AUTHOR=Choo Vivian L. , Sievenpiper John L. 

TITLE=The Ecologic Validity of Fructose Feeding Trials: Supraphysiological Feeding of Fructose in Human Trials Requires Careful Consideration When Drawing Conclusions on Cardiometabolic Risk

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 2 - 2015

YEAR=2015

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2015.00012

DOI=10.3389/fnut.2015.00012

ISSN=2296-861X

ABSTRACT=Background: Select trials of fructose overfeeding have been used to implicate fructose as a driver of cardiometabolic risk.
Objective: We examined temporal trends of fructose dose in human controlled feeding trials of fructose and cardiometabolic risk.
Methods: We combined studies from eight meta-analyses on fructose and cardiometabolic risk to assess the average fructose dose used in these trials.  Two types of trials were identified: 1) substitution trials, in which energy from fructose was exchanged with equal energy from other carbohydrates, 2) addition trials, in which energy from fructose supplemented a diet compared to the diet alone. 
Results: 64 substitution trials and 16 addition trials were included.  The weighted average fructose dose in substitution trials was 101.7 g/d (95% CI: 98.4 - 105.1 g/d), and the weighted average fructose dose in addition trials was 187.3 g/d (95% CI: 181.4 - 192.9 g/d).
Conclusions: Average fructose dose in substitution and addition trials greatly exceed national levels of reported fructose intake (49 ± 1.0 g/d) (NHANES 1977-2004). Future trials using fructose doses at real world levels are needed.