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Recent studies have shown that added sugars, particularly those containing fructose, are a principal driver of diabetes and prediabetes, even more so than other carbohydrates, according to the authors of a new report in Mayo Clinic Proceedings.1
“At current levels, added sugar consumption, and added fructose consumption in particular, are fueling a worsening epidemic of type 2 diabetes,” said lead author James J. DiNicolantonio, PharmD, a cardiovascular research scientist at Saint Luke’s Mid America Heart Institute, in Kansas City, Mo. The report calls for people to drastically reduce the amount of added sugar, and especially added fructose, they consume.
Added sugar recommendations from health organizations vary widely. The Institute of Medicine recommends a maximum of 25 percent of total calories from added sugars, while the 2010 Dietary Guidelines for Americans say that most people should consume no more than about 5 to 15 percent of calories from a combination of solid fats and added sugars. The World Health Organization advises limiting added sugars to less than 10 percent of total calories and, for additional health benefits, to less than 5 percent of total calories.
Consuming too much added fructose results in derangement of both overall metabolism and global insulin resistance, but dietary sugars that don’t contain fructose seem to be less harmful in these respects, according to the authors, who say several clinical trials support these results. In addition, fructose found naturally in some whole foods like fruits and vegetables don’t pose health problems and are likely protective against diabetes and related metabolic disorders. The authors propose that dietary guidelines be modified to encourage individuals to replace processed foods containing added sugars such as fructose with whole foods like fruits and vegetables.
According to the 2010 Dietary Guidelines, the body’s response to sugar doesn’t depend on whether they are naturally present in food or added to foods. However, sugars found naturally in foods are part of the food’s total package of nutrients and other healthful components, while many foods that contain added sugar often supply calories, but few or no essential nutrients and no dietary fiber.
1 DiNicolantonio JJ, O'Keefe JH, Lucan SC. Added fructose: a principal driver of type 2 diabetes and its consequences. Mayo Clin Proc. 2015. [Epub ahead of print]