Effect of fructose on triglycerides: a meta‐analysis of controlled feeding trials

Background Health agencies have expressed concern that fructose may contribute to hyper‐triglyceridemia (HTG) in people with and without diabetes (DM). Purpose To investigate the effect of fructose on triglycerides (TG), we conducted a meta‐analysis of controlled feeding trials. Methods We searched MEDLINE, EMBASE, CINAHL and the Cochrane Library for relevant trials of ≥7days. Data were aggregated by the generic inverse variance method using random effects models and expressed as mean differences (MD) with 95% confidence intervals (CI). Heterogeneity was assessed (Chi 2 ) and quantified (I 2 ). Study quality was assessed by the Heyland score. Results 46 isocaloric (n=549 non‐DM, n=174 DM) and 7 hypercaloric (n=127 non‐DM) trials met eligibility criteria. In isocaloric trials, fructose did not significantly effect TG (MD= 0.05 [95% CI: −0.02, 0.12]) with significant evidence of inter‐study heterogeneity. There was no effect modification by diabetes status. In hypercaloric feeding trials, fructose had a TG‐raising effect (MD=0.32 [95% CI: 0.08, 0.56]) with significant inter‐study heterogeneity. Limitations The majority of the trials were <12‐weeks and of poor study quality. Conclusions Isocaloric fructose does not have significant TG‐raising effects whereas hypercaloric trials did, however excess energy may be a cofounder. Funding: Canadian Institutes of Health Research (CIHR). Grant Funding Source : ASN