Fructose, insulin resistance, and metabolic dyslipidemia

[you]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC552336/

Fructose is readily absorbed and rapidly metabolized by human liver. For thousands of years humans consumed fructose amounting to 16–20 grams per day, largely from fresh fruits. Westernization of diets has resulted in significant increases in added fructose, leading to typical daily consumptions amounting to 85–100 grams of fructose per day. The exposure of the liver to such large quantities of fructose leads to rapid stimulation of lipogenesis and TG accumulation, which in turn contributes to reduced insulin sensitivity and hepatic insulin resistance/glucose intolerance.

How did this get published in a peer-reviewed journal?

16-20 grams of fructose per day? That's a SINGLE serving of fruit. Not two, not three, not four. A single serving of fruit.

The alarming increase in fructose consumption may be an important contributor to the epidemic of obesity and insulin resistant diabetes in both pediatric and adult populations. For thousands of years, the human diet contained a relatively small amount of naturally occurring fructose from fruits and other complex foods. Adaptation of humans to a high glucose/low fructose diet has meant that hepatic carbohydrate metabolism is designed to actively metabolize glucose with a limited capacity for metabolizing a small daily intake of fructose. The increasing application of high fructose sweeteners over the past few decades has resulted in a considerable rise in the dietary intake of fructose. A high flux of fructose to the liver, the main organ capable of metabolizing this simple carbohydrate, disturbs normal hepatic carbohydrate metabolism leading to two major consequences (Figure ​(Figure2):2): perturbations in glucose metabolism and glucose uptake pathways, and a significantly enhanced rate of de novo lipogenesis and TG synthesis, driven by the high flux of glycerol and acyl portions of TG molecules coming from fructose catabolism. These metabolic disturbances appear to underlie the induction of insulin resistance commonly observed with high fructose feeding in both humans and animal models. Fructose induced insulin resistant states are commonly characterized by a profound metabolic dyslipidemia, which appears to result from hepatic and intestinal overproduction of atherogenic lipoprotein particles. Taking into consideration that a typical western diet not only contains high levels of fructose but is also rich in both fat and cholesterol, synergistic interactions among these nutrients can readily occur leading to a greater degree of insulin resistance and dyslipidemia. In conclusion, emerging evidence from recent epidemiological and biochemical studies clearly suggests that the high dietary intake of fructose has rapidly become an important causative factor in the development of the metabolic syndrome. There is an urgent need for increased public awareness of the risks associated with high fructose consumption and greater efforts should be made to curb the supplementation of packaged foods with high fructose additives.

 

[Such_Saturation]

Well perhaps they only had one fruit.

 

[jyb]

It is not easy to collect pounds and pounds of oranges, make orange juice by hand and then store it safely without a fridge. Now if you have to do that in the wild on top of taking care of the milk/meat... So I think it's plausible to have had a single serving per day on average over all seasons, if any.

 

[you]

It is not easy to collect pounds and pounds of oranges, make orange juice by hand and then store it safely without a fridge. It's a whole lot of organisation, so if you have to do that in the wild on top of taking care of the milk/meat... So I think it's plausible to have had a single serving per day on average over all seasons, if any.

Who says you need to collect pounds and pounds of oranges to get more a single serving of fruit?

 

[jyb]

Who says you need to collect pounds and pounds of oranges to get more a single serving of fruit?

It gives an idea of the relative amounts, compared to now where you can buy a bottle of OJ and sucrose in a few seconds any time of the year. I did say on average over the year. As for collecting pounds of oranges...that's what I needed to get a decent amount of OJ. So if I drink an OJ from the store, this is like eating many oranges - for sure would feel sick if I ate so many raw with the fibre.

 

[EnoreeG]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC552336/

How did this get published in a peer-reviewed journal?

16-20 grams of fructose per day? That's a SINGLE serving of fruit. Not two, not three, not four. A single serving of fruit.

