title: The effect of dietary sucrose on blood lipids, serum insulin, platelet adhesiveness and body weight in human volunteers Walking Reduces Postprandial Insulin Secretion in Obese Adolescents Consuming a High-Fructose or High-Glucose Diet. No difference between high-fructose and high-glucose diets on liver triacylglycerol or biochemistry in healthy overweight men. Raisins and additional walking have distinct effects on plasma lipids and inflammatory cytokines Dietary Fructose Reduction Improves Markers of Cardiovascular Disease Risk in Hispanic-American Adolescents with NAFLD Orange juice allied to a reduced-calorie diet results in weight loss and ameliorates obesity-related biomarkers: A randomized controlled trial. Impaired cellular insulin binding and insulin sensitivity induced by high-fructose feeding in normal subjects. Day-long glucose, insulin, and fructose responses of hyperinsulinemic and nonhyperinsulinemic men adapted to diets containing either fructose or high-amylose cornstarch. Effects of dietary fructose on plasma lipids in healthy subjects. Sugar-sweetened product consumption alters glucose homeostasis compared with dairy product consumption in men and women at risk of type 2 diabetes mellitus. Family dietary coaching to improve nutritional intakes and body weight control: a randomized controlled trial. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. No Effect of Added Sugar Consumed at Median American Intake Level on Glucose Tolerance or Insulin Resistance The effect of sucrose content in high and low carbohydrate diets on plasma glucose, insulin, and lipid responses in hypertriglyceridemic humans. A randomised four-intervention crossover study investigating the effect of carbohydrates on daytime profiles of insulin, glucose, non-esterified fatty acids and triacylglycerols in middle-aged men. A randomized study of raisins versus alternative snacks on glycemic control and other cardiovascular risk factors in patients with type 2 diabetes mellitus The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Energy compensation following consumption of sugar-reduced products: a randomized controlled trial Sugar- and artificially sweetened beverages and intrahepatic fat: A randomized controlled trial. Hypercaloric diets with increased meal frequency, but not meal size, increase intrahepatic triglycerides: A randomized controlled trial Effects of natural honey on blood glucose and lipid profile in young healthy Pakistani males. Postprandial glucose and insulin levels in type 2 diabetes mellitus patients after consumption of ready-to-eat mixed meals Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids: the CARMEN study. The Carbohydrate Ratio Management in European National diets. Weight loss associated with a daily intake of three apples or three pears among overweight women. Increased postprandial glycaemia, insulinemia, and lipidemia after 10 weeks’ sucrose-rich diet compared to an artificially sweetened diet: a randomised controlled trial Consumption of a Diet Low in Advanced Glycation End Products for 4 Weeks Improves Insulin Sensitivity in Overweight Women Does sucrose intake affect antropometric variables, glycemia, lipemia and C-reactive protein in subjects with type 1 diabetes?: a controlled-trial Effect of Eucaloric High- and Low-Sucrose Diets With Identical Macronutrient Profile on Insulin Resistance and Vascular Risk Effect of fruit restriction on glycemic control in patients with type 2 diabetes – a randomized trial Fructose and insulin sensitivity in patients with type 2 diabetes. Effects of a short-term overfeeding with fructose or glucose in healthy young males. Effect of a High-Fructose Weight-Maintaining Diet on Lipogenesis and Liver Fat. Sucrose in the diet of diabetic patients — just another carbohydrate? Effects of natural honey consumption in diabetic patients: an 8-week randomized clinical trial Effect of banana consumption on faecal microbiota: a randomised, controlled trial. Incretin, insulinotropic and glucose-lowering effects of whey protein pre-load in type 2 diabetes: a randomised clinical trial Effect of the addition of simple sugars to mixed meals on the glycemic control of insulin treated diabetic patients. Effects of Two Energy-Restricted Diets Containing Different Fruit Amounts on Body Weight Loss and Macronutrient Oxidation Beneficial Effects of Palatable Guar and Guar Plus Fructose Diets in Diabetic Children [Effect of high sucrose- and high-fat diets ingested under free-living conditions in insulin resistance in normal weight and overweight women]. The effect of minimal dietary changes with raisins in NAFLD patients with non-significant fibrosis: a randomized controlled intervention. Effect of daily supplementation of fruits on oxidative stress indices and glycaemic status in type 2 diabetes mellitus. A randomized trial on the effects of flavorings on the health benefits of daily peanut consumption. Raisins Compared with Other Snack Effects on Glycemia and Blood Pressure: A Randomized, Controlled Trial Graded sucrose/carbohydrate diets in overtly hypertriglyceridemic diabetic patients. A pilot, randomized controlled trial to examine the health outcomes of raisin consumption in patients with diabetes. Large variations of sucrose in constant carbohydrate diets in type II diabetes. Effects of 4-week very-high-fructose/glucose diets on insulin sensitivity, visceral fat and intrahepatic lipids: an exploratory trial. High hepatic SCD1 activity is associated with low liver fat content in healthy subjects under a lipogenic diet. Two weeks of overfeeding with candy, but not peanuts, increases insulin levels and body weight Fructose overconsumption causes dyslipidemia and ectopic lipid deposition in healthy subjects with and without a family history of type 2 diabetes. Reformulating cereal bars: high resistant starch reduces in vitro digestibility but not in vivo glucose or insulin response; whey protein reduces glucose but disproportionately increases insulin. Attenuation of meal-induced inflammatory and thrombotic responses in overweight men and women after 6-week daily strawberry (Fragaria) intake. A randomized placebo-controlled trial. Effects of sugar-sweetened and sugar-free cocoa on endothelial function in overweight adults.
abstract: A study was made of the effect of high or low intake of sucrose for periods of 14 days in a group of nineteen apparently healthy men . The high sucrose diet produced no change in blood levels of cholesterol or phospholipids , or in glucose tolerance , but it produced a significant rise in triglycerides in all nineteen men . In six of them , there was in addition a rise in serum immunoreactive insulin , especially during the glucose tolerance test , and these same six subjects also showed a considerable increase in weight and a significant increase in platelet adhesiveness . There was no difference between the six subjects and the remaining thirteen in any of the other measurements , or in the diets they consumed during the experiment . The changes produced by sucrose had disappeared , or nearly so , after 14 days of normal diet . It is suggested that the effect of sucrose in producing hyperinsulinism may be more relevant to its possible role in the aetiology of ischaemic heart disease than its effect on blood lipids . It is further suggested that only some individuals are susceptible to the development of ischaemic heart disease by dietary sucrose , and that these may be identified as those that show ‘ sucrose-induced hyperinsulinism ’ BACKGROUND This study assessed if walking at a self-selected pace could improve postpr and ial glucose and insulin concentrations in obese adolescents consuming high-fructose ( HF ) or high-glucose ( HG ) diets . METHODS Seven obese male and female adolescents ( 18 ± 1 yr ) performed 4 , 15-day trials in a r and om order , including 1 ) HF-diet ( 50 g fructose/d added to normal diet ) while being sedentary , 2 ) HG-diet ( 50 g glucose/d ) while sedentary , 3 ) HF-diet with additional walking , and 4 ) HG-diet with additional walking . On the 15th day of each trial , the participants performed mixed meal testing in the laboratory in which they consumed three liquid shakes ( either HF or HG ) and during the HF and HG sedentary trials , the participants took < 4000 steps while in the laboratory but during the walking trials took ≥ 13,000 steps during testing . RESULTS Walking did not alter postpr and ial glucose concentrations . Although walking reduced insulin secretion by 34 % and 25 % during the HF- and HG-diet , respectively ( P < .05 ) , total insulin concentrations were only significantly reduced ( P > .05 ) with walking during the HF trial , possibly because walking enhanced insulin clearance to a greater extent during the HF-diet . CONCLUSIONS Walking reduces postpr and ial insulin secretion in obese adolescents consuming a high-fructose or high-glucose diet BACKGROUND & AIMS Diets high in fructose have been proposed to contribute to nonalcoholic fatty liver disease . We compared the effects of high-fructose and matched glucose intake on hepatic triacylglycerol ( TAG ) concentration and other liver parameters . DESIGN In a double-blind study , we r and omly assigned 32 healthy but central ly overweight men to groups that received either a high-fructose or high-glucose diet ( 25 % energy ) . These diets were provided during an initial isocaloric period of 2 weeks , followed by a 6-week washout period , and then again during a hypercaloric 2-week period . The primary outcome measure was hepatic level of TAG , with additional assessment s of TAG levels in serum and soleus muscle , hepatic levels of adenosine triphosphate , and systemic and hepatic insulin resistance . RESULTS During the isocaloric period of the study , both groups had stable body weights and concentrations of TAG in liver , serum , and soleus muscle . The high-fructose diet produced an increase of 22 ± 52 μmol/L in the serum level of uric acid , whereas the high-glucose diet led to a reduction of 23 ± 25 μmol/L ( P < .01 ) . The high-fructose diet also produced an increase of 0.8 ± 0.9 in the homeostasis model assessment of insulin resistance , whereas the high-glucose diet produced an increase of only 0.1 ± 0.7 ( P = .03 ) . During the hypercaloric period , participants in the high-fructose and high-glucose groups had similar increases in weight ( 1.0 ± 1.4 vs 0.6 ± 1.0 kg ; P = .29 ) and absolute concentration of TAG in liver ( 1.70 % ± 2.6 % vs 2.05 % ± 2.9 % ; P = .73 ) and serum ( 0.36 ± 0.75 vs 0.33 ± 0.38 mmol/L ; P = .91 ) , and similar results in biochemical assays of liver function . Body weight changes were associated with changes in liver biochemistry and concentration of TAGs . CONCLUSIONS In the isocaloric period , overweight men who were on a high-fructose or a high-glucose diet did not develop any significant changes in hepatic concentration of TAGs or serum levels of liver enzymes . However , in the hypercaloric period , both high-fructose and high-glucose diets produced significant increases in these parameters without any significant difference between the 2 groups . This indicates an energy-mediated , rather than a specific macronutrient-mediated , effect . Clinical trials.gov no : NCT01050140 Background Raisins are a significant source of dietary fiber and polyphenols , which may reduce cardiovascular disease ( CVD ) risk by affecting lipoprotein metabolism and inflammation . Walking represents a low intensity exercise intervention that may also reduce CVD risk . The purpose of this study was to determine the effects of consuming raisins , increasing steps walked , or a combination of these interventions on blood pressure , plasma lipids , glucose , insulin and inflammatory cytokines . Results Thirty-four men and postmenopausal women were matched for weight and gender and r and omly assigned to consume 1 cup raisins/d ( RAISIN ) , increase the amount of steps walked/d ( WALK ) or a combination of both interventions ( RAISINS + WALK ) . The subjects completed a 2 wk run-in