Sugars and Health - Evidence Map

Project Summary Title and Description

Sugars and Health - Evidence Map
This evidence map on sugars and health outcomes was developed using an iterative process. Evidence Map data are being used to support a stakeholders ‘ decision-making on refining research questions and topic prioritization. The goal of this Future Research Needs project is to characterize the available evidence regarding the intake of sugars and health outcomes and identify priority areas where additional research needs remain.
Authors of Report
Methodology description
Abstract submitted to Experimental Biology 2014: Sugars and health: Applying evidence mapping techniques to assess the evidence. Objective: Evidence mapping (EM) is a novel, systematic method for describing the volume and characteristics of research in a broad field. We applied EM to evaluate the empirical evidence of the state of science on the relationships between sugars and cardiometabolic health-related outcomes. Methods: A pre-defined, systematic study selection process was applied to a broad Medline search (through April 2013) of the existing literature on sugars. Studies reporting cardiometabolic risk factors and/or related clinical outcomes were selected for this study. Data from the studies were extracted and deposited to a data repository. Descriptive analyses were performed. Results: Our EM included 207 studies (196 intervention and 11 cohort studies). Of the intervention studies, the most common sugar interventions were sucrose (40%) and fructose (31%), and the top two controls were glucose (14%) and starch (13%). The most studied outcomes were glycemic profiles (27%), plasma lipids (11%), and anthropometrics (7%). Studies were generally short in duration (median 26 days, ranging from <1 to 730 days). 89% were in adults and 6% were in children. The 11 cohort studies investigated 3 different sugar exposures and 9 different hard clinical outcomes. Conclusions: An extensive but heterogeneous body of evidence exists in this broad field of research. EM is a useful method for identifying "hot" research areas and research gaps. Evidence-based methods are effective to direct future research.
Funding Source
The International Life Sciences Institute (ILSI) North American Branch.

Key Questions

1. What is the effect of sugars on health outcomes in intervention studies?
2. What is the effect of sugar on health outcomes in cohort studies?

Associated Extraction Forms

Associated Studies (each link opens a new tab)

Effect of eucaloric high- and low-sucrose diets with identical macronutrient profile on insulin resistance and vascular risk: a randomized controlled trial.2006
Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial.
Fructose overconsumption causes dyslipidemia and ectopic lipid deposition in healthy subjects with and without a family history of type 2 diabetes.
A 4-wk high-fructose diet alters lipid metabolism without affecting insulin sensitivity or ectopic lipids in healthy humans.
Effects of a short-term overfeeding with fructose or glucose in healthy young males.
Excessive fructose intake induces the features of metabolic syndrome in healthy adult men: role of uric acid in the hypertensive response.2010
Diet-induced changes in serum transaminase and triglyceride levels in healthy adult men. Role of sucrose and excess calories.1983
Effects of 4-week very-high-fructose/glucose diets on insulin sensitivity, visceral fat and intrahepatic lipids: an exploratory trial.2011
Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans.2009
Fructose and oxidized low-density lipoprotein in pediatric nonalcoholic fatty liver disease: a pilot study.2009
Effects of natural honey consumption in diabetic patients: an 8-week randomized clinical trial.2009
Glycemic index and dietary fiber and the risk of type 2 diabetes.2004
Interaction of dietary sucrose and fiber on serum lipids in healthy young men fed high carbohydrate diets.
Children with NAFLD are more sensitive to the adverse metabolic effects of fructose beverages than children without NAFLD.2012
Blood lipid distribution of hyperinsulinemic men consuming three levels of fructose.1983
Moderate increase in dietary sucrose does not influence fasting or postprandial serum lipids regardless of the presence of apolipoprotein E2 allele in healthy subjects.
Sucrose in a lipid-rich meal amplifies the postprandial excursion of serum and lipoprotein triglyceride and cholesterol concentrations by decreasing triglyceride clearance.1994
Triglyceride integrated concentrations: effect of variation of source and amount of dietary carbohydrate.
