Fructose and the link to the metabolicsyndrome                            Piero Portincasa, MD, PhD                       ...
NAFLD: Associated with Metabolic Syndrome                                                       17/09/12                  ...
The “BOTERO Syndrome”                                        17/09/12                                       P. Portincasa,...
17/09/12Food fast!                               4             Fast food!    P.                          Porti            ...
5FRUITS AND VEGETABLES                    P.                    Portincasa,                                  17/09/1      ...
6                                                   P.            17/09/1                                                 ...
7                                                            P.               17/09/1                                     ...
8                                          P.          17/09/1                                          Portincasa, 2Fruit...
9                                                  P.            17/09/1                                                  ...
10                                       P.            17/09/1                                       Portincasa,   2      ...
FRUCTOSE........FRIEND…     OR ENEMY?
Fructose consumption         16–20 grams/day (only fresh fruits)                                               74%85–100 g...
Dietary fructose                                         monosaccharide Fructose  •   a free hexose  •   as the disacchar...
According to the USDA database, foods with more fructose than glucose include:                                        Fruc...
Metabolic pathways of entry of (A) glucose and                       (B) fructose into the glycolytic pathway of the      ...
Central administration of fructose Fructose exerts an orexigenic effect       Seung Hun Cha et al., Proc Natl Acad Sci U S...
 The brain, like the liver, possesses a unique set of  enzymes that enables fructose to bypass the rate-  limiting step i...
FRUCTOSE IN THE LIVER        A high flux of fructose to the liver (the main organ          capable of metabolizing this s...
MTP (microsomial triglyceride transfer protein)Basciano et al. Nutr Metab (Lond). 2005; 2: 5.
Increased fructose intake                                upregulation ofNAFLD                           KHK               ...
keypointsHigh dietary intake of fructose                            NAFLD               insulindyslipidemia   resistance  ...
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Fructose and the link to the metabolic syndrome - di Piero Portincasa e Leonilde Bonfrate

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Fructose and the link to the metabolic syndrome - di Piero Portincasa e
Leonilde Bonfrate. 31 maggio 2012. Corso di formazione "valore nutrizionale e salutistico di prodotti agroalimentari” - Università degli studi di Bari.

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Fructose and the link to the metabolic syndrome - di Piero Portincasa e Leonilde Bonfrate

