Greater insulin response to acute fructose ingestion among Māori and Pacific people compared to European people living in Aotearoa New Zealand

Intern Med J. 2019 Feb;49(2):196-202. doi: 10.1111/imj.14135.


Background: Fructose consumption has been linked with insulin resistance, obesity and diabetes, which are more prevalent in those of Māori or Pacific ethnicity compared to New Zealand European.

Aim: To determine whether the acute effects of fructose consumption on serum glucose, insulin, lipids and C-reactive protein differs according to body mass index (BMI) and/or ethnicity.

Methods: Participants of Māori (n = 25), Pacific (n = 26) or New Zealand European (n = 25) ethnicity consumed a 64 g fructose/16 g glucose solution. Changes in lipids, glucose, insulin and C-reactive protein were analysed using mixed models for repeated measures.

Results: After adjustment for age and gender, those with higher BMI had a higher glucose (P = 0.0064) and insulin (P = 0.0007) response than those with lower BMI. Those of Māori or Pacific ethnicity had similar glucose levels (P = 0.077) to those of New Zealand European ethnicity but higher insulin responses (P = 0.0005), which remained after additional adjustment for BMI (P = 0.001). Reported sugar-sweetened beverages (SSB) intake was higher among Māori and Pacific than New Zealand European (median 1.0 vs 0.0 SSB/day P = 0.002).

Conclusion: Even after adjustment for BMI, those of Māori and Pacific ethnicity have a significantly higher insulin response to fructose than New Zealand Europeans. Higher habitual SSB intake may be a contributing factor.

Keywords: Māori; Pacific; body mass index; ethnicity; fructose; insulin resistance.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose / analysis
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Eating*
  • Europe / ethnology
  • Female
  • Fructose / administration & dosage*
  • Healthy Volunteers
  • Humans
  • Insulin / blood*
  • Insulin Resistance / ethnology*
  • Male
  • Middle Aged
  • Native Hawaiian or Other Pacific Islander
  • New Zealand / ethnology
  • Pacific Islands / ethnology
  • Sugar-Sweetened Beverages
  • White People
  • Young Adult


  • Blood Glucose
  • Insulin
  • Fructose
  • C-Reactive Protein