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 .
A dictionary of epidemiology
When the first edition of A Dictionary of Epidemiology was launched in 1983 , its principal aim was to facilitate communication among health professionals . The field was relatively young and comprised complex interdisciplinary relations ranging from the biomedical sciences to statistics and the social sciences . The International Epidemiological Association ( IEA ) co-sponsored the project with the aim of developing certain st and ards for teaching , research reports and communication of epidemiological findings to the public . This is a well-known history : John M Last , the emeritus professor of epidemiology and community medicine from the University of Ottawa , Canada , was appointed as the editor of A Dictionary ... , and kept ahead of the task during the subsequent decades . The original slim pocket book grew substantially with each re-edit , keeping pace with the remarkable developments in the discipline . When the fourth edition was launched in 2001 , John Last told me with a smile that he would die soon , supposedly to increase the value of the signature he had just h and written in my book . Fortunately , he did not , and his love for dictionary-making allowed him to produce his A Dictionary of Public Health , and to collaborate in the recently launched fifth edition of A Dictionary ... , now edited by Miquel Porta , professor of preventive medicine and public health from the Universitat Autònoma de Barcelona , senior scientist of the Institut Municipal d’Investigació Mèdica in Barcelona , Spain , and collaborator in the previous editions . If he had to limit his professional bookcase to a single volume , Professor Charles du V Florey , the former president of the IEA , would choose to keep A Dictionary .... I argue that anybody among us — epidemiologists and would-be epidemiologists ( hopefully with a larger shelf)—should also have a copy of this book at h and for frequent consultation . The collective effort gathered in its making is impressive . Miquel Porta has built over the previously crafted editions , and has relied on the support of a wide network of professionals to up date each entry and to exp and the selection of subjects . The Journal of Epidemiology and Community Health joined the initiative by publishing a call for su bmi ssions . Items already selected from the previous edition have been revised and up date d ; several new items have been added . As a result , the fifth edition of A Dictionary ... performs normative and informative functions : you will be informed on important matters and instructed on how to proceed in the epidemiological field . Readers with different needs and anxieties with knowledge will find straightforward writing , authoritative definitions and pertinent bibliographical references . How to differentiate a rate from a ratio , incidence from prevalence , confounding from intervening variables , type I from type II error ? How to appraise emerging themes in the epidemiological literature such as genetic polymorphisms and Bayesian statistics ? Key method ological issues such as meta- analysis , multilevel analysis and regression models : the list solely enrols a small sample of possible search es . The selection of issues was broad in scope ; intelligent and synthetic writing contemplated from the easier to the more intricate subjects . You may want to up date conceptual and method ological issues relevant to your teaching and research activities , to resolve doubts or to confirm an impression . You may want to check on terminology , fulfil curiosities or learn about topics unrelated to your preferential themes . You may be a professional applied to other health specialities , an undergraduate or a high school student . Several users will meet their needs by consulting A Dictionary ... ; even those who aim lessly scan the text may find some valuable insight . While it will not resolve all your needs in the epidemiological field , it surely provides enough substance to build on — a very good start or ammunition for more comprehensive search es . Miquel Porta dealt with the challenge of preparing reader-friendly texts on a wide range of subjects , which will satisfy both a beginner and an experienced epidemiologist . He seems to have transposed Occam ’s razor ( see the correspondent entry : ‘ ‘ the philosophical principle of parsimony ... assumptions to explain a phenomenon must not be multiplied beyond necessity ... ’ ’ ) to the writing of the book . If I may indulge in selftestimony , I found my teenage daughter consulting the book and it motivated a conversation on subjects so dear to me .... Arousing the interest of the young for a speciality admittedly perceived as difficult by adolescents ; as goes the popular saying , this is priceless ! ‘ ‘ Epidemiology is the study of the occurrence and distribution of healthrelated states or events in specified population s , including the study of the determinants influencing such states , and the application of this knowledge to control the health problems ’ ’ . The definition has matured over the years and presents slight modifications from its previous formulation in the fourth edition . The entry for ‘ ‘ Epidemiology ’ ’ exp and s the conceptualisation of terms comprised in the definition and includes historical aspects . In subsequent years , this definition will be the benchmark of the discipline , until Miquel Porta and his collaborators eventually prepare a further edition to meet the new needs that the future may bring forth . I dare to guess that the prospect i ve sixth edition of A Dictionary ... will have an online dynamic interface interacting with the hard copy . I also dare to guess that it will include a new entry for A Dictionary of Epidemiology , whose importance to the professional field will surely have earned it
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 .