Sugar, HFCS, Fruit Juice, The Lustig Effect & More...

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

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Sugar, HFCS, Fruit Juice, The Lustig Effect & More...

Postby JeffN » Wed Feb 19, 2014 8:10 am

1) High Fructose Corn Syrup & The Lustig Effect - A great article on how the media distorted the science & created a national epidemic of misinformation & fear.
http://www.forbes.com/sites/trevorbutte ... -thoughts/

2) Fructose, Sugar, Obesity and You!
http://www.jeffnovick.com/RD/Q_%26_As/E ... d_You.html

3) Toxic Effects of Sugar: Should We Be Afraid of Fructose.
http://www.biomedcentral.com/1741-7007/10/42

4) Fate of fructose: Interview with Dr. John Sievenpiper
http://evolvinghealthscience.blogspot.c ... n.html?m=1

5) Robert Lustig found incompetent
https://robertlustigsugarbittertruthinf ... n-science/

6) The bitter truth about fructose alarmism.
http://www.alanaragonblog.com/2010/01/2 ... -alarmism/

7) Fruit Juice: Just Another Sugar?
http://www.drmcdougall.com/forums/viewt ... 22&t=41620

8) The WHO New Recommendations for Added Sugar Intake
https://www.drmcdougall.com/forums/view ... 22&t=41862

9) Is Fruit Juice Healthy?
http://youtu.be/HCEM0SrJudQ

10 ) Juicing & Cleansing
https://www.drmcdougall.com/forums/view ... 31#p495831

11) Public Health England - The Scientific Advisory Committee on Nutrition recommendations on carbohydrates, including sugars and fibre
https://www.drmcdougall.com/forums/view ... 40#p502740

In Health
Jeff
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Re: Sugar, HFCS, Fruit Juice, The Lustig Effect & More...

Postby JeffN » Mon Oct 05, 2015 7:33 am

Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals.
Raatz SK, Johnson LK, Picklo MJ.
J Nutr. 2015 Oct;145(10):2265-72. doi: 10.3945/jn.115.218016. Epub 2015 Sep 2.
PMID: 26338891

Abstract

Background:
Public health recommendations call for a reduction in added sugars; however, controversy exists over whether all nutritive sweeteners produce similar metabolic effects.

Objective:
The objective was to compare the effects of the chronic consumption of 3 nutritive sweeteners [honey, sucrose, and high-fructose corn syrup containing 55% fructose (HFCS55)] on circulating glucose, insulin, lipids, and inflammatory markers; body weight; and blood pressure in individuals with normal glucose tolerance (GT) and those with impaired glucose tolerance (IGT).

Methods:
In a crossover design, participants consumed daily, in random order, 50 g carbohydrate from assigned sweeteners for 2 wk with a 2- to 4-wk washout period between treatments. Participants included 28 GT and 27 IGT volunteers with a mean age of 38.9±3.6 y and 52.1±2.7 y, respectively, and a body mass index (in kg/m2) of 26±0.8 and 31.5±1.0, respectively. Body weight, blood pressure (BP), serum inflammatory markers, lipids, fasting glucose and insulin, and oral-glucose-tolerance tests (OGTTs) were completed pre- and post-treatment. The OGTT incremental areas under the curve (iAUCs) for glucose and insulin were determined and homeostasis model assessment of insulin resistance (HOMA-IR) scores were calculated.

Results:
Body weight and serum glucose, insulin, inflammatory markers, and total and LDL-cholesterol concentrations were significantly higher in the IGT group than in the GT group at baseline. Glucose, insulin, HOMA-IR, and the OGTT iAUC for glucose or insulin did not differ by treatment, but all responses were significantly higher in the IGT group compared with the GT group. Body weight was unchanged by treatment. Systolic BP was unchanged, whereas diastolic BP was significantly lower in response to sugar intake across all treatments. An increase in high-sensitivity C-reactive protein (hsCRP) was observed in the IGT group in response to all sugars. No treatment effect was observed for interleukin 6. HDL cholesterol did not differ as a result of status or treatment. Triglyceride (TG) concentrations increased significantly from pre- to post-treatment in response to all sugars tested.

Conclusions:
Daily intake of 50 g carbohydrate from honey, sucrose, or HFCS55 for 14 d resulted in similar effects on measures of glycemia, lipid metabolism, and inflammation. All 3 increased TG concentrations in both GT and IGT individuals and elevated glycemic and inflammatory responses in the latter. This trial was registered at clinicaltrials.gov as NCT01371
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Re: Sugar, HFCS, Fruit Juice, The Lustig Effect & More...

Postby JeffN » Wed Apr 05, 2017 7:03 am

Journal of the American Heart Association
ORIGINAL RESEARCH

Effect of Fructose on Established Lipid Targets: A Systematic Review and Meta‐Analysis of Controlled Feeding Trials
Journal of the American Heart Association. 2015;4:e001700
Originally published September 10, 2015
https://doi.org/10.1161/JAHA.114.001700

http://jaha.ahajournals.org/content/4/9/e001700

Abstract

Background
Debate over the role of fructose in mediating cardiovascular risk remains active. To update the evidence on the effect of fructose on established therapeutic lipid targets for cardiovascular disease (low‐density lipoprotein cholesterol [LDL]‐C, apolipoprotein B, non‐high‐density lipoprotein cholesterol [HDL‐C]), and metabolic syndrome (triglycerides and HDL‐C), we conducted a systematic review and meta‐analysis of controlled feeding trials.

