Fructose as a sweetener … should we avoid it?

Fructose is naturally present in many fruits and vegetables that people can include as part of a healthy, balanced diet.

However, researchers are studying the links between foods high in fructose and obesity, diabetes and even some types of cancer, but there is also evidence that fructose is not harmful to health when consumed in moderation.

Compared with glucose, fructose has a different metabolism, a very low glycemic index (4 times lower), does not require insulin to enter cells, produces less modification of the glycemic curve, has a high sweetening power, so it was considered a solution for the diabetic patient.

However, there is currently sufficient evidence that fructose consumption produces certain metabolically unfavorable actions such as insulin resistance, increased fasting and postprandial triglycerides, increased blood pressure, increased uric acid production and increased protein glycation capacity.

In a 2017 study on fructose in food and its metabolic aspects, it was established that the health effects of fructose consumption depend on the amount consumed. A moderate consumption of fructose, less than 50 g / day, would not affect health. It was highlighted that the consumption of a liter and a half of sweetened drink (soft drink, soda) can provide between 88 and 129 g of fructose, which far exceeds the recommendation.

The controversy about whether high fructose consumption has been a determining factor in the current prevalence of obesity and its comorbidities, or whether its effects are similar to those of an equivalent consumption of other sugars, continues.

What is fructose?

Fructose is a natural monosaccharide sugar that is present in fruits and honey. Some vegetables contain fructose, but generally in smaller amounts than fruits. In this form, fructose sugars can be part of a healthy diet.

Fructose is the sweetest of the natural caloric sweeteners. As a result, less fructose, compared to other sugars, can be used in cooking to achieve the same sweetness.

Fructose is also part of sucrose (table sugar) and high fructose corn syrup (HFCS), which manufacturers add to unhealthy processed foods such as sodas, desserts, candy, baked goods, juices, packed fruits and others.

Most varieties of HFCS contain 42 or 55% fructose and 45% glucose. This means that HFCS contains the same amount of fructose as sucrose or table sugar.

In comparison, honey contains a ratio of 50% fructose and 50% glucose.

Is the consumption of fructose advisable?

Consuming fructose from natural sources, such as fresh fruits and vegetables, is beneficial for your health.

On the other hand, numerous studies have described a relationship between the consumption of processed foods rich in fructose, in the form of HFCS, with the prevalence of adverse health effects, among which the following stand out:

Obesity, dyslipidemia, insulin resistance, type 2 diabetes, nonalcoholic fatty liver, hyperuricemia, and kidney damage.

In contrast, a significant number of studies conclude that the effects of a high consumption of fructose are similar to those of an equivalent consumption of other sugars, such as glucose and sucrose.


What evidence is there against fructose?

Some researchers believe that the body processes fructose differently from other types of sugars.

In particular, there is concern that when a person consumes fructose in excess, it can stimulate the body to deposit extra fat, especially in the liver, which can contribute to nonalcoholic fatty liver disease.

According to research from 2017, ingesting excessive amounts of fructose is associated with: increased food intake because it does not induce satiety, insulin resistance, as it causes inflammation, increased risk of obesity and its consequences (such as metabolic syndrome) and an increase in the accumulation of fats in the body, since it influences the way in which fats and carbohydrates are broken down in the body.

In a 2019 study with mice, researchers found that fructose and glucose, when added to a high-fat diet , affect the metabolic mechanisms of the liver in opposite ways.

It appears that high levels of fructose can alter the metabolism of fats in the liver in a detrimental way to health, while high levels of glucose can improve it. Fructose causes the liver to accumulate fat which is in contrast to the effect of adding more glucose to the diet, which promotes the liver’s ability to burn fat and therefore contributes to a healthier metabolism.

What is the evidence for fructose?

For many researchers it is difficult to elucidate if fructose is as or more harmful than other sugars. This is because foods that contain high levels of added fructose generally also contain high levels of other sugars, such as glucose.

To date (February 2020), the opinion of the United States Food and Drug Administration (FDA) is still valid, stating that it is not aware of any evidence that foods containing HFCS are less safe than other foods containing HFCS. similar sweeteners, such as sucrose and honey.

The FDA classifies HFCS, the most controversial of the fructose-containing ingredients, as safe for consumption.

However, people should limit their intake of all added sugars, including HFCS and sucrose.

In a 2015 study on the effects of high fructose and sucrose consumption on metabolic parameters, in obese and diabetic rats, using starch as a control, it was found that the effects of fructose and sucrose on the evaluated variables (biomass, abdominal fat deposit, blood glycolipid profile, lipids, and liver histology) were not different from each other. However, plasma cholesterol and triglyceride values ​​were higher in the groups of rats fed fructose and sucrose, while in the group of animals that only consumed starch, liver lipid values ​​were higher.

Fructose vs. Glucose

Fructose bound to glucose is what is known as sucrose or table sugar.

Unlike fructose, the body breaks down glucose to a large extent in cells. The small intestine generally absorbs this type of sugar and sends it to the cells for energy. Researchers generally regard glucose as the body’s preferred carbohydrate source for this purpose.

When a person ingests glucose, the chemical structure of the compound causes the pancreas to release insulin, a hormone that allows cells to use glucose for energy.

