Table 2.
Dietary intervention studies investigating the effect of fructose/HFCS, sucrose, or glucose on biomarkers of subclinical inflammation. Extracted data on baseline concentrations, results, and funding sources.
| First Author, Year, Country | Outcome Baseline Concentrations 1 | Results | Funding Source †† | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Percent changes in inflammatory marker after completion of intervention | Statistical Tests Comment | |||||||||
| hsCRP/CRP | IL-6 | TNF-α | MCP-1 | sICAM-1 | sE-selectin | Adipo-nectin | ||||
| Aeberli et al. (2011) [39] Switzerland |
hsCRP (ng/mL) 205.6 ± 430.7 Adiponectin (μg/mL) 6.44 ± 7.69 |
High fructose: +109.19% * Moderate fructose:+82.2% High sucrose: +105.2% * High glucose: +89.74% * |
N/A | N/A | N/A | N/A | N/A | High fructose: +18.6% * Moderate fructose: +14.8% High sucrose: +17.8% High glucose:+20.6% * |
No treatment effect for hsCRP and adiponectin reported. hsCRP increased significantly after all of the interventions -highest increase observed in high fructose group |
NR |
| Angelopoulos et al. (2016) [38] USA |
CRP (mg/L) Fructose group: 1.74 ± 1.74 HFCS group: 1.92 ± 2.10 Sucrose group: 1.74 ± 1.78 Glucose group: 1.21 ± 1.43 |
Fructose: +24.1% * HFCS: −3.1% Sucrose: −1.7% Glucose: +23.9% * |
N/A | N/A | N/A | N/A | N/A | N/A | No significant between-group changes in CRP for fructose, HFCS, sucrose and glucose as compared to each other. p-Values not reported. |
Industry |
| Cox/Rezvani et al. (2009) [33,34] USA |
MCP-1 (pg/mL) 144.7 ± 18.8 sE-selectin (ng/dL) 45.0 ± 5.5 sICAM-1 (ng/mL) 221.9 ± 6.3 CRP (mg/L)3.7 ± 0.8 IL-6 (pg/mL) 3.5 ± 0.7 Adiponectin (ug/mL): 7.7 ± 1.1 TNF-α: NR |
Fructose: −16.2% * Glucose: −22.8% * |
Fructose: −11.4% * Glucose: +18.2% * |
Fructose: −12.8% * Glucose: +0.3% * |
Fructose: +37.7% * Glucose: −8.6% * |
Fructose: +2.9% * Glucose: −1% * |
Fructose: +14.4% * Glucose: −1.6% * |
Fructose: −14.8% * Glucose: −9.1% * |
Significant between-group change in MCP-1 (p = 0.03). Significant within-group change in sE-selectin (p = 0.048). But no significant between-group difference (p = 0.17). No significant between-group change in sICAM-1 (p = 0.22) CRP (p = 0.33) IL-6 (p = 0.31) adiponectin (p = 0.10) TNF-α (p = 0.42) |
Agency |
| Jin et al. (2014) [35] USA |
hsCRP (mg/L) 6.78 ± 3.16 | Fructose: +4.13% * Glucose: −23.4% * |
N/A | N/A | N/A | N/A | N/A | N/A | Significant between-group change in hsCRP (p = 0.019). | Agency |
| Johnson et al. (2015) [40] Finland |
CRP (mg/L) Low-fructose: 6.8 ± 7.4 Moderate-fructose: 10.9 ± 10.2 |
Low-fructose: −8.8% Moderate-fructose: −29.3% |
N/A | N/A | N/A | N/A | N/A | N/A | No significant between-group change in CRP (p = 0.278) Confounder (low-calorie diet → weight loss) |
Agency |
| Johnston et al. (2013) [37] UK |
CRP (mg/L) 1.01 ± 1.08 IL-6 (pg/mL) 3.56 ± 4.84 TNF-α (pg/mL)1.92 ± 0.5 |
Isocaloric period: Fructose:−21.8% * Glucose: −11.4% * Hyper-caloric period: Fructose:−8.9% * Glucose:+40% * |
Isocaloric period: Fructose:−4.2% * Glucose: −5.8% * Hyper-caloric period: Fructose:+23.8% * Glucose:−39.6% * |
Isocaloric period: Fructose:−0.5% Glucose: −2.5% Hyper-caloric period: Fructose: −4.7% Glucose: −0.5% |
N/A | N/A | N/A | N/A | No significant between-group change in CRP (p = 0.37), IL-6 (p = 0.23) or TNF-α (p = 0.36) in isocaloric or hypercaloric periods |
