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 High-fructose corn syrup and sucrose have equivalent effects on energy-regulating hormones at normal human consumption levels. Effects of high-fructose corn syrup and sucrose consumption on circulating glucose, insulin, leptin, and ghrelin and on appetite in normal-weight women. The effects of four hypocaloric diets containing different levels of sucrose or high fructose corn syrup on weight loss and related parameters Effects on uric acid, body mass index and blood pressure in adolescents of consuming beverages sweetened with high-fructose corn syrup Effect of drinking soda sweetened with aspartame or high-fructose corn syrup on food intake and body weight. 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. Effect of sugars in solutions on subjective appetite and short-term food intake in 9- to 14-year-old normal weight boys Macronutrient disposal during controlled overfeeding with glucose, fructose, sucrose, or fat in lean and obese women. A dose-response study of consuming high-fructose corn syrup-sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults. Sugars and risk of mortality in the NIH-AARP Diet and Health Study. Liquid meal replacements and glycemic control in obese type 2 diabetes patients. Acute effects of feeding fructose, glucose and sucrose on blood lipid levels and systemic inflammation Moderate Amounts of Fructose Consumption Impair Insulin Sensitivity in Healthy Young Men The fermentable fibre inulin increases postprandial serum short-chain fatty acids and reduces free-fatty acids and ghrelin in healthy subjects. Impaired cellular insulin binding and insulin sensitivity induced by high-fructose feeding in normal subjects. Effects of dietary fructose on plasma lipids in healthy subjects. Dietary glycemic load, carbohydrate, sugar, and colorectal cancer risk in men and women. 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 Consumption of sucrose-sweetened soft drinks increases plasma levels of uric acid in overweight and obese subjects: a 6-month randomised controlled trial Short-term effects of various sugars on antinatriuresis and blood pressure changes in normotensive young men. A prospective study of sugar intake and risk of type 2 diabetes in women. Effect of glucose, sucrose and fructose on plasma glucose and insulin responses in normal humans: comparison with white bread Sugars in diet and risk of cancer in the NIH‐AARP Diet and Health Study Turku sugar studies. V. Final report on the effect of sucrose, fructose and xylitol diets on the caries incidence in man. Brain functional magnetic resonance imaging response to glucose and fructose infusions in humans. Dietary fructose reduces circulating insulin and leptin, attenuates postprandial suppression of ghrelin, and increases triglycerides in women. Fructose consumption and the risk of kidney stones. Blood lipid distribution of hyperinsulinemic men consuming three levels of fructose. The Effects of Physiologic Amounts of Simple Sugars on Lipoprotein, Glucose, and Insulin Levels in Normal Subjects Dietary glycemic load and risk of colorectal cancer in the Women's Health Study. Coffee consumption attenuates short-term fructose-induced liver insulin resistance in healthy men. The effects of drinks made from simple sugars on blood pressure in healthy older people. Grape Polyphenols Prevent Fructose-Induced Oxidative Stress and Insulin Resistance in First-Degree Relatives of Type 2 Diabetic Patients Effects of supplementation with essential amino acids on intrahepatic lipid concentrations during fructose overfeeding in humans. Consumption of fructose-sweetened beverages for 10 weeks reduces net fat oxidation and energy expenditure in overweight/obese men and women Effect of Meal Dilution on the Postprandial Glycemic Response: Implications for glycemic testing Consumption of a Diet Low in Advanced Glycation End Products for 4 Weeks Improves Insulin Sensitivity in Overweight Women Effects of 4-week very-high-fructose/glucose diets on insulin sensitivity, visceral fat and intrahepatic lipids: an exploratory trial. Caries control through the use of sugar substitutes.