Well, until man started breeding fruit trees to his satisfaction, it took a lot of pieces of any kind of fruit to total 16-20 grams of fructose. Primitive fruit (still available if you want to seek it out) not only had a lower fructose to glucose ratio, but it also had very, very little sucrose (which you remember is half fructose itself!).

This study shows the percentages in some wild fruits (not grams per fruit), but you can get the idea:

http://2ndchance.info/wildprimatediets.pdf

Check Table 1 on the fourth page of the link.

Now look at the carbohydrate of a navel orange:

http://nutritiondata.self.com/facts/fruits-and-fruit-juices/1968/2

Notice, in contrast to the wild fruits, the orange not only has more simple fructose than glucose, but it also has twice as much sucrose as glucose. So adding the fructose component of sucrose (half of it), plus the simple fructose, you have over twice as much fructose in an orange as you have simple glucose. In some of the wild fruits from that Table 1, after you added all the fructose up, you had usually less than half as much fructose as glucose. So percentage wise, fructose in modern fruits is higher than glucose. Wild fruits have hardly any sucrose.

That's percentages of total sugars. I don't have the weights of the wild fruits from that study. We can only guess that the wild fruit is more pulp and less sweet than modern fruits though. So if an orange has 14 gm. of sugars in an 165 mg. portion and that is 7 mg fructose, you can figure that the wild fruits had only about 1/2 of that, or less than 4 mg for a 165 mg portion. That is certainly going to be several guava's. So, not one fruit, but several handfulls to even give you just 4 mg of fructose. Multiply that by 5 to get your estimated 20 mg. of fructose. That's a lot'a guava! if my calculations are correct. And if the wild fruits really had way less sugar content than modern fruits, it gets even more distorted.

 

[you]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC552336/



How did this get published in a peer-reviewed journal?

16-20 grams of fructose per day? That's a SINGLE serving of fruit. Not two, not three, not four. A single serving of fruit.

Well, until man started breeding fruit trees to his satisfaction, it took a lot of pieces of any kind of fruit to total 16-20 grams of fructose. Primitive fruit (still available if you want to seek it out) not only had a lower fructose to glucose ratio, but it also had very, very little sucrose (which you remember is half fructose itself!).

This study shows the percentages in some wild fruits (not grams per fruit), but you can get the idea:

http://2ndchance.info/wildprimatediets.pdf

Check Table 1 on the fourth page of the link.

Now look at the carbohydrate of a navel orange:

http://nutritiondata.self.com/facts/fruits-and-fruit-juices/1968/2

Notice, in contrast to the wild fruits, the orange not only has more simple fructose than glucose, but it also has twice as much sucrose as glucose. So adding the fructose component of sucrose (half of it), plus the simple fructose, you have over twice as much fructose in an orange as you have simple glucose. In some of the wild fruits from that Table 1, after you added all the fructose up, you had usually less than half as much fructose as glucose. So percentage wise, fructose in modern fruits is higher than glucose. Wild fruits have hardly any sucrose.

That's percentages of total sugars. I don't have the weights of the wild fruits from that study. We can only guess that the wild fruit is more pulp and less sweet than modern fruits though. So if an orange has 14 gm. of sugars in an 165 mg. portion and that is 7 mg fructose, you can figure that the wild fruits only about 1/2 of that, or less than 4 mg for a 165 mg portion. That is certainly going to be several guava's. So, not one fruit, but several handfulls to even give you just 4 mg of fructose. Multiply that by 5 to get your estimated 20 mg. of fructose. That's a lot'a guava! if my calculations are correct. And if the wild fruits really had way less sugar content than modern fruits, it gets even more distorted.

I'm doubtful of the theory that modern fruits have that much more sugar than way before.

How can it even be proven and isn't it in the best interest for the fruits to be sweeter?

