , and Cox proportional hazards models were used to estimate hazard ratios ( HRs ) and 95 % confidence intervals ( CIs ) for the association between energy-adjusted quartile levels of GL , overall GI , total carbohydrates , total sugar and ovarian cancer risk . RESULTS During a mean 16.4 years of follow-up , we observed 264 incident ovarian cancer cases .  GI and total carbohydrate and sugar intakes were not associated with ovarian cancer risk in the total cohort . GL was positively associated with a 72 % increase in risk of ovarian cancer ( HR=1.72 , 95 % CI=1.13 - 2.62 , Ptrend=0.01 ) and the magnitude of the association was slightly greater among postmenopausal ( HR=1.89 , 95 % CI=0.98 - 3.65 , Ptrend=0.03 ) than among premenopausal women ( HR=1.64 , 95 % CI=0.95 - 2.88 , Ptrend=0.07 ) . CONCLUSIONS Our data suggest that consumption of diets with high GL values may be associated with increased risk of ovarian cancer It is now known that health benefits associated with diets rich in fruit and vegetables may be partly derived from intake of polyphenols . Berry polyphenols may influence carbohydrate metabolism and absorption and hence postpr and ial glycaemia . To date , studies related to polyphenol effects on the glycaemic response have been completed only in liquids using either monosaccharides or disaccharides . It remains to be determined whether berries known to be rich in polyphenols can reduce the glycaemic response ( GR ) to a solid polysaccharide meal . The aim of the present study was to investigate whether berries alter postpr and ial hyperglycaemia and consequently the GR to a starchy food . Blood glucose was tested on seven occasions , on three occasions using a reference food and on four occasions using pancakes supplemented with either raspberries or blueberries or control pancakes containing similar amounts of fructose and glucose . Results showed that there were no differences in GR ( blueberry 51·3 ( SEM 5·7 ) ; raspberry 54·7 ( SEM 5·6 ) ; blueberry control 43·9 ( SEM 4·2 ) ; raspberry control 41·8 ( SEM 6·4 ) ) , GR area under the curve or satiety index between any of the tests . The present study indicates that the ability of berries to reduce blood glucose from starch-based foods is unsubstantiated Excess sugar consumption may promote adverse changes in  hepatic and total body insulin resistance .  Debate continues over the effects of sugars at more typically consumed levels and whether the identity of the sugar consumed is important . In the present study participants ( 20–60 years old ) were r and omly assigned to one of five groups , three that consumed low fat milk with added fructose containing sugars in amounts equivalent to the 50th percentile of fructose consumption ( US ) , one which consumed low-fat milk sweetened with glucose , and one unsweetened low-fat milk control group . The intervention lasted ten weeks . In the entire study population there was less than 1 kg increase in weight ( 73.6 ± 13.0 vs. 74.5 ± 13.3 kg , p < 0.001 ) , but the change in weight was comparable among groups ( p > 0.05 ) . There were no changes in fasting glucose ( 49 ± 0.4 vs. 5.0 ± 0.5 mmol/L ) , insulin ( 56.9 ± 38.9 vs. 61.8 ± 50.0 pmol/L ) , or insulin resistance , as measured by the Homeostasis Model Assessment method ( 1.8 ± 1.3 vs. 2.0 ± 1.5 , all p > 0.05 ) . These data suggest that added sugar consumed at the median American intake level does not produce changes in measures of insulin sensitivity or glucose tolerance and that no sugar has more deleterious effects than others Objective To examine the relation between intake of sugar sweetened soft drinks and fructose and the  risk of incident gout in men . Design Prospect i ve cohort over 12 years . Setting Health professionals follow-up study . Participants 46 393 men with no history of gout at baseline who provided information on intake of soft drinks and fructose through vali date d food frequency question naires . Main outcome measure Incident cases of gout meeting the American College of Rheumatology survey criteria for gout . Results During the 12 years of follow-up 755 confirmed incident cases of gout were reported . Increasing intake of sugar sweetened soft drinks was associated with an increasing risk of gout . Compared with consumption of less than one serving of sugar sweetened soft drinks a month the multivariate relative risk of gout for 5 - 6 servings a week was 1.29 ( 95 % confidence interval 1.00 to 1.68 ) , for one serving a day was 1.45 ( 1.02 to 2.08 ) , and for two or more servings a day was 1.85 ( 1.08 to 3.16 ; P for trend=0.002 ) . Diet soft drinks were not associated with risk of gout ( P for trend=0.99 ) . The multivariate relative risk of gout according to increasing fifths of fructose intake were 1.00 , 1.29 , 1.41 , 1.84 , and 2.02 ( 1.49 to 2.75 ; P for trend < 0.001 ) . Other major contributors to fructose intake such as total fruit juice or fructose rich fruits ( apples and oranges ) were also associated with a higher risk of gout ( P values for trend < 0.05 ) . Conclusions Prospect i ve data suggest that consumption of sugar sweetened soft drinks and fructose is strongly associated with an increased  risk of gout in men . Furthermore , fructose rich fruits and fruit juices may also increase the risk .  Diet soft drinks were not associated with the risk of gout OBJECTIVES : To compare the response by overweight individuals , counselled in a work environment , to energy-reduced diets in which the amount of sucrose-containing foods is varied . DESIGN : Two energy-reduced diets were design ed as a weight-reducing programme . A low-sugar diet ( LSD ) providing 5 % of its energy from sucrose and a sugar-containing diet ( SCD ) providing 10 % of its energy from sucrose incorporated as sweet foods were devised . Both diets were constructed to contain about 33 % of the energy from fat . The diets , design ed to provide a deficit of 2.51 MJ/day ( 600 kcal/day ) per individual , were r and omly allocated to subjects in an 8 week parallel design study .SUBJECTS : Ninety-five subjects were recruited from a large service industry if they were more than 7 kg ( 1 stone ) in weight above body mass index ( BMI ) 25 kg/m2 . Sixty-eight subjects completed the programme . MEASUREMENTS : Fortnightly body weight measurements were taken using calibrated scales ; BMI at baseline and week 8 ; and nutrient intake using 2 day food record diaries at baseline and weeks 2 , 4 and 8 . RESULTS : Weight loss over the 8 weeks was 2.2 kg ( LSD ) and 3.0 kg ( SCD ) . BMI changed from 29.2 on the LSD and 30.1 kg/m2 SCD at baseline to 28.2 and 28.8 kg/m2 at week 8 respectively . The actual prescribed commercially added sucrose intakes were 5 % energy ( LSD ) or 10 % energy ( SCD ) . Reported percentage energy from fat was significantly lower on the SCD ( and would seem to support the theory of an inverse relationship between fat and sugar ) than on the LSD , where there was seen to be no significant reduction . There was no evidence of micronutrient dilution that could be directly attributed to the sucrose content of the diets . CONCLUSION : These results provide no justification for the exclusion of added sucrose in weight-reducing diets Objective : To examine the effect of barley flour ( barley cultivar , Hordeum Vulgare var Himalaya 292 ) incorporated into breakfast and lunch compared with otherwise identical meals containing white wheat flour on the thermic effect of food ( TEF ) , subsequent food intake and metabolic parameters . Design : R and omized single blinded crossover study . Setting : Outpatient setting .Subjects and methods : Fourteen healthy women consumed a test breakfast at 0700 h.  