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 .
A randomized trial of sugar-sweetened beverages and adolescent body weight.
BACKGROUND Consumption of sugar-sweetened beverages may cause excessive weight gain . We aim ed to assess the effect on weight gain of an intervention that included the provision of noncaloric beverages at home for overweight and obese adolescents . METHODS We r and omly assigned 224 overweight and obese adolescents who regularly consumed sugar-sweetened beverages to experimental and control groups . The experimental group received a 1-year intervention design ed to decrease consumption of sugar-sweetened beverages , with follow-up for an additional year without intervention . We hypothesized that the experimental group would gain weight at a slower rate than the control group . RESULTS Retention rates were 97 % at 1 year and 93 % at 2 years . Reported consumption of sugar-sweetened beverages was similar at baseline in the experimental and control groups ( 1.7 servings per day ) , declined to nearly 0 in the experimental group at 1 year , and remained lower in the experimental group than in the control group at 2 years . The primary outcome , the change in mean body-mass index ( BMI , the weight in kilograms divided by the square of the height in meters ) at 2 years , did not differ significantly between the two groups ( change in experimental group minus change in control group , -0.3 ; P=0.46 ) . At 1 year , however , there were significant between-group differences for changes in BMI ( -0.57 , P=0.045 ) and weight ( -1.9 kg , P=0.04 ) . We found evidence of effect modification according to ethnic group at 1 year ( P=0.04 ) and 2 years ( P=0.01 ) . In a prespecified analysis according to ethnic group , among Hispanic participants ( 27 in the experimental group and 19 in the control group ) , there was a significant between-group difference in the change in BMI at 1 year ( -1.79 , P=0.007 ) and 2 years ( -2.35 , P=0.01 ) , but not among non-Hispanic participants ( P>0.35 at years 1 and 2 ) . The change in body fat as a percentage of total weight did not differ significantly between groups at 2 years ( -0.5 % , P=0.40 ) . There were no adverse events related to study participation . CONCLUSIONS Among overweight and obese adolescents , the increase in BMI was smaller in the experimental group than in the control group after a 1-year intervention design ed to reduce consumption of sugar-sweetened beverages , but not at the 2-year follow-up ( the prespecified primary outcome ) . ( Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others ; Clinical Trials.gov number , NCT00381160 . )
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 .