Abstract

Fructose occurs in fruits, vegetable, and sweetened drinks alongside glucose as free sugars or bound in sucrose, but may also be bought in a pure form. A link between sugar-sweetened drinks (SSD) and body mass index (BMI, kg/m2) is inferred from systematic reviews of both prospective cohort studies (PCSs) and randomized, controlled trials (RCTs) (Malik et al., 2006; Wolf and Dansinger, 2008). The link is seemingly strong because such studies rank highly among types of studies according to evidence-based principles on causality. On the other hand, the study results are heterogeneous, and more objective meta-analysis shows SSDs to have a “small” effect on BMI (Forshee et al., 2008); therefore, a focus on fructose and SSD may then serve only to divert attention from major causes of obesity (Storey, 2008). A number of complications and false claims arise when interpreting epidemiological and interventional studies on fructose or SSDs. The first is a notion that high-fructose corn syrup (HFCS) differs from suc...

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