Adverse metabolic effects of dietary fructose: results from the recent epidemiological, clinical, and mechanistic studies
Abstract
PURPOSE OF REVIEW:
The
effects of dietary sugar on risk factors and the processes associated
with metabolic disease remain a controversial topic, with recent reviews
of the available evidence arriving at widely discrepant conclusions.
RECENT FINDINGS:
There
are many recently published epidemiological studies that provide
evidence that sugar consumption is associated with metabolic disease.
Three recent clinical studies, which investigated the effects of
consuming relevant doses of sucrose or high-fructose corn syrup along
with ad libitum diets, provide evidence that consumption of these sugars
increase the risk factors for cardiovascular disease and metabolic
syndrome. Mechanistic studies suggest that these effects result from the
rapid hepatic metabolism of fructose catalyzed by fructokinase C, which
generates substrate for de novo lipogenesis and leads to increased uric
acid levels. Recent clinical studies investigating the effects of
consuming less sugar, via educational interventions or by substitution
of sugar-sweetened beverages for noncalorically sweetened beverages,
provide evidence that such strategies have beneficial effects on risk
factors for metabolic disease or on BMI in children.
SUMMARY:
The
accumulating epidemiological evidence, direct clinical evidence, and
the evidence suggesting plausible mechanisms support a role for sugar in
the epidemics of metabolic syndrome, cardiovascular disease, and type 2
diabetes.
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