From today's NY Times... interesting given the debate raging around sugar in general and fructose in particular that seem to show contradictory things.  Variability in response, probably explains a lot of the diversity of opinion.

 

Vulnerability to Fructose Varies, Health Study Finds

By ANAHAD O'CONNOR

 OCTOBER 13, 2014 9:20 PMOctober 13, 2014 9:20 pm

Fructose, a sugar widely consumed in the form of high-fructose corn syrup, may promote obesity and diabetes by overstimulating a hormone that helps to regulate fat accumulation, researchers reported on Monday.

The study, carried out at Harvard Medical School, marks the first time that scientists have identified a hormone that rises sharply and consistently in response to eating fructose. The finding suggests that people may vary in their sensitivity to the sugar, and that eventually it may be possible to test an individual for susceptibility to illnesses linked to weight gain.

Fructose stimulated the sharpest rise in the hormone in people who were obese, an increase that the researchers believe may trigger resistance to its effects, according to the study, which was published in the journal Molecular Metabolism. But even among lean people, there was wide variation in this response.

“This shows us that different people for whatever reasons have differences in their fructose metabolism,” said Dr. Mark A. Herman, an assistant professor of medicine at Harvard and an author of the study. “It suggests that fructose may be relatively safer for some people than others.”

Most researchers agree that no single factor is responsible for the nationwide obesity epidemic, but the rise in sugar consumption that began several decades ago is considered a likely contributor. Between 1970 and 2000, the amount of added sugars in the food supply rose 25 percent.

Some of this was in the form of table sugar, or sucrose — a molecule of fructose bound to a molecule of glucose. But much of the increase stemmed from the introduction of high-fructose corn syrup, a cheaper sweetener that usually contains slightly more fructose than glucose.

When these sweeteners are consumed, glucose is absorbed into the bloodstream and ushered into tissues like fat and muscle with assistance from insulin. But fructose takes a different route.

The vast majority of it goes to the liver, where it stimulates the production of triglycerides, some of which are packaged into lipoproteins with cholesterol and secreted into the bloodstream.

A buildup of these triglycerides in the liver itself leads to nonalcoholic fatty liver disease, an increasingly common metabolic disorder that affects about 10 percent of children and as many as a third of all adults. Fatty liver often coincides with insulin resistance, a precursor to Type 2 diabetes, and it is a strong risk factor for heart disease.

“There’s no question that fructose is a sugar that promotes fat storage in the liver,” said Christopher B. Newgard, the director of the Sarah W. Stedman Nutrition and Metabolism Center at Duke University School of Medicine, who was not involved in the study. “In that sense, it’s a sugar that is a bad actor in the development of metabolic syndrome and Type 2 diabetes.”

...

The researchers said they planned to look at whether ethnicity and other factors influence the response to fructose. And they cautioned that some foods would likely have less of an impact on FGF21, like fresh fruit, which has fiber that slows the rate at which its fructose is metabolized.

Thanks Tom. I always look forward to these posts. Keep them coming.

Yeap.  Dr. Robert Lustig covers it well in his YouTube videos.  He also wrote a book about it called "Fat Chance", but I'd start with the YouTube stuff if you want to know more.

Dr. Lustig is an MIT graduation with a resume that's like 70 pages long (no kidding).  To say he is one smart cookie is an incredible understatement.

He's also a leader who is promoting much stricter government involvement in the solution

Both the book and the video are quite compelling, I agree.  Good to see some solid research backing him up.

Thanks for mentioning the book, I put it on my paperbackswap wish list.

It seems to me that fructose would be something patients with liver failure would be encouraged to avoid. My dad has cirrhosis and the doctors have told him to cut out salt (and alcohol of course), but have said nothing about sugar. My parents swear he doesn't eat much, but he drinks juice, eats sweetened yogurt and granola... 

I just think the state of nutritional counseling from doctors these days is really pretty poor.

I agree that nutritional counseling is not optimal when received from a doctor.  I love NUTs.

Very interesting article,  particularly regarding the effect of fatty liver.

Thanks for sharing!  I've got fructose malabsorption so this is relevant to me :)

Really interesting read.  Thank you for sharing this article.