Things You Should Know About fructose

Consult a registered dietitian for a complete list of foods your daughter should eat or avoid if she has fructose intolerance. The dietitian can also help create a healthy diet plan for your daughter to make sure she gets the nutrients she needs.

Over the last 10-15 years, there has been a lot of discussion about the role that fructose plays in many of our chronic health issues, including obesity, diabetes, non-alcoholic fatty liver disease, and many others.

We should look at fructose in the context it is being consumed and how it fits into the lifestyle of an individual. If someone is getting ~30-50 grams a day from apples, watermelon, blueberries, etc., there is no real reason to be concerned with their intake. If they are getting ~30-50 grams a day from soda, other sugar-sweetened beverages, and other processed foods, it may be worth discussing the context of their dietary choices and less about the actual fructose content of those foods.

Fructose comes from natural foods, such as honey or fruits, and it can be healthy as part of a balanced diet. However, people should limit their intake of processed forms of fructose, including high fructose corn syrup.

High-fructose corn syrup is a common ingredient in packaged foods. Food manufacturers use it because it makes food sweet like sugar, but is less expensive. Read on to learn about the safety of high-fructose corn syrup and its role in your health.

Take the time to read the ingredients to determine how much added sugar is in your foods. Choose products with the least amount of added sugar. Foods that contain sugar in the first few ingredients, including HFCS, should be limited. For more information about sugar and what to look for on the label, see the Frequently Asked Questions about sugar.

Added sugars should be limited, but there is no need to worry about those found naturally in foods. Consuming a diet high in whole foods and low in processed foods is the best way to avoid added sugars.

Recent research reviews by Dolan et al. (44, 45) reported that no adverse effect on triglycerides or weight was observed in multiple trials using fructose at up to the 95th percentile population consumption level. Meta-analyses by Ha et al. (46) also documented that no increases in blood pressure or propensity toward obesity occurred at up to the 90th percentile population consumption levels of fructose (47). It should be emphasized that these meta-analyses included only studies exploring consumption of fructose in isolation. Stanhope et al. (36) also did not find increases in blood pressure when obese individuals consumed as much as 25% of energy as either fructose or glucose.

The AHA recommendations for upper limits of added sugar consumption, which are currently exceeded by >90% of the population, should be taken with caution. Recent research reviews have reported that fructose consumption at up to the 90th percentile population consumption level in either healthy weight or obese individuals does not result in increased triglycerides or weight gain (44, 45). Moreover, studies in our research laboratory at levels of 2 to 3 times those recommended by the AHA did not show any adverse impact on lipids (64). A recently completed trial in our research laboratory involving 352 overweight or obese individuals who consumed up to the 90th percentile population consumption levels for fructose as part of mixed-nutrient, eucaloric diets did not show any adverse effect on total cholesterol (P = 0.88) or LDL cholesterol (P = 0.85). A significant 14% increase in triglycerides was noted, although it must be emphasized that triglyceride levels remained within the normal range both before and after measurement (65).

Other investigators have reported results in which sugar consumption increased lipids in human subjects. In particular, Stanhope et al. (66), using a model in which 25% of energy consumption from fructose was compared with 25% energy consumption from glucose in acute experiments showed increases in triglycerides. Once again, however, it should be noted that pure fructose and pure glucose are rarely consumed in the human diet and that the reported levels were within established population norms. Other investigators including Raben et al. (67), Marckmann (68), Maersk et al. (69), and Stanhope et al. (70) also reported a variety of increased lipid measurements in individuals after sugar consumption.

