title: Added fructose: a principal driver of type 2 diabetes mellitus and its consequences.
abstract: Data from animal experiments and human studies implicate added sugars (eg, sucrose and high-fructose corn syrup) in the development of diabetes mellitus and related metabolic derangements that raise cardiovascular (CV) risk. Added fructose in particular (eg, as a constituent of added sucrose or as the main component of high-fructose sweeteners) may pose the greatest problem for incident diabetes, diabetes-related metabolic abnormalities, and CV risk. Conversely, whole foods that contain fructose (eg, fruits and vegetables) pose no problem for health and are likely protective against diabetes and adverse CV outcomes. Several dietary guidelines appropriately recommend consuming whole foods over foods with added sugars, but some (eg, recommendations from the American Diabetes Association) do not recommend restricting fructose-containing added sugars to any specific level. Other guidelines (such as from the Institute of Medicine) allow up to 25% of calories as fructose-containing added sugars. Intake of added fructose at such high levels would undoubtedly worsen rates of diabetes and its complications. There is no need for added fructose or any added sugars in the diet; reducing intake to 5% of total calories (the level now suggested by the World Health Organization) has been shown to improve glucose tolerance in humans and decrease the prevalence of diabetes and the metabolic derangements that often precede and accompany it. Reducing the intake of added sugars could translate to reduced diabetes-related morbidity and premature mortality for populations.
authors: Department of Preventive Cardiology at Saint Luke's Mid America Heart Institute, Kansas City, MO. Electronic address: jjdinicol@gmail.com.
authors: James J
authors: JJ
authors: DiNicolantonio
authors: Department of Preventive Cardiology at Saint Luke's Mid America Heart Institute, Kansas City, MO.
authors: James H
authors: JH
authors: O'Keefe
authors: Department of Family and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
authors: Sean C
authors: SC
authors: Lucan
mesh_terms: D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000453:epidemiology; D005632:Fructose / Q000008:administration & dosage / Q000009:adverse effects*; D017408:Guidelines as Topic; D006801:Humans; D015994:Incidence; D012307:Risk Factors; D013549:Sweetening Agents / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D013549:Sweetening Agents; D005632:Fructose