Is fructose consumption associated with diet quality?: A cross-sectional study
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Abstract
The aim of this study was to evaluate the relationship between the consumption of fructose and the score of the diet quality in healthy adults. This cross-sectional study included 100 healthy adults. A 3-day dietary record and a 24-item fructose frequency questionnaire were used to evaluate the nutritional status and fructose consumption of individuals. Anthropometric parameters were measured. The Dietary Quality Index-International (DQI-I) scores were calculated for the evaluation of dietary quality. The mean total DQI-I scores were 58.6 ± 7.7, and a total of 82% of adults had a DQI-I score in the “needs improvement diet” category. Total DQI-I scores of the moderate fructose consumption group were significantly higher than the high fructose consumption group. High fructose consumption was also significantly and negatively associated with the total DQI-I score (r = –0.369, p = 0.000). It was determined that there is a correlation between fructose consumption and diet quality. As fructose consumption increases, diet quality scores tend to decrease. To enhance diet quality in adults, it would be beneficial to regularly assess dietary habits and provide nutritional education.
Riferimenti bibliografici
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Cara KC, Fan Z, Chiu YH, Jiang X, Alhmly HF, Chung M. Associations between intake of dietary sugars and diet quality: A systematic review of recent literature. Nutrients. 2024;16(11):1549. 10.3390/NU16111549
Cho IY, Lee KM, Lee Y, Paek CM, Kim HJ, Kim JY, et al. Assessment of dietary habits using the diet quality index-international in cerebrovascular and cardiovascular disease patients. Nutrients. 2021;13(2):1–11. 10.3390/NU13020542
Clemente-Suárez VJ, Mielgo-Ayuso J, Martín-Rodríguez A, Ramos-Campo DJ, Redondo-Flórez L, Tornero-Aguilera JF. The burden of carbohydrates in health and disease. Nutrients. 2022;14(18):3809. 10.3390/NU14183809
Diaz T, Strong KL, Cao B, Guthold R, Moran AC, Moller AB., et al. A call for standardised age-disaggregated health data. Lancet Healthy Longev. 2021;2(7):e436–43. 10.1016/S2666-7568(21)00115-X
Dornas WC, de Lima WG, Pedrosa ML, Silva ME. Health implications of high-fructose intake and current research. Adv Nutr. 2015;6(6):729–37. 10.3945/AN.114.008144
Duffey KJ, Popkin BM. High-fructose corn syrup: Is this what’s for dinner? Am J Clin Nutr. 2008;88(6):1722S–32S. 10.3945/AJCN.2008.25825C
Edwards CH, Rossi M, Corpe CP, Butterworth PJ, Ellis PR. The role of sugars and sweeteners in food, diet and health: Alternatives for the future. Trends Food Sci Technol. 2016;56:158–66. 10.1016/j.tifs.2016.07.008
Espino-Rosales D, Lopez-Moro A, Heras-González L, Jimenez-Casquet MJ, Olea-Serrano F, Mariscal-Arcas M. Estimation of the quality of the diet of Mexican university students using DQI-I. Healthcare (Basel, Switzerland). 2023;11(1):138. 10.3390/HEALTHCARE11010138
Foroumandi E, Alizadeh M, Kheirouri S. Dietary quality index is negatively associated with serum advanced glycation end products in healthy adults. Clin Nutr ESPEN. 2020;36:111–5. 10.1016/J.CLNESP.2020.01.007
García-Montero C, Fraile-Martínez O, Gómez-Lahoz AM, Pekarek L, Castellanos AJ, Noguerales-Fraguas F, et al. Nutritional components in Western diet versus Mediterranean diet at the gut microbiota-immune system interplay. Implications for health and disease. Nutrients. 2021;13(2): 1–53. 10.3390/NU13020699
