{"title":"Fructose-containing sugars and metabolic risk: a systematic review and meta-analysis.","authors":"Prasetya Guntari, Astina Junaida, Palupi Eny, Namkieat Pichamon, Jiamjarasrangsi Wiroj, Sapwarobol Suwimol","doi":"10.29219/fnr.v69.11062","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Fructose-containing sugars are widely consumed, yet their metabolic effects remain debated.</p><p><strong>Objective: </strong>This meta-analysis aimed to evaluate the impact of different fructose-containing sugars on glycaemic control, lipid profiles, and uric acid levels in adults.</p><p><strong>Methods: </strong>A total of 17 study codes from seven clinical trials were included, with intervention durations ranging from 7 h to 49 days. Interventions were classified as fructose, fructose-glucose mixtures (F/G), honey, or sucrose. Comparators varied and included unsweetened beverages, artificial sweeteners, and habitual diets. Meta-analyses using random-effects models assessed outcomes including fasting blood glucose (FBG), serum insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), very low-density lipoprotein cholesterol (VLDL-c), and uric acid. Effect sizes were reported as Hedges' <i>g</i>.</p><p><strong>Results: </strong>Fructose-glucose mixtures intake significantly increased FBG (Hedges' <i>g</i> = 0.474, <i>P</i> = 0.002) and serum insulin (Hedges' <i>g</i> = 0.592, <i>P</i> < 0.001), while fructose, honey, and sucrose showed no significant effects. Monosaccharide intake modestly increased insulin (<i>P</i> = 0.006). Fructose and sucrose alone did not affect TC, but their combined intake resulted in a significant increase (Hedges' <i>g</i> = 0.412, <i>P</i> = 0.009). No significant changes were observed in LDL-c, VLDL-c, or pooled metabolic outcomes. Fructose intake was strongly associated with increased uric acid (Hedges' <i>g</i> = 1.628, <i>P</i> < 0.001), and pooled analysis of fructose, F/G, and honey also showed a significant increase (Hedges' <i>g</i> = 0.550, <i>P</i> = 0.028).</p><p><strong>Conclusion: </strong>The short-term consumption of added sugars - fructose, sucrose, and F/G mixtures - had minimal effects on FBG, insulin, triglycerides (TG), non-esterified fatty acids (NEFAs), high-density lipoprotein cholesterol (HDL-c), and VLDL-c. However, significant increases in TC and LDL-c were observed, particularly with fructose and sucrose, indicating adverse effects on lipid metabolism. Some fructose interventions, especially those using high-fructose corn syrup, also showed marked increases in uric acid. While acute metabolic changes were limited, these findings suggest that regular intake of added sugars may elevate cardiometabolic risk. Long-term studies are warranted to clarify chronic effects and inform dietary guidelines.</p>","PeriodicalId":12119,"journal":{"name":"Food & Nutrition Research","volume":"69 ","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664302/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Food & Nutrition Research","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.29219/fnr.v69.11062","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"FOOD SCIENCE & TECHNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Fructose-containing sugars are widely consumed, yet their metabolic effects remain debated.
Objective: This meta-analysis aimed to evaluate the impact of different fructose-containing sugars on glycaemic control, lipid profiles, and uric acid levels in adults.
Methods: A total of 17 study codes from seven clinical trials were included, with intervention durations ranging from 7 h to 49 days. Interventions were classified as fructose, fructose-glucose mixtures (F/G), honey, or sucrose. Comparators varied and included unsweetened beverages, artificial sweeteners, and habitual diets. Meta-analyses using random-effects models assessed outcomes including fasting blood glucose (FBG), serum insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), very low-density lipoprotein cholesterol (VLDL-c), and uric acid. Effect sizes were reported as Hedges' g.
Results: Fructose-glucose mixtures intake significantly increased FBG (Hedges' g = 0.474, P = 0.002) and serum insulin (Hedges' g = 0.592, P < 0.001), while fructose, honey, and sucrose showed no significant effects. Monosaccharide intake modestly increased insulin (P = 0.006). Fructose and sucrose alone did not affect TC, but their combined intake resulted in a significant increase (Hedges' g = 0.412, P = 0.009). No significant changes were observed in LDL-c, VLDL-c, or pooled metabolic outcomes. Fructose intake was strongly associated with increased uric acid (Hedges' g = 1.628, P < 0.001), and pooled analysis of fructose, F/G, and honey also showed a significant increase (Hedges' g = 0.550, P = 0.028).
