Great!  Lovely!  This stuff is in tons of things marketed to our kids.  I’d know — I have two of them running around.  Well, not right now as it’s after 11pm.  But I would if I were doing this during a sane hour.

Increase in triglycerides, blood pressure, and lowered good cholesterol levels.  That’s quite the trifecta there.

From Medscape:

High Fructose Intake Linked to Metabolic Syndrome, Kidney Disease

Anthony J. Brown, MD

January 15, 2010 — Excessive intake of fructose, a common sweetener in soft drinks, can induce features of metabolic syndrome and may be a risk factor for chronic kidney disease, according to the findings from two studies.

The results of both studies suggest that these adverse effects are mediated, at least in part, through elevations in uric acid levels.

“Excessive fructose intake causes metabolic syndrome in animals and can be partially prevented by lowering the uric acid level,” Dr. S. E. Perez-Pozo, lead author of the first study, and colleagues note. “We tested the hypothesis that fructose might induce features of metabolic syndrome in adult men and whether that is protected by allopurinol.”

The researchers’ study, reported in the December 22nd online issue of the International Journal of Obesity, featured 74 adult men who were randomized to receive 200 g fructose daily for 2 weeks without or without allopurinol. Primary endpoints included changes in ambulatory blood pressure, lipid levels, glucose and insulin, homeostatic model assessment (HOMA) index, body mass index, and criteria for metabolic syndrome.

Fructose intake was associated with an average increase in systolic and diastolic blood pressure of 7 and 5 mm Hg, respectively (p < 0.004 and p < 0.007, respectively), Dr. Perez-Pozo, from Son Llatzer Hospital–Palm of Majorca, Spain, and colleagues report.

Mean fasting triglyceride levels rose by 0.62 mmol/L (p < 0.002), while high-density lipoprotein cholesterol levels fell by 0.06 mmol/L (p < 0.001).

Although plasma glucose levels did not change, a significant increase in fasting insulin and HOMA indices was observed. Depending on the criteria used, the prevalence of metabolic syndrome increased by 25% to 33%.

Allopurinol treatment reduced uric acid levels and prevented the increase in blood pressure. In addition, it reduced levels of low-density lipoprotein cholesterol. Although allopurinol did not reduce HOMA or fasting triglyceride levels, it did help stave off newly diagnosed metabolic syndrome (p = 0.009).

The results “suggest that the primary effect of lowering the uric acid level on the metabolic syndrome induced by fructose is to reduce the blood pressure elevation,” the authors conclude. “It remains possible that the lowering of uric acid level might be beneficial on lipids and insulin resistance if postprandial levels were targeted as opposed to fasting levels,” they add.

In the second study, published in the December 23rd online issue of Kidney International, Dr. Andrew S. Bomback, from Columbia University College of Physicians and Surgeons, New York, and colleagues assessed the impact of sugar-sweetened soda intake on the risk of hyperuricemia and reduced kidney function. They analyzed data from 15,745 patients in the Atherosclerosis Risk in Communities Study who completed dietary questionnaires at baseline and had levels of creatinine and uric acid measured.

On cross-sectional analysis, consumption of more than 1 soda per day increased the odds of hyperuricemia by 31% relative to intake of less than 1 soda per day. Likewise, such intake was associated with 46% increased risk of chronic kidney disease, defined as an estimated glomerular filtration rate of <60 mL/min per 1.73 meters-squared. In subjects with uric acid levels over 9.0 mg/dL, intake of more than 1 soda per day increased the risk of kidney disease by 159%.

By contrast, on longitudinal analysis, high soda intake was not linked with hyperuricemia or chronic kidney disease at either 3 years or 9 years, the findings indicate.

Given that only the cross-sectional analysis showed a significant association between soda intake and hyperuricemia/chronic kidney disease, “our findings add to but in no way close the heated discussion over the potential dangers of sugar-sweetened soda,” the authors conclude.

Int J Obesity. Published online December 22, 2009.

Kidney Int. Published online December 23, 2009.

Wow.  No wonder my pregnancies sucked. I was fat AND I couldn’t sleep.

From Medscape:

High BMI, Lack of Sleep Linked to Need for Migraine Treatment During Pregnancy

NEW YORK (Reuters Health) Dec 25 – A high pre-pregnancy body mass index (BMI) and a lack of sleep predict whether women will need migraine medications during pregnancy, new research shows.

An estimated 20%-80% of women report migraines during pregnancy, study co-author Dr. Katerina Nezvalova-Henriksen, of the University of Oslo, Norway, and colleagues write in the December issue of Cephalalgia.

“Many migraineurs may experience an exacerbation of their symptoms at the beginning of the first trimester,” the team notes. “Consequently, these women may require pharmacotherapy during this period, which also corresponds to the most vulnerable period of fetal development.”

To narrow down which women were likely to need migraine medications during pregnancy, Dr. Nezvalova-Henriksen and her colleagues analyzed the newest available data from the Norwegian Mother and Child Cohort Study. That effort is an observational, prospective cohort study of 60,435 pregnant women recruited between 1999 and 2006 and conducted by the Norwegian Institute of Public Health.

