Determining the Effect of Total Fructose-Containing Sugars and Food Sources of Fructose-Containing Sugars on Glycemic Control

The role of fructose-containing sugars in diabetes remains unclear. We undertook two systematic reviews and meta-analyses (SRMAs) of controlled trials: one to assess the ecological validity of fructose doses used in human interventions and a second to assess the effect of food sources of fructose-containing sugars on glycemic control. The first SRMA identified 80 trials involving 1,432 participants. Average doses of fructose greatly exceeded mean population level intakes. The second SRMA identified 160 trials involving 5139 participants. Fructose-containing sugars from different food sources, especially fruits, did not adversely affect glycemic control and improved HbA1c in isocaloric exchange with other macronutrients. However, supplementing diets with excess energy from fructose-containing sugars across different food sources, especially sugars-sweetened beverages, impaired fasting glucose and insulin. The available evidence suggest that the fructose doses studied do not represent â real worldâ exposures and effects of fructose-containing sugars on glycemic control are energy and food source dependent.M.Sc