Energy expenditure , respiratory quotient ( RQ ) , appetite ratings using a visual analogue scale ( VAS ) , insulin and glucose levels  were measured before and after a test lunch at 1330 h. Food intake was recorded for the remainder of the day . Results : The TEF was 5 % for both test lunches and meal type did not affect any variable measured by the VAS . There was an increase in post-pr and ial RQ above baseline ( 0.80 ) independent of treatment ( 0.88 and 0.90 for barley and wheat-containg meals , respectively , P<0.001 ) . Mean area under the glycaemic response curve ( AUC )  for wheat-containing meals was 4.68±1.67 mmol/l/h , 22 % higher than for the barley-containing meals ( 3.67±1.91 mmol/l/h ) , P=0.05 . AUC of insulin in response to wheat-containing meals ( 78.1±35.3 mIU/l/h ) was 32 % greater than barley-containing meals ( 52.8±24.7 mU/l/h ) , P<0.02 . Ad libitum food intake over the next 10 h was reduced by 23 % ( 9.6 vs 11.0 MJ , P<0.05 ) after the wheat-containing meals compared to the barley-containing glycaemic index meals . Conclusion : Inclusion of an ingredient containing increased soluble fibre and amylose did not reduce spontaneous food intake but rather was associated with higher subsequent energy intakes despite its reduced glycaemic and insulinemic effects . Sponsorship : CSIRO , Human Nutrition , Adelaide , Australia CONTEXT Fructose-rich beverages such as sugar-sweetened soda and orange juice can increase serum uric acid levels and , thus , the risk of gout , but prospect i ve data on the relationship are limited . OBJECTIVE To examine the relationship between intake of fructose-rich beverages and fructose and the risk of incident gout among women . DESIGN , SETTING , AND PARTICIPANTS In the Nurses ' Health Study , a US prospect i ve cohort study spanning 22 years ( 1984 - 2006 ) , we analyzed data from 78,906 women with no history of gout at baseline who provided information on intake of beverages and fructose through vali date d food frequency question naires . MAIN OUTCOME MEASURE Incident cases that met the American College of Rheumatology survey criteria for gout . RESULTS During 22 years of follow-up , we documented 778 confirmed incident cases of gout . Increasing intake of sugar-sweetened soda was independently associated with increasing risk of gout . Compared with consumption of less than 1 serving per month of sugar-sweetened soda , the multivariate relative risk of gout for 1 serving per day was 1.74 ( 95 % confidence interval [ CI ] , 1.19 - 2.55 ) and for 2 or more servings per day was 2.39 ( 95 % CI , 1.34 - 4.26 ) ( P<.001 for trend ) . The corresponding relative risks for orange juice were 1.41 ( 95 % CI , 1.03 - 1.93 ) and 2.42 ( 95 % CI , 1.27 - 4.63 ) ( P = .02 for trend ) . The absolute risk differences corresponding to these relative risks were 36 and 68 cases per 100,000 person-years for sugar-sweetened soda and 14 and 47 cases per 100,000 person-years for orange juice , respectively . Diet soft drinks were not associated with the risk of gout ( P = .27 for trend ) . Compared with the lowest quintile of fructose intake , the multivariate relative risk of gout in the top quintile was 1.62 ( 95 % CI , 1.20 - 2.19 ; P = .004 for trend ) ( risk difference of 28 cases per 100,000 person-years ) . CONCLUSION Among this cohort of women , consumption of fructose-rich beverages is associated with an increased risk of incident gout , although the contribution of these beverages to the risk of gout in the population is likely modest given the low incidence rate among women Prospect i ve epidemiologic data on the effects of different types of dietary sugars on cancer incidence have been limited . In this report , we investigated the association of total sugars , sucrose , fructose , added sugars , added sucrose and added fructose in the diet with risk of 24 malignancies . Participants ( n = 435,674 ) aged 50–71 years from the NIH‐AARP Diet and Health Study were followed for 7.2 years . The intake of individual sugars was assessed using a 124‐item food frequency question naire ( FFQ ) . Cox proportional hazards regression was used to estimate hazard ratios ( HR ) and 95 % confidence intervals ( CI ) in multivariable models adjusted for confounding factors pertinent to individual cancers . We identified 29,099 cancer cases in men and 13,355 cases in women . In gender‐combined analyses , added sugars were positively associated with risk of esophageal adenocarcinoma ( HRQ5 vs. Q1 : 1.62 , 95 % CI : 1.07–2.45 ; ptrend = 0.01 ) , added fructose was associated with risk of small intestine cancer ( HRQ5 vs. Q1 : 2.20 , 95 % CI : 1.16–4.16 ; ptrend = 0.009 ) and all investigated sugars were associated with increased risk of pleural cancer . In women , all investigated sugars were inversely associated with ovarian cancer . We found no association between dietary sugars and risk of colorectal or any other major cancer . Measurement error in FFQ‐reported dietary sugars may have limited our ability to obtain more conclusive findings . Statistically significant associations observed for the rare cancers are of interest and warrant further investigation AIMS In animals , intracerebroventricular glucose and fructose have opposing effects on appetite and weight regulation . In humans , functional brain magnetic resonance imaging ( fMRI ) studies during glucose ingestion or infusion have demonstrated suppression of hypothalamic signalling , but no studies have compared the effects of glucose and fructose . We therefore sought to determine if the brain response differed to glucose vs. fructose in humans independently of the ingestive process . METHODS Nine healthy , normal weight subjects underwent blood oxygenation level dependent ( BOLD ) fMRI measurements during either intravenous ( IV ) glucose ( 0.3 mg/kg ) , fructose ( 0.3 mg/kg ) or saline , administered over 2 min in a r and omized , double-blind , crossover study . Blood was sample d every 5 min during a baseline period and following infusion for 60 min in total for glucose , fructose , lactate and insulin levels . RESULTS No significant brain BOLD signal changes were detected in response to IV saline .  BOLD signal in the cortical control areas increased during glucose infusion ( p = 0.002 ) , corresponding with increased plasma glucose and insulin levels . In contrast , BOLD signal decreased in the cortical control areas during fructose infusion ( p = 0.006 ) , corresponding with increases of plasma fructose and lactate . Neither glucose nor fructose infusions significantly altered BOLD signal in the hypothalamus . CONCLUSION In normal weight humans , cortical responses as assessed by BOLD fMRI to infused glucose are opposite to those of fructose . Differential brain responses to these sugars and their metabolites may provide insight into the neurologic basis for dysregulation of food intake during high dietary fructose intake Background Recent studies have demonstrated a relationship between fructose consumption and risk of developing metabolic syndrome . Mechanisms by which dietary fructose mediates metabolic changes are poorly understood . This study compared the effects of fructose , glucose and sucrose consumption on post-postpr and ial lipemia and low grade inflammation measured as hs-CRP . Methods This was a r and omized , single blinded , cross-over trial involving healthy subjects ( n = 14 ) . After an overnight fast , participants were given one of 3 different isocaloric drinks , containing 50 g of either fructose or glucose or sucrose dissolved in water .  Blood sample s were collected at baseline , 30 , 60 and 120 minutes post intervention for the analysis of blood lipids , glucose , insulin and high sensitivity C-reactive protein ( hs-CRP ) . Results Glucose and sucrose supplementation initially result ed in a significant increase in glucose and insulin levels compared to fructose supplementation and returned to near baseline values within 2 hours . Change in plasma cholesterol , LDL and HDL-cholesterol ( measured as area under curve , AUC ) was significantly higher when participants consumed fructose compared with glucose or sucrose ( P < 0.05 ) . AUC for plasma triglyceride levels however remained unchanged regardless of the dietary intervention . Change in AUC for hs-CRP was also significantly higher in subjects consuming fructose compared with those consuming glucose ( P < 0.05 ) , but not sucrose ( P = 0.07 ) . Conclusion This study demonstrates that fructose as a sole source of energy modulates plasma lipids and hsCRP levels in healthy individuals . The significance of increase in HDL-cholesterol with a concurrent increase in LDL-cholesterol and elevated hs-CRP levels remains to be delineated when considering health effects of feeding fructose-rich diets . Registration number for clinical The American Heart Association ( AHA ) has advocated that women and men not consume more than 100 and 150 kcal/day , respectively , from added sugars . These levels are currently exceeded by over 90 % of the adult population in the United States . Few data exist on longer-term metabolic effects when sucrose and High Fructose Corn Syrup ( HFCS ) , the principal sources of added dietary sugars , are consumed at levels typical of the general population . Sixty five overweight and obese individuals were placed on a eucaloric ( weight stable ) diet for 10-weeks , which incorporated sucrose- or HFCS-sweetened , low-fat milk at 10 % or 20 % of calories in a r and omized , double-blinded study . All groups responded similarly ( interaction p > 0.05 ) . There was no change in body weight in any of the groups over the 10-week study , or in systolic or diastolic blood pressure . Likewise , there were no changes in total cholesterol , triglycerides , low-density lipoprotein ( LDL ) , or apolipoprotein B ( Apo B ) . We conclude that ( 1 ) when consumed as part of a eucaloric diet fructose — when given with glucose ( as normally consumed ) does not promote weight gain or an atherogenic lipid profile even when consumed at two to four times the level recently recommended by the AHA . ( 2 ) There were no differences between HFCS and sucrose on these parameters Laboratory and clinical data indicate an antitumor effect of 1,25(OH)2 vitamin D ( 1,25(OH)2D ) on prostate cancer . High calcium intake suppresses formation of 1,25(OH)2D from 25(OH)D , thereby decreasing the 1,25(OH)2D level . Ingestion of fructose reduces plasma phosphate transiently , and hypophosphatemia stimulates 1,25(OH)2D production . We thus conducted a prospect i ve study among 47,781 men of the Health Professionals Follow-Up Study free of cancer in 1986 to examine whether calcium and fructose intake influenced risk of prostate cancer .  