Dietary Fructose Consumption Among US Children and Adults: The Third National Health and Nutrition Examination Survey

Department of Pediatrics, Gastroenterology, Hepatology and Nutrition, Graduate Division of Biological and Biomedical Sciences, Nutrition and Health Science Program, Emory University, Atlanta, Georgia, USA.
Medscape journal of medicine 01/2008; 10(7):160.
Source: PubMed


High fructose intake has been associated with increased de novo lipogenesis in the liver as well as increased plasma triglycerides, insulin resistance, and obesity. Fructose occurs naturally in fruits and vegetables; however, it is added to many processed foods as table sugar (sucrose) and high-fructose corn syrup. Dietary data from a nationally representative sample in 1977-1978 estimated that mean consumption of fructose was 37 g/day (8% of total intake). Little is known about more recent fructose consumption patterns.
We determined the amount and sources of dietary fructose among US adults and children.
We examined fructose consumption patterns by sex, age group, race/ethnicity, socioeconomic status, and body mass index for 21,483 children and adults. We used a single 24-hour dietary recall administered in the third National Health and Examination Survey (NHANES).
Weighted estimates of fructose intake were tested for significant differences (P < .05) between groups.
The mean consumption of fructose was estimated to be 54.7g/day (range, 38.4-72.8) and accounted for 10.2% of total caloric intake. Consumption was highest among adolescents (12-18 years) at 72.8 g/day (12.1% of total calories). One fourth of adolescents consumed at least 15% of calories from fructose. The largest source of fructose was sugar-sweetened beverages (30%) followed by grains (22%) and fruit or fruit juice (19%).
Over 10% of Americans' daily calories were from fructose. These results, when compared with a previous nationally representative study, suggest that fructose consumption has increased. Further research is needed to understand the impact of increased intake of fructose on human health.

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    • "Consumption of fructose in the U.S. has increased over the past 30 years, possibly by as much as 25% [29], via food sources such as fruit juice and HFCS in soft drinks [30] [31]. Recent estimates place the mean fructose consumption among Americans at 10% of dietary intake and as high as 15% in up to one-fourth of adolescents [29] [30]. Approximately 10% of adults consume as many as 25% of their daily calories from added sugar [32]. "
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    ABSTRACT: Nonalcoholic fatty liver disease (NAFLD) prevalence is increasing worldwide, with the affected US population estimated near 30%. Diet is a recognized risk factor in the NAFLD spectrum, which includes nonalcoholic steatohepatitis (NASH) and fibrosis. Low hepatic copper (Cu) was recently linked to clinical NAFLD/NASH severity. Simple sugar consumption including sucrose and fructose is implicated in NAFLD, while consumption of these macronutrients also decreases liver Cu levels. Though dietary sugar and low Cu are implicated in NAFLD, transcript-level responses that connect diet and pathology are not established. We have developed a mature rat model of NAFLD induced by dietary Cu deficiency, human-relevant high sucrose intake (30% w/w) or both factors in combination. Compared to the control diet with adequate Cu and 10% (w/w) sucrose, rats fed either high-sucrose or low-Cu diet had increased hepatic expression of genes involved in inflammation and fibrogenesis, including hepatic stellate cell activation, while the combination of diet factors also increased ATP citrate lyase and fatty acid synthase gene transcription (fold change >2, P<0.02). Low dietary Cu decreased hepatic and serum Cu (P≤0.05), promoted lipid peroxidation and induced NAFLD-like histopathology, while the combined factors also induced fasting hepatic insulin resistance and liver damage. Neither low Cu nor 30% sucrose in the diet led to enhanced weight gain. Taken together, transcript profiles, histological and biochemical data indicate that low Cu and high sucrose promote hepatic gene expression and physiological responses associated with NAFLD and NASH, even in the absence of obesity or severe steatosis. Copyright © 2015. Published by Elsevier Inc.
    The Journal of nutritional biochemistry 05/2015; 134. DOI:10.1016/j.jnutbio.2015.04.009 · 3.79 Impact Factor
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    • "Based on National Health and Nutrition Examination Survey (NHANES) data from 1988 to 1994, mean intake of fructose among children and adults was 54.7 g/d, however, adolescents ages 12–18 y consumed 72.8 g/d [36] of fructose. More recently, 1999–2004 NHANES data showed that young males (15–18 y) in the 95th percentile of fructose consumption , consume 121 g/d of fructose [36]. This value is twice as high than when assessed in 1978 [34] and 10 times higher than the 6 g/d per-capita value used to determine the safety of Table 3 Sugar profile of sodas "
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    ABSTRACT: Objective Excess fructose consumption is hypothesized to be associated with metabolic disease risk. Actual fructose consumption levels are difficult to estimate because of the unlabeled quantity of fructose in beverages. We therefore determined through laboratory analysis the fructose content in beverages made with and without high fructose corn syrup (HFCS) as an added sweetener. Research Methods and Procedures: Sugar sweetened beverages (SSBs) and fruit juice drinks that were either made with or without HFCS were analyzed in separate, independent laboratories via 3 different methods to determine sugar profiles. Results For SSBs, the three independent laboratory methods showed consistent and reproducible results. In SSBs made with HFCS, fructose constituted 60.6±2.7% of sugar content. In juices sweetened with HFCS, fructose accounted for 52.1±5.9% of sugar content, although in some juices made from 100% fruit, fructose concentration reached 65.35 g/L accounting for 67% of sugars. Conclusion Our results provide evidence of higher than expected amounts of free fructose in some beverages. Popular beverages made with HFCS have a fructose: glucose ratio of approximately 60:40, and thus contain 50% more fructose than glucose. Some pure fruit juices have twice as much fructose as glucose. These findings suggest that beverages made with HFCS and some juices have a sugar profile very different than sucrose, in which amounts of fructose and glucose are equivalent. Current dietary analyses may underestimate actual fructose consumption.
    Nutrition 07/2014; 30(7-8). DOI:10.1016/j.nut.2014.04.003 · 2.93 Impact Factor
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    • "Fructose from fruit in the form of fruit juices accounted for just 19.1% of fructose intake. Given the continued increase in the use of fructose and HFCSs and the inconsistencies in reporting fructose intake, it has been suggested that the percentage of energy consumed as fructose is greater than 20% in a substantial proportion of the US population [24]. The most recent analysis from the National Health and Nutrition Examination Survey 2005– 2008 reported that one half of the US population consumes sugar drinks on any given day and that 25% consumes at least 200 kcal, which is equivalent to more than one 12 oz can of soft drink and as much as 5% of the population consumes at least 560 kcal, more than four 12 oz cans of soft drink [29]. "
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    ABSTRACT: The consumption of artificially sweetened processed foods, particularly high in fructose or high fructose corn syrup, has increased significantly in the past few decades. As such, interest into the long term outcomes of consuming high levels of fructose has increased significantly, particularly when the exposure is early in life. Epidemiological and experimental evidence has linked fructose consumption to the metabolic syndrome and associated comorbidities-implicating fructose as a potential factor in the obesity epidemic. Yet, despite the widespread consumption of fructose-containing foods and beverages and the rising incidence of maternal obesity, little attention has been paid to the possible adverse effects of maternal fructose consumption on the developing fetus and long term effects on offspring. In this paper we review studies investigating the effects of fructose intake on metabolic outcomes in both mother and offspring using human and experimental studies.
    Journal of obesity 04/2014; 2014(3):203474. DOI:10.1155/2014/203474
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