Dietary Fructose and Risk of Metabolic Syndrome in Adults

Tehran Lipid and Glucose Study

Firoozeh Hosseini-Esfahani; Zahra Bahadoran; Parvin Mirmiran; Somayeh Hosseinpour-Niazi; Farhad Hosseinpanah; Fereidoun Azizi

Disclosures

Nutr Metab. 2011;8(50) 

In This Article

Abstract and Introduction

Abstract

Background Studies have shown that the excessive fructose intake may induce adverse metabolic effects. There is no direct evidence from epidemiological studies to clarify the association between usual amounts of fructose intake and the metabolic syndrome.
Objective The aim this study was to determine the association of fructose intake and prevalence of metabolic syndrome (MetS) and its components in Tehranian adults.
Methods This cross-sectional population based study was conducted on 2537 subjects (45% men) aged 19–70 y, participants of the Tehran Lipid and Glucose Study (2006–2008). Dietary data were collected using a validated 168 item semi-quantitative food frequency questionnaire. Dietary fructose intake was calculated by sum of natural fructose (NF) in fruits and vegetables and added fructose (AF) in commercial foods. MetS was defined according to the modified NCEP ATP III for Iranian adults.
Results The mean ages of men and women were 40.5 ± 13.6 and 38.6 ± 12.8 years, respectively. Mean total dietary fructose intakes were 46.5 ± 24.5 (NF: 19.6 ± 10.7 and AF: 26.9 ± 13.9) and 37.3 ± 24.2 g/d (NF: 18.6 ± 10.5 and AF: 18.7 ± 13.6) in men and women, respectively. Compared with those in the lowest quartile of fructose intakes, men and women in the highest quartile, respectively, had 33% (95% CI, 1.15–1.47) and 20% (95% CI, 1.09–1.27) higher risk of the metabolic syndrome; 39% (CI, 1.16–1.63) and 20% (CI, 1.07–1.27) higher risk of abdominal obesity; 11% (CI, 1.02–1.17) and 9% (CI, 1.02–1.14) higher risk of hypertension; and 9% (CI, 1–1.15) and 9% (1.04–1.12) higher risk of impaired fasting glucose.
Conclusion Higher consumption of dietary fructose may have adverse metabolic effects.

Introduction

Fructose is the sweetest tasting carbohydrate, found in many fruits and vegetables. In the past, dietary intake of fructose was used to be 16–20 grams per day, mainly from fresh fruits and vegetables. But in the last three decades, increased consumption of industrialized foods such as soft drinks, fruit juices, bakery products, canned fruits, jams, jellies and cookies, containing added sugars (sucrose, high fructose corn syrup, honey, molasses, and other syrups) has resulted in a significant increase in fructose intakes of 85–100 grams per day.[1,2] Recent data suggest parallel increasing trends in fructose intake and the increase in obesity and type 2 diabetes in the last 35 years.[3,4] Reports confirmed by animal and human clinical studies, indicating that the excessive fructose intakes induce adverse metabolic effects;[5–10] however there is no direct evidence from epidemiological studies to clarify the association between current amounts of dietary fructose intake and the metabolic syndrome components. Metabolic syndrome (MetS), a worldwide epidemic health problem, is characterized by central obesity, hypertension, insulin resistance, and lipid profiles abnormalities.[11] The prevalence of MetS in Iranian adults is reported to be one of the highest worldwide, with a rate of 33.7%.[12,13] Considering the lack of data on dietary fructose intake in Iranian adults, the aim of this cross sectional study was to assess dietary intakes of fructose and to investigate the association between fructose intake and prevalence of MetS risk factors, in a sample selected from the Tehran Lipid and Glucose Study.

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