Glycemic and cardiometabolic effects of rare sugars allulose and tagatose: a systematic review and meta-analysis of controlled human intervention trials
Abstract
Background: Allulose and tagatose are rare monosaccharides gaining attention as potential alternatives to added sugars.
Objectives: This systematic review and meta-analysis aimed to evaluate the effects of allulose and tagatose supplementation on glycemic, cardiometabolic, and anthropometric outcomes in adults.
Methods: The Medline, Embase, and Cochrane libraries were searched through 30 April, 2025, for controlled human intervention trials reporting the effects of tagatose or allulose on postprandial and fasting glucose and insulin concentrations, blood lipids, uric acid, and anthropometric measures of adiposity in adults. Meta-analyses were conducted using mean differences (MDs) with random-effects models applied to all analyses. The risk of bias was evaluated using the Cochrane Risk of Bias 2 and Risk of Bias In Nonrandomized Studies-Interventions tools, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.
Results: Of 4905 initial reports, 20 trials were identified (12 allulose trials and 8 tagatose trials; 1033 participants). Allulose significantly reduced postprandial glucose [incremental AUC: standardized mean difference (SMD) = -0.66; 95% confidence interval: -0.92, -0.39; moderate certainty] and insulin [SMD = -1.27 (-2.14, -0.40); I2 = 96%; P = 0.03; moderate certainty], with no significant effects on glycated hemoglobin (HbA1c), fasting glucose or insulin, lipids, uric acid, or body…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,033 participants or records.
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