I'd love to see more studies looking at glycated hemoglobin and heart disease risk. Many of the changes Dr. Davis recommends, limiting fructose  & glucose, wheat elimination,  and even correction of vitamin D levels can reduce a person's glycated hemoglobin levels.

Nephropal has a recent blog on fructose
Fructose Intake and Kidney Stones
I was interested to see the impact of fructose on magnesium status.
I wasn't aware also that
High fructose consumption combined with low dietary magnesium intake may increase the incidence of the metabolic syndrome by inducing inflammation

Stanhope et al is a very interesting study. I'd love to see it repeated with a larger group of subjects as well as with different percentages of fructose consumption and in diets with different macronutrient composition. I'm assuming fructose sweetened drinks were used rather than actual fruit as they are directly comparable with glucose sweetened drinks?

So I guess I've got to give up all fruit now. What is the acceptable level of fructose per day?

"a diet rich in fructose"

OK avoiding ALL wheat seems to be a good idea.  But avoid all/virtually all fructose?  Do you really think that for a healthy active person i.e. someone exercising, that say 1 cup of berries and an apple or 2 per day is too much fructose?

Okay, you make a clear case against fructose and sucrose... and I thank you for making it clear to us, but...

Fructose is in almost everything, including some of the most antioxidant rich, nutrient dense fruits and vegetables.  I'm sure your not advocating we all stop eating fresh pomegranates, apples, berries, tomatoes, peppers, lettuce, cabbage, etc.

We await your guidance on what would be a safe upper daily limit for fructose consumption that would help us avoid its coronary risk factors while we may continue to enjoy the numerous benefits that reside in the same foods.

So it's clear that what is proposed eg in the popular in Europe Montignac diet - use fructose in place of sugar due to its low GI - may be a harmful bs. But if I keep my carbs under 100g, do you think it makes much difference if it's fruit, honey, veggies or just a handful of pure fructose powder?

After watching the u-tube video "Sugar the Bitter Truth" by Dr. Lustig, I concluded that fructose is more a direct cause of heart disease rather than just another risk factor like cholesterol. Fructose actually causes the arteries to become inflamed and inflammation is the beginning of heart disease, right?
Josephine
Hawaii

Can you comment on the role of fresh fruits like apples,oranges,berries,etc?Do they also raise the risk factors?

Sugar Is a Poison, Says UCSF Obesity Expert
This article highlights the main points of Lustig's 80 minute video
Sugar: The Bitter Truth

This is what Lustig has to say on fruit.
Fruit is fine but we should think twice before drinking juice or feeding it to our kids. The fiber in whole fruit contributes to a sense of fullness. It is rare to see a child eat more than one orange, but it is common for kids to consume much more sugar and calories as orange juice.

Eating fiber also results in less carbohydrate being absorbed in the gut, Lustig notes. In addition, he says, fiber consumption allows the brain to receive a satiety signal sooner than it would otherwise, so we stop eating sooner.

The video goes into the biochemistry of fructose metabolism in some detail. I urge you to stick with it although it is quite complex. It gets a bit clearer when you reach the summary slides at the end.

As an answer to your many inquiries in todays comments. You can never go wrong following the lead of our ancient ancestors.  Yes they ate some fruit, mostly berries that were seasonaly availlable only,  very small and not very sweeet by todays standards.  I eat a cup or less of only berries, combined with 2 tablespoons of high antioxident cacao nibs and a tablespoon of ground flax seeds for breakfasy wvwry morning.  This keeps my blood sugar below <100 mg/dl and my A1c levels below 5.  This is a work in progress, because, I am on a constant experimental path of reversing my metabolic syndrom diseases.  As an asside, there is a Dr. Bernstein who wrote several books relative to diabetes, who said that he hasn't had a piece of fruit in 30 years, all without ersity what so ever.  

The few doctors who's advice I follow without question are You Dr. Davis along with Dr. Kenneth Tourgeman M.D. "nephropal.blogspot.com"

For health reasons, I strictly try to mimic the eating patterns of our early ancestors where possible.  Yes they ate fruit, limited by seasonal requirements.  However, the fruit they ate was very small and not very sweet, not like today's farm engineered varieties. Therefore, I limit what fruit I eat to one cup or less daily.  I combine this with 2 tablespoons of the antioxidant rich super food cacao nibs (dark chocolate), and 1 tablespoon of ground flax seeds.  When in doubt I ask myself the question, "what would my caveman ancestors have eaten?"  I live by this health supporting guide.  I find the food delicious and very satisfying.  

Of course, I would not do any of this without the sage advice of a few brave doctors who care only about reversing or curing disease and do not give a whit about following some outdated and wrong dogma. More valiant doctors must step up.  

I have become healthy because of you Dr. Davis, through your fine blog, and the direct care and supervision of Dr. Kenneth Tourgeman  "nephropal.blogspot.com"

The best types of fruit and berries are those with the highest nutrition to fructose ratio, like blueberries and strawberries. If eating an apple, consider just eating the skin and a little farther in; no need to eat all the way to the core.

Billye and StephenB--

Excellent insights into how to keep fruit in the diet without suffering its adverse effects.

Anon--

Yes, Dr. Lustig does an absolutely bang-up job of describing the rationale behind the destructive effects of fructose. It is the best presentation on this topic--and from the principal investigator, no less.

It is a must-see. I watched it last night.

Slides used in a previous presentation by Dr Lustig.
these are mostly the same as those used in his recent You Tube video but may be helpful for people with poor internet connections who are not able to watch the video.

Dr. Lustig's lecture is incredible-- I just finished watching it.

I think he overstates the case for fiber, and is too accepting of glucose in the diet, however. I agree that glucose is much better than fructose, and isn't a huge problem for a healthy person, but given that most Americans are metabolically "crippled" and teetering on the edge of diabetes, heart disease, etc., it would seem wise to me not to go pushing glucose as a great thing.

My quibbles with Dr. Lustig are minor, however. Overall it's a fantastic presentation.

How would you explain the evolution of primate frugivores in relation to human health, and why a diet probably greater than 50% fructose is obviously benign for them?

(Yes, I know current fruit varieties have more fructose.)

My daughter (who is Canadian) is currently in the US doing some research at the National Archives. She mentioned to me that she finds the fruit juice she's had too sweet to drink (she's staying at a hotel, so fresh fruit is hard to come by and the breakfast is all wheat). This was not only some anonymous apple juice, but also a bottle of Tropicana (she didn't check the label to see if there was added fructose), so she has switched to water. She also commented on how ridiculously large the portions were in restaurants.

It's no wonder that Americans are getting larger and larger (Canadians are too, but not as quickly.)

Also note that many foods labeled "heart healthy" because of low-fat, low saturated fat, addition of sterol esters, or fiber, also contain fructose sources, especially high-fructose corn syrup.

Hilarious Billye!

"For health reasons, I strictly try to mimic the eating patterns of our early ancestors where possible. Yes they ate fruit, limited by seasonal requirements. However, the fruit they ate was very small and not very sweet, not like today's farm engineered varieties. Therefore, I limit what fruit I eat to one cup or less daily. I combine this with 2 tablespoons of the antioxidant rich super food cacao nibs (dark chocolate), and 1 tablespoon of ground flax seeds. "

And did our ancient ancestor blend powdered cacao nibs and flax with their berries? SO much for strictly following cavemen.

This is fact. Hepatic metabolism of fructose also differs greatly from that of glucose. Fructose-induced hyperlipidemia has also been hypothesized to be of intestinal origin. That can be risky.

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Beautiful.

Thank you.