Conclusion: The short-term consumption of added sugars - fructose, sucrose, and F/G mixtures - had minimal effects on FBG, insulin, triglycerides (TG), non-esterified fatty acids (NEFAs), high-density lipoprotein cholesterol (HDL-c), and VLDL-c. However, significant increases in TC and LDL-c were observed, particularly with fructose and sucrose, indicating adverse effects on lipid metabolism. Some fructose interventions, especially those using high-fructose corn syrup, also showed marked increases in uric acid. While acute metabolic changes were limited, these findings suggest that regular intake of added sugars may elevate cardiometabolic risk. Long-term studies are warranted to clarify chronic effects and inform dietary guidelines.
背景：含果糖的糖被广泛食用，但其代谢作用仍有争议。目的：本荟萃分析旨在评估不同含果糖糖对成人血糖控制、血脂和尿酸水平的影响。方法：纳入7项临床试验共17项研究代码，干预时间为7 h ~ 49天。干预措施分为果糖、果糖-葡萄糖混合物（F/G）、蜂蜜或蔗糖。比较对象多种多样，包括无糖饮料、人工甜味剂和习惯性饮食。meta分析采用随机效应模型评估结果，包括空腹血糖（FBG）、血清胰岛素、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-c）、极低密度脂蛋白胆固醇（VLDL-c）和尿酸。结果：果糖-葡萄糖混合物摄入显著增加空腹血糖（Hedges' g = 0.474, P = 0.002）和血清胰岛素（Hedges' g = 0.592, P < 0.001），而果糖、蜂蜜和蔗糖无显著影响。单糖摄入适度增加胰岛素（P = 0.006）。单独摄入果糖和蔗糖对TC没有影响，但它们的联合摄入导致TC显著增加（Hedges’g = 0.412, P = 0.009）。LDL-c、VLDL-c或汇总代谢结果未观察到显著变化。果糖摄入与尿酸升高密切相关（Hedges' g = 1.628, P < 0.001），合并分析果糖、F/ g和蜂蜜也显示显著升高（Hedges' g = 0.550, P = 0.028）。结论：短期摄入添加糖——果糖、蔗糖和F/G混合物——对FBG、胰岛素、甘油三酯（TG）、非酯化脂肪酸（NEFAs）、高密度脂蛋白胆固醇（HDL-c）和VLDL-c的影响很小。然而，观察到TC和LDL-c显著增加，特别是果糖和蔗糖，表明对脂质代谢有不利影响。一些果糖干预，尤其是那些使用高果糖玉米糖浆的干预，也显示出尿酸的显著增加。虽然急性代谢变化有限，但这些发现表明，定期摄入添加糖可能会增加心脏代谢风险。有必要进行长期研究，以阐明慢性影响并为饮食指南提供信息。
期刊介绍：
Food & Nutrition Research is a peer-reviewed journal that presents the latest scientific research in various fields focusing on human nutrition. The journal publishes both quantitative and qualitative research papers.
Through an Open Access publishing model, Food & Nutrition Research opens an important forum for researchers from academic and private arenas to exchange the latest results from research on human nutrition in a broad sense, both original papers and reviews, including:
* Associations and effects of foods and nutrients on health
* Dietary patterns and health
* Molecular nutrition
* Health claims on foods
* Nutrition and cognitive functions
* Nutritional effects of food composition and processing
* Nutrition in developing countries
* Animal and in vitro models with clear relevance for human nutrition
* Nutrition and the Environment
* Food and Nutrition Education
* Nutrition and Economics
Research papers on food chemistry (focus on chemical composition and analysis of foods) are generally not considered eligible, unless the results have a clear impact on human nutrition.
The journal focuses on the different aspects of nutrition for people involved in nutrition research such as Dentists, Dieticians, Medical doctors, Nutritionists, Teachers, Journalists and Manufacturers in the food and pharmaceutical industries.
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