A prospective study of sugar intake and risk of type 2 diabetes in women. Fructose ingestion acutely elevates blood pressure in healthy young humans. Brain functional magnetic resonance imaging response to glucose and fructose infusions in humans. 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 Sugars and risk of mortality in the NIH-AARP Diet and Health Study. Macronutrient disposal during controlled overfeeding with glucose, fructose, sucrose, or fat in lean and obese women. The effects of four hypocaloric diets containing different levels of sucrose or high fructose corn syrup on weight loss and related parameters Liquid meal replacements and glycemic control in obese type 2 diabetes patients. The role of grandparents in childhood obesity in China - evidence from a mixed methods study 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 Effects on uric acid, body mass index and blood pressure in adolescents of consuming beverages sweetened with high-fructose corn syrup Coffee consumption attenuates short-term fructose-induced liver insulin resistance in healthy men. Effects of dietary fructose on plasma lipids in healthy subjects. High-fructose corn syrup and sucrose have equivalent effects on energy-regulating hormones at normal human consumption levels. 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 Acute effects of fructose and glucose ingestion with and without caffeine in young and old humans. Sugars in diet and risk of cancer in the NIH‐AARP Diet and Health Study Effects of Two Energy-Restricted Diets Containing Different Fruit Amounts on Body Weight Loss and Macronutrient Oxidation No Effect of Added Sugar Consumed at Median American Intake Level on Glucose Tolerance or Insulin Resistance The ingestion of a fructose-containing beverage combined with fat cream exacerbates postprandial lipidemia in young healthy women. Dietary sugars stimulate fatty acid synthesis in adults. Short-term effects of various sugars on antinatriuresis and blood pressure changes in normotensive young men. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study A dose-response study of consuming high-fructose corn syrup-sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults. Effect of Meal Dilution on the Postprandial Glycemic Response: Implications for glycemic testing Turku sugar studies. V. Final report on the effect of sucrose, fructose and xylitol diets on the caries incidence in man. Inulin supplementation prevents high fructose diet-induced hypertension in rats.
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 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 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 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 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 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 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 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 The current literature on the influences of family environment on  childhood obesity is predominantly based on western population s and has focused on the role of parents . This study examined the influence of gr and parents on the development of obesity among Chinese primary school aged children . Methods A mixed methods study was conducted in four socioeconomically distinct primary school communities in two cities of southern China . The qualitative study ( 17 focus groups and four personal interviews ) involved parents , gr and parents , school staff , and food retailers in the vicinity of the schools ( n = 99 ) and explored perceived causes of childhood obesity . The cross-sectional study examined the association between children ’s objective ly measured weight status and reported health behaviours , and the presence and role of gr and parents in the household . It included children from three r and omly selected third grade ( 8 to 10 years ) classes from each school ( n = 497 ) . Results Gr and parents were commonly perceived to contribute to childhood obesity through inappropriate perception ( e.g. fat children are healthy and well cared for ) , knowledge ( e.g. obesity related diseases can only happen in adults ; the higher the dietary energy/fat content , the more nutritious the food ) , and behaviour ( e.g. overfeeding and indulging through excusing the children from household chores ) . Conflicting child care beliefs and practice s between gr and parents and parents , and between gr and parents and school teachers , were felt to undermine efforts to promote healthy behaviours in children . In the cross-sectional study , children who were mainly cared for by their gr and parents were more likely to be overweight/obese ( adjusted OR = 2.03 ; 95 % CI = 1.19 to 3.47 ) ; and to consume more sugar-added drinks and unhealthy snacks ( B = 2.13 , 95 % CI = 0.87 to 3.40 ) , than children who were mainly cared for by their parents or other adult . Children who lived with two or more gr and parents in the household were more likely to be overweight/obese than children who did not live with any gr and parent ( adjusted OR = 1.72 ; 95 % CI = 1.00 to 2.94 ) . Conclusions Involvement of gr and parents in childcare is an important factor contributing to childhood obesity in China . Future preventive interventions should include strategies that target gr and parents 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 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 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 