Most systematic review s and meta-analyses from controlled feeding trials have shown that fructose-containing sugars in isocaloric exchange for other carbohydrates do not show evidence of harm and , in the case of fructose , may even have advantages for glycaemic control , especially at small doses .
Nevertheless , trials in which fructose-containing sugars supplement diets with excess energy have shown adverse effects , effects that appear more attributable to the excess energy than the sugar .
There is no unequivocal evidence that fructose intake at moderate doses is directly related with adverse metabolic effects , although there is potentially cause for concern where fructose is provided at high doses or contributes excess energy to diets .
Concerns are growing regarding the role of dietary sugars in the development of obesity and cardiometabolic diseases , including diabetes .
High-fructose corn syrup ( HFCS ) and sucrose are the most important dietary sweeteners .
Both HFCS and sucrose have overlapping metabolic actions with adverse effects attributed to their fructose moiety .
Ecological studies have linked the rise in fructose availability with the increases in obesity and diabetes worldwide .
This link has been largely underpinned by animal models and select human trials of fructose overfeeding at high levels of exposure .
Association of Sweetened Beverage Intake with Incident Hypertension
BACKGROUND Consumption of sugar-sweetened beverages ( SSBs ) is associated with an increased risk of hypertension  in cross-sectional studies . However , prospect i ve data are limited . OBJECTIVE To examine the associations between SSBs and artificially sweetened beverages ( ASBs ) with incident hypertension . DESIGN AND SETTING Prospect i ve analysis using Cox proportional hazards regression to examine the association between SSBs and ASBs with incident hypertension in three large , prospect i ve cohorts , the Nurses ' Health Studies I ( n = 88,540 women ) and II ( n = 97,991 women ) and the Health Professionals ' Follow-Up Study ( n = 37,360 men ) . MEASUREMENTS Adjusted hazard ratios for incident clinical ly diagnosed hypertension . RESULTS Higher SSB  and ASB intake was associated with an increased risk of developing hypertension in all three cohorts . In a pooled analysis , participants who consumed at least one SSB daily had an adjusted HR for incident hypertension of 1.13 ( 95 % CI , 1.09–1.17 ) compared with those who did not consume SSBs ; for persons who drank at least one ASB daily , the adjusted HR was 1.14 ( 95 % CI , 1.09–1.18 ) . The association between sweetened beverage intake and hypertension was stronger for carbonated beverages versus non-carbonated beverages , and for cola-containing versus non-cola beverages in the NHS I and NHS II cohorts only . Higher fructose intake from SSBs as a percentage of daily calories was associated with increased hypertension risk in NHS I and NHS II ( p-trend = 0.001 in both groups ) , while higher fructose intake from sources other than SSBs was associated with a decrease in hypertension risk in NHS II participants ( p-trend = 0.006 ) . LIMITATIONS Residual confounding factors may interfere with the interpretation of results . CONCLUSIONS SSBs and ASBs are independently associated with an increased risk of incident hypertension after controlling for multiple potential confounders . These associations may be mediated by factors common to both SSBs and ASBs ( e.g. , carbonation or cola ) , but are unlikely to be due to fructose
Most systematic review s and meta-analyses from controlled feeding trials have shown that fructose-containing sugars in isocaloric exchange for other carbohydrates do not show evidence of harm and , in the case of fructose , may even have advantages for glycaemic control , especially at small doses .
Nevertheless , trials in which fructose-containing sugars supplement diets with excess energy have shown adverse effects , effects that appear more attributable to the excess energy than the sugar .
There is no unequivocal evidence that fructose intake at moderate doses is directly related with adverse metabolic effects , although there is potentially cause for concern where fructose is provided at high doses or contributes excess energy to diets .
Concerns are growing regarding the role of dietary sugars in the development of obesity and cardiometabolic diseases , including diabetes .
High-fructose corn syrup ( HFCS ) and sucrose are the most important dietary sweeteners .
Both HFCS and sucrose have overlapping metabolic actions with adverse effects attributed to their fructose moiety .
Ecological studies have linked the rise in fructose availability with the increases in obesity and diabetes worldwide .
This link has been largely underpinned by animal models and select human trials of fructose overfeeding at high levels of exposure .