Fruktoz ve sağlık

Yıl 2016, Cilt: 9 Sayı: 3, 150 - 158, 15.12.2016

Sabriye Arslan , Nevin Şanlıer

Öz

Fruktoz meyve ve balda bulunan doğal bir şeker olup en büyük kaynakları besinlere eklenen sükroz ve yüksek fruktozlu mısır şurubudur (HFCS). Geçmişte fruktoz alımı daha çok meyve ve bal gibi doğal kaynaklardan sağlanmakta iken son 30 yılda birçok besine eklenen şekerlerle birlikte günlük fruktoz alımı önemli miktarda artmıştır. Son çalışmalar fruktoz alımındaki artışın obezite ve tip 2 diyabetteki artışa paralel olduğunu göstermektedir. Bunun dışında aşırı fruktoz alımının hipertansiyon, hiperlipidemi, nonalkolik karaciğer yağlanması, gut vb. hastalıklarla ilişkili olabileceği bildirilmektedir. Ancak fruktozun bazı hastalıklarla ilişkisi üzerinde son dönemde çok fazla durulsa da tüm fruktoz kaynaklarının aynı etkiye sahip olmadığı göz önünde bulundurulmalıdır. Fruktoz ve sağlık ilişkisini inceleyen insan çalışmalarının sınırlı oluşu ve çalışmalarda kullanılan fruktoz miktarlarının çoğunlukla çok yüksek miktarlarda olması, fruktozun insan sağlığı üzerindeki etkileri hakkında yorum yapmayı güçleştirmektedir. Bu derlemede fruktozun sağlık üzerine etkileri ele alınmıştır.

