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Fructose and Diabetes

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Potential Benefits of Fructose

The relationship between fructose and diabetes is a troubled relationship, which in recent times seems closer than ever to a breaking point. We are in fact talking about a “strange” sugar, often recommended in the presence of diabetes due to its low glycemic index (19-23).

After its ingestion, in fact, blood glucose levels increase much less than what is recorded after the intake of a similar quantity of glucose (glycemic index 100) or sucrose (glycemic index 68); the same goes for insulinemia, which does not increase significantly.

Furthermore, fructose has a higher sweetening power than sugar; this allows it to be used in smaller quantities to sweeten foods. Finally, its caloric value is 3.75 KCal per gram, therefore slightly lower than that of sucrose (3.92 Kcal/g).

Why Diabetics Should Avoid Excess Fructose

The characteristics listed so far seem to celebrate a successful and long-lasting marriage between fructose and diabetes. Unfortunately, however, by analyzing the metabolism of this sugar we realize that at high doses the relationship seriously slopes to the point of an almost definitive breakdown. Data in hand, in fact, several studies demonstrate that HIGH fructose intakes (> 40-60 grams per day which are added to that already present in fruit and honey) lead to rather negative metabolic consequences:

  • fructose has a capacity to form advanced glycation products (AGE) approximately seven times greater than that of glucose (excess sugars bind to some groups of proteins, forming these advanced glycation products which damage tissues);
  • fructose does not suppress ghrelin (a gastric hormone that stimulates appetite);
  • chronic exposure to fructose favors the onset of metabolic syndrome;
  • a diet particularly rich in fructose increases insulin resistance; in fact, although this sugar does not directly increase insulin secretion, it does so indirectly, hindering the hepatic metabolism of glucose and its transformation into glycogen (the form in which the liver stores glucose);
  • fructose increases lipogenesis de novo, and the synthesis of triglycerides and fatty acids; essentially, therefore, fructose, despite being a carbohydrate, is metabolised like a fat and is associated with an increase in triglycerides.

For all these reasons, it has been shown that chronic exposure to high levels of fructose favors the onset of:

These effects have mostly been demonstrated in laboratory animals, and do not appear to be linked to the effect of the additional calories induced by fructose supplementation, given that all these negative consequences have not been recorded following diets equally rich in glucose and starch. Although the effects of fructose in the human body are still to be clarified, these studies certainly cannot be ignored.

As if that wasn't enough, the intensive use of fructose in drinks and many products, in the form of corn syrup and the like, has been linked to the increase in obesity recorded in recent decades. The major bugaboo, however, derives from the ability of fructose to increase triglycerides, with a consequent increase in cardiovascular risk.

For the above, the US association “The American Diabetes Association” states that the use of added fructose to sweeten foods is inadvisable in the presence of diabetes, but there is no reason to also avoid the quantity of fructose naturally present in foods such as fruit, honey and vegetables.

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