Overall, 3840 (5.7%) women reported having a migraine during the first 5 months of pregnancy. Of these, 2525 (72.6%) reported using migraine medications during pregnancy.

About 76% of women who reported migraine both prior to and during pregnancy reported using a migraine agent during pregnancy, compared with 51.8% who reported migraine during pregnancy only.

The most common migraine agents used included non-narcotic analgesics (54.1%) and triptans (25.4%).

After adjusting for sociodemographic factors and comorbidities, sleep duration <5 h (odds ratio, OR, 1.5), pre-pregnancy BMI > 25.0 kg/m squared (OR 1.3), and being on sick leave (OR 1.3) were associated with the use of migraine medications during pregnancy.

By contrast, women who reported acute musculoskeletal pain of the back, neck, and/or shoulder were less likely to use migraine medications during pregnancy (OR 0.6).

When it came to particular types of migraine medications, young mothers and those who had more than child were less likely to use triptans, while those who stopped taking serotonin-selective reuptake inhibitors and beta-receptor agonists prescribed before pregnancy were more likely to use triptans.

“Many women need drug treatment for migraine during pregnancy, and the choice of pharmacotherapy during this period may be influenced by maternal sociodemographic factors and comorbidities,” the authors conclude.

Cephalalgia 2009;29:1267-1276.

Another benefit to breastfeeding

On December 21, 2009, in Pregnancy after WLS, by Andrea

While most of my readers are post-RNYers, I know that some are going to be Banders or VSGers — ones that don’t have an automatic “cure” or “remission” to diabetes due to the intestinal switch done from RNY or DS.  So I’m including this for any Banders or VSGers that might decide to get pregnant at some point.

I couldn’t nurse my two kiddos post op, wish I could have — but there’s nothing to say that those who have had surgery cannot and here is more reason to do so.

From Medscape:

Breast-Feeding May Protect the Mother From Metabolic Syndrome

Laurie Barclay, MD

December 17, 2009 — Breast-feeding may protect the nursing mother from the metabolic syndrome, according to the results of a prospective, observational cohort study reported in the December 3 Online First issue of Diabetes.

“The Metabolic Syndrome is a clustering of risk factors related to obesity and metabolism that strongly predicts future diabetes and possibly, coronary heart disease during midlife and early death for women,” lead author Erica Gunderson, PhD, from Kaiser Permanente’s Division of Research in Oakland, California, said in a news release. “Because the Metabolic Syndrome affects about 18 to 37 percent of U.S. women between ages 20-59, the childbearing years may be a vulnerable period for its development. Postpartum screening of risk factors for diabetes and heart disease may offer an important opportunity for primary prevention.”

The multicenter, population-based US cohort used for this study consisted of 1399 nulliparous women (39% black, aged 18 – 30 years) enrolled in the ongoing Coronary Artery Risk Development in Young Adults Study. Participants were free of the metabolic syndrome at baseline from 1985 to 1986 and before subsequent pregnancies. At 7, 10, 15, and/or 20 years after baseline, participants were re-examined, and National Cholesterol Education Program criteria were used to identify incident cases of metabolic syndrome.

The investigators used complementary log-log models to estimate relative hazards of incident metabolic syndrome among time-dependent lactation duration categories by gestational diabetes mellitus, after adjustment for age, race, study center, time-dependent parity, baseline body mass index, components of the metabolic syndrome, education, smoking, and physical activity.

Of 704 parous women, 84 had gestational diabetes and 620 did not. During 9993 person-years, there were 120 incident cases of metabolic syndrome, yielding an overall crude incidence rate of 12.0 per 1000 person-years (10.8 for nongestational diabetes and 22.1 for gestational diabetes). Increasing duration of lactation was associated with lower crude incidence rates of metabolic syndrome from 0 to 1 month through 9 months or more of breast-feeding (P < .001).

“The findings indicate that breastfeeding a child may have lasting favorable effects on a woman’s risk factors for later developing diabetes or heart disease,” Dr. Gunderson said.

Risk reductions associated with longer duration of lactation were greater among women with gestational diabetes (fully adjusted relative hazards range, 0.14 – 0.56; P = .03) vs those without gestational diabetes (fully adjusted relative hazards range, 0.44 – 0.61; P = .03).

Limitations of this study include observational design and possible residual confounding.

“Longer duration of lactation was associated with lower incidence of the metabolic syndrome years post-weaning among women with a history of GDM [gestational diabetes mellitus] and without GDM controlling for preconception measurements, BMI [body mass index], socio-demographic and lifestyle traits,” the study authors conclude. “Further investigation is needed to elucidate the mechanisms through which lactation may influence women’s cardiometabolic risk profiles, and whether lifestyle modifications, including lactation duration, may affect development of coronary heart disease and type 2 diabetes, particularly among high-risk groups such as women with a history of GDM.”

The National Institutes of Health (the National Heart, Lung, and Blood Institute; the National Institute of Diabetes, Digestive and Kidney Diseases) and the American Diabetes Association supported this study. The study authors have disclosed no relevant financial relationships.

Diabetes. Published online December 3, 2009. Abstract