period , followed by a 6 wk intervention . Systolic blood pressure was reduced for all subjects ( P = 0.008 ) . Plasma total cholesterol was decreased by 9.4 % for all subjects ( P < 0.005 ) , which was explained by a 13.7 % reduction in plasma LDL cholesterol ( LDL-C ) ( P < 0.001 ) . Plasma triglycerides ( TG ) concentrations were decreased by 19.5 % for WALK ( P < 0.05 for group effect ) . Plasma TNF-α was decreased from 3.5 ng/L to 2.1 ng/L for RAISIN ( P < 0.025 for time and group × time effect ) . All subjects had a reduction in plasma sICAM-1 ( P < 0.01 ) . Conclusion This research shows that simple lifestyle modifications such as adding raisins to the diet or increasing steps walked have distinct beneficial effects on CVD risk Nonalcoholic fatty liver disease ( NAFLD ) is now thought to be the most common liver disease worldwide . Cardiovascular complications are a leading cause of mortality in NAFLD . Fructose , a common nutrient in the westernized diet , has been reported to be associated with increased cardiovascular risk , but its impact on adolescents with NAFLD is not well understood . We design ed a 4-week r and omized , controlled , double-blinded beverage intervention study . Twenty-four overweight Hispanic-American adolescents who had hepatic fat > 8 % on imaging and who were regular consumers of sweet beverages were enrolled and r and omized to calorie-matched study -provided fructose only or glucose only beverages . After 4 weeks , there was no significant change in hepatic fat or body weight in either group . In the glucose beverage group there was significantly improved adipose insulin sensitivity , high sensitivity C-reactive protein ( hs-CRP ) , and low-density lipoprotein ( LDL ) oxidation . These findings demonstrate that reduction of fructose improves several important factors related to cardiovascular disease despite a lack of measurable improvement in hepatic steatosis . Reducing dietary fructose may be an effective intervention to blunt atherosclerosis progression among NAFLD patients and should be evaluated in longer term clinical trials OBJECTIVE Assumptions have linked orange juice ( OJ ) consumption with weight gain and adverse effects on health due to its sugar content ; however , epidemiologic studies have not shown increased risk for overweight or obesity with the consumption of 100 % OJ . The aim of this study was to verify whether the combination of a reduced-calorie diet ( RCD ) and 100 % OJ contribute to weight loss , promote changes in glucose and lipid metabolism , and improve diet quality in obese individuals . METHODS A r and omized controlled trial with 78 obese patients ( age 36 ± 1 y , body mass index [ BMI ] 33 ± 3 kg/m2 ) were enrolled in two groups : Individuals in the OJ group su bmi tted to an RCD that included OJ ( 500 mL/d ) , and individuals in the control group su bmi tted to an RCD without OJ . Body composition , biochemical biomarkers , and dietary intake were analyzed over a 12-wk period . RESULTS Both treatments had similar outcomes regarding body weight ( -6.5 kg ; P = 0.363 ) , BMI ( -2.5 kg/m2 ; P = 0.34 ) , lean mass ( -1 kg ; P = 0.29 ) , fat mass ( -5 kg ; P = 0.58 ) , body fat ( -3 % ; P = 0.15 ) , and waist-to-hip ratio ( -0.1 ; P = 0.79 ) . Insulin levels in the OJ group decreased by 18 % ( P = 0.05 ) , homeostasis model assessment -insulin resistance by 33 % ( P = 0.04 ) , total cholesterol by 24 % ( P = 0.004 ) , low-density lipoprotein cholesterol by 24 % ( P ≤ 0.001 ) , and high-sensitivity C-reactive protein levels by 33 % ( P = 0.001 ) compared with the control group . Consumption of energy and nutrients was similar between the two groups , but vitamin C and folate increased by 62 % ( P ≤ 0.015 ) and 39 % ( P = 0.033 ) , respectively , after OJ intervention . CONCLUSION When consumed concomitantly with an RCD , OJ does not inhibit weight loss ; ameliorate the insulin sensitivity , lipid profile , or inflammatory status , or contribute nutritionally to the quality of the diet We have studied whether the sucrose-induced reduction of insulin sensitivity and cellular insulin binding in normal man is related to the fructose or the glucose moiety . Seven young healthy subjects were fed their usual diets plus 1000 kcal extra glucose per day and eight young healthy subjects were fed their usual diets with addition of 1000 kcal extra fructose per day . The dietary regimens continued for 1 week . Before change of diet there were no statistically significant differences between body weight and fasting plasma concentrations of glucose , insulin , and ketone bodies in the two groups studied . High-glucose feeding caused no significant changes in insulin binding or insulin sensitivity whereas high-fructose feeding was accompanied by a significant reduction both of insulin binding ( P less than 0.05 ) and insulin sensitivity ( P less than 0.05 ) . The changes in insulin binding and insulin sensitivity correlated linearly ( r = 0.52 , P less than 0.01 ) . We conclude that fructose seems to be responsible for the impaired insulin binding and insulin sensitivity induced by sucrose Ten hyperinsulinemic and 11 nonhyperinsulinemic men consumed a typical American diet containing 20 % of calories either as fructose or as high-amylose cornstarch for 5 wk in a crossover design to determine their effects on indices of glucose tolerance . Blood glucose , insulin , and fructose  were determined before and 30 , 60 , 90 , 120 and 180 min after breakfast , lunch , and dinner . Glucose responses were significantly lower 60 and 120 min and the insulin response lower 60 min after the meals containing fructose .  Hyperinsulinemic men showed a tendency toward decreased insulin sensitivity after consuming fructose on the basis of an increased insulin-to-glucose ratio and decreased insulin binding to erythrocytes . These results generally show a beneficial effect of fructose on glucose tolerance ; however , recommendations for including large amounts of fructose in the diet should also be based on a complete evaluation of the effect on other metabolic risk factors BACKGROUND About 9 % of average dietary energy intake in the United States comes from fructose . Such a high consumption raises concern about the metabolic effects of this sugar . OBJECTIVE The objective of this study was to determine the effect of dietary fructose on plasma lipids . DESIGN The study was conducted in the General Clinical Research Center at Fairview-University of Minnesota Medical Center . The participants were 24 healthy adult volunteers ( 12 men and 12 women ; 6 of each sex were aged < 40 y and 6 of each sex were aged > /=40 y ) . All subjects received 2 isoenergetic study diets assigned by using a r and omized , balanced crossover design . One diet provided 17 % of energy as fructose . The other diet was sweetened with glucose and was nearly devoid of fructose . Each diet was fed for 6 wk . Both diets were composed of common foods and contained nearly identical amounts of carbohydrate , protein , fat , fiber , cholesterol , and saturated , monounsaturated , and polyunsaturated fatty acids . All meals were prepared in the metabolic kitchen of the General Clinical Research Center . RESULTS The responses to the study diets differed by sex . In men , the fructose diet produced significantly higher fasting , postpr and ial , and daylong plasma triacylglycerol concentrations than did the glucose diet . The daylong plasma triacylglycerol concentration after 6 wk of the fructose diet was 32 % greater in men than the corresponding concentration during the glucose diet ( P : < 0.001 ) . The fructose diet had no significant effect on fasting or postpr and ial plasma triacylglycerol concentrations in women . The fructose diet also had no persistent effect on fasting plasma cholesterol , HDL cholesterol , or LDL cholesterol in either men or women . CONCLUSIONS Dietary fructose was associated with increased fasting and postpr and ial plasma triacylglycerol concentrations in men . Diets high in added fructose may be undesirable , particularly for men . Glucose may be a suitable replacement sugar BACKGROUND Dietary patterns characterized by high intakes of fruits and vegetables , whole grains , low-fat dairy products , and low glycemic load have been associated with lower type 2 diabetes mellitus ( T2DM ) risk . In contrast , dietary patterns that include high intakes of refined grains , processed meats , and high amounts of added sugars have been associated with increased T2DM risk . OBJECTIVE This r and omized , 2-period crossover trial compared the effects of dairy and sugar-sweetened product ( SSP ) consumption on insulin sensitivity and pancreatic β-cell function in men and women at risk of the development of T2DM who habitually consume sugar-sweetened beverages . METHODS In a r and omized , controlled crossover trial , participants consumed dairy products ( 474 mL/d 2 % milk and 170 g/d low-fat yogurt ) and SSPs ( 710 mL/d nondiet soda and 108 g/d nondairy pudding ) , each for 6 wk , with a 2-wk washout between treatments . A liquid meal tolerance test ( LMTT ) was administered at baseline and the end of each period . RESULTS Participants were 50 % female with a mean age and body mass index of 53.8 y and 32.2 kg/m(2 ) , respectively . Changes from baseline were significantly different between dairy product and SSP conditions for median homeostasis model assessment 2-insulin sensitivity ( HOMA2-%S ) ( 1.3 vs. -21.3 % , respectively , P = 0.009 ; baseline = 118 % ) , mean LMTT disposition index ( -0.03 vs. -0.36 , respectively , P = 0.011 ; baseline = 2.59 ) , mean HDL cholesterol ( 0.8 vs. -4.2 % , respectively , P = 0.015 ; baseline = 44.3 mg/dL ) , and mean serum 25-hydroxyvitamin D [ 25(OH)D ] ( 11.7 vs. -3.3 , respectively , P = 0.022 ; baseline = 24.5 μg/L ) . Changes from baseline in LMTT Matsuda insulin sensitivity index ( -0.10 vs. -0.49 , respectively ; baseline = 4.16 ) and mean HOMA2-β-cell function ( -2.0 vs. 5.3 % , respectively ; baseline = 72.6 % ) did not differ significantly between treatments . CONCLUSION These results suggest that SSP consumption is associated with less favorable values for HOMA2-%S , LMTT disposition index , HDL cholesterol , and serum 25(OH)D in men and women at risk of T2DM vs. baseline values and values during dairy product consumption . This trial was registered at clinical trials.gov as NCT01936935 OBJECTIVE To test the hypothesis that family dietary coaching would improve nutritional intakes and weight control in free-living ( noninstitutionalized ) children and parents . DESIGN R and omized controlled trial . SETTING Fifty-four elementary schools in Paris , France . PARTICIPANTS One thous and thirteen children ( mean age , 7.7 years ) and 1013 parents ( mean age , 40.5 years ) . INTERVENTION Families were r and omly assigned to group A ( advised to reduce fat and to increase complex carbohydrate intake ) , group B ( advised to reduce both fat and sugar and to increase complex carbohydrate intake ) , or a control group ( given no advice ) . Groups A and B received monthly phone counseling and Internet-based monitoring for 8 months . OUTCOME MEASURES Changes in nutritional intake , body mass index ( calculated as weight in kilograms divided by height in meters squared ) , fat mass , physical activity , blood indicators , and quality of life . RESULTS Compared with controls , participants in the intervention groups achieved their nutritional targets for fat intake and to a smaller extent for sugar and complex carbohydrate intake , leading to a decrease in energy intake ( children , P < .001 ; parents , P = .02 ) . Mean changes in body mass index were similar among children ( group A , + 0.05 , 95 % confidence interval [ CI ] , - 0.06 to 0.16 ; group B , + 0.10 , 95 % CI , - 0.03 to 0.23 ; control group , + 0.13 , 95 % CI , 0.04 - 0.22 ; P = .45 ) , but differed in parents ( group A , + 0.13 , 95 % CI , - 0.01 to 0.27 ; group B , - 0.02 , 95 % CI , - 0.14 to 0.11 ; control group , + 0.24 , 95 % CI , 0.13 - 0.34 ; P = .001 ) , with a significant difference between group B and the control group ( P = .01 ) . CONCLUSIONS Family dietary coaching improves nutritional intake in free-living children and parents , with beneficial effects on weight control in parents . Trial Registration clinical trials.gov Identifier : NCT00456911 BACKGROUND The consumption of sucrose-sweetened soft drinks ( SSSDs ) has been associated with obesity , the metabolic syndrome , and cardiovascular disorders in observational and short-term intervention studies . Too few long-term intervention studies in humans have examined the effects of soft drinks . OBJECTIVE We compared the effects of SSSDs with those of isocaloric milk and a noncaloric soft drink on changes in total fat mass and ectopic fat deposition ( in liver and muscle tissue ) . DESIGN Overweight subjects ( n = 47 ) were r and omly assigned to 4 different test drinks ( 1 L/d for 6 mo ) : SSSD ( regular cola ) , isocaloric semiskim milk , aspartame-sweetened diet cola , and water . The amount of intrahepatic fat and intramyocellular fat was measured with (1)H-magnetic resonance spectroscopy . Other endpoints were fat mass , fat distribution ( dual-energy X-ray absorptiometry and magnetic resonance imaging ) , and metabolic risk factors . RESULTS The relative changes between baseline and the end of 6-mo intervention were significantly higher in the regular cola group than in the 3 other groups for liver fat ( 132 - 143 % , sex-adjusted mean ; P < 0.01 ) , skeletal muscle fat ( 117 - 221 % ; P < 0.05 ) , visceral fat ( 24 - 31 % ; P < 0.05 ) , blood triglycerides ( 32 % ; P < 0.01 ) , and total cholesterol ( 11 % ; P < 0.01 ) . Total fat mass was not significantly different between the 4 beverage groups . Milk and diet cola reduced systolic blood pressure by 10 - 15 % compared with regular cola ( P < 0.05 ) . Otherwise , diet cola had effects similar to those of water . CONCLUSION Daily intake of SSSDs for 6 mo increases ectopic fat accumulation and lipids compared with milk , diet cola , and water . Thus , daily intake of SSSDs is likely to enhance the risk of cardiovascular and metabolic diseases . This trial is registered at clinical trials.gov as NCT00777647 Excess sugar consumption may promote adverse changes in  hepatic and total body insulin resistance .  Debate continues over the effects of sugars at more typically consumed levels and whether the identity of the sugar consumed is important . In the present study participants ( 20–60 years old ) were r and omly assigned to one of five groups , three that consumed low fat milk with added fructose containing sugars in amounts equivalent to the 50th percentile of fructose consumption ( US ) , one which consumed low-fat milk sweetened with glucose , and one unsweetened low-fat milk control group . The intervention lasted ten weeks . In the entire study population there was less than 1 kg increase in weight ( 73.6 ± 13.0 vs. 74.5 ± 13.3 kg , p < 0.001 ) , but the change in weight was comparable among groups ( p > 0.05 ) . There were no changes in fasting glucose ( 49 ± 0.4 vs. 5.0 ± 0.5 mmol/L ) , insulin ( 56.9 ± 38.9 vs. 61.8 ± 50.0 pmol/L ) , or insulin resistance , as measured by the Homeostasis Model Assessment method ( 1.8 ± 1.3 vs. 2.0 ± 1.5 , all p > 0.05 ) . These data suggest that added sugar consumed at the median American intake level does not produce changes in measures of insulin sensitivity or glucose tolerance and that no sugar has more deleterious effects than others To further underst and the effect of high carbohydrate (CHO)-low fat diets and the role of variations in dietary sucrose on CHO and lipid metabolism , 10 patients with hypertriglyceridemia were fed 2 isocaloric , typical American diets , containing 40 % and 60 % CHO , for 15 days in r and om sequence . Each patient was their own control , and they were divided into 2 groups of 5 patients each . In one group , sucrose was held constant at 13 % of total calories ( 40 - 13 % and 60 - 13 % ) , whereas the sucrose content was 9 % of the total calories on a 40 % CHO diet ( 40 - 9 % ) , and 15 % of total calories on a 60 % CHO diet ( 60 - 15 % ) in the other group . Fasting and postpr and ial blood sample s were analyzed for plasma glucose , insulin , cholesterol ( Chol ) , and triglycerides ( TG ) , as well as for Chol and TG in chylomicrons , very low density , low density , and high density lipoproteins ( HDL ) . Fasting plasma TG levels were significantly increased in both groups on the 60 % CHO diet , primarily due to increases in very low density-TG concentration . The magnitude of the elevation was attenuated when sucrose content was kept constant . Postpr and ial TG responses were qualitatively similar . There were no significant changes in plasma Chol concentrations , except for a modest fall in plasma HDL-Chol level after the 60 - 13 % diet period ( P less than 0.05 ) . No significant differences were found in fasting plasma glucose or insulin concentration . However , postpr and ial glucose and insulin responses were increased on both high CHO diets . The results of these studies demonstrate that high CHO-low fat diets , in general , tend to elevate plasma glucose , insulin , and TG concentrations and reduce HDL-Chol concentration in patients with endogenous hypertriglyceridemia . In addition , these data illustrate the important role that small variations in dietary sucrose can play in modulation of CHO and lipid metabolism Postpr and ial concentrations of glucose , insulin and triacylglycerols ( TG ) correlate to risk for CHD . Carbohydrates affect many metabolites that could have a potential effect on cardiovascular risk factors . The objective of the present study was to examine , using a r and omised prospect i ve study , the acute ( day 1 ) and ad libitum medium-term ( day 24 ) effects of four diets : a high-fat diet ( HIGH-FAT ; 50 % fat , > 34 % monounsaturated fatty acids ) ; a low-glycaemic index ( GI ) diet ( LOW-GI ; high-carbohydrate , low-GI ) ; a high-sucrose diet ( SUCROSE ; high carbohydrate increase of 90 g sucrose/d ) ; a high-GI diet ( HIGH-GI ; high-carbohydrate , high-GI ) . Daytime profiles ( 8 h ) ( breakfast , lunch and tea ) of lipid and carbohydrate metabolism were completed during day 1 and day 24 . Seventeen middle-aged men with one or more cardiac risk factors completed the study . There was no change from day 1 or between diets in fasting glucose , lipids or homeostatic assessment model ( HOMA ) on day 24 . The HIGH-FAT compared with the three high-carbohydrate diets was associated with lower postpr and ial insulin and glucose but higher postpr and ial TG and non-esterified fatty acids ( NEFA ) . There was a significant increase in the 6 h ( 15.00 hours ) TG concentration ( day 1 , 2.6 ( sem 0.3 ) mmol/l v. day 24 , 3.3 ( sem 0.3 ) mmol/l ; P<0.01 ) on the SUCROSE diet . Postpr and ial HOMA ( i.e. incremental area under the curve ( IAUC ) glucose ( mmol/l per min)xIAUC insulin/22.5 ( mU/l per min ) ) median changes from day 1 to day 24 were -61 , -43 , -20 and + 31 % for the HIGH-FAT , LOW-GI , SUCROSE and HIGH-GI diets respectively . The HIGH-GI percentage change was significantly different from the other three diets ( P<0.001 ) . Despite being advised to maintain an identical energy intake there was a significant weight change ( -0.27 ( sem 0.3 ) kg ; P<0.02 ) on the LOW-GI diet compared with the SUCROSE diet ( + 0.84 ( sem 0.3 ) kg ) . In conclusion the HIGH-FAT diet had a beneficial effect on postpr and ial glucose and insulin over time but it was associated with higher postpr and ial concentrations of TG and NEFA . Conversely the HIGH-GI diet appeared to increase postpr and ial insulin resistance over the study period Abstract Just as the type and duration of physical activity can have variable effects on the glucose levels and other cardiometabolic parameters among patients with type 2 diabetes mellitus ( T2DM ) , so can the types of foods have variable effects as well . This 12-week r and omized study of 51 study participants evaluated the impact of routine consumption of dark raisins versus alternative processed snacks on glucose levels and other cardiovascular risk factors among patients with type T2DM . In this study , compared to alternative processed snacks , those who consumed raisins had a significant 23 % reduction in postpr and ial glucose levels ( P = 0.024 ) . Also compared to snacks , those who consumed raisins had a 19 % reduction in fasting glucose and 0.12 % reduction in hemoglobin A1c , although these latter findings did not achieve statistical significance . Regarding blood pressure , compared to alternative processed snacks , those who consumed raisins had a significant 8.7 mmHg reduction in systolic blood pressure ( P = 0.035 ) ( 7.5 % [ P = 0.031 ] ) but did not experience a significant reduction in diastolic blood pressure . Compared to alternative processed snacks , those who consumed raisins did not have a significant improvement in body weight , body mass index , waist circumference , fasting insulin , homeostatic model assessment of insulin resistance , total cholesterol , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol ( HDL ) , triglyceride , or non-HDL cholesterol levels . Overall , these data support raisins as a healthy alternative compare to processed snacks in patients with T2DM Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Purpose Consumption of sugar-reformulated products ( commercially available foods and beverages that have been reduced in sugar content through reformulation ) is a potential strategy for lowering sugar intake at a population level . The impact of sugar-reformulated products on body weight , energy balance ( EB ) dynamics and cardiovascular disease risk indicators has yet to be established . The REFORMulated foods ( REFORM ) study examined the impact of an 8-week sugar-reformulated product exchange on body weight , EB dynamics , blood pressure , arterial stiffness , glycemia and lipemia . Methods A r and omized , controlled , double-blind , crossover dietary intervention study was performed with fifty healthy normal to overweight men and women ( age 32.0 ± 9.8 year , BMI 23.5 ± 3.0 kg/m2 ) who were r and omly assigned to consume either regular sugar or sugar-reduced foods and beverages for 8 weeks , separated by 4-week washout period . Body weight , energy intake ( EI ) , energy expenditure and vascular markers were assessed at baseline and after both interventions . Results We found that carbohydrate ( P < 0.001 ) , total sugars ( P < 0.001 ) and non-milk extrinsic sugars ( P < 0.001 ) ( % EI ) were lower , whereas fat ( P = 0.001 ) and protein ( P = 0.038 ) intakes ( % EI ) were higher on the sugar-reduced than the regular diet . No effects on body weight , blood pressure , arterial stiffness , fasting glycemia or lipemia were observed . Conclusions Consumption of sugar-reduced products , as part of a blinded dietary exchange for an 8-week period , result ed in a significant reduction in sugar intake . Body weight did not change significantly , which we propose was due to energy compensation OBJECTIVE To test the hypothesis that substituting artificially sweetened beverages ( ASB ) for sugar-sweetened beverages ( SSB ) decreases intrahepatocellular lipid concentrations ( IHCL ) in overweight subjects with high SSB consumption . METHODS About 31 healthy subjects with BMI greater than 25 kg/m(2 ) and a daily consumption of at least 660 ml SSB were r and omized to a 12-week intervention in which they replaced SSBs with ASBs . Their IHCL ( magnetic resonance spectroscopy ) , visceral adipose tissue volume ( VAT ; magnetic resonance imaging ) , food intake ( 2-day food records ) , and fasting blood concentrations of metabolic markers were measured after a 4-week run-in period and after a 12-week period with ASB or control ( CTRL ) . RESULTS About 27 subjects completed the study .  