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 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 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 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 Objective : The dietary intake of fructose-rich sugar-sweetened beverages ( SSB ) may have a significant role in raising serum uric acid ( SUA ) levels as well as the risk of contracting gout and cardiovascular risk factors . Our objective was to investigate the impact of SSB intake on SUA , body mass index ( BMI ) and systolic blood pressure ( SBP ) among adolescents in Taiwan . Methods : We evaluated data from 2727 representative adolescents who were multistage sample d from 36 Junior High schools in Taiwan . We cross-sectionally collected demographic , physical , dietary and anthropometric variables , and prospect ively measured clinical outcomes . Data were analyzed using multiple regression and logistic models adjusted for covariates . Results : We found that 87.7 % of adolescents were SSB drinkers , with 25.1 % drinking > 500 ml per day of such beverages . Increased SSB intake was associated with increased waist and hip circumferences , body fat , BMI , SBP and SUA . As compared with non-drinkers , SSB drinkers had a 3.2–4.9 elevated risk of obesity . The prevalence of hyperuricemia in heavy SSB  users ( 40.2–49.4 % ) was appreciably greater than that for non-users ( 24.2 % ) . Adolescents who consumed > 500 ml per day of heavy high-fructose corn syrup ( HFCS ) containing beverages had a 0.42 mg dl−1 higher SUA level and a 2.0–2.1 increased risk of developing hyperuricemia than non-drinkers . The consumption of HFCS-rich beverages was also found to interact with obesity in determining higher levels of SUA ( 2.2–2.4 mg dl−1 increases ) . Conclusion : High SSB consumption has a notable effect on increased levels of BMI and SUA . The intake of HFCS-rich beverages and BMI were likely to interactively strengthen SUA levels among obese adolescents 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 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 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 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 National Health and Nutrition Examination Survey data show an increased risk of cardiovascular disease ( CVD ) mortality with an increased intake of added sugar . OBJECTIVE We determined the dose-response effects of consuming beverages sweetened with high-fructose corn syrup ( HFCS ) at zero , low , medium , and high proportions of energy requirements ( Ereq ) on circulating lipid/lipoprotein risk factors for CVD and uric acid in adults [ age : 18 - 40 y ; body mass index ( in kg/m(2 ) ) : 18 - 35 ] . DESIGN We conducted a parallel-arm , nonr and omized , double-blinded intervention study in which adults participated in 3.5 inpatient days of baseline testing at the University of California Davis Clinical and Translational Science Center 's Clinical Research Center . Participants then consumed beverages sweetened with HFCS at 0 % ( aspartame sweetened , n = 23 ) , 10 % ( n = 18 ) , 17.5 % ( n = 16 ) , or 25 % ( n = 28 ) of Ereq during 13 outpatient days and during 3.5 inpatient days of intervention testing at the research center . We conducted 24-h serial blood collection s during the baseline and intervention testing periods . RESULTS Consuming beverages containing 10 % , 17.5 % , or 25 % Ereq from HFCS produced significant linear dose-response increases of lipid/lipoprotein risk factors for CVD and uric acid : postpr and ial triglyceride ( 0 % : 0 ± 4 ; 10 % : 22 ± 8 ; 17.5 % : 25 ± 5 : 25 % : 37 ± 5 mg/dL , mean of Δ ± SE , P < 0.0001 effect of HFCS-dose ) , fasting LDL cholesterol ( 0 % : -1.0 ± 3.1 ; 10 % : 7.4 ± 3.2 ; 17.5 % : 8.2 ± 3.1 ; 25 % : 15.9 ± 3.1 mg/dL , P < 0.0001 ) , and 24-h mean uric acid concentrations ( 0 % : -0.13 ± 0.07 ; 10 % : 0.15 ± 0.06 ; 17.5 % : 0.30 ± 0.07 ; 25 % : 0.59 ± 0.09 mg/dL , P < 0.0001 ) . Compared with beverages containing 0 % HFCS , all 3 doses of HFCS-containing beverages increased concentrations of postpr and ial triglyceride , and the 2 higher doses increased fasting and /or postpr and ial concentrations of non-HDL cholesterol , LDL cholesterol , apolipoprotein B , apolipoprotein CIII , and uric acid . CONCLUSIONS Consuming beverages containing 10 % , 17.5 % , or 25 % Ereq from HFCS produced dose-dependent increases in circulating lipid/lipoprotein risk factors for CVD and uric acid within 2 wk . These results provide mechanistic support for the epidemiologic evidence that the risk of cardiovascular mortality is positively associated with consumption of increasing amounts of added sugars . This trial was registered at clinical trials.gov as NCT01103921 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 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 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 OBJECTIVE Adverse