Submitted to: Journal of Clinical Investigation
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/11/2009
Publication Date: 5/1/2009
Publication URL: www.jci.org/articles/view/37385/pdf
Citation: Stanhope, K.L., Keim, N.L., Griffen, S.C., Bremer, A.A., Graham, J.L., Hatcher, B., Cox, C., Mcgahan, J.P., Seibert, A., Krauss, R.M., Chiu, S., Schaefer, E.J., Ai, M., Otokozawa, S., Nakajima, K., Nakano, T., Beysen, C., Schwarz, J.M., Hellerstein, M.K., Berglund, L., Havel, P.J. 2009. Effects of consuming fructose- or glucose-sweetened beverages for 10 weeks on lipids, insulin sensitivity and adiposity. Journal of Clinical Investigation. 119(5):1322-1334, 2009. Interpretive Summary: Consumption of sweeteners containing fructose has increased dramatically in the American diet over the past 3 decades, in parallel with the increasing incidence of obesity. We studied the effect of consuming large quantities of beverages (about 25% of total calorie intake) sweetened with fructose over a 10 week period in overweight men and women and compared the effects to those produced by an equivalent amount of beverages sweetened with pure glucose. The ingestion of fructose sweetened beverages led to increases in circulating lipids known to be associated with increased risk of heart disease, changes in glucose metabolism associated with increased risk of diabetes, and increases in body fat accumulation in the abdominal area. All of these changes indicate that consumption of large amounts of fructose on a daily basis produces multiple features of the metabolic syndrome and increases risk for development of chronic disease.
Technical Abstract: Animal studies have documented that, compared with glucose, dietary fructose promotes dyslipidemia and insulin resistance. Experimental evidence that fructose consumption in humans promotes dyslipidemia and insulin resistance compared with glucose consumption has been equivocal. We tested the hypothesis that 10 weeks of consuming fructose as beverages at 25% of energy requirements would promote dyslipidemia and decrease insulin sensitivity in overweight/obese adults (age 40-72 years) compared with glucose consumption. Fasting triglyceride concentrations were increased after 10-weeks of glucose consumption, but not after fructose consumption, whereas postprandial triglycerides were markedly increased (~100%) during fructose consumption, but not glucose consumption. Fasting concentrations of LDL, apoB, small dense LDL, oxidized LDL and postprandial concentrations of remnant-like lipoprotein (RLP)-TG and RLP-cholesterol were significantly increased after 10-weeks fructose consumption, but not after glucose consumption. Fasting plasma glucose, insulin and HOMA-IR were significantly increased in subjects consuming fructose, but unchanged in subjects consuming glucose. Insulin sensitivity was significantly decreased by ~17% after fructose consumption, but not after glucose consumption. Subjects consuming fructose exhibited significantly increased intra-abdominal fat accumulation, whereas subjects consuming glucose did not. Consumption of a high fructose diet promotes the development of dyslipidemia, insulin resistance, and visceral adiposity in overweight/obese adults.