Coronary Artery Disease (CAD) and High Fructose Corn Syrup

The correlation of Coronary Artery Disease to High Fructose Corn Syrup (HFCS) consumption has been analyzed frequently over the last fifteen years. HFCS is an artificial sweetener that, like sucrose (table sugar), contains a mix of glucose and fructose. However, while sucrose contains a 1:1 ratio of fructose and glucose, HFCS is most frequently composed of 55% fructose and 45% glucose, and can range up to 90% fructose composition¹. HFCS is found in countless food products, including fruit and dairy products, baked goods, cereals, as well as artificial beverages². Between the years 1970-1990, HFCS consumption increased between 20-40%, exceeding growth in consumption of any other food product. Soda and juice concentrates account for the majority of HFCS intake: between 1970-1995, HFCS consumption grew from 80 to 132 kcal/day³. In the year 2000, corn syrups accounted for 42% of added sweeteners consumed⁴.

Amongst several other health issues, HFCS has been implicated in the increased incidence of coronary artery disease. Cardiovascular disease is the leading cause of death throughout the Western world, and second most common cause of death worldwide. By 2020, it is predicted that 40% of all deaths will be due to cardiovascular disease⁵.

Studies on High Fructose Corn Syrup and CAD:

Studies on the effect of High Fructose Corn Syrup on Coronary Artery

Soda: An injection of HFCS

Disease have shown positive correlations. The majority of these studies analyzed sugar-sweetened beverages (soda/juice concentrates) because these food products serve as the largest source of High Fructose Corn Syrup. Notable studies are presented here, beginning with a classification of ‘positive, neutral, or no’ correlation of HFCS to CAD:

Positive Correlation. A study of 42,883 men found a strong correlation between HFCS and Coronary Artery Disease. Men who were in the top quartile of SSB consumption (3.7/week - 9/day) were 20% more likely to develop CAD than men who fell into the lowest quartile (less than 2/month). Furthermore, when other factors such as Body Mass Index, overall health of diet, and total energy consumption were taken into account, the correlation between SSB’s and Coronary Artery disease remained significant. This suggests that sugar sweetened beverages, and HFCS by association, may have a very specific pathway to causing Coronary Artery Disease⁹.

Positive Correlation. A study of 88,520 women also showed a strong correlation between High Fructose Corn Syrup and Coronary Artery Disease. The women’s dietary habits were followed for a course of 24 years, between 1980 and 2004. Data analysis showed that women who consumed 2 or more SSBs/d had 35% increased risk of CAD, while women who drank 1 SSB/day had a 23% increased risk of CAD. Similar to the other study, accounting for risk factors such as BMI did not lower the statistic significance of the correlation¹⁰.

Mechanisms by which HFCS impacts Coronary Artery Disease:

Fructose may exacerbate symptoms leading to coronary artery disease through a variety of mechanisms. Unlike normal table sugar, the fructose contained in HFCS is not bonded to glucose molecules. When consumed, these free fructose molecules are favorably metabolized by the liver into fats in a process called lipogenesis. The end result is an unusually elevated triglyceride level in the blood⁶. High triglyceride levels have been associated with greater risk of coronary artery disease on several occasions⁷.

Consumption of sugar-sweetened beverages, the predominant source of High Fructose Corn Syrup, also may contribute to CAD due to the high glycemic load associated with these drinks. Glycemic load is a measurement of how much a food/drink will raise a person’s blood glucose level after consumption. Food products with high glycemic loads have been associated with increased inflammatory response of the body’s circulatory system, a symptom consistently correlated with increased risk of coronary artery disease⁸.

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2. Hanover LM, White JS. Manufacturing, composition, and applications of fructose. AM J Clin Nutr. 1993; 58:724S-32S.

3. Malik VS, Popkin BM, Bray GA, et al. Sugar-sweetened beverages, obesity, Type 2 Diabetes Mellitus, and Cardiovascular Disease Risk. Circulation. 2010;121:1356-1364.

4. Putnam JJ, Allshouse JE. Food consumption, prices and expenditures, 1970-1997. US Department of Agriculture Economic Research Service statistical bulletin no. 965, April. Washington, DC: US Government Printing Office. 1999.

5. Willerson JT, Ridker PM. Inflammation as a Cardiovascular Risk Factor. Circulation. 2004; 109: II-2-II-10

6. Ferder L, Ferder MD, Inserra F. The role of high-fructose corn syrup in metabolic syndrome and hypertension. Curr Hypertens Rep. 2010;12:105-112.

7. Sarwar N, Danesh J, Eiriksdottir G, et al. Triglycerides and the risk of coronary heart disease. Circulation 2007;115:450–8.

8. Liu S, Willett WC, Stampfer MJ, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 2000;71:1455–61.

9. Koning L, Malik VS, Kellogg MD, et al. Sweetened Beverage Consumption, Incident Coronary Heart Disease, and Biomarkers of Risk in Men. Circulation. 2012;125:1735-1741.

10. Fung TT, Malik V, Rexrode KM, et al. Sweetened beverage consumption and risk of coronary heart disease in women. AM J Clin Nutr 2009;89: 1-6.