Ad libitum intake of low-fat diets rich in either starchy foods or sucrose: effects on blood lipids, factor VII coagulant activity, and fibrinogen.2000
Mechanisms for the acute effect of fructose on postprandial lipemia.2007
Is carbohydrate intake in the first years of life related to future risk of NCDs?2012
Metabolic effects of dietary fructose in diabetic subjects.1992
Effectiveness of dietary advice given by community dietitians to men with elevated blood cholesterol in a clinical setting: a pilot study.2003
Isocaloric exchange of dietary starch and sucrose in humans. I. Effects on levels of fasting blood lipids.1979
Metabolic effects of honey (alone or combined with other foods) in type II diabetics.-- Not Found --
Effect of an empowerment-based nutrition promotion program on food consumption and serum lipid levels in hyperlipidemic Thai elderly.2008
Natural honey and cardiovascular risk factors; effects on blood glucose, cholesterol, triacylglycerole, CRP, and body weight compared with sucrose.2008
Effects of isomalt consumption on gastrointestinal and metabolic parameters in healthy volunteers.
Effects of supplementation with essential amino acids on intrahepatic lipid concentrations during fructose overfeeding in humans.2012
Twenty-four-hour endocrine and metabolic profiles following consumption of high-fructose corn syrup-, sucrose-, fructose-, and glucose-sweetened beverages with meals.2008
The effect of various vegetable supplements on serum cholesterol.1981
Men at increased risk of coronary heart disease are not different from age- and weight-matched healthy controls in their postprandial triglyceride, nonesterified fatty acid, or incretin responses to sucrose.2002
Effects on serum lipids of reducing dietary sucrose or starch for 22 weeks in normal men.1972
Moderate diet control in children: the effects on metabolic indicators that predict obesity-related degenerative diseases.1982
The influence of frequency of sucrose intake on serum lipid, protein and carbohydrate levels.1970
Serum insulin and glucose in hyperinsulinemic subjects fed three different levels of sucrose.
Moderate intake of sucrose does not impair metabolic control in pump-treated diabetic out-patients.
Metabolic effects of adding sucrose and aspartame to the diet of subjects with noninsulin-dependent diabetes mellitus.
Comparative study of isomalt and sucrose by means of continuous indirect calorimetry.1984
Sucrose in the diet of diabetic patients--just another carbohydrate?1986
The effects of drinks made from simple sugars on blood pressure in healthy older people.2005
Lack of detectable deleterious effects on metabolic control of daily fructose ingestion for 2 mo in NIDDM patients.-- Not Found --
Effect of sucrose-containing snacks on blood glucose control.1989
Dietary fructose reduces circulating insulin and leptin, attenuates postprandial suppression of ghrelin, and increases triglycerides in women.2004
Similar glycemic responses to high versus moderate sucrose-containing foods in test meals for adolescents with type 1 diabetes and fasting euglycemia.2001
The effectiveness of glucose, sucrose, and fructose in treating hypoglycemia in children with type 1 diabetes.2010
Sublingual sugar administration as an alternative to intravenous dextrose administration to correct hypoglycemia among children in the tropics.2005
Blood insulin, glucose, fructose and gastric inhibitory polypeptide levels in carbohydrate-sensitive and normal men given a sucrose or invert sugar tolerance test.
Effect of glucose, sucrose and fructose on plasma glucose and insulin responses in normal humans: comparison with white bread.1998
Long-term effects of eating sucrose on metabolic control of type 1 (insulin-dependent) diabetic outpatients.-- Not Found --
Day-long glucose, insulin, and fructose responses of hyperinsulinemic and nonhyperinsulinemic men adapted to diets containing either fructose or high-amylose cornstarch.
Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus.1987
Diurnal metabolic profiles after 14 d of an ad libitum high-starch, high-sucrose, or high-fat diet in normal-weight never-obese and postobese women.2001
Glycemic response to sucrose-containing mixed meals in diets of children of with insulin-dependent diabetes mellitus.1991
Blood lipids, lipoproteins, apoproteins, and uric acid in men fed diets containing fructose or high-amylose cornstarch.1989
Prevalence of daily hyperglycemia in obese type 2 diabetic men compared with that in lean and obese normoglycemic men: effect of consumption of a sucrose-containing beverage.
