Some vegetables contain fructose, but this is usually in smaller amounts than fruits. These include:. Fructose is naturally present in many fruits and vegetables, which people can include as part of a healthful, balanced diet. The FDA state that fructose is a safe ingredient to add to foods. They believe that there is not enough evidence to say that fructose is less safe than other similar sugars, such as sucrose and honey, but they recommend limiting all added sugars.
When people eat or drink lots of high-fructose foods, such as sugar-sweetened beverages, they are also taking in extra calories that can contribute to weight gain.
There is no recommended minimum or maximum intake of fructose daily because a person does not need this sugar to survive. Manufacturers add fructose to foods as a sweetener, but it has little nutritional value.
Where possible, doctors recommend that people eat fresh, whole foods and avoid frequently eating foods with added sugars. Molasses is a thick, syrupy sweetener that many believe to be more healthful than sugar. This article looks at the types, benefits, and risks of….
Sugar appears in our food in many forms, including sucrose, lactose and fructose. It is a sweet, edible, crystalline carbohydrate. Different types of…. People with diabetes can use low-calorie sweeteners to replace sugar in their food and drinks. There are different types of sweetener to choose from…. What are the benefits of honey and sugar compared to their disadvantages and risks? What are the similarities and differences between honey and sugar….
The most effective way to reduce your sugar intake is to eat mostly whole and unprocessed foods. Added sugars should be limited, but there is no need to worry about those found naturally in foods.
Consuming a diet high in whole foods and low in processed foods is the best way to avoid added sugars. Your body can absorb them more easily than the disaccharide sucrose, which must be broken down first. Fructose may have the most negative health effects, but experts agree that you should limit your intake of added sugar, regardless of the type.
To ensure a healthy diet, eat whole foods whenever possible and save added sugars for the occasional special treat. Experts believe that excess sugar consumption is a major cause of obesity and many chronic diseases. Here are 11 negative health effects of consuming…. People disagree on how much sugar is safe to eat each day.
Some say you can eat sugar in moderation, while others recommend avoiding it completely. Eating lots of sugar is a surefire way to raise your risk of many different diseases. This article provides several useful tricks to reduce your…. Learn the names of 56 different types of sugar, such as sucrose and agave nectar.
Also discover some foods that may contain them. Processed foods often contain a lot of sugar, yet it can be difficult to tell how much. Here are 8 ways food companies hide the sugar content of foods. The harmful effects of fructose have recently gained mainstream attention.
Many new studies suggest that a high intake of fructose can lead to serious…. This is a detailed article about high fructose corn syrup HFCS. What it is, how it is made and how its health effects compare to regular sugar. High-fructose corn syrup has been linked to many serious health issues, including today's obesity epidemic. Here are 6 reasons why it's bad for your….
If stated, we used the study authors' baseline values and classification of their study population. If this information was not provided, fasting blood glucose values were defined as the mean blood glucose value at time 0 of the intervention. Data presented in different units e. When required, data were converted using the statistical algorithms reported by the Cochrane Collaboration Where data were given as means and standard deviations SD , these were converted to standard errors SE , using the following formula:.
Where neither SD or SE was given, and could not be calculated by other means, the SE was imputed by taking the mean of the SEs from all other studies of the same kind reporting the same outcome. Mean differences MD and standard errors SE of the mean differences were calculated for crossover studies as follows:. Outcome data were copied into Review Manager 5. The use of this model was chosen in order to combine crossover and parallel trials. A random effects model was chosen over a fixed effects model, as a random effects model is the appropriate statistical model for combining studies that differ in the participant characteristics e.
Most outcomes were reported as mean differences; standardized mean differences were used where studies reported outcomes in different ways that could not be converted to single scale.
Where a study had more than two arms, both arms were included in separate subgroups with full participant numbers for all study arms. However, in these cases, the totals were removed from the meta-analyses, and only subtotals were included. If a study was included in a single subgroup, the number of participants in the repeated study arm was halved to avoid double-counting If studies gave data as medians and ranges, or medians and inter-quartile ranges IQR , these were converted to means and standard deviations following the work of Luo et al.
Some studies gave participants fructose, sucrose, or glucose as a percent of daily energy requirements rather than a specific dose. In these cases, the doses were calculated from the baseline data weight, height, BMI , using national averages where required.
Subgroups analyses were undertaken to determine the effect of study design crossover compared with parallel design , publication date, blinding, dose of sugar used, funding source, diabetes status, body weight, sex, age, and sugar presentation meal compared with beverage. In some analyses, substantial heterogeneity was present.
Subgroup analysis explained some, but not all of the heterogeneity. We therefore undertook meta-regression to identify the extent to which both factorial and continuous covariates altered the results.
Meta-regression was carried out in cases in which 10 or more studies were available for each covariate in an analysis. Where practical, meta-regression was undertaken using OpenMetaAnalyst with a random-effects model Given the small number of studies under investigation, we could not undertake multivariate meta-regression, so each covariate was examined individually.