Cox et al. (100) reported that fructose consumption at 25% of calories compared with glucose at 25% of calories acutely increased uric acid profiles. However, research in our laboratory comparing HFCS with sucrose yielded identical responses and no increases in acute levels of uric acid in either normal weight or obese women (101, 102). Moreover, a recently completed trial in our research laboratory in which individuals consumed up to 30% of calories (90th percentile population consumption level for fructose) over a 10-wk period did not show any increase in uric acid. Thus, the issue of whether increased fructose consumption results in increases in uric acid or blood pressure remains in dispute. It should be pointed out that Maersk et al. (69) reported increased visceral adipose tissue in response to 6 wk of consumption of 1 L/d of sucrose-sweetened cola. Increased visceral adipose tissue is an established risk factor for metabolic syndrome. However, research in our laboratory did not confirm these findings. Whether fructose consumption results in increased risk factors for metabolic syndrome also remains in dispute. Studies exploring whether fatty infiltration of the liver or muscle occurs in response to fructose consumption have produced disparate findings. Differences in duration of these studies (research studies varying in length from 4 to 10 wk) have not shown any increases in liver or muscle fatty infiltration in response to fructose consumption, whereas the Maersk et al. 6-mo study did show this phenomenon. This indicates that further research studies, perhaps of longer duration, are required to resolve this issue.

Hereditary fructose intolerance should not be confused with a condition called fructose malabsorption. In people with fructose malabsorption, the cells of the intestine cannot absorb fructose normally, leading to bloating, diarrhea or constipation, flatulence, and stomach pain. Fructose malabsorption is thought to affect approximately 40 percent of individuals in the Western hemisphere; its cause is unknown.

As a result, high-fructose corn syrup went from 1% of sweeteners in the U.S. in the 1970s to 42% by 2004. From 1977 to 1978, the average American consumed about 37 grams of fructose per day. In 2008, this jumped to 54.7 grams, about 10.2% of total daily calories. The number was even higher in teenagers, at 72.8 grams per day.

You've probably heard the terms fructose, glucose, lactose and sucrose before, and you may know that they're all types of sugar. But do you know how they differ from one another, or whether some are better for you than others? Use our handy guide to shed some light on the secrets of sugar...

Due to its glucose content, sucrose has a GI value of 65. As it is made up of glucose and fructose, the latter is metabolised in the liver and holds the same issues as those mentioned for fructose above. Due to its glucose content, sucrose does lead to an elevation in blood glucose. Diabetics should therefore be mindful of foods containing sucrose.

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Limit processed foods with fructose as an ingredient but continue to eat fruit which is high in vitamins, minerals and fiber. Finally, meals and snacks should include whole grains/starches, protein, dairy, fruit, vegetables and fats. By eating foods from each food group at each meal, an individual ensures the body has a proper balance of all the nutrients it needs to function.

The annual American Society for Nutrition Public Information Committee symposium for 2007 titled "High Fructose Corn Syrup (HFCS): Everything You Wanted to Know, But Were Afraid to Ask" served as a platform to address the controversy surrounding HFCS. Speakers from academia and industry came together to provide up-to-date information on this food ingredient. The proceedings from the symposium covered 1) considerable background on what HFCS is and why it is used as a food ingredient, 2) the contribution HFCS makes to consumers' diets, and 3) the latest research on the metabolic effects of HFCS. The data presented indicated that HFCS is very similar to sucrose, being about 55% fructose and 45% glucose, and thus, not surprisingly, few metabolic differences were found comparing HFCS and sucrose. That said, HFCS does contribute to added sugars and calories, and those concerned with managing their weight should be concerned about calories from beverages and other foods, regardless of HFCS content.

Oh, high fructose corn syrup, how do we hate thee? Let us count the ways: High fructose corn syrup makes you fatter. It makes you dumber. It ages you and makes your skin worse. It makes you addicted to it. In fact, a study out of the University of the Philippines Diliman linked the sugar to diabetes and metabolic diseases. And yet, high fructose corn syrup can be found in a ton of common, store-bought foods. The sweetener is so popular that many Americans are consuming a few dozen pounds of it every year (not kidding), which certainly explains why so many of us are overweight and struggling with health issues. Even scarier? High fructose corn syrup can be found in things you might not even be reading the nutrition label for, like ketchup.

Lunch meat is, unfortunately, much more than protein and fats. Many brands of deli meat are loaded with harmful additives and preservatives like nitrates, colored with artificial dyes, and flavored with high fructose corn syrup. The BBQ and honey-smoked flavors should raise a red flag, but all of them are suspects. 2b1af7f3a8