Endocrine and metabolic effects of consuming fructose- and glucose-sweetened beverages with meals in obese men and women: influence of insulin resistance on plasma triglyceride responses.2009
Sugar alters the level of serum insulin and plasma glucose and the serum cortisol:DHEAS ratio in female migraine sufferers.
Effects of dietary fructose on plasma lipids in healthy subjects.2000
Effects of high-fructose corn syrup and sucrose consumption on circulating glucose, insulin, leptin, and ghrelin and on appetite in normal-weight women.
A low fructose diet in the treatment of pediatric obesity: a pilot study.2011
Fructose prefeeding reduces the glycemic response to a high-glycemic index, starchy food in humans.2002
Reduced glycaemic and insulinaemic responses following isomaltulose ingestion: implications for postprandial substrate use.
Increased sucrose intake is not associated with a change in glucose or insulin sensitivity in people with type 2 diabetes.2007
Effects of basswood honey, honey-comparable glucose-fructose solution, and oral glucose tolerance test solution on serum insulin, glucose, and C-peptide concentrations in healthy subjects.2008
Effects of dietary sucrose intake on glycaemic control in Nigerians with type 2 diabetes.2007
Weight loss in overweight subjects following low-sucrose or sucrose-containing diets.2001
Safety of new algorithms for premeal insulin boluses in high glycaemic index meals in persons with type 1 diabetes mellitus using insulin pumps.2008
Consumption of rapeseed honey leads to higher serum fructose levels compared with analogue glucose/fructose solutions.2011
Consumption of the slow-digesting waxy maize starch leads to blunted plasma glucose and insulin response but does not influence energy expenditure or appetite in humans.
Long-term dietary compensation for added sugar: effects of supplementary sucrose drinks over a 4-week period.
Delayed effects of coffee, tea and sucrose on postprandial glycemia in lean, young, healthy adults.2008
Influence of mulberry leaf extract on the blood glucose and breath hydrogen response to ingestion of 75 g sucrose by type 2 diabetic and control subjects.
Consumption of fructose-sweetened beverages for 10 weeks increases postprandial triacylglycerol and apolipoprotein-B concentrations in overweight and obese women.2008
Metabolic responses to prolonged consumption of glucose- and fructose-sweetened beverages are not associated with postprandial or 24-h glucose and insulin excursions.
The effects of four hypocaloric diets containing different levels of sucrose or high fructose corn syrup on weight loss and related parameters.2012
The effect of two energy-restricted diets, a low-fructose diet versus a moderate natural fructose diet, on weight loss and metabolic syndrome parameters: a randomized controlled trial.2011
Long-term effects of dietary fructose on carbohydrate metabolism in non-insulin-dependent diabetes mellitus.1990
Comparative effects of several simple carbohydrates on erythrocyte insulin receptors in obese subjects.1986
Metabolic and behavioral effects of a high-sucrose diet during weight loss.
Gastric inhibitory polypeptide, dietary-induced thermogenesis, and obesity.1987
Acute effects on insulin sensitivity and diurnal metabolic profiles of a high-sucrose compared with a high-starch diet.1998
Metabolic effects of dietary sucrose and fructose in type II diabetic subjects.1996
Metabolic effects of dietary fructose and sucrose in types I and II diabetic subjects.1986
Fructose ingestion acutely elevates blood pressure in healthy young humans.2008
Comparing advice to decrease both dietary fat and sucrose, or dietary fat only, on weight loss, weight maintenance and perceived quality of life.2010
Non-pharmacological treatment of hypertension in primary health care: a comparative clinical trial of two education strategies in health and nutrition.
Family dietary coaching to improve nutritional intakes and body weight control: a randomized controlled trial.2008
Reduction in risk factors for type 2 diabetes mellitus in response to a low-sugar, high-fiber dietary intervention in overweight Latino adolescents.2009
Randomized controlled trial to improve adiposity, inflammation, and insulin resistance in obese African-American and Latino youth.2012
Effects of dietary changes on cellular insulin binding and in vivo insulin sensitivity.1980
Effects of sucrose drinks on macronutrient intake, body weight, and mood state in overweight women over 4 weeks.
