Energy balance
Fructose-containing sugars do not exhibit unique metabolic or endocrine harms causing obesity or cardiometabolic disease when consumed in isocaloric substitution for other digestible carbohydrates; any adverse effects are mediated solely by excess caloric intake.
You do not need to fear fructose or added sugars if you are consuming them within your daily calorie needs and replacing other carbohydrates. Isocaloric substitution of fructose for other carbs does not worsen cardiometabolic risk factors like blood pressure, lipids, or insulin sensitivity. Focus on total energy balance and overall dietary quality rather than demonizing specific sugars.
The highest level of evidence from systematic reviews and meta-analyses of controlled trials has not shown that fructose-containing sugars behave any differently from other forms of digestible carbohydrates. Fructose-containing sugars can only lead to weight gain and other unintended harms on cardiometabolic risk factors insofar as the excess calories they provide.
Why this rating
Based on systematic reviews and meta-analyses of controlled trials (RCTs) and prospective cohort studies, representing the highest levels of evidence.
Source
Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes
Tauseef Khan et al. · Zeitschrift für Ernährungswissenschaft · 2016
DOI 10.1007/s00394-016-1345-3
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