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Fructose consumption and its impact on human health: Diet and risk of cardiovascular disease
O consumo da frutose e o seu impacto na saúde humana: a alimentação nos dias de hoje e o risco das doenças cardiovasculares
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"Marques" "email" => array:1 [ 0 => "cmarques@fmed.uc.pt" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Universidade de Coimbra, Centro de Neurociências e Biologia Celular, Instituto Biomédico de Investigação da Luz e da Imagem, Coimbra, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universidade de Coimbra, Faculdade de Medicina, Instituto Biomédico de Investigação da Luz e da Imagem, Coimbra, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "O consumo da frutose e o seu impacto na saúde humana: a alimentação nos dias de hoje e o risco das doenças cardiovasculares" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">According to the World Health Organization (WHO), around 17.5 million people die each year from cardiovascular disease (CVD), making it the leading cause of death worldwide. One risk factor for CVD is poor diet, the prevalence of which has increased in recent years.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–5</span></a> Various bodies, including the WHO and the American Heart Association, recommend reducing the quantity of added sugars in the diet,<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> which could lead to a 20% decrease in mortality due to CVD by 2020.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">7,8</span></a> The direct link between consumption of sugar-rich products and high cardiovascular morbidity and mortality means there is a need to develop and implement preventive measures to reduce sugar intake, particularly in children, in whom the problem assumes even more worrying proportions.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Sugars are divided into monosaccharides and disaccharides. The most common monosaccharides in food are fructose, glucose and galactose. Fructose is naturally found in fruit and fruit-derived products like juices, and is sometimes added as a sweetener to other products such as soft drinks and biscuits. Corn syrup, which is high in fructose, is the most common added sugar and is most often consumed in soft drinks. The metabolism of fructose is different from that of other sugars and produces certain harmful byproducts. The association between fructose consumption and CVD risk factors such as hypertension, obesity, insulin resistance, diabetes and the metabolic syndrome has been the subject of much research. Studies in animal models have shown that a fructose-rich diet increases susceptibility to myocardial ischemia-reperfusion injury.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Various studies have indicated that high fructose intake due to widespread use of this sugar in foods and drinks can lead to metabolic changes, including increased triglycerides, insulin resistance and hepatic steatosis, but the results are inconclusive.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> It is therefore important to investigate the physiology of excessive fructose consumption and its effects on health. In this issue of the <span class="elsevierStyleItalic">Journal</span>, Ramos et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> assess the effect of chronic fructose consumption on biochemical and body parameters in rats. Their results show that fructose consumption is associated with abdominal adiposity and increased serum triglyceride levels in these animals. Furthermore, the increasing incidence of obesity in populations worldwide in the era of high fructose consumption suggests that a fructose-rich diet may be a major factor in body weight gain. Obesity and excessive visceral fat are directly and indirectly responsible for increasing cardiovascular mortality, particularly through lipid metabolism disorders and weight gain, largely due to excessive energy intake.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Moreover, fructose does not stimulate production of insulin and leptin, which transmit information to the central nervous system, and therefore may not induce the same feeling of satiety that is experienced after a glucose-based meal, and so reduced insulin and leptin production may contribute to increased energy intake and weight gain in animals and humans. In addition, consumption of fructose-sweetened products increases the likelihood of developing insulin resistance, which accounts for most of the features predisposing to atherothrombosis in obesity.