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Effects on uric acid, body mass index and blood pressure in adolescents of consuming beverages sweetened with high-fructose corn syrup

Abstract

Objective:

The dietary intake of fructose-rich sugar-sweetened beverages (SSB) may have a significant role in raising serum uric acid (SUA) levels as well as the risk of contracting gout and cardiovascular risk factors. Our objective was to investigate the impact of SSB intake on SUA, body mass index (BMI) and systolic blood pressure (SBP) among adolescents in Taiwan.

Methods:

We evaluated data from 2727 representative adolescents who were multistage sampled from 36 Junior High schools in Taiwan. We cross-sectionally collected demographic, physical, dietary and anthropometric variables, and prospectively measured clinical outcomes. Data were analyzed using multiple regression and logistic models adjusted for covariates.

Results:

We found that 87.7% of adolescents were SSB drinkers, with 25.1% drinking >500 ml per day of such beverages. Increased SSB intake was associated with increased waist and hip circumferences, body fat, BMI, SBP and SUA. As compared with non-drinkers, SSB drinkers had a 3.2–4.9 elevated risk of obesity. The prevalence of hyperuricemia in heavy SSB users (40.2–49.4%) was appreciably greater than that for non-users (24.2%). Adolescents who consumed >500 ml per day of heavy high-fructose corn syrup (HFCS) containing beverages had a 0.42 mg dl−1 higher SUA level and a 2.0–2.1 increased risk of developing hyperuricemia than non-drinkers. The consumption of HFCS-rich beverages was also found to interact with obesity in determining higher levels of SUA (2.2–2.4 mg dl−1 increases).

Conclusion:

High SSB consumption has a notable effect on increased levels of BMI and SUA. The intake of HFCS-rich beverages and BMI were likely to interactively strengthen SUA levels among obese adolescents.

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References

  1. The Bogalusa Heart Study. 20th Anniversary Symposium. Am J Med Sci 1995; 310: S1–S138.

  2. Gagliardi AC, Miname MH, Santos RD . Uric acid: a marker of increased cardiovascular risk. Atherosclerosis 2009; 202: 11–17.

    Article  CAS  Google Scholar 

  3. Bao W, Srinivasan SR, Valdez R, Greenlund KJ, Wattigney WA, Berenson GS . Longitudinal changes in cardiovascular risk from childhood to young adulthood in offspring of parents with coronary artery disease: the Bogalusa Heart Study. JAM A 1997; 278: 1749–1754.

    Article  CAS  Google Scholar 

  4. Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 2010; 56: 1113–1132.

    Article  Google Scholar 

  5. Ford ES, Li C, Cook S, Choi HK . Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation 2007; 115: 2526–2532.

    Article  CAS  Google Scholar 

  6. Chang HY, Pan WH, Yeh WT, Tsai KS . Hyperuricemia and gout in Taiwan: results from the Nutritional and Health Survey in Taiwan (1993-96). J Rheumatol 2001; 28: 1640–1646.

    CAS  PubMed  Google Scholar 

  7. Oyama C, Takahashi T, Oyamada M, Oyamada T, Ohno T, Miyashita M et al. Serum uric acid as an obesity-related indicator in early adolescence. Tohoku J Exp Med 2006; 209: 257–262.

    Article  CAS  Google Scholar 

  8. DeBoer MD, Gurka MJ . Ability among adolescents for the metabolic syndrome to predict elevations in factors associated with type 2 diabetes and cardiovascular disease: data from the national health and nutrition examination survey 1999-2006. Metab Syndr Relat Disord 2010; 8: 343–353.

    Article  Google Scholar 

  9. Trent ME, Ludwig DS . Adolescent obesity, a need for greater awareness and improved treatment. Curr Opin Pediatr 1999; 11: 297–302.

    Article  CAS  Google Scholar 

  10. Chu NF . Prevalence of obesity in Taiwan. Obes Rev 2005; 6: 271–274.

    Article  Google Scholar 

  11. Taiwan Chain Store Almanac. Taiwan Chain Stores and Franchise Association, 2009. Taipei.

  12. Bray GA, Nielsen SJ, Popkin BM . Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr 2004; 79: 537–543.

    Article  CAS  Google Scholar 

  13. Rutledge AC, Adeli K . Fructose and the metabolic syndrome: pathophysiology and molecular mechanisms. Nutr Rev 2007; 65: S13–S23.

    Article  Google Scholar 

  14. Choi HK, Willett W, Curhan G . Fructose-rich beverages and risk of gout in women. JAMA 2010; 304: 2270–2278.

    Article  CAS  Google Scholar 

  15. Johnson RJ, Segal MS, Sautin Y, Nakagawa T, Feig DI, Kang DH et al. Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease. Am J Clin Nutr 2007; 86: 899–906.

    CAS  Google Scholar 

  16. Dai S, McNeill JH . Fructose-induced hypertension in rats is concentration- and duration-dependent. J Pharmacol Toxicol Methods 1995; 33: 101–107.

    Article  CAS  Google Scholar 

  17. Nguyen S, Choi HK, Lustig RH, Hsu CY . Sugar-sweetened beverages, serum uric acid, and blood pressure in adolescents. J Pediatr 2009; 154: 807–813.

    Article  CAS  Google Scholar 

  18. Malik VS, Schulze MB, Hu FB . Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 2006; 84: 274–288.

    Article  CAS  Google Scholar 

  19. Forshee RA, Storey ML, Allison DB, Glinsmann WH, Hein GL, Lineback DR et al. A critical examination of the evidence relating high fructose corn syrup and weight gain. Crit Rev Food Sci Nutr 2007; 47: 561–582.

