Acute metabolic responses to high fructose corn syrup ingestion in adolescents with overweight/obesity and diabetes

Introduction: Childhood obesity remains high in prevalence. Sugar-sweetened beverages containing high fructose corn syrup (HFCS) are a common source of excess calories among children and adolescents. Fructose metabolism differs from glucose metabolism, which may also differ from fructose + glucose metabolism in HFCS consumption. The purpose of this study was to determine the acute metabolic effects of HFCS ingestion after soft drink consumption in adolescents who are lean, have overweight/obesity, or have type 2 diabetes (T2DM).

Methods: Adolescents age 13-19 years were recruited into three groups: lean controls (n = 10), overweight/ obese without diabetes (n = 10), or uncomplicated T2DM on metformin monotherapy (n = 5). After an overnight fast, subjects drank 12 ounces of soda containing HFCS. Blood samples were collected at time zero and every 15 min for 120 min to be analyzed for fructose, glucose, and insulin levels.

Results: Glucose and fructose concentrations rose quickly in the first 15 min. Fructose, which was very low at baseline, rose to 100-200 μM and remained higher than fasting concentrations even at 120 min in all groups. Glucose increased after soft drink consumption, with the highest concentrations among subjects with T2DM, but returned to baseline fasting levels at 120 min. Insulin levels increased 15 min after soft drink consumption and were the highest in the obese group. Lactate rose non-significantly in all subjects, with no differences between groups.

Conclusion: Among adolescents who are lean, overweight/obese, or have T2DM, drinking an HFCS-containing soft drink exposes the liver to fructose. Glucose excursions in T2DM may be impacted by exaggerated glucose cycling, or fructose metabolism to glucose. The context of fructose consumption with or without other carbohydrates is an important consideration in studies of fructose metabolism.