Anahtar kelimeler: Fruktoz, sağlık, yüksek fruktozlu mısır şurubu 

Kaynakça

• Kaynaklar
• Park YK, Yetley EA. Intakes and food sources of fructose in the United States. Am J Clin Nutr 1993;58(5 Suppl):737S-47S.
• Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, Hu FB. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA 2004;292(8):27-34.
• United States Department of Agriculture National Nutrient Database for Standard Reference. Erişim yeri: http://ndb.nal.usda.gov. Erişim tarihi: 15.03.2016
• Goran MI, Ulijaszek SJ, Ventura EE. High fructose corn syrup and diabetes prevalence: a global perspective. Glob Public Health 2013;8(1):55-64.
• Forshee RA, Storey ML, Allison DB, Glinsmann WH, Hein GL, Lineback DR, Miller SA, Nicklas TA, Weaver GA, White JS. A critical examination of the evidence relating high fructose corn syrup and weight gain. Crit Rev Food Sci Nutr 2007;47(6):561-82.
• Neilson EG. The fructose nation. J Am Soc Nephrol 2007;18(10):2619-21.
• Gaby AR. Adverse effects of dietary fructose. Altern Med Rev 2005;10(4):294-306.
• Feinman RD, Fine EJ. Fructose in perspective. Nutr & Metab 2013;10(1):10-45.
• Sanchez-Lozada LG, Le M, Segal M, Johnson RJ. How safe is fructose for persons with or without diabetes? Am J Clin Nutr 2008;88:1189-90.
• Institue of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids. Washington: National Academies Press; 2005. Erişim: http://nap.edu/10490 Erişim tarihi:12.04.2016.
• World Health Organization. Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015. Erişim: http://apps.who.int/iris/bitstream/10665/149782/1/9789241549028_eng.pdf. Erişim tarihi: 12.03.2016.
• Assy N, Nasser G, Kamayse I, Nseir W, Beniashvili Z, Djibre A, Grosovski M. Soft drink consumption linked with fatty liver in the absence of traditional risk factors. Can J Gastroenterol 2008;22(10):811-6.
• Aeberli I, Gerber PA, Hochuli M, Kohler S, Haile SR, Gouni-Berthold I, Berthold HK, Spinas GA, Berneis K. Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. Am J Clin Nutr 2011;94(2):479-85.
• Stanhope KL, Havel PJ. Fructose consumption: potential mechanisms for its effects to increase visceral adiposity and induce dyslipidemia and insulin resistance. Curr Opin Lipidol 2008;19(1):16-24.
• Vasselli JR, Scarpace PJ, Harris RB, Banks WA. Dietary components in the development of leptin resistance. Adv Nutr 2013;4(2):164-75.
• Shapiro A, Mu W, Roncal C, Cheng KY, Johnson RJ, Scarpace PJ. Fructose-induced leptin resistance exacerbates weight gain in response to subsequent high-fat feeding. Am J Physiol Regul Integr Comp Physiol 2008;295(5):R1370-5.
• Livesey G, Taylor R. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am J Clin Nutr 2008;88(5):1419-37.
• Rodin J. Comparative effects of fructose, aspartame, glucose, and water preloads on calorie and macronutrient intake. Am J Clin Nutr 1990;51(3):428-35.
• Schwarz JM, Acheson KJ, Tappy L, Piolino V, Müller MJ, Felber JP, Jéquier E. Thermogenesis and fructose metabolism in humans. Am J Physiol 1992;262(5 Pt 1):E591-8.
• Rizkalla SW. Health implications of fructose consumption: A review of recent data. Nutr Metab 2010;7:82.
• Türkiye Endokrinoloji ve Metabolizma Derneği. Diabetes mellitus ve komplikasyonlarının tanı, tedavi ve izlem kılavuzu-2015. Ankara: Diabetes Mellitus Çalışma ve Eğitim Grubu; 2015. Erişim: http://www.turkendokrin.org/files/15055_DIYABET_web(1).pdf. Erişim tarihi: 03.03.2016.
• Hallfrisch J, Ellwood KC, Michaelis OE, Reiser S, O'Dorisio TM, Prather ES. Effects of dietary fructose on plasma glucose and hormone responses in normal and hyperinsulinemic men. J Nutr 1983;113(9):1819-26.
• Wu T, Giovannucci E, Pischon T, Hankinson SE, Ma J, Rifai N, Rimm EB. Fructose, glycemic load, and quantity and quality of carbohydrate in relation to plasma C-peptide concentrations in US women. Am J Clin Nutr 2004;80(4):1043-9.
• Koivisto VA, Yki‐Järvinen H. Fructose and insulin sensitivity in patients with type 2 diabetes. J Intern Med 1993;233(2):145-53.
• Shulman GI. Cellular mechanisms of insulin resistance. J Clin Invest 2000;106:171–6.
• Chen L, Caballero B, Mitchell DC, Loria C, Lin PH, Champagne CM, Elmer PJ, Ard JD, Batch BC, Anderson CA, Appel LJ. Reducing consumption of sugar-sweetened beverages is associated with reduced blood pressure a prospective study among United States adults. Circulation 2010;121(22):2398-2406.
• Perez-Pozo SE, Schold J, Nakagawa T, Sanchez-Lozada LG, Johnson RJ, Lillo JL. Excessive fructose intake induces the features of metabolic syndrome in healthy adult men: role of uric acid in the hypertensive response. Intern J Obes 2010;34(3):454-61.
