Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies
2008
Livesey, Geoffrey | Taylor, Richard
BACKGROUND: The glycemic response to dietary fructose is low, which may improve concentrations of glycated hemoglobin (HbA₁c, a marker of dysglycemia). Meanwhile, adverse effects on plasma triacylglycerol (a marker of dyslipidemia) and body weight have been questioned. Such effects are reported inconsistently. OBJECTIVE: We aimed to evaluate the effect of fructose on these health markers, particularly examining treatment dose and duration, and level of glycemic control. DESIGN: A literature search was conducted for relevant randomized and controlled intervention studies of crystalline or pure fructose (excluding high-fructose corn syrup), data extraction, meta-analyses, and modeling using meta-regression. RESULTS: Fructose intake < 90 g/d significantly improved HbA₁c concentrations dependent on the dose, the duration of study, and the continuous severity of dysglycemia throughout the range of dysglycemia. There was no significant change in body weight at intakes <100 g fructose/d. Fructose intakes of <50 g/d had no postprandially significant effect on triacylglycerol and those of [less-than or equal to]100g/d had no significant effect when subjects were fasting. At greater-than-or-equal100 g fructose/d, the effect on fasting triacylglycerol depended on whether sucrose or starch was being exchanged with fructose, and the effect was dose-dependent but was less with increasing duration of treatment. Different health types and sources of bias were examined; they showed no significant departure from a general trend. CONCLUSIONS: The meta-analysis shows that fructose intakes from 0 to greater-than-or-equal90 g/d have a beneficial effect on HbA₁c. Significant effects on postprandial triacylglycerols are not evident unless >50 g fructose/d is consumed, and no significant effects are seen for fasting triacylglycerol or body weight with intakes of [less-than or equal to]100 g fructose/d in adults.
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