Between 1986 and 1994 , 1369 non-stage A1 and 423 advanced ( extraprostatic ) cases of prostate cancer were diagnosed . Higher consumption of calcium  was related to advanced prostate cancer [ multivariate relative risk ( RR ) , 2.97 ; 95 % confidence interval ( CI ) , 1.61 - 5.50 for intakes > or = 2000 mg/day versus < 500 mg/day ; P , trend , 0.002 ] and metastatic prostate cancer ( RR , 4.57 ; CI , 1.88 - 11.1 ; P , trend , < 0.001 ) . Calcium from food sources and from supplements independently increased risk .  High fructose intake was related to a lower risk of advanced prostate cancer ( multivariate RR , 0.51 ; CI , 0.33 - 0.80 , for intakes > 70 versus < or = 40 g/day ; P , trend , 0.007 ) . Fruit intake was inversely associated with risk of advanced prostate cancer ( RR , 0.63 ; 95 % CI , 0.43 - 0.93 ; for > 5 versus < or = 1 serving per day ) , and this association was accounted for by fructose intake . Non-fruit sources of fructose similarly predicted lower risk of advanced prostate cancer . A moderate positive association between energy-adjusted fat intake and advanced prostate cancer was attenuated and no longer statistically significant when controlled for calcium and fructose . Our findings provide indirect evidence for a protective influence of high 1,25(OH)2D levels on prostate cancer and support increased fruit consumption and avoidance of high calcium intake to reduce the risk of advanced prostate cancer To examine whether artificial sweeteners aid in the control of long-term food intake and body weight , we gave free-living , normal-weight subjects 1150 g soda sweetened with aspartame ( APM ) or high-fructose corn syrup ( HFCS ) per day . Relative to when no soda was given , drinking APM-sweetened soda for 3 wk significantly reduced calorie intake of both females ( n = 9 ) and males ( n = 21 ) and decreased the body weight of males but not of females . However , drinking HFCS-sweetened soda for 3 wk significantly increased the calorie intake and body weight of both sexes . Ingesting either type of soda reduced intake of sugar from the diet without affecting intake of other nutrients . Drinking large volumes of APM-sweetened soda , in contrast to drinking HFCS-sweetened soda , reduces sugar intake and thus may facilitate the control of calorie intake and body weight In this study the satiating capacity of three beverages containing 3 g barley β-glucan , or 2.5 g dietary fibre ( DF ) from fruit , or without DF ( control ) was evaluated . Fourteen healthy volunteers were r and omized to have isocaloric breakfasts including one of the beverages in different occasions . Appetite ratings over 3 h post-breakfast and energy intakes at ad libitum lunch , blood glucose , insulin , ghrelin , PYY , GLP-1 , GIP , and PP concentrations , and 24 h food intake , were assessed . The bevaerages containing DF increased fullness and satiety over 3 h post-breakfast , but only the β-glucan-enriched vs. the control significantly reduced energy intakes by 18 % at lunch and 40 % over the rest of the day . Blood ghrelin and PP responses were differently modulated by beverages . The fruit-based and the β-glucan-enriched beverage suppressed by 8.9 % and 8.1 % ghrelin response over the 3 h and the first hour post-breakfast , respectively , while only the latter increased PP response by 34.6 % , compared to the control . A sucrose-sweetened beverage providing 3 g barley β-glucans can control food intake by modulating PP response and it can even reduce 24 h energy intake . Ghrelin suppression by fruit dietary fibre and mixed sugars was not sufficient to significantly reduce food intake compared to the control OBJECTIVE : To examine the effects of a sugar-only ( SO ) beverage vs one containing a mixed-nutrient ( MN ) composition on energy expenditure and feelings of hunger and satiety . HYPOTHESIS : A beverage containing a mixed macronutrient composition will lead to greater thermic effect of food and feelings of fullness than an isocaloric beverage containing only sugar . RESEARCH METHODS AND PROCEDURES : Adults were r and omly assigned to receive a 2510 kJ ( 600 kcal ) SO liquid formula followed by an isovolumic , isoenergetic , MN liquid formula with an energy distribution of 17 % protein , 67 % carbohydrates as sucrose and corn syrup solids , and 16 % fat , or vice versa , in a crossover design . The carbohydrate source in the two beverages was identical : 1:1 ratio of sucrose and corn syrup solids ( 25 dextrose equivalents ) . The thermic response was calculated as the 7 h deviation from resting metabolic rate ( RMR ) . Subjects provided hunger/satiety ratings and other related information by visual analog scales at regular intervals throughout the study period . RESULTS : In all , 20 subjects completed the protocol ; one was removed from the thermic effect analysis due to discrepant RMRs . Following beverage ingestion , SO and MN liquid meals produced 7 h thermic effects of ( X±s.e.m . ) 274.1±27.6 kJ ( 65.5±6.6 kcal ) and 372.0±33.9 kJ ( 88.9±8.1 kcal ) , respectively , result ing in a significant ( P<0.01 ) difference between meals ( Δ=97.9±35.1 kJ [ 23.4±8.4 kcal ] ) . Analysis of satiety ratings using area under the curve analysis showed greater feelings of satiety ( P<0.05 ) with MN compared to SO consumption . Also , subjects felt that they could eat less ( P<0.05 ) after consumption of the MN vs SO beverage . DISCUSSION : In comparison to MN beverages , SO beverages are associated with a relatively high-energy retention without accompanying subjective hunger/fullness compensations , suggesting a basis for their role in long-term unintentional weight gain in healthy adults OBJECTIVE To investigate prospect ively whether intake of total or type of sugar is associated with the risk of developing type 2 diabetes . The contribution of sugar intake to the pathogenesis of type 2 diabetes has not been settled in the context of primary prevention because of limited prospect i ve data . RESEARCH DESIGN AND METHODS The Women 's Health Study is a r and omized controlled trial of aspirin and vitamin E in the prevention of cardiovascular disease and cancer . A vali date d semiquantitative food frequency question naire was completed by 39,345 women aged 45 years and older . The main outcome was the incidence of type 2 diabetes . The predictor was sugar intake , including sucrose , glucose , fructose , and lactose . Using Cox proportional hazard models , multivariate RRs of type 2 diabetes for increasing quintiles of sugar intake compared with the lowest quintile were estimated . RESULTS Compared with the lowest quintile of sugar intake , the RRs and 95 % CIs for the highest quintiles were 0.84 ( 0.67 - 1.04 ) for sucrose , 0.96 ( 0.78 - 1.19 ) for fructose , 1.04 ( 0.85 - 1.28 ) for glucose , and 0.99 ( 0.80 - 1.22 ) for lactose , after adjustment for known risk factors for type 2 diabetes . Similar findings of no association were obtained in subgroup analyses stratified by BMI . CONCLUSIONS Intake of sugars does not appear to play a deleterious role in primary prevention of type 2 diabetes . These prospect i ve data support the recent American Diabetes Association 's guideline that a moderate amount of sugar can be incorporated in a healthy diet Background and Objective : The role of sugars in solutions on subjective appetite and food intake ( FI ) has received little investigation in children . Therefore , we examined the effect of isocaloric solutions ( 200 kcal/250 ml ) of sugars including sucrose , high-fructose corn syrup-55 ( HFCS ) or glucose , compared with a non-caloric sucralose control , on subjective appetite and FI in 9- to 14-year-old normal weight ( NW ) boys . Participants and Methods : NW boys ( n=15 ) received each of the test solutions , in r and om order , 60 min before an ad libitum pizza meal .  