Clinical aspects of sucrose and fructose metabolism

The per capita consumption of sugars in the United States accounts for approximately 21% of total calorie intake. Most Americans eat and enjoy sugar-containing foods every day, but the use of sugars in the diabetic diet has traditionally been proscribed for fear of aggravating hyperglycemia. However, short-term and most longer-term studies demonstrate that dietary sucrose does not cause a greater postprandial rise in plasma glucose than isocaloric amounts of other common carbohydrates. The available evidence suggests that sucrose has a glycemic effect similar to that of bread, potatoes, and rice. Dietary fructose, in contrast, may produce a lesser postprandial rise in plasma glucose than other common carbohydrates. There is considerable controversy about the effects of dietary sucrose and fructose on serum lipids, and their effects on other metabolic events, such as the nonenzymatic glycosylation of proteins, are uncertain. Nevertheless, it is reasonable to allow diabetic patients to consume sugar-containing foods as long as they do so in a controlled fashion.