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 .
Consumption of fatty foods and incident type 2 diabetes in populations from eight European countries
Background / Objectives : Diets high in saturated and trans fat and low in unsaturated fat may increase type 2 diabetes ( T2D ) risk , but studies on foods high in fat per unit weight are sparse . We assessed whether the intake of vegetable oil , butter , margarine , nuts and seeds and cakes and cookies is related to incident T2D.Subjects/ Methods : A case-cohort study was conducted , nested within eight countries of the European Prospect i ve Investigation into Cancer ( EPIC ) , with 12 403 incident T2D cases and a subcohort of 16 835 people , identified from a cohort of 340 234 people . Diet was assessed at baseline ( 1991–1999 ) by country-specific question naires . Country-specific hazard ratios ( HRs ) across four categories of fatty foods ( nonconsumers and tertiles among consumers ) were combined with r and om-effects meta- analysis . Results : After adjustment not including body mass index ( BMI ) , nonconsumers of butter , nuts and seeds and cakes and cookies were at higher T2D risk compared with the middle tertile of consumption . Among consumers , cakes and cookies were inversely related to T2D ( HRs across increasing tertiles 1.14 , 1.00 and 0.92 , respectively ; P-trend < 0.0001 ) . All these associations attenuated upon adjustment for BMI , except the higher risk of nonconsumers of cakes and cookies ( HR 1.57 ) . Higher consumption of margarine  became positively associated after BMI adjustment ( HRs across increasing consumption tertiles : 0.93 , 1.00 and 1.12 ; P-trend 0.03 ) . Within consumers , vegetable oil , butter and nuts and seeds were unrelated to T2D . Conclusions : Fatty foods were generally not associated with T2D , apart from weak positive association for margarine . The higher risk among nonconsumers of cakes and cookies needs further explanation
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 .