effects of hypercaloric , high-fructose diets on insulin sensitivity and lipids in human subjects have been shown repeatedly . The implication s of fructose in amounts close to usual daily consumption , however , have not been well studied . This study assessed the effect of moderate amounts of fructose and sucrose compared with glucose on glucose and lipid metabolism . RESEARCH DESIGN AND METHODS Nine healthy , normal-weight male volunteers ( aged 21–25 years ) were studied in this double-blind , r and omized , cross-over trial . All subjects consumed four different sweetened beverages ( 600 mL/day ) for 3 weeks each : medium fructose ( MF ) at 40 g/day , and high fructose ( HF ) , high glucose ( HG ) , and high sucrose ( HS ) each at 80 g/day . Euglycemic-hyperinsulinemic clamps with [6,6]-2H2 glucose labeling were used to measure endogenous glucose production . Lipid profile , glucose , and insulin were measured in fasting sample s. RESULTS Hepatic suppression of glucose production during the clamp was significantly lower after HF ( 59.4 ± 11.0 % ) than HG ( 70.3 ± 10.5 % , P < 0.05 ) , whereas fasting glucose , insulin , and C-peptide did not differ between the interventions . Compared with HG , LDL cholesterol and total cholesterol were significantly higher after MF , HF , and HS , and free fatty acids were significantly increased after MF , but not after the two other interventions ( P < 0.05 ) . Subjects ’ energy intake during the interventions did not differ significantly from baseline intake . CONCLUSIONS This study clearly shows that moderate amounts of fructose and sucrose significantly alter hepatic insulin sensitivity and lipid metabolism compared with similar amounts of glucose It is thought that diets high in dietary fibre are associated with reduced risk for type 2 diabetes  , at least in part because the short-chain fatty acids ( SCFAs ) produced during the colonic fermentation of fibre beneficially influence circulating concentrations of free-fatty acids ( FFAs ) and gut hormones involved in the regulation of blood glucose and body mass . However , there is a paucity of data showing this sequence of events in humans . Thus , our objective was to determine the effect of the fermentable fibre inulin on postpr and ial glucose , insulin , SCFA , FFA , and gut hormone responses in healthy subjects . Overnight fasted healthy subjects ( n = 12 ) were studied for 6 h after consuming 400 mL drinks , containing 80 g high-fructose corn syrup ( 80HFCS ) , 56 g HFCS ( 56HFCS ) , or 56 g HFCS plus 24 g inulin ( Inulin ) , using a r and omized , single-blind , crossover design . A st and ard lunch was served 4 h after the test drink . Glucose and insulin responses after Inulin did not differ significantly from those after 80HFCS or 56HFCS . Serum acetate , propionate , and butyrate were significantly higher after Inulin than after HFCS drinks from 4 - 6 h. FFAs fell at a similar rate after all 3 test drinks , but were lower after Inulin than after 56HFCS at 4 h ( 0.40 + /- 0.06 vs. 0.51 + /- 0.06 mmol*L-1 ; p < 0.05 ) . Compared with 56HFCS , Inulin significantly increased plasma glucagon-like peptide-1 concentrations at 30 min , and reduced ghrelin at 4.5 h and 6 h. The results are consistent with the hypothesis that dietary fibre increases the production of colonic SCFAs , which may reduce type 2 diabetes risk by reducing postpr and ial FFAs and favorably affecting gut hormones , which regulate food intake We have studied whether the sucrose-induced reduction of insulin sensitivity and cellular insulin binding in normal man is related to the fructose or the glucose moiety . Seven young healthy subjects were fed their usual diets plus 1000 kcal extra glucose per day and eight young healthy subjects were fed their usual diets with addition of 1000 kcal extra fructose per day . The dietary regimens continued for 1 week . Before change of diet there were no statistically significant differences between body weight and fasting plasma concentrations of glucose , insulin , and ketone bodies in the two groups studied . High-glucose feeding caused no significant changes in insulin binding or insulin sensitivity whereas high-fructose feeding was accompanied by a significant reduction both of insulin binding ( P less than 0.05 ) and insulin sensitivity ( P less than 0.05 ) . The changes in insulin binding and insulin sensitivity correlated linearly ( r = 0.52 , P less than 0.01 ) . We conclude that fructose seems to be responsible for the impaired insulin binding and insulin sensitivity induced by sucrose 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 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 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 Background / Objectives : Sucrose-sweetened soft drinks ( SSSDs ) are associated with the development of metabolic disorders . Fructose is a major component of SSSDs and is demonstrated to