Fructose

What is fructose?

Fructose or levulose or fruit sugar is a simple sugar, which belongs to simple carbohydrates.

Name origin: from Latin fructus = fruit; -ose denotes sugar.

Nutrition Facts for Fructose:

  • Calories per gram = 3.6 [1]
  • Glycemic index (GI) for a 25 g portion = 11 [58]
  • Sweetness, relative to sucrose = 120-190% [49,63]
  • Net carbs = 100%

Fructose Chemical Formula

Fructose has the same chemical formula as glucose (C6H12O6), but with slightly different arrangement of atoms.

Fructose and glucose structure

Picture 1. Fructose has a different structure than glucose.

Is fructose an essential nutrient?

Fructose is not an essential nutrient, which means you do not need to get it from food to be healthy. All fructose you need can be produced in your body from glucose.

Fructose Functions

  • Fructose is a source of energy; it can provide 3.6 Calories per gram, which is about the same as sucrose (table sugar) [1,2].
  • Fructose enhances the absorption of water, sodium and potassium [3].

Fructose Sources

Main fructose sources include fruits, fruit juices, honey, soft drinks sweetened by high-fructose corn syrup (HFCS), and products sweetened by agave syrup or invert sugar. Certain medicinal and multivitamin syrups are sweetened by fructose.

Table sugar (sucrose) is digested to glucose and fructose.

Fructose is called fruit sugar, because fruits are its main source, but fruits also contain other sugars, mainly glucose and sucrose.

Fructose Absorption

Like most other nutrients, fructose is absorbed in the small intestine.

Healthy adults can absorb from 25 to about 50 grams of fructose from a fructose solution in one sitting [10,12].

Fructose is absorbed in the jejunum (the middle part of the small intestine) by the help of transport molecules GLUT5 [78] and, in the presence of glucose (so, when consumed along with carbohydrates that can yield glucose) also by the GLUT2 transporters [79]. Fructose can be also absorbed in the ileum (the last part of the small intestine) and colon by the help of GLUT7 transporters [78].

STIMULATORS of fructose absorption:

Glucose

When the amount of glucose in a meal equals or exceeds the amount of fructose, than even in individuals with fructose malabsorption, all fructose from a meal should be absorbed [10,12,13,14,16,17,18].

In one experiment, only two of ten healthy adult participants completely absorbed 50 grams of fructose from a single meal, but all of them completely absorbed a combination of 50 grams of fructose and 50 grams of glucose, and also 100 grams of sucrose, which is made of 50% glucose and 50% fructose [14].

Fructose can be independently absorbed by the help of the transport molecule in the small intestinal lining, called GLUT-5; this transport is saturable – only up to about 50 grams of fructose from one meal can be absorbed this way. In the presence of glucose, fructose can be also absorbed by the help of the transport molecule GLUT-2; this transport is not saturable within realistic fructose intake [10,11].

Other enhancers of fructose absorption:

  • Sucrose (table sugar) [19] and  galactose (from milk) [10]
  • Amino acids L-alanine, L-glutamine, L-phenylalanine and L-proline from meat and other protein foods [16]
  • In diabetes 2, the absorption of fructose (and glucose and galactose) is enhanced due to an increased number of GLUT-2 and GLUT-5 transporters in the small intestinal lining [19,20].

INHIBITORS of fructose absorption:

  • Sorbitol [21]
  • Stress [10,19]
  • Small intestinal bacterial overgrowth (SIBO) [26]
  • Crohn’s disease [22]
  • Celiac disease [54]
  • Chemotherapy or radiation therapy

Fructose Malabsorption

Fructose malabsorption is defined as an inability to completely absorb 25 grams or more of fructose from a test meal during a breath test with fructose [8,12,50]. Individuals with severe fructose malabsorption may not be able to absorb as little as 5 grams of fructose. Some researchers do not consider fructose malabsorption a disease but a physiological phenomenon [51].