IHCL was reduced to 74 % of the initial values with ASB ( N = 14 ; P < 0.05 ) but did not change with CTRL . The decrease in IHCL attained with ASB was more important in subjects with IHCL greater than 60 mmol/l than in subjects with low IHCL . ALT decreased significantly with SSB only in subjects with IHCL greater than 60 mmol/l . There was otherwise no significant effect of ASB on body weight , VAT , or metabolic markers . CONCLUSIONS In subjects with overweight or obesity and a high SSB intake , replacing SSB with ASB decreased intrahepatic fat over a 12-week period American children consume up to 27 % of calories from high-fat and high-sugar snacks . Both sugar and fat consumption have been implicated as a cause of hepatic steatosis and obesity but the effect of meal pattern is largely understudied . We hypothesized that a high meal frequency , compared to consuming large meals , is detrimental in the accumulation of intrahepatic and abdominal fat . To test this hypothesis , we r and omized 36 lean , healthy men to a 40 % hypercaloric diet for 6 weeks or a eucaloric control diet and measured intrahepatic triglyceride content ( IHTG ) using proton magnetic resonance spectroscopy ( 1H-MRS ) , abdominal fat using magnetic resonance imaging ( MRI ) , and insulin sensitivity using a hyperinsulinemic euglycemic clamp with a glucose isotope tracer before and after the diet intervention . The caloric surplus consisted of fat and sugar ( high-fat-high-sugar ; HFHS ) or sugar only ( high-sugar ; HS ) and was consumed together with , or between , the three main meals , thereby increasing meal size or meal frequency . All hypercaloric diets similarly increased body mass index ( BMI ) . Increasing meal frequency significantly increased IHTG ( HFHS mean relative increase of 45 % ; P = 0.016 and HS mean relative increase of 110 % ; P = 0.047 ) , whereas increasing meal size did not ( 2-way analysis of variance [ ANOVA ] size versus frequency P = 0.03 ) . Abdominal fat increased in the HFHS-frequency group ( + 63.3 ± 42.8 mL ; P = 0.004 ) and tended to increase in the HS-frequency group ( + 46.5 ± 50.7 mL ; P = 0.08 ) . Hepatic insulin sensitivity tended to decrease in the HFHS-frequency group while peripheral insulin sensitivity was not affected . Conclusion : A hypercaloric diet with high meal frequency increased IHTG and abdominal fat independent of caloric content and body weight gain , whereas increasing meal size did not . This study suggests that snacking , a common feature in the Western diet , independently contributes to hepatic steatosis and obesity . ( Trial registration : http://www.forestplots.net ; nr . NCT01297738 . ) ( Hepatology 2014;60:545–553 BACKGROUND Honey has been shown to have beneficial effects on the glucose and lipid profiles in patients at high risk of heart diseases . Therefore , this study was carried out to investigate the effects of natural honey on blood glucose and lipid profile in healthy individuals . METHODS A r and omized controlled trial was carried out in the Army Medical College , Rawalpindi , Pakistan , spanning 4 weeks , that is , from 15th Feb-15th March 2009 . A total of 70 healthy young boarders of the same college were included in the study and r and omly divided into two groups of 35 each using r and om number table . Seventy gram ( 70 g ) of honey was given to each individual in the experimental group daily for a period of 4 weeks while control group was kept on the same diet as that of experimental group except honey . The fasting glucose , total cholesterol , low density lipoprotein ( LDL ) , high density lipoprotein ( HDL ) and triglyceride ( TG ) levels were measured before and after the experiment . RESULTS The fasting glucose levels in both groups were raised . However , the increase in the experimental group was significantly less than that in the control group ( p < 0.05 ) . The levels of total cholesterol , LDL and triglycerides in the control group increased while those in the experiment group decreased significantly ( p < 0.05 ) , while HDL levels were decreased in the former and increased in the latter group ( p < 0.05 ) . CONCLUSION Natural honey consumption significantly limits the rise in blood glucose along with a significant decrease in the levels of total cholesterol , LDL and triglycerides , and increase HDL in young healthy adults Abstract Purpose To compare the effects of three ready-to-eat mixed meals , with a high fiber content and low glycemic index , on postpr and ial glycemic and insulinemic response in patients with Type 2 diabetes mellitus ( T2DM ) . Methods The current study followed a prospect i ve , three-way , cross-over design . Twenty-four patients with T2DM consumed three ready-to-eat mixed meals , i.e. , “ wild greens pie ” ( meal 1 ) , “ chicken burgers with boiled vegetables ” ( meal 2 ) and “ vegetable moussaka ” ( meal 3 ) and an oral glucose load , all providing 50 g of carbohydrates . Venous blood was collected at 0 , 30 , 60 , 90 and 120 min postpr and ial . Statistical analyses included repeated measures analysis of variance and calculations of the area under the glucose and insulin curves ( AUC ) for each one of the test meals and the oral glucose load . Results Patients consuming each one of the three mixed meals showed better postpr and ial glycemic responses compared to the oral glucose load ( P < 0.001 ) . Furthermore , patients consuming meal 3 showed a better insulinemic response compared to the oral glucose load and meal 1 , after 60 and 120 min postpr and ial , respectively ( P < 0.05 ) . In addition , the increase observed in HOMA-IR values from T0 to T120 was significantly lower for meal 3 , compared to the oral glucose load ( P < 0.001 ) . Conclusions The three ready-to-eat mixed meals examined in the present study were found to elicit significantly lower glycemic responses compared to the oral glucose load in diabetic patients . The mixed meals examined in the present study could be proposed as effective , palatable and practical solutions for diabetics for glucose control OBJECTIVE To investigate the long-term effects of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates . DESIGN R and omized controlled multicentre trial ( CARMEN ) , in which subjects were allocated for 6 months either to a seasonal control group ( no intervention ) or to one of three experimental groups : a control diet group ( dietary intervention typical of the average national intake ) ; a low-fat high simple carbohydrate group ; or a low-fat high complex carbohydrate group . SUBJECTS Three hundred and ninety eight moderately obese adults . MEASUREMENTS The change in body weight was the primary outcome ; changes in body composition and blood lipids were secondary outcomes . RESULTS Body weight loss in the low-fat high simple carbohydrate and low-fat high complex carbohydrate groups was 0.9 kg ( P < 0.05 ) and 1.8 kg ( P < 0.001 ) , while the control diet and seasonal control groups gained weight ( 0.8 and 0.1 kg , NS ) . Fat mass changed by -1.3 kg ( P < 0.01 ) , -1.8 kg ( P < 0.001 ) and + 0.6 kg ( NS ) in the low-fat high simple carbohydrate , low-fat high complex carbohydrate and control diet groups , respectively . Changes in blood lipids did not differ significantly between the dietary treatment groups . CONCLUSION Our findings suggest that reduction of fat intake results in a modest but significant reduction in body weight and body fatness . The concomitant increase in either simple or complex carbohydrates did not indicate significant differences in weight change . No adverse effects on blood lipids were observed . These findings underline the importance of this dietary change and its potential impact on the public health implication s of obesity OBJECTIVE We investigated the effect of fruit intake on body weight change . METHODS Hypercholesterolemic , overweight ( body mass index > 25 kg/m2 ) , and non-smoking women , 30 to 50 y of age , were r and omized to receive , free of charge , one of three dietary supplements : apples , pears , or oat cookies . Women were instructed to eat one supplement three times a day in a total of six meals a day . Participants ( 411 women ) were recruited at a primary care center of the State University of Rio de Janeiro , Brazil . Fifty-one women had fasting blood cholesterol levels greater than 6.2 mM/L ( 240 mg/dL ) and 49 were r and omized . Subjects were instructed by a dietitian to eat a diet ( 55 % of energy from carbohydrate , 15 % from protein , and 30 % from fat ) to encourage weight reduction at the rate of 1 kg/mo . RESULTS After 12 wk of follow-up , the fruit group lost 1.22 kg ( 95 % confidence interval = 0.44 - 1.85 ) , whereas the oat group had a non-significant weight loss of 0.88 kg ( 0.37 - 2.13 ) . The difference between the two groups was statistically significant ( P = 0.004 ) . To explore further the body weight loss associated with fruit intake , we measured the ratio of glucose to insulin . A significantly greater decrease of blood glucose was observed among those who had eaten fruits compared with those who had eaten oat cookies , but the glucose : insulin ratio was not statistically different from baseline to follow-up . Adherence to the diet was high , as indicated by changes in serum triacylglycerols , total cholesterol , and reported fruit intake . Fruit intake in the oat group throughout treatment was minimal . CONCLUSIONS Intake of fruits may contribute to weight loss Background The importance of exchanging sucrose for artificial sweeteners on risk factors for developing diabetes and cardiovascular diseases is not yet clear . Objective To investigate the effects of a diet high in sucrose versus a diet high in artificial sweeteners on fasting and postpr and ial metabolic profiles after 10 weeks . Design Healthy overweight subjects were r and omised to consume drinks and foods sweetened with either sucrose ( ∼2 g/kg body weight ) ( n = 12 ) or artificial sweeteners ( n = 11 ) as supplements to their usual diet . Supplements were similar on the two diets and consisted of beverages ( ∼80 weight% ) and solid foods ( yoghurts , marmalade , ice cream , stewed fruits ) . The rest of the diet was free of choice and ad libitum . Before ( week 0 ) and after the intervention ( week 10 ) fasting blood sample s were drawn and in week 10 , postpr and ial blood was sample d during an 8-hour meal test ( breakfast and lunch ) . Results After 10 weeks postpr and ial glucose , insulin , lactate , triglyceride , leptin , glucagon , and GLP-1 were all significantly higher in the sucrose compared with the sweetener group . After adjusting for differences in body weight changes and fasting values ( week 10 ) , postpr and ial glucose , lactate , insulin , GIP , and GLP-1 were significantly higher and after further adjusting for differences in energy and sucrose intake , postpr and ial lactate , insulin , GIP , and GLP-1 levels were still significantly higher on the sucrose-rich diet . Conclusion A sucrose-rich diet consumed for 10 weeks result ed in significant elevations of postpr and ial glycaemia , insulinemia , and lipidemia compared to a diet rich in artificial sweeteners in slightly overweight healthy subjects OBJECTIVE High-heat cooking of food induces the formation of advanced glycation end products ( AGEs ) , which are thought to impair glucose metabolism in type 2 diabetic patients . High intake of fructose might additionally affect endogenous formation of AGEs . This parallel intervention study investigated whether the addition of fructose or cooking methods influencing the AGE content of food affect insulin sensitivity in overweight individuals . RESEARCH DESIGN AND METHODS Seventy-four overweight women were r and omized to follow either a high- or low-AGE diet for 4 weeks , together with consumption of either fructose or glucose drinks .  