CHICAGO, June 25 -- Fructose in sodas and other beverages -- but not glucose -- can set patients on the fast track to atherosclerosis, investigators here reported.
Overweight men and women assigned to drink fructose-sweetened beverages as 25% of their energy intake developed atherogenic lipid profiles in just two weeks, whereas those who drank glucose-sweetened drinks did not, said Kimber Stanhope, M.S., of the University of California at Davis, and colleagues.
"Compared with consumption of glucose, 10 weeks of fructose consumption as 25% of energy requirements promoted the development of an atherogenic lioproprotein phenotype and glucose intolerance/insulin resistance in older, overweight and obese men and women," Stanhope said at the American Diabetes Association meeting.
Fructose, which in the U.S. is mostly derived from corn syrup, is a common ingredient in soft drinks, including sodas and sweetened juices. It is about twice as sweet pound for pound as sucrose, and is relatively inexpensive, making it attractive to soft-drink makers.
Consumption of fructose-sweetened beverages increased by 135% from 1977 to 2001, Stanhope said. He speculated that the increased consumption could in part explain the rise in the rate of metabolic syndrome.
The investigators enrolled 23 overweight men and women into a randomized study. The patients were told that were participating in a diet study, but did not know that they would be getting drinks with one of two types of sugars.
The 23 patients, ranging in age from 43 to 70, had body mass-indices ranging from 25 to 35 kg/m2. They spent the first two weeks of the study on an inpatient unit for baseline measures, including 24 hour blood monitoring, while the patients ate an energy balanced diet. Additional 24-hour blood readings were collected at eight and 10 weeks.
The patients were then randomly assigned on an outpatient basis to eat their normal diets, with 25% of their energy requirements to come from either fructose-sweetened drinks (13 patients) or glucose-sweetened beverages (10 patients).
During the ninth week the patients came back to the clinical trials center for and additional two weeks to drink their assigned beverages while on the energy balanced diets.
The authors found that after just two weeks of fructose drinking, 24-hour postprandial triglycerides more than doubled, increasing by 212% + 59% (P<0.0001). In contrast, there was a non-significant trend toward decrease in triglycerides among the patients who drank glucose-sweetened beverages.
Neither fructose nor glucose consumption affected fasting triglyceride levels, however.
In addition, patients who took fructose had increases in fasting plasma concentrations of LDL (up 17% + 4%), Apolipoprotein B (up 28% 7%), small dense LDL (up 27% + 11%), postprandial concentrations of remnant lipoprotein (up 77% + 19%) and of remnant-like particle cholesterol (up 53% + 12%; P for each <0.01). None of these parameters was unchanged in patients who drank glucose.
"These effects appear to be exacerbated when fructose sweetened-beverages are consumed with a typical ad labium western diet compared with an energy-balanced moderate fat diet," she said.
No information on study funding sources or author conflicts of interest was available.Primary source: American Diabetes Association 2007 Scientific SessionsSource reference: Stanhope K et al. "Consumption of Fructiose-, but not Glucose-Sweetened Beverages Produces an Atherogenic Lipid Profile in Overweight/Obese Men and Women." Abstract 062, presented June 23.\
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