Subjective appetite was measured at baseline ( 0 min ) , and 15 , 30 , 45 and 60 min . Results : Only glucose ( P=0.003 ) , but neither sucrose nor HFCS , reduced FI compared with the sucralose control . This led to a higher cumulative energy intake , compared with sucralose , after sucrose ( P=0.009 ) and HFCS ( P=0.01 ) , but not after glucose . In all treatment sessions , subjective average appetite increased from baseline to 60 min , but change from baseline average appetite was the highest after sucrose ( P<0.005 ) . Furthermore , sucrose ( r=−0.59 , P=0.02 ) and HFCS ( r=−0.56 , P=0.03 ) , but not glucose , were inversely associated with test meal FI when the treatment dose ( 200 kcal ) was expressed on a body weight ( kg ) basis . Conclusions : Change from baseline subjective average appetite was the highest after sucrose , but only the glucose solution suppressed FI at the test meal 60 min later in NW boys Background Prospect i ve studies in humans examining the effects of fructose consumption on biological markers associated with the development of metabolic syndrome are lacking . Therefore we investigated the relative effects of 10 wks of fructose or glucose consumption on plasma uric acid and RBP-4 concentrations , as well as liver enzyme ( AST , ALT , and GGT ) activities in men and women . Methods As part of a parallel arm study , older ( age 40–72 ) , overweight and obese male and female subjects ( BMI 25–35 kg/m2 ) consumed glucose- or fructose-sweetened beverages providing 25 % of energy requirements for 10 wks . Fasting and 24-h blood collection s were performed at baseline and following 10 wks of intervention and plasma concentrations of uric acid , RBP-4 and liver enzyme activities were measured . Results Consumption of fructose , but not glucose , led to significant increases of 24-h uric acid profiles ( P < 0.0001 ) and RBP-4 concentrations ( P = 0.012 ) , as well as plasma GGT activity ( P = 0.04 ) . Fasting plasma uric acid concentrations increased in both groups ; however , the response was significantly greater in subjects consuming fructose ( P = 0.002 for effect of sugar ) . Within the fructose group male subjects exhibited larger increases of RBP-4 levels than women ( P = 0.024 ) . Conclusions These findings suggest that consumption of fructose at 25 % of energy requirements for 10 wks , compared with isocaloric consumption of glucose , may contribute to the development of components of the metabolic syndrome by increasing circulating uric acid , GGT activity , suggesting alteration of hepatic function , and the production of RBP-4 Purpose Consumption of sugar-reformulated products ( commercially available foods and beverages that have been reduced in sugar content through reformulation ) is a potential strategy for lowering sugar intake at a population level . The impact of sugar-reformulated products on body weight , energy balance ( EB ) dynamics and cardiovascular disease risk indicators has yet to be established . The REFORMulated foods ( REFORM ) study examined the impact of an 8-week sugar-reformulated product exchange on body weight , EB dynamics , blood pressure , arterial stiffness , glycemia and lipemia . Methods A r and omized , controlled , double-blind , crossover dietary intervention study was performed with fifty healthy normal to overweight men and women ( age 32.0 ± 9.8 year , BMI 23.5 ± 3.0 kg/m2 ) who were r and omly assigned to consume either regular sugar or sugar-reduced foods and beverages for 8 weeks , separated by 4-week washout period . Body weight , energy intake ( EI ) , energy expenditure and vascular markers were assessed at baseline and after both interventions . Results We found that carbohydrate ( P < 0.001 ) , total sugars ( P < 0.001 ) and non-milk extrinsic sugars ( P < 0.001 ) ( % EI ) were lower , whereas fat ( P = 0.001 ) and protein ( P = 0.038 ) intakes ( % EI ) were higher on the sugar-reduced than the regular diet . No effects on body weight , blood pressure , arterial stiffness , fasting glycemia or lipemia were observed . Conclusions Consumption of sugar-reduced products , as part of a blinded dietary exchange for an 8-week period , result ed in a significant reduction in sugar intake . Body weight did not change significantly , which we propose was due to energy compensation Intake of high-fructose corn syrup ( HFCS ) has been suggested to contribute to the increased prevalence of obesity , whereas a number of studies and organizations have reported metabolic equivalence between HFCS and sucrose . We hypothesized that HFCS and sucrose would have similar effects on energy-regulating hormones and metabolic substrates at normal levels of human consumption and that these values would not change over a 10-week , free-living period at these consumption levels . This was a r and omized , prospect i ve , double-blind , parallel group study in which 138 adult men and women consumed 10 weeks of low-fat milk sweetened with either HFCS or sucrose at levels of the 25th , 50th , and 90th percentile population consumption of fructose ( the equivalent of 40 , 90 , or 150 g of sugar per day in a 2000-kcal diet ) . Before and after the 10-week intervention , 24-hour blood sample s were collected . The area under the curve ( AUC ) for glucose , insulin , leptin , active ghrelin , triglyceride , and uric acid was measured . There were no group differences at baseline or posttesting for all outcomes ( interaction , P > .05 ) . The AUC response of glucose , active ghrelin , and uric acid did not change between baseline and posttesting ( P > .05 ) , whereas the AUC response of insulin ( P < .05 ) , leptin ( P < .001 ) , and triglyceride ( P < .01 ) increased over the course of the intervention when the 6 groups were averaged . We conclude that there are no differences in the metabolic effects of HFCS and sucrose when compared at low , medium , and high levels of consumption The glycaemic index ( GI ) concept was originally introduced to classify different sources of carbohydrate (CHO)-rich foods , usually having an energy content of > 80 % from CHO , to their effect on post-meal glycaemia . It was assumed to apply to foods that primarily deliver available CHO , causing hyperglycaemia . Low-GI foods were classified as being digested and absorbed slowly and high-GI foods as being rapidly digested and absorbed , result ing in different glycaemic responses . Low-GI foods were found to induce benefits on certain risk factors for CVD and diabetes . Accordingly it has been proposed that GI classification of foods and drinks could be useful to help consumers make ' healthy food choices ' within specific food groups . Classification of foods according to their impact on blood glucose responses requires a st and ardised way of measuring such responses . The present review discusses the most relevant method ological considerations and highlights specific recommendations regarding number of subjects , sex , subject status , inclusion and exclusion criteria , pre-test conditions , CHO test dose , blood sampling procedures , sampling times , test r and omisation and calculation of glycaemic response area under the curve . All together , these technical recommendations will help to implement or reinforce measurement of GI in laboratories and help to ensure quality of results . Since there is current international interest in alternative ways of expressing glycaemic responses to foods , some of these methods are discussed Background The replacement of sucrose with HFCS in food products has been suggested as playing a role in the development of obesity as a public health issue . The objective of this study was to examine the effects of four equally hypocaloric diets containing different levels of sucrose or high fructose corn syrup ( HFCS ) . Methods This was a r and omized , prospect i ve , double blind trial , with overweight/obese participants measured for body composition and blood chemistry before and after the completion of 12 weeks following a hypocaloric diet .  