Consuming sucrose- or HFCS-sweetened beverages increases hepatic lipid and decreases insulin sensitivity in adults

Authors: SIGALA, DESIREE - University Of California, Davis; HIERONIMUS, BETTINA - Max Rubner-Institut (MRI); MEDICI, VALENTINA - Uc Davis Medical Center; LEE, VIVIEN - University Of California, Davis; NUNEZ, MARINELLE - University Of California, Davis; BREMER, ANDREW - Uc Davis Medical Center; COX, CHAD - California State University; PRICE, CANDICE - University Of California, Davis; BENYAM, YANET - University Of California, Davis; CHAUDHARI, ABHIJIT - Uc Davis Medical Center; ABDELHAFEZ, YASSER - Uc Davis Medical Center; MCGAHAN, JOHN - Uc Davis Medical Center; GORAN, MICHAEL - Children'S Hospital Los Angeles; SIRLIN, CLAUDE - University Of California, San Diego; PACINI, GIOVANNI - National Research Council - Italy; TURA, ANDREA - National Research Council - Italy; Keim, Nancy; HAVEL, PETER - University Of California, Davis; STANHOPE, KIMBER - University Of California, Davis

Submitted to: Journal of Clinical Endocrinology and Metabolism
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/6/2021
Publication Date: 7/15/2021
Citation: Sigala, D.M., Hieronimus, B., Medici, V., Lee, V., Nunez, M.V., Bremer, A.A., Cox, C.L., Price, C.A., Benyam, Y., Chaudhari, A.J., Abdelhafez, Y., McGahan, J.P., Goran, M., Sirlin, C.B., Pacini, G., Tura, A., Keim, N.L., Havel, P.J., Stanhope, K.L. 2021. Consuming sucrose- or HFCS-sweetened beverages increases hepatic lipid and decreases insulin sensitivity in adults. Journal of Clinical Endocrinology and Metabolism. 106(11):3248-3264. https://doi.org/10.1210/clinem/dgab508.
DOI: https://doi.org/10.1210/clinem/dgab508

Interpretive Summary: Young adults have high consumption of sweeteners in the form of sugar-sweetened beverages. These beverages contribute to added sugars that should only be consumed in moderation, due to accumulating evidence that added sugars are linked with obesity and metabolic diseases. In this study, the focus was on young adults to determine the effects of consuming large quantities of beverages sweetened with the caloric sweeteners: either high fructose corn syrup (HFCS), sucrose, or the non-caloric sweetener, aspartame. Along with eating their usual diets, study volunteers consumed the caloric sweeteners at 25% of energy needs, or the non-caloric sweetener at 0% of energy needs, over a 2-week period. We found that both HFCS and sucrose increased the amount of liver fat, and lead to worsened glucose tolerance, compared to the non-caloric sweetener. These findings, along with other emerging data regarding sugar-sweetened beverages, suggest that new, feasible strategies to limit the consumption of added sugars in beverages are needed.

Technical Abstract: Context: Studies in rodents and humans suggest that HFCS-sweetened diets promote greater metabolic dysfunction than sucrose-sweetened diets. Objective: To compare the effects of consuming three sweetened beverages (SB): HFCS-SB, sucrose-sweetened beverage (SB), or a control beverage sweetened with aspartame on metabolic outcomes in humans. Design: A parallel, double-blinded, NIH-funded study. Setting: Experimental procedures were conducted during 3.5 days of inpatient residence with controlled feeding at a research clinic before (baseline) and after a 12-day outpatient intervention period. Participants: 75 adults (18-40 years) were assigned to SB groups matched for sex, BMI (18-35kg/m2), fasting triglyceride, lipoproteins and insulin concentrations. Intervention: 3 servings/day of HFCS- or sucrose-SB providing 25% of energy requirement or aspartame-SB, consumed for 16 days. Main Outcome Measures: %hepatic lipid, Matsuda insulin sensitivity index (ISI), Predicted M ISI. Results: SB-group significantly affected (P=0.020) the absolute changes in hepatic lipid induced by consumption of sucrose-SB (0.6±0.2%, P<0.001 vs baseline), HFCS-SB (0.4±0.2%, P<0.05 vs baseline) and aspartame-SB (-0.2±0.2%). SB-group affected both Matsuda (P=0.0014) and Predicted M ISI (P=0.045), with insulin sensitivity decreasing after consumption of sucrose-SB (Matsuda: -0.50±0.18, P<0.01; Predicted M: -0.058±0.027, P<0.05 versus baseline) and HFCS-SB (Matsuda: -0.22±0.16, P<0.01; Predicted M: -0.075±0.034, P<0.01 versus baseline), but not aspartame-SB (Matsuda: 0.30±0.14; Predicted M: 0.026±0.025). Sucrose- and HFCS-SB increased fasting and postprandial plasma concentrations of lipids, lipoproteins, and uric acid compared with aspartame-SB. No outcomes were differentially affected by sucrose- compared with HFCS-SB. Effects of SB-group remained significant when analyses were adjusted for changes in body weight. Conclusions: Both sucrose- and HFCS-SB induced detrimental changes in hepatic lipid, insulin sensitivity, and circulating lipids, lipoproteins and uric acid.