title: Fructose and Cardiometabolic Health: What the Evidence From Sugar-Sweetened Beverages Tells Us.
abstract: Recent attention has focused on fructose as having a unique role in the pathogenesis of cardiometabolic diseases. However, because we rarely consume fructose in isolation, the major source of fructose in the diet comes from fructose-containing sugars, sucrose and high fructose corn syrup, in sugar-sweetened beverages and foods. Intake of sugar-sweetened beverages has been consistently linked to increased risk of obesity, type 2 diabetes, and cardiovascular disease in various populations. Putative underlying mechanisms include incomplete compensation for liquid calories, adverse glycemic effects, and increased hepatic metabolism of fructose leading to de novo lipogenesis, production of uric acid, and accumulation of visceral and ectopic fat. In this review we summarize the epidemiological and clinical trial evidence evaluating added sugars, especially sugar-sweetened beverages, and the risk of obesity, diabetes, and cardiovascular disease and address potential biological mechanisms with an emphasis on fructose physiology. We also discuss strategies to reduce intake of fructose-containing beverages.
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Vasanti S
authors.initials: VS
authors.lastname: Malik
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Electronic address: nhbfh@channing.harvard.edu.
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
mesh_terms: D000293:Adolescent; D000328:Adult; D001628:Beverages / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism; D002149:Energy Intake; D005247:Feeding Behavior; D005632:Fructose / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism; D006801:Humans; D009765:Obesity / Q000453:epidemiology*; D013549:Sweetening Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D013549:Sweetening Agents; D005632:Fructose
keywords: cardiometabolic diseases; diabetes; fructose; obesity