Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: Division of Endocrinology, University of Southern California Keck School of Medicine, Los Angeles (Dr Page); Department of Psychiatry (Dr Sinha), Section of Endocrinology (Dr Sherwin; email@example.com), Yale University School of Medicine, New Haven, Connecticut.
In Reply: Dr Hertzler points out that peak levels of plasma fructose following fructose ingestion were much less than the peak levels of plasma glucose following glucose ingestion and suggests such differences would be expected to lead to differential brain responses. We agree that this is likely to be one important factor contributing to the diminished ability of fructose vs glucose to suppress human brain activity in regions that control feeding behavior, particularly in the hypothalamus, which contains specific glucose-sensing neurons.1
Page KA, Sinha R, Sherwin RS. Differential Effects of Fructose and Glucose on Cerebral Blood Flow—Reply. JAMA. 2013;309(17):1768. doi:10.1001/jama.2013.3367