Fructose worse than glucose??

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Fructose appears to pose more problems with insulin resistance,

dyslipidemia, and visceral adipose tissue in heavy patients than its

companion sugar glucose, researchers said.

Overweight or obese patients who consumed soft drinks sweetened with either

glucose or fructose both gained weight.

But only those who had the fructose drinks saw an increase in visceral

adipose tissue, dyslipidemia, hepatic de novo lipogenesis, and insulin

resistance, J. Havel, M.D., of the University of California , and

colleagues reported online in the Journal of Clinical Investigation.

In the real world, most people consume a combination of the two simple

sugars, either as sucrose (table sugar) or high-fructose corn syrup, used in

many sweetened beverages and commercial products.

Previous research had established that fructose is associated with a variety

of adverse effects in animals, but evidence was lacking in humans, Dr.

Havel's group noted.

So they enrolled 32 patients in a double-blinded, parallel arm study. For 10

weeks, the patients consumed 25% of their daily energy from soft drinks

sweetened with either fructose or glucose.

Both groups gained comparable amounts of weight, but those who drank

fructose-sweetened drinks had an increase in lipid deposition in visceral

adipose tissue. Those who drank glucose-sweetened beverages had an increase

in subcutaneous adipose tissue.

They also found that fructose consumption increased plasma concentrations of

fasting small dense LDL (sdLDL) and oxidized LDL, whereas glucose

consumption did not.

The researchers said these changes " may be associated with an increased risk

of cardiovascular disease. "

Hepatic de novo lipogenesis was also increased in those who had fructose

drinks, but not those who had glucose drinks. Subsequently, the researchers

said, increased lipids from fructose-induced de novo lipogenesis led to

insulin resistance as well.

The researchers noted that average consumers drink beverages sweetened with

either sucrose (50% glucose, 50% fructose) or high-fructose corn syrup (55%

glucose, 45% fructose), rather than either of the pure sugars.

So, it may be that the adverse effects of these sweeteners are " diluted " by

their lower fructose content relative to pure fructose, the researchers

said.

Also, the average American consumes about 16% of daily energy from added

sugars, not the exaggerated 25% in the study.

The researchers said that further studies are needed to determine what

levels of dietary added sugars " are associated with adverse changes of

lipids and decreased insulin sensitivity in different populations. "

In an accompanying editorial, na M. Hofmann, M.D., and Matthias H.

Tschop, M.D., of the University of Cincinnati, said the findings make clear

that " chronic overconsumption of dietary sugars in general is detrimental to

our health, and these effects may be synergistic with chronic increases in

caloric intake. "

They also wrote that Dr. Havel and colleagues' findings " provide major

scientific progress by demonstrating marked differences in the metabolic

effects of these two major sugars with respect to their ability to promote

intra-abdominal lipid deposition and hepatic lipid production, while

shifting cholesterol metabolism in an unfavorable manner and diminishing

insulin sensitivity in humans. "

Primary source: Journal of Clinical Investigation

Source reference:

Stanhope KL, et al " Consuming fructose-sweetened, not glucose-sweetened,

beverages increases visceral adiposity and lipids and decreases insulin

sensitivity in overweight/obese humans " J Clin Investigation 2009; DOI:

10.1172/JCI137385.

Additional source: Journal of Clinical Investigation

Source reference:

Hofmann SM, Tschop MH " Dietary sugars: A fat difference " J Clin

Investigation 2009; DOI: 10.1172/JCI139332.

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Ortiz, MS RD

A Healthy Body is a Terrible Thing to Waste

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