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Publication
Synergistic effects of fructose and glucose on lipoprotein risk factors for
cardiovascular disease in young adults.
Authors Hieronimus B, Medici V, Bremer AA, Lee V, Nunez MV, Sigala DM, Keim NL, Havel
PJ, Stanhope KL
Submitted By Submitted Externally on 3/9/2022
Status Published
Journal Metabolism: clinical and experimental
Year 2020
Date Published 11/1/2020
Volume : Pages 112 : 154356
PubMed Reference 32916151
Abstract Fructose consumption increases risk factors for cardiometabolic disease. It is
assumed that the effects of free sugars on risk factors are less potent because
they contain less fructose. We compared the effects of consuming fructose,
glucose or their combination, high fructose corn syrup (HFCS), on
cardiometabolic risk factors., Adults (18-40?years; BMI 18-35?kg/m2)
participated in a parallel, double-blinded dietary intervention during which
beverages sweetened with aspartame, glucose (25% of energy requirements (ereq)),
fructose or HFCS (25% and 17.5% ereq) were consumed for two weeks. Groups were
matched for sex, baseline BMI and plasma lipid/lipoprotein concentrations. 24-h
serial blood samples were collected at baseline and at the end of intervention.
Primary outcomes were 24-h triglyceride AUC, LDL-cholesterol (C), and
apolipoprotein (apo)B. Interactions between fructose and glucose were assessed
post hoc., 145 subjects (26.0?±?5.8?years; body mass index 25.0?±?3.7?kg/m2)
completed the study. As expected, the increase of 24-h triglycerides compared
with aspartame was highest during fructose consumption (25%: 6.66?mmol/Lx24h 95%
CI [1.90 to 11.63], P?=?0.0013 versus aspartame), intermediate during HFCS
consumption (25%: 4.68?mmol/Lx24h 95% CI [-0.18 to 9.55], P?=?0.066 versus
aspartame) and lowest during glucose consumption. In contrast, the increase of
LDL-C was highest during HFCS consumption (25%: 0.46?mmol/L 95% CI [0.16 to
0.77], P?=?0.0002 versus aspartame) and intermediate during fructose consumption
(25%: 0.33?mmol/L 95% CI [0.03 to 0.63], P?=?0.023 versus aspartame), as was the
increase of apoB (HFCS-25%: 0.108?g/L 95%CI [0.032 to 0.184], P?=?0.001;
fructose 25%: 0.072?g/L 95%CI [-0.004 to 0.148], P?=?0.074 versus aspartame).
The post hoc analyses showed significant interactive effects of fructose*glucose
on LDL-C and apoB (both P?significant interaction between fructose and glucose contributed to increases of
lipoprotein risk factors when the two monosaccharides were co-ingested as HFCS.
Thus, the effects of HFCS on lipoprotein risks factors are not solely mediated
by the fructose content and it cannot be assumed that glucose is a benign
component of HFCS. Our findings suggest that HFCS may be as harmful as
isocaloric amounts of pure fructose and provide further support for the urgency
to implement strategies to limit free sugar consumption.




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