Linda Zukley

High-fructose corn syrup, energy intake, and appetite regulation

High-fructose corn syrup (HFCS) has been implicated in excess weight gain through mechanisms seen in some acute feeding studies and by virtue of its abundance in the food supply during years of increasing obesity. Compared with pure glucose, fructose is thought to be associated with insufficient secretion of insulin and leptin and suppression of ghrelin. However, when HFCS is compared with sucrose, the more commonly consumed sweetener, such differences are not apparent, and appetite and energy intake do not differ in the short-term. Longer-term studies on connections between HFCS, potential mechanisms, and body weight have not been conducted. The main objective of this review was to examine collective data on associations between consumption of HFCS and energy balance, with particular focus on energy intake and its regulation.

The Effect of High-Fructose Corn Syrup Consumption on Triglycerides and Uric Acid

Rates of overweight and obesity have been on a steady rise for decades, and the problems society faces from this and associated metabolic diseases are many. As a result, the need to understand the contributing factors is great. A very compelling case can be made that excess sugar consumption has played a significant role. In addition, fructose, as a component of the vast majority of caloric sweeteners, is seen to be particularly insidious. Evidence shows that fructose bypasses many of the bodys satiating signals, thus potentially promoting overconsumption of energy, weight gain, and the development on insulin resistance. It has also been shown to increase uric acid levels, which in turn promotes many of the abnormalities seen in the metabolic syndrome including hypertriglyceridemia. However, the main source of fructose in the diet is high-fructose corn syrup (HFCS), an artificially manufactured disaccharide that is only 55% fructose. This review highlights the fact that limited data are available about the metabolic effects of HFCS compared with other caloric sweeteners. The data suggest that HFCS yields similar metabolic responses to other caloric sweeteners such as sucrose.

The Rationale for Intervention to Reduce the Risk of Coronary Heart Disease

Cardiovascular diseases remain extremely common and the United States and are the single most common cause for death in both men and women. Many risk factors including cigarette smoking, elevated cholesterol, high blood pressure, obesity and in inactive lifestyle carry a significant lifestyle component. This fact is recognized in the National Guidelines for the Treatment of many risk factors for cardiovascular disease. Moreover, lifestyle intervention, in combination with proper medical and/or surgical therapy can play a significant role in the management of existing cardiovascular disease. In this review, we provide background and rationale for interventions to reduce the risk of coronary heart disease with a particular emphasis on intervening to improve lifestyle related issues. To achieve the best outcomes clinicians must be skilled not only in pharmacologic and surgical therapies but also in counseling patients on various lifestyle interventions to lower the risk of cardiovascular disease.

Lifestyle Medicine Strategies for Risk Factor Reduction, Prevention, and Treatment of Coronary Heart Disease: Part II

Coronary heart disease remains the leading killer of men and women in the United States. Coronary heart disease also represents one of the quintessential lifestyle-related diseases. Many of the major risk factors for coronary heart disease, including elevated cholesterol, high blood pressure, cigarette smoking, an inactive lifestyle, and obesity, have very significant lifestyle-related components. In part I of this review, the authors discussed the rationale for using lifestyle medicine strategies as part of a comprehensive approach to preventing, reducing the risk, or treating coronary heart disease. In part II, the authors focus on practical strategies for incorporating lifestyle medicine techniques into clinical practice. The overall framework is based on the American College of Cardiologys Bethesda Conference, which places risk factors into 4 categories depending on the likelihood that modifying a particular risk factor will result in lowering the risk of coronary heart disease. The authors have similarly grouped lifestyle medicine strategies to explore how these interventions can be employed in each of the classes of interventions defined by the American College of Cardiology. Although the authors recognize that individual clinicians have time constraints which affect utilization of lifestyle medicine strategies, the best outcomes can be achieved by combining these interventions with more traditional modalities for reducing the risk, preventing, or treating coronary heart disease.