Glucose and insulin concentrations — after fasting and 2 h after an oral glucose tolerance test — were measured before and after the intervention . Homeostasis model assessment of insulin resistance ( HOMA-IR ) and insulin sensitivity index were calculated . Dietary and urinary AGE concentrations were measured ( liquid chromatography t and em mass spectrometry ) to estimate AGE intake and excretion . RESULTS When adjusted for changes in anthropometric measures during the intervention , the low-AGE diet decreased urinary AGEs , fasting insulin concentrations , and HOMA-IR , compared with the high-AGE diet . Addition of fructose did not affect any outcomes . CONCLUSIONS Diets with high AGE content may increase the development of insulin resistance . AGEs can be reduced by modulation of cooking methods but is unaffected by moderate fructose intake Background It is unclear if the sugar intake may affect metabolic parameters in individuals with type 1 diabetes . Therefore , the purpose of this study was to evaluate the effects of sucrose intake in glycemic , lipemic , anthropometric variables , as well as in C-reactive protein ( CRP ) levels in these individuals . Methods Thirty-three subjects with type 1 diabetes were evaluated at baseline and 3-months after intervention . Volunteers were r and omized into groups : sucrose-free ( diet without sucrose ) or sucrose-added ( foods containing sucrose in composition ) . Both groups received the same macronutrient composition and used the carbohydrate counting methods . All underwent an interview and anthropometric evaluation . Blood was drawn for glycated haemoglobin , glucose , total cholesterol , HDL , and CRP measurement , and the medical charts were review ed in all cases . Results At baseline , anthropometric , clinical and laboratory variables did not differ between groups , except for the triglycerides . Although at baseline triglycerides levels were higher in the sucrose-added group ( p = 0.01 ) , they did not differ between groups after the intervention ( p = 0.92 ) . After 3-months , CRP was higher in the sucrose-added than in the sucrose-free group ( p = 0.04 ) , but no further differences were found between the groups , including the insulin requirements , anthropometric variables , body composition , and glycemic control . Both groups showed sugars intake above the recommendations at baseline and after intervention . Conclusions Sucrose intake , along with a disciplined diet , did not affect insulin requirements , anthropometric variables , body composition , lipemic and glycemic control . However , although the sucrose intakes increase CRP levels , the amount of sugar in the diet was not associated with this inflammatory marker The long-term impact of dietary carbohydrate type , in particular sucrose , on insulin resistance and the development of diabetes and atherosclerosis is not established . Current guidelines for the healthy population advise restriction of sucrose intake . We investigated the effect of high- versus low-sucrose diet ( 25 vs. 10 % , respectively , of total energy intake ) in 13 healthy subjects aged 33 ± 3 years ( mean ± SE ) , BMI 26.6 ± 0.9 kg/m2 , in a r and omized crossover design with sequential 6-week dietary interventions separated by a 4-week washout . Weight maintenance , eucaloric diets with identical macronutrient profiles and fiber content were design ed . All food was weighed and distributed . Insulin action was assessed using a two-step euglycemic clamp ;  glycemic profiles were assessed by the continuous glucose monitoring system and vascular compliance by pulse-wave analysis . There was no change in weight across the study . Peripheral glucose uptake and suppression of endogenous glucose production were similar after each diet . Glycemic profiles and measures of vascular compliance did not change . A rise in total and LDL cholesterol was observed . In this study , a high-sucrose intake as part of an eucaloric , weight-maintaining diet had no detrimental effect on insulin sensitivity , glycemic profiles , or measures of vascular compliance in healthy nondiabetic subjects Background Medical nutrition therapy is recognized as an important treatment option in type 2 diabetes . Most guidelines recommend eating a diet with a high intake of fiber-rich food including fruit . This is based on the many positive effects of fruit on human health . However some health professionals have concerns that fruit intake has a negative impact on glycemic control and therefore recommend restricting the fruit intake . We found no studies addressing this important clinical question . The objective was to investigate whether an advice to reduce the intake of fruit to patients with type 2 diabetes affects HbA1c , bodyweight , waist circumference and fruit intake . Methods This was an open r and omized controlled trial with two parallel groups . The primary outcome was a change in HbA1c during 12 weeks of intervention . Participants were r and omized to one of two interventions ; medical nutrition therapy + advice to consume at least two pieces of fruit a day ( high-fruit ) or medical nutrition therapy + advice to consume no more than two pieces of fruit a day ( low-fruit ) . All participants had two consultations with a registered dietitian . Fruit intake was self-reported using 3-day fruit records and dietary recalls . All assessment s were made by the “ intention to treat ” principle . Results The study population consisted of 63 men and women with newly diagnosed type 2 diabetes . All patients completed the trial . The high-fruit group increased fruit intake with 125 grams ( CI 95 % ; 78 to 172 ) and the low-fruit group reduced intake with 51 grams ( CI 95 % ; -18 to −83 ) . HbA1c decreased in both groups with no difference between the groups ( diff . : 0.19 % , CI 95 % ; -0.23 to 0.62 ) . Both groups reduced body weight and waist circumference , however there was no difference between the groups . Conclusions A recommendation to reduce fruit intake as part of st and ard medical nutrition therapy in overweight patients with newly diagnosed type 2 diabetes result ed in eating less fruit . It had however no effect on HbA1c , weight loss or waist circumference . We recommend that the intake of fruit should not be restricted in patients with type 2 diabetes . Trial registration http://www . clinical trials.gov ; Identifier : NCT01010594 The effect of dietary fructose ( 20 % of carbohydrate calories , 45 - 65 g day-1 for 4 weeks ) on glycaemic control , serum lipid , lipoprotein and apoprotein A-I and A-II concentrations and on insulin sensitivity was studied in 10 type 2 diabetic patients . The study was done in a r and omized , double-blind fashion with crystalline fructose or placebo administered evenly during 4 meals or snacks per day . The patients were hospitalized throughout the study periods . The fasting plasma glucose concentration decreased during the fructose ( from 10.7 + /- 1.4 mmol l-1 to 8.0 + /- 0.8 mmol l-1 , P < 0.02 ) and the control diet ( from 10.1 + /- 0.9 mmol l-1 to 8.0 + /- 0.7 mmol l-1 , P < 0.05 ) . The mean diurnal blood glucose concentration also fell both during the fructose ( from 10.8 + /- 0.5 mmol l-1 to 8.4 + /- 0.3 mmol l-1 , P < 0.001 ) and the control diet ( from 10.3 + /- 0.3 mmol l-1 to 8.8 + /- 0.9 mmol l-1 , P < 0.01 ) . The HbA1 concentration improved ( P < 0.02 ) only during the fructose diet . Insulin sensitivity increased by 34 % ( P < 0.05 ) during the fructose diet , but remained unchanged during the control period . Serum insulin , triglyceride , apoprotein A-I and A-II concentrations , body weight , blood pressure and blood lactate remained unchanged during both diets . In conclusion , substitution of moderate amounts of fructose for complex carbohydrates can improve glycaemic control and insulin sensitivity in patients with type 2 diabetes Consumption of simple carbohydrates has markedly increased over the past decades , and may be involved in the increased prevalence in metabolic diseases . Whether an increased intake of fructose is specifically related to a dysregulation of glucose and lipid metabolism remains controversial . We therefore compared the effects of hypercaloric diets enriched with fructose ( HFrD ) or glucose ( HGlcD ) in healthy men . Eleven subjects were studied in a r and omised order after 7 d of the following diets : ( 1 ) weight maintenance , control diet ; ( 2 ) HFrD ( 3.5 g fructose/kg fat-free mass ( ffm ) per d , + 35 % energy intake ) ; ( 3 ) HGlcD ( 3.5 g glucose/kg ffm per d , + 35 % energy intake ) . Fasting hepatic glucose output ( HGO ) was measured with 6,6 - 2H2-glucose . Intrahepatocellular lipids ( IHCL ) and intramyocellular lipids ( IMCL ) were measured by 1H magnetic resonance spectroscopy . Both fructose and glucose increased fasting VLDL-TAG ( HFrD : + 59 % , P < 0.05 ; HGlcD : + 31 % , P = 0.11 ) and IHCL ( HFrD : + 52 % , P < 0.05 ; HGlcD : + 58 % , P = 0.06 ) . HGO increased after both diets ( HFrD : + 5 % , P < 0.05 ; HGlcD : + 5 % , P = 0.05 ) . No change was observed in fasting glycaemia , insulin and alanine aminotransferase concentrations . IMCL increased significantly only after the HGlcD ( HFrD : + 24 % , NS ; HGlcD : + 59 % , P < 0.05 ) . IHCL and VLDL-TAG were not different between hypercaloric HFrD and HGlcD , but were increased compared to values observed with a weight maintenance diet . However , glucose led to a higher increase in IMCL than fructose CONTEXT Consumption of high-fructose diets promotes hepatic fatty acid synthesis ( de novo lipogenesis [ DNL ] ) and an atherogenic lipid profile . It is unclear whether these effects occur independent of positive energy balance and weight gain . OBJECTIVES We compared the effects of a high-fructose , ( 25 % of energy content ) weight-maintaining diet to those of an isocaloric diet with the same macronutrient distribution but in which complex carbohydrate ( CCHO ) was substituted for fructose . DESIGN , SETTING , AND PARTICIPANTS Eight healthy men were studied as in patients for consecutive 9-day periods . Stable isotope tracers were used to measure fractional hepatic DNL and endogenous glucose production ( EGP ) and its suppression during a euglycemic-hyperinsulinemic clamp . Liver fat was measured by magnetic resonance spectroscopy . RESULTS Weight remained stable . Regardless of the order in which the diets were fed , the high-fructose diet was associated with both higher DNL ( average , 18.6 ± 1.4 % vs 11.0 ± 1.4 % for CCHO ; P = .001 ) and higher liver fat ( median , + 137 % of CCHO ; P = .016 ) in all participants . Fasting EGP and insulin-mediated glucose disposal did not differ significantly , but EGP during hyperinsulinemia was greater ( 0.60 ± 0.07 vs 0.46 ± 0.06 mg/kg/min ; P = .013 ) with the high-fructose diet , suggesting blunted suppression of EGP . CONCLUSION Short-term high-fructose intake was associated with increased DNL and liver fat in healthy men fed weight-maintaining diets Summary The effects of regularly eating sucrose were studied in 23 diabetic patients , 12 Type 1 ( insulin-dependent ) and 11 Type 2 ( non-insulin-dependent ) , with differing degrees of glycaemic control . Two diets , each lasting 6 weeks , were compared in a r and omised cross-over study . Both diets were high in fibre and low in fat . In one diet 45 g of complex carbohydrate was replaced by 45 g of sucrose taken at mealtimes . There were no significant biochemical differences between the two diets in either Type 1 or Type 2 patients . In Type 1 patients the mean ( ±SEM ) fasting plasma glucose was 10.5 ( 1.8 ) mmol/1 on the control diet and 10.3 ( 1.5 ) mmol/1 on sucrose . In Type 2 patients the levels were 9.1 ( 0.8 ) mmol/1 and 8.9 ( 0.8 ) mmol/l respectively . Glycosylated haemoglobin for the Type 1 patients was 9.9 % on control and 10.3 % on sucrose ; for Type 2 patients the figures were 9.3 % and 9.0 % respectively . There were no differences in mean daily plasma glucose levels or diurnal glucose profiles . Cholesterol ( total and in lipoprotein fractions ) was unchanged , as were diurnal triglyceride profiles and plasma insulin profiles in the Type 2 patients . There were no changes in medication or body weight . We conclude that a moderate amount of sucrose taken daily at mealtimes does not cause deterioration in metabolic control in diabetic patients following a high fibre/low fat diet Objectives We investigated