Physiological handling of dietary fructose-containing sugars: implications for health

Abstract

Fructose has always been present in our diet, but its consumption has increased markedly over the past 200 years. This is mainly due to consumption of sucrose or high-fructose corn syrup in industrial foods and beverages. Unlike glucose, fructose cannot be directly used as an energy source by all cells of the human body and needs first to be converted into glucose, lactate or fatty acids in the liver, intestine and kidney. Because of this specific two-step metabolism, some energy is consumed in splanchnic organs to convert fructose into other substrates, resulting in a lower net energy efficiency of fructose compared with glucose. A high intake of fructose-containing sugars is associated with body weight gain in large cohort studies, and fructose can certainly contribute to energy imbalance leading to obesity. Whether fructose-containing foods promote obesity more than other energy-dense foods remains controversial, however. A short-term (days–weeks) high-fructose intake is not associated with an increased fasting glycemia nor to an impaired insulin-mediated glucose transport in healthy subjects. It, however, increases hepatic glucose production, basal and postprandial blood triglyceride concentrations and intrahepatic fat content. Whether these metabolic alterations are early markers of metabolic dysfunction or merely adaptations to the specific two-step fructose metabolism remain unknown.

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Acknowledgements

This article is based on a symposium entitled ‘Sweeteners and Health: Findings from Recent Research and their Impact on Obesity and Related Metabolic Conditions’ presented at the European Congress on Obesity on 7 May 2015 with sponsorship from Rippe Lifestyle Institute. The work reported in this review has been supported by the Swiss National Science Foundation grant to Luc Tappy (Numbers 32003B_156167 and 320030_138428).

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Correspondence to L Tappy.

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LT has received lecture fees from Rippe Lifestyle Institute, Nestlé SA and Soremartec. He has also received grant support from Swiss National Foundation for Science and Federal Office for Sport BASPO, Switzerland and serves as an expert witness for the French food security agency ANSES. The VC declares no conflict of interest.

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Campos, V., Tappy, L. Physiological handling of dietary fructose-containing sugars: implications for health. Int J Obes 40, S6–S11 (2016). https://doi.org/10.1038/ijo.2016.8

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