    Article  CAS  Google Scholar 

  20. Gibson S . Sugar-sweetened soft drinks and obesity: a systematic review of the evidence from observational studies and interventions. Nutr Res Rev 2008; 21: 134–147.

    Article  Google Scholar 

  21. Food and Drug Administration. Department of Health, Executive Yuan, Republic of China. Taiwanese food and nutrients databank. http://www.doh.gov.tw/FoodAnalysis, 1993.

  22. Ridley K, Ainsworth BE, Olds TS . Development of a compendium of energy expenditures for youth. Int J Behav Nutr Phys Act 2008; 5: 45.

    Article  Google Scholar 

  23. Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M et al. Human blood pressure determination by sphygmomanometry. Circulation 1993; 88: 2460–2470.

    Article  CAS  Google Scholar 

  24. Allain CC, Poon LS, Chan CS, Richmond W, Fu PC . Enzymatic determination of total serum cholesterol. Clin Chem 1974; 20: 470–475.

    CAS  Google Scholar 

  25. Sachs L, Batra KL, Zimmermann B . Medical implications of hyperuricemia. Med Health R I 2009; 92: 353–355.

    PubMed  Google Scholar 

  26. Smyth CJ, Holers VM . Gout, Hyperuricemia, and Other Crystal Associated Arthropathies. Marcel Dekker: New York, 1999; 205–218.

    Google Scholar 

  27. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D . A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999; 130: 461–470.

    Article  CAS  Google Scholar 

  28. Mickey RM, Greenland S . The impact of confounder selection criteria on effect estimation. Am J Epidemiol 1989; 129: 125–137.

    Article  CAS  Google Scholar 

  29. Lee CH, Yang SF, Peng CY, Li RN, Chen YC, Chan TF et al. The precancerous effect of emitted cooking oil fumes on precursor lesions of cervical cancer. Int J Cancer 2010; 127: 932–941.

    Article  CAS  Google Scholar 

  30. Reiser S, Powell AS, Scholfield DJ, Panda P, Ellwood KC, Canary JJ . Blood lipids, lipoproteins, apoproteins, and uric acid in men fed diets containing fructose or high-amylose cornstarch. Am J Clin Nutr 1989; 49: 832–839.

    Article  CAS  Google Scholar 

  31. Emmerson BT . Effect of oral fructose on urate production. Ann Rheum Dis 1974; 33: 276–280.

    Article  CAS  Google Scholar 

  32. Choi JW, Ford ES, Gao X, Choi HK . Sugar-sweetened soft drinks, diet soft drinks, and serum uric acid level: the Third National Health and Nutrition Examination Survey. Arthritis Rheum 2008; 59: 109–116.

    Article  CAS  Google Scholar 

  33. Vazquez-Mellado J, Alvarez Hernandez E, Burgos-Vargas R . Primary prevention in rheumatology: the importance of hyperuricemia. Best Pract Res Clin Rheumatol 2004; 18: 111–124.

    Article  CAS  Google Scholar 

  34. Nissinen K, Mikkila V, Mannisto S, Lahti-Koski M, Rasanen L, Viikari J et al. Sweets and sugar-sweetened soft drink intake in childhood in relation to adult BMI and overweight. The Cardiovascular Risk in Young Finns Study. Public Health Nutr 2009; 12: 2018–2026.

    Article  Google Scholar 

  35. Lim S, Zoellner JM, Lee JM, Burt BA, Sandretto AM, Sohn W et al. Obesity and sugar-sweetened beverages in African-American preschool children: a longitudinal study. Obesity (Silver Spring) 2009; 17: 1262–1268.

    Article  Google Scholar 

  36. Laska MN, Murray DM, Lytle LA, Harnack LJ . Longitudinal associations between key dietary behaviors and weight gain over time: transitions through the adolescent years. Obesity (Silver Spring) 2012; 20: 118–125.

    Article  Google Scholar 

  37. Collison KS, Zaidi MZ, Subhani SN, Al-Rubeaan K, Shoukri M, Al-Mohanna FA . Sugar-sweetened carbonated beverage consumption correlates with BMI, waist circumference, and poor dietary choices in school children. BMC Public Health 2010; 10: 234.

    Article  Google Scholar 

  38. Francis DK, Van den Broeck J, Younger N, McFarlane S, Rudder K, Gordon-Strachan G et al. Fast-food and sweetened beverage consumption: association with overweight and high waist circumference in adolescents. Public Health Nutr 2009; 12: 1106–1114.

    Article  Google Scholar 

  39. Clabaugh K, Neuberger GB . Research evidence for reducing sugar sweetened beverages in children. Issues Compr Pediatr Nurs 2011; 34: 119–130.

    Article  Google Scholar 

  40. Sharma N, Okere IC, Duda MK, Johnson J, Yuan CL, Chandler MP et al. High fructose diet increases mortality in hypertensive rats compared to a complex carbohydrate or high fat diet. Am J Hypertens 2007; 20: 403–409.

    Article  CAS  Google Scholar 

  41. Tran LT, Yuen VG, McNeill JH . The fructose-fed rat: a review on the mechanisms of fructose-induced insulin resistance and hypertension. Mol Cell Biochem 2009; 332: 145–159.

    Article  CAS  Google Scholar 

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Acknowledgements

This work was supported by the Taiwan National Science Council (NSC 96-2314-B-037-041-MY3 and NSC 99-2314-B-037-057-MY3).

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Correspondence to C-H Lee.

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Supplementary Information accompanies the paper on International Journal of Obesity website

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Lin, WT., Huang, HL., Huang, MC. et al. Effects on uric acid, body mass index and blood pressure in adolescents of consuming beverages sweetened with high-fructose corn syrup. Int J Obes 37, 532–539 (2013). https://doi.org/10.1038/ijo.2012.121

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