The average caloric deficit achieved on the hypocaloric diets was 309 kcal . Results Reductions were observed in all measures of adiposity including body mass , BMI , % body fat , waist circumference and fat mass for all four hypocaloric groups , as well as reductions in the exercise only group for body mass , BMI and waist circumference . Conclusions Similar decreases in weight and indices of adiposity are observed when overweight or obese individuals are fed hypocaloric diets containing levels of sucrose or high fructose corn syrup typically consumed by adults in the United States Hyperinsulinemia may explain excess colorectal cancer among individuals who are overweight or inactive . Recent studies have observed elevated colorectal cancer risk among individuals with elevated insulin levels 2 hours after oral glucose challenge or with elevated plasma C-peptide levels . The effect of consuming a high glycemic diet on colorectal risk , however , remains uncertain . Two prospect i ve cohort studies , the Nurses ' Health Study and the Health Professionals Follow-up Study , contributed up to 20 years of follow-up . After exclusions , 1,809 incident colorectal cancers were available for analyses .  Dietary glycemic load ( GL ) was calculated as a function of glycemic index ( postpr and ial blood glucose response as compared with a reference food ) , carbohydrate content , and frequency of intake of individual foods reported on food frequency question naires . Multivariable Cox proportional hazards models were used to adjust for potential confounders . Intakes of dietary carbohydrate , GL , overall glycemic index , sucrose , and fructose were not associated with  colorectal cancer risk in women . A small increase in risk was observed in men with high dietary GL ( multivariate relative risk , 1.32 ; 95 % confidence interval , 0.98 - 1.79 ; highest versus lowest quintile ) , sucrose or fructose ( multivariate relative risk , 1.37 ; 95 % confidence interval , 1.05 - 1.78 ; highest versus lowest quintile of fructose , P = 0.008 ) . Associations were slightly stronger among men with elevated body mass index ( > or = 25 kg/m(2 ) ) . Results among women were similar after stratifying by body mass index or physical activity . High intakes of GL , fructose , and sucrose were related to an elevated  colorectal cancer risk among men . For women , however , these factors did not seem to increase the risk of colorectal cancer OBJECTIVE We tested whether the presence of both  child-targeted and nutrition-focused ( i.e. parent-targeted ) marketing cues on food packaging was associated with the nutritional content of these products . DESIGN We conducted a quantitative content analysis of 403 food packages chosen r and omly from the supermarket 's online portal along with all products ( n 312 ) from the cereal aisle in a supermarket from the Southeastern USA . We examined main and interaction effects for cues on nutritional content ( e.g. energy density , sugar , sodium , fibre ) . SETTING A regional supermarket chain in the Southeastern USA . RESULTS Tests of main effects indicated that increased presence of nutritional cues was linked to more nutritious content ( e.g. less sugar , less saturated fat , more fibre ) while the increased presence of child-targeted cues was uniformly associated with less nutritious content ( e.g. more sugar , less protein , less fibre ) . Among the interaction effects , results revealed that products with increased nutrition-focused and child-targeted cues were likely to contain significantly more sugar and less protein than other products . CONCLUSIONS Products that seek to engage children with their packaging in the supermarket are significantly less nutritious than foods that do not , while product packages that suggest nutritional benefits have more nutritious content . More importantly , the study provides evidence that those products which try to engage both child and parent consumers are significantly less healthy in crucial ways ( e.g. more sugar , less fibre ) than products that do not Aging is associated with a decline in energy expenditure ( EE ) , glucose intolerance , and a reduction in body nitrogen content . In addition , a reduction in the thermic response to glucose but not to fructose or protein has been reported in the elderly . The present study was conducted to further examine nutrient-induced thermogenesis and the effects of specific sugars on amino acid metabolism in relation to age . After 3 days on a weight-maintaining , 250-g carbohydrate diet , 16 healthy non-obese men and women in two age groups ( 18 to 29 and 66 to 80 years ) consumed on 4 different days 500 mL of either a 75-g fructose or 75-g glucose solution , with or without 300 mg caffeine or vitamin C as a placebo .  Blood substrate and hormone levels and EE , using indirect calorimetry , were measured at timed intervals for 3 hours after consumption of the drinks . There was no difference in the carbohydrate-induced increase in EE in either young or old even after adjustments for body weight and fat-free mass ( FFM ) . An approximately 20-fold increase in serum caffeine levels increased EE in both groups ( P < .003 ) , but had minimal effects on substrate and hormone responses . In contrast to glucose , fructose induced a marked elevation in plasma alanine from combined basal levels of 301 + /- 24 to approximately 500 + /- 18 mumol/L ( mean + /- SEM ) in both groups ( P < .001 ) . However , both fructose and glucose ingestion result ed in a similar decline in branched-chain and aromatic amino acids . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE To investigate the effect of varying the volume of sugar meals on the postpr and ial glycemic response ( PGR ) . RESEARCH DESIGN AND METHODS On six separate occasions , after an overnight fast , blood glucose concentrations were measured in eight healthy subjects ( 34 ± 4 years of age , BMI 22.9 ± 0.9 kg/m2 ) after the consumption of 25 g glucose , sucrose , or fructose dissolved in either 200 or 600 ml of water .  Blood was obtained at fasting and then at times 15 , 30 , 45 , 60 , and 90 min after the start of the test meal . RESULTS PGR was found to be influenced by carbohydrate type ( P < 0.001 ) . Mean response areas ( min · mmol · l−1 ) to the three sugars were statistically different ( P < 0.05 ) . Glucose had the highest response area ( 90.0 ± 8.1 ) , followed by sucrose ( 61.3 ± 5.0 ) and then fructose ( 14.7 ± 2.8 ) . Independent of this effect , PGR was also found to be influenced by volume dose ( P < 0.01 ) . By tripling meal volume from 200 to 600 ml , PGR areas were significantly increased for all three sugars , glucose ( 79.3 ± 10.3 vs. 100.8 ± 12.0 , P = 0.035 ) , sucrose ( 52.6 ± 5.5 vs. 70 ± 7.4 , P = 0.0094 ) , and fructose ( 11.0 ± 3.8 vs. 18.4 ± 3.9 , P = 0.012 ) . Where the effects of time ( P < 0.05 ) and dose ( P < 0.05 ) were determined to be independent ( interaction nonsignificant ) for all three sugars , this increase in volume also significantly increased glycemic concentrations at 15 min , for glucose ( P = 0.033 ) and sucrose ( P = 0.026 ) , suggesting that changes in gastric emptying time may be a mechanism of action . CONCLUSIONS Varying the volume of liquid sugar meals alters PGR.Underst and ing this concept may help to reduce variability both in the glycemic testing of foods and oral glucose tolerance testing Objective : To describe  dietary carbohydrate intakes  and their food sources among 27 centres in 10 countries participating in the European Prospect i ve Investigation into Cancer and Nutrition ( EPIC ) study . Methods : Between 1995 and 2000 , 36 034 subjects , aged between 35–74 years , were administered a st and ardized , 24-h dietary recall using a computerized interview software programme ( EPIC-SOFT ) . Intakes ( g/day ) of total carbohydrate , sugars , starch and fibre were estimated using the st and ardized EPIC Nutrient Data base ( ENDB ) . Mean intakes were adjusted for age , total energy intake , height and weight , and were weighted by season and day of recall . Results : Adjusted mean total carbohydrate intakes were highest in Italy and in the UK health-conscious cohort , and were lowest in Spain , Greece and France . Total fibre intakes were highest in the UK health-conscious cohort and lowest in Sweden and the UK general population . Bread contributed the highest proportion of carbohydrates ( mainly starches ) in every centre . Fruit consumption contributed a greater proportion of total carbohydrates ( mainly sugars ) among women than among men , and in southern centres compared with northern centres . Bread , fruits and vegetables represented the largest sources of fibre , but food sources varied considerably between centres . In stratified analyses , carbohydrate intakes tended to be higher among subjects who were physically active , never-smokers or non-drinkers of alcohol . Conclusions :  Dietary carbohydrate intakes  and in particular their food sources varied considerably between these 10 European countries . Intakes also varied according to gender and lifestyle factors . These data will form the basis for future aetiological analyses of the role of dietary carbohydrates in influencing health and disease Objective : To determine and compare the glycaemic index ( GI ) values of a range of  Vietnamese foods in two racial groups . Design and subjects : Twelve healthy subjects ( six Asian and six Caucasian ) consumed 50 g carbohydrate portions of a reference food ( glucose sugar ) and nine Vietnamese foods ( three rices , three noodle products and three sweet foods ) in r and om order after an overnight fast . The reference food was tested on two separate occasions , and the Vietnamese foods were each tested once . Capillary blood sample s were taken at time 0 ( fasting ) , 15 , 30 , 45 , 60 , 90 and 120 min from the start of each meal . Sample s were analysed for plasma glucose and the incremental areas under the plasma glucose curves ( AUC ) were used to calculate the GI values of the test foods , using glucose as the reference food ( ie GI value of glucose=100 ) . The mean GI value of each food was calculated for the entire group of subjects ( n=12 ) and for both racial groups ( n=6 ) . Results : The three rices had surprisingly high GI values ( 86–109 ) , whereas the noodle products had relatively low GI values ( 39–61 ) . The sugar-rich foods produced intermediate GI values ( 54–79 ) . The GI values for the nine foods calculated separately for the two racial groups were not significantly different from each other ( P=0.26 ) . Conclusions : The GI values derived from Caucasian subjects are likely to be applicable to Asian population s. Varieties of imported rice from Thail and were found to have high GI values . Alternative low-GI staples , such as rice noodles , may be preferable for Asian/Vietnamese people with diabetes . Sponsorship : This study was funded by the University of Sydney . European Journal of Clinical Nutrition ( 2001 ) 55 , OBJECTIVE Although weight management is an important component in the treatment of type 2 diabetes , there has been concern about the use of liquid meal replacements ( MRs ) in treating obese patients with type 2 diabetes because of the sugar content of the MRs . The goal of this study was to evaluate the safety and feasibility of using MRs for weight loss in obese patients with type 2 diabetes . RESEARCH METHODS AND PROCEDURES Seventy-five subjects with type 2 diabetes , treated only with oral agents , were recruited for this 12-week clinical study . Subjects were r and omized into three groups using either a MR containing lactose , fructose , and sucrose , a MR in which fructose and sucrose were replaced with oligosaccharides ( sugar-free Slim-Fast ) , or an exchange diet plan ( EDP ) using the proportion of macronutrients recommended by the American Diabetes Association . RESULTS Fifty-seven patients ( 41 MR and 16 EDP ) finished the study . None developed serious adverse effects , including major hypoglycemic reactions . Weight losses in the MR 1 and MR 2 groups were comparable ( 6.4 % and 6.7 % , respectively ) and greater than the weight loss in the EDP group ( 4.9 % ) . Fasting glucose level was significantly reduced in the MR group compared with the EDP group ( p = 0.012 ) . There was a significant reduction in the MR group in total cholesterol and low-density lipoprotein cholesterol that was not seen in the EDP group . DISCUSSION We have shown that liquid MRs are a safe and effective weight loss tool for obese subjects with type 2 diabetes , and can result in improvements in body weight , glucose , insulin , hemoglobin A1c and lipid levels OBJECTIVE To test the efficacy of nutritional guidelines for school lunch cooks aim ing to reduce added sugar in school meals and their own sugar intake . METHODS A controlled r and omized cluster trial was carried out in twenty public schools in the municipality of Niteroi in Rio de Janeiro , Southeastern Brazil , from March to December 2007 . A nutrition educational program was implemented in the schools in question through messages , activities and printed educational material s encouraging reduced levels of added sugar in school meals and in the school lunch cooks ' own intake . The reduced availability of added sugar in schools was evaluated using spreadsheets including data on the monthly use of food item supplies . The cooks ' individual food intake was evaluated by a Food Frequency Question naire . Anthropometric measurements were taken according to st and ardized techniques and variation in weight was measured throughout the duration of the study . RESULTS There was a more marked reduction in the intervention schools compared to the control schools ( -6.0 kg versus 0.34 kg ) , but no statistically significant difference ( p = 0.21 ) , although the study power was low . Both groups of school lunch cooks showed a reduction in the consumption of sweets and sweetened beverages , but the difference in sugar intake was not statistically significant . Weight loss and a reduction in total energy consumption occurred in both groups , but the difference between them was not statistically significant , and there was no alteration in the percentages of adequacy of macronutrients in relation to energy consumption . CONCLUSIONS The strategy of reducing the use and consumption of sugar by school lunch cooks from public schools could not be proved to be effective BACKGROUND Previous short-term studies ( < or = 6 h ) showed differences in energy expenditure ( EE ) and macronutrient oxidation in response to overfeeding with different types of dietary carbohydrate . This finding could have implication s for obesity . OBJECTIVE We used 96-h continuous whole-body calorimetry in 8 lean and 5 obese women to assess metabolic disposal ( energy dissipation and glycogen or fat storage ) of a controlled excess of dietary energy supplied as different carbohydrate sources or as fat . DESIGN Five dietary treatments were applied in r and om order : energy balance ( control ) and overfeeding by 50 % of energy requirements with fat ( O(fat ) ) or predominantly with glucose , fructose , or sucrose ( O(cho ) ) .  Macronutrient oxidation rates were assessed from nonprotein gaseous exchanges . Net macronutrient balances were calculated as cumulative differences between intake and oxidation . RESULTS Increased EE in response to overfeeding dissipated 7.9 % of the energy excess with a variation in EE of < 1.7 % across overfeeding treatments ( NS ) . EE during the O(fat ) treatment significantly exceeded that during the control treatment in the lean but not in the obese women . There were no significant differences between lean and obese women in macronutrient oxidation or balances , so data were pooled . O(cho ) induced glycogen storage on day 1 ( approximately 100 g ) but thereafter progressively stimulated carbohydrate oxidation so that balance was reached on days 3 and 4 . Fat oxidation was proportionately suppressed . Of the excess carbohydrate , 74 % was oxidized ; there were no significant differences between the various O(cho ) treatments . O(fat ) stimulated fat oxidation by 18 % and suppressed carbohydrate oxidation . On average , 12 % of the excess energy was stored as glycogen and 88 % as fat ; there was no significant difference between overfeeding treatments . CONCLUSION There was no significant difference in fat balance during controlled overfeeding with fat , fructose , glucose , or sucrose BACKGROUND Consumption of sugar-sweetened beverages ( SSBs ) is associated with an increased risk of hypertension  in cross-sectional studies . However , prospect i ve data are limited . OBJECTIVE To examine the associations between SSBs and artificially sweetened beverages ( ASBs ) with incident hypertension . DESIGN AND SETTING Prospect i ve analysis using Cox proportional hazards regression to examine the association between SSBs and ASBs with incident hypertension in three large , prospect i ve cohorts , the Nurses ' Health Studies I ( n = 88,540 women ) and II ( n = 97,991 women ) and the Health Professionals ' Follow-Up Study ( n = 37,360 men ) . MEASUREMENTS Adjusted hazard ratios for incident clinical ly diagnosed hypertension . RESULTS Higher SSB  and ASB intake was associated with an increased risk of developing hypertension in all three cohorts . In a