How safe is fructose for persons with or without diabetes?

摘要

In this issue of the journal, Livesey and Taylor (1) present a meta-analysis of clinical trials evaluating the effects of fructose intake. They concluded that fructose is safe at doses of <90 g/d and that it may have the added benefit of lowering concentrations of glycated hemoglobin (HbA1c). This meta-analysis is difficult to interpret, because it involves randomized and nonrandomized studies of differing designs, mixed populations (diabetic and nondiabetic, lean and obese), different control diets (including some sucrose-based diets that contained fructose), different study durations, and limited endpoints; it also represents an analysis by an industry-sponsored group of a highly selected list of studies (42 of 3331). Nevertheless, it is important to discuss the conclusions of Livesey and Taylor in light of current knowledge of fructose and its metabolic effects.