Intake of high fructose corn syrup sweetened soft drinks, fruit drinks and apple juice is associated with prevalent coronary heart disease, in U.S. adults, ages 45–59 y

Abstract

Background: Intake of high excess free fructose (EFF) beverages, including high fructose corn syrup (HFCS), sweetened soft drinks, fruit drinks, and apple juice, may be associated with childhood asthma, adult idiopathic chronic bronchitis/ COPD, and autoimmune arthritis, possibly due to underlying fructose malabsorption. Fructose malabsorption may contribute to the intestinal in situ formation of advanced glycation end-products (enFruAGEs) that travel to other tissues and promote inflammation. Chronic respiratory conditions and arthritis are comorbidities of coronary heart disease (CHD). The objective of this study was to investigate the association between intake of high EFF beverages and CHD. Methods: In this cross sectional study (NHANES 2003(NHANES -2006 of adults, aged 45-59 y, n = 1230, the exposure variables were non-diet soft drinks, and any combination of high EFF beverages including non-diet soft drinks, fruit drinks, and apple juice. Analyses of diet soft drinks, diet fruit drinks, and orange juice (non/low EFF beverages) were included for comparison. The outcome was self-reported history of coronary heart disease and/or angina (CHD). Rao Scott Ҳ 2 was used for prevalence differences and logistic regression for associations, adjusted for age, sex, raceethnicity, BMI, socio-economic status, health insurance coverage, smoking, physical activity level, hypertension, energy intake, fruit and vegetable intake, glycated hemoglobin, pre-diabetes, and diabetes.Results: Intake of any combination of HFCS sweetened soft drinks, fruit drinks, and apple juice (tEFF) was significantly associated with CHD in adults aged 45-59 y. Adults consuming tEFF ≥5 times/wk. were 2.8 times more likely to report CHD than ≤3 times/mo consumers (OR 2.82; 95% CI 1.16-6.84; P = 0.023), independent of all covariates.Conclusion: HFCS sweetened soft drinks, fruit drinks, and apple juice may contribute to CHD, a common comorbidity of chronic respiratory conditions and autoimmune arthritis, possibly due to the high ratio of fructose to glucose in these beverages. Underlying fructose malabsorption may contribute to the intestinal in situ formation of pro-inflammatory enFruAGEs, that are eventually absorbed and induce inflammation of the coronary arteries. Additional research is needed.

Excess free fructose, apple juice, high fructose corn syrup and childhood asthma risk – the National Children’s Study

“…This study and prior research results [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] are consistent with the "fructositis" hypothesis [10] -that unabsorbed unpaired fructose in the gut of fructose Cox regression hazard ratios (HR), their 95% confidence intervals and p values are shown. Significant associations are denoted with asterisks.…”

“…However, existing research shows that intake prevalence at 12 months [42,48] and usual intake patterns [46] of 100% juice and soda/fruit drinks persist through ages two and 3 years. Furthermore, results are consistent with case study evidence [10], and prior studies, [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] including research wherein soda intake was associated with doctor diagnosed active asthma among hospital admitted patients [27]. Another limitation is that 100% juice types were not distinguished, which limited our ability to measure the true risk associated with apple vs. other juices.…”

“…Recent case study [10] motivated epidemiological [11][12][13][14][15][16], biochemical [17][18][19], and other research [20][21][22][23][24][25][26][27][28] provides consistent evidence that the asthma epidemic may be associated with the ubiquitous presence of high fructose corn syrup (HFCS) [29,30] in the US food supply. Results [10] of a rigorous food elimination diet [31], in a normal weight 2-3 year old, provided evidence that HFCS intake triggers gastro-intestinal distress, airway mucus hypersecretion that overwhelms the airways, chronic bronchitis, asthma and joint pain.…”

Influence of information received by the consumer on the sensory perception of processed orange juice

“…The terms used were: watery, orange color, fruit, overripe, acid, natural, cloudy, transparent, cooked flavor (Lee et al, ), bitter, artificial, sweet smell, citric, sweet (Pineli, Aguiar, Fiusa, et al, ), for kids, cheap, expensive, breakfast (Cardinal, Zamora, Chambers, Carbonell Barrachina, & Hough, ). In addition, we used scientific criteria attributed to orange juice, such as nutritive, healthy, vitamin C (O'Neil, Nicklas, Rampersaud, & Fulgoni, ), durability (Mastello, Janzantti, Bisconsin‐Júnior, & Monteiro, ), tasty (Kim, Lee, Kwak, & Kang, ), sugar (MacGregor & Hashem, ; Shefferly, Scharf, & DeBoer, ), high calorie (Van Grieken, Renders, van de Gaar, Hirasing, & Raat, ), preservative (Zengin, Yüzbasıoglu, Ünal, Yilmaz, & Aksoy, ), unhealthy (DeChristopher, Uribarri, & Tucker, ; Shefferly et al, ), chemical (Linke, Casagrande, & Cardoso, ; Zhang & Ma, ), sustainable (Aschemann‐Witzel, ).…”

How can previous knowledge about food science/technology and received information affect consumer perception of processed orange juice?

“…The terms used were: watery, orange color, fruit, natural, consistent, cooked flavor (Lee, Findlay, & Meullenet, ), bitter, artificial, citric smell, sweet (Pineli et al, ), for kids, cheap, expensive, breakfast (Cardinal, Zamora, Chambers, Carbonell Barrachina, & Hough, ). In addition, we used scientific criteria attributed to orange juice, such as nutritious, healthy, vitamin C (O'neil, Nicklas, Rampersaud, & Fulgoni, ), durable (Mastello, Janzantti, Bisconsin‐Júnior, & Monteiro, ), easy to prepare (Van loco, Vandevijvere, Cimenci, Vinkx, & Goscinny, ), tasty (Kim, Lee, Kwak, & Kang, ), sugar (MacGregor & Hashem, ; Shefferly, Scharf, & Deboer, ), nectar (Pineli et al, ), high calories (Van grieken, Renders, Van De Gaar, Hirasing, & Raat, ), preservative (Zengin, Yüzbaşioĝlu, Ünal, Yilmaz, & Aksoy, ), unhealthy (De Christopher, Uribarri, & Tucker, ; Shefferly et al, ), chemical (Linke et al, ; Zhang & Ma, ), sustainable, and waste reduction (Aschemann‐Witzel, ). In order to balance CATA terms and stimuli, for each block of 100 answers, we closed the questionnaires momentarily and rearranged the pages of stimuli (each stimulus was placed in one separated page) and we also randomized the CATA terms of each stimulus.…”