A cause of fructose malabsorption is not known. The disorder can be present in infants or it can develop at any later time in life [25]. Fructose malabsorption can also develop as a transitional complication in small intestinal bacterial overgrowth (SIBO) [26], celiac disease or Crohn’s disease [22].

Symptoms

Symptoms of fructose malabsorption can include excessive abdominal bloating and gas (flatulence), abdominal cramps and pain, diarrhea, constipation, nausea, vomiting, excessive belching, heartburn (gastric reflux) and lethargy or depression within few to several hours of ingesting fructose [8,27]. Constant diarrhea may result in an unintended weight loss.

Diagnosis

Fructose malabsorption can be diagnosed on the basis of a positive hydrogen breath test with fructose, which can be ordered by a gastroenterologist or a registered dietitian. The test involves overnight fasting and then drinking a fructose solution, which usually contains 25 g of fructose, followed by measuring the amount of hydrogen in the exhaled air few hours later [50].

The test may be false negative in up to 30% of individuals with fructose malabsorption who do not expel hydrogen through the lungs [53].

Some individuals diagnosed with irritable bowel syndrome (IBS) may actually have fructose malabsorption and some can have both conditions.

Mechanism

Individuals with fructose malabsorption have a deficiency of a transport molecule called GLUT-5 in the small intestinal lining [8]. After a meal, the fructose that remains unabsorbed stays in the intestine, attracts water from the body into the intestine and can thus trigger diarrhea. When fructose reaches the large intestine, normal intestinal bacteria consume it and convert it to gases, such as hydrogen, carbon dioxide and methane, which can cause abdominal bloating and excessive gas.

Fructose malabsorption has been also associated with depression; possible causes include tryptophan and folate deficiency [28,29,30,31]. The prevalence of fructose malabsorption among individuals with IBS is not higher than in general population [21].

Low-Fructose Diet

Individuals with fructose malabsorption benefit from a low-fructose diet, which means avoiding meals that contain more than 0.5 g of “net fructose” (Chart 1), which is the amount of fructose higher than the total amount of glucose from all glucose sources in a meal: glucose (100% glucose), starch (100% glucose), maltose (100 % glucose), sucrose (50% glucose) and lactose (50% glucose) [7,8]. For example, a meal that contains 20 g fructose, 10 g starch (which is 10 g glucose) and 10 g sucrose (which is 5 g fructose and 5 g glucose) contains 20 g + 5 g fructose – (10 g + 5 g glucose) = 25 – 15 = 10 grams of net fructose.