pooled analysis , participants who consumed at least one SSB daily had an adjusted HR for incident hypertension of 1.13 ( 95 % CI , 1.09–1.17 ) compared with those who did not consume SSBs ; for persons who drank at least one ASB daily , the adjusted HR was 1.14 ( 95 % CI , 1.09–1.18 ) . The association between sweetened beverage intake and hypertension was stronger for carbonated beverages versus non-carbonated beverages , and for cola-containing versus non-cola beverages in the NHS I and NHS II cohorts only . Higher fructose intake from SSBs as a percentage of daily calories was associated with increased hypertension risk in NHS I and NHS II ( p-trend = 0.001 in both groups ) , while higher fructose intake from sources other than SSBs was associated with a decrease in hypertension risk in NHS II participants ( p-trend = 0.006 ) . LIMITATIONS Residual confounding factors may interfere with the interpretation of results . CONCLUSIONS SSBs and ASBs are independently associated with an increased risk of incident hypertension after controlling for multiple potential confounders . These associations may be mediated by factors common to both SSBs and ASBs ( e.g. , carbonation or cola ) , but are unlikely to be due to fructose Fructose consumption has markedly increased over the past decades . This intake may increase the urinary excretion of calcium , oxalate , uric acid , and other factors associated with kidney stone risk . We prospect ively examined the relationship between fructose intake and incident kidney stones in the Nurses ' Health Study I ( NHS I ) ( 93,730 older women ) , the Nurses ' Health Study II ( NHS II ) ( 101,824 younger women ) , and the Health Professionals Follow-up Study ( 45,984 men ) . Food frequency question naires were used to assess free fructose and sucrose intake every 4 years . Total-fructose intake was calculated as free fructose plus half the intake of sucrose , and expressed as percentage of total energy . Cox proportional hazard regressions were adjusted for age , body mass index ( BMI ) , thiazide use , caloric intake , and other dietary factors . We documented 4902 incident kidney stones  during a combined 48 years of follow-up . The multivariate relative risks of kidney stones significantly increased for participants in the highest compared to the lowest quintile of total-fructose intake for all three study groups . Free-fructose intake was also associated with increased risk . Non-fructose carbohydrates were not associated with increased risk in any cohort . Our study suggests that fructose intake is independently associated with an increased risk of incident kidney stones Background : It is hypothesized that a solid form of food or food components suppresses subjective appetite and short-term food intake ( FI ) more than a liquid form . Objective : To compare the effect of eating solid vs drinking liquid forms of gelatin , sucrose and its component mixtures , and whey protein , on  subjective appetite and FI in young men . Design and subjects : A r and omized crossover design was used in three experiments in which the subjects were healthy males of normal weight .  Solid and liquid forms of gelatin ( 6 g ) ( experiment 1 , n=14 ) , sucrose ( 75 g ) and a mixture of 50 % glucose/50 % fructose ( G50:F50 ) ( experiment 2 , n=15 ) , and acid and sweet whey protein ( 50 g ) ( experiment 3 , n=14 ) were compared . The controls were water ( experiments 1 and 3 ) and calorie-free sweetened water with gelatin ( sweet gelatin , experiment 1 ) or calorie-free sweetened water ( sweet control , experiment 2 ) . Subjective average appetite was measured by visual analog scales over 1 h and ad libitum FI was measured 1 h after treatment consumption . Results : Average appetite area under the curve was not different between solid and liquid forms of sugars , but was larger , indicating greater satiety for solid compared with liquid forms of gelatin and sweet , but not acid whey protein . The FI was not different from that of control because of solid or liquid sugars or gelatin treatments . However , both solid and liquid forms of whey protein , with no difference among them , suppressed FI compared with control ( P<0.05 ) . Conclusion : Macronutrient composition is more important than physical state of foods in determining subjective appetite and FI BACKGROUND A high fructose intake can lead to postpr and ial hypertriacylglycerolemia . The underlying mechanism is unclear . OBJECTIVE The objective of the study was to investigate the mechanisms involved in fructose-induced hypertriacylglycerolemia and the contribution of de novo lipogenesis in an acute setting . DESIGN In a r and omized , crossover study , 14 subjects were given a fructose or glucose test meal after an overnight fast . [(2)H2]Palmitate and [U(13)C]d-fructose or [U(13)C]d-glucose were added to trace the h and ling of dietary fats and the fate of dietary sugars in the body . Blood sample s were taken before and after the meal . Respiratory exchange ratio was measured by using indirect calorimetry , and breath sample s were collected . RESULTS Plasma triacylglycerol and VLDL-triacylglycerol concentrations were significantly higher ( P = 0.001 for both ) , whereas the concentrations of insulin and [(2)H2]palmitate in nonesterified fatty acids were significantly lower after fructose than after glucose ( P = 0.002 and 0.03 , respectively ) . The respiratory exchange ratio was higher after fructose ( P = 0.04 ) ; significantly ( P = 0.003 ) more carbon from sugars was recovered in breath carbon dioxide over 6 h after fructose ( 30.5 % ) than after glucose ( 24.5 % ) . At 240 min , newly synthesized fatty acids from fructose made up approximately 0.4 % of circulating VLDL-triacylglycerol , whereas newly synthesized triacylglycerol-glycerol made up 38 % . Newly synthesized fatty acids and triacylglycerol-glycerol from glucose contributed almost none of VLDL-triacylglycerol ( P = 0.002 and 0.007 for glucose and fructose , respectively ) . CONCLUSIONS The lower insulin excursion after fructose may result in less activation of adipose tissue lipoprotein lipase , which led to impaired triacylglycerol clearance . The contribution of de novo lipogenesis to fructose-induced hypertriacylglycerolemia is small , but its effect on altering the partitioning of fatty acids toward esterification may be considerable BACKGROUND The diet may influence the development of abdominal obesity , but the few studies that have prospect ively examined the relations between diet and changes in waist circumference ( WC ) have given inconsistent results . OBJECTIVE Associations between total energy intake , energy intake from macronutrients , and energy intake from macronutrient subgroups based on different food sources and 5-y differences in WC ( DWC ) were investigated . DESIGN A Danish cohort of 22 570 women and 20 126 men aged 50 - 64 y with baseline data on WC , diet , BMI , and potential confounders reported their WC 5 y later . Associations of baseline diet with DWC were assessed by multiple linear regression analysis . RESULTS Neither total energy intake nor energy intake from each of the macronutrients was associated with DWC , except for an inverse association with protein , especially animal protein . In women , positive associations with DWC were seen for carbohydrate from refined grains and potatoes and from foods with simple sugars , whereas carbohydrate from fruit and vegetables was inversely associated and significantly different from any other carbohydrate subgroup . The results for men resembled those for women , although none were significant . Vegetable fat was positively associated with DWC for both men and women in a combined analysis . A U-shaped association between alcohol from wine and DWC was present for both sexes , and alcohol from spirits was positively associated with DWC in women . CONCLUSIONS Although no significant associations with total energy or energy from fat , carbohydrate , or alcohol were observed , protein intake was inversely related to DWC , and some macronutrient subgroups were significantly associated with DWC STUDY OBJECTIVE To investigate the prevalence and nature of low energy reporting in a dietary survey of British adults over 65 years of age . DESIGN R and omly selected cross sectional sample of 2060 British adults over 65 years . Four day weighed food diaries and question naires on health , lifestyle and socioeconomic characteristics . SETTING Great Britain . PARTICIPANTS 539 women and 558 men over 65 years who were free living and completed four day food diaries .  