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The metabolic and endocrine response and health implications of consuming sugar-sweetened beverages: findings from recent randomized controlled trials.

Rippe JM - Adv Nutr (2013)

Bottom Line: The effects of HFCS and sucrose in sugar-sweetened beverages, in particular, have generated intense scientific debate that has spilled over to the public.This controversy is related to well-known differences in metabolism between fructose and glucose in the liver.Other evidence has been drawn from animal studies and epidemiologic or cohort studies.

View Article: PubMed Central - PubMed

Affiliation: University of Central Florida Medical School, Orlando, FL; and Rippe Lifestyle Institute, Shrewsbury, MA and Celebration, FL.

ABSTRACT
Fructose-containing sugars, including fructose itself, high fructose corn syrup (HFCS), and sucrose have engendered considerable controversy. The effects of HFCS and sucrose in sugar-sweetened beverages, in particular, have generated intense scientific debate that has spilled over to the public. This controversy is related to well-known differences in metabolism between fructose and glucose in the liver. In addition, research studies have often been conducted comparing pure fructose and pure glucose even though neither is consumed to any appreciable degree in isolation in the human diet. Other evidence has been drawn from animal studies and epidemiologic or cohort studies. Few randomized controlled trials (RCTs) have compared HFCS with sucrose (the 2 sugars most commonly consumed in the human diet) at dosage amounts within the normal human consumption range. This review compares results of recently concluded RCTs with other forms of evidence related to fructose, HFCS, and sucrose. We conclude that great caution must be used when suggesting adverse health effects of consuming these sugars in the normal way they are consumed and at the normal amounts in the human diet, because RCTs do not support adverse health consequences at these doses when employing these sugars.

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Metabolism of fructose and glucose in the liver. Although there are differences in metabolism, the pathways are interactive, as indicated in the figure. Reproduced from (22) with permission. ADP, adenosine diphosphate; AMP, adenosine monophosphate; ATP, adenosine-5'-triphosphate; CO2, carbon dioxide; GLUT, glucose transporters.
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fig4: Metabolism of fructose and glucose in the liver. Although there are differences in metabolism, the pathways are interactive, as indicated in the figure. Reproduced from (22) with permission. ADP, adenosine diphosphate; AMP, adenosine monophosphate; ATP, adenosine-5'-triphosphate; CO2, carbon dioxide; GLUT, glucose transporters.

Mentions: Fructose is metabolized differently than glucose in the liver, as illustrated in Figure 4. More than 90% of absorbed fructose is cleared on first pass by the liver. As shown in this figure, there is an interactive pathway between glucose and fructose metabolism. It has been estimated that >50% of fructose is metabolized into glucose, another 15% into glycogen, 25% into lactate, and a few percent into carbon dioxide (22). In various studies, 1–5% of fructose consumed can be converted into TGs in the process of de novo lipogenesis (DNL). The amount of fat generated through this process in normal human metabolism is on the order of 1% of the amount of fat typically consumed in the human diet (95). Nonetheless, some investigators have suggested that DNL may contribute to increased fat in the liver (96–99) and might ultimately lead to NAFLD, which is the leading cause of chronic liver disease and the need for liver transplantation in the world (27, 28).


The metabolic and endocrine response and health implications of consuming sugar-sweetened beverages: findings from recent randomized controlled trials.

Rippe JM - Adv Nutr (2013)

Metabolism of fructose and glucose in the liver. Although there are differences in metabolism, the pathways are interactive, as indicated in the figure. Reproduced from (22) with permission. ADP, adenosine diphosphate; AMP, adenosine monophosphate; ATP, adenosine-5'-triphosphate; CO2, carbon dioxide; GLUT, glucose transporters.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3823516&req=5

fig4: Metabolism of fructose and glucose in the liver. Although there are differences in metabolism, the pathways are interactive, as indicated in the figure. Reproduced from (22) with permission. ADP, adenosine diphosphate; AMP, adenosine monophosphate; ATP, adenosine-5'-triphosphate; CO2, carbon dioxide; GLUT, glucose transporters.
Mentions: Fructose is metabolized differently than glucose in the liver, as illustrated in Figure 4. More than 90% of absorbed fructose is cleared on first pass by the liver. As shown in this figure, there is an interactive pathway between glucose and fructose metabolism. It has been estimated that >50% of fructose is metabolized into glucose, another 15% into glycogen, 25% into lactate, and a few percent into carbon dioxide (22). In various studies, 1–5% of fructose consumed can be converted into TGs in the process of de novo lipogenesis (DNL). The amount of fat generated through this process in normal human metabolism is on the order of 1% of the amount of fat typically consumed in the human diet (95). Nonetheless, some investigators have suggested that DNL may contribute to increased fat in the liver (96–99) and might ultimately lead to NAFLD, which is the leading cause of chronic liver disease and the need for liver transplantation in the world (27, 28).

Bottom Line: The effects of HFCS and sucrose in sugar-sweetened beverages, in particular, have generated intense scientific debate that has spilled over to the public.This controversy is related to well-known differences in metabolism between fructose and glucose in the liver.Other evidence has been drawn from animal studies and epidemiologic or cohort studies.

View Article: PubMed Central - PubMed

Affiliation: University of Central Florida Medical School, Orlando, FL; and Rippe Lifestyle Institute, Shrewsbury, MA and Celebration, FL.

ABSTRACT
Fructose-containing sugars, including fructose itself, high fructose corn syrup (HFCS), and sucrose have engendered considerable controversy. The effects of HFCS and sucrose in sugar-sweetened beverages, in particular, have generated intense scientific debate that has spilled over to the public. This controversy is related to well-known differences in metabolism between fructose and glucose in the liver. In addition, research studies have often been conducted comparing pure fructose and pure glucose even though neither is consumed to any appreciable degree in isolation in the human diet. Other evidence has been drawn from animal studies and epidemiologic or cohort studies. Few randomized controlled trials (RCTs) have compared HFCS with sucrose (the 2 sugars most commonly consumed in the human diet) at dosage amounts within the normal human consumption range. This review compares results of recently concluded RCTs with other forms of evidence related to fructose, HFCS, and sucrose. We conclude that great caution must be used when suggesting adverse health effects of consuming these sugars in the normal way they are consumed and at the normal amounts in the human diet, because RCTs do not support adverse health consequences at these doses when employing these sugars.

Show MeSH