Added fructose: a principal driver of type 2 diabetes mellitus and its consequences

James J. DiNicolantonio, James H. O'Keefe, Sean C. Lucan

Research output: Contribution to journalReview article

70 Citations (Scopus)

Abstract

Data from animal experiments and human studies implicate added sugars (eg, sucrose and high-fructose corn syrup) in the development of diabetes mellitus and related metabolic derangements that raise cardiovascular (CV) risk. Added fructose in particular (eg, as a constituent of added sucrose or as the main component of high-fructose sweeteners) may pose the greatest problem for incident diabetes, diabetes-related metabolic abnormalities, and CV risk. Conversely, whole foods that contain fructose (eg, fruits and vegetables) pose no problem for health and are likely protective against diabetes and adverse CV outcomes. Several dietary guidelines appropriately recommend consuming whole foods over foods with added sugars, but some (eg, recommendations from the American Diabetes Association) do not recommend restricting fructose-containing added sugars to any specific level. Other guidelines (such as from the Institute of Medicine) allow up to 25% of calories as fructose-containing added sugars. Intake of added fructose at such high levels would undoubtedly worsen rates of diabetes and its complications. There is no need for added fructose or any added sugars in the diet; reducing intake to 5% of total calories (the level now suggested by the World Health Organization) has been shown to improve glucose tolerance in humans and decrease the prevalence of diabetes and the metabolic derangements that often precede and accompany it. Reducing the intake of added sugars could translate to reduced diabetes-related morbidity and premature mortality for populations.

Original languageEnglish (US)
Pages (from-to)372-381
Number of pages10
JournalMayo Clinic Proceedings
Volume90
Issue number3
DOIs
StatePublished - Mar 1 2015

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Fructose
Type 2 Diabetes Mellitus
Food
Sucrose
Cardiovascular Abnormalities
Sweetening Agents
Nutrition Policy
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Premature Mortality
Diabetes Complications
Vegetables
Fruit
Diabetes Mellitus
Guidelines
Diet
Morbidity
Glucose
Health
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Added fructose : a principal driver of type 2 diabetes mellitus and its consequences. / DiNicolantonio, James J.; O'Keefe, James H.; Lucan, Sean C.

In: Mayo Clinic Proceedings, Vol. 90, No. 3, 01.03.2015, p. 372-381.

Research output: Contribution to journalReview article

DiNicolantonio, James J. ; O'Keefe, James H. ; Lucan, Sean C. / Added fructose : a principal driver of type 2 diabetes mellitus and its consequences. In: Mayo Clinic Proceedings. 2015 ; Vol. 90, No. 3. pp. 372-381.
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