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• W2066234766 abstract "Click to increase image sizeClick to decrease image size We thank Dr. Baschetti for his recommendation. Following his suggestion, we examined the association between the consumption of types of sugars (e.g., sucrose, fructose, etc.) including starch and serum lipids using linear mixed models as in our previous analyses [–]. Sugar and starch intake data were computed from 24-hour dietary recalls used in our study. Results showed that daily average sucrose intake was 46.7 grams (SD = 20.6), with only 2% of subjects consuming more than 100 grams of sucrose per day, which limits the analyses using the cut-point suggested by Dr. Baschetti for sucrose intake []. Cross-sectionally, we found that fructose showed a marginally significant inverse association with triglycerides (p = 0.06); galactose showed a marginally significant inverse association with total cholesterol (p = 0.09), and sucrose was not associated with blood lipids. Longitudinally, starch (p = 0.04) and lactose intake (p = 0.046) were inversely associated with HDL cholesterol levels; sucrose intake was inversely associated with triglyceride levels (p = 0.01); and fructose intake was inversely associated with total cholesterol (p = 0.02). The average triglyceride level in our study was 143 mg/dl (SD = 119), with 18 subjects (3.1%) having levels over 400 mg/dl. Perhaps more associations would be found in a population with high triglyceride levels.Our output files provide us with total quantity in grams of each type of carbohydrate per person per day, but not adjusted for the form or concentration for which they consumed. This may help to explain the apparent discrepancy in the results differing for foods containing equivalent amounts of sugar. For example, the glycemic response would be quite different for corresponding amounts of fructose if the source is from fruits or vegetables, which would tend to contain high quantities of fiber, in comparison to food additives such as high-fructose corn syrup (fructose/glucose) in soft drinks. The major limitation with classifying carbohydrates as “simple” or “complex” has been the inability of this classification scheme to predict plasma glucose and insulin responses []. For example, some starchy foods are digested and absorbed quickly, which means their effect on blood glucose and insulin can be very similar to the effect of ingesting sucrose or glucose; some of these foods, such as white jasmine rice, some potatoes and certain types of white bread, raise blood glucose even more than would an equivalent amount of carbohydrate from pure sucrose []. The glycemic index, on the other hand, is a classification scheme that takes into account the physiological response to a given amount of carbohydrate-containing food []. This allows people to choose foods that do not cause large postprandial spikes in blood glucose and therefore reduces demand on insulin secretion. While it does make sense that the form and concentration in which a sugar is ingested may be an important determinant of the body’s response to sugar intake (as opposed to just the actual quantity of sugar); we believe that the glycemic index covers these as well as other factors that affect the rate of absorption of sugars from foods.It would certainly be worthwhile to further investigate the effects of the form (solid or liquid), and concentration in which sugar is ingested. We suggest that this can be done much more efficiently and effectively in a feeding trial rather than in an epidemiological study. This would ensure sufficient contrasts in exposure and would obviate the need to have subjects estimate their dietary intakes, a process associated with a variety of unavoidable errors [–]. REFERENCESMa Y, Li Y, Chiriboga D, Olendzki B, Hebert J, Li W, Haffner A, Gendreau K, Ockene I: Association between carbohydrate intake and serum lipids.J Am Coll Nutr25 :155– 163,2006 . [Taylor & Francis Online], [Web of Science ®], [Google Scholar]Ma Y, Olendzki B, Chiriboga D, Hebert J, Li Y, Li W, Campbell M, Gendreau K, Ockene IS: Association between dietary carbohydrates and body weight.Am J Epidemiol161 :359– 367,2005 . [Crossref], [PubMed], [Web of Science ®], [Google Scholar]Ma Y, Griffith J, Chasan-Taber L, Olendzki B, Jackson E, Stanek III E, Li W, Pagoto S, Hafner A, Ockene I: Association between dietary fiber and serum C-reactive protein.Am J Clin Nutr83 :760– 766,2006 . 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• W2066234766 title "Carbohydrate Intake, Serum Lipids, and Evolution" @default.
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