Effect of fructose and its epimers on postprandial carbohydrate metabolism: A systematic review and meta-analysis

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 2020-11, Vol.39 (11), p.3308-3318
• Main Authors: Braunstein, Catherine R., Noronha, Jarvis C., Khan, Tauseef A., Mejia, Sonia Blanco, Wolever, Thomas MS, Josse, Robert G., Kendall, Cyril WC, Sievenpiper, John L.
• Format: Article
• Language: English
• Subjects: Allulose; Diabetes; Fructose; Meta-analysis; Postprandial carbohydrate metabolism
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2020.03.002

To synthesize the evidence of the effect of small doses (≤30-g/meal) of fructose and its epimers (allulose, tagatose, and sorbose) on the postprandial glucose and insulin response to carbohydrate-containing meals. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through to April 9, 2019. We included randomized (RCTs) and non-randomized acute, single-meal, controlled feeding trials that added ≤30-g of fructose or its epimers either prior to or with a carbohydrate-containing meal compared with the same meal alone. Outcomes included the incremental area under the curve (iAUC) for glucose and insulin, the Matsuda Insulin Sensitivity Index, and the Early Insulin Secretion Index. Data were expressed as ratio of means (RoM) with 95% CIs and pooled using the inverse variance method. The overall certainty of the evidence was evaluated using GRADE. Forty trial comparisons (n = 400) were included (none for sorbose). Allulose significantly reduced the postprandial iAUC glucose response by 10% (0.90 [0.84 to 0.96], P