induce uric acid ( UA ) production and stimulate fat accumulation independent of excess caloric intake . UA induce insulin resistance and low- grade inflammation , suggesting that UA may have a causal role in the development of metabolic complications . The objective of this study is to investigate the long-term effects of consuming SSSDs on circulating levels of UA in overweight and obese subjects . Subjects/ Methods : Using a previously published study , circulating UA levels were assessed at baseline and after 6 months using chromogenic enzymatic absorptiometry . The study included 47 overweight and obese subjects without diabetes , r and omised to consume 1 l daily of either SSSD ( regular cola ) , isocaloric semi-skimmed milk , diet cola or water for 6 months . Results : Circulating UA levels increased ~15 % ( P=0.02 ) after the 6-month intervention in the SSSD group with no change in the other groups . In the SSSD  group , circulating UA levels increased significantly after the intervention in both absolute ( P=0.005 ) and relative values ( P=0.004 ) . The change in UA after the intervention correlated with changes in liver fat ( P=0.005 ) , triglycerides ( P=0.02 ) and insulin ( P=0.002 ) . Conclusions : In this secondary analysis daily intake of 1 l SSSD for 6 months was found to increase circulating UA levels compared with isocaloric milk , diet cola and water . Thus , a high daily intake of SSSDs in overweight and obese subjects without overt diabetes may increase the risk of developing metabolic complications through the elevation of UA . This trial is registered at Clinical Trials.gov as NCT00777647 This is a report of the effects of sugars on salt metabolism and on blood pressure .  Twenty young men , none of whom had a personal or family history of hypertension , were orally hydrated after an overnight fast and required to lie recumbent for 6 h except for urinary voiding and blood pressure measurements which were performed at 1/2 h intervals . Venous blood sample s were drawn at hourly intervals . The volunteers were kept constantly hydrated by giving them water to drink equivalent to the volumes of urine voided . Two hours from the start of the experiment each subject was given one of the following sugars : glucose , fructose , sucrose , galactose , lactose , or water alone . After oral hydration the subjects appeared to develop natriuresis and kaliuresis . This was quickly abolished by ingestion of either glucose , fructose , sucrose , or lactose , but not by galactose or water alone . Fructose was the most potent antinatriuretic agent . Both glucose and sucrose significantly elevated systolic blood pressure . This lasted for 2 h after glucose ingestion and 1 h after sucrose ingestion 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 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 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 The purpose was to study differences in the  caries increment rate  as influenced by various sugars . The trial involved almost complete substitution of sucrose ( S ) by fructose ( F ) or xylitol ( X ) during a period of 2 years . There were no significant initial differences as to caries status between the prospect i ve sugar groups ; 35 subjects in the S-group , 38 in the F-group , and 52 in the X-group . During the entire study 10 subjects discontinued or were excluded . The clinical and radiographical observer error was reported and discussed . After 2 years the mean increment of decayed , missed and filled tooth surfaces was 7.2 in the S-group , 3.8 in the F-group , and 0.0 in the X-group . The weakness of the DMFS-index in not showing the development of new secondary caries and the increase in size of the lesions was overcome by expressing the caries activity in terms of indices showing the total quantitative and qualitative development . The results showed a massive reduction of the caries increment in relation to xylitol consumption . Fructose was found to be less cariogenic than sucrose . It was suggested that the non- and anticariogenic properties of xylitol principally depend on its lack of suitability for microbial metabolism and physico-chemical effects in plaque and saliva 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 Previous studies indicate that leptin secretion is regulated by insulin-mediated glucose metabolism . Because fructose , unlike glucose , does not stimulate insulin secretion , we hypothesized that meals high in fructose would result in lower leptin concentrations than meals containing the same amount of glucose . Blood sample s were collected every 30 - 60 min for 24 h from 12 normal-weight women on 2 r and omized days during which the subjects consumed three meals containing 55 , 30 , and 15 % of total kilocalories as carbohydrate , fat , and protein , respectively , with 30 % of kilocalories as either a fructose-sweetened [ high fructose ( HFr ) ] or