Foods with net fructose

Picture 1. Foods high in net fructose

Chart 1. Foods With Net Fructose

FOOD (serving) FRUCTOSE (g) NET FRUCTOSE* (g)
Agave, cooked (100 g) 18.5 16
Pure fructose syrup (1 tbsp, 20 g) 13-16 Up to 16
Pear juice (1 cup, 237 mL) 18 14
Apple juice (1 cup, 237 mL) 16 8
Agave nectar (1 tbsp, 20 g) 11 7
Apple (1 medium, 180 g) 12.5 6.5
Pear (1 medium, 180 g) 12 6
Applesauce (1/2 cup, 122 g) 7 4.5
Mango (1 cup, sliced, 165 g) 7.5 4.5
Honey (1 tbsp, 21 g) [5] 6-9 Up to 4.5
Cola-type soft drink with HFCS-55 (1 cup, 237 mL) 15 4
Asian pear (4 oz, 110 g) 7 4
Watermelon (1 cup, diced, 150 g) 6 2.5
Sport drink (1 cup, 237 mL) 8 2.5
High fructose corn syrup (HFCS-55, isoglucose, fructose-glucose syrup) (1 tbsp, 20 g) 8.5 2
Carambola (star fruit) (3 oz, 85 g) 3 2
Mandarin (1 large, 6 oz, 170 g) 3.5 2
Feijoa (1 cup, 243 g) 7 1.5
Nance (1 cup, 120 g) 5.5 1.5
Guava, ripe (1 cup, 165 g) 3 1.5
Bread, white, reduced calories (3.5 oz, 100 g) 2.5 1.5
Grapes (1 cup, 150 g) 12.5 1.5
Grape juice (1 cup, 237 mL) 19 1.5
Raisins (2 oz, 57 g) 17 1
Bread, whole wheat (3.5 oz, 100 g) 4.5 1
Tomato, red, ripe (1 cup, 150 g) 2 1
Corn, yellow, from cob (100 g) 1.5 1
Orange (1 medium, 5 oz, 140 g) 2.5 1
Tangerines (1 cup, 195 g) 4.7 0.5
Strawberries (1 cup, 150 g) 3.5 0.5
Banana, ripe (7″, 120 g) 3.5 0.5
Pineapple (1 cup, 165 g) 12 0.5
Orange juice (1 cup, 237 mL) 10.5 0.5
Honeydew melon (1 cup, 177 g) 5 0.5
Cantaloupe (1 cup, 177 g) 3.5 0.5
Raspberries (1 cup, 120 g) 3 0.5
Cabbage, green (100 g) 2 0.5
Bagel (3.5 oz, 100 g) 1.5 0.5
Beans, green, microwaved (1/2 cup, 62 g) 1 0.5

Chart 1 references: [5,6,7]

Other foods high in fructose but NOT in net fructose [6]:

The following foods, which are high in fructose but not in net fructose, might also trigger symptoms in some individuals with fructose malabsorption:

  • Sweeteners: invert sugar, blackstrap molasses
  • Fruits: figs, jackfruit, lychee (litchis), pomegranate, sapote, banana, kiwifruit, dates, strawberries, currants (red and white)

Some individuals may also benefit from avoiding:

  • Sorbitol and other sugar alcohols or polyols, such as xylitol, maltitol and mannitol in plums, prunes, chewing gum, candies and certain soft drinks
  • Fructans (inulin and fructooligosaccharides or FOS) in wheat, onions, asparagus, Jerusalem artichokes, leeks and chicory roots
  • Galactans in legumes (beans, peas, lentils)
  • Lactose
  • (Avoidance of all of the above nutrients is called a low-FODMAP diet)

Adding glucose to foods high in net fructose or consuming them along with starchy foods, for example eating an apple with bread, may prevent symptoms, but this may not work for everyone.

A low-fructose diet typically results in an obvious improvement of symptoms within 2-4 days, but it may take several weeks for all symptoms to disappear completely. If a low-fructose diet does not help, you can ask a doctor for additional tests, such as a breath test for lactose intolerance or small intestinal bacterial overgrowth (SIBO).