Here's an alternative viewpoint. http://rawfoodsos.com/2011/05/31/wild-a ... ent-fruit/

 

[Tom]

In China the diabetes prevalence was 9.6% in 2013, and I read somewhere that there´s 500 million pre diabetics in China now. In the US the diabetes prevalence is 10.9%. Most countries is around 6-10% at this point. It is hard to find any correlation between fructose intake and diabetes prevalence by country.

http://www.idf.org/diabetesatlas
http://www.diabetesresearchclinicalprac ... 68-8227(13)00385-9/fulltext

 

[jyb]

In China the diabetes prevalence was 9.6% in 2013, and I read somewhere that there´s 500 million pre diabetics in China now. In the US the diabetes prevalence is 10.9%. Most countries is around 6-10% at this point. It is hard to find any correlation between fructose intake and diabetes prevalence by country.

I see some countries that have nearly as much reported diabetes rate, 9%, yet I would view them as very clearly healthier or with less metabolic problem than USA which has "only" 1% more. So those incidence rates don't speak to me much.

The undiagnosed rates are very significant. So these rates only make sense if you think the undiagnosed part is the same proportion for all countries. Any change from that assumption and you have a wildly different ranking.

 

[Tom]

The prevalence I mentioned included the undiagnosed and, yes, it is difficult to know this 100% accurately. It´s an estimate found in the study I mentioned (http://www.ncbi.nlm.nih.gov/pubmed/24630390) based on http://jama.jamanetwork.com/article.asp ... id=1734701 for China. The estimated prevalence of pre diabetes is already higher in China than in the US.

 

[jyb]

The prevalence I mentioned included the undiagnosed and, yes, it is difficult to know this 100% accurately. It´s an estimate found in the study I mentioned (http://www.ncbi.nlm.nih.gov/pubmed/24630390) based on http://jama.jamanetwork.com/article.asp ... id=1734701 for China. The estimated prevalence of pre diabetes is already higher in China than in the US.

I take it back. It seems the official total rate for the US is indeed near 10%, like may countries. So, I remained surprised.

 

[tara]

Is this saying that in many countries close to 10% of the population have diabetes? Really?

 

[Tom]

According to Peat vegetable oil (PUFAs) and lack of potassium (fruits, vegetables) can be causes of diabetes. Fructose may actually be helpful in balancing blood sugar, reducing need for insulin etc. So to me it isn´t necessarily so surprising if diabetes prevalence is soon higher in China than in the US. It would be interesting to see if there´s differences between palm oil and soybean oil in these developing countries.

 

[sugar daddy]

I also don't believe this idea that only modern fruits are sweet and contain fructose and you don't have to worry about refrigeration or seasons when you live in Equatorial forests.

I think it would have been easier to collect fruit than catch an animal.

Also people have been collecting honey for thousands of years and have keep beehives as well.

The data suggests a much stronger link between PUFAs and diabetes.
This is just more sugar demonisation

 

[EnoreeG]

I also don't believe this idea that only modern fruits are sweet and contain fructose and you don't have to worry about refrigeration or seasons when you live in Equatorial forests.

I think it would have been easier to collect fruit than catch an animal.

Also people have been collecting honey for thousands of years and have keep beehives as well.

The data suggests a much stronger link between PUFAs and diabetes.
This is just more sugar demonisation

While I don't take issue with the final statements of the study quoted in the OP, (that the great rise in HFCS is responsible for some serious degenerative issues), I want to modify a comment I made earlier in the thread.

I do agree with you that we might question the claim that "only modern fruits are sweet and contain fructose". After I put in a comment above citing a paper that studies primitive fruits from only Panama which found they were way lower in fructose than modern fruits, I found this article by Denise Minger (highly regarded since debunking "The China Study") which shows the type of sugars contained in both domesticated and wild fruits across a far broader range of geography, including a lot of wild tropical fruits (and none of those from Panama).

http://rawfoodsos.com/2011/05/31/wild-and-ancient-fruit/

Though it emphasizes tropical fruit to make it's point while admitting that cold-climate fruits tend to be more sparing of fructose, and though Ms. Minger still got to pick the fruits she dealt with, it sill points out that at least many ancient tropical fruits were very high in fructose and even sucrose.

