Are Liquid Sugars Different from Solid Sugar in Their Ability to Cause Metabolic Syndrome?

Abstract

Objective: Intake of sugary drinks, especially soft drinks, carries increased risk for obesity and diabetes. This article reviews whether sugary drinks carry different risks for metabolic syndrome compared with foods that contain natural or added sugars. Methods: A narrative review was performed to evaluate differences between liquid and solid sugars in their ability to induce metabolic syndrome and to discuss potential mechanisms to account for the differences. Results: Epidemiological studies support liquid added sugars, such as soft drinks, as carrying greater risk for development of metabolic syndrome compared with solid sugar. Some studies suggest that fruit juice may also confer relatively higher risk for weight gain and insulin resistance compared with natural fruits. Experimental evidence suggests this may be due to differences in how fructose is metabolized. Fructose induces metabolic disease by reducing the energy levels in liver cells, mediated by the concentration of fructose to which the cells are exposed. The concentration relates to the quantity and speed at which fructose is ingested, absorbed, and metabolized. Conclusions: Although reduced intake of added sugars (sucrose and high-fructose corn syrup) remains a general recommendation, there is evidence that sugary soft drinks may provide greater health risks relative to sugar-containing foods.

Cerebral Fructose Metabolism as a Potential Mechanism Driving Alzheimer’s Disease

“…Recently, a clinical study placed subjects on a high-sugar, high-fat diet with a more healthy diet, and found that at 4 days an impairment in short term memory and hippocampal function could be shown in the high sugar, high-fat diet group (Attuquayefio et al, 2017 ). The observation that total and liquid sugars are more likely associated with cognitive dysfunction is consistent with studies showing that liquid sugars cause more significant ATP depletion and metabolic effects, while the negative studies with natural fruits are also consistent given the presence of antioxidants and flavonols in fruits that are known to counter fructose effects (Sundborn et al, 2019 ).…”

“…However, the remarkable increase in sugar and HFCS intake has led to excessive and chronic activation of this pathway, resulting in increased risk for metabolic syndrome, obesity, and diabetes ( Figure 2 ; Johnson et al, 2013 ). The risk is particularly high with liquid sugars, such as soft drinks, as the high fructose content coupled with rapid intake leads to high concentrations in the liver that can lead to more profound intracellular energy depletion (Sundborn et al, 2019 ). While dietary fructose is a major source of fructose, endogenous production of fructose may also drive the metabolic syndrome, such as in response to high glycemic carbohydrates and high salt diets (Lanaspa et al, 2013 , 2018 ).…”

Sugar-Sweetened Beverages and Cardiometabolic Health: An Update of the Evidence

“…Sugars in juice are absorbed more quickly than those in fruit and vegetables, which are absorbed more slowly due in part to their fiber content [95,96]. The rapid absorption of liquid fructose (from juice) compared to solid forms is more likely to result in higher concentrations of fructose in the liver and increase the rate of hepatic extraction of fructose, de novo lipogenesis, and production of lipids [97,98]. A recent study in the REGARDS cohort found that fruit juice intake was associated with a higher risk of all-cause mortality [62].…”

Differences in metabolic and liver pathobiology induced by two dietary mouse models of nonalcoholic fatty liver disease

“…Mice were fasted for 5 hours prior to intraperitoneal injection with insulin Humulin R (Eli Lilly, IN, USA) at 0.7 IU/kg body weight or 0.5 IU/kg body weight for males and females, respectively. Blood glucose levels were taken from tail vein using a Freestyle Lite glucometer (Abbott, IL, USA) at 0, 15,30,45,60,90 and 120 minutes post-injection.…”