The effect of low-fructose diet on anthropometric and metabolic factors: A systematic review and meta-analysis

Aims: In recent decades, there has been a rise in the consumption of sugars containing fructose, raising concerns about their association with metabolic disorders and obesity. We conducted a systematic review and meta -analysis of randomized controlled trials to assess the effects of a low -fructose diet on anthropometric and metabolic variables. Data synthesis: We conducted a systematic review and meta -analysis of randomized controlled trials to assess the effects of low -fructose diets on anthropometric and metabolic factors. Relevant studies were identified by searching electronic databases such as PubMed, Scopus, and Web of Science up to January 2023. The quality of the included studies was assessed using the Cochrane risk -of -bias tool. Ten trials with varying intervention durations (ranging from 4 to 24 weeks) and a total of 750 participants were included. The analysis revealed that a lowfructose diet had no significant effect on weight but did have a significant impact on body mass index (SMD = -0.2; 95 % CI: -0.37, -0.04, P = 0.017) and waist circumference (SMD = -0.48; 95 % CI: -0.67, -0.29, P < 0.0001). Furthermore, a low -fructose diet significantly affected systolic blood pressure (SMD = -0.24; 95 % CI: -0.39, -0.09, P = 0.002), fasting blood glucose (SMD = -0.23; 95 % CI: -0.40, -0.07, P = 0.005), hemoglobin A1c (SMD = -0.62; 95 % CI: -0.93, -0.31, P < 0.0001), and triglyceride levels (SMD = -0.17; 95 % CI: -0.33, -0.02, P = 0.028). However, it had no significant effect on diastolic blood pressure, insulin levels, or homeostatic model assessment of insulin resistance. Subgroup analysis indicated that a low -fructose diet had a greater effect on healthy participants aged over 50 years. Conclusions: Meta -analysis results suggest that low -fructose diets significantly reduce body mass index, waist circumference, systolic blood pressure, fasting blood glucose, hemoglobin A1c, and triglyceride levels. Additionally, the results of the current study suggest that a low -fructose diet may be more effective in healthy individuals who are older than 50 years old compared to those younger than 50 years old. (c) 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.