A dose-response study of consuming high-fructose corn syrup-sweetened beverages on lipid/lipoprotein risk factors for cardiovascular disease in young adults
Open accessAbstract
Background National Health and Nutrition Examination Survey data show an increased risk of cardiovascular disease (CVD) mortality with an increased intake of added sugar.Objective We determined the dose-response effects of consuming beverages sweetened with high-fructose corn syrup (HFCS) at zero, low, medium, and high proportions of energy requirements (Ereq) on circulating lipid/lipoprotein risk factors for CVD and uric acid in adults [age: 18-40 y; body mass index (in kg/m(2)): 18-35].Design We conducted a parallel-arm, nonrandomized, double-blinded intervention study in which adults participated in 3.5 inpatient days of baseline testing at the University of California Davis Clinical and Translational Science Center's Clinical Research Center. Participants then consumed beverages sweetened with HFCS at 0% (aspartame sweetened, n = 23), 10% (n = 18), 17.5% (n = 16), or 25% (n = 28) of Ereq during 13 outpatient days and during 3.5 inpatient days of intervention testing at the research center. We conducted 24-h serial blood collections during the baseline and intervention testing periods.Results Consuming beverages containing 10%, 17.5%, or 25% Ereq from HFCS produced significant linear dose-response increases of lipid/lipoprotein risk factors for CVD and uric acid: postprandial triglyceride (0%: 0 ± 4; 10%: 22 ± 8; 17.5%: 25 ± 5: 25%: 37 ± 5 mg/dL, mean of Δ ± SE, P < 0.0001 effect of HFCS-dose), fasting LDL cholesterol (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). Compared with beverages containing 0% HFCS, all 3 doses of HFCS-containing beverages increased concentrations of postprandial triglyceride, and the 2 higher doses increased fasting and/or postprandial concentrations of non-HDL cholesterol, LDL cholesterol, apolipoprotein B, apolipoprotein CIII, and uric acid.Conclusions Consuming beverages containing 10%, 17.5%, or 25% Ereq from HFCS produced dose-dependent increases in circulating lipid/lipoprotein risk factors for CVD and uric acid within 2 wk. These results provide mechanistic support for the epidemiologic evidence that the risk of cardiovascular mortality is positively associated with consumption of increasing amounts of added sugars. This trial was registered at clinicaltrials.gov as NCT01103921.
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Meta-analyses have reported efficacy of omega-3 fatty acids in lowering serum triglycerides.
“The efficacy of omega-3 fatty acids in lowering serum TGs has also been reported in meta-analyses [157].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [157]
Sucrose is an important dietary source of fructose.
“Sucrose, a disaccharidecontaining glucose and fructose, represents an important source of fructose in the diet. 158,175”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [175]
The effects of fructose on triglycerides are dose dependent; with habitual fructose intake between 15% and 20% of total energy, plasma triglycerides increase by as much as 30-40%.
“These effects are dose dependent; with a habitual fructose consumption between 15 and 20% of the total energy intake, plasma TG increases as much as 30-40%.”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [175]
Habitual consumption of significant amounts of dietary fructose, more than 10% of energy, contributes to triglyceride elevations, particularly in people with hypertriglyceridaemia.
“Habitual consumption of significant amounts ( . 10% energy) of dietary fructose contributes to TG elevations, particularly in people with HTG.”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [175]
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References 53 · Cited by 270
- Authors
- 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.
- Affiliations
- Western Human Nutrition Research Center (US)
- Corresponding author
- Stanhope, Kimber L
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2015-06
- Volume
- 101
- Issue
- 6
- Pages
- 1144-1154
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC4441807
- OpenAlex
- W2043105362
- Cited by
- 270
- References
- 53
- Citations by year
- 2026: 6 · 2025: 11 · 2024: 11 · 2023: 27 · 2022: 24 · 2021: 33 · 2020: 29 · 2019: 24 · 2018: 26 · 2017: 36 · 2016: 34 · 2015: 9
- FWCI
- 30.35
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- NIH/National Heart, Lung and Blood Institute (1R01 HL09133, 1R01 HL107256)
- National Center for Research Resources
- NIH Roadmap for Medical Research (UL1 RR024146)
- Building Interdisciplinary Research Careers
- National Institute of Child Health and Human Development
- Office of Research on Women’s Health
- Women’s Health (K12 HD051958)
- Office of Dietary Supplements (USDA-ARS CRIS 5306-51530-022-00D)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- high fructose corn syrup, sweetened beverages, added sugars, cardiovascular risk factors, LDL cholesterol, triglycerides, uric acid, dose-response relationship, young adults, aspartame, energy intake, dyslipidemia, hyperuricemia, hypertriglyceridemia
- MeSH terms
- Adolescent, Adult, Apolipoproteins B, Beverages, Blood Glucose, Cardiovascular Diseases, Dose-Response Relationship, Drug, Double-Blind Method, Fasting, Female, Humans, Cholesterol, HDL, Cholesterol, LDL, Male, Nutrition Surveys, Risk Factors, Sweetening Agents, Triglycerides, Uric Acid, Body Mass Index, Postprandial Period, Apolipoprotein C-III, Waist Circumference, Young Adult, High Fructose Corn Syrup
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