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Fructose: Friend or Foe?

Long thought to be the better sugar for people with diabetes, fructose may not be so great after all.


By Jack Challem

Most people think of fructose as a natural fruit sugar. After all, it’s one of the main sugars (along with glucose and sucrose) in fruits. But in fact, the amount of fructose in most fruits is relatively small, compared with other dietary sources. Fruit also contains many beneficial nutrients, including fiber, which slows the absorption of sugars.

The fructose found in processed foods, however, is another story. Between 1980 and 2000, Americans actually decreased their intake of sucrose (table sugar), but the amount of fructose in the American diet more than tripled. The reason was that food makers replaced sucrose (table sugar) with high-fructose corn syrup (HFCS) to sweeten foods and beverages.

HFCS does not come from fruit. Instead, it is a highly purified blend of sugars (typically 55 percent fructose and 45 percent glucose) derived from corn. Because the fructose in HFCS is part of a manmade blend (as opposed to the natural compound of sugars found in fruit), the body metabolizes it very differently from other sugars.

Research findings

Between 2000 and 2010, a lot of research came out linking fructose to an increased risk for health complications such as obesity, diabetes, high cholesterol, and heart disease. These research findings garnered a lot of press attention, and American’s responded by decreasing their fructose consumption. According to the U.S. Department of Agriculture (USDA), as of 2015, consumption of HFCS was the lowest it has been since 1992.

But this doesn’t necessarily mean people are healthier. On the one hand, we’re seeing a decrease in HFCS consumption; but on the other hand, we are also seeing sugar consumption reach a 30-year high. And current research shows negative consequences from high consumption of both types of sweeteners. In fact, there are a number of recent studies that contradict the research from the early 2000s and suggest that HFCS isn’t any more harmful than regular sugar when consumed at normal levels.

While more research is needed to put an end to the HFCS debate, one thing is clear. A healthy diet that minimizes processed carbohydrates or sugar-sweetened food and beverage intake has always been the healthy choice for most people, particularly those with type 2 diabetes.

What you can do

First, make a decision to get your added sweetness from whole fruit. Fruit provides a wealth of good nutrition, especially high-fiber, non-starchy fruits such as berries, nectarines, and apples. Consider adding some of these (fresh or frozen) to unsweetened yogurt or cream.

Read the ingredients lists on bottles and packages. Pay attention to added syrups, juices, and concentrates used to sweeten; and reject products containing HFCS. Make a habit of controlling your sweet tooth and limiting your intake of all added sweeteners such as HFCS, fructose, sucrose (sugar), glucose, and corn syrup to improve your control of blood sugar.

Skip soft drinks and fruit juices altogether, when possible. A typical 12-ounce soft drink, sweetened with HFCS, provides the equivalent of 12 teaspoons of sugars and about 150 calories. Some brands of fruit juice are even worse. Those are calories you probably don’t need or should at least be spent on something more nutritious. Try switching to water, seltzer, or other unsweetened beverages like herbal tea. You can choose flavored varieties, or you can infuse them with your own fruit such as lemon wedges, lime wedges, raspberries, or strawberry slices.

Jack Challem, The Nutrition Reporter™, is a member of the American Society for Nutrition and one of America’s most trusted nutrition and health writers. He is the bestselling author of more than twenty books, including Stop Prediabetes Now, and gives nutrition presentations across the United States and around the world. For more, visit www.nutritionreporter.com.

Sources

eChristopher, L. R., Uribarri, J., and Tucker, K. L. 2016. “Intake of high-fructose corn syrup sweetened soft drinks, fruit drinks and apple juice is associated with prevalent arthritis in US adults, aged 20-30 years.” Nutrition and Diabetes 6: e199.Khan, T. A., Blanco-Mejia, S., de Souza, R., Kendall, C. W. C., and Sievenpiper, J. L. 2016. “Relation of total sugars and fructose-containing sugars with risk of cardiovascular disease: A systematic review and meta-analysis of prospective cohort studies.” The FASEB Journal 30 (1): Supplement 904.7.Lowndes, J., Kawiecki, D., Pardo, S., Nguyen, V., Melanson, K. J., Yu, Z., and Rippe, J. M. 2016. “The effects of four hypocaloric diets containing different levels of sucrose or high fructose corn syrup on weight loss and related parameters.” Nutrition Journal 11: 55.

Popkin, B. M., and Hawkes, C. 2916. “Sweetening of the global diet, particularly beverages: Patterns, trends, and policy responses.” The Lancet 4 (2): 174-186.

S. Department of Agriculture. 2016. “Sugar and sweeteners yearbook tables.” U. S. Department of Agriculture Economic Research Service. Last Modified March 16, 2017.
https://www.ers.usda.gov/data-products/sugar-and-sweeteners-yearbook-tables.aspx.

van Buul, V. J., Tappy, L., and Brouns, F. J. P. H. 2014. “Misconceptions about fructose-containing sugars and their role in the obesity epidemic.” Nutrition Research Reviews 27 (1): 119-130.

White, J. S. 2013. “Challenging the fructose hypothesis: New perspectives on fructose consumption and metabolism.” Advances in Nutrition 4: 246-256.

Updated by Julia Telfer, 3/17.


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