Both diabetic patients and people starting a diet to lose weight usually do without table sugar (sucrose) And replace it with fructose. Unlike sucrose, fructose does not require insulin to be incorporated into cells.
for them, Fructose is widely considered “more healthful” than sucrose., which has supported an increase in its consumption in recent years even in healthy patients. However, and although it may seem counterintuitive, fructose does not appear to be as beneficial as previously thought.
Obesity Overtakes Us
it’s clear that The goal of reducing sugar consumption is more than reasonable. In recent decades, the prevalence of obesity and related disorders has increased to alarming numbers and is expected to affect more than 1 billion people by 2030. and improper dietary patterns.
In particular, one of the most widespread dietary patterns in recent decades, and one that is associated with a greater risk of developing obesity, is “Western” or Western diet, It is characterized by being highly energetic, rich in free sugars and saturated fats, low in vegetables and fruits and consequently low in fiber. The debate is on alternatives.
fructose is the invisible enemy
Since these environmental factors are controllable, conventional treatments against obesity focus on limiting energy intake (hypocaloric diet) and increasing energy expenditure (physical activity). This type of treatment is also recommended for individuals with diabetes type 2, Since most of them are obese too.
simultaneously, Replacing sucrose or table sugar with fructose has been a common practice in the diets of diabetics., This is because, unlike sucrose, fructose does not require insulin to be incorporated into cells. For this reason, a perception has been made that fructose is “healthier” than sucrose, favoring an increase in its consumption in recent years.
In addition, the food industry has added fructose (in high amounts) to a variety of products through sweeteners such as corn syrup.
First Stop: Liver
But is it really as healthy as they paint it? To answer, we must keep in mind that after intestinal absorption, fructose is directed to the liver via the portal vein (which carries blood from the intestines, spleen, pancreas, and gallbladder to the liver). . There it is metabolized to be used as a substrate in various metabolic processes. This metabolism (phosphorylation) of fructose can lead to depletion of hepatic stores of free phosphate, As a result, in addition to increasing the production of purines (nitrogenous bases), it can lead to overproduction of uric acid, which is a risk factor for the development of gout.
In addition, chronic consumption of fructose causes Changes in lipid metabolism. Its incorporation and metabolism in the liver generates a metabolite (malonyl-CoA) that enhances the synthesis of fatty acids. In addition, it inhibits the enzyme responsible for introducing fatty acids into the mitochondria for oxidation (carnitine-palmitoyltransferase-1A, CPT1A).
As a result of an imbalance in the synthesis-oxidation of fats, the fatty deposits in the liver It favors, increases the risk of steatosis (excess triglycerides in the liver) and supports the secretion of very low density lipoproteins (VLDL) into the circulation. This increases the risk not only by increasing the dumping of triglycerides in the blood suffering from heart diseases But its availability is also increased for incorporation into visceral adipose tissue, ie in the abdomen and around the organs. This is all related to chronic low-grade systemic inflammation.
Consuming fructose can lead to diabetes
Paradoxically, fructose (in theory a substitute for table sugar for diabetics) has gone from being the “solution” to causing the problem. Consuming this sugar may contribute to the development of insulin resistance in non-diabetic subjects.
This is because when an obese, non-diabetic person consumes fructose, their levels a hormone called GLP-1 (glucagon-like peptide hormone-type 1) grows rapidly and with time. This increase appears to be directly related to an increase in insulin secretion by the pancreas. Furthermore, if GLP-1 levels remain elevated over time, insulin secretion is maintained as well. As a result, a state of hyperinsulinemia occurs that can alter sensitivity to it and lead to a state of insulin resistance.
On the other hand, the overproduction of uric acid in the liverAcquired from high fructose consumption, is related to insulin resistance.
Not all fructose is created equal
It is necessary to clarify that fructose, in addition to being one of the most commonly consumed sugars, is also naturally present in fruits and vegetables. Although the composition of fructose is the same regardless of the type of food it is found in, it is The food matrix is the factor that determines its physiological effects.
while Sugary drinks contain free fructose and not just nutrients, fruits and vegetables are composed of a complex matrix that includes fiber, micronutrients (minerals and vitamins) and other non-nutritive components such as polyphenols, which have been linked to improved health .
The fact is that all of these compounds interact with fructose to cause its metabolic effects to differ, for example, slowing down its intestinal absorption. For this reason, beyond the fructose content of a fruit (6 g in 100 g of banana) compared to a sweetened drink (6.3 g in a 100 g cola drink), what is important is the matrix where it is included.
Therefore, consumption of fruits and vegetables for excess free fructose consumption is not related to the metabolic problems described above. On the contrary, it is recommended to consume fruits to enjoy good health.
