Abstract
Questions have been raised as to whether dietary carbohydrate intake is directly related to the development of type 2 diabetes. Of particular importance, fructose-induced insulin resistance has been previously shown in animals. However, the implications of such findings for humans are unclear as these models typically use very high doses of sugars and from sources not commonly consumed. Little is known about how the typical consumption of sugar in humans affects risk factors for diabetes. 355 weight-stable (weight change * AUC30 I) and whole body insulin sensitivity and hepatic insulin resistance using the Matsuda Composite Insulin Sensitivity Index (ISI). There was a small increase in weight in the entire cohort (169.1 ± 30.6 vs 171.6 ± 31.8 lbs, p 0.05) nor by sugar type (p > 0.05). In the entire cohort insulin sensitivity decreased as evidenced by an increase in HOMA IR (1.8 ± 1.3 vs 2.3 ± 3.4, p 0.05). Neither sugar level nor sugar type had any effect on any of these three measures (interaction p > 0.05). These data show that risk factors for diabetes do not vary between the 8% (25th percentile), and the 30% group (95th percentile) although insulin sensitivity may be affected by sugar consumption across a wide range of typical consumption levels. Importantly, the type of sugar (HFCS versus sucrose) had no effect on any response.
Highlights
Type 2 diabetes has increased dramatically worldwide in the past 20 years and represents a major global public health concern [1]
This study contributes to the growing literature that at normal human consumption levels of fructose in eucaloric diets risk factors for diabetes are not increased
There were no differences for risk factors for diabetes when comparing 8% of calories from added sugars, a level consistent with the upper limit recommended by the American Heart Association (AHA), World Health Organization (WHO) and draft report of SACN with 18% of calories and with 30%, which was comparable to the upper limit recommended by the DGA 2010 and Institute of Medicine (IOM)
Summary
Type 2 diabetes has increased dramatically worldwide in the past 20 years and represents a major global public health concern [1]. It has been estimated that 6.4% of the world population is currently diabetic and this estimate rises to 7.7% worldwide by the year 2030 [2]. While diabetes is a significant problem in the developed world, these increases are anticipated to effect developing countries disproportionately with an estimated 20% increase in diabetic adults in developed countries compared with an estimated 69% increase in the number of diabetic adults in developing countries [2]. The increased prevalence of diabetes has led to substantial increases in high blood pressure, stroke, heart disease, kidney disease, and risk of breast, colon and other cancers. These problems will become more prevalent as the diabetes epidemic continues to grow. The increased prevalence of diabetes has been clearly linked to worldwide increases in obesity which has led scientists to explore a variety of dietary factors in the etiology of these related conditions [5]-[8]
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