Background

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.

Methods

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.

Findings

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 < 0.01), but not on 24-h triglyceride (P = 0.340).

Conclusion

A 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.

中文翻译：

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果糖和葡萄糖对年轻人心血管疾病脂蛋白危险因素的协同作用。

背景

果糖摄入会增加心脏代谢疾病的危险因素。假设游离糖对风险因素的影响较小，因为它们含有较少的果糖。我们比较了食用果糖、葡萄糖或其组合、高果糖玉米糖浆 (HFCS) 对心脏代谢危险因素的影响。

方法

成年人（18-40 岁；BMI 18-35 kg/m ²）参与了一项平行的双盲饮食干预，在此期间，饮料中添加了阿斯巴甜、葡萄糖（能量需求的 25% (ereq)）、果糖或 HFCS（25 % 和 17.5% ereq) 被消耗了两周。各组的性别、基线 BMI 和血浆脂质/脂蛋白浓度相匹配。在基线和干预结束时收集 24 小时连续血样。主要结果是 24 小时甘油三酯 AUC、低密度脂蛋白胆固醇 (C) 和载脂蛋白 (apo)B。事后评估果糖和葡萄糖之间的相互作用。

发现

145 名受试者（26.0 ± 5.8 岁；体重指数 25.0 ± 3.7 kg/m ²）完成了研究。正如预期的那样，与阿斯巴甜相比，24 小时甘油三酯的增加在果糖消耗期间最高（25%：6.66 mmol/Lx24h 95% CI [1.90 至 11.63]， 与阿斯巴甜相比P = 0.0013），在 HFCS 消耗期间居中（25%： 4.68 mmol/Lx24h 95% CI [-0.18 至 9.55]，P  = 0.066（与阿斯巴甜相比），在葡萄糖消耗期间最低。相比之下，食用 HFCS 期间 LDL-C 的增加最高（25%：0.46 mmol/L 95% CI [0.16 至 0.77]， 与阿斯巴甜相比，P = 0.0002）和果糖消耗期间的中间值（25%：0.33 mmol/L 95% CI [0.03 至 0.63]，P = 0.023 与阿斯巴甜），apoB 的增加也是如此（HFCS-25%：0.108 g/L 95%CI [0.032 至 0.184]，P  = 0.001；果糖 25%：0.072 g/L 95%CI [-0.004 至0.148]，P  = 0.074 与阿斯巴甜）。

事后分析显示果糖*葡萄糖对 LDL-C 和 apoB 有显着的交互作用（均P  < 0.01），但对 24 小时甘油三酯无显着交互作用（P  = 0.340）。

结论

当两种单糖作为 HFCS 共同摄入时，果糖和葡萄糖之间的显着相互作用导致脂蛋白风险因素的增加。因此，HFCS 对脂蛋白风险因素的影响不仅仅由果糖含量介导，也不能假设葡萄糖是 HFCS 的良性成分。我们的研究结果表明，HFCS 可能与等热量的纯果糖一样有害，并进一步支持了实施限制游离糖消耗策略的紧迫性。