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Invited Commentary
Nutrition, Obesity, and Exercise
July 9, 2020

Current Intake and Demographic Disparities in the Association of Fructose-Rich Foods and Metabolic Syndrome

Author Affiliations
  • 1Department of Nutrition and Food Studies, Steinhardt School of Culture, Education and Human Development, New York University, New York
JAMA Netw Open. 2020;3(7):e2010224. doi:10.1001/jamanetworkopen.2020.10224

Since the 1970s, when high fructose corn syrup (HFCS) began to replace sucrose in soft drinks, added fructose intake has increased to a mean of approximately 7.5% of total energy intake.1 For comparison, the 2015-2020 Dietary Guidelines for Americans recommend that less than 10% of energy in the diet come from total added sugars. Added sugar intake has been decreasing in recent years, but in 2016, US adults consumed 14.4% of energy as added sugar.2

In 2004, a commentary by Bray et al3 observed that as HFCS consumption increased in the US, prevalence of obesity also increased. They,3 and subsequent authors,4 found that aspects of fructose metabolism could influence metabolic syndrome (MetS) risk factors, including fatty acid synthesis, obesity, and insulin sensitivity. Although Bray et al3 presented their data as a hypothesis, the article sparked a controversy about fructose consumption and risk of chronic diseases, including MetS, compared with glucose and sucrose, even though HFCS has the same composition of fructose and glucose as sucrose. Despite the ongoing discussion about whether one type of sweetener is worse for health than another, it is helpful to determine any differences in the risks of consuming these simple sugars to provide the best guidance to consumers and to advocate for a healthful food supply.

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