Agency Industry—related conflict of interest |
| Lowndes et al. (2014) [38]USA |
CRP (mg/L) HFCS 8%En intake: 1.9 ± 1.9 HFCS 18%En intake: 1.6 ± 1.6 HFCS 30%En intake: 2.1 ± 2.1 Sucrose 8%En intake: 1.5 ± 1.6 Sucrose 18%En intake: 2.0 ± 1.8 Sucrose 30%En intake: 1.5 ± 1.8 |
HFCS: 8%En: +26.3% 18%En: +25% 30%En: 0% Sucrose: 8%En: +40% 18%En: +5% 30%En: +6.7% |
N/A | N/A | N/A | N/A | N/A | N/A | No significant between-group change (HFCS vs. sucrose) (p = 0.679)No significant between-group changes in CRP between various intake amounts (8% vs. 18% vs. 30%) (p = 0.597) Percent increases in the 30%En groups were low/lowest. |
Industry |
| Madero et al. (2011) [41] Mexico |
sICAM (ng/dL) Low-fructose: 4.44 ± 0.11 Moderate-fructose: 4.37 ± 0.11 |
N/A | N/A | N/A | N/A | Low-fructose: −6.3% Moderate-fructose: −9.6% |
N/A | N/A | No significant between-group change in sICAM-1 (P = 0.19) Significant within-group decrease for sICAM-1 in low-fructose (p = 0.01) and moderate-fructose (p < 0.0001). Confounder (low-calorie diet → weight loss) |
Agency |
| Markey et al. (2013) [45] UK |
CRP (mg/L) Regular sugar intake: 0.93 ± 0.94 Reduced sugar intake: 1.05 ± 1.35 |
Regular sugar: +6.5% Re-formulated sugar: +15.2% |
N/A | N/A | N/A | N/A | N/A | N/A | No treatment effect for sucrose (p = 0.593) | Agency |
| Raatz et al. (2015) [42] USA |
hsCRP (mg/L) Glucose tolerant (NGT): 2.2 ± 0.5 Glucose impaired (IGT): 4.6± 0.8 IL-6 (pg/mL) Glucose tolerant (NGT): 1.6 ± 0.2 Glucose impaired (IGT): 2.6 ± 0.5 |
HFCS: NGT: −5% IGT: +29.6% Sucrose: NGT: −20% IGT: +15.8% Honey: NGT: +8.7% IGT: +41.2% |
HFCS: NGT: +7.7% NGT: +6.7% Sucrose: IGT: −22.2% NGT: +3.5% Honey: NGT: +23.1% IGT: +19.4% |
N/A | N/A | N/A | N/A | N/A | No treatment effect for hsCRP or IL-6. | Agency |
| Silbernagel et al. (2014) [36] Germany |
CRP (mg/dL) 0.13 ± 0.06 MCP-1 (pg/mL) 275 ± 34 E-selectin (ng/mL) 31.8 ±5.1 |
Fructose: −7.7% * Glucose: +57% * |
N/A | N/A | Fructose: −16.7% * Glucose: −9.1% * |
N/A | Fructose: −7.8% * Glucose: +3.5% * |
N/A | No significant between-group change in CRP (P = 0.284), MCP-1 (p = 0.803) or E-selectin (p = 0.311) |
Agency |
| Sorensen et al. (2005) [46]Denmark |
CRP (mg/L) 1.8 (0.9–3.0) |
Sucrose: +6% Artificial sweetener: −26% |
N/A | N/A | N/A | N/A | N/A | N/A | No significant between-group change (p = 0.1) Percent changes reported after excluding 4 subjects with CRP > 10 mg/L |
Industry |
| Yaghoobi et al. (2008) [44] Iran |
hsCRP (mg/dL) Healthy subjects (normal hsCRP levels): 4.8 ± 3.2 Subjects with elevated hsCRP 9.9 ± 3.6 |
Sucrose: −1% Honey: −3.3% |
N/A | N/A | N/A | N/A | N/A | N/A | No significant between-group effect observed (p > 0.5). | Agency |
* represents studies in which fructose or sucrose was isocalorically compared to glucose. 1 Data refer to mean ± SD unless otherwise indicated; N/A: not investigated NR: not reported. 2 Both studies report from one original study by Stanhope et al. [32] and each study (Cox et al., Rezvani et al.) reports on different inflammatory markers measured in the original study. †† Funding sources. Agency: funding from government, university, or not-for-profit health agency sources. Industry: funding from companies that utilize dietary sugar for profit. NR: not reported. Johnston et al. reports conflict of interest of the author, IA Macdonald, who is on the Scientific Advisory Boards for Mars, Inc. and Coca Cola.