So I'm not saying anything on the value/risk of the fructose issue, but only adding something to the consideration of whether humans have really changed their balance of types of sugars by eating more modern fruits (and ignoring the introduction of HFCS into the diet). This whole point is moot if someone wishes to defend (or damn) the use of HFCS, because that is an overwhelmingly larger component of diet for most of the population for a few of the developed countries shown in Tom's "figure 26" above, especially the USA.

 

[Westside PUFAs]

"Westernization of diets has resulted in significant increases in added fructose"

I feel that there is a difference between HFCS and ripe, sweet fruit. Yes, peoples source of fructose is HFCS, not ripe fruit. Is it fair to call HFCS fructose? I think if you examined them under a microscope, the differences would be vast. People with metabolic syndrome are not eating a fruitarian diet. No, I do not believe that the quote someone posted about HFCS being "metabolically the same" as fruit fructose, is a real quote. It doesn't seem to be something that he would say, to me. Especially when he recommends Mexicoke over HFCS coke.

I go by craving sweet. To me that means eat fruit. "When your liver has enough glycogen stored, sweet things aren't appetizing." - RP

 

[EnoreeG]

"Westernization of diets has resulted in significant increases in added fructose"

I feel that there is a difference between HFCS and ripe, sweet fruit. Yes, peoples source of fructose is HFCS, not ripe fruit. Is it fair to call HFCS fructose? I think if you examined them under a microscope, the differences would be vast. People with metabolic syndrome are not eating a fruitarian diet. No, I do not believe that the quote someone posted about HFCS being "metabolically the same" as fruit fructose, is a real quote. It doesn't seem to be something that he would say, to me. Especially when he recommends Mexicoke over HFCS coke.

I go by craving sweet. To me that means eat fruit. "When your liver has enough glycogen stored, sweet things aren't appetizing." - RP

Well, a lot of the "increases" in fructose that the OP article speaks of are neither HFCS nor fruits. If you look at the chart posted by Tom (but remember the units are calories (4 times the grams) you see current consumption of sweeteners (thus exclusive of fruits). Most countries shown don't even touch HFCS. They take in a lot of added sweeteners though. If you find a country that is truly a "Westernized" one that the OP article speaks of, like Australia, you see that, exclusive of fruit and HFCS, the intake is around 600 calories (150 gm) of what just has to be table sugar which is half fructose. That's about 75 gm of fructose. Add in a modest amount of fruit, and you have the 85-100 gm of fructose claimed by the original quote.

With this in mind, the original quote

The alarming increase in fructose consumption may be an important contributor to the epidemic of obesity and insulin resistant diabetes in both pediatric and adult populations.

may be right. May. Later, it was quoted as:

Taking into consideration that a typical western diet not only contains high levels of fructose but is also rich in both fat and cholesterol, synergistic interactions among these nutrients can readily occur leading to a greater degree of insulin resistance and dyslipidemia.

As I read it, this article was a warning on fructose, but allowed for other contributing causes. There was no cause/effect proof of anything, including fructose being a "cause".

 

[tara]

I would have guessed (but don't know) that early humans might have been eating a higher fructose to glucose ratio than current humans - starches may be more neolithic - many currently widespread starches have been developed for agriculture by humans, and are best eaten cooked. Fruits could be eaten raw, and did not require the development of agriculture.

 

[tara]

No, I do not believe that the quote someone posted about HFCS being "metabolically the same" as fruit fructose, is a real quote.

I thought Peat said HFCS was probably metabolically similar to sucrose. They are both refined, lacking in all the minerals necessary to metabolise them.
There have also been studies showing HFCS may contain more carbs and calories than usually shown on the label, and I guess more than counted in studies upthread.

I go by craving sweet. To me that means eat fruit. "When your liver has enough glycogen stored, sweet things aren't appetizing." - RP

This makes sense to me.

 

[Tom]

http://wholehealthsource.blogspot.de/20 ... n-non.html