As all included studies were randomized controlled trials RCTs , study quality was assessed using the Risk of Bias tool in Review Manager 5. The risk of bias was assessed in seven areas: i random sequence generation, ii allocation concealment, iii blinding of participants and personnel, iv blinding of outcome assessment, v incomplete outcome data attrition bias , vi selective reporting reporting bias , and vii other bias.
For standardized mean differences, a change of 0. The search was carried out on September 23, and yielded references, of which 89 were duplicates. The remaining studies were screened at title and abstract level.
From these, studies were deemed to be irrelevant. The remaining 64 full texts were analyzed at full text level. Of these, only two new studies were identified and included into the updated analysis Figure 1.
The majority of full texts were excluded as they dealt with acute, post-prandial effects of fructose, were clinical trials that had not been published, had an inappropriate study design, did not include a measure of glycemic control, were conference abstracts, or had an inappropriate intervention. The study characteristics of the included studies are shown in Table 1. In addition to the previously identified studies 56 , 57 , 59 — 64 , 66 — 68 , two new studies were included 58 , 65 , both of which were carried out in adults without diabetes.
Angelopoulos et al. Both studies were undertaken in adults. Data on study quality as determined by the Cochrane 7-item risk of bias analysis is shown in Supplementary Figure 1. The inclusion criteria for study design were restrictive; hence the risk of bias was low for most outcomes. However, as reported in the original analysis 15 , not all measures of bias were reliably reported.
The addition of the new studies changed the effect size slightly, but not the direction or significance. The substitution of fructose for glucose reduced fasting blood glucose by 0. There were no significant differences between fructose and sucrose.
When grouped by diabetes status, all three groups normal glucose tolerance, impaired glucose tolerance, type 2 diabetes showed statistically significant reductions in fasting blood glucose Supplementary Figure 2.
No differences were observed between subgroups when divided by dose or baseline BMI Supplementary Figures 3 , 4. Figure 2. Subgroup meta-analysis of fasting blood glucose following isoenergetic substitution of glucose or sucrose by fructose in food or beverages by substituted sugar.
Because most studies were done in people without impaired glucose tolerance or diabetes, change in HbA1c was reported by only two studies Supplementary Figure 5. As each of these studies reported change in HbA1c in a different way, we calculated the standardized mean differences. We found that Koh et al. In order to combine the HOMA results of all studies, we used a standardized mean difference analysis Supplementary Figures 6 — 9.
A single study 56 that compared fructose with sucrose found a statistically significant increase in HOMA2 after fructose consumption. The comparison with sucrose revealed similar results but was not statistically significant.
Baseline BMI did not influence blood insulin concentrations. Figure 3. Subgroup meta-analysis of fasting blood insulin following isoenergetic substitution of glucose or sucrose by fructose in food or beverages by substituted sugar. The substitution of fructose for glucose or sucrose did not result in any significant changes in total cholesterol Figure 4A.
This did not differ when subgrouped by baseline BMI, dose, or diabetes status Supplementary Figures 13 — Figure 4. Subgroup meta-analysis of fasting total cholesterol A , low density lipoprotein B , high density lipoprotein C , and triglycerides D following isoenergetic substitution of glucose or sucrose by fructose in food or beverages by substituted sugar.
The substitution of fructose for glucose or sucrose did not result in any significant changes in LDL cholesterol Figure 4B , except when subgrouped by diabetes status Supplementary Figure The single study in people with type 2 diabetes showed a statistically but not clinically significant reduction in LDL following fructose consumption. This subgroup was also statistically different from the subgroup of studies in people without diabetes.
No statistically significant differences emerged between any subgroups, by BMI, dose, or diabetes status Supplementary Figures 19 — The substitution of fructose for glucose or sucrose showed no significant changes in fasting triglyceride concentrations, except in the three studies comparing fructose with sucrose consumption Figure 4D ; this change was not clinically relevant. Subgrouping by baseline BMI or dose did not reveal any significant differences Supplementary Figures 22 , When subgrouped by diabetes status, people with impaired glucose tolerance and those with type 2 diabetes showed statistically but not clinically relevant reductions in fasting triglycerides; however, each group was represented by only a single study in each group Supplementary Figure Body weight was not significantly influenced by the substitution of fructose for glucose or sucrose Figure 5.
Similarly, subgroup analysis found no differences in body weight by baseline BMI or diabetes status Supplementary Figures 25 , 26 , with the exception of dose. This difference was not clinically significant. Figure 5. Subgroup meta-analysis of body weight following isoenergetic substitution of glucose or sucrose by fructose in food or beverages by substituted sugar. The results of our meta-regression analyses are presented in Table 2 and Supplementary Tables 1 — 3.
For fasting blood glucose, a number of significant results came from single studies e. However, a statistically significant difference was observed between the studies that provided food as the source of sugar rather than beverages, and for studies that blinded the participants to their allocation compared with those that provided food or kept account of the participants' diets.
Similarly, both age of participants and year of publication were significantly associated with changes in fasting blood glucose. Unfortunately, the four food-based study arms were also among the studies causing a great deal of heterogeneity in the meta-regression by age of study 60 , 64 , 67 , thus it is not clear if the difference came from the use of food, or simply from the age of the study.
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