British Journal of Nutrition

Metabolism and Metabolic Studies

Effects of 4-week very-high-fructose/glucose diets on insulin sensitivity, visceral fat and intrahepatic lipids: an exploratory trial

Guenther Silbernagela1, Juergen Machanna2, Susanne Unmutha1, Fritz Schicka2, Norbert Stefana1, Hans U. Häringa1 and Andreas Fritschea1 c1

a1 Division of Endocrinology, Diabetology, Nephrology, Vascular Disease and Clinical Chemistry, Department of Internal Medicine, Eberhard-Karls-University Tübingen, Otfried-Müller-Straße 10, 72076 Tübingen, Germany

a2 Section on Experimental Radiology, Department of Diagnostic Radiology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany


An increasing amount of fructose in the diet is suggested to play a causal role in the pathogenesis of the metabolic syndrome, type 2 diabetes and fatty liver. Our aim was to investigate and compare the effects of very high fructose and very high glucose in hyperenergetic diets on glucose and lipid metabolism and on fat depots in healthy humans. We conducted an exploratory, prospective, randomised, single-blinded, intervention trial. Participants in addition to a balanced weight-maintaining diet received 150 g of fructose or glucose/d for 4 weeks. Insulin sensitivity was estimated from oral glucose tolerance tests. Visceral and subcutaneous abdominal fat was determined with MRI. Liver fat and intramyocellular lipids of the tibialis anterior muscle were measured with 1H magnetic resonance spectroscopy. A total of twenty healthy subjects (fructose group n 10 and glucose group n 10; twelve males and eight females) completed the study. They had a mean age of 30·5 (sem 2·0) years and a mean BMI of 25·9 (sem 0·5) kg/m2. Insulin sensitivity appeared to decrease both in the fructose and glucose groups. TAG markedly increased in the fructose group. No strong alterations or treatment effects were found for liver fat, visceral fat, subcutaneous abdominal fat and intramyocellular lipids of the tibialis anterior muscle. In conclusion, the effects of very high fructose and very high glucose in hyperenergetic diets on glucose metabolism and body fat composition were not different in the healthy participants of the present study. However, elevation of plasma TAG seemed to be fructose-specific.

(Received July 05 2010)

(Revised December 06 2010)

(Accepted December 09 2010)

(Online publication March 14 2011)


Abbreviations: IMCL, intramyocellular lipid; OGTT, oral glucose tolerance test; TUFROG, TUebingen Fructose Or Glucose