Chart 2. Low-Fructose Diet

SAFE TO EAT TO TRY TO AVOID
SUGARS, SYRUPS, SWEETENERS
Acesulfam potassium, almond s., aspartame, barley malt s., brown rice s., brown sugar, Chinese rock sugar, chocolate s., corn s. (glucose s.), coconut s., corn syrup solids, dextrin, fondant,  glucose (dextrose), glycerine (glycerol), glycogen, golden s. (cane s., light treacle), grape s., HFCS-42, high maltose corn syrup (HMCS), invert sugar (treacle), liquid glucose, maltodextrin (modified starch), maltose s., maple s., neotame, pancake s., raw sugar (Turbinado, Demerara, jaggery, coconut palm sugar – gur), rice s., saccharin, sorghum s., starch s., stevia, sucanat, sucralose, sucrose (table, beet or cane sugar), sucrose s. (liquid sugar), sukrin, tagatose, trehalose, trimoline *s. = syrup Blackstrap molasses (black treacle), caramel, liquorice (licorice), dulcitol, (galactitol), erythritol, hydrogenated starch hydrolysates (HSH), isomalt, lactitol, maltitol, mannitol, xylitol Agave nectar (in tequila, margaritas, soft drinks), fructose, high fructose corn syrup (HFCS-55), honey; rice fructose syrup (in China), sorbitol
SWEETS and DESERTS
Bonbons, cakes, candies, chocolate, confectionery, fudge, gelatin, gums, jellies, lollipops, marzipan, marshmallow, pies, puddings, sherbets (sorbets) and toffees containing “safe” sweeteners Anything containing the above sweeteners Anything containing the above “to avoid” sweeteners
FRUITS
Avocado, aubergine, cranberries, dates, figs, grapefruit, jack-fruit, kiwifruit, kumquat, lemons, limes, olives, passion fruit, persimmon, pomegranate Apricot, banana, blackberries, blueberries, boysenberries, cantaloupe, cherries, currants, gooseberries, grapes, honeydew melon, lychee (litchis), mamey apple, nectarines, orange, papaya (pawpaw), peach, pineapple, plums, prunes, quince, raisins, rhubarb, strawberries, raspberries, tamarillo, tangelo Apple, carambola (star fruit), custard apple, guava, mandarins (tangerines), mango, nashi fruit (Asian pear), pear, sultana, watermelon, zante currants and related juices, compotes and jams
VEGETABLES, LEGUMES
Beets, bouillon, Brussel’s sprouts, carrots, cauliflower, celery, cucumber, dandelion greens, eggplant, endive, escarole, fennel, kale, lettuce, mustard greens, okra, potatoes (white, sweet), pumpkin, radishes, rutabagas, sauerkraut, shallots, spinach, swede, Swiss chard, turnip, watercress Artichoke, asparagus, broccoli, cabbage, cucumbers (pickled), garlic, legumes (beans, peas and lentils), leeks, mushrooms, onions, peppers, squash (summer), tomatoes, zucchini
CEREALS
Barley, breads, pasta and ready-to-eat cereals without fructose, corn meal (degermed), cornflakes (non-flavored), grits, grouts, oatmeal, porridge (cooked oatmeal), plain muffins, rice (white, brown), rice or buckwheat noodles, rye bread, tortilla Wheat, including dinkle, kamut, sourdoughs, spelt, wholemeal, and wheat products: biscuits, cookies, noodles, pasta, pastries; raisin bran
PROTEIN FOODS
Meat, fish, other seafood, eggs, nuts, seeds Coconut milk and cream
DAIRY
Plain, unsweetened milk, yogurt, cheese, custard, ice cream
SAUCES and SPICES
Basil, bay, cinnamon, cumin, curry, marjoram, oregano, parsley, rosemary, thyme, vinegar (apple cider, balsamic, distilled) BBQ sauce, coriander, chutney, hot mustard, ketchup, parsnip, relish, soy sauce Sauces: sweet & sour; Spices: chervil, dill weed, ginger, hot chili pepper
BEVERAGES
Water (tap, non-flavored bottled, mineral), tea, coffee, soft drinks sweetened by glucose, sucrose or other sweeteners listed above; dry wines, unsweetened distilled alcoholic beverages (gin, rum, vodka, whiskey) Juices from fruits listed above; coffee substitutes with chicory; alcohol (fortified wines and liquers may be problematic) Juices from fruits listed above, soft drinks with sorbitol or HFCS

Chart 2 sources: USDA.gov [6], Tandofline [12], Foodintolerances.org [51]

Complications of Fructose Malabsorption

  • Small intestinal bacterial overgrowth (SIBO)
  • Fructose malabsorption may cause deficiency of tryptophan [27,28], folate [27,30] and zinc [65].

Hereditary Fructose Intolerance (HFI)

Hereditary fructose intolerance is a rare genetic disorder with the accumulation of fructose in the liver because of the lack of the enzyme fructose 1-phosphate aldolase, because of which fructose cannot be converted to glucose. Symptoms, such as severe abdominal cramps and vomiting, appear for the first time in early childhood after introduction of the fructose-containing foods [32].

