With the increase in fructose intake, primarily as sugar-sweetened beverages, occurring coincidently with the increase in prevalence of overweight and obesity during the past two decades, it is important to examine the evidence that links fructose consumption and body weight gain. In epidemiological studies, consumption of larger amounts of soft drinks and sweetened beverages is associated with greater weight gain in women and increased energy intake and higher body mass index in children. In experimental studies, when fructose- or sucrose-sweetened beverages are added to the diet, subjects do not compensate for the additional energy provided by these beverages by reducing energy intake from other sources, and total energy intake increases. Possibly, this lack of compensation may be explained by the lack of a significant effect of fructose ingestion on the secretion of hormones involved in the long-term regulation of food intake.
Data comparing the effects of ingesting fructose-and glucose-sweetened beverages with meals indicate that fructose ingestion results in smaller increases in blood glucose and insulin concentrations following the meals. In addition, circulating leptin concentrations are lower, and the normal suppressive effect of meal consumption on ghrelin concentrations is attenuated with fructose beverages. Glucose, insulin, leptin, and ghrelin are all involved in the long-term control of food intake and body weight regulation through the central nervous system. Since these key signals are absent or weakened with fructose consumption, chronic consumption of a diet high in fructose could contribute, along with dietary fat and inactivity, to increased energy intake, weight gain, and obesity.
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