Abstract
Objective:There is a link between joint and gut inflammation of unknown etiology in arthritis. Existing research indicates that regular consumption of high-fructose corn syrup sweetened (HFCS) soft drinks, but not diet soft drinks, may be associated with increased risk of seropositive rheumatoid arthritis (RA) in women, independent of other dietary and lifestyle factors. One unexplored hypothesis for this association is that fructose malabsorption, due to regular consumption of excess free fructose (EFF) and HFCS, contributes to fructose reactivity in the gastrointestinal tract and intestinal in situ formation of enFruAGEs, which once absorbed, travel beyond the intestinal boundaries to other tissues and promote inflammation. In separate studies, the accumulation of advanced glycation end-products has been associated with joint inflammation in RA. Objective of this study was to assess the association between EFF beverages intake and non-age, non-wear and tear-associated arthritis in US young adults.Methods:In this cross sectional study of 1209 adults aged 20–30y, (Nutrition and Health Examination Surveys 2003–2006) exposure variables were high EFF beverages, including HFCS sweetened soft drinks, and any combination of HFCS sweetened soft drinks, fruit drinks (FD) and apple juice, referred to as tEFF. Analyses of diet soda and diet FD were included for comparison. The outcome was self-reported arthritis. Rao Scott Ҳ2 was used for prevalence differences and logistic regression for associations, adjusted for confounders.Results:Young adults consuming any combination of high EFF beverages (tEFF) ⩾5 times/week (but not diet soda) were three times as likely to have arthritis as non/low consumers (odds ratios=3.01; p⩽0.021; 95% confidence intervals=1.20–7.59), independent of all covariates, including physical activity, other dietary factors, blood glucose and smoking.Conclusion:EFF beverage intake is significantly associated with arthritis in US adults aged 20–30 years, possibly due to the intestinal in situ formation of enFruAGEs.
Highlights
Arthritis encompasses musculoskeletal disorders consisting of 4100 different conditions that destroy joints, bones, muscles, cartilage and other connective tissues, hampering or halting physical movement
Consumption of beverages high in excess-free fructose was significantly correlated with arthritis in US young adults aged 20–30 years
Analyses based on NHANES are generalizable to the US non-institutionalized civilian population.[38]
Summary
Arthritis encompasses musculoskeletal disorders consisting of 4100 different conditions that destroy joints, bones, muscles, cartilage and other connective tissues, hampering or halting physical movement. With the exception of ‘wear and tear’ ageassociated osteoarthritis, most forms of arthritis are auto-immune disorders that are characterized by inflammation wherein the exact etiologies are unknown.[1] According to the US Center for Disease Control, during the period of this study, 21.6% of the adult. US population (46.4 million persons) had doctor-diagnosed arthritis and 8.3% (17.4 million) had arthritis-attributable activity limitations. The risk of developing most types of arthritis increases with age, arthritis occurs in young people. Types of arthritis most known to affect young adults include ankylosing spondylitis,[3] rheumatoid arthritis (RA),[4,5] lupus erythematosus,[6,7] psoriatic arthritis[8] and undifferentiated arthritis.[9,10]
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