Diet for HFI

Individuals with HFI should avoid foods containing even tiny amounts of fructose, sucrose, sorbitol, isomalt, maltitol, inulin, fructooligosaccharides (FOS), stachyose, raffinose, invert sugar, high fructose corn syrup (HFCS), agave nectar, blackstrap molasses  and certain other syrups, which means most fruits and fruit products, certain vegetables, nuts, wheat products and commercial foods sweetened by mentioned sweeteners [33]. Individuals with HFI should consult with their doctors or registered dietitians to get exact lists of foods to avoid. Here are extensive, but not complete lists of foods containing fructose and sucrose.

Other disorders of fructose metabolism: essential fructosuria and 3-fructose 1,6 bisphosphatase deficiency [34].

Essential Fructosuria

Essential fructosuria is a benign genetic disorder without symptoms in which fructose cannot be completely converted to glucose. The excessive amount of fructose is excreted in the urine [34,69].

Fructose Metabolism: the Fate of Fructose After Absorption

Most of the absorbed fructose enters the liver, where it is mainly converted to glucose: about 50% of the ingested fructose appears as blood glucose, which can be used as a source of energy; the rest of glucose is mainly stored as glycogen or converted to lactate [23]. To a much smaller extent, fructose is converted to free fatty acids, ketone bodies, VLDL cholesterol and triglycerides [55].

The Effect of Fructose on the Insulin Release

Unlike glucose, fructose does not require insulin to be able to enter the body cells. Ingestion of fructose triggers only minor raise of insulin levels in healthy individuals, but markedly greater raise in individuals with diabetes [23].

The Effect of Fructose on Blood Glucose Levels

Fructose has a low glycemic index (GI = 11) and has a lower effect on the increase of blood glucose and insulin levels than other common carbohydrates [15-p.9;23,58,59,60]. Fructose ingested along with glucose, and sucrose, which is composed of 50% glucose and 50% fructose, raise insulin levels more than fructose or glucose alone [55].

The Effect of Fructose on LDL Cholesterol and Triglyceride Levels

Consumption of more than 50 grams of fructose per day may increase triglyceride levels after meals, and consumption of more than 100 g of fructose per day may increase fasting triglyceride and LDL cholesterol levels [23,67,76].

Fructose intake in excess of body calorie needs but not high fructose intake by itself may contribute to the development of metabolic syndrome (visceral obesity, high blood pressure, insulin resistance, high LDL cholesterol) [74,75].

Fructose and Exercise

  • Moderate amounts of fructose may reduce the feeling of fatigue during exercise [23].
  • Fructose added to other carbohydrates promotes carbohydrate oxidation during endurance training [23,45,46]. Ingested glucose can be oxidized at the maximum level 1.0-1.1 g/min, but a combination of glucose and fructose can result in up to 40% greater oxidation rate [23].

Possible Consequences of Excessive Fructose Intake

Currently, there is no evidence that free fructose–as in invert sugar or high-fructose corn sugar–would have more adverse effects than fructose as part of sucrose (which is 50% glucose, 50% fructose) [23].

Diarrhea

The laxation threshold for fructose–the amount that can trigger diarrhea–is about 70 grams per day, but it may be significantly higher or lower in some individuals [15;p.237].

Gout

High fructose intake may increase blood uric acid levels (hyperuricemia) [23,77]. Hyperuricemia can increase the risk of gout.

In two studies, high fructose intake was modestly associated with an increased risk of gout in women [36] and strongly associated with increased risk of gout in men  [37] but in one 2009 review it was not [38].

Kidney Stones

In one 2008 review of studies, high fructose intake was associated with increased risk of kidney stones [39].

Dental Caries

Fructose can promote tooth decay, but less than sucrose and glucose [35,43].

Appetite and Weight Gain

  • Fructose consumed as part of a mixed meal does not seem to have any effect on appetite [23].
  • There seem to be no long-term differences in effects of fructose and glucose on weight gain [23,44,70].

