Decreased Consumption of Added Fructose Reduces Waist Circumference and Blood Glucose Concentration in Patients with Overweight and Obesity. The DISFRUTE Study: A Randomised Trial in Primary Care

The relationship between fructose intake and insulin resistance remains controversial. Our purpose was to determine whether a reduction in dietary fructose is effective in decreasing insulin resistance (HOMA2-IR). This field trial was conducted on 438 adults with overweight and obese status, without diabetes. A total of 121 patients in a low fructose diet (LFD) group and 118 in a standard diet (SD) group completed the 24-week study. Both diets were prescribed with 30&ndash
40% of energy intake restriction. There were no between-group differences in HOMA2-IR. However, larger decreases were seen in the LFD group in waist circumference (&minus
7.0 vs. &minus
4.8 = &minus
2.2 cms, 95% CI: &minus
3.7, &minus
0.7) and fasting blood glucose &minus
0.25 vs. &minus
0.11 = &minus
0.14 mmol/L, 95% CI: &minus
0.028, &minus
0.02). The percentage of reduction in calorie intake was similar. Only were differences observed in the % energy intake for some nutrients: total fructose (&minus
2 vs. &minus
0.6 = &minus
1.4, 95% CI: &minus
2.6, &minus
0.3), MUFA (&minus
1.7 vs. &minus
0.4 = &minus
1.3, 95% CI: &minus
2.4, &minus
0.2), protein (5.1 vs. 3.6 = 1.4, 95% CI: 0.1, 2.7). The decrease in fructose consumption originated mainly from the reduction in added fructose (&minus
2.8 vs. &minus
1.9 = &minus
0.9, 95% CI: &minus
1.6, &minus
0.03). These results were corroborated after multivariate adjustments. The low fructose diet did not reduce insulin resistance. However, it reduced waist circumference and fasting blood glucose concentration, which suggests a decrease in hepatic insulin resistance.