Effect of Dietary Sugar Intake on Biomarkers of Subclinical Inflammation: A Systematic Review and Meta-Analysis of Intervention Studies.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of controlled intervention trials.
PubMed 29757229 · doi:10.3390/nu10050606
What was done
Authors conducted a systematic review and random-effects meta-analysis searching MEDLINE, EMBASE, and Cochrane databases for controlled intervention studies evaluating the effects of fructose, sucrose, high-fructose corn syrup (HFCS), and glucose on subclinical inflammation markers ((hs)CRP, IL-6, IL-18, IL-1RA, TNF-α, MCP-1, sICAM-1, sE-selectin, adiponectin). Included studies required adults or adolescents, ≥20 participants, and ≥2 weeks duration. Evidence quality was assessed using NutriGrade.
What was found
Thirteen studies with 1,141 participants were included, but only (hs)CRP had sufficient studies (≥3) to pool. Meta-analysis showed no significant difference in (hs)CRP between fructose intervention and glucose control groups (mean difference: −0.03 mg/L [95% CI: −0.52, 0.46], I² = 44%). There were also no differences between HFCS and sucrose interventions (mean difference: 0.21 mg/L [95% CI: −0.11, 0.53], I² = 0%). Both comparisons were rated as low quality of evidence by NutriGrade.
Why it matters
Available human trial data do not support the idea that dietary fructose or HFCS drives systemic subclinical inflammation more than other sugars.
Limits
Only (hs)CRP had enough data to be pooled in meta-analysis, leaving other key inflammatory biomarkers unanalyzed. The overall evidence base remains small, and NutriGrade ratings indicated low-quality evidence for the primary comparisons.
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- contradicts Diets high in added sugars chronically elevate C-reactive protein (CRP), an inflammatory marker correlated with tumor progression and metastasis.