No difference in ad libitum energy intake in healthy men and women consuming beverages sweetened with fructose, glucose, or high-fructose corn syrup: a randomized trial

Abstract

Background: Increased energy intake is consistently observed in individuals consuming sugar-sweetened beverages (SSBs), likely mainly because of an inadequate satiety response to liquid calories. However, SSBs have a high content of fructose, the consumption of which acutely fails to trigger responses in key signals involved in energy homeostasis. It is unclear whether the fructose content of SSBs contributes to the increased energy intake in individuals drinking SSBs.

Objective: We investigated whether the relative amounts of fructose and glucose in SSBs modifies ad libitum energy intake over 8 d in healthy adults without fructose malabsorption.

Design: We conducted 2 randomized, controlled, double-blind crossover studies to compare the effects of consuming 4 servings/d of a fructose-, glucose-, or aspartame-sweetened beverage (study A; n = 9) or a fructose-, glucose-, or high-fructose corn syrup (HFCS)-sweetened beverage (study B; n = 24) for 8 d on overall energy intake. SSBs were provided at 25% of estimated energy requirement, or an equivalent volume of the aspartame-sweetened beverage, and consumption was mandatory. All solid foods were provided at 125% of estimated energy requirements and were consumed ad libitum.

Results: In study A, ad libitum energy intake was 120% ± 10%, 117% ± 12%, and 102% ± 15% of estimated energy requirements when subjects consumed the fructose-, glucose-, and aspartame-sweetened beverages. Energy intake was significantly higher in the fructose and glucose phases than in the aspartame phase (P < 0.003 for each), with no difference between the fructose and glucose phases (P = 0.462). In study B, total energy intake during the fructose, HFCS, and glucose phases was 116% ± 14%, 116% ± 16%, and 116% ± 16% of the subject's estimated total energy requirements (P = 0.880).

Conclusions: In healthy adults, total 8-d ad libitum energy intake was increased in individuals consuming SSBs compared with aspartame-sweetened beverages. The energy overconsumption observed in individuals consuming SSBs occurred independently of the relative amounts of fructose and glucose in the beverages. These trials were registered at clinicaltrials.gov as NCT00475475 and NCT01424306.

Keywords: HFCS; energy intake; fructose; humans; obesity; overweight; sugar-sweetened beverages.

© 2015 American Society for Nutrition.

Figures

FIGURE 1

Study designs. In both study A and study B, participants completed each of 3 diet periods, during which they consumed standardized solid foods ad libitum, as well as 4 mandatory servings per day of beverages sweetened with fructose, glucose, or aspartame (study A) or fructose, glucose, or HFCS (study B). The order in which the beverages were consumed was randomized, and the intervention periods were separated by washout periods of 20 d each. All foods and beverages were provided, and ad libitum energy intake was assessed by weighing all foods that were not consumed and subtracting those calories from the number of calories in the foods provided. HFCS, high-fructose corn syrup.

FIGURE 2

Mean ± SD daily energy intake from solid foods (gray portion of the bars) and beverages (white portion of the bars), as a percentage of estimated total energy requirement during each diet period for study A (n = 9) and study B (n = 24). Energy intake from solid foods was not affected by the calorie content of the sweetened beverages or the type of sugar used to sweeten beverages in either study, which led to lower overall energy intake in participants consuming aspartame-sweetened beverages than in participants consuming fructose- or glucose-sweetened beverages in study A. No difference in total energy intake was observed when participants consumed beverages sweetened with fructose, HFCS, or glucose. P values were determined by post hoc paired t tests with Bonferroni correction for multiple testing for study A and by repeated-measures ANOVA for study B. ETEE, estimated total energy expenditure; HFCS, high-fructose corn syrup.