Consumption of fructose and high fructose corn syrup increase postprandial triglycerides, LDL-cholesterol, and apolipoprotein-B in young men and women

Abstract

Context: The American Heart Association Nutrition Committee recommends women and men consume no more than 100 and 150 kcal of added sugar per day, respectively, whereas the Dietary Guidelines for Americans, 2010, suggests a maximal added sugar intake of 25% or less of total energy.

Objective: To address this discrepancy, we compared the effects of consuming glucose, fructose, or high-fructose corn syrup (HFCS) at 25% of energy requirements (E) on risk factors for cardiovascular disease. PARTICIPANTS, DESIGN AND SETTING, AND INTERVENTION: Forty-eight adults (aged 18-40 yr; body mass index 18-35 kg/m(2)) resided at the Clinical Research Center for 3.5 d of baseline testing while consuming energy-balanced diets containing 55% E complex carbohydrate. For 12 outpatient days, they consumed usual ad libitum diets along with three servings per day of glucose, fructose, or HFCS-sweetened beverages (n = 16/group), which provided 25% E requirements. Subjects then consumed energy-balanced diets containing 25% E sugar-sweetened beverages/30% E complex carbohydrate during 3.5 d of inpatient intervention testing.

Main outcome measures: Twenty-four-hour triglyceride area under the curve, fasting plasma low-density lipoprotein (LDL), and apolipoprotein B (apoB) concentrations were measured.

Results: Twenty-four-hour triglyceride area under the curve was increased compared with baseline during consumption of fructose (+4.7 ± 1.2 mmol/liter × 24 h, P = 0.0032) and HFCS (+1.8 ± 1.4 mmol/liter × 24 h, P = 0.035) but not glucose (-1.9 ± 0.9 mmol/liter × 24 h, P = 0.14). Fasting LDL and apoB concentrations were increased during consumption of fructose (LDL: +0.29 ± 0.082 mmol/liter, P = 0.0023; apoB: +0.093 ± 0.022 g/liter, P = 0.0005) and HFCS (LDL: +0.42 ± 0.11 mmol/liter, P < 0.0001; apoB: +0.12 ± 0.031 g/liter, P < 0.0001) but not glucose (LDL: +0.012 ± 0.071 mmol/liter, P = 0.86; apoB: +0.0097 ± 0.019 g/liter, P = 0.90).

Conclusions: Consumption of HFCS-sweetened beverages for 2 wk at 25% E increased risk factors for cardiovascular disease comparably with fructose and more than glucose in young adults.

Fig. 1.

Twenty-four-hour TG profiles during consumption of complex carbohydrate and during consumption of sugar-sweetened beverages. The change of 24-h TG concentrations over fasting concentrations during consumption of energy-balanced baseline diet containing 55% E complex carbohydrate at 0 wk and during consumption of energy-balanced intervention diet containing 30% E complex carbohydrate and 25% E glucose (A), fructose (B), or HFCS (C) at 2 wk (n = 16/group). Data are mean ± sem.

Fig. 2.

Effects of sugar-sweetened beverage consumption on TG concentrations. The change in 24-h TG AUC (A), late-night to late-evening TG (B), and fasting TG concentrations (C) compared with baseline after consuming 25% of energy requirements as glucose-, fructose-, or HFCS-sweetened beverages for 2 wk is shown. S, P < 0.05; SS, P < 0.01, effect of sugar; two-factor (sugar, gender) PROC MIXED analysis on Δ with adjustment for BMI (B), ΔBW (C), and outcome at baseline (A). *, P < 0.05, **, P < 0.01, ****, P < 0.0001, LS means different from zero. A, Δ different from B; Δ, Tukey's (n = 16/group). Data are mean ± sem.

Fig. 3.

Effects of sugar-sweetened beverage consumption on risk factors for cardiovascular disease. The change in fasting LDL (A), non-HDL-C (B), apoB concentrations (C), and apoB to apoA1 ratio (D) after consuming 25% of energy requirements as glucose-, fructose-, or HFCS-sweetened beverages for 2 wk. ss, P < 0.01, effect of sugar; two-factor (sugar, gender) PROC MIXED analysis on Δ with adjustment for BMI, ΔBW (D), and outcome at baseline (A–C). **, P < 0.01, ***, P < 0.001, ****, P < 0.0001, LS means different from zero. A, Δ different from B, Δ, Tukey's (n = 16/group). Data are mean ± sem.