Fructose does not trigger the release of insulin, nor the release of hormones such as leptin, which tells the brain that a person is full, or inhibits the hormones that tell the body that they are hungry. As a result, the researchers suggest that fructose is more harmful to people, as they would eat more.

However, a person should remember that sugary foods containing glucose also have calories and consuming too much calories can lead to weight gain.

The American Heart Association, AHA, recommends that men consume no more than 150 calories from added table sugar per day. This is equivalent to 9 teaspoons, or 36 grams (g). Women should restrict their intake of added sugar to no more than 100 calories per day, which is equivalent to 6 teaspoons, or 25 g.

What is high fructose corn syrup?

High Fructose Corn Syrup (HFCS) is a sweetener that manufacturers make from cornstarch. As with other sugars, it can cause tooth decay, obesity, and metabolic syndrome when a person consumes it in large amounts.

Starch consists of chains of glucose, which is a sugar. The breakdown of cornstarch into individual glucose molecules produces corn syrup.

To make HFCS, manufacturers add enzymes to corn syrup that convert some of the glucose into fructose.

Since the 1980s, fructose, mainly as high fructose corn syrup (HFCS) in its two most common presentations, 42% or 55% fructose, has been replacing other sweeteners and today represents more than 40% of consumption. of sweeteners worldwide.

Health experts continue to debate whether high fructose corn syrup (HFCS) is worse than other sugars. Many natural and organic health advocates argue that HFCS is more dangerous than other sugars.


Is HFCS safe to consume?

Research has consistently shown links between HFCS consumption and obesity and metabolic dysregulation.

According to a 2017 mouse study, consumption of HFCS increased fasting glucose and reduced the ability of mice to eliminate it from the body. The study also found changes in dopamine in the group that consumed HFCS. Dopamine is a neurotransmitter that affects motivational and rewarding emotions. Previous research has linked dopamine involvement with obesity.

Contrary to some previous studies, HFCS did not increase body weight. This suggests that HFCS can weaken health, even if it does not cause weight gain.

A 2012 analysis of 43 countries found that diabetes rates are 20% higher in those where HFCS is readily available.

Other studies have linked the availability of HFCS to higher rates of conditions such as diabetes and heart disease. However, this research is correlational and does not mean that HFCS directly causes these conditions. In countries where HFCS is prevalent, people may prefer sweetened foods or consume large amounts of all types of sugar.

This is the reason why it is difficult to establish whether HFCS is safe or not. Most research suggests that the availability of HFCS is correlated with an increase in health problems. Still, the availability of HFCS is also generally correlated with high sugar intake. There is little evidence to suggest that HFCS is inherently more harmful than other sugars.

The problem with HFCS is its prevalence. It is present in many foods, including those that do not taste sweet, such as pizza and crackers.


Conclusions about fructose

When people eat or drink a lot of fructose-rich foods, such as sweetened beverages (sodas, sodas), they also take in extra calories that can contribute to weight gain.

There is no recommended minimum or maximum daily intake of fructose because a person does not need this sugar to survive. Manufacturers add fructose to foods as a sweetener, but it has little nutritional value.

Doctors recommend that people eat fresh food and avoid eating foods with added sugars frequently.

The debate over the risks of HFCS continues. As with other sugars, it is not necessary to include HFCS in a healthy diet. Their inclusion can increase the risk of developing health problems.

People who want to limit their consumption of HFCS may be frustrated by the abundance of foods that contain added HFCS. People who cannot eliminate HFCS from their diet completely can still reap health benefits from reducing consumption. They can do this by limiting their soda intake and eating fewer processed snacks.

Consulted bibliography

Dietary Sugars Alter Hepatic Fatty Acid Oxidation via Transcriptional and Post-translational Modifications of Mitochondrial Proteins

Cell Metabolism. Vol 30 (4): 735-753, 2019

High Fructose Corn Syrup Questions and Answers

United States Food and Drug Administration (FDA) 04/01/2018

High fructose corn syrup induces metabolic dysregulation and altered dopamine signaling in the absence of obesity

PLoS On. Vol 12 (12), 2017

Divergent effects of glucose and fructose on hepatic lipogenesis and insulin signaling

J Clin Invest. Vol 127 (11): 4059–4074, 2017

Fructose Consumption in the Development of Obesity and the Effects of Different Protocols of Physical Exercise on the Hepatic Metabolism

Nutrients. Vol 9 (4): 405, 2017

Critical analysis of fructose consumption part 1. Fructose in food. Metabolic aspects

Nutrition Update. Vol. 18 (1), 2017

Fructose-Rich Beverage Intake and Central Adiposity, Uric Acid, and Pediatric Insulin Resistance

The Journal of Pediatrics. Vol 171: 90–96, 2016

Effects of high fructose and sucrose consumption on metabolic parameters in obese and diabetic rats

Rev. Chilena de Nutrición vol.42 (2), 2015

High fructose corn syrup and diabetes prevalence: A global perspective

Global Public Health. An International Journal for Research, Policy and Practice. Vol 8 (1), 2013

High fructose corn syrup: Production, uses and public health concerns

Biotechnol. Mol. Biol. Rev. Vol. 5 (5): 71-78, 2010

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