Researchers say fructose does not impact emerging indicator for cardiovascular disease

Fructose, the sugar often blamed for the obesity epidemic, does not itself have any impact on an emerging marker for the risk of cardiovascular disease known as postprandial triglycerides, new research has found.

03 jan 2014--However, overconsumption of calories from fructose can have substantial adverse effects on health, said Dr. John Sievenpiper, a researcher in the Clinical Nutrition and Risk Factor Modification Centre of St. Michael's Hospital.

"This is more evidence that fructose has adverse effects only insofar as it contributes to excess calories," said Dr. Sievenpiper.

Fructose, which is naturally found in fruit, vegetables and honey, is a simple sugar that together with glucose forms sucrose, the basis of table sugar. It is also found in high-fructose corn syrup, the most common sweetener in commercially prepared foods.

Dr. Sievenpiper conducted a meta-analysis of existing studies on fructose and its impact on the level of triglycerides, a fat found in blood, after eating. Testing for these triglycerides—in addition to the standard testing for blood glucose levels—is becoming more common for people trying to determine their risk for cardiovascular disease, although health care professionals remain divided on its usefulness.

Dr. Sievenpiper's results appear in the January 2014 issue of the journal Atheroclerosis.

"Fructose doesn't behave any differently than other refined carbohydrates," he said. "The increases you see are when fructose provides extra calories."

Provided by St. Michael's Hospital

Fructose consumption increases risk factors for heart disease

A recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM) found that adults who consumed high fructose corn syrup for two weeks as 25 percent of their daily calorie requirement had increased blood levels of cholesterol and triglycerides, which have been shown to be indicators of increased risk for heart disease.

31 july 2011--The American Heart Association recommends that people consume only five percent of calories as added sugar. The Dietary Guidelines for Americans 2010 suggest an upper limit of
25 percent or less of daily calories consumed as added sugar. To address this discrepancy in recommended consumption levels, researchers examined what happened when young overweight and normal weight adults consumed fructose, high fructose corn syrup or glucose at the 25 percent upper limit.

"While there is evidence that people who consume sugar are more likely to have heart disease or diabetes, it is controversial as to whether high sugar diets may actually promote these diseases, and dietary guidelines are conflicting," said the study's senior author, Kimber Stanhope, PhD, of the University of California, Davis. "Our findings demonstrate that several factors associated with an elevated risk for cardiovascular disease were increased in individuals consuming 25 percent of their calories as fructose or high fructose corn syrup, but consumption of glucose did not have this effect."

In this study, researchers examined 48 adults between the ages of 18 and 40 years and compared the effects of consuming 25 percent of one's daily calorie requirement as glucose, fructose or high fructose corn syrup on risk factors for cardiovascular disease. They found that within two weeks, study participants consuming fructose or high fructose corn syrup, but not glucose, exhibited increased concentrations of LDL cholesterol, triglycerides and apolipoprotein-B (a protein which can lead to plaques that cause vascular disease).

"These results suggest that consumption of sugar may promote heart disease," said Stanhope. "Additionally our findings provide evidence that the upper limit of 25 percent of daily calories consumed as added sugar as suggested by The Dietary Guidelines for American 2010 may need to be re-evaluated."

Provided by The Endocrine Society

The not-so-sweet truth about sugar : a risk choice?

More and more people have become aware of the dangers of excessive fructose in diet. A new review on fructose in an upcoming issue of the Journal of the American Society of Nephrology (JASN) indicates just how dangerous this simple sugar may be.

23 nov 2010--Richard J. Johnson, MD and Takahiko Nakagawa, MD (Division of Renal Diseases and Hypertension, University of Colorado) provide a concise overview of recent clinical and experimental studies to understand how excessive amounts of fructose, present in added sugars, may play a role in high blood pressure, diabetes, obesity, and chronic kidney disease (CKD).

Dietary fructose is present primarily in added dietary sugars, honey, and fruit. Americans most frequently ingest fructose from sucrose, a disaccharide containing 50% fructose and 50% glucose bonded together, and high fructose corn syrup (HFCS), a mixture of free fructose and free glucose, usually in a 55/45 proportion. With the introduction of HFCS in the 1970s, an increased intake of fructose has occurred and obesity rates have risen simultaneously.

The link between excessive intake of fructose and metabolic syndrome is becoming increasingly established. However, in this review of the literature, the authors conclude that there is also increasing evidence that fructose may play a role in hypertension and renal disease. "Science shows us there is a potentially negative impact of excessive amounts of sugar and high fructose corn syrup on cardiovascular and kidney health," explains Dr. Johnson. He continues that "excessive fructose intake could be viewed as an increasingly risky food and beverage additive."

Concerned that physicians may be overlooking this health problem when advising CKD patients to follow a low protein diet, Dr. Johnson and Dr. Nakagawa recommend that low protein diets include an attempt to restrict added sugars containing fructose.

More information: The article, entitled "The Effect of Fructose on Renal Biology and Disease," will appear online on November 29, 2010

Provided by American Society of Nephrology

ADA: Cheap Fructose May Exact High Metabolic Price

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.\