• Madero M, Perez-Pozo SE, Jalal D, Johnson RJ, Sánchez-Lozada LG. Dietary fructose and hypertension. Curr Hypertens Rep 2011;13(1):29-35.
• Brown IJ, Stamler J, Van HL, Robertson CE, Chan Q, Dyer AR, Huang CC, Rodriguez BL, Zhao L, Daviglus ML, Ueshima H, Elliott P. Sugar-sweetened beverage, sugar intake of individuals, and their blood pressure: international study of macro/micronutrients and blood pressure. Hypertension 2011;57:695–701.
• Forman JP, Choi H, Curhan GC. Fructose and vitamin C intake do not influence risk for developing hypertension. J Am Soc Nephrol 2009;20(4):863-71.
• Ouyang X, Cirillo P, Sautin Y, McCall S, Bruchette JL, Diehl AM, Johnson RJ, Abdelmalek MF. Fructose consumption as a risk factor for non-alcoholic fatty liver disease. J Hepatol 2008;48(6):993-9.
• Chiu S, Sievenpiper JL, De Souza RJ, Cozma AI, Mirrahimi A, Carleton AJ, Ha V, Di Buono M, Jenkins AL, Leiter LA, Wolever TM, Don-Wauchope AC, Beyene J, Kendall CW, Jenkins DJ. Effect of fructose on markers of non-alcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis of controlled feeding trials. Eur J Clin Nutr 2014;68(4):416-23.
• Choi HK, Willett W, Curhan G. Fructose-rich beverages and risk of gout in women. JAMA 2010;304(20):2270-8.
• Taylor EN, Curhan GC. Fructose consumption and the risk of kidney stones. Kidney Int 2008;73(2):207-12.
• Abate N, Chandalia M, Cabo-Chan AV, Moe OW, Sakhaee K. The metabolic syndrome and uric acid nephrolithiasis: novel features of renal manifestation of insulin resistance. Kidney Int 2004;65(2):386-92.
• Douard V, Asgerally A, Sabbagh Y, Sugiura S, Shapses SA, Casirola D, Ferraris RP. Dietary fructose inhibits intestinal calcium absorption and induces vitamin D insufficiency in CKD. J Am Soc Nephrol 2010;21(2):261-71.
• Shoham DA, Durazo-Arvizu R, Kramer H, Luke A, Vupputuri S, Kshirsagar A, Cooper RS. Sugary soda consumption and albuminuria: results from the National Health and Nutrition Examination Survey, 1999–2004. PloS One 2008;3(10):e3431.
• Charrez B, Qiao L, Hebbard L. The role of fructose in metabolism and cancer. Horm Mol Biol Clin Investig 2015;22(2):79-89.
• Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US. adults. N Engl J Med 2003;348:1625–38.
• Parekh N, Chandran U, Bandera EV. Obesity in cancer survival. Annu Rev Nutr 2012;32:311–42.
• Jiao L, Flood A, Subar AF, Hollenbeck AR, Schatzkin A, Stolzenberg- Solomon R. Glycemic index, carbohydrates, glycemic load, and the risk of pancreatic cancer in a prospective cohort study. Cancer Epidemiol Biomarkers Prev 2009;18:1144–51.
• Meyerhardt JA, Sato K, Niedzwiecki D, Ye C, Saltz LB, Mayer RJ, Mowat RB, Whittom R, Hantel A, Benson A, Wigler DS, Venook A, Fuchs CS. Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Natl Cancer Inst 2012;104:1702–11.
• Michaud DS, Fuchs CS, Liu S, Willett WC, Colditz GA, Giovannucci E. Dietary glycemic load, carbohydrate, sugar, and colorectal cancer risk in men and women. Cancer Epidemiol Biomarkers Prev 2005;14:138–47.
• Liu H, Huang D, McArthur DL, Boros LG, Nissen N, Heaney AP. Fructose induces transketolase flux to promote pancreatic cancer growth. Cancer Res 2010;70:6368–76.
• Kumamoto R, Uto H, Oda K, Ibusuki R, Tanoue S, Arima S, Mawatari S, Kumagai K, Numata M, Tamai T, Moriuchi A, Fujita H, Oketani M, Ido A, Tsubouchi H. Dietary fructose enhances the incidence of precancerous hepatocytes induced by administration of diethylnitrosamine in rat. Eur J Med Res 2013;18:54.
• Cao D, Lu H, Lewis TL, Li L. Intake of sucrose-sweetened water induces insulin resistance and exacerbates memory deficits and amyloidosis in a transgenic mouse model of Alzheimer disease. J Biol Chem 2007;282(50):36275-82.
• Mielke JG, Taghibiglou C, Liu L, Zhang, Y, Jia Z, Adeli K, Wang YT. A biochemical and functional characterization of diet‐induced brain insulin resistance. J Neurochem 2005;93(6):1568-78.
• Jameel F, Phang M, Wood LG, Garg ML. Acute effects of feeding fructose, glucose and sucrose on blood lipid levels and systemic inflammation. Lipid Health Dis 2014;13(1):195.
• Cirillo P, Gersch MS, Mu W, Scherer PM, Kim KM, Gesualdo L, Henderson GN, Johnson RJ, Sautin YY. Ketohexokinase-dependent metabolism of fructose induces proinflammatory mediators in proximal tubular cells. J Am Soc Nephrol 2009;20(3):545-53.
• Yamazaki M, Munetsuna E, Yamada H, Ando Y, Mizuno G, Murase Y, Kondo K, Ishikawa H, Teradaira R, Suzuki K, Ohashi K. Fructose consumption induces hypomethylation of hepatic mitochondrial DNA in rats. Life Sci 2016;149:146-52.