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COMMENTARY |
1 From the Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA (GAB), and the Department of Nutrition, University of North Carolina, Chapel Hill (SJN and BMP).
Obesity is a major epidemic, but its causes are still unclear. In this article, we investigate the relation between the intake of high-fructose corn syrup (HFCS) and the development of obesity. We analyzed food consumption patterns by using US Department of Agriculture food consumption tables from 1967 to 2000. The consumption of HFCS increased > 1000% between 1970 and 1990, far exceeding the changes in intake of any other food or food group. HFCS now represents > 40% of caloric sweeteners added to foods and beverages and is the sole caloric sweetener in soft drinks in the United States. Our most conservative estimate of the consumption of HFCS indicates a daily average of 132 kcal for all Americans aged 
2 y, and the top 20% of consumers of caloric sweeteners ingest 316 kcal from HFCS/d. The increased use of HFCS in the United States mirrors the rapid increase in obesity. The digestion, absorption, and metabolism of fructose differ from those of glucose. Hepatic metabolism of fructose favors de novo lipogenesis. In addition, unlike glucose, fructose does not stimulate insulin secretion or enhance leptin production. Because insulin and leptin act as key afferent signals in the regulation of food intake and body weight, this suggests that dietary fructose may contribute to increased energy intake and weight gain. Furthermore, calorically sweetened beverages may enhance caloric overconsumption. Thus, the increase in consumption of HFCS has a temporal relation to the epidemic of obesity, and the overconsumption of HFCS in calorically sweetened beverages may play a role in the epidemic of obesity.
Key Words: Epidemiology • food intake • obesity • artificial sweeteners • fructose
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 N. P. Paynter, H.-C. Yeh, S. Voutilainen, M. I. Schmidt, G. Heiss, A. R. Folsom, F. L. Brancati, and W. H. L. Kao Coffee and Sweetened Beverage Consumption and the Risk of Type 2 Diabetes Mellitus: The Atherosclerosis Risk in Communities Study Am. J. Epidemiol., December 1, 2006; 164(11): 1075 - 1084. [Abstract] [Full Text] [PDF]
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S. C Larsson, L. Bergkvist, and A. Wolk Consumption of sugar and sugar-sweetened foods and the risk of pancreatic cancer in a prospective study. Am. J. Clinical Nutrition, November 1, 2006; 84(5): 1171 - 1176. [Abstract] [Full Text] [PDF]
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Z. T. Bloomgarden Third Annual World Congress on the Insulin Resistance Syndrome: Associated conditions. Diabetes Care, September 1, 2006; 29(9): 2165 - 2174. [Full Text] [PDF]
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V. S Malik, M. B Schulze, and F. B Hu Intake of sugar-sweetened beverages and weight gain: a systematic review. Am. J. Clinical Nutrition, August 1, 2006; 84(2): 274 - 288. [Abstract] [Full Text] [PDF]
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B. M Popkin Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am. J. Clinical Nutrition, August 1, 2006; 84(2): 289 - 298. [Abstract] [Full Text] [PDF]
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B. M Popkin, L. E Armstrong, G. M Bray, B. Caballero, B. Frei, and W. C Willett A new proposed guidance system for beverage consumption in the United States Am. J. Clinical Nutrition, March 1, 2006; 83(3): 529 - 542. [Abstract] [Full Text] [PDF]
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 C. B. Ebbeling, H. A. Feldman, S. K. Osganian, V. R. Chomitz, S. J. Ellenbogen, and D. S. Ludwig Effects of Decreasing Sugar-Sweetened Beverage Consumption on Body Weight in Adolescents: A Randomized, Controlled Pilot Study Pediatrics, March 1, 2006; 117(3): 673 - 680. [Abstract] [Full Text] [PDF]
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T. Nakagawa, H. Hu, S. Zharikov, K. R. Tuttle, R. A. Short, O. Glushakova, X. Ouyang, D. I. Feig, E. R. Block, J. Herrera-Acosta, et al. A causal role for uric acid in fructose-induced metabolic syndrome Am J Physiol Renal Physiol, March 1, 2006; 290(3): F625 - F631. [Abstract] [Full Text] [PDF]
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M. Bes-Rastrollo, A. Sanchez-Villegas, E. Gomez-Gracia, J A. Martinez, R. M Pajares, and M. A Martinez-Gonzalez Predictors of weight gain in a Mediterranean cohort: the Seguimiento Universidad de Navarra Study 1 Am. J. Clinical Nutrition, February 1, 2006; 83(2): 362 - 370. [Abstract] [Full Text] [PDF]
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F. Greenway Virus-induced obesity Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2006; 290(1): R188 - R189. [Full Text] [PDF]
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 H. K. Choi, D. B. Mount, and A. M. Reginato Pathogenesis of Gout Ann Intern Med, October 4, 2005; 143(7): 499 - 516. [Full Text] [PDF]
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A. Drewnowski Concept of a nutritious food: toward a nutrient density score Am. J. Clinical Nutrition, October 1, 2005; 82(4): 721 - 732. [Abstract] [Full Text] [PDF]
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 P Aro, J Ronkainen, N J Talley, T Storskrubb, E Bolling-Sternevald, and L Agreus Body mass index and chronic unexplained gastrointestinal symptoms: an adult endoscopic population based study Gut, October 1, 2005; 54(10): 1377 - 1383. [Abstract] [Full Text] [PDF]
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A. Drewnowski and N. Darmon The economics of obesity: dietary energy density and energy cost Am. J. Clinical Nutrition, July 1, 2005; 82(1): 265S - 273S. [Abstract] [Full Text] [PDF]
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 D. Faeh, K. Minehira, J.-M. Schwarz, R. Periasamy, S. Park, and L. Tappy Effect of Fructose Overfeeding and Fish Oil Administration on Hepatic De Novo Lipogenesis and Insulin Sensitivity in Healthy Men Diabetes, July 1, 2005; 54(7): 1907 - 1913. [Abstract] [Full Text] [PDF]
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Y. Wei, D. Wang, and M. J. Pagliassotti Fructose Selectively Modulates c-jun N-Terminal Kinase Activity and Insulin Signaling in Rat Primary Hepatocytes J. Nutr., July 1, 2005; 135(7): 1642 - 1646. [Abstract] [Full Text] [PDF]
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Z. T. Bloomgarden Second World Congress on the Insulin Resistance Syndrome: Insulin resistance syndrome and nonalcoholic fatty liver disease Diabetes Care, June 1, 2005; 28(6): 1518 - 1523. [Full Text] [PDF]
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 X.-L. Cui, A. M. Schlesier, E. L. Fisher, C. Cerqueira, and R. P. Ferraris Fructose-induced increases in neonatal rat intestinal fructose transport involve the PI3-kinase/Akt signaling pathway Am J Physiol Gastrointest Liver Physiol, June 1, 2005; 288(6): G1310 - G1320. [Abstract] [Full Text] [PDF]
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 S. Bawa The role of the consumption of beverages in the obesity epidemic Perspectives in Public Health, May 1, 2005; 125(3): 124 - 128. [Abstract] [PDF]
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S. E. la Fleur, H. Houshyar, M. Roy, and M. F. Dallman Choice of Lard, But Not Total Lard Calories, Damps Adrenocorticotropin Responses to Restraint Endocrinology, May 1, 2005; 146(5): 2193 - 2199. [Abstract] [Full Text] [PDF]
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