Decreased Consumption of Added Fructose Reduces Waist Circumference and Blood Glucose Concentration in Patients with Overweight and Obesity. The DISFRUTE Study: A Randomised Trial in Primary Care

• Published in: Nutrients 2020-04, Vol.12 (4), p.1149
• Main Authors: Domínguez-Coello, Santiago, Carrillo-Fernández, Lourdes, Gobierno-Hernández, Jesús, Méndez-Abad, Manuel, Borges-Álamo, Carlos, García-Dopico, José Antonio, Aguirre-Jaime, Armando, León, Antonio Cabrera-de
• Format: Article
• Language: English
• Subjects: Adult; Blood; Blood glucose; Blood Glucose - metabolism; Blood levels; Body weight; clinical trial; Diabetes mellitus; Diet, Carbohydrate-Restricted; Dietary Carbohydrates - administration & dosage; Dietary Carbohydrates - adverse effects; Energy intake; Fasting; Fasting - blood; Female; Fructose; Fructose - administration & dosage; Fructose - adverse effects; Fruits; Glucose; Health care; Humans; Insulin; Insulin Resistance; Kinases; Liver - metabolism; Male; non-alcoholic fatty liver disease (NAFLD); Nutrient deficiency; Nutrients; Obesity; Obesity - blood; Obesity - diet therapy; Obesity - metabolism; Overweight - blood; Overweight - diet therapy; Overweight - metabolism; Primary care; sugars; Waist Circumference
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12041149

The relationship between fructose intake and insulin resistance remains controversial. Our purpose was to determine whether a reduction in dietary fructose is effective in decreasing insulin resistance (HOMA2-IR). This field trial was conducted on 438 adults with overweight and obese status, without diabetes. A total of 121 patients in a low fructose diet (LFD) group and 118 in a standard diet (SD) group completed the 24-week study. Both diets were prescribed with 30-40% of energy intake restriction. There were no between-group differences in HOMA2-IR. However, larger decreases were seen in the LFD group in waist circumference (-7.0 vs. -4.8 = -2.2 cms, 95% CI: -3.7, -0.7) and fasting blood glucose -0.25 vs. -0.11 = -0.14 mmol/L, 95% CI: -0.028, -0.02). The percentage of reduction in calorie intake was similar. Only were differences observed in the % energy intake for some nutrients: total fructose (-2 vs. -0.6 = -1.4, 95% CI: -2.6, -0.3), MUFA (-1.7 vs. -0.4 = -1.3, 95% CI: -2.4, -0.2), protein (5.1 vs. 3.6 = 1.4, 95% CI: 0.1, 2.7). The decrease in fructose consumption originated mainly from the reduction in added fructose (-2.8 vs. -1.9 = -0.9, 95% CI: -1.6, -0.03). These results were corroborated after multivariate adjustments. The low fructose diet did not reduce insulin resistance. However, it reduced waist circumference and fasting blood glucose concentration, which suggests a decrease in hepatic insulin resistance.