Is fructose bad for you? It doesn’t cause spikes in insulin and blood sugar, 
but large amounts of fructose may contribute to overeating. Most
of the sugar we eat gets broken down and absorbed in the small
intestine. Swarms of specialized enzymes attack larger molecules and
convert them into three simpler sugars: mainly glucose, but also
galactose (a part of lactose, the sugar in milk) and fructose. There
are a few more steps involved in breaking down the starches in bread,
potatoes, and the like, but ultimately starch shares a similar
digestive fate. Our
livers prudently stow away some of the absorbed glucose as glycogen, a
molecule that can be turned back into glucose when we haven’t eaten for
a while. But most of the sugary stuff is distributed right away.
Glucose levels in the bloodshoot up, and the pancreas gets busy,
pumping out the insulin that cells throughout the body need in order to
take in glucose and use it for energy. Post-meal
glucose and insulin spikes are perfectly normal and entirely
unavoidable. But if they’re too big, or come too often, they’re
harmful. Canadian researchers devised the glycemic index (GI) to make
it easier to compare how different foods affect blood sugar levels: the
higher the GI number, the bigger the increase in blood sugar. A number
of studies have found that people who eat a lot of high-GI foods —
cookies, candy, bread made with refined flour, potatoes — have higher
rates of diabetes and heart disease. Specialized metabolism Pretty
much all of the body’s cells come equipped with enzymes that allow them
to harness glucose. But the enzyme that metabolizes fructose, called
fructokinase, is found exclusively in liver cells. So although fructose
isinvolved in glucose metabolism indirectly, fructose metabolism is
pretty specialized. As a result, if you eat fructose, your blood
glucose and insulin levels stay fairly level. If,
as the GI-index research indicates, glucose and insulin increases are a
problem, then substituting fructose for other sugars in the food supply
looks like it might be a solution. But,
alas, it’s more complicated than that. For all the mischief that
glucose and insulin cause, they do trigger some helpful hormonal
changes. Levels of leptin, the satiety hormone that gives us a full
feeling, go up when insulin surges, and levels of ghrelin, the “hunger
hormone,” go down. There’s fairly good evidence that fructose has just
the opposite effect, reducing leptin, so we don’t necessarily feel full
after a fructose-filled meal, and not lowering ghrelin as much as
glucose does, so we stay hungry. For this reason, some experts see
high-fructose diets as contributing toovereating. Another
problem: Oversupply the metabolic pathway for fructose with the sugar,
and the liver ends up churning out triglycerides — fat that circulates
in the blood. The same is true of glucose and its metabolic pathway,
but it takes larger amounts. That floozy — is she to blame? Fructose
is a naturally occurring sugar. You’ll find it in honey, vegetables (in
small amounts), and, of course, fruit. Not all the sugar in fruit is
fructose, which is one of the reasons (lack of fiber is another) that
some fruits, such as watermelon, have a high glycemic index. But
most people’s intake of fructose from fruits and vegetables is dwarfed
by what they get from sucrose — better known as table sugar, or just
sugar — and high-fructose corn syrup. Sucrose is a two-sugar molecule
(a disaccharide) consisting of fructose and glucose. High-fructose corn
syrup is corn syrup that has been processed toincrease the fructose
level, which makes it taste sweeter. The most common variety is 55%
fructose and 45% glucose. In the United States, high-fructose corn
syrup has replaced sucrose as a sweetener, especially in soft drinks,
but in many other foods too. Sally Squires, the Washington Post
nutrition columnist, has called it “the floozy of the sugar world:
sweeter and cheaper than sucrose, but viewed with distrust by some
consumers.” Experts
debate how responsible high-fructose corn syrup is for the American
obesity epidemic and the soaring type 2 diabetes rate. Those who see a
connection note that the great American weight problem and the
sweetening of the food supply with the suspect syrup happened at about
the same time. They also point to fructose metabolism and its
triglyceride output. Doubters
counter with several arguments. Sucrose and high-fructose corn syrup
contain about the same amount of fructose and glucose (a 50-50 split
versus a 55-45one), so it’s questionable whether the metabolic effects
are that different. Many of the damning metabolic studies have used
all-fructose solutions, not high-fructose corn syrup. And the trouble
is all the nutritionally empty, added sugar in our diets, not any
particular form of that sugar. Eat fruit Where
does this leave us? Certainly no one should stop eating fruit out of
some misguided fear of fructose. Most varieties of fruit are brimming
with nutritional virtue — vitamins, minerals, fiber — and have
relatively little fructose and other sugar. Is
high-fructose corn syrup especially harmful? Hard to say. At this
point, the case against soft drinks sweetened with the stuff is pretty
persuasive, although even that might be just a matter of the added
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