glucose-sweetened [ high glucose ( HGl ) ] beverage . Meals were isocaloric in the two treatments . Postpr and ial glycemic excursions were reduced by 66 + /- 12 % , and insulin responses were 65 + /- 5 % lower ( both P < 0.001 ) during HFr consumption . The area under the curve for leptin during the first 12 h ( -33 + /- 7 % ; P < 0.005 ) , the entire 24 h ( -21 + /- 8 % ; P < 0.02 ) , and the diurnal amplitude ( peak - nadir ) ( 24 + /- 6 % ; P < 0.0025 ) were reduced on the HFr day compared with the HGl day . In addition , circulating levels of the orexigenic gastroenteric hormone , ghrelin , were suppressed by approximately 30 % 1 - 2 h after ingestion of each HGl meal ( P < 0.01 ) , but postpr and ial suppression of ghrelin was significantly less pronounced after HFr meals ( P < 0.05 vs. HGl ) . Consumption of HFr meals produced a rapid and prolonged elevation of plasma triglycerides compared with the HGl day ( P < 0.005 ) . Because insulin and leptin , and possibly ghrelin , function as key signals to the central nervous system in the long-term regulation of energy balance , decreases of circulating insulin and leptin and increased ghrelin concentrations , as demonstrated in this study , could lead to increased caloric intake and ultimately contribute to weight gain and obesity during chronic consumption of diets high in 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 Twelve carbohydrate-sensitive men selected due to their abnormally high insulin responses to a sucrose load and 12 men with normal insulin responses were fed diets containing 0 , 7.5 , and 15 % fructose for 5 wk each in a cross-over design . The diets contained 43 % total carbohydrate , 42 % fat , and 15 % protein . Initial fasting total cholesterol and low-density lipoprotein cholesterol were higher in the hyperinsulinemic men than in the controls . Diastolic blood pressure was not affected by diet , but systolic blood pressure was slightly higher after the men consumed the 0 % fructose diet . Free fatty acids were not different . Total plasma cholesterol and low-density lipoprotein cholesterol were higher after the men consumed 7.5 and 15 % fructose than when they consumed the 0 % fructose diet . Plasma triglyceride increased significantly as fructose in the diets of the hyperinsulinemics increased , but was not affected in the controls . These changes in blood lipids are associated with heart disease 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 Although diet is believed to influence colorectal cancer risk , the long-term effects of a diet with a high glycemic load are unclear . The growing recognition that colorectal cancer may be promoted by hyperinsulinemia and insulin resistance suggests that a diet inducing high blood glucose levels and an elevated insulin response may contribute to a metabolic environment conducive to tumor growth . We prospect ively followed a cohort of 38 451 women for an average of 7.9 years and identified 174 with incident colorectal cancer . We used baseline dietary intake measurements  , assessed with a semiquantitative food-frequency question naire , to examine the associations of  dietary glycemic load , overall dietary glycemic index , carbohydrate , fiber , nonfiber carbohydrate , sucrose , and fructose with the subsequent development of colorectal cancer . Cox proportional hazards models were used to estimate relative risks ( RRs ) . Dietary glycemic load was statistically significantly associated with an increased risk of colorectal cancer ( adjusted RR = 2.85 , 95 % confidence interval [ CI ] = 1.40 to 5.80 , comparing extreme quintiles of dietary glycemic load ; P(trend ) = .004 ) and was associated , although not statistically significantly , with overall glycemic index ( corresponding RR = 1.71 , 95 % CI = 0.98 to 2.98 ; P(trend ) = .04 ) . Total carbohydrate ( adjusted RR = 2.41 , 95 % CI = 1.10 to 5.27 , comparing extreme quintiles of carbohydrate ; P(trend ) = .02 ) , nonfiber carbohydrate ( corresponding RR = 2.60 , 95 % CI = 1.22 to 5.54 ; P(trend ) = .02 ) , and fructose ( corresponding RR = 2.09 , 95 % CI = 1.13 to 3.87 ; P(trend ) = .08 ) were also statistically significantly associated with increased risk . Thus , our data indicate that a diet with a high dietary glycemic load may increase the risk of colorectal cancer in women BACKGROUND Epidemiologic and experimental data have suggested that chlorogenic acid , which is a polyphenol contained in green coffee beans , prevents diet-induced hepatic steatosis and insulin resistance . OBJECTIVE We assessed whether the consumption of chlorogenic acid-rich coffee attenuates the effects of short-term fructose overfeeding , dietary conditions known to increase intrahepatocellular lipids ( IHCLs ) , and blood triglyceride concentrations and to decrease hepatic insulin sensitivity in healthy humans . DESIGN Effects of 3 different coffees were assessed in 10 healthy