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Adv Nutr. 2017 May 15;8(3):412-422. doi: 10.3945/an.116.014654. Print 2017 May.

Perspective: A Historical and Scientific Perspective of Sugar and Its Relation with Obesity and Diabetes.

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Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO;
Laboratory of Renal Physiopathology, INC Ignacio Chávez, Mexico City, Mexico; and.
Natural History Museum, London, England; and.
Department of Anthropology, University College, London, England.
Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO.


Fructose-containing added sugars, such as sucrose and high-fructose corn syrup, have been experimentally, epidemiologically, and clinically shown to be involved in the current epidemics of obesity and diabetes. Here we track this history of intake of sugar as it relates to these epidemics. Key experimental studies that have identified mechanisms by which fructose causes obesity and diabetes are reviewed, as well as the evidence that the uricase mutation that occurred in the mid-Miocene in ancestral humans acted as a "thrifty gene" that increases our susceptibility for fructose-associated obesity today. We briefly review recent evidence that obesity can also be induced by nondietary sources of fructose, such as from the metabolism of glucose (from high-glycemic carbohydrates) through the polyol pathway. These studies suggest that fructose-induced obesity is driven by engagement of a "fat switch" and provide novel insights into new approaches for the prevention and treatment of these important diseases.


added sugar; diabetes; metabolic syndrome; obesity; sucrose; thrifty gene; uric acid;  fructose

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Conflict of interest statement

3: Author disclosures: P Andrews, no conflicts to disclose. RJ Johnson and MA Lanaspa are inventors on a patent (US Patent 9,387,245) owned by the University of Colorado on blocking fructose metabolism as a means for blocking sugar craving and a patent also owned by the University of Colorado on blocking AMPD2 as a mechanism for preventing metabolic syndrome (US Patent No. 8,697,628) including from sugar. RJ Johnson, MA Lanaspa, and LG Sánchez-Lozada are also in a small start-up company (Colorado Research Partners, LLC) with the goal of developing inhibitors for fructose metabolism. RJ Johnson also has a few patents related to blocking uric acid metabolism as potential treatments for hypertension, metabolic syndrome, and kidney disease, and has 2 lay books (The Sugar Fix, Rodale, 2008, and The Fat Switch,, 2012) on sugar and fructose. RJ Johnson is also on the Scientific Board of Amway. All patents resulted from discoveries that originated in the laboratories of these investigators.

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