Effect of sugars on markers of cardiometabolic disease an overview of meta-analyses

Over the last 50 years, global sugar consumption patterns have increased in parallel with the increase in refined grain and sugar-sweetened beverage (SSB) products [1,2]. As reviewed in other chapters, added sugars-primarily sucrose and high-fructose corn syrup (HFCS)-have long been implicated in metabolic and cardiovascular disorders [3]. Recent attention has focused on the fructose moiety of sugars, buttressing a potential fructose-mediated role in exacerbating cardiometabolic risk factors including body weight, glycemic control, blood pressure, blood lipids, and hepatic function [2,4,5]. The effects of chronic, fructose-containing sugar consumption have even been likened to those of chronic alcoholism [5]. Likewise, several public health initiatives directed toward limiting sugar intake have been proposed, including taxing SSBs [6], SSB serving size restrictions in New York City [7], front-of-package warning labels similar to that on cigarette packages [8], and the use of a fructose index (similar to the glycemic index) to predict fructose-mediated cardiovascular disease (CVD) risk [9].