Table 4

 Characteristics of trials comparing the effect on body weight change in adults of isocaloric diets high in free sugars with diets relatively low in free sugars

StudyMethodsParticipantsDietOutcomesStudy durationDose
InterventionControl
Bantle 199248Randomised crossover trial of isocaloric metabolically controlled dietary interventions12 men and women with type 2 diabetesHigh fructose, high carbohydrate diet (55% of energy)High starch, low sugars, high carbohydrate diet (55% of energy)Plasma glucose, urinary glucose, lipids, postprandial triglycerides, body weight4 weeks per treatment20% of total energy/day from sucrose v <3% of total energy/day from fructose
Bantle 199349Randomised crossover trial of isocaloric metabolically controlled dietary interventions12 men and women with type 2 diabetes; 6 with type 1 diabetesHigh sucrose, high carbohydrate diet (55% of energy)High starch, low sugars, high carbohydrate diet (55% of energy)Plasma glucose, urinary glucose, lipids, postprandial triglycerides, body weight4 weeks per treatment19% of total energy/day from sucrose v <3% of total energy/day from sucrose
Grigoresco 198850Randomised crossover comparing isocaloric, free living diets8 well controlled adults with type 2 diabetesIsoglucidic diet replacing 30g/d starch with 30g/d fructoseStarch dietGlycaemic control, glycaemic and insulinaemic responses, uric acid, lipids, body weight2 months30 g/day of fructose v 30 g/day of starch
Koivisto 199351Double blind, randomised, isocaloric, hospital inpatient, crossover study10 men and women with type 2 diabetesHigh carbohydrate diet supplemented with crystalline fructoseHigh carbohydrate dietGlycaemic control, lipid and lipoprotein metabolism, insulin sensitivity4 weeks20% of total energy (45-65 g/day) from fructose replacing complex carbohydrate
Malerbi 199652Crossover trial of isocaloric, weight maintaining diets16 free living men and women with type 2 diabetes(1) High fructose diet; (2) high sucrose dietHigh starch dietMetabolic and B cell secretion effects28 days per treatment with 14 day washout periods(1) 63 g/day of fructose and 5 g/day of sucrose; (2) 3 g/day of fructose and 79 g/day of sucrose; control: 3 g/day of fructose and 14 g/day of sucrose
Mann 1972b53Randomised crossover trial of hospital treatments9 normolipidemic men with history of non-metabolic health condition in previous yearTypical Western diet with about 140 g/day of sucroseTypical Western diet with isocaloric replacement of sucrose with complex carbohydrateSerum lipids14 days140 g/day in the intervention group, which was replaced with starch in the control group
Mann 197354Clinical metabolic inpatient crossover trial of isocaloric, controlled energy diets9 men (7 with chronic neurological disorders, 2 apparently healthy)High sucrose, Western dietNormal sucrose Western dietSerum lipids14 days160 g/day v 80 g/day of sucrose (difference of 17% TE)*
Osei 198955Randomised crossover study13 men and women with type 2 diabetes (outpatients)Weight maintaining, diabetic, high carbohydrate (50% of energy), high fructose dietIsocaloric, weight maintaining, diabetic diet, high in complex carbohydrates (50% of energy)Serum glucose, HbA1c, lipids, serum uric acid, serum lactic acid, weight6 months per treatment60 g/day of crystalline fructose replacing complex carbohydrate
Peterson 198656Randomised crossover trial of two 6 week diets23 non-obese men and women with type 1 and type 2 diabetes, otherwise healthyHigh sucrose diet (same as for control diet but 45 g/day sucrose replacing starch) High fibre, high CHO dietGlycaemic control, lipids6 weeks per treatment45 g/day of sucrose replaced with 45 g/day of complex carbohydrate
Santacroce 199057Randomised crossover study comparing two isocaloric diets12 adults with insulin dependent diabetesTypical Italian, high CHO, low fat, diabetic diet supplemented with sucroseTypical Italian, high CHO, low fat, low sucrose diabetic dietGlycaemic control, lipids2 months per treatment30 g/day of sucrose replaced with 30 g of starch
Swanson 199258Randomised crossover design feeding trial comparing isoenergetic diets14 healthy, normal to overweight men and womenHigh fructose (20% TE) dietLow fructose (<3% TE), high starch dietMetabolic variables including HbA1c, glycaemic responses, serum lactate, lipids28 days per treatment100 g/day v 14 g/day of fructose†

CHO=carbohydrates; TE=total energy intake; HbA1c=glycated haemoglobin.

*Treatments were not given in a randomised order.

†Carbohydrates differed only in the proportions of starch and fructose.