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Fructose toxicity: is the science ready for public health actions?

Tappy, Luca,b; Mittendorfer, Bettinac

Current Opinion in Clinical Nutrition & Metabolic Care: July 2012 - Volume 15 - Issue 4 - p 357–361
doi: 10.1097/MCO.0b013e328354727e
CARBOHYDRATES: Edited by Luc Tappy and Bettina Mittendorfer

Purpose of review The assumption that fructose may be toxic and involved in the pathogenesis of noncommunicable diseases such as obesity, diabetes mellitus, dyslipidemia, and even cancer has resulted in the call for public health action, such as introducing taxes on sweetened beverages. This review evaluates the scientific basis for such action.

Recent findings Although some studies hint towards some potential adverse effects of excessive fructose consumption especially when combined with excess energy intake, the results from clinical trials do not support a significant detrimental effect of fructose on metabolic health when consumed as part of a weight-maintaining diet in amounts consistent with the average-estimated fructose consumption in Western countries. However, definitive studies are missing.

Summary Public health policies to eliminate or limit fructose in the diet should be considered premature. Instead, efforts should be made to promote a healthy lifestyle that includes physical activity and nutritious foods while avoiding intake of excess calories until solid evidence to support action against fructose is available. Public health is almost certainly to benefit more from policies that are aimed at promoting what is known to be good than from policies that are prohibiting what is not (yet) known to be bad.

aDepartment of Physiology, University of Lausanne

bService of Endocrinology, Diabetes and Metabolism, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

cCenter for Human Nutrition, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA

Correspondence to Luc Tappy, MD, Department of Physiology, University of Lausanne, 7, rue du Bugnon, CH-1005 Lausanne, Switzerland. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.