Abstract

OBJECTIVE: There have been <i>unsafe levels of unpaired fructose</i> in the high fructose corn syrup (HFCS) in US beverages, and research/case study evidence shows that their intake is associated with greater asthma prevalence/risk/incidence, a debilitating disease, likely due to fructose malabsorption, gut fructosylation and gut dysbiosis mechanisms. The 'unexplained' asthma epidemic has disproportionately affected children and Black individuals, groups with higher fructose malabsorption prevalence than others, and research to assess disproportionately higher asthma risk/incidence among Black individuals in association with HFCS-sweetened beverage intake is lacking. DESIGN: Demographic, lifestyle and dietary data collected at enrollment (1985-86), and incident asthma through exam 5 (1995-96), were used in Cox proportional hazards models to assess HFCS intake associations (hazard ratios) with asthma risk/incidence. SETTING: CARDIA study participants from Birmingham, AL, Chicago, IL, Minneapolis, MN and Oakland, CA. PARTICIPANTS: 1998 Black and 2104 White young adults. RESULTS: HFCS-sweetened beverage intake &gt; once/week <i>was</i> significantly associated with higher asthma risk relative to ≤ once/week (<i>P</i>-trend = 0·04), among Black participants only; risk was 2·8 times higher among 2-4 times/week consumers (HR = 2·8, 95 % CI 1·1, 7·3, <i>P</i> = 0·04) and 3·5 times higher when consumed multiple times/d, independent of <i>sucrose</i> intake/obesity/dietary quality/smoking/in-home smoke-exposure (HR = 3·5, 95 % CI 1·3, 9·9, <i>P</i> = 0·02). Intake of <i>orange juice</i>, with nominal unpaired fructose, was <i>not</i> associated with asthma in either group, <i>nor was intake of sucrose</i>, a disaccharide (paired) of fructose/glucose. CONCLUSIONS: Ubiquitous HFCS in the US food supply, with HFCS that contains high/unsafe unpaired fructose, also known as excess-free-fructose, and the fructose/gut/lung/axis are overlooked risk factors in the 'unexplained' US asthma epidemic that disproportionately affects Black individuals.