The Effects of Fructose-Containing Sugars on Weight, Body Composition and Cardiometabolic Risk Factors When Consumed at up to the 90th Percentile Population Consumption Level for Fructose

Abstract

The American Heart Association (AHA) and World Health Organization (WHO) have recommended restricting calories from added sugars at lower levels than the Institute of Medicine (IOM) recommendations, which are incorporated in the Dietary Guidelines for Americans 2010 (DGAs 2010). Sucrose (SUC) and high fructose corn syrup (HFCS) have been singled out for particular concern, because of their fructose content, which has been specifically implicated for its atherogenic potential and possible role in elevating blood pressure through uric acid-mediated endothelial dysfunction. This study explored the effects when these sugars are consumed at typical population levels up to the 90th percentile population consumption level for fructose. Three hundred fifty five overweight or obese individuals aged 20–60 years old were placed on a eucaloric diet for 10 weeks, which incorporated SUC- or HFCS-sweetened, low-fat milk at 8%, 18% or 30% of calories. There was a slight change in body weight in the entire cohort (169.1 ± 30.6 vs. 171.6 ± 31.8 lbs, p < 0.01), a decrease in HDL (52.9 ± 12.2 vs. 52.0 ± 13.9 mg/dL, p < 0.05) and an increase in triglycerides (104.1 ± 51.8 vs. 114.1 ± 64.7 mg/dL, p < 0.001). However, total cholesterol (183.5 ± 42.8 vs. 184.4 mg/dL, p > 0.05), LDL (110.3 ± 32.0 vs. 110.5 ± 38.9 mg/dL, p > 0.05), SBP (109.4 ± 10.9 vs. 108.3 ± 10.9 mmHg, p > 0.05) and DBP (72.1 ± 8.0 vs. 71.3 ± 8.0 mmHg, p > 0.05) were all unchanged. In no instance did the amount or type of sugar consumed affect the response to the intervention (interaction p > 0.05). These data suggest that: (1) when consumed as part of a normal diet, common fructose-containing sugars do not raise blood pressure, even when consumed at the 90th percentile population consumption level for fructose (five times the upper level recommended by the AHA and three times the upper level recommended by WHO); (2) changes in the lipid profile are mixed, but modest.

Fructose-Containing Sugars and Cardiovascular Disease

“…In trials in our laboratory involving various levels of sugar consumption, ranging from the 25th to 95th percentile population consumption level for fructose (160-600 kcal/d), no changes in LDL cholesterol were demonstrated after 10 wk in a free-living environment compared with baseline when consumed as part of a mixed-nutrient diet (54). Thus, the effects of sugar, in general, and fructose-containing sugars, in particular, on LDL cholesterol remain in dispute.…”

High Fructose Corn Syrup and Sucrose Sweetened Milk Improve Dietary Quality during Weight Loss by Displacing Energy Dense, Nutrient Poor Foods

“…The higher carbohydrate diet employed in the Women's Health Initiative had no effect on either triglycerides or high density lipoprotein [42]. Some investigators have suggested that added sugars may increase abnormalities by raising low density lipoprotein (LDL) [43] [44], although research in our laboratory has yielded no change in either LDL or total cholesterol [34] [45].…”

“…It has been argued that degradation of fructose, which is a component of both HFCS and sucrose, may result in increased levels of uric acid which, in turn, result in endothelial dysfunction and high blood pressure [31]- [33]. Research in our laboratory has not demonstrated increases in uric acid, systolic, or diastolic blood pressure in response to increased consumption of sugar sweetened beverages at up to the 90 th percentile population consumption level for fructose [34]. Some epidemiologic studies have suggested that there is an increased risk of obesity and poor dietary quality amongst individuals who consume large amounts of sugar sweetened beverages [35]- [37].…”

Sugars and Health Controversies: What Does the Science Say?

“…Other studies have not corroborated these findings. Results from several RCTs from our research laboratory did not show elevations in blood pressure at amounts up to the 90th percentile population consumption level for fructose-containing sugars (49,50). Thus, there is little evidence to support that sugar consumption per se is a significant risk factor for elevated blood pressure.…”

“…Research in an RCT in our laboratory, however, showed that individuals who consumed either sucrose or HFCS at 10% or 20% of total calories (25th or 50th percentile population intake levels of fructose) in an isocaloric diet in a free-living environment showed no changes in total cholesterol, TGs, LDL cholesterol, or apoB (36). In a mildly hypercaloric trial, however, a 10% increase in TGs occurred (49,50). Thus, it appears that adverse effects of sugars related to lipids are more likely to be a result of excess energy than to sugar per se.…”