volunteers in a r and omized , controlled , crossover trial . IHCLs , hepatic glucose production ( HGP ) ( by 6,6-d2 glucose dilution ) , and fasting lipid oxidation were measured after 14 d of consumption of caffeinated coffee high in chlorogenic acid ( C-HCA ) , decaffeinated coffee high in chlorogenic acid , or decaffeinated coffee with regular amounts of chlorogenic acid ( D-RCA ) ; during the last 6 d of the study , the weight-maintenance diet of subjects was supplemented with 4 g fructose · kg(-1 ) · d(-1 ) ( total energy intake ± SD : 143 ± 1 % of weight-maintenance requirements ) . All participants were also studied without coffee supplementation , either with 4 g fructose · kg(-1 ) · d(-1 ) ( high fructose only ) or without high fructose ( control ) . RESULTS Compared with the control diet , the high-fructose diet significantly increased IHCLs by 102 ± 36 % and HGP by 16 ± 3 % and decreased fasting lipid oxidation by 100 ± 29 % ( all P < 0.05 ) . All 3 coffees significantly decreased HGP . Fasting lipid oxidation increased with C-HCA and D-RCA ( P < 0.05 ) . None of the 3 coffees significantly altered IHCLs . CONCLUSIONS Coffee consumption attenuates hepatic insulin resistance but not the increase of IHCLs induced by fructose overfeeding . This effect does not appear to be mediated by differences in the caffeine or chlorogenic acid content . This trial was registered at clinical trials.gov as NCT00827450 The objective of the research was to determine the blood pressure ( BP ) lowering effects in older people of 50 g carbohydrate drinks with varying carbohydrate content using a r and omised , cross-over study with ten ( six females ) healthy older subjects ( mean age 72.20 ( sem 1.50 ) years ) .  BP , heart rate and glucometer-derived blood glucose levels were determined at baseline and following the ingestion of equal volumes ( 300 ml ) of water and carbohydrate drinks with varying nutrient content ( glucose , sucrose and fructose ) . A significant decline in BP over the first 60 min was seen following  glucose ( systolic BP ( SBP ) P<0.01 , diastolic BP ( DBP ) P<0.01 , mean arterial BP ( MAP ) P=0.03 ) and sucrose ( SBP P<0.01 , DBP P<0.01 , MAP P<0.01 ) ingestion , although the decrease occurred earlier after glucose than sucrose ingestion ( SBP 7.33 ( sem 2.19 ) v. 21.00 ( sem 4.30 ) min ( P=0.03 ) and MAP 11.22 ( sem 3.10 ) v. 17.00 ( sem 3.78 ) min ( P=0.03 ) ) . BP increased after water ingestion ( SBP P=0.04 , DBP P=0.18 , MAP P=0.02 ) but did not change after fructose ingestion ( SBP P=0.36 , DBP P=0.81 , MAP P=0.34 ) . Post hoc analyses revealed that the BP ( SBP , DBP and MAP ) decrease following glucose and sucrose ingestion were similar but significantly greater than following fructose or water ingestion . Sucrose , which is used widely ( table sugar ) , reduces BP as much as glucose . In contrast to this , fructose ingestion causes no change in BP . Further studies are required to determine if the substitution of glucose or sucrose with fructose may be beneficial in the medical management of older people with severe symptomatic postpr and ial hypotension OBJECTIVE To assess the clinical efficacy of nutritional amounts of grape polyphenols ( PPs ) in counteracting the metabolic alterations of high-fructose diet , including oxidative stress and insulin resistance ( IR ) , in healthy volunteers with high metabolic risk . RESEARCH DESIGN AND METHODS Thirty-eight healthy overweight/obese first-degree relatives of type 2 diabetic patients ( 18 men and 20 women ) were r and omized in a double-blind controlled trial between a grape PP ( 2 g/day ) and a placebo ( PCB ) group . Subjects were investigated at baseline and after 8 and 9 weeks of supplementation , the last 6 days of which they all received 3 g/kg fat-free mass/day of fructose . The primary end point was the protective effect of  grape PPs  on fructose-induced IR . RESULTS In the PCB group , fructose induced 1 ) a 20 % decrease in hepatic insulin sensitivity index ( P < 0.05 ) and an 11 % decrease in glucose infusion rate ( P < 0.05 ) as evaluated during a two-step hyperinsulinemic-euglycemic clamp , 2 ) an increase in systemic ( urinary F2-isoprostanes ) and muscle ( thiobarbituric acid – reactive substances and protein carbonylation ) oxidative stress ( P < 0.05 ) , and 3 ) a downregulation of mitochondrial genes and decreased mitochondrial respiration ( P < 0.05 ) . All the deleterious effects of fructose were fully blunted by grape PP supplementation . Antioxidative defenses , inflammatory markers , and main adipokines were affected neither by fructose nor by grape PPs . CONCLUSIONS A natural mixture of grape PPs at nutritional doses efficiently prevents fructose-induced oxidative stress and IR . The current interest in grape PP ingredients and products by the global food and nutrition industries could well make them a stepping-stone of preventive nutrition BACKGROUND