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100% Fruit juice and measures of glycemic control and insulin sensitivity: a meta‐analysis of randomized controlled trials
Author(s) -
Murphy Mary M,
Barrett Erin C,
Barraj Leila M
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.902.4
Subject(s) - glycemic , meta analysis , randomized controlled trial , medicine , micronutrient , insulin , homeostatic model assessment , insulin resistance , glycemic index , insulin sensitivity , pathology
Fruit juices are nutrient dense foods providing a range of micronutrients and bioactive substances. Nutritional guidance, however, typically recommends limited consumption of fruit in the form of juice due to concerns over low fiber content and potential for overconsumption. Consumption of fruit is promoted to support health though the effects of 100% fruit juice (100% FJ) consumption on measures of glucose control are conflicting. The purpose of this study was to systematically review and quantitatively summarize results from randomized controlled trials (RCTs) of 100% FJ on glycemic control and insulin sensitivity. Eligible studies were identified from a systematic review of PubMed and hand searches of reference lists from reviews and relevant papers. Using data from 17 RCTs, meta‐analyses evaluated the standardized mean difference (SMD) in fasting blood glucose (15 studies), fasting blood insulin (11 studies), and the homeostatic model assessment of insulin resistance (HOMA‐IR, 6 studies) between the 100% FJ intervention and control groups. Analyses were first conducted using a fixed effects model. If significant heterogeneity was observed (p‐value<0.1, I 2 statistic >50%), analyses were repeated assuming a random effects model. For sub‐analyses of outcomes with data from fewer than three trials, the fixed effects model was used. Statistical analyses for the meta‐analysis were completed with STATA, version 12.1. Compared to the control group, 100% FJ had no significant effect on the SMD of fasting blood glucose (−0.20, 95% CI: −0.43, 0.02, p=0.08, I 2 = 68.4, random effects), fasting blood insulin (−0.07, 95% CI: −0.20, 0.06, p=0.27, I 2 = 0, fixed effects), or HOMA‐IR (−0.16, 95% CI: −0.41, 0.10, p=0.22, I 2 = 58.4, random effects). Statistically significant associations were detected in sub‐analyses of fasting blood glucose by type of fruit juice (berry juice), type of control product (no beverage control), geographic location of the study (Asia), and study quality (Jadad score < 4) and in sub‐analyses of HOMA‐IR by duration of intervention (2–7 weeks). In all cases the observed effect in sub‐analyses was beneficial (i.e., reduced fasting blood glucose or insulin), though the significance of these findings may be limited by the small number of trials. These findings from RCTs, which relate to markers for diabetes, are consistent with findings from some observational studies which suggest that consumption of 100% fruit juice is not associated with increased risk of diabetes. High quality studies of longer duration with glycemic control and insulin sensitivity as primary outcomes for interventions using commonly consumed juices may help to clarify the role of 100% fruit juice on markers of diabetes. Support or Funding Information Supported by the Juice Products Association.