the effect of natural honey on body weight and some blood biochemical indices of diabetic subjects . Methods Forty-eight diabetic type 2 patients were r and omly assigned into two groups : the honey group received oral natural honey for 8 weeks , and the control group did not take honey . Before the onset of the study ( week 0 ) and after 8 weeks , weight measurements were taken and fasting blood sample s were drawn . Results After adjustment for the baseline values , there were no significant differences in the fasting blood sugars between the two groups . Body weight , total cholesterol , low-density lipoprotein-cholesterol and triglyceride decreased ( P = 0.000 ) , and high-density lipoprotein-cholesterol increased significantly ( P < 0.01 ) in honey group . The levels of hemoglobin A1C increased significantly in this group ( P < 0.01 ) . Conclusion The results of this study demonstrate that 8-week consumption of honey can provide beneficial effects on body weight and blood lipids of diabetic patients . However , since an increase in the hemoglobin A1C levels was observed , cautious consumption of this food by diabetic patients is recommended Banana is a widely consumed fruit , which contains considerable amounts of potential prebiotic indigestible carbohydrates . In our r and omised , controlled trial we aim ed to evaluate the in vivo prebiotic effect of banana consumption on faecal microbiota . Thirty-four healthy women participated in the study , having Body Mass Index ( BMI ) 24 - 30 kg/m(2 ) , age 19 - 45 years , without history of gastrointestinal disease and no antibiotic and other medication use two months prior the initiation and during the study . All women were asked to maintain their usual dietary habits for 60 days and they were r and omly assigned to consume twice a day a pre-meal snack , either one medium banana , or one cup of banana-flavoured drink or one cup of water ( control group ) . Stool sample s were collected at baseline , on days 30 and 60 of intervention for enumeration of total anaerobes , bifidobacteria and lactobacilli by plate count techniques , as well as for pH and short chain fatty acids ( SCFAs ) measurement . Gastrointestinal symptoms were also recorded . Mean bifidobacterial levels were increased only in the banana group both at 30 and 60 days of intervention , but this change did not reach a statistical significance . No significant overall differences in the total concentrations and molar ratios of SCFAs were detected according to dietary intervention . Analysis of the gastrointestinal symptoms records revealed significantly lower bloating levels in the banana group , compared to controls , at 26 - 35 days ( p = 0.009 ) and 51 - 60 days ( p = 0.010 ) . Banana consumption had also no adverse effects on evacuation patterns . We concluded that daily consumption of bananas is a well-tolerated eating behaviour , which may induce bifidogenesis in healthy women experiencing body weight problems Abstract Aims /hypothesisSince protein ingestion is known to stimulate the secretion of glucagon-like peptide-1 ( GLP-1 ) , we hypothesised that enhancing GLP-1 secretion to harness its insulinotropic/beta cell-stimulating activity with whey protein pre-load may have beneficial glucose-lowering effects in type 2 diabetes . Methods In a r and omised , open-label crossover clinical trial , we studied 15 individuals with well-controlled type 2 diabetes who were not taking any medications except for sulfonylurea or metformin . These participants consumed , on two separate days , 50 g whey in 250 ml water or placebo ( 250 ml water ) followed by a st and ardised high-glycaemic-index breakfast in a hospital setting . Participants were r and omised using a coin flip . The primary endpoints of the study were plasma concentrations of glucose , intact GLP-1 and insulin during the 30 min following meal ingestion . Results In each group , 15 patients were analysed . The results showed that over the whole 180 min post-meal period , glucose levels were reduced by 28 % after whey pre-load with a uniform reduction during both early and late phases . Insulin and C-peptide responses were both significantly higher ( by 105 % and 43 % , respectively ) with whey pre-load . Notably , the early insulin response was 96 % higher after whey . Similarly , both total GLP-1 ( tGLP-1 ) and intact GLP-1 ( iGLP-1 ) levels were significantly higher ( by 141 % and 298 % , respectively ) with whey pre-load . Dipeptidyl peptidase 4 plasma activity did not display any significant difference after breakfast between the groups . Conclusions /interpretationIn summary , consumption of whey protein shortly before a high-glycaemic-index breakfast increased the early pr and ial and late insulin secretion , augmented tGLP-1 and iGLP-1 responses and reduced postpr and ial glycaemia in type 2 diabetic patients . Whey protein may therefore represent a novel approach for enhancing glucose-lowering strategies in type 2 diabetes . Trial registration Clinical Trials.gov NCT01571622 Funding The Israeli Ministry of Health and Milk Council funded the research In order to evaluate the long term effects of a daily intake of simple sugars upon the glycemic control , 10 insulin treated diabetic out patients received , according to a r and omized cross over design , a conventional or a sucrose-enriched isocaloric , isoglucidic diet ( about 20 g sucrose per day , given as desserts and /or soft drinks during or after mixed meals ) for 3 months each . The daily insulin doses remained identical during both diets : 0.58 + /- 0.07 vs 0.58 + /- 0.06 U/kg body weight ( mean + /- SEM ) after conventional and sugar-enriched diet , respectively . The percentages of short acting insulin were also similar : 50 + /- 4 vs 49 + /- 4 % . The mean glycemic profiles after lunch and dinner were comparable with both regimens . Moreover , glycosylated hemoglobin levels were 10.0 + /- 0.3 vs 9.9 + /- 0.4 % after conventional and sucrose enriched diet , respectively . Plasma cholesterol and triglycerides remained unchanged . In conclusion , a relatively small daily intake of sucrose for 3 months has no clinical and /or metabolic side effects . Therefore , it seems no longer justified to completely ban sucrose from the diet of diabetic patients The consumption of specific foods in energy-restricted diets may affect the weight loss process . The purpose of this research was to evaluate whether obese women following two hypocaloric diets with distinct fruit content differ in weight loss and metabolic responses .  Fifteen obese women were included , who were r and omly assigned to follow a low or a high-fruit energy-restricted diet for 8 weeks . The main outcome variables were weight and fat losses . Metabolic measurements concerning macronutrient oxidation were also assessed by using 13C labelled fructose and indirect calorimetry . The induced weight loss was similar for both diets ( 6.9 ± 2 % vs. 6.6 ± 2 % , p = 0.785 ) . Both experimental diets similarly improved the lipid plasma profile in the participants , but the cholesterol fall was higher in obese subjects receiving the diet containing more fruit . No statistical differences in lipids carbohydrates and 13C labelled fructose utilisation were observed , but protein oxidation was differently affected by the experimental diets . The compensatory effects of the associated fibre/fructose intake may explain the lack of a specific effect of the fruit amount on hypocaloric diets design ed to weight loss , although the increased fibre content from enriched fruit diets may be involved in the favourable effects on cholesterol plasma levels This r and omized cross‐over study evaluates the effects of extended , guar and guar + fructose diets on the metabolic balance of children with insulin‐dependent diabetes mellitus ( IDDM ) . We studied 22 children ; mean age 12.2 years , mean duration of diabetes 4.4 years . The diet was supplemented for three weeks with guar in palatable form ( 5 % of daily carbohydrate intake ) and with guar + fructose ( 1 g of fructose/kg body weight , max 30 g/d ) for another three weeks . A control group ( 8 children , mean age 12.3 , duration of diabetes 4.3 years ) followed the same experimental protocol without guar supplementation .  The metabolic balance was assessed by glucosuria index ( per cent of tests with less than 1 % glucosuria from all urine tests ) and measurements of red cell glycohaemoglobin A1c ( HbA1c ) . Serum total and HDL‐choiesterol , C‐peptide , pancreatic and enteroglucagon were also measured . HbA1c decreased during guar ( p<0.001 ) and guar + fructose diet ( p<0.001 ) . The glucosuria index improved ( p<0.02 ) and the serum total cholesterol concentration decreased ( p<0.02 ) during the experimental guar diets . Guar in acceptable form and quantity in the diet appears to improve metabolic control of diabetic children OBJECTIVE The purpose of this study was to investigate the effect of high sucrose diet ( HD ) and high fat diet ( RFD ) ingested under free-living conditions , on insulin homeostasis , verifies the association between insulin resistance and body composition as well . RESEARCH METHODS AND PROCEDURES 20 healthy women , 13 normal-weight ( 22.5 + /- 2.1 years of age ; BMI 22.2 + /- 1.9 kg/m2 ) and 7 over-weight ( 21.8 + /- 2.8 years of age ; BMI 28.4 + /- 3.2 kg/m2 ) , included in 2 groups G1 and G2 respectively , they were r and omized to intake HD diets ( 59 % carbohydrate including 23.0 % of sucrose ; 28.0 % lipid ; 13.0 % protein ; 20.2 g fiber ) or HDF ( 42.0 % carbohydrates including 1.3 % of sucrose ; 45.0 % lipid ; 13.0 % protein ; 22.2 g fiber ) after initial assessment ( BD ) . It was taken anthropometric measures , body composition and blood sample s were obtained for fasting and post-pr and ial glucose and insulin determinations . RESULTS Glycemia , insulinemia and HOMA-IR did not differ between groups ( p > 0.05 ) . Although on BD , HOMA-IR correlates positively with weight ( r = 0.750 ) , BMI ( r = 0.929 ) , waist circumference ( WC ) ( r = 0.750 ) and percentage body fat ( r = 0.857 ) for G2 group . The values of fasting HOMA-IR on BD were significantly greater than HFD for G1 group ( p < 0.05 ) . On HD the total carbohydrates amount and sucrose are greater than BD and HFD . CONCLUSION The results confirm direct correlation between HOMA-IR , abdominal obesity and body fat . Therefore diet can modulate the insulinemic action Aim ing at investigating the potential effect of minimal dietary changes in NAFLD patients with non-significant fibrosis , 55 patients with NAFLD were enrolled in a r and omized controlled clinical trial . Patients were assigned into two isocaloric dietary treatment groups for 24 weeks : ( a ) nutritional counseling ( Control arm , N = 27 ) , ( b ) nutritional counseling with currants included ( two fruit servings , 36 g per day ) , substituting snacks of similar caloric content ( Currant arm , N = 28 ) . Clinical tests , anthropometrics , inflammatory and oxidative stress markers were conducted pre- and post-intervention . A total of 50 patients completed the trial . Significant differences between the two arms post-intervention were observed in fasting glucose and in IL-6 levels , these being significantly decreased only in Currant patients . Body weight , BMI , HbA1c , CRP and EUS values decreased in both arms , differences being insignificant between the two arms post-intervention . Participants in the Currant arm had significantly reduced total body fat , WC and trunk fat . Ultrasound scanning improved significantly in patients snacking currants daily . Also , volunteers enrolled in the Currant arm showed a reduced intake of saturated fatty acids . Because BW regulation has been officially recognised as a treatment approach in NAFLD an additional analysis was repeated in patients adhering to this . Post-intervention , the decrease in IL-6 and in fasting glucose was significantly higher in Currant patients who lost BW compared to their counterparts in the Control arm . Conclusively , minimal modifications in snacking choices , such as the inclusion of dried grapes in diet , are beneficial in NAFLD patients with non-significant fibrosis This study sought to examine whether consumption of two low-calorie fruit/day for 3-months can effectively improve oxidative stress , anthropometry , blood pressure and glycaemic control in type 2 diabetes mellitus . Study involved 123 patients who were assigned to receive either st and ard care or with additional dietary therapy .  