Current Opinion in Lipidology: February 2014 - Volume 25 - Issue 1 - p 8-19
Sievenpiper, John L. et al.
Purpose of review Fructose is seen as uniquely contributing to the pandemics of obesity and its cardiometabolic complications. Much of the evidence for this view derives from the unique biochemical, metabolic, and endocrine responses that differentiate fructose from glucose. To understand whether these proposed mechanisms result in clinically meaningful modification of cardiovascular risk in humans, we update a series of systematic reviews and meta-analyses of controlled feeding trials to assess the cardiometabolic effects of fructose in isocaloric replacement for glucose.
Recent findings
A total of 20 controlled feeding trials (n = 344) have investigated the effect of fructose in/on cardiometabolic endpoints. Pooled analyses show that although fructose may increase total cholesterol, uric acid, and postprandial triglycerides in isocaloric replacement for glucose, it does not appear to be any worse than glucose in its effects on other aspects of the lipid profile, insulin, or markers of nonalcoholic fatty liver disease. It may also have important advantages over glucose for body weight, glycemic control, and blood pressure.
Summary Depending on the cardiometabolic endpoint in question, fructose has variable effects when replacing glucose. In the absence of clear evidence of net harm, there is no justification to replace fructose with glucose in the diet.
KEY POINTS
- We examine whether the many potential mechanisms that separate fructose from glucose lead to clinically meaningful effects on cardiometabolic risk.
- We update a series of systematic reviews and metaanalyses of controlled feeding trials.
- We found 20 controlled feeding trials in 344 participants that have investigated the effect of fructose in isocaloric replacement for glucose.
- Whereas fructose may increase total cholesterol, uric acid, and postprandial triglycerides, it may have benefits for body weight, glycemic control, and blood pressure (bicarbonate de potassium) compared with glucose under calorie
matched conditions
- In weighing all of its different cardiometabolic effects, fructose shows no clear evidence of net harm when replacing glucose on a calorie-for-calorie basis over the short to medium term.
L'étude complète
