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Rare sugars: metabolic impacts and mechanisms of action: a scoping review

Smith, Alison; Avery, Amanda; Ford, Rebecca; Yang, Qian; Goux, Aurélie; Mukherjee, Indraneil; Neville, David C.A.; Jethwa, Preeti

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Alison Smith

Aurélie Goux

Indraneil Mukherjee

David C.A. Neville


Food manufacturers are under increasing pressure to limit the amount of free sugars in their products. Many have reformulated products to replace sucrose, glucose and fructose with alternative sweeteners, but some of these have been associated with additional health concerns. Rare sugars are "monosaccharides and their derivatives that hardly exist in nature", and there is increasing evidence that they could have health benefits. This review aimed to scope the existing literature in order to identify the most commonly researched rare sugars, to ascertain their proposed health benefits, mechanisms of action and potential uses, and to highlight knowledge gaps. A process of iterative database searching identified 55 relevant articles. The reported effects of rare sugars were noted, along with details of the research methodologies conducted. Our results indicated that the most common rare sugars investigated are D-psicose and D-tagatose, with the potential health benefits divided into three topics: glycaemic control, body composition and cardiovascular disease. All the rare sugars investigated have the potential to suppress postprandial elevation of blood glucose and improve glycaemic control in both human and animal models. Some animal studies have suggested that certain rare sugars may also improve lipid profiles, alter the gut microbiome and reduce pro-inflammatory cytokine expression. The present review demonstrates that rare sugars could play a role in reducing the development of obesity, type 2 diabetes, and/or cardiovascular disease. However, understanding of the mechanisms by which rare sugars may exert their effects is limited, and their effectiveness when used in reformulated products is unknown.

Journal Article Type Article
Acceptance Date Sep 6, 2021
Online Publication Date Sep 10, 2021
Publication Date Aug 14, 2022
Deposit Date Sep 6, 2021
Publicly Available Date Sep 15, 2021
Journal British Journal of Nutrition
Print ISSN 0007-1145
Electronic ISSN 1475-2662
Peer Reviewed Peer Reviewed
Volume 128
Issue 3
Pages 389-406
Public URL
Publisher URL
Additional Information Copyright: © The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society; License: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.; Free to read: This content has been made available to all.


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