Dietary intervention result ed in significant reduction in malondialdehyde , plasma glucose , glycated haemoglobin and improvement in antioxidants like vitamin C and reduced glutathione when compared to controls . Mean plasma levels of vitamin C increased by 64 % ( p < 0.001 ) . There were no differences in waist circumference , waist-to-hip ratio , blood pressure , vitamin E and superoxide dismutase in the intervention group at follow-up . Diet rich in fruits can improve some antioxidants which are likely to reduce oxidative stress in type 2 diabetes . Regular consumption of fruits can lower the glycaemic status in these patients . The study supports the usefulness of plasma vitamin C as a biomarker for fruit intake BACKGROUND Chronic peanut consumption is associated with health benefits . To encourage consumption , peanuts are marketed with various flavorings , but questions have been raised as to whether seasonings offset the benefits of peanuts alone . OBJECTIVE This study sought to determine whether flavorings on peanuts affect health benefits over 12 wk . DESIGN In a r and omized , parallel-group trial , 151 participants received 42 g peanuts/d as 14-g servings of 3 different flavors ( n = 50 ) or a single flavor ( n = 25 - 26/group ) . Anthropometric indexes , blood pressure , and heart rate were measured biweekly . Cardiovascular disease risk factors ( serum lipids , insulin , glucose , and cortisol ) were assessed monthly . RESULTS No single added flavor differentially altered body weight , body fat , body mass index , heart rate , or blood indexes in the total sample . Participants at greater risk of cardiovascular disease had significantly greater mean ( ± SE ) reductions in diastolic blood pressure ( -5.0 ± 1.7 mm Hg compared with -0.7 ± 0.6 mm Hg ) , cholesterol ( -12.1 ± 8.5 mg/dL compared with + 5.6 ± 2.0 mg/dL ) , and triglycerides ( -31.7 ± 15.8 mg/dL compared with + 2.3 ± 3.0 mg/dL ) ( n = 27 , 24 , and 15 , respectively ; P < 0.01 ) than did those at lower risk , who did not have significantly different cholesterol or triglyceride concentrations . Consumption of a variety of flavors led to greater weight gain ( 0.9 ± 0.3 kg ) compared with individual flavors alone ( 0.5 ± 0.2 kg ) ( P < 0.05 ) , but increases in fat and lean masses were not significant . CONCLUSIONS Regardless of flavoring , peanut consumption offered significant benefits to participants with elevated serum lipids and blood pressure . Sensory variety led to a small , but significant , increase in body weight in comparison with ingestion of a single flavor but no change in fat mass Abstract Objective : To compare effects of raisin snacks with conventional snacks on glycemia and cardiovascular risk factors . Material s and Methods : A 12–week , r and omized , controlled trial compared 3–times – a – day consumption of raisins with intake of processed snacks on glycemia and cardiovascular risk factors . Men and women were r and omized to snacks ( n = 15 ) or raisins ( n = 31 ) . Outcome measures were performed at baseline , 4 , 8 , and 12 weeks . Results : Fasting plasma glucose levels were not significantly affected by intake of raisins or snacks . Mean subject post pr and ial glucose levels were significantly reduced by raisin intake at 12 weeks ; changes with raisin intake were −13.1 mg/dL ( P = 0.003 vs baseline ; P = 0.03 vs snacks ) . Eating raisins significantly decreased glycated hemoglobin ( HbA1c ) level ( −0.12 % ; P = 0.004 ) , a significantly greater level decrease than seen with snack intake ( P = 0.036 ) . Snack intake did not significantly affect subject systolic or diastolic blood pressure ( BP ) . Raisin intake was associated with reductions in systolic blood pressure ( SBP ) at 4 , 8 , and 12 weeks with mean changes of −6.0 to 10.2 mmHg ; all these changes were statistically significant ( P = 0.015 to 0.001 ) . Raisins were associated with significantly greater changes in diastolic blood pressure ( DBP ) at 4 , 8 , and 12 weeks than snacks ( P < 0.05 ) . Body weight did not significantly change within or between groups . Conclusions : Regular consumption of raisins  may reduce glycemia and cardiovascular risk factors , including BP rate Overtly hypertriglyceridemic patients with non-insulin-dependent diabetes mellitus were given a control diet containing 120 g of sucrose and 50 percent carbohydrate , and later r and omly assigned to receive isocaloric high- ( 220 g ) , intermediate- ( 120 g ) , or low- ( less than 3 g ) sucrose/carbohydrate diets for four weeks . The low-sucrose diet group demonstrated a modest but significant decrease in mean fasting serum glucose level in the first week only , although this change was no different from the other two dietary groups and was not sustained . All groups had little change in late postpr and ial serum glucose levels from control values , and no significant alterations in 24-hour glycosuria . The high-sucrose diet group demonstrated a significant increase in fasting serum triglyceride levels by the second week of the study , whereas the intermediate- and low-sucrose diet groups showed a decrease in mean fasting triglyceride levels . In contrast , the low-sucrose diet group 's late postpr and ial serum triglyceride levels increased by the fourth week , whereas levels fell in the high-sucrose diet group . Mean fasting serum cholesterol concentrations decreased from control values in the high-sucrose diet group . Thus , although very high sucrose and carbohydrate consumption is clearly deleterious to fasting tryglyceride levels in non-insulin-dependent diabetes mellitus with preexisting hypertriglyceridemia , it appears that low dietary sucrose and carbohydrate proportions do not further improve prepr and ial glycemia and glycosuria and may adversely affect late postpr and ial serum triglyceride concentration . This study suggests that isocaloric sucrose and carbohydrate restriction below usual daily levels ( 120 g per day ) offers no consistent benefit in glycemia or lipid control in overt type II diabetes OBJECTIVES Dried fruits , like their fresh homologues , contain relatively high concentrations of antioxidants . The aim of this study was to determine the health outcomes of raisin consumption on patients with diabetes . METHODS We examined the effects of dried grapes ( Vitis vinifera ) cultivated in Greece , namely Corinthian Raisins ( CR ) on blood pressure , fasting glucose , glucated hemoglobin ( HbA1c ) , lipid peroxidation , high-sensitivity C-reactive protein , antioxidant status , and cytokines in patients with type 2 diabetes mellitus ( T2DM ) . Forty-eight well-controlled patients with T2DM from the diabetes outpatient clinic of our hospital were recruited to a two-armed , r and omized , controlled , 24-wk prospect i ve intervention trial in order to examine the health outcomes of CR consumption . All participants were reported to consume less fruits and vegetables than the recommended amount of five servings daily . Participants in the intervention were instructed to consume CR equal to two fruit servings ( 36 g/d ) , replacing snacks with similar energy density twice during the day . Anthropometric and blood pressure measurements , assessment of dietary intake , and fasting blood draws were conducted at baseline and at week 24 . Also , phenolic compounds present in CR were analyzed in plasma of the patients . t Test for parametric data and Mann-Whitney test or Wilcoxon test for non-parametric data were performed . Significance was set at P < 0.05 . RESULTS Body weight , glycemic control , and lipid profile were not affected in either arm . Patients in the CR arm reduced their diastolic blood pressure and increased their total antioxidant potential significantly compared with baseline . The differences between the two groups at week 24 were significant . No change in high-sensitivity C-reactive protein was observed . A significant difference in plasma circulating p-hydroxybenzoic acid was observed between groups at the end of the trial . CONCLUSIONS Our study shows that naturally CR may improve health features in patients with well-controlled T2DM Several studies show that sucrose does not aggravate hyperglycemia in type II diabetes mellitus , but sucrose is still restricted in dietary recommendations . Since sucrose in high carbohydrate diets elevates fasting triglyceride levels , the effects of sucrose were evaluated in diets with fixed carbohydrate levels . Eighteen diabetic volunteers receiving no medication were given weight maintenance diets with 50 percent carbohydrate , 35 percent fat , 15 percent protein , and 120 g of sucrose for 10 days as in patients . They were then r and omly assigned diets of similar composition with either 220 g of sucrose ( high sucrose diet ) or less than 3 g of sucrose daily ( complex carbohydrate [ CHO ] diet ) for one additional month . There were no differences in fasting , one- , two- , and three-hour post-lunch serum glucose levels ; 24-hour glycosuria ; glycohemoglobin levels ; fasting and postpr and ial serum triglyceride levels , or fasting high-density lipoprotein-cholesterol levels .  Twelve patients with preexisting higher triglyceridemia  had similar trends , but the postpr and ial triglyceride levels were lower in the high sucrose diet group of this subset ( p less than 0.05 in the third week ) . Postpr and ial serum insulin levels declined in the second week on the complex CHO diet . More than 75-fold difference in sucrose intake with constant carbohydrate and fat did not affect glycemic or triglyceridemic control in type II diabetic patients . The reported high sucrose-carbohydrate-induced rise in fasting triglyceridemia was not present when a diet high in sucrose was given without changing total carbohydrate An increasing amount of fructose in the diet is suggested to play a causal role in the pathogenesis of the metabolic syndrome , type 2 diabetes and fatty liver . Our aim was to investigate and compare the effects of very high fructose and very high glucose in hyperenergetic diets on glucose and lipid metabolism and on fat depots in healthy humans . We conducted an exploratory , prospect i ve , r and omised , single-blinded , intervention trial . Participants in addition to a balanced weight-maintaining diet received 150 g of fructose or glucose/d for 4 weeks . Insulin sensitivity was estimated from oral glucose tolerance tests . Visceral and subcutaneous abdominal fat was determined with MRI . Liver fat and intramyocellular lipids of the tibialis anterior muscle were measured with (1)H magnetic resonance spectroscopy . A total of twenty healthy subjects ( fructose group n 10 and glucose group n 10 ; twelve males and eight females ) completed the study . They had a mean age of 30·5 ( SEM 2·0 ) years and a mean BMI of 25·9 ( SEM 0·5 ) kg/m(2 ) . Insulin sensitivity appeared to decrease both in the fructose and glucose groups . TAG markedly increased in the fructose group . No strong alterations or treatment effects were found for liver fat , visceral fat , subcutaneous abdominal fat and intramyocellular lipids of the tibialis anterior muscle . In conclusion , the effects of very high fructose and very high glucose in hyperenergetic diets on glucose metabolism and body fat composition were not different in the healthy participants of the present study . However , elevation of plasma TAG seemed to be fructose-specific CONTEXT Increased hepatic de novo lipogenesis ( DNL ) in response to dietary sugar is implicated in the pathophysiology of fatty liver . Saturated fatty acids are the product of