Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes.
Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes.
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DOI：
10.1007/s00394-016-1345-3
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发表时间：
2016-11
影响因子：
5
通讯作者：
Sievenpiper JL
中科院分区：
文献类型：
--
作者：
Khan TA;Sievenpiper JL
含果糖的糖由于其在肥胖症和包括糖尿病在内的心脏代谢疾病中的假定作用而作为公共卫生目标受到关注。果糖部分由于其独特的内分泌信号和病理生理作用而被挑出来作为糖危害的主要驱动因素。然而，这仅得到生态学研究、过度喂养动物模型和选择超生理剂量或缺乏能量控制的人类干预研究的支持。来自对照试验的系统综述和荟萃分析的最高水平的证据并没有表明含果糖的糖与其他形式的可消化碳水化合物有任何不同。含果糖的糖只会导致体重增加和其他对心脏代谢风险因素的意外伤害，因为它们提供了过量的卡路里。前瞻性队列研究提供了最强有力的观察证据，表明含果糖的糖与心脏代谢风险（包括体重增加、心血管疾病结局和糖尿病）之间存在关联，但仅限于含糖饮料，而不包括其他来源的糖。事实上，含糖饮料是不健康生活方式的标志，饮用者消耗更多的卡路里，运动量更少，吸烟更多，饮食模式也很差。以含糖食品和饮料形式过量消费糖的可能性使得将糖作为多余卡路里的来源成为一种谨慎的策略。然而，糖含量不应该是健康饮食的唯一决定因素。饮食中还有许多其他因素，一些提供多余的卡路里，而另一些提供有益的营养素。我们不应该只关注一种能量来源，而应该考虑整个饮食对健康的益处。
Fructose-containing sugars are a focus of attention as a public health target for their putative role in obesity and cardiometabolic disease including diabetes. The fructose moiety is singled out to be the primary driver for the harms of sugars due to its unique endocrine signal and pathophysiological role. However, this is only supported by ecological studies, animal models of overfeeding and select human intervention studies with supraphysiological doses or lack of control for energy. The highest level of evidence from systematic reviews and meta-analyses of controlled trials has not shown that fructose-containing sugars behave any differently from other forms of digestible carbohydrates. Fructose-containing sugars can only lead to weight gain and other unintended harms on cardiometabolic risk factors insofar as the excess calories they provide. Prospective cohort studies, which provide the strongest observational evidence, have shown an association between fructose-containing sugars and cardiometabolic risk including weight gain, cardiovascular disease outcomes and diabetes only when restricted to sugar-sweetened beverages and not for sugars from other sources. In fact, sugar-sweetened beverages are a marker of an unhealthy lifestyle and their drinkers consume more calories, exercise less, smoke more and have a poor dietary pattern. The potential for overconsumption of sugars in the form of sugary foods and drinks makes targeting sugars, as a source of excess calories, a prudent strategy. However, sugar content should not be the sole determinant of a healthy diet. There are many other factors in the diet—some providing excess calories while others provide beneficial nutrients. Rather than just focusing on one energy source, we should consider the whole diet for health benefits.
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影响因子：
3.7
作者：
Basu S;Yoffe P;Hills N;Lustig RH
通讯作者：
Lustig RH
影响因子：
7.1
作者：
Bernstein, Adam M.;de Koning, Lawrence;Willett, Walter C.
通讯作者：
Willett, Walter C.
影响因子：
7.1
作者：
Albala, Cecilia;Ebbeling, Cara B.;Ludwig, David S.
通讯作者：
Ludwig, David S.
影响因子：
6.1
作者：
Almiron-Roig E;Palla L;Guest K;Ricchiuti C;Vint N;Jebb SA;Drewnowski A
通讯作者：
Drewnowski A
影响因子：
16.2
作者：
Atkinson FS;Foster-Powell K;Brand-Miller JC
通讯作者：
Brand-Miller JC