A high dietary protein intake has been shown to blunt the deposition of intrahepatic lipids in high-fat- and high-carbohydrate-fed rodents and humans . OBJECTIVE The aim of this study was to evaluate the effect of essential amino acid supplementation on the increase in hepatic fat content induced by a high-fructose diet in healthy subjects . DESIGN Nine healthy male volunteers were studied on 3 occasions in a r and omized , crossover design after 6 d of dietary intervention . Dietary conditions consisted of a weight-maintenance balanced diet ( control ) or the same balanced diet supplemented with 3 g fructose · kg(-1 ) · d(-1 ) and 6.77 g of a mixture of 5 essential amino acids 3 times/d ( leucine , isoleucine , valine , lysine , and threonine ) ( HFrAA ) or with 3 g fructose · kg(-1 ) · d(-1 ) and a maltodextrin placebo 3 times/d ( HFr ) ; there was a washout period of 4 to 10 wk between each condition . For each condition , the intrahepatocellular lipid ( IHCL ) concentration , VLDL-triglyceride concentration , and VLDL-[(13)C]palmitate production were measured after oral loading with [(13)C]fructose . RESULTS HFr increased the IHCL content ( 1.27 ± 0.31 compared with 2.74 ± 0.55 vol % ; P < 0.05 ) and VLDL-triglyceride ( 0.55 ± 0.06 compared with 1.40 ± 0.15 mmol/L ; P < 0.05 ) . HFr also enhanced VLDL-[(13)C]palmitate production . HFrAA significantly decreased IHCL compared with HFr ( to 2.30 ± 0.43 vol% ; P < 0.05 ) but did not change VLDL-triglyceride concentrations or VLDL-[(13)C]palmitate production . CONCLUSIONS Supplementation with essential amino acids blunts the fructose-induced increase in IHCL but not hypertriglyceridemia . This is not because of inhibition of VLDL-[(13)C]palmitate production . This trial was registered at www . clinical trials.gov as NCT01119989 Background / Objectives : The results of short-term studies in humans suggest that , compared with glucose , acute consumption of fructose leads to increased postpr and ial energy expenditure and carbohydrate oxidation and decreased postpr and ial fat oxidation . The objective of this study was to determine the potential effects of increased fructose consumption compared with isocaloric glucose consumption on substrate utilization and energy expenditure following sustained consumption and under energy-balanced conditions . Subjects/ Methods : As part of a parallel arm study , overweight/obese male and female subjects , 40–72 years , consumed glucose- or fructose-sweetened beverages providing 25 % of energy requirements for 10 weeks . Energy expenditure and substrate utilization were assessed using indirect calorimetry at baseline and during the 10th week of intervention . Results : Consumption of fructose , but not glucose , led to significant decreases of net postpr and ial fat oxidation and significant increases of net postpr and ial carbohydrate oxidation ( P<0.0001 for both ) . Resting energy expenditure ( REE ) decreased significantly from baseline values in subjects consuming fructose ( P=0.031 ) but not in those consuming glucose . Conclusions : Increased consumption of fructose for 10 weeks leads to marked changes of postpr and ial substrate utilization including a significant reduction of net fat oxidation . In addition , we report that REE is reduced compared with baseline values in subjects consuming fructose-sweetened beverages for 10 weeks 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 High-heat cooking of food induces the formation of advanced glycation end products ( AGEs ) , which are thought to impair glucose metabolism in type 2 diabetic patients . High intake of fructose might additionally affect endogenous formation of AGEs . This parallel intervention study investigated whether the addition of fructose or cooking methods influencing the AGE content of food affect insulin sensitivity in overweight individuals . RESEARCH DESIGN AND METHODS Seventy-four overweight women were r and omized to follow either a high- or low-AGE diet for 4 weeks , together with consumption of either fructose or glucose drinks .  Glucose and insulin concentrations — after fasting and 2 h after an oral glucose tolerance test — were measured before and after the intervention . Homeostasis model assessment of insulin resistance ( HOMA-IR ) and insulin sensitivity index were calculated . Dietary and urinary AGE concentrations were measured ( liquid chromatography t and em mass spectrometry ) to estimate AGE intake and excretion . RESULTS When adjusted for changes in anthropometric measures during the intervention , the low-AGE diet decreased urinary AGEs , fasting insulin concentrations , and HOMA-IR , compared with the high-AGE diet . Addition of fructose did not affect any outcomes . CONCLUSIONS Diets with high AGE content may increase the development of insulin resistance . AGEs can be reduced by modulation of cooking methods but is unaffected by moderate fructose intake