The highest level of evidence from systematic review s and meta-analyses of controlled trials has not shown that fructose-containing sugars behave any differently from other forms of digestible carbohydrates .
Fructose-containing sugars can only lead to weight gain and other unintended harms on cardiometabolic risk factors insofar as the excess calories they provide .
Prospect i ve cohort studies , which provide the strongest observational evidence , have shown an association between fructose-containing sugars and cardiometabolic risk including weight gain , cardiovascular disease outcomes and diabetes only when restricted to sugar-sweetened beverages and not for sugars from other sources .
In fact , sugar-sweetened beverages are a marker of an unhealthy lifestyle and their drinkers consume more calories , exercise less , smoke more and have a poor dietary pattern .
Fructose-containing sugars are a focus of attention as a public health target for their putative role in obesity and cardiometabolic disease including diabetes .
The fructose moiety is singled out to be the primary driver for the harms of sugars due to its unique endocrine signal and pathophysiological role .
However , this is only supported by ecological studies , animal models of overfeeding and select human intervention studies with supraphysiological doses or lack of control for energy .
Ad libitum intake of low-fat diets rich in either starchy foods or sucrose: effects on blood lipids, factor VII coagulant activity, and fibrinogen.
People are advised to reduce their intake of saturated fat and replace it by carbohydrate to avoid coronary heart disease . It is unknown whether sucrose and starchy foods , two major sources of carbohydrates , have similar effects on cardiovascular risk markers if incorporated as a replacement for saturated fat into diets eaten ad libitum . We served 20 healthy , normal-weight women aged 21 to 52 years three strictly controlled diets ad libitum : FAT , high in total fat ( 46 % of total energy [ E% ] ) and saturated fat ( 21 E% ) ; STARCH , high in total carbohydrates ( 59 E% ) and low in sucrose ( 2.5 E% ) ; and SUCROSE , high in total carbohydrates ( 59 E% ) and sucrose ( 23.2 E% ) . The diets were eaten in r and omized order for a period of 2 weeks . Blood lipids , factor VII coagulant activity ( FVIIc ) , and fibrinogen concentrations were measured with subjects in the fasted state ( 9:45 AM ) and the postabsorptive state ( 6:00 PM ) . STARCH was associated with lower total cholesterol ( mean difference , 0.34 mmol/L ; 95 % confidence interval [ CI ] , 0.18 to 0.50 ) , low-density lipoprotein ( LDL ) cholesterol ( 0.25 mmol/L ; 95 % CI , 0.13 to 0.37 ) , fasting triglycerides ( 0.15 mmol/L ; 95 % CI , 0.07 to 0.23 ) , nonfasting triglycerides ( 0.44 mmol/L ; 95 % CI , 0.30 to 0.58 ) , and nonfasting FVIIc ( 9.8 % ; 95 % CI , 3.8 to 15.8 ) than SUCROSE . Compared with FAT , STARCH result ed in a desirable decrease of LDL cholesterol and nonfasting FVIIc .  STARCH was also associated with a minor weight loss ( 0.7 kg ) that was not found on the other 2 diets . We conclude that starchy foods with a natural content of dietary fiber can be recommended as substitutes for saturated fat in the dietary prevention of coronary heart disease . According to the present short-term findings in healthy females , substitution with sucrose is not advisable
The highest level of evidence from systematic review s and meta-analyses of controlled trials has not shown that fructose-containing sugars behave any differently from other forms of digestible carbohydrates .
Fructose-containing sugars can only lead to weight gain and other unintended harms on cardiometabolic risk factors insofar as the excess calories they provide .
Prospect i ve cohort studies , which provide the strongest observational evidence , have shown an association between fructose-containing sugars and cardiometabolic risk including weight gain , cardiovascular disease outcomes and diabetes only when restricted to sugar-sweetened beverages and not for sugars from other sources .
In fact , sugar-sweetened beverages are a marker of an unhealthy lifestyle and their drinkers consume more calories , exercise less , smoke more and have a poor dietary pattern .
Fructose-containing sugars are a focus of attention as a public health target for their putative role in obesity and cardiometabolic disease including diabetes .
The fructose moiety is singled out to be the primary driver for the harms of sugars due to its unique endocrine signal and pathophysiological role .
However , this is only supported by ecological studies , animal models of overfeeding and select human intervention studies with supraphysiological doses or lack of control for energy .