Effects of dietary fructose on plasma glucose and hormone responses in normal and hyperinsulinemic men.1983
Graded sucrose/carbohydrate diets in overtly hypertriglyceridemic diabetic patients.1984
Turku sugar studies XI. Effects of sucrose, fructose and xylitol diets on glucose, lipid and urate metabolism.1976
Effect of carbohydrate ingestion on adipose tissue lipolysis during long-lasting exercise in trained men.1998
Inhibition of glycemic and hormonal responses after repetitive sucrose and starch loads by different doses of the alpha-glucosidase inhibitor miglitol (BAY m 1099) in man.1991
The role of gastric inhibitory polypeptide in the augmented insulin response to sucrose.-- Not Found --
The metabolic response to various doses of fructose in type II diabetic subjects.1992
Comparative effects of fructose, aspartame, glucose, and water preloads on calorie and macronutrient intake.
Thermogenesis in men and women induced by fructose vs glucose added to a meal.1989
Effect of solid and liquid carbohydrates upon postprandial pancreatic endocrine function.1981
The effects of sucrose meal on insulin requirement in IDDM and its modulation by acarbose.1986
Replacement of dietary fat by sucrose or starch: effects on 14 d ad libitum energy intake, energy expenditure and body weight in formerly obese and never-obese subjects.1997
Hyperglycemic effect of sucrose ingestion in IDDM patients controlled by artificial pancreas.1989
Metabolic effects of fructose supplementation in diabetic individuals.1989
Reassessing the effects of simple carbohydrates on the serum triglyceride responses to fat meals.1988
The effect of dietary sucrose on blood lipids, serum insulin, platelet adhesiveness and body weight in human volunteers.1969
Sucrose or honey at breakfast have no additional acute hyperglycaemic effect over an isoglucidic amount of bread in type 2 diabetic patients.1985
Augmented gastric inhibitory polypeptide and insulin responses to a meal after an increase in carbohydrate (sucrose) intake.1984
Urinary chromium excretion and insulinogenic properties of carbohydrates.1990
Isocaloric exchange of dietary starch and sucrose in humans. II. Effect on fasting blood insulin, glucose, and glucagon and on insulin and glucose response to a sucrose load.1979
The effects of carbohydrate-enriched meals on glucose turnover and metabolic clearance rates of glucose in type 2 diabetic patients.1986
Effect of variations in oral fat and carbohydrate load on postprandial lipemia.1995
Effects of oral fructose in normal, diabetic, and impaired glucose tolerance subjects.
A crossover trial of high and low sucrose-carbohydrate diets in type II diabetics with hypertriglyceridemia.1986
The glycaemic effect of simple sugars in mid-morning and afternoon snacks in childhood diabetes.1990
Plasma glucose responses to glucose, sucrose, and honey in patients with diabetes mellitus: an analysis of glycaemic and peak incremental indices.1985
Effects of fructose feeding on blood parameters and blood pressure in impaired glucose-tolerant subjects.1988
Effect of fructose overfeeding and fish oil administration on hepatic de novo lipogenesis and insulin sensitivity in healthy men.2005
Markedly blunted metabolic effects of fructose in healthy young female subjects compared with male subjects.2008
Changes in blood glucose and insulin after an oral palatinose administration in normal subjects.1985
Influence of fiber, xylitol and fructose in enteral formulas on glucose and lipid metabolism in normal subjects.1993
Metabolic effects of dietary sucrose in type II diabetic subjects.1993
Effects of daily consumption of honey solution on hematological indices and blood levels of minerals and enzymes in normal individuals.2003
Consumption of fructose and high fructose corn syrup increase postprandial triglycerides, LDL-cholesterol, and apolipoprotein-B in young men and women.2011
The effects of physiologic amounts of simple sugars on lipoprotein, glucose, and insulin levels in normal subjects.-- Not Found --
Effects of dietary macronutrient content on glucose metabolism in children.2002
Metabolic effects of fructose and glucose: implications for food intake.1988
Sweetener augmentation of serum triacylglycerol during a fat challenge test in humans.
