June 25, 2012: When replacing other sugars and starches, fructose improves blood sugar control, according to a new study published in Diabetes Care.

Without changing calories, the authors report that, replacing dietary carbohydrates with fructose improves hemoglobin A1c (HbA1c), a marker of long-term glucose control, in people with both Type I and Type II Diabetes.

This simple sugar exchange may be beneficial for populations suffering with poor blood glucose control. Researchers from St. Michael’s Hospital in Toronto, Canada, wrote that the reduction seen in HbA1c is similar to what’s expected from blood sugar-lowering agents.

Hemoglobin is an oxygen-carrying protein present in the blood stream. When blood sugar is too high for too long, glycated proteins—sugars binding to the surface of proteins—will increase. A high level of glycated hemoglobin (HbA1c) is an indicator that blood sugar has been in disarray.

In this meta-analysis, researchers pooled the results of 18 well-designed studies that evaluated the effects of exchanging fructose for other sources of carbohydrate. Noted as low-glycemic, fructose does not cause a large spike in blood sugar after meals. Fructose is naturally present in fruits, vegetables, and honey—foods that likely haven’t increased in the American diet.

Reporting an average decrease of 0.53 percent in HbA1c, the authors write, “fructose replacement of other carbohydrates resulted in clinically significant improvements in glycemic control, without significantly affecting insulin in diabetic individuals.”

Fructose Redemption?

Currently, some organizations including the American Diabetes Association (ADA) have put forth guidelines to limit the consumption of fructose. These guidelines are based on a perceived threat of elevated blood lipids. However, recent research by this same research group through meta-analyses has found that fructose eaten in normal amounts does not have any adverse effect on blood lipids or bodyweight.

Fructose is metabolized a little differently than other carbohydrates. Because the metabolism is quite thrifty, most sources of fuel—proteins, carbohydrates, and fats—can be interconverted to meet the body’s needs. Fructose, glucose, and galactose can have the same end-points in the body, but they do not tread identical paths.

Glucose (similar to galactose) is more readily oxidized (converted to energy), while fructose has one extra step. With a potential to detour, the body may pause during fructose metabolism, deciding its fate as a sugar or in forming a triglyceride. This is the basis of the argument against fructose. What these researchers emphasize however is that fructose will only jump ship when caloric intake is excessive—and still, this only occurs in small amounts.

Even when the body is teeming with extra calories, less than 10 percent of fructose will actually go toward triglyceride formation, the authors explain. The rest is burned up as energy or stored as glycogen—just like other forms of carbohydrate. What’s more, when not overeaten but eaten moderately (in amounts similar to that of found in fruit), these results are evidence that including fructose is a bit better for blood sugar.

“Over the last decade, there have been connections made between fructose intake and rates of obesity, however, this research suggests that the problem is likely one of overconsumption, not fructose,” said the senior researcher, Dr. John Sievenpiper.

Encouraging the ADA to take a second look at the research, the authors reiterate that “fructose has been shown to improve glycemia without adversely affecting lipids when exchanged for other carbohydrates.” In other words: calorie for calorie, moderate intake does not bring on more fat.

Marked with high rates of obesity and Type II Diabetes—bad diets and unbalanced blood sugar are obviously to blame for bulging waistlines. “We’re seeing that there may be benefit if fructose wasn’t being consumed in such large amounts,” said Adrian Cozma, lead author of this study.

These results were reported in a meta-analysis. Since this paper pooled existing data, the authors had no control over population sizes, medications, fructose intakes, or length of the trials. The authors note that more research is necessary to fully understand the impact of fructose exchange on blood sugar.

Reference

Cozma AI et al. Effect of Fructose on Glycemic Control in Diabetes: A Systematic Review and Meta-analysis of Controlled Feeding Trials. Diabetes Care 2012;35:1-10.doi:10.2337/dc12-0073

source: http://www.isagenixhealth.net/blog/2012/06/25/fructose-betters-blood-sugar-in-diabetes/

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