Research Updates | Diabetes
The food source and energy content of a food or drink with fructose-containing sugars mediates its effect on glycaemic control. Sugar sweetened beverages that add excess energy have harmful effects, but most food sources (especially fruit) do not.
Controlled intervention studies of at least seven days’ duration and assessing the effect of different food sources of fructose-containing sugars on glycaemic control in people with and without diabetes were included (a total of 155 study comparisons). Most of the evidence was classified as low quality. Total fructose-containing sugars had no harmful effect on any outcomes in substitution or subtraction studies. In fact in substitution studies, a reduction in HbA1C (a beneficial outcome) was found. A harmful effect was seen on fasting insulin in addition studies and ad-libitum studies. There was an interaction by food source: fruit and fruit juice were beneficial and sweetened milk and mixed sources were harmful in substitution studies; and harmful effects from SSB and fruit juice were noted in addition studies on at least one outcome. The authors conclude more high quality RCTs are needed.
Choo VL, Viguiliouk E, Blanco Mejia S et al. Food sources of fructose-containing sugars and glycaemic control: systematic review and meta-analysis of controlled intervention studies. BMJ 2018;363:k4644 https://www.bmj.com/content/363/bmj.k4644