Catalytic amounts of fructose may improve glucose tolerance in subjects with uncontrolled non-insulin-dependent diabetes.2006
Metabolic effects of fructose as a natural sweetener in the physiologic meals of ambulatory obese patients with type II diabetes.1987
Lipid metabolism in non-insulin-dependent diabetes: effects of long-term treatment with fructose-supplemented mixed meals.1989
Acute effect of fructose on postprandial lipaemia in diabetic and non-diabetic subjects.1998
Metabolic consequence of two-week fructose feeding in diabetic subjects.-- Not Found --
Low-fructose diet lowers blood pressure and inflammation in patients with chronic kidney disease.
The effect of kind of carbohydrate in the diet and use of oral contraceptives on metabolism of young women. III. Serum glucose, insulin, and glucagon.1980
Glycemic index and postprandial blood glucose response to Japanese strawberry jam in normal adults.2010
Metabolic effects of dietary fructose in healthy subjects.1992
Effects of high-fructose corn syrup and sucrose on the pharmacokinetics of fructose and acute metabolic and hemodynamic responses in healthy subjects.2012
Carbohydrate tolerance and serum lipid responses to type of dietary carbohydrate and oral contraceptive use in young women.
Effects of conventional sucrose-based, fructose-based and isomalt-based chocolates on postprandial metabolism in non-insulin-dependent diabetics.1991
Postprandial triglyceride and retinyl ester responses to oral fat: effects of fructose.
Differential effects of honey, sucrose, and fructose on blood sugar levels.-- Not Found --
Comparison of the glycaemic effect of fructose, sucrose and starch-containing mid-morning snacks in insulin-dependent diabetics.1983
Immunoreactive beta-endorphin increases after an aspartame chocolate drink in healthy human subjects.1991
Does dietary fructose affect the control of diabetes in children?
The metabolic effects of 2-week fructose feeding in normal subjects.1984
Effect of the introduction of dietary sucrose on metabolic control in children and adolescents with type I diabetes.
Effects of oral fructose and glucose on plasma GLP-1 and appetite in normal subjects.1999
Sucrose sensitivity of patients with coronary artery disease.1977
Effects of galactose, glucose and fructose on carbohydrate-lipid metabolism.1979
Previous exercise nullifies the plasma triacylglycerol response to repeated fructose ingestion in young men.1985
Effect of dietary fructose on triglyceride transport and glucoregulatory hormones in hypertriglyceridemic men.1979
Some effects, in man, of varying the load of glucose, sucrose, fructose, or sorbitol on various metabolites in blood.1978
Effects of dietary fructose and sucrose on plasma triglyceride metabolism in patients with endogenous hypertriglyceridemia.
A comparison of carbohydrate metabolism after sucrose, sorbitol, and fructose meals in normal and diabetic subjects.-- Not Found --
The effects of oral sucrose and of estimated infarct size on plasma free fatty acids, plasma glucose and serum insulin in the early stages of acute myocardial infarction.1979
Dietary carbohydrates and glycaemic load and the incidence of symptomatic gall stone disease in men.2005
High saturated fat and low starch and fibre are associated with hyperinsulinaemia in a non-diabetic population: the San Luis Valley Diabetes Study.1997
Fructose consumption and the risk of kidney stones.2008
A prospective study of sugar intake and risk of type 2 diabetes in women.
Intake of macronutrients as predictors of 5-y changes in waist circumference.2006
Adverse effects on risk of ischaemic heart disease of adding sugar to hot beverages in hypertensives using diuretics. A six year follow-up in the Copenhagen Male Study.1996
Dietary fiber, carbohydrate quality and quantity, and mortality risk of individuals with diabetes mellitus.
Relationship of dietary intake to subsequent coronary heart disease incidence: The Puerto Rico Heart Health Program.
A controlled evaluation of a fitness and nutrition intervention program on cardiovascular health in 10- to 12-year-old children.1995
Effects of sucrose on plasma concentrations and urinary excretion of purine bases.2007
Short-term effects of various sugars on antinatriuresis and blood pressure changes in normotensive young men.1983
Sucrose and various carbohydrate-containing foods and serum lipids in man.1974
The search for an optimized treatment of hypoglycemia. Carbohydrates in tablets, solutin, or gel for the correction of insulin reactions.1990
An insulinogenic effect of oral fructose in humans during postprandial hyperglycemia.
