The Effect Of ‘Catalytic’ Doses Of Fructose And Its Epimers In Acute Single‐Meal Feeding Trials: A Systematic Review And Meta‐Analysis Of Controlled Trials
Bibliographic record
Abstract
Objective ‘Catalytic’ doses (<10g/meal or 36g/day) of fructose and its epimers (allulose, tagatose, and sorbose) may reduce postprandial glycemic responses to carbohydrate loads in people with and without diabetes by inducing glycogen synthesis. To synthesize the evidence of the effects of fructose and its epimers on acute postprandial carbohydrate metabolism, we conducted a systematic review and meta‐analysis of controlled trials. Methods We searched Medline, EMBASE, and the Cochrane Library (through Feb 12 2016). We included controlled, single‐meal feeding trials (≥2 hours) investigating the effect of fructose and its epimers (allulose, tagatose, and sorbose) on the postprandial metabolic responses to carbohydrate control meals compared to the same control meals without the sugars. Two independent reviewers extracted all relevant data and assessed risk of bias of individual trials using the Cochrane Risk of Bias Tool. Outcomes included plasma glucose and insulin incremental area‐under‐the‐curve (iAUC). Data were pooled using the generic inverse variance method and expressed as mean differences (MD) with 95% confidence intervals (95% CI). Heterogeneity was assessed by the Cochran Q statistic and quantified by the I 2 statistic. Results Eligibility criteria were met by 9 controlled feeding trials involving 144 participants in people with and without diabetes. Fructose (5 trial comparisons, MD= −28.65 mmol/L*min [95% CI, −55.36 to −1.93], p=0.04) and allulose (5 trial comparisons, MD= −39.79 mmol/L*min [95% CI, −67.35 to 12.22], p= 0.005) but not tagatose (15 trial comparisons) significantly reduced the postprandial plasma glucose iAUC responses to the carbohydrate control meals. Only allulose significantly reduced the postprandial plasma insulin iAUC to the carbohydrate control meals (MD= −2950.59 pmol/L*min [95% CI, −4844.11 to −1057.06], p=0.002). There was no evidence of heterogeneity in any of the analyses (P>0.1). Conclusions Pooled analyses indicate that small doses of fructose and allulose but not tagatose may improve the postprandial glycemic responses to carbohydrate meals without adversely affecting insulin response. There is a need for long‐term randomized controlled trials to assess whether these acute single‐meal effects lead to sustainable benefits in people with and without diabetes. Protocol registration: clinicaltrials.gov identifier, NCT02776722. Support or Funding Information The Tate and Lyle Nutritional Research Fund at the University of Toronto, Canadian Diabetes Association (CDA), Banting & Best Diabetes Centre, and PSI Foundation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.057 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.025 | 0.032 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".