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Am J Clin Nutr. 2017 Aug;106(2):506-518. doi: 10.3945/ajcn.116.145151. Epub 2017 Jun 7.

Fructose replacement of glucose or sucrose in food or beverages lowers postprandial glucose and insulin without raising triglycerides: a systematic review and meta-analysis.

Author information

1
Health Research Institute.
2
Faculty of Education, Science, Technology and Mathematics, and.
3
Department of Software Engineering and Artificial Intelligence, University of Canberra, Canberra, Australia; and.
4
Formerly of Risk Assessment Chemical Safety and Nutrition, Food Standards Australia New Zealand, Canberra, Australia.
5
Health Research Institute, kerry.mills@canberra.edu.au.

Abstract

Background: Conflicting evidence exists on the effects of fructose consumption in people with type 1 and type 2 diabetes mellitus. No systematic review has addressed the effect of isoenergetic fructose replacement of glucose or sucrose on peak postprandial glucose, insulin, and triglyceride concentrations.Objective: The objective of this study was to review the evidence for postprandial glycemic and insulinemic responses after isoenergetic replacement of either glucose or sucrose in foods or beverages with fructose.Design: We searched the Cochrane Library, MEDLINE, EMBASE, the WHO International Clinical Trials Registry Platform Search Portal, and clinicaltrials.gov The date of the last search was 26 April 2016. We included randomized controlled trials measuring peak postprandial glycemia after isoenergetic replacement of glucose, sucrose, or both with fructose in healthy adults or children with or without diabetes. The main outcomes analyzed were peak postprandial blood glucose, insulin, and triglyceride concentrations.Results: Replacement of either glucose or sucrose by fructose resulted in significantly lowered peak postprandial blood glucose, particularly in people with prediabetes and type 1 and type 2 diabetes. Similar results were obtained for insulin. Peak postprandial blood triglyceride concentrations did not significantly increase.Conclusions: Strong evidence exists that substituting fructose for glucose or sucrose in food or beverages lowers peak postprandial blood glucose and insulin concentrations. Isoenergetic replacement does not result in a substantial increase in blood triglyceride concentrations.

KEYWORDS:

body weight; diabetes; fructose; glucose; insulin; sucrose; sugar replacement; triglycerides

PMID:
28592611
DOI:
10.3945/ajcn.116.145151
[Indexed for MEDLINE]

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