DNL and exert lipotoxic effects that promote liver fat accumulation . Desaturation of fatty acids by stearoyl-CoA desaturase 1 ( SCD1 ) can prevent these deleterious effects . Here we investigated whether DNL and SCD1 are activated in parallel by dietary sugar and influence liver fat accumulation . METHODS In 20 healthy subjects ( eight females and 12 males , aged 30.5 ± 2.0 yr , body mass index 25.9 ± 0.5 kg/m(2 ) ) who received a 4-wk lipogenic diet supplemented with 150 g/d of monosaccharides  , hepatic SCD1 activity and DNL were determined using vali date d fatty acid ratios ( 16:1n-7/16:0 ; 16:0/18:2n-6 ) in very low-density lipoprotein triglycerides . Liver fat content was measured by localized (1)H-magnetic resonance spectroscopy . RESULTS At baseline , liver fat content was positively associated with the DNL ( r = 0.54 , P = 0.01 ) but not the SCD1 activity index ( r = 0.16 , P = 0.49 ) . Dietary sugar supplementation increased liver fat content and DNL and SCD1 activity indices ( + 33 , + 19 , and + 8 % , respectively ) . The increase of the DNL index was strongly related to the changes in liver fat content  during the sugar supplementation ( r = 0.75 , P = 0.0001 ) but showed no association with changes in the SCD1 activity ( P > 0.35 ) . After the monosaccharide supplementation , the DNL index was still positively associated with liver fat content ( r = 0.52 , P = 0.02 ) , whereas SCD1 activity showed a strong negative correlation with liver fat content ( r = -0.63 , P = 0.002 ) . CONCLUSIONS DNL is closely linked with hepatic steatosis under dietary conditions rich in monosaccharides . Our data suggest that the individual hepatic SCD1 activity is a determinant of liver fat accumulation under lipogenic dietary conditions Abstract Objective : To study the effects of snacking based on fast acting carbohydrates ( c and y ) or fat and protein ( peanuts ) in a prospect i ve r and omized , parallel intervention study . Methods : Basal metabolic rate ( BMR ) and cardiovascular risk factors were measured before and after hyper-alimentation by addition of 20kcal/kg ( 84kJ/kg ) body weight of either c and y or roasted peanuts , to the regular caloric intake , for two weeks in healthy subjects . Eleven men and 14 women completed the r and omized study . Results : Energy-intake increased similarly in the groups ( c and y : + 46.1±35 % , peanuts : + 46.8±28 % p=0.96 ) . Body-weight ( c and y : from 67.3±7.6 kg to 68.1±7.3 kg , p=0.01 , nuts : from 68.7±6.1 kg to 69.0±5.7 kg p=0.3 ) and waist circumference increased significantly only in the c and y group . At the end of the study LDL cholesterol ( c and y : 2.6±0.4mmol/l peanuts : 2.1±0.4mmol/l , p=0.005 ) and ApoB/ApoA-1-ratio ( c and y : 0.68±0.16 peanuts 0.53±0.11 , p=0.01 ) were higher in the c and y group than in the peanut group . On the other h and , BMR increased only in the peanut group ( c and y : from 6.657±1.1MJ/24h to 6.762±1.1MJ/24h , p=0.3 nuts : from 6.896±0.98MJ/24h to 7.256±1.1MJ/24h , p=0.02 ) . Conclusion : Two weeks of snacking based on peanuts does not cause the same negative metabolic effects as an isocaloric diet in which the snacking is based on short acting carbohydrates in the form of c and y in non-obese healthy subjects BACKGROUND Both nutritional and genetic factors are involved in the pathogenesis of nonalcoholic fatty liver disease and insulin resistance . OBJECTIVE The aim was to assess the effects of fructose , a potent stimulator of hepatic de novo lipogenesis , on intrahepatocellular lipids ( IHCLs ) and insulin sensitivity in healthy offspring of patients with type 2 diabetes (OffT2D)--a subgroup of individuals prone to metabolic disorders . DESIGN Sixteen male OffT2D and 8 control subjects were studied in a crossover design after either a 7-d isocaloric diet or a hypercaloric high-fructose diet ( 3.5 g x kg FFM(-1 ) x d(-1 ) , + 35 % energy intake ) . Hepatic and whole-body insulin sensitivity were assessed with a 2-step hyperinsulinemic euglycemic clamp ( 0.3 and 1.0 mU x kg(-1 ) x min(-1 ) ) , together with 6,6-[2H2]glucose . IHCLs and intramyocellular lipids ( IMCLs ) were measured by 1H-magnetic resonance spectroscopy . RESULTS The OffT2D group had significantly ( P < 0.05 ) higher IHCLs ( + 94 % ) , total triacylglycerols ( + 35 % ) , and lower whole-body insulin sensitivity ( -27 % ) than did the control group . The high-fructose diet significantly increased IHCLs ( control : + 76 % ; OffT2D : + 79 % ) , IMCLs ( control : + 47 % ; OffT2D : + 24 % ) , VLDL-triacylglycerols ( control : + 51 % ; OffT2D : + 110 % ) , and fasting hepatic glucose output ( control : + 4 % ; OffT2D : + 5 % ) . Furthermore , the effects of fructose on VLDL-triacylglycerols were higher in the OffT2D group ( group x diet interaction : P < 0.05 ) . CONCLUSIONS A 7-d high-fructose diet increased ectopic lipid deposition in liver and muscle and fasting VLDL-triacylglycerols and decreased hepatic insulin sensitivity . Fructose-induced alterations in VLDL-triacylglycerols appeared to be of greater magnitude in the OffT2D group , which suggests that these individuals may be more prone to developing dyslipidemia when challenged by high fructose intakes . This trial was registered at clinical trials.gov as NCT00523562 BACKGROUND Resistant starch ( RS ) and whey protein are thought to be effective nutrients for reducing glycemic responses . OBJECTIVE We aim ed to determine the effect of varying the sucrose , RS , and whey protein content of cereal bars on glucose and insulin responses . DESIGN Twelve healthy subjects [ mean ± SD age : 36 ± 12 y ; mean ± SD body mass index ( in kg/m2 ) : 24.9 ± 2.7 ] consumed 40 g available-carbohydrate ( avCHO ) portions of 5 whole-grain cereal bars that contained varying amounts of RS and whey protein concentrate [ WPC ; 70 % protein ; RS : WPC , % wt : wt : 15:0 ( Bar15/0 ) ; 15:0 , low in sucrose ( Bar15/0LS ) ; 15:5 ( Bar15/5 ) ; 10:5 ( Bar10/5 ) ; and 10:10 ( Bar10/10 ) ] and 2 portion sizes of a control bar low in whole grains , protein , and RS [ control 1 contained 40 g avCHO ( Control1 ) ; control 2 contained total carbohydrate equal to Bar15/0LS ( Control2 ) ] on separate days by using a r and omized crossover design . Glucose and insulin responses in vivo and carbohydrate digestibility in vitro were measured over 3 h. RESULTS Incremental area under the curve ( iAUC ) over 0 - 3 h for glucose ( min × mmol/L ) differed significantly between treatments ( P < 0.001 ) [ Bar15/0LS ( mean ± SEM ) , 169 ± 14 ; Control2 , 164 ± 20 ; Bar15/0 , 144 ± 15 ; Control1 , 140 ± 17 ; Bar10/5 , 117 ± 12 ; Bar15/5 , 116 ± 9 ; and Bar10/10 , 100 ± 9 ; Tukey 's least significant difference = 42 , P < 0.05 ] , but insulin iAUC did not differ significantly . Higher protein content was associated with a lower glucose iAUC ( P = 0.028 ) and a higher insulin-to-glucose iAUC ratio ( P = 0.002 ) All 5 RS-containing bars were digested in vitro ∼30 % more slowly than the control bars ( P < 0.05 ) ; however , in vivo responses were not related to digestibility in vitro . Glucose and insulin responses elicited by high-RS , whey protein-free bars were similar to those elicited from control bars . CONCLUSIONS The inclusion of RS in cereal bar formulations did not reduce glycemic responses despite slower starch digestion in vitro . Thus , caution is required when extrapolating in vitro starch digestibility to in vivo glycemic response . The inclusion of whey protein in cereal bar formulations to reduce glycemic response requires caution because this may be associated with a disproportionate increase in insulin as judged by an increased insulin-to-glucose iAUC ratio . This trial was registered at clinical trials.gov as NCT02537587 AIM A pro-thrombotic , pro-inflammatory diet can play a causative role in atherosclerotic-cardiovascular diseases .  Dietary intervention studies provide insight into their pathophysiological manifestations and opportunities for prevention and management . We previously showed in an acute-meal setting that a beverage containing polyphenolic- and antioxidant-rich strawberry ( Fragaria ) vs placebo attenuated postpr and ial ( fed-state ) increases in biomarkers of oxidative and inflammatory stress , and insulin concentrations , induced by a high carbohydrate/fat ( HCF ) meal . In the present study , we aim ed to extend our findings and investigate hypotheses related to the effects of chronic/6-week ( wk ) strawberry consumption on HCF meal-induced increases in glucose , insulin , and indicators of inflammation and hemostasis . METHODS In a crossover design , 14 women and 10 men ( mean age , BMI : 50.9±15 years , 29.2±2.3 kg/m(2 ) , respectively ) , were r and omized to a 6-wk strawberry or placebo beverage followed by an HCF meal with assessment s for 6-hours ( h ) postpr and ially . RESULTS HCF meal responses after 6-wk strawberry beverage showed significantly attenuated postpr and ial PAI-1 concentrations compared to the placebo ( p = 0.002 ) ; the difference was most notable at 6 h. The IL-1 β response was attenuated with strawberry compared to the placebo ( p = 0.05 ) . IL-6 attenuation was apparent but non-significant ; IL-6 rose significantly from baseline to 6 h after the HCF meal following a placebo ( p ≤0.01 ) , although it remained relatively flat following the strawberry beverage from fasting to 6 h. No significant treatment-related differences were apparent for platelet aggregation , hsCRP , TNF-α , insulin , or glucose . CONCLUSION These data are the first to suggest that regular consumption of strawberry , a polyphenolic- and antioxidant-rich fruit , may provide protection from HCF meal-induced increases in fibrinolytic and inflammatory factors in at-risk men and women BACKGROUND Studies of cocoa suggest an array of cardiovascular benefits ; however , the effects of daily intake of sugar-free and sugar-sweetened cocoa beverages on endothelial function ( EF ) have yet to be established . METHODS 44 adults ( BMI 25 - 35 kg/m2 ) participated in a r and omized , controlled , crossover trial . Participants were r and omly assigned to a treatment sequence : sugar-free cocoa beverage , sugar-sweetened cocoa beverage , and sugar-sweetened cocoa-free placebo . Treatments were administered daily for 6 weeks , with a 4-week washout period . RESULTS Cocoa ingestion improved EF measured as flow-mediated dilation ( FMD ) compared to placebo ( sugar-free cocoa : change , 2.4 % [ 95 % CI , 1.5 to 3.2 ] vs. -0.8 % [ 95 % CI , -1.9 to 0.3 ] ; difference , 3.2 % [ 95 % CI , 1.8 to 4.6 ] ; p<0.001 and sugar-sweetened cocoa : change , 1.5 % [ 95 % CI , 0.6 to 2.4 ] vs. -0.8 % [ 95 % CI , -1.9 to 0.3 ] ; difference , 2.3 % [ 95 % CI , 0.9 to 3.7 ] ; p=0.002 ) . The magnitude of improvement in FMD after consumption of sugar-free versus sugar-sweetened cocoa was greater , but not significantly . Other biomarkers of cardiac risk did not change appreciably from baseline . BMI remained stable throughout the study . CONCLUSIONS Daily cocoa ingestion improves EF independently of other biomarkers of cardiac risk , and does not cause weight gain . Sugar-free preparations may further augment endothelial function
target: There was interaction by food source , with specific food sources showing beneficial effects ( fruit and fruit juice ) or harmful effects ( sweetened milk and mixed sources ) in substitution studies and harmful effects ( sugars‐sweetened beverages and fruit juice ) in addition studies on at least one outcome .
  Conclusions Energy control and food source appear to mediate the effect of fructose‐containing sugars on glycaemic control .
  Although most food sources of these sugars ( especially fruit ) do not have a harmful effect in energy matched substitutions with other macronutrients , several food sources of fructose‐containing sugars ( especially sugars‐sweetened beverages ) adding excess energy to diets have harmful effects .
background: Objective To assess the effect of different food sources of fructose‐containing sugars  on glycaemic control at different levels of energy control .