Gil Á, de Victoria EM, Olza J. Indicators for the evaluation of diet quality. Nutr Hosp. 2015;31(Suppl 3):128–44. 10.3305/NH.2015.31.SUP3.8761
Guerrero MLP, Pérez-Rodríguez F. 2017. Diet Quality Indices for Nutrition Assessment: Types and Applications. In M. C. Hurda (Ed.), Functional Food–Improve Health through Adequate Food. IntechOpen. 10.5772/INTECHOPEN.69807
Hannou SA, Haslam DE, McKeown NM, Herman MA. Fructose metabolism and metabolic disease. J Clin Invest. 2018;128(2):545–55. 10.1172/JCI96702
Hernández-Díazcouder A, Romero-Nava R, Carbó R, Sánchez-Lozada LG, Sánchez-Muñoz F. High fructose intake and adipogenesis. Int J Mol Sci. 2019;20(11):2787. 10.3390/IJMS20112787
Hosseini-Esfahani F, Bahadoran Z, Mirmiran P, Hosseinpour-Niazi S, Hosseinpanah F, Azizi F. Dietary fructose and risk of metabolic syndrome in adults: Tehran lipid and glucose study. Nutr Metab. 2011;8(1):50. 10.1186/1743-7075-8-50
Inci MK, Park SH, Helsley RN, Attia SL, Softic S. Fructose impairs fat oxidation: Implications for the mechanism of western diet-induced NAFLD. J Nutr Biochem. 2023;114:109224. 10.1016/J.JNUTBIO.2022.109224
Jameel F, Phang M, Wood LG, Garg ML. Acute effects of feeding fructose, glucose and sucrose on blood lipid levels and systemic inflammation. Lipids Health Dis. 2014;13(1):195. 10.1186/1476-511X-13-195
Johnson RJ, Murray R. Fructose, exercise, and health. Curr Sports Med Rep. 2010;9(4):253–8. 10.1249/JSR.0B013E3181E7DEF4
Johnson RK, Appel LJ, Brands M, Howard BV, Lefevre M, Lustig RH, et al. Dietary sugars intake and cardiovascular health. Circulation. 2009;120(11):1011–20. 10.1161/CIRCULATIONAHA.109.192627
Kant AK. Indexes of overall diet quality: A review. J Am Diet Assoc. 1996;96(8):785–91. 10.1016/S0002-8223(96)00217-9
Keskin E, Yoldas Ilktac H. Fructose consumption correlates with triglyceride-glucose index and glycemic status in healthy adults. Clin Nutr ESPEN. 2022;52:184–9. 10.1016/J.CLNESP.2022.11.008
Kim MH, Bae YJ. Evaluation of diet quality of children and adolescents based on nutrient and food group intake and diet quality index-international (DQI-I). Korean J Community Nutr. 2016;15(1):1–14.
Kim S, Haines PS, Siega-Riz AM, Popkin BM. The diet quality index-international (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr. 2003;133(11):3476–84. 10.1093/JN/133.11.3476
King C, Lanaspa MA, Jensen T, Tolan DR, Sánchez-Lozada LG, Johnson RJ. Uric acid as a cause of the metabolic syndrome. Contrib Nephrol. 2018;192:88–102. 10.1159/000484283
Kolderup A, Svihus B. Fructose metabolism and relation to atherosclerosis, type 2 diabetes, and obesity. J Nutr Metab. 2015;2015:823081. 10.1155/2015/823081
Kopec M, Beton-Mysur K. The role of glucose and fructose on lipid droplet metabolism in human normal bronchial and cancer lung cells by Raman spectroscopy. Chem Phys Lipids. 2024;259:105375. 10.1016/J.CHEMPHYSLIP.2023.105375
Lee YD, Kim KW, Choi KS, Kim M, Cho YJ, Sohn C. Development of dietary pattern evaluation tool for adults and correlation with dietary quality index. Nutr Res Pract. 2016;10(3):305–12. 10.4162/NRP.2016.10.3.305
Malik VS, Hu FB. Fructose and cardiometabolic health: What the evidence from sugar-sweetened beverages tells us. J Am Coll Cardiol. 2015;66(14):1615. 10.1016/J.JACC.2015.08.025
Mock K, Lateef S, Benedito VA, Tou JC. High-fructose corn syrup-55 consumption alters hepatic lipid metabolism and promotes triglyceride accumulation. J Nutr Biochem. 2017;39:32–9. 10.1016/J.JNUTBIO.2016.09.010