Blood Pressure

According to 3 systematic reviews of studies, high fructose intake is not associated with high blood pressure [47,48,52].

Coronary Heart Disease

Currently, there is no firm evidence about the relation between high fructose consumption and coronary heart disease [23].

Fatty Liver

There is insufficient evidence about the association between high fructose intake and an increased risk of fatty liver [72,73].

Fructose and Diabetes Mellitus

Studies made so far have found no consistent relationship between high fructose intake, insulin resistance and diabetes 2 [23].

Fructose increases blood glucose levels after meals in individuals with diabetes 2 less than glucose or sucrose [60,61].

According to one 2012 systematic review of controlled feeding trials, replacing fructose for other carbohydrates have resulted in a decrease of HbA1c by 0.53%, in average [71].

Consumption of more than 60 g of fructose per day may increase triglyceride levels in individuals with diabetes 2 2 [66].

Oral fructose appears to be less effective in treating hypoglycemia than oral sucrose or glucose in children with diabetes 1 [62].

Fructose Production

Fructose as a sweetener is usually produced from corn starch or sucrose, which is obtained from sugar cane or sugar beets.

Fructose and Cooking

  • Commercially, fructose is available as a powder (fructose, crystalline fructose, fruit sugar) or syrup (pure fructose syrup).
  • Fructose powder is as a white, crystalline substance, without odor, 120-190% as sweet as sucrose [17,64-p.275;68].
  • Fructose is hygroscopic – it readily absorbs moisture from the air at relative humidity above 60° C [64-p.273;68].
  • Fructose solubility in water at 77 °F (25 °C) is about 400 g/100 mL [68]. Fructose solubility in 95% ethanol at 20° C is about 6 g/100 mL [64-p.274].
  • Fructose melting point = 216-270 °F (102-132 °C); the melting point rises with the rate of heating [41].
  • Fructose decomposes at 216-221 °F (102-105 °C) [64-p.273].
  • Fructose is a reducing sugar [42] and it easily undergoes the Maillard browning reaction in the presence of amino acids [43].
  • Caramelization of fructose starts at 230 °F (110 °C) [24].

