This systematic review investigated the effect of fructose on risk factors associated with diabetes. Searches were restricted to clinical/randomised controlled trials in humans, and reviews/meta-analyses thereof. Two reviews found no evidence that fructose is addictive (1) or less satiating than other carbohydrates (2). Two reviews found that there were no significant effects of consuming ≤100 g fructose/d on body weight in adults, but that consuming >100 g of added fructose/d may lead to modest (0.44 kg/wk) weight gain (3;4).One review found that statistically significant weight loss (-0.55 kg) occurred in overweight/obese individuals (4). One review found that consuming 10 g fructose/d may lead to an average 5.7% improvement in HbA1c (3) and another determined that consuming “catalytic” doses ( ≤ 36 g/d) may lead to a significant improvement in HbA1c (-0.40%) without adversely affecting fasting insulin, uric acid or triglycerides (5). One review found that isocaloric exchange of fructose for other carbohydrates may significantly decrease diastolic (-1.54) and mean arterial pressure (-1.16) but had no effect on systolic blood pressure (-1.10) (6). One review found that consuming ≥100 g of fructose/d significantly increased fasting triglycerides and >50 g a day increased postprandial triglycerides (3) and another found that consuming >60 g of fructose/d had a triglyceride-raising effect in people with type 2 diabetes (7). In conclusion, “catalytic” doses of added fructose (<50 g/d) may aid weight loss, improve HbA1c and blood pressure, but moderately high (>50 but ≤100 g) amounts may have an adverse effect on postprandial triglycerides and large amounts (>100 g) on top of regular food intake will contribute to weight gain and fasting triglyceridaemia.

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(2) Moran TH. J Nutr 2009;139(6):1253S-6S.
(3) Livesey G, Taylor R. Am J Clin Nutr 2008;88(5):1419-37.
(4) Sievenpiper JL, et al. Ann Intern Med 2012;156(4):291-304.
(5) Sievenpiper JL, et al. Br J Nutr 2012;1-6.
(6) Ha V, et al. Hypertension 2012; 59(4):787-95
(7) Sievenpiper JL, et al. Diabetes Care 2009;32(10):1930-7.