MAIN RESULTS A high proportion of men and women were classified as low energy reporters ( LERs ) . Reported consumption of full fat dairy products , sugar and sweet foods , and alcoholic drinks differed most between LERs and non-LERs . Among LERs , reported protein and starch intakes were higher , fat , sugar and alcohol intakes were lower . LERs of either sex were more likely to be obese , male LERs were also more likely to belong to the manual social classes . CONCLUSIONS The high level of low energy reporting probably result ed from a coalescence of factors such as the weighed diary methodology and a reluctance to report consumption of unhealthy foods . The use of validatory biomarkers such as doubly labelled water needs to be more widespread Background Discretionary food and beverages ( products high in saturated fat , added sugars , and salt ) are detrimental to a healthy diet . Nevertheless , they provide 42 % of total energy and account for 53 % of food and beverage expenditure for remote living Aboriginal and Torres Strait Isl and er Australians , contributing to the excessive burden of chronic diseases experienced by this population group . Objective The aim of this study is to test an intervention to reduce sales of discretionary products , in collaboration with the Arnhem L and Progress Aboriginal Corporation ( ALPA ) , which operates 25 stores in very remote Australia , by reducing their merch and ising and substituting with core products in remote Australian communities . Methods We will use a community-level r and omized controlled pragmatic trial design . Stores r and omized to the intervention group will be supported by ALPA to reduce merch and ising of 4 food categories ( sugar , sugar-sweetened beverages , sweet biscuits , and confectionery ) that together provide 64 % of energy from discretionary foods and 87 % of total free sugars in very remote community stores . The remaining stores ( 50 % of total ) will serve as controls and conduct business as usual . Electronic store sales data will be collected at baseline , 12-weeks intervention , and 24-weeks postintervention to objective ly assess the primary outcome of percent change in purchases of free sugars ( g/megajoule ) and secondary business- and diet-related outcomes . Critical to ensuring translation to improved store policies and healthier diets in remote Indigenous Australia , we will conduct ( 1 ) an in-depth implementation evaluation to assess fidelity , ( 2 ) a customer intercept survey to investigate the relationship between customer characteristics and discretionary food purchasing , and ( 3 ) a qualitative study to identify policy supports for scale-up of health-enabling policy action in stores . Results As of August 2018 , 20 stores consented to participate and were r and omized to receive the intervention or continue usual business . The 12-week strategy ended in December 2018 . The 24-week postintervention follow-up will occur in May 2019 . Trial results are expected for 2019 . Conclusions Novel pragmatic research approaches are needed to inform policy for healthy retail food environments . This research will greatly advance our underst and ing of how the retail food environment can be used to improve population -level diet in the remote Australian Aboriginal and Torres Strait Isl and er context and retail setting s globally . Trial Registration Australian New Zeal and Clinical Trials Registry ACTRN12618001588280 ; http://www.anzctr.org.au/Trial/ Registration /Trial Review .aspx?id=375933 ( Archived by WebCite at http://www.webcitation.org/76dbQEmwN ) International Registered Report Identifier ( IRRID ) DERR1 - Significance Fructose compared with glucose may be a weaker suppressor of appetite . Here we sought to determine the effects of fructose versus glucose on brain , hormone , and appetitive responses to food cues and food-approach behavior . We show that the ingestion of fructose compared with glucose result ed in smaller increases in plasma insulin levels and greater brain responses to food cues in the visual cortex and left orbital frontal cortex . Ingestion of fructose versus glucose also led to greater hunger and desire for food and a greater willingness to give up long-term monetary rewards to obtain immediate high-calorie foods . These findings suggest that ingestion of fructose relative to glucose activates brain regions involved in attention and reward processing and may promote feeding behavior . Prior studies suggest that fructose compared with glucose may be a weaker suppressor of appetite , and neuroimaging research shows that food cues trigger greater brain reward responses in a fasted relative to a fed state . We sought to determine the effects of ingesting fructose versus glucose on brain , hormone , and appetitive responses to food cues and food-approach behavior . Twenty-four healthy volunteers underwent two functional magnetic resonance imaging ( fMRI ) sessions with ingestion of either fructose or glucose in a double-blinded , r and om-order cross-over design . fMRI was performed while participants viewed images of high-calorie foods and nonfood items using a block design . After each block , participants rated hunger and desire for food . Participants also performed a decision task in which they chose between immediate food rewards and delayed monetary bonuses . Hormones were measured at baseline and 30 and 60 min after drink ingestion . Ingestion of fructose relative to glucose result ed in smaller increases in plasma insulin levels and greater brain reactivity to food cues in the visual cortex ( in whole-brain analysis ) and left orbital frontal cortex ( in region-of-interest analysis ) . Parallel to the neuroimaging findings , fructose versus glucose led to greater hunger and desire for food and a greater willingness to give up long-term monetary rewards to obtain immediate high-calorie foods . These findings suggest that ingestion of fructose relative to glucose results in greater activation of brain regions involved in attention and reward processing and may promote feeding behavior OBJECTIVE Fructose has been implicated in obesity , partly due to lack of insulin-mediated leptin stimulation and ghrelin suppression . Most work has examined effects of pure fructose , rather than high-fructose corn syrup ( HFCS ) , the most commonly consumed form of fructose . This study examined effects of beverages sweetened with HFCS or sucrose ( Suc ) , when consumed with mixed meals , on blood glucose , insulin , leptin , ghrelin , and appetite . METHODS Thirty lean women were studied on two r and omized 2-d visits during which HFCS- and Suc-sweetened beverages were consumed as 30 % of energy on isocaloric diets during day 1 while blood was sample d. On day 2 , food was eaten ad libitum . Subjects rated appetite at design ated times throughout visits . RESULTS No significant differences between the two sweeteners were seen in fasting plasma glucose , insulin , leptin , and ghrelin ( P > 0.05 ) . The within-day variation in all four items was not different between the two visits ( P > 0.05 ) . Net areas under the curve were similar for glucose , insulin , and leptin ( P > 0.05 ) . There were no differences in energy or macronutrient intake on day 2 . The only appetite variable that differed between sweeteners was desire to eat , which had a higher area under the curve the day after Suc compared with HFCS . CONCLUSION These short-term results suggest that , when fructose is consumed in the form of HFCS , the measured metabolic responses do not differ from Suc in lean women . Further research is required to examine appetite responses and to determine if these findings hold true for obese individuals , males , or longer periods
There was interaction by food source , with specific food sources showing beneficial effects ( fruit and fruit juice ) or harmful effects ( sweetened milk and mixed sources ) in substitution studies and harmful effects ( sugars‐sweetened beverages and fruit juice ) in addition studies on at least one outcome .
Conclusions Energy control and food source appear to mediate the effect of fructose‐containing sugars on glycaemic control .
Although most food sources of these sugars ( especially fruit ) do not have a harmful effect in energy matched substitutions with other macronutrients , several food sources of fructose‐containing sugars ( especially sugars‐sweetened beverages ) adding excess energy to diets have harmful effects .
Objective To assess the effect of different food sources of fructose‐containing sugars  on glycaemic control at different levels of energy control .