  1. Calculation of the energy content of foods – energy conversion factors Food and Agriculture Organization
  2. Elia M et al, 2007, Physiological aspects of energy metabolism and gastrointestinal effects of carbohydrates European Journal of Clinical Nutrition
  3. Fordtran JS, 1975, Stimulation of active and passive sodium absorption by sugars in the human jejunum The Journal of Clinical Investigation
  4. Schaefer EJ et al, 2009, Dietary Fructose and Glucose Differentially Affect Lipid and Glucose Homeostasis PubMed Central
  5. Carbohydrates and sweetness of honey Honey.com
  6. List of foods high in fructose US Department of Agriculture
  7. Monosaccharide and net fructose content of common foods and ingredients Tandfonline.com
  8. Rao SSC et al, 2007, The Ability of the Normal Human Small Intestine to Absorb Fructose: Evaluation by Breath Testing PubMed Central
  9. List of foods high in fructose Fineli.fi
  10. Gibson PR et al, 2007, Review article: fructose malabsorption and the bigger picture Wiley Online Library
  11. Kellett GL, 2007, Stress and intestinal sugar absorption Regulatory, Integrative and Comparative Physiology
  12. Latulippe ME et al, 2011, Fructose Malabsorption and Intolerance: Effects of Fructose with and without Simultaneous Glucose Ingestion Tandofline.com
  13. Skoog SM et al, 2008, Comparison of breath testing with fructose and high fructose corn syrups in health and IBS PubMed Central
  14. Rumessen JJ et al, 1986, Absorption capacity of fructose in healthy adults. Comparison with sucrose and its constituent monosaccharides Gut
  15. Mitchell H, 2006, Sweeteners-and-Sugarf-Alternatives-in-Food-Technology
  16. Hoekstra JH et al, 1996, Facilitating effect of amino acids on fructose and sorbitol absorption in children PubMed
  17. White JS, 2008, Straight talk about high-fructose corn syrup: what it is and what it ain’t The American Journal of Clinical Nutrition
  18. Riby JE, 1993, Fructose absorption The American Journal of Clinical Nutrition
  19. Kellet GL et al, 2005, Apical GLUT2, A Major Pathway of Intestinal Sugar Absorption Diabetes
  20. Dyer R et al, 2002, Expression of monosaccharide transporters in intestine of diabetic humans Gastrointestinal and Liver Physiology
  21. Simrén M et al, 2006, Use and abuse of hydrogen breath tests PubMed Central
  22. Barret JS et al, 2009, Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disorders PubMed
  23. Tappy L et al, 2010, Metabolic Effects of Fructose and the Worldwide Increase in Obesity Physiological Reviews
  24. Caramelization Minnesota State University, Moorhead
  25. Jones HF et al, 2011, Effect of age on fructose malabsorption in children presenting with gastrointestinal symptoms PubMed
  26. Nucera G et al, 2005, Abnormal breath tests to lactose, fructose and sorbitol in irritable bowel syndrome may be explained by small intestinal bacterial overgrowth Wiley Online Library
  27. Ledochowski M et al, 2001, Increased serum amylase and lipase in fructose malabsorbers PubMed
  28. Ledochowski M et al, 2001, Fructose malabsorption is associated with decreased plasma tryptophan PubMed
  29. Ledochowski M et al, 2000, Carbohydrate malabsorption syndromes and early signs of mental depression in females PubMed
  30. Ledochowski M et al, 1999, Fructose Malabsorption Is Associated with Lower Plasma Folic Acid Concentrations in Middle-Aged Subjects Clinical Chemistry
  31. Varea V et al, 2005, Malabsorption of carbohydrates and depression in children and adolescents PubMed
  32. Hereditary fructose intolerance Genetics Home Reference
  33. Sugars and sweeteners Boston University
  34. Nounou H, Disorders of Fructose Metabolism King Soud University
  35. Utreja D et al, 2010, A study of influence of sugars on the modulations of dental plaque pH in children with rampant caries, moderate caries and no caries Journal of Indian Society of Pedodontics and Preventive Dentistry
  36. Choi HK et al, 2010, Fructose-Rich Beverages and the Risk of Gout in Women PubMed Central
  37. Choi HK et al, 2008, Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study PubMed Central
  38. Sun SZ et al, 2010, Lack of association between dietary fructose and hyperuricemia risk in adults Nutrition & Metabolism
  39. Taylor EN et al, 2008, Fructose consumption and the risk of kidney stones PubMed
  40. Knight J et al, 2010, Metabolism of Fructose to Oxalate and Glycolate PubMed Central
  41. Hurtta M et al, 2204, Melting behaviour of D-sucrose, D-glucose and D-fructose Helsinki University of Technology Library