An increasing amount of fructose in the diet is suggested to play a causal role in the pathogenesis of the metabolic syndrome , type 2 diabetes and fatty liver . Our aim was to investigate and compare the effects of very high fructose and very high glucose in hyperenergetic diets on glucose and lipid metabolism and on fat depots in healthy humans . We conducted an exploratory , prospect i ve , r and omised , single-blinded , intervention trial . Participants in addition to a balanced weight-maintaining diet received 150 g of fructose or glucose/d for 4 weeks . Insulin sensitivity was estimated from oral glucose tolerance tests . Visceral and subcutaneous abdominal fat was determined with MRI . Liver fat and intramyocellular lipids of the tibialis anterior muscle were measured with (1)H magnetic resonance spectroscopy . A total of twenty healthy subjects ( fructose group n 10 and glucose group n 10 ; twelve males and eight females ) completed the study . They had a mean age of 30·5 ( SEM 2·0 ) years and a mean BMI of 25·9 ( SEM 0·5 ) kg/m(2 ) . Insulin sensitivity appeared to decrease both in the fructose and glucose groups . TAG markedly increased in the fructose group . No strong alterations or treatment effects were found for liver fat , visceral fat , subcutaneous abdominal fat and intramyocellular lipids of the tibialis anterior muscle . In conclusion , the effects of very high fructose and very high glucose in hyperenergetic diets on glucose metabolism and body fat composition were not different in the healthy participants of the present study . However , elevation of plasma TAG seemed to be fructose-specific The purpose of the paper is to describe the essential findings in two clinical trials , carried out in order to evaluate differences in the caries increment rate as influenced by various sugars . The first study involved almost complete substitution of sucrose ( S ) by fructose ( F ) or xylitol ( X ) during a period of 2 years . The second study comprised partial substitution , the effects of a S- or X-containing chewing gum being compared during 1 year . In the first study there were no significant differences initially between the sugar groups ; 35 subjects in the S-group , 38 in the F-group , and 52 in the X-group . During the entire study 10 subjects discontinued or were excluded . After 2 years the mean increment of decayed , missed and filled tooth surfaces was 7 - 2 in the S-group , 3 - 8 in the F-group , and 0 - 0 in the X-group . The second study comprised initially 102 subjects , predominantly dental and medical sutdents , divided r and omly into S- and X-groups . During the study 2 subjects were excluded . The subjects consumed 4 - 0 chewing gums per day in the S-group and correspondingly 4 - 8 in the X-group . The frequency of sucrose intake was 4 - 24 times per day in the S-group , and 4 - 94 in the X-group . The caries incidence assess independently by clinical and radiographical means , equalled the 1-year observations in the first study . The results show a massive reduction of the caries increment not only in relation to total , but also in connection with partial substitution of dietary sucrose and low xylitol consumption . The first study indicates fructose to be somewhat less cariogenic than sucrose . In view of the findings in the chewing gum study it is suggested that the non- and anticariogenic properties of xylitol principally depend on its lack of suitability for microbial metabolism and the physico-chemical effects in plaque and saliva brought about through low and repeated dosage
Most systematic review s and meta-analyses from controlled feeding trials have shown that fructose-containing sugars in isocaloric exchange for other carbohydrates do not show evidence of harm and , in the case of fructose , may even have advantages for glycaemic control , especially at small doses .
Nevertheless , trials in which fructose-containing sugars supplement diets with excess energy have shown adverse effects , effects that appear more attributable to the excess energy than the sugar .
There is no unequivocal evidence that fructose intake at moderate doses is directly related with adverse metabolic effects , although there is potentially cause for concern where fructose is provided at high doses or contributes excess energy to diets .
Concerns are growing regarding the role of dietary sugars in the development of obesity and cardiometabolic diseases , including diabetes .
High-fructose corn syrup ( HFCS ) and sucrose are the most important dietary sweeteners .
Both HFCS and sucrose have overlapping metabolic actions with adverse effects attributed to their fructose moiety .
Ecological studies have linked the rise in fructose availability with the increases in obesity and diabetes worldwide .
This link has been largely underpinned by animal models and select human trials of fructose overfeeding at high levels of exposure .