The American journal of clinical nutrition
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The rise of blood glucose in normal and diabetic subjects after meals varies markedly and depends on many factors, including the source of the carbohydrate, its method of preparation, and the composition of the total meal. Classification of carbohydrates as simple or complex does not predict their effects on blood glucose or insulin. Rapidly absorbed carbohydrates, which produce large blood glucose and insulin responses, may be in the form of both sugars and starches. ⋯ The natural sugars in fruit and fruit juices raise blood glucose approximately as much as does sucrose and less than do most refined starchy carbohydrate foods. The optimum amount of sugars in the diet is not known. However, undue avoidance of sugars is not necessary for blood glucose control and is not advised because it may result in increased intakes of fat and high-glycemic-index starch.
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Carbohydrate sweeteners in the diet, which are sources of added sugars, have recently undergone changes that vary considerably among countries. The major driving force for these changes is a technological development that permits conversion of corn and other starches to sweeteners. Major changes in the type of sweeteners used in the United States began in the mid-1970s. ⋯ A UK Department of Health report followed in 1989. An overview of issues is provided, terminologies used to describe sugars and sweeteners are defined, the findings of the US and UK reports are reviewed, trends in the availability of added and naturally occurring sugars are evaluated, and recommendations for future assessment of sugars are discussed. The potential problem of underreporting of food intakes in national food consumption surveys is also reviewed.