Najibi N, Jahromi MK, Teymoori F, Farhadnejad H, Salehi-Sahlabadi A, Mirmiran P. International diet quality index and revised diet quality index relationship with non-alcoholic fatty liver disease: A case-control study. BMC Gastroenterol. 2023;23(1):1–10. 10.1186/S12876-023-03082-X/TABLES/4
Page KA, Melrose AJ. Brain, hormone and appetite responses to glucose versus fructose. Curr Opin Behav Sci. 2016;9:111–7. 10.1016/j.cobeha.2016.03.002
Rippe JM, Angelopoulos TJ. Sucrose, high-fructose corn syrup, and fructose, their metabolism and potential health effects: What do we really know? Adv Nutr. 2013;4(2):236–45. 10.3945/AN.112.002824
Shin M-K, Kim Y-S, Kim J-H, Kim S-H, Kim Y. Dietary patterns and their associations with the diet quality index-international (DQI-I) in Korean women with gestational diabetes mellitus. Clin Nutr Res. 2015;4(4):216. 10.7762/CNR.2015.4.4.216
Slining MM, Popkin BM. Trends in intakes and sources of solid fats and added sugars among U.S. children and adolescents: 1994–2010. Pediatr Obes. 2013;8(4):307–24. 10.1111/J.2047-6310.2013.00156.X
Sluik D, Engelen AI, Feskens EJ. Fructose consumption in the Netherlands: The Dutch National Food Consumption Survey 2007–2010. Eur J Clin Nutr. 2015;69(4):475–81. 10.1038/EJCN.2014.267
Stricker S, Rudloff S, Geier A, Steveling A, Roeb E, Zimmer KP. Fructose consumption-free sugars and their health effects. Deutsch Arztebl Int. 2021;118(5):71–80. 10.3238/ARZTEBL.M2021.0010
Triantafyllou GA, Paschou SA, Mantzoros CS. Leptin and hormones: Energy homeostasis. Endocrinol Metab Clin North Am. 2016;45(3):633–45. 10.1016/J.ECL.2016.04.012
Tur JA, Romaguera D, Pons A. The diet quality index-international (DQI-I): Is it a useful tool to evaluate the quality of the Mediterranean diet? Br J Nutr. 2005;93(3):369–76. 10.1079/BJN20041363
Vos MB, Kimmons JE, Gillespie C, Welsh J, Blanck HM. Dietary fructose consumption among US children and adults: The third National Health and Nutrition Examination Survey. Medscape J Med. 2008;10(7):160. PMid: 18769702.
Wheeler ML, Pi-Sunyer FX. Carbohydrate issues: Type and amount. J Am Diet Assoc. 2008;108(4 Suppl 1):S34-9. 10.1016/J.JADA.2008.01.024
World Health Organization (WHO). 2015. Guideline: Sugars intake for adults and children. https://www.who.int/publications/i/item/9789241549028
World Health Organization (WHO). 2008. Waist circumference and waist-hip ratio: Report of a WHO expert consultation. https://iris.who.int/bitstream/handle/10665/44583/9789241501491_eng.pdf?sequence=1
Yau AMW, McLaughlin J, Gilmore W, Maughan RJ, Evans GH. The acute effects of simple sugar ingestion on appetite, gut-derived hormone response, and metabolic markers in men. Nutrients. 2017;9(2):135. 10.3390/NU9020135
Cara KC, Fan Z, Chiu YH, Jiang X, Alhmly HF, Chung M. Associations between intake of dietary sugars and diet quality: A systematic review of recent literature. Nutrients. 2024;16(11):1549. 10.3390/NU16111549
Cho IY, Lee KM, Lee Y, Paek CM, Kim HJ, Kim JY, et al. Assessment of dietary habits using the diet quality index-international in cerebrovascular and cardiovascular disease patients. Nutrients. 2021;13(2):1–11. 10.3390/NU13020542
Clemente-Suárez VJ, Mielgo-Ayuso J, Martín-Rodríguez A, Ramos-Campo DJ, Redondo-Flórez L, Tornero-Aguilera JF. The burden of carbohydrates in health and disease. Nutrients. 2022;14(18):3809. 10.3390/NU14183809
Diaz T, Strong KL, Cao B, Guthold R, Moran AC, Moller AB., et al. A call for standardised age-disaggregated health data. Lancet Healthy Longev. 2021;2(7):e436–43. 10.1016/S2666-7568(21)00115-X
