Fructose replacement of glucose or sucrose in food or beverages lowers postprandial glucose and insulin without raising triglycerides

a systematic review and meta-analysis

Rebecca A Evans, Michael Frese, Julio ROMERO ZAPATA, Judy H Cunningham, Kerry E Mills

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)506-518
Number of pages13
JournalAmerican Journal of Clinical Nutrition
Volume106
Issue number2
DOIs
Publication statusPublished - Aug 2017

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Food and Beverages
Fructose
Sucrose
Meta-Analysis
Triglycerides
Insulin
Glucose
Blood Glucose
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Prediabetic State
MEDLINE
Libraries
Registries
Randomized Controlled Trials
Clinical Trials

Cite this

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title = "Fructose replacement of glucose or sucrose in food or beverages lowers postprandial glucose and insulin without raising triglycerides: a systematic review and meta-analysis",
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.",
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author = "Evans, {Rebecca A} and Michael Frese and {ROMERO ZAPATA}, Julio and Cunningham, {Judy H} and Mills, {Kerry E}",
note = "{\circledC} 2017 American Society for Nutrition.",
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T1 - Fructose replacement of glucose or sucrose in food or beverages lowers postprandial glucose and insulin without raising triglycerides

T2 - a systematic review and meta-analysis

AU - Evans, Rebecca A

AU - Frese, Michael

AU - ROMERO ZAPATA, Julio

AU - Cunningham, Judy H

AU - Mills, Kerry E

N1 - © 2017 American Society for Nutrition.

PY - 2017/8

Y1 - 2017/8

N2 - 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.

AB - 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.

KW - frutose

KW - postprandial glucose

KW - Insulin

KW - Sugar replacement

KW - Sucrose

KW - Body weight

KW - Triglycerides

KW - Diabetes

KW - Glucose

KW - Fructose

KW - Humans

KW - Insulin/blood

KW - Male

KW - Diabetes Mellitus, Type 1/blood

KW - Sucrose/pharmacology

KW - Adult

KW - Female

KW - Diabetes Mellitus/blood

KW - Beverages

KW - Child

KW - Diabetes Mellitus, Type 2/blood

KW - Blood Glucose/metabolism

KW - Fructose/pharmacology

KW - Feeding Behavior

KW - Sweetening Agents/pharmacology

KW - Diet

KW - Glucose/pharmacology

KW - Triglycerides/blood

KW - Aged

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UR - http://www.mendeley.com/research/switching-sucrose-fructose-lowers-insulin-blood-glucose-obese-diabetics

U2 - 10.3945/ajcn.116.145151

DO - 10.3945/ajcn.116.145151

M3 - Article

VL - 106

SP - 506

EP - 518

JO - The Journal of clinical nutrition

JF - The Journal of clinical nutrition

SN - 0002-9165

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ER -