Methods and Results
MEDLINE, EMBASE, CINHAL, and the Cochrane Library were searched through July 7, 2015 for controlled feeding trials with follow‐up ≥7 days, which investigated the effect of oral fructose compared to a control carbohydrate on lipids (LDL‐C, apolipoprotein B, non‐HDL‐C, triglycerides, and HDL‐C) in participants of all health backgrounds. Two independent reviewers extracted relevant data. Data were pooled using random effects models and expressed as mean difference with 95% CI. Interstudy heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). Eligibility criteria were met by 51 isocaloric trials (n=943), in which fructose was provided in isocaloric exchange for other carbohydrates, and 8 hypercaloric trials (n=125), in which fructose supplemented control diets with excess calories compared to the control diets alone without the excess calories. Fructose had no effect on LDL‐C, non‐HDL‐C, apolipoprotein B, triglycerides, or HDL‐C in isocaloric trials. However, in hypercaloric trials, fructose increased apolipoprotein B (n=2 trials; mean difference = 0.18 mmol/L; 95% CI: 0.05, 0.30; P=0.005) and triglycerides (n=8 trials; mean difference = 0.26 mmol/L; 95% CI: 0.11, 0.41; P<0.001). The study is limited by small sample sizes, limited follow‐up, and low quality scores of the included trials.

Conclusions
Pooled analyses showed that fructose only had an adverse effect on established lipid targets when added to existing diets so as to provide excess calories (+21% to 35% energy). When isocalorically exchanged for other carbohydrates, fructose had no adverse effects on blood lipids. More trials that are larger, longer, and higher quality are required.



Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies.
CMAJ. 2017 May 23;189(20):E711-E720. doi: 10.1503/cmaj.160706.

Abstract

BACKGROUND:
Sugar-sweetened beverages are associated with type 2 diabetes. To assess whether this association holds for the fructose-containing sugars they contain, we conducted a systematic review and meta-analysis of prospective cohort studies.
METHODS:
We searched MEDLINE, Embase, CINAHL and the Cochrane Library (through June 2016). We included prospective cohort studies that assessed the relation of fructose-containing sugars with incident type 2 diabetes. Two independent reviewers extracted relevant data and assessed risk of bias. We pooled risk ratios (RRs) using random effects meta-analyses. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.
RESULTS:
Fiffeen prospective cohort studies (251 261 unique participants, 16 416 cases) met the eligibility criteria, comparing the highest intake (median 137, 35.2 and 78 g/d) with the lowest intake (median 65, 9.7 and 25.8 g/d) of total sugars, fructose and sucrose, respectively. Although there was no association of total sugars (RR 0.91, 95% confidence interval [CI] 0.76-1.09) or fructose (RR 1.04, 95% CI 0.84-1.29) with type 2 diabetes, sucrose was associated with a decreased risk of type 2 diabetes (RR 0.89, 95% CI 0.80-0.98). Our confidence in the estimates was limited by evidence of serious inconsistency between studies for total sugars and fructose, and serious imprecision in the pooled estimates for all 3 sugar categories.

INTERPRETATION:
Current evidence does not allow us to conclude that fructose-containing sugars independent of food form are associated with increased risk of type 2 diabetes. Further research is likely to affect our estimates.
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Re: Sugar, HFCS, Fruit Juice, The Lustig Effect & More...

Postby JeffN » Tue Sep 29, 2020 12:24 pm

Looks like the USDA is finally going to catch up . It’s not 5% but 6% is close enough

:)


New Limits Urged on Americans’ Sugar Consumption Amid Rising Obesity Concerns
- Americans should get no more than 6% of their daily calories from added sugar, a federal committee recommends, down from the current 10% guideline
WSJ
By Andrea Petersen
Sept. 28, 2020 7:00 pm ET

https://www.wsj.com/articles/new-limits ... 1601334000
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Re: Sugar, HFCS, Fruit Juice, The Lustig Effect & More...

Postby JeffN » Wed Apr 28, 2021 10:41 am

Chronic Fructose Substitution for Glucose or Sucrose in Food or Beverages and Metabolic Outcomes: An Updated Systematic Review and Meta-Analysis
Frontiers in Nutrition | April 2021 | Volume 8 | Article 647600

https://www.frontiersin.org/articles/10 ... 47600/full

Despite the publication of several of meta-analyses in recent years, the effects of fructose on human health remains a topic of debate. We previously undertook two meta-analyses on post-prandial and chronic responses to isoenergetic replacement of fructose for sucrose or glucose in food or beverages (Evans et al. 2017, AJCN 106:506–518 & 519–529). Here we report on the results of an updated search with a complete re-extraction of previously identified studies and a new and more detailed subgroup-analysis and meta-regression. We identified two studies that were published after our previous analyses, which slightly altered effect sizes and conclusions. Overall, the isoenergetic substitution of fructose for glucose resulted in a statistically significant but clinically irrelevant reduction in fasting blood glucose, insulin, and triglyceride concentrations. A subgroup analysis by diabetes status revealed much larger reductions in fasting blood glucose in people with impaired glucose tolerance and type 2 diabetes. However, each of these subgroups contained only a single study. In people with a healthy body mass index, fructose consumption was associated with statistically significant, but clinically irrelevant reductions in fasting blood glucose and fasting blood insulin. Meta-regression of the outcomes by a number of pre-identified and post-hoc covariates revealed some sources of heterogeneity, such as year of publication, age of the participants at baseline, and participants’ sex. However, the small number of studies and the large number of potential covariates precluded detailed investigations of effect sizes in different subpopulations. For example, well-controlled, high quality studies in people with impaired glucose tolerance and type 2 diabetes are still lacking. Taken together, the available data suggest that chronic consumption of fructose is neither more beneficial, nor more harmful than equivalent doses of sucrose or glucose for glycemic and other metabolic outcomes.
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