High fructose corn syrup, excess-free-fructose, and risk of coronary heart disease among African Americans- the Jackson Heart Study.
High fructose corn syrup, excess-free-fructose, and risk of coronary heart disease among African Americans- the Jackson Heart Study.
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DOI：
10.1186/s40795-020-00396-x
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发表时间：
2020-12-08
期刊：
影响因子：
2
通讯作者：
Tucker KL
中科院分区：
文献类型：
--
作者：
DeChristopher LR;Auerbach BJ;Tucker KL
研究人员试图解释 1980 年至 2010 年间黑人与白人冠心病 (CHD) 死亡率差异从接近均等增加到约 30% 的情况。影响因素包括因保险覆盖范围的差异而导致的心血管疾病预防和治疗差异。最近的研究表明饮食/环境因素可能是造成这种差异的原因。未吸收/腔内果糖会改变肠道细菌负荷、组成和多样性。有证据表明，这种微生物组破坏会促进高血压和动脉粥样硬化。心肠轴可能在一定程度上解释了黑人与白人冠心病的差异，因为非裔美国人中果糖吸收不良的患病率较高。 1980 年至 2010 年间，过量游离果糖（引发吸收不良的果糖类型）的摄入量超过了与果糖吸收不良相关的剂量（~ 5g–10g），根据主观、追溯应用的损失调整之前的食物供应数据推断。这是由于从 1980 年开始，工业偏好从蔗糖转向高果糖玉米糖浆 (HFCS)。在此期间，HFCS 成为美国汽水中的主要甜味剂。重要的是，HFCS 中的果糖含量比想象的要多，因为流行汽水中的果糖与葡萄糖的比例（1.9:1 和 1.5:1）已经超过了普遍认为的安全水平（1.2:1）。大多数天然食品的比例为 ~ 1:1。在最近的一项研究中，每周≥5 次。食用高果糖玉米糖浆加糖苏打水/果汁饮料/和苹果汁（高过量游离果糖饮料）的消费者比很少/从不食用的消费者更有可能患冠心病。非裔美国人的杰克逊心脏研究数据被用来检验这样的假设：相对于低/不频繁摄入 HFCS 加糖苏打水/果汁饮料，经常摄入会增加冠心病风险，但橙汁（一种低过量游离果糖果汁）不会增加冠心病风险。 Cox 比例风险模型使用 3407-3621 名年龄 21-93 岁（平均 55 岁）参与者的前瞻性数据来计算风险比。每周饮用 HFCS 甜苏打水 5-6 次的非裔美国人。或 HFCS 加糖苏打水和/或果汁饮料的任何组合≥3 次/天，其 CHD 风险增加 ~ 2（HR 2.08，95% CI 1.03–4.20，P = 0.041）和 2.5–3 倍（HR 2.98，95% CI 1.15–7.76；P = 0.025），分别比从不/很少消费者、独立于混杂因素。与无糖汽水或 100% 橙汁没有关联，后者的血糖曲线与 HFCS 加糖汽水相似，但果糖与葡萄糖的比例为 1:1:1。食品供应中普遍存在的高果糖玉米糖浆可能会使非裔美国人患冠心病的风险增加。
Researchers have sought to explain the black-white coronary heart disease (CHD) mortality disparity that increased from near parity to ~ 30% between 1980 and 2010. Contributing factors include cardiovascular disease prevention and treatment disparities attributable to disparities in insurance coverage. Recent research suggests that dietary/environmental factors may be contributors to the disparity. Unabsorbed/luminal fructose alters gut bacterial load, composition and diversity. There is evidence that such microbiome disruptions promote hypertension and atherosclerosis. The heart-gut axis may, in part, explain the black-white CHD disparity, as fructose malabsorption prevalence is higher among African Americans. Between 1980 and 2010, consumption of excess-free-fructose–the fructose type that triggers malabsorption-exceeded dosages associated with fructose malabsorption (~ 5 g–10 g), as extrapolated from food availability data before subjective, retroactively-applied loss adjustments. This occurred due to an industrial preference shift from sucrose to high-fructose-corn-syrup (HFCS) that began ~ 1980. During this period, HFCS became the main sweetener in US soda. Importantly, there has been more fructose in HFCS than thought, as the fructose-to-glucose ratio in popular sodas (1.9-to-1 and 1.5-to-1) has exceeded generally-recognized-as-safe levels (1.2-to-1). Most natural foods contain a ~ 1-to-1 ratio. In one recent study, ≥5 times/wk. consumers of HFCS sweetened soda/fruit drinks/and apple juice-high excess-free-fructose beverages–were more likely to have CHD, than seldom/never consumers. Jackson-Heart-Study data of African Americans was used to test the hypothesis that regular relative to low/infrequent intake of HFCS sweetened soda/fruit drinks increases CHD risk, but not orange juice-a low excess-free-fructose juice. Cox proportional hazards models were used to calculate hazard ratios using prospective data of 3407–3621 participants, aged 21–93 y (mean 55 y). African Americans who consumed HFCS sweetend soda 5-6x/wk. or any combination of HFCS sweetened soda and/or fruit drinks ≥3 times/day had ~ 2 (HR 2.08, 95% CI 1.03–4.20, P = 0.041) and 2.5–3 times higher CHD risk (HR 2.98, 95% CI 1.15–7.76; P = 0.025), respectively, than never/seldom consumers, independent of confounders. There were no associations with diet-soda or 100% orange-juice, which has a similar glycemic profile as HFCS sweetened soda, but contains a ~ 1:1 fructose-to-glucose ratio. The ubiquitous presence of HFCS in the food supply may pre-dispose African Americans to increased CHD risk.