  1. 1. Fructose and the link to the metabolicsyndrome Piero Portincasa, MD, PhD Leonilde Bonfrate,MD Department of Internal and Public Medicine University of Bari Medical School Bari – Italy p.portincasa@semeiotica.uniba.it
  2. 2. NAFLD: Associated with Metabolic Syndrome 17/09/12 Metabolic Syndrome Obesity P. Portincasa, UNIBA Diabetes DyslipidemiaEPIDEMIA DEL III MILLENNIO
  3. 3. The “BOTERO Syndrome” 17/09/12 P. Portincasa, UNIBA 329.04.05
  4. 4. 17/09/12Food fast! 4 Fast food! P. Porti ncas a, UNI
  5. 5. 5FRUITS AND VEGETABLES P. Portincasa, 17/09/1 2 UNIBA
  6. 6. 6 P. 17/09/1 Portincasa, 2FRUITS AND VEGETABLES UNIBA • Consumption is inversely related to the risk of coronary heart disease (CHD) and strokeThe effect of fruit and vegetable intake on risk for coronary heart disease. AUJoshipura KJ; Hu FB; Manson JE; Stampfer MJ; Rimm EB; Speizer FE; Colditz G;Ascherio A; Rosner B; Spiegelman D; Willett WC SO Ann Intern Med 2001 Jun19;134(12):1106-14.Legume consumption and risk of coronary heart disease in US men and women:NHANES I Epidemiologic Follow-up Study. AU Bazzano LA; He J; Ogden LG; Loria C;Vupputuri S; Myers L; Whelton PK SO Arch Intern Med 2001 Nov 26;161(21):2573-8.
  7. 7. 7 P. 17/09/1 Portincasa, 2The effect of fruit and vegetable intake on risk for coronary heart disease. AU Joshipura KJ; Hu FB; UNIBAManson JE; Stampfer MJ; Rimm EB; Speizer FE; Colditz G; Ascherio A; Rosner B; Spiegelman D;Willett WC SO Ann Intern Med 2001 Jun 19;134(12):1106-14. • The Nurses Health Study and the Health Professionals Follow-Up Study • 84 251 women 34 to 59 yrs of age who for 14 yrs and 42 148 men 40 to 75 yrs followed for 8 yrs • Incidence of nonfatal myocardial infarction or fatal coronary heart disease (1127 cases in women and 1063 cases in men). • Diet assessed by using food-frequency questionnaires • CONCLUSIONS: Consumption of fruits and vegetables, particularly green leafy vegetables and vitamin C-rich fruits and vegetables, appears to have a
  8. 8. 8 P. 17/09/1 Portincasa, 2Fruit and vegetable consumption and stroke: meta-analysis UNIBA ofcohort studies. He FJ; Nowson CA; MacGregor GA Lancet. 2006Jan 28;367(9507):320-6.  • MEDLINE, EMBASE, the Cochrane Library, and bibliographies of retrieved articles• 8 studies, 9 independent cohorts• 257,551 individuals (4917 stroke events), average follow-up of 13 years• relative risk of stroke was 0.89 (95% CI 0.83-0.97) for those with 3 to 5 servings per day, and 0.74 (0.69-0.79) >5 servings per day.• Fruit and vegetables significant protective effect on both ischaemic and haemorrhagic stroke.
  9. 9. 9 P. 17/09/1 Portincasa, 2 UNIBALyn M Steffen Jan 28, 2006, The Lancet, Vol. 367 No. 9507 pp 278-279
  10. 10. 10 P. 17/09/1 Portincasa, 2 UNIBA 5 a day!Lancet. 2006 Jan 28;367(9507):320-6.
  11. 11. FRUCTOSE........FRIEND… OR ENEMY?
  12. 12. Fructose consumption 16–20 grams/day (only fresh fruits) 74%85–100 grams/day Basciano et al; Nutr Metab (Lond). 2005; 2: 5.
  13. 13. Dietary fructose monosaccharide Fructose • a free hexose • as the disaccharide (sucrose: glucose-fructose) • in a polymerized form (fructans) Up to one half of the population unable to completely absorb a sucrose load of 25 g 4 Kcal / g Glycemic index: 23 (sucrose: 57)
  14. 14. According to the USDA database, foods with more fructose than glucose include: Fructose (grams / Glucose (grams / Food 100 grams) 100 grams) High fructose 55 to 90 45 to 10 corn syrup Sucrose 50 50 (for reference) Honey 40.9 35.7 Raisins 29.8 27.8 Pears 6.2 2.8 Apples 5.9 2.4 Fruit juice e.g. Apples, 5 to 7 2 to 3 Pears Watermelon 3.4 1.6
  15. 15. Metabolic pathways of entry of (A) glucose and (B) fructose into the glycolytic pathway of the CNS Cha S H et al. PNAS 2008;105:16871-16875©2008 by National Academy of Sciences
  16. 16. Central administration of fructose Fructose exerts an orexigenic effect Seung Hun Cha et al., Proc Natl Acad Sci U S A. November 2008
  17. 17.  The brain, like the liver, possesses a unique set of enzymes that enables fructose to bypass the rate- limiting step in glycolysis and thereby rapidly deplete ATP in the hypothalamus The central administration of fructose rapidly lowers ATP, increases P-AMPK and P-ACC (acetyl-CoA carboxylase ), and decreases malonyl-CoA in the hypothalamus, whereas centrally administered glucose has the inverse effects.
  18. 18. FRUCTOSE IN THE LIVER  A high flux of fructose to the liver (the main organ capable of metabolizing this simple carbohydrate)1. perturbs glucose metabolism and glucose uptake pathways (Fructose-induced insulin resistance)2. leads to a significantly enhanced rate of de novo lipogenesis and triglyceride (TG) synthesis, driven by the high flux of glycerol and acyl portions of TG molecules from fructose catabolism.
  19. 19. MTP (microsomial triglyceride transfer protein)Basciano et al. Nutr Metab (Lond). 2005; 2: 5.
  20. 20. Increased fructose intake upregulation ofNAFLD KHK (fructokinase) fructose-induced ATP depletion Hepatic necroinflammation
  21. 21. keypointsHigh dietary intake of fructose NAFLD insulindyslipidemia resistance metabolic syndrome

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