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Title:   Author  item
                                            STANHOPE, KIMBER - University Of Californiaitem
                                            MEDICI, VALENTINA - University Of Californiaitem
                                            BREMER, ANDREW - University Of Californiaitem
                                            LEE, VIVIEN - University Of Californiaitem
                                            LAM, HAZEL - University Of Californiaitem
                                            NUNEZ, MARINELLE - University Of Californiaitem
                                            CHEN, GUOXIA - University Of Californiaitem
                                            Keim, Nancyitem
                                            HAVEL, PETER - University Of California
  Submitted to: The American Journal of Clinical Nutrition
                                    Publication Type: Peer Reviewed Journal
                                    Publication Acceptance Date: 3/24/2015
                                    Publication  Date: 4/22/2015
                                    Citation: Stanhope, K.L., Medici, V., Bremer, A.A., Lee, V., Lam, H.D., Nunez, M.V., Chen, G.X., Keim, N.L., Havel, P.J. 2015. A dose-response of consuming high fructose corn syrup-sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults. American Journal of Clinical Nutrition. 101(6):1144-1154. doi: 10.3945/ajcn.114.100461.Interpretive Summary: There is controversy regarding the consumption of sugar and its potential to increase risk of chronic disease. To date, many of the controlled experiments conducted in humans have incorporated very high levels of sugars in the diet. In this study, we tested the effect of drinking beverages, sweetened with high fructose corn syrup, that provided high, moderate, low, or no calories from sugar in the daily diet of young adults for 2 weeks. We found increased levels of common risk factors for heart disease—the amount of triglycerides and  low-density lipoprotein cholesterol in blood—in response to the low dose and this response grew larger as the dose of sugar in the diet increased. These findings suggest that regular consumption of sugar, even at low doses, may contribute to higher risk of heart disease, and more research is needed to determine prudent levels of added sugar in the diet.
                                Technical Abstract: National Health and Nutrition Examination Survey data show increased risk of cardiovascular disease (CVD) mortality with increased intake of added sugar across quintiles. Objective: To determine the dose response effects of consuming beverages sweetened with high fructose corn syrup (HFCS) at zero, low, medium and high levels (0, 10, 17.5 or 25%) of energy requirements (Ereq) on uric acid and lipid/lipoprotein risk factors for CVD. Design: Parallel-arm, double-blinded intervention study. Setting: 3.5 inpatient days of baseline testing at University of California Davis Clinical Research Center (CCRC), followed by 12 outpatient days at home and then 3.5 inpatient days of intervention testing at the CCRC.Participants: 85 adults, age: 26 ± 6y; BMI: 24.7 ± 3.6kg/m2 (mean ± SD). Intervention:  Consumption of 0% (aspartame), 10%, 17.5% or 25% Ereq HFCS-sweetened beverages for 2 weeks. Main outcomes and measures: Plasma concentrations of fasting, postprandial and/or 24-hour lipids, lipoproteins, and uric acid. Results: Consuming beverages containing 0, 10, 17.5 or 25% Ereq from HFCS produced significant linear dose response effects in lipid/lipoprotein risk factors for CVD.  Late-evening postprandial triglycerides  (0%:0±4; 10%:22±8; 17.5%:25±5; 25%:37±5 mg/dl, mean of '±SE, P<0.0001 effect of HFCS dose), fasting low-density lipoprotein cholesterol (LDL-C) (0%:-1.0±3.1; 10%:7.4±3.2; 17.5%:8.2±3.1; 25%:15.9±3.1 mg/dl, P<0.0001), and 24-h mean uric acid concentrations (0%:-0.13±0.07; 10%:0.15±0.06; 17.5%:0.30±0.07; 25%:0.59±0.09 mg/dl, P=<0.0001) increased as dose of HFCS increased. Consumption of the HFCS-sweetened beverages significantly increased postprandial triglycerides and fasting and postprandial non-high-density lipoprotein-C, LDL-C, and apolipoprotein B, compared with baseline, even in participants consuming beverages providing 10% Ereq from HFCS. Conclusions and relevance: Consuming 0, 10, 17.5 or 25% Ereq from HFCS-sweetened beverages produced dose-dependent increases in all outcomes within 2 weeks in young adults, with significant increases of lipid/lipoprotein risk factors for CVD at even the 10% Ereq level. These results provide mechanistic support for the recent report of increased risk of CVD mortality with increased intake of added sugar across quintiles1. Humans may be sensitive to the adverse effects of sustained sugar consumption at a relatively wide range of intake levels. Carefully controlled diet intervention studies to determine prudent levels of added sugar consumption are needed.


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