High Fructose Corn Syrup and Sucrose do not Differ in Their Effects on Cardiometabolic Risk Factors: A Series of Systematic Reviews and Meta‐Analyses of Randomized Controlled Trials

Background Increased consumption of fructose‐containing sugars has been implicated in the development of obesity, diabetes and their cardiometabolic complications. HFCS has come under particular scrutiny more than sucrose due to its higher ratio of fructose to glucose. Objective To compare the effects of HFCS and sucrose on cardiometabolic risk factors, we conducted a series of systematic reviews and meta‐analyses of controlled trials lasting 蠅7 days. Data Sources MEDLINE, EMBASE, CINAHL and the Cochrane Library (through February 27, 2014). Data Extraction Two independent reviewers extracted data from eligible trials. Data were pooled using the generic inverse variance method and expressed as mean differences with 95% confidence intervals. Data Synthesis Eligibility criteria were met by 7 randomized controlled trials (n=659) comparing the effects of HFCS versus sucrose over a wide dose range (8‐30% total energy) and median follow‐up of 10 weeks (range, 10‐12 weeks) on various cardiometabolic endpoints: body weight, measures of adiposity, serum lipids, blood pressure, glycemic control, uric acid and inflammation. Sucrose and HFCS did not differ in their effects across all cardiometabolic endpoints (P>0.05). Conclusion Pooled analyses show that HFCS and sucrose in isocaloric comparisons behave similarly in their effects on cardiometabolic risk factors. To inform public policy further, there is a need for high quality trials focusing on the effects of ad libitum substitution of HFCS or sucrose with other sources of calories likely to replace them under ‘real world’ conditions.