Abstract P277: Impact of Fructose and Fructose Containing Sugars on Indices of Cardiometabolic Health When Consumed at Typical Levels
Authors: Lowndes Joshua , Sinnett Stephanie , Grench Kory , Jordan Richard , Rippe James 
Published: July 2021

The American Heart Association recommends that women and men should not consume more than 100 or 150 kcal/day, respectively, from added sugars. Pure fructose in large dosages has been shown to adversely affect indices of cardiometabolic health in a variety of ways. However, pure fructose is rarely consumed, and it is unclear whether the same risks apply to the common sources of fructose in the American diet - sucrose and high fructose corn syrup (HFCS). The purpose of this study was to compare the effect on components of cardiometabolic health of fructose compared to other fructose containing sugars and glucose when consumed at levels typical of the American population.

268 individuals aged 20-60 years old were required to drink sugar-sweetened low fat milk every day for 10 weeks as part of their usual diet. All participants had been at a stable weight (± 3%) for 30 days prior to enrollment and were given recommendations on how to account for calories in the milk, but were given no further dietary guidance. The amount of milk consumed was individualized for each participant based on the estimated number of calories required to maintain body weight (via Miflin St Jeor equation) and random group assignment: Groups 1 and 2 - 9% estimated caloric intake from fructose or glucose respectively added to milk. Groups 3 and 4 - 18% of estimated caloric intake from HFCS or sucrose respectively added to the milk (50
th
percentile population consumption levels of fructose, 180-360 Kcal).

There was a small increase in body mass (162.2 ± 27.8 vs 164.2 ± 28.1 lbs, p<0.001) in the entire cohort, but there were no changes in HDL (52.51 ±12.77 vs 52.36 ± 12.40 mg/dl), CRP (1.63 ±1.77 vs 176 ±1.94 mg/L), fasting glucose (90 ± 6.50 vs 90.66 ±7.89 mg/dl), insulin (8.55 ±6.10 vs 11.20 ±39.32 (μIU/ml), HOMA measurement of insulin resistance (1.60 ±1.43 vs 1.74 ±1.29), or the glucose (13.28 ±2.53 vs 13.16 ±2.56 min*mg/dl) or insulin (2.52 ±1.32 vs 2.54 ± 1.57 min*mU/ml) area under the curve in response to an OGTT (all p>0.05). Small increases in waist circumference (80.88 ±9.45 vs 81.45 ± 9.46cm, p<0.001), abdominal fat measured by DEXA (36.31 ± 11.58 vs 36.84 ± 11.20% p<0.05), and Apolipoprotein B (86.53 ±25.79 vs 90.78 vs 25.62 mg/dl, p<0.001) were observed, but in all cases the type of sugar consumed had no effect on the response of any measure (p>0.05). The one exception was triglycerides, which increased in the entire cohort (101.56 ± 56.47 vs 111.70 vs 79.14mg/dl, p<0.01), but to a greater degree in the group consuming HFCS than compared to the group consuming glucose (98.20 ± 52.46 vs 129.03 ± 120.49 and 100.28 ±56.19 vs 99.86 ± 57.21mg/dl, p<0.05).

These data suggest that when consumed as part of normal diet at typical levels the effects of sugars on cardiovascular risk factors are small and primarily limited to aspects of body composition even when levels are substantially higher than those recommended by the AHA.