The Role of High-Fructose Corn Syrup in Metabolic Syndrome and Hypertension
- 3k Downloads
Obesity and related diseases are an important and growing health concern in the United States and around the world. Soft drinks and other sugar-sweetened beverages are now the primary sources of added sugars in Americans’ diets. The metabolic syndrome is a cluster of common pathologies, including abdominal obesity linked to an excess of visceral fat, fatty liver, insulin resistance, hyperinsulinemia, dyslipidemia, and hypertension. Trends in all of these alterations are related to the consumption of dietary fructose and the introduction of high-fructose corn syrup (HFCS) as a sweetener in soft drinks and other foods. Experimental and clinical evidence suggests a progressive association between HFCS consumption, obesity, and the other injury processes. However, experimental HFCS consumption seems to produce some of the changes associated with metabolic syndrome even without increasing the body weight. Metabolic damage associated with HFCS probably is not limited to obesity-pathway mechanisms.
KeywordsHigh fructose corn syrup HFCS Cardiovascular disease Hypertension Dyslipidemia Metabolic syndrome
No potential conflicts of interest relevant to this article were reported.
Papers of particular interest, published recently, have been highlighted as: • Of importance, •• Of major importance
- 1.Ogden CL, Carroll MD, McDowell MA, Flegal KM: Obesity among adults in the United States—no change since 2003–2004. NCHS data brief no 1. Hyattsville, MD: National Center for Health Statistics. 2007.Google Scholar
- 6.•• Johnson RJ, Segal MS, Sautin Y, et al.: Potential role of sugar (fructose) in the epidemic of disease. Am J Clin Nutr 2007, 86(4):899–906. This very important review suggests that fructose intake may be a risk factor for hypertension, insulin resistance, hypertriglyceridemia, obesity, type 2 diabetes, preeclampsia, chronic kidney disease, stroke, cardiovascular disease, and mortality. It also shows that the appearance of these disorders is epidemiologically linked to increased fructose consumption.Google Scholar
- 13.• Stanhope KL, Schwarz JM, Keim NL, et al.: Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest 2009, 119(5):1322–1334. In this paper, Stanhope et al. demonstrate that consumption of fructose-sweetened (but not glucose-sweetened) beverages for 10 weeks increases de novo lipid synthesis, promotes dyslipidemia, impairs insulin sensitivity, and increases visceral adiposity in overweight or obese adults.Google Scholar
- 34.Reaven GM: Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988, 37(12):1595–1607.Google Scholar
- 36.Jalal DI, Smits G, Johnson R: Increased fructose intake is independently associated with elevated blood pressure. Findings from the National Health and Nutrition Examination Survey (2003-2006) [abstract TH-FC037]. Presented at American Society of Nephrology Renal Week. San Diego, CA; October 27–November 1, 2009.Google Scholar
- 44.Wei Y, Pagliassotti MJ: Hepatospecific effects of fructose on c-jun NH2-terminal kinase: implications for hepatic insulin resistance. Am J Physiol 2004, 287(5):E926–E933.Google Scholar
- 50.• Collison KS, Saleh SM, Bakheet RH, et al.: Diabetes of the liver: the link between nonalcoholic fatty liver disease and HFCS-55. Obesity (Silver Spring) 2009, 17(11):2003–2013. The aim of this study was to establish whether HFCS could contribute to the pathogenesis of NAFLD, by examining the effects of HFCS-55 on hepatocyte lipogenesis, insulin signaling, and cellular function in vitro and in vivo. Taken together, the findings indicate a potential mechanism by which HFCS may contribute to the pathogenesis of NAFLD.Google Scholar
- 52.• Sánchez-Lozada LG, Tapia E, Jimenez A, et al.: Fructose-induced metabolic syndrome is associated with glomerular hypertension and renal microvascular damage in rats. Am J Physiol Renal Physiol 2007, 292(1):F423–F429. A good experimental design showing that fructose administration in diet or drinking water induced hypertension, hyperuricemia, and hypertriglyceridemia. In addition, rats given higher fructose doses developed kidney hypertrophy, glomerular hypertension, cortical vasoconstriction, and arteriolopathy of preglomerular vessels. In summary, fructose-induced metabolic syndrome is associated with renal disturbances characterized by renal hypertrophy, arteriolopathy, glomerular hypertension, and cortical vasoconstriction.Google Scholar
- 57.•• Neilson EG: The fructose nation. J Am Soc Nephrol 2007, 18(10):2619–2621. This very good editorial summarizes the problem of high fructose intake and its emergence as a cheaper, widely used alternative to sucrose. This author also points out that obesity may not be the only driver of metabolic syndrome.Google Scholar
- 61.• Johnson RK, Appel LJ, Brands M, et al.: Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation 2009, 120(11):1011–1020. In this review, Johnson et al. analyze national survey data and show that excessive consumption of added sugars is contributing to overconsumption of discretionary calories by Americans. The American Heart Association recommends reductions in the intake of added sugars to no more than 100 calories per day for most American women and no more than 150 calories per day for most American men.Google Scholar