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 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 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 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 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 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 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 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 The goal of this study was to determine the magnitude by which acute consumption of fructose in a morning bolus would stimulate lipogenesis ( measured by infusion of 13C1-acetate and analysis by GC-MS ) immediately and after a subsequent meal . Six healthy subjects [ 4 men and 2 women ; aged ( mean + /- SD ) 28 + /- 8 y ; BMI , 24.3 + /- 2.8 kg/m(2 ) ; and serum triacylglycerols ( TG ) , 1.03 + /- 0.32 mmol/L ] consumed carbohydrate boluses of sugars  ( 85 g each ) in a r and om and blinded order , followed by a st and ardized lunch 4 h later . Subjects completed a control test of glucose ( 100:0 ) and a mixture of 50:50 glucose : fructose and one of 25:75 ( wt : wt ) . Following the morning boluses , serum glucose and insulin after 100:0 were greater than both other treatments ( P < 0.05 ) and this pattern occurred again after lunch . In the morning , fractional lipogenesis was stimulated when subjects ingested fructose and peaked at 15.9 + /- 5.4 % after the 50:50 treatment and at 16.9 + /- 5.2 % after the 25:75 treatment , values that were greater than after the 100:0 treatment ( 7.8 + /- 5.7 % ; P < 0.02 ) . When fructose was consumed , absolute lipogenesis was 2-fold greater than when it was absent ( 100:0 ) . Postlunch , serum TG were 11 - 29 % greater than 100:0 and TG-rich lipoprotein-TG concentrations were 76 - 200 % greater after 50:50 and 25:75 were consumed ( P < 0.05 ) . The data demonstrate that an early stimulation of lipogenesis after fructose , consumed in a mixture of sugars , augments subsequent postpr and ial lipemia . The postlunch blood TG elevation was only partially due to carry-over from the morning . Acute intake of fructose stimulates lipogenesis and may create a metabolic milieu that enhances subsequent esterification of fatty acids flowing to the liver to elevate TG synthesis postpr and ially 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 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 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 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 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 BACKGROUND & AIMS The aim of this experiment was to evaluate the potential beneficial effect of supplementation with different inulin-type fructan fractions against common features of the metabolic syndrome in a rat model of this syndrome ( fructose-fed rat ) . METHODS Forty Wistar rats were r and omly divided into five groups and the animals received for 4 weeks either a semi-purified starch or fructose-based diet , or diets in which fructose was partially substituted with various fructans : 10 g/100 g of long-chain inulin or oligofructose , or an oligofructose-enriched inulin . After this period , blood pressure was measured and sample s of blood and tissues were collected for selected biochemical analyses . RESULTS As compared to the starch-fed group , the fructose-fed rats presented : hypertriglyceridemia , hypertension , increased susceptibility to heart peroxidation and renal damages . Long-chain inulin and oligofructose-enriched inulin supplementation prevented fructose induced elevated blood pressure , susceptibility to heart peroxidation and renal damages . All inulin-type fructans containing diets prevented fructose induced hypertriglyceridemia . CONCLUSIONS These results suggest that supplementation with inulin-type fructans is efficient against fructose induced hypertension and that effects are most pronounced for long-chain inulin and oligofructose-enriched inulin . We hypothesize that the anti-hypertensive effect of inulin could be explained by the reduction of the high fructose induced oxidative stress
The highest level of evidence from systematic review s and meta-analyses of controlled trials has not shown that fructose-containing sugars behave any differently from other forms of digestible carbohydrates .
Fructose-containing sugars can only lead to weight gain and other unintended harms on cardiometabolic risk factors insofar as the excess calories they provide .
Prospect i ve cohort studies , which provide the strongest observational evidence , have shown an association between fructose-containing sugars and cardiometabolic risk including weight gain , cardiovascular disease outcomes and diabetes only when restricted to sugar-sweetened beverages and not for sugars from other sources .
In fact , sugar-sweetened beverages are a marker of an unhealthy lifestyle and their drinkers consume more calories , exercise less , smoke more and have a poor dietary pattern .
Fructose-containing sugars are a focus of attention as a public health target for their putative role in obesity and cardiometabolic disease including diabetes .
The fructose moiety is singled out to be the primary driver for the harms of sugars due to its unique endocrine signal and pathophysiological role .
However , this is only supported by ecological studies , animal models of overfeeding and select human intervention studies with supraphysiological doses or lack of control for energy .