Abstract
Although there are many well-documented metabolic effects linked to the fructose component of a very high sugar diet, a healthy diet is also likely to contain appreciable fructose, even if confined to that found in fruits and vegetables. These normal levels of fructose are metabolized in specialized pathways that synergize with glucose at several metabolic steps. Glucose potentiates fructose absorption from the gut, while fructose catalyzes glucose uptake and storage in the liver. Fructose accelerates carbohydrate oxidation after a meal. In addition, emerging evidence suggests that fructose may also play a role in the secretion of insulin and GLP-1, and in the maturation of preadipocytes to increase fat storage capacity. Therefore, fructose undergoing its normal metabolism has the interesting property of potentiating the disposal of a dietary carbohydrate load through several routes.
Highlights
There have been a considerable number of recent studies designed to understand whether fructose, in the current western diet rich in fructose-containing sugars, contributes uniquely to obesity, diabetes, and their complications
Normal fructose metabolism will be discussed, including several ways in which it synergizes with glucose to increase the rate of disposal of a dietary carbohydrate load
The normal roles of fructose in human metabolism are circumscribed by the amounts of fructose found in a meal, the time course of absorption from the gut, and the concentrations of these sugars and their metabolic intermediates found in different parts of the bloodstream throughout the body
Summary
There have been a considerable number of recent studies designed to understand whether fructose, in the current western diet rich in fructose-containing sugars, contributes uniquely to obesity, diabetes, and their complications. Much of the recent literature, while providing important health information, is not relevant for the purpose of understanding the metabolism of low levels of fructose eaten as a minor fraction of the carbohydrate found in a well-balanced meal. Glucose derived from the same meal is metabolized in synergy with fructose. Only studies where fructose and glucose are consumed together can yield insight regarding the normal metabolic fate of the sugars. Fructose is absorbed in the great majority of people when eaten as part of the disaccharide sucrose, or together with glucose at roughly similar or higher levels [1]. Normal fructose metabolism will be discussed, including several ways in which it synergizes with glucose to increase the rate of disposal of a dietary carbohydrate load
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