Dornas WC, de Lima WG, Pedrosa ML, Silva ME. Health implications of high-fructose intake and current research. Adv Nutr. 2015;6(6):729–37. 10.3945/AN.114.008144
Duffey KJ, Popkin BM. High-fructose corn syrup: Is this what’s for dinner? Am J Clin Nutr. 2008;88(6):1722S–32S. 10.3945/AJCN.2008.25825C
Edwards CH, Rossi M, Corpe CP, Butterworth PJ, Ellis PR. The role of sugars and sweeteners in food, diet and health: Alternatives for the future. Trends Food Sci Technol. 2016;56:158–66. 10.1016/j.tifs.2016.07.008
Espino-Rosales D, Lopez-Moro A, Heras-González L, Jimenez-Casquet MJ, Olea-Serrano F, Mariscal-Arcas M. Estimation of the quality of the diet of Mexican university students using DQI-I. Healthcare (Basel, Switzerland). 2023;11(1):138. 10.3390/HEALTHCARE11010138
Foroumandi E, Alizadeh M, Kheirouri S. Dietary quality index is negatively associated with serum advanced glycation end products in healthy adults. Clin Nutr ESPEN. 2020;36:111–5. 10.1016/J.CLNESP.2020.01.007
García-Montero C, Fraile-Martínez O, Gómez-Lahoz AM, Pekarek L, Castellanos AJ, Noguerales-Fraguas F, et al. Nutritional components in Western diet versus Mediterranean diet at the gut microbiota-immune system interplay. Implications for health and disease. Nutrients. 2021;13(2): 1–53. 10.3390/NU13020699
Gil Á, de Victoria EM, Olza J. Indicators for the evaluation of diet quality. Nutr Hosp. 2015;31(Suppl 3):128–44. 10.3305/NH.2015.31.SUP3.8761
Guerrero MLP, Pérez-Rodríguez F. 2017. Diet Quality Indices for Nutrition Assessment: Types and Applications. In M. C. Hurda (Ed.), Functional Food–Improve Health through Adequate Food. IntechOpen. 10.5772/INTECHOPEN.69807
Hannou SA, Haslam DE, McKeown NM, Herman MA. Fructose metabolism and metabolic disease. J Clin Invest. 2018;128(2):545–55. 10.1172/JCI96702
Hernández-Díazcouder A, Romero-Nava R, Carbó R, Sánchez-Lozada LG, Sánchez-Muñoz F. High fructose intake and adipogenesis. Int J Mol Sci. 2019;20(11):2787. 10.3390/IJMS20112787
Hosseini-Esfahani F, Bahadoran Z, Mirmiran P, Hosseinpour-Niazi S, Hosseinpanah F, Azizi F. Dietary fructose and risk of metabolic syndrome in adults: Tehran lipid and glucose study. Nutr Metab. 2011;8(1):50. 10.1186/1743-7075-8-50
Inci MK, Park SH, Helsley RN, Attia SL, Softic S. Fructose impairs fat oxidation: Implications for the mechanism of western diet-induced NAFLD. J Nutr Biochem. 2023;114:109224. 10.1016/J.JNUTBIO.2022.109224
Jameel F, Phang M, Wood LG, Garg ML. Acute effects of feeding fructose, glucose and sucrose on blood lipid levels and systemic inflammation. Lipids Health Dis. 2014;13(1):195. 10.1186/1476-511X-13-195
Johnson RJ, Murray R. Fructose, exercise, and health. Curr Sports Med Rep. 2010;9(4):253–8. 10.1249/JSR.0B013E3181E7DEF4
Johnson RK, Appel LJ, Brands M, Howard BV, Lefevre M, Lustig RH, et al. Dietary sugars intake and cardiovascular health. Circulation. 2009;120(11):1011–20. 10.1161/CIRCULATIONAHA.109.192627
Kant AK. Indexes of overall diet quality: A review. J Am Diet Assoc. 1996;96(8):785–91. 10.1016/S0002-8223(96)00217-9
Keskin E, Yoldas Ilktac H. Fructose consumption correlates with triglyceride-glucose index and glycemic status in healthy adults. Clin Nutr ESPEN. 2022;52:184–9. 10.1016/J.CLNESP.2022.11.008
Kim MH, Bae YJ. Evaluation of diet quality of children and adolescents based on nutrient and food group intake and diet quality index-international (DQI-I). Korean J Community Nutr. 2016;15(1):1–14.
