Differential effects of fructose on glycemic control: A systematic review and meta‐analysis of controlled feeding trials Conferences uri icon

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abstract

  • ObjectiveFructose has become a focus of concern. To assess the effect of fructose on glycemic control, we conducted a systematic review and meta‐analysis.MethodsWe searched MEDLINE, EMBASE, and Cochrane Library (up to Nov 5, 2012) for relevant controlled trials ≥7‐days. Two independent reviewers extracted data. Data were pooled using random effects models for glycated blood proteins (GBP) and fasting glucose (FG) and insulin (FI).ResultsEligibility criteria were met by 47 isocaloric trials (n=863), in which fructose was exchanged isocalorically for other carbohydrate, and 12 hypercaloric trials (n=143), in which the diet was supplemented with excess energy from fructose. Fructose in isocaloric trials reduced GBP (standardized mean difference = − 0.29 [95% CI: −0.46, −0.11]), equivalent to a ~0.59% reduction in HbA1c, in people with and without diabetes. In contrast, fructose in hypercaloric trials increased FG (mean difference [MD] = 0.18 mmol/L [95% CI: 0.08, 0.29]) and FI (MD = 6.06 pmol/L [95% CI: 3.70, 8.31]).LimitationsMost trials were small, short, and of poor quality.ConclusionsIsocaloric exchange of fructose for other carbohydrate improves glycemic control in people with and without diabetes. Fructose providing excess energy, however, raises fasting glucose and insulin levels, an effect that may be more owing to excess energy than fructose.Funding: Canadian Institutes of Health Research.Grant Funding Source: CIHR

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publication date

  • April 2013