  42. Reducing and non-reducing sugars Ausetute.com.au
  43. Facts about fructose Fructose.org
  44. Sievenpiper JL et al, 2013, Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies  thebmj
  45. Johnson JR t al, 2010, Fructose, exercise, and health PubMed
  46. Rowlands DS et al, 2010, Effect of graded fructose coingestion with maltodextrin on exogenous 14C-fructose and 13C-glucose oxidation efficiency and high-intensity cycling performance Journal of Applied Physiology
  47. de Souza JR et al, 2013, The effect of fructose on risk of incident hypertension: a systematic review and meta-analysis of 3 large U.S. prospective cohorts  The FASEB Journal
  48. Jayalath VH et al, 2014, Total fructose intake and risk of hypertension: a systematic review and meta-analysis of prospective cohorts  PubMed Central
  49. Sweetness of sugar Canadian Sugar Institute
  50. Ghoshal UC, 2011, How to Interpret Hydrogen Breath Tests PubMed Central
  51. Barret JS et al, 2007, Clinical Ramifications of Malabsorption of Fructose and Other Short-chain Carbohydrates Foodintolerances.org
  52. Ha V et al, 2012, Effect of fructose on blood pressure: a systematic review and meta-analysis of controlled feeding trials PubMed
  53. Helms S et al, Fructose malabsorption, Assessment of dietary fructose intake Medscape
  54. Guest JE, 2013, Carbohydrate intolerance and celiac disease Celiac Support Association
  55. Mayes PA, 1993, Intermediary metabolism of fructose The American Journal of Clinical Nutrition
  56. Kim Y et al, 2011, Combination of erythritol and fructose increases gastrointestinal symptoms in healthy adults  PubMed
  57. Montonen J et al, 2007, Consumption of Sweetened Beverages and Intakes of Fructose and Glucose Predict Type 2 Diabetes Occurrence The Journal of Nutrition
  58. Foster-Powell K et al, 2002, International table of glycemic index and glycemic load values: 2002 The American Journal of Clinical Nutrition
  59. Bantle JP, 2009, Dietary Fructose and Metabolic Syndrome and Diabetes The Journal of Nutrition
  60. Crapo PA et al, 1980, Effects of oral fructose in normal, diabetic, and impaired glucose tolerance subjects PubMed
  61. Fryburg DA et al, 1990, Is exogenous fructose metabolism truly insulin independent? PubMed
  62. Husband AC et al, 2010, The effectiveness of glucose, sucrose, and fructose in treating hypoglycemia in children with type 1 diabetes PubMed
  63. Sweeteners: A Summary of their Properties Hawkins Wats
  64. Rowe RC et al, 2009 Handbook of Pharmaceutical Excipients Sixth Edition
  65. Ledochowski M et al, 2001, Decreased Serum Zinc in Fructose Malabsorbers Clinical Chemistry
  66. Sievenpiper JL et al, 2009, Heterogeneous Effects of Fructose on Blood Lipids in Individuals With Type 2 Diabetes PubMed Central
  67. Livesey G et al, 2008, Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies  PubMed
  68. Hanover LM et al, 193, Manufacturing, composition, and applications of fructose The American Journal Of Clinical Nutrition
  69. Fructosuria WebMD
  70. Sievenpiper JL et al, 2012, Effect of fructose on body weight in controlled feeding trials: a systematic review and meta-analysis  PubMed
  71. Cosma AI et al, 2012, Effect of fructose on glycemic control in diabetes: a systematic review and meta-analysis of controlled feeding trials  PubMed Central
  72. Chung M et al, 2014, Fructose, high-fructose corn syrup, sucrose, and nonalcoholic fatty liver disease or indexes of liver health: a systematic review and meta-analysis  The American Journal of Clinical Nutrition
  73. Chiu S et al, 2014, Effect of fructose on markers of non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of controlled feeding trials  European Journal of Clinical Nutrition
  74. Stanhope KL et al, 2014, Fructose consumption: potential mechanisms for its effects to increase visceral adiposity and induce dyslipidemia and insulin resistance  PubMed Central
  75. Tappy L et al, 2012, Fructose toxicity: is the science ready for public health actions?  PubMed Central
  76. Zhang JH et al, 2013, Very high fructose intake increases serum LDL-cholesterol and total cholesterol: a meta-analysis of controlled feeding trials  PubMed
  77. Gao X et al, 2007, Intake of added sugar and sugar-sweetened drink and serum uric acid concentration in US men and women  PubMed
  78. Cheeseman C, 2008, GLUT7: a new intestinal facilitated hexose transporter  American Journal of Physiology Endocrinology and Metabolism
  79. Kellet GL et al, 2005, Apical GLUT2, A Major Pathway of Intestinal Sugar Absorption  Diabetes

Comments are closed.