Kim S, Haines PS, Siega-Riz AM, Popkin BM. The diet quality index-international (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr. 2003;133(11):3476–84. 10.1093/JN/133.11.3476
King C, Lanaspa MA, Jensen T, Tolan DR, Sánchez-Lozada LG, Johnson RJ. Uric acid as a cause of the metabolic syndrome. Contrib Nephrol. 2018;192:88–102. 10.1159/000484283
Kolderup A, Svihus B. Fructose metabolism and relation to atherosclerosis, type 2 diabetes, and obesity. J Nutr Metab. 2015;2015:823081. 10.1155/2015/823081
Kopec M, Beton-Mysur K. The role of glucose and fructose on lipid droplet metabolism in human normal bronchial and cancer lung cells by Raman spectroscopy. Chem Phys Lipids. 2024;259:105375. 10.1016/J.CHEMPHYSLIP.2023.105375
Lee YD, Kim KW, Choi KS, Kim M, Cho YJ, Sohn C. Development of dietary pattern evaluation tool for adults and correlation with dietary quality index. Nutr Res Pract. 2016;10(3):305–12. 10.4162/NRP.2016.10.3.305
Malik VS, Hu FB. Fructose and cardiometabolic health: What the evidence from sugar-sweetened beverages tells us. J Am Coll Cardiol. 2015;66(14):1615. 10.1016/J.JACC.2015.08.025
Mock K, Lateef S, Benedito VA, Tou JC. High-fructose corn syrup-55 consumption alters hepatic lipid metabolism and promotes triglyceride accumulation. J Nutr Biochem. 2017;39:32–9. 10.1016/J.JNUTBIO.2016.09.010
Najibi N, Jahromi MK, Teymoori F, Farhadnejad H, Salehi-Sahlabadi A, Mirmiran P. International diet quality index and revised diet quality index relationship with non-alcoholic fatty liver disease: A case-control study. BMC Gastroenterol. 2023;23(1):1–10. 10.1186/S12876-023-03082-X/TABLES/4
Page KA, Melrose AJ. Brain, hormone and appetite responses to glucose versus fructose. Curr Opin Behav Sci. 2016;9:111–7. 10.1016/j.cobeha.2016.03.002
Rippe JM, Angelopoulos TJ. Sucrose, high-fructose corn syrup, and fructose, their metabolism and potential health effects: What do we really know? Adv Nutr. 2013;4(2):236–45. 10.3945/AN.112.002824
Shin M-K, Kim Y-S, Kim J-H, Kim S-H, Kim Y. Dietary patterns and their associations with the diet quality index-international (DQI-I) in Korean women with gestational diabetes mellitus. Clin Nutr Res. 2015;4(4):216. 10.7762/CNR.2015.4.4.216
Slining MM, Popkin BM. Trends in intakes and sources of solid fats and added sugars among U.S. children and adolescents: 1994–2010. Pediatr Obes. 2013;8(4):307–24. 10.1111/J.2047-6310.2013.00156.X
Sluik D, Engelen AI, Feskens EJ. Fructose consumption in the Netherlands: The Dutch National Food Consumption Survey 2007–2010. Eur J Clin Nutr. 2015;69(4):475–81. 10.1038/EJCN.2014.267
Stricker S, Rudloff S, Geier A, Steveling A, Roeb E, Zimmer KP. Fructose consumption-free sugars and their health effects. Deutsch Arztebl Int. 2021;118(5):71–80. 10.3238/ARZTEBL.M2021.0010
Triantafyllou GA, Paschou SA, Mantzoros CS. Leptin and hormones: Energy homeostasis. Endocrinol Metab Clin North Am. 2016;45(3):633–45. 10.1016/J.ECL.2016.04.012
Tur JA, Romaguera D, Pons A. The diet quality index-international (DQI-I): Is it a useful tool to evaluate the quality of the Mediterranean diet? Br J Nutr. 2005;93(3):369–76. 10.1079/BJN20041363
Vos MB, Kimmons JE, Gillespie C, Welsh J, Blanck HM. Dietary fructose consumption among US children and adults: The third National Health and Nutrition Examination Survey. Medscape J Med. 2008;10(7):160. PMid: 18769702.
Wheeler ML, Pi-Sunyer FX. Carbohydrate issues: Type and amount. J Am Diet Assoc. 2008;108(4 Suppl 1):S34-9. 10.1016/J.JADA.2008.01.024
World Health Organization (WHO). 2015. Guideline: Sugars intake for adults and children. https://www.who.int/publications/i/item/9789241549028
World Health Organization (WHO). 2008. Waist circumference and waist-hip ratio: Report of a WHO expert consultation. https://iris.who.int/bitstream/handle/10665/44583/9789241501491_eng.pdf?sequence=1
Yau AMW, McLaughlin J, Gilmore W, Maughan RJ, Evans GH. The acute effects of simple sugar ingestion on appetite, gut-derived hormone response, and metabolic markers in men. Nutrients. 2017;9(2):135. 10.3390/NU9020135
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Apr 4, 2025
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Keskin, E., & Yoldas Ilktac, H. (2025). Is fructose consumption associated with diet quality?: A cross-sectional study. Italian Journal of Food Science, 37(2), 374-381. https://doi.org/10.15586/ijfs.v37i2.2973
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Come citare
Keskin, E., & Yoldas Ilktac, H. (2025). Is fructose consumption associated with diet quality?: A cross-sectional study. Italian Journal of Food Science, 37(2), 374-381. https://doi.org/10.15586/ijfs.v37i2.2973