Dietary fructose effects on lipoprotein metabolism and risk for coronary artery disease.

In this chapter I have attempted to review the current literature drawing on those studies that I believe provide the best scientific evidence in regard to this issue. When those studies that provide the best scientific evidence are reviewed, there is evidence that increasing dietary fructose consumption can significantly increase fasting plasma triglyceride and cholesterol concentrations. Specifically, these changes are associated with an increase in both VLDL and LDL particles, without any apparent change in HDL particle concentrations. It appears that the magnitude of the deleterious effects vary depending on such factors as age; sex, baseline glucose, insulin, and triglyceride concentrations; the presence of insulin resistance; and the amount of dietary fructose consumed. Finally, not all studies are consistent in these findings, however, the positive data cannot easily be dismissed and may be of substantial clinical importance. This is particularly true given the fact that: 1) these deleterious changes occur in the absence of any beneficial effect on lipoprotein metabolism, and 2) these abnormalities in lipoprotein metabolism appear to be greater in those individuals already at an increased risk for coronary artery disease.