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Substituting sucrose, fructose with starch lowers LDL-C concentrations

10 Jan 2020
There are many much beloved sources of carbohydrates we can taste, according to new findings

Replacing sucrose and fructose with starch results in reduced low-density lipoprotein cholesterol (LDL-C) concentrations, reveals a study. Moreover, substitution of fructose with glucose provides a beneficial effect on insulin resistance as well as uric acid concentrations.

This network meta-analysis (NMA) included randomized controlled trials (RCTs) investigating the isocaloric effect of substituting dietary sugars (fructose, glucose, sucrose) with other sugars or starch on cardiometabolic risk markers, such as LDL-C, triacylglycerol (TG), fasting glucose (FG), glycated haemoglobin (HbA1c), insulin resistance (HOMA-IR), uric acid, C-reactive protein (CRP), alanine transaminase (ALT), aspartate transaminase (AST) and liver fat content.

The investigators calculated the pooled mean differences (MDs) with 95 percent confidence intervals (CIs) and ranked the surface under the cumulative ranking curves (SUCRAs) to identify the most beneficial intervention for each outcome. They also used the Confidence In Network Meta-Analysis tool to assess the certainty of evidence.

Thirty-eight RCTs, including a total of 1,383 participants, met the eligibility criteria. LDL-C concentrations decreased with interventions replacing sucrose with starch (MD, –0.23 mmol/L, 95 percent CI, –0.38 to –0.07 mmol/L) or fructose with starch (MD, –0.22 mmol/L, 95 percent CI, –0.39 to –0.05 mmol/L; SUCRAstarch, 98 percent).

Substituting sucrose with starch also reduced FG concentrations (MD, –0.14 mmol/L, 95 percent CI, –0.29 to 0.01 mmol/L; SUCRAstarch, 91 percent). In addition, the exchange of fructose with an equivalent energy amount of glucose lowered HOMA-IR (MD, –0.36, 95 percent CI, –0.71 to –0.02; SUCRAglucose, 74 percent) and uric acid (MD, –23.77, 95 percent CI, –44.21 to –3.32 µmol/L; SUCRAglucose, 93 percent).

No significant effects were noted for TG, HbA1c, CRP, ALT and AST, according to the investigators, adding that the study was limited by its very low-to-moderate certainty of evidence.

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Most Read Articles
3 days ago
A recent study reports a mean growth rate of proximal aorta of about 0.1 mm/year in hypertensive patients with known aortic dilatation. In addition, those with increased rather than normal aortic z score have slower dilatation over time.
Tristan Manalac, 2 days ago
The coronavirus disease 2019 (COVID-19) appears to be more dangerous among cancer patients, who tend suffer more severe complications and faster disease progression, according to a new study.
6 days ago
Knee osteoarthritis (OA), whether symptomatic or radiographic, contributes to an increased risk of all-cause mortality, with the risk increase from symptomatic knee OA partially attributed to its effect on disability and quality of life (QoL).
2 days ago
Cuff-based excess pressure (XSP) is modestly associated with carotid intima–media thickness independent of conventional risk factors, reveals a recent study.