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> It is therefore essential to intervene to change these habits that are harmful to health. Against this background, the results of the study by Ramos et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> appear to suggest that fructose consumption leads to increased abdominal fat and changes in triglyceride levels, which implies increased risk of cardiovascular disease, but is not directly associated with body weight gain.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Marques C. O consumo da frutose e o seu impacto na saúde humana: a alimentação nos dias de hoje e o risco das doenças cardiovasculares. Rev Port Cardiol. 2017;36:943–944.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of fructose consumption on food intake and biochemical and body parameters in Wistar rats" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V.W. Ramos" 1 => "L.O. Batista" 2 => "K.T. 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Singh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10557-011-6312-x" "Revista" => array:6 [ "tituloSerie" => "Cardiovasc Drugs Ther" "fecha" => "2011" "volumen" => "25" "paginaInicial" => "285" "paginaFinal" => "297" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21671014" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Science souring on sugar" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W.C. Willett" 1 => "D.S. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 21 | 4 | 25 |
| 2024 October | 78 | 50 | 128 |
| 2024 September | 104 | 43 | 147 |
| 2024 August | 56 | 41 | 97 |
| 2024 July | 47 | 33 | 80 |
| 2024 June | 48 | 26 | 74 |
| 2024 May | 38 | 22 | 60 |
| 2024 April | 39 | 37 | 76 |
| 2024 March | 41 | 27 | 68 |
| 2024 February | 41 | 24 | 65 |
| 2024 January | 21 | 22 | 43 |
| 2023 December | 45 | 27 | 72 |
| 2023 November | 67 | 34 | 101 |
| 2023 October | 64 | 18 | 82 |
| 2023 September | 24 | 19 | 43 |
| 2023 August | 48 | 13 | 61 |
| 2023 July | 54 | 6 | 60 |
| 2023 June | 44 | 16 | 60 |
| 2023 May | 81 | 26 | 107 |
| 2023 April | 59 | 14 | 73 |
| 2023 March | 89 | 36 | 125 |
| 2023 February | 66 | 23 | 89 |
| 2023 January | 47 | 26 | 73 |
| 2022 December | 68 | 24 | 92 |
| 2022 November | 66 | 34 | 100 |
| 2022 October | 70 | 32 | 102 |
| 2022 September | 64 | 46 | 110 |
| 2022 August | 59 | 32 | 91 |
| 2022 July | 43 | 41 | 84 |
| 2022 June | 67 | 41 | 108 |
| 2022 May | 77 | 38 | 115 |
| 2022 April | 52 | 32 | 84 |
| 2022 March | 54 | 54 | 108 |
| 2022 February | 51 | 48 | 99 |
| 2022 January | 53 | 32 | 85 |
| 2021 December | 22 | 35 | 57 |
| 2021 November | 29 | 42 | 71 |
| 2021 October | 36 | 54 | 90 |
| 2021 September | 20 | 33 | 53 |
| 2021 August | 34 | 43 | 77 |
| 2021 July | 25 | 40 | 65 |
| 2021 June | 27 | 23 | 50 |
| 2021 May | 36 | 54 | 90 |
| 2021 April | 68 | 56 | 124 |
| 2021 March | 76 | 25 | 101 |
| 2021 February | 60 | 31 | 91 |
| 2021 January | 32 | 24 | 56 |
| 2020 December | 44 | 25 | 69 |
| 2020 November | 38 | 19 | 57 |
| 2020 October | 37 | 14 | 51 |
| 2020 September | 54 | 17 | 71 |
| 2020 August | 16 | 10 | 26 |
| 2020 July | 46 | 13 | 59 |
| 2020 June | 25 | 19 | 44 |
| 2020 May | 41 | 12 | 53 |
| 2020 April | 38 | 20 | 58 |
| 2020 March | 39 | 10 | 49 |
| 2020 February | 66 | 29 | 95 |
| 2020 January | 35 | 11 | 46 |
| 2019 December | 41 | 10 | 51 |
| 2019 November | 23 | 6 | 29 |
| 2019 October | 31 | 9 | 40 |
| 2019 September | 19 | 7 | 26 |
| 2019 August | 38 | 6 | 44 |
| 2019 July | 45 | 7 | 52 |
| 2019 June | 36 | 14 | 50 |
| 2019 May | 36 | 9 | 45 |
| 2019 April | 33 | 20 | 53 |
| 2019 March | 79 | 13 | 92 |
| 2019 February | 88 | 12 | 100 |
| 2019 January | 40 | 12 | 52 |
| 2018 December | 67 | 15 | 82 |
| 2018 November | 94 | 11 | 105 |
| 2018 October | 66 | 21 | 87 |
| 2018 September | 42 | 15 | 57 |
| 2018 August | 34 | 8 | 42 |
| 2018 July | 20 | 6 | 26 |
| 2018 June | 37 | 9 | 46 |
| 2018 May | 23 | 6 | 29 |
| 2018 April | 45 | 18 | 63 |
| 2018 March | 102 | 18 | 120 |
| 2018 February | 92 | 21 | 113 |
| 2018 January | 109 | 49 | 158 |
| 2017 December | 60 | 43 | 103 |
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