Blood glucose and plasma insulin responses to fat free milk and low-lactose fat free milk in healthy human volunteers.1987
Maternal sugar consumption and risk of preeclampsia in nulliparous Norwegian women.2012
Effects of hunger state on flavour pleasantness conditioning at home: flavour-nutrient learning vs. flavour-flavour learning.2007
Effect of sucrose and safflower oil preloads on short term appetite and food intake of young men.
Added thermogenic and satiety effects of a mixed nutrient vs a sugar-only beverage.2004
Effects of several simple sugars on serum glucose and serum fructose levels in normal and diabetic subjects.1988
Influence of fructose and glucose on serum lipid levels in men and pre- and postmenopausal women.1966
Dietary sugar in the production of hyperglyceridemia in patients with hyperlipemia and atherosclerosis.1965
Two varieties of honey that are available in Malaysia gave intermediate glycemic index values when tested among healthy individuals.2009
Effect of fat- and sucrose-containing foods on the size of eating episodes and energy intake in lean males: potential for causing overconsumption.
Skim milk compared with a fruit drink acutely reduces appetite and energy intake in overweight men and women.2009
Effect of drinking compared with eating sugars or whey protein on short-term appetite and food intake.
Ingested glucose and fructose in serum lipids in healthy men and after myocardial infarction.1968
Relationship between dietary carbohydrates and fats in their influence on serum lipid concentrations.1972
Effects of glucose-to-fructose ratios in solutions on subjective satiety, food intake, and satiety hormones in young men.
Satiety scores and satiety hormone response after sucrose-sweetened soft drink compared with isocaloric semi-skimmed milk and with non-caloric soft drink: a controlled trial.
The effects of sugar-free vs sugar-rich beverages on feelings of fullness and subsequent food intake.
Increased satiety after intake of a chocolate milk drink compared with a carbonated beverage, but no difference in subsequent ad libitum lunch intake.2007
Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels.
Effects of fructose vs glucose on regional cerebral blood flow in brain regions involved with appetite and reward pathways.2013
Effects of sucrose on salivary flow and composition: differences between real and sham intake.2009
The effects of sucrose and maize oil on subsequent food intake and mood.
Sugars and satiety: does the type of sweetener make a difference?
Evaluation of the independent and combined effects of xylitol and polydextrose consumed as a snack on hunger and energy intake over 10 d.
Effects of short-term overfeeding with fructose, fat and fructose plus fat on plasma and hepatic lipids in healthy men.2010
Fructose and vitamin C intake do not influence risk for developing hypertension.2009
Assessment of endothelial function and blood metabolite status following acute ingestion of a fructose-containing beverage.2010
Effects of ingested fructose and infused glucagon on endogenous glucose production in obese NIDDM patients, obese non-diabetic subjects, and healthy subjects.1996
A dual sugar challenge test for lipogenic sensitivity to dietary fructose.2011
Enhancement of alimentary hyperglyceridemia by fructose and glycerol in man.1966
Plasma fructose, uric acid, and inorganic phosphorus responses of hyperinsulinemic men fed fructose.1986
Plasma amino acids and insulin levels in obesity: response to carbohydrate intake and tryptophan supplements.1988
Endocrine responses to sugar ingestion in man. Advantages of fructose over sucrose and glucose.1980
Comparison of the effects of aspartame and sucrose on appetite and food intake.1988
Effect of the addition of simple sugars to mixed meals on the glycemic control of insulin treated diabetic patients.-- Not Found --
Metabolic effects of dietary fructose in insulin dependent diabetes of adults.1972
Changes in serum pre-beta-lipoprotein following the feeding of sucrose. A preliminary trial in physically active and inactive young male students.1973
Effect of acarbose on the increased plasma concentration of uric acid induced by sucrose ingestion.2008
The effect of oral administration of sucrose on the turnover rate of plasma free fatty acids and on the esterification rate of plasma free fatty acids to plasma triglycerides in normal subjects, patients with primary endogenous hypertriglyceridemia, and patients with well controlled diabetes mellitus.1972
Substrate incorporation into hepatic lipids and proteins in vitro in patients with pre-beta hyperlipoproteinemia.1975
Type of snack influences satiety responses in adult women.2010

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