Increased Fructose Intake as a Risk

809 Increased Fructose Intake as a Risk Factor For Dementia The American Heart Association (AHA) has recently released new recommendations to reduce the dietary intake of added sugars. Such changes are advocated due to the established link between high sugar intake and metabolic derangement and adverse health conditions including, for example, obesity and diabetes (1). The statement of the AHA report did not mention the potential effects of added sugars on risk of chronic neurodegenerative diseases, such as dementia, either through a direct influence on pathogenesis or through metabolic diseases, such as diabetes or hypertension. Animal models of dementia suggest that excess consumption of fructose contained in refined sugars like sucrose and high-fructose corn syrup (HFCS) can promote dementia pathogenesis through increased central neuronal insulin resistance and deposition of beta amyloid (associated with Alzheimer’s disease, AD) (2,3). Currently, there is a lack of evidence for an effect of fructose on cognitive functions in humans, and a high intake of fructosebased sweeteners might be a significant risk factor for the development of dementia, independent of changes in the world age demographic and mortality rates (4–6). This article will explore the potential link between dietary and health secular trends in the United States, namely the growing consumption of fructose-based sweeteners as a risk factor for dementia in the ageing population. Secular Trends in Dietary Intake and Risk of Chronic Disease Data on fructose and refined sugar consumption from European and Asian countries are scarce. In these regions, dietary intake is typically not assessed individually but rather estimated from population food disappearance. As such, the current epidemiological evidence on secular trends and the association between sugar intake and cardiometabolic diseases is derived from data collected in American National Surveys (NHANES) (5) and population-based cohorts including, for example, the Framingham study (7) and the Nurses Health Study (8). We will use available U.S. data to explore the potential association between increased fructose intake and risk of cognitive decline with the assumption that any association can be extrapolated to countries with similar demographic and health/lifestyle behaviors. Recent diet secular trends include reduced fat intake and increased intake of refined carbohydrate, especially with regard to HFCS (5,9). The powerful sweetening properties of fructose have been exploited by the food industry to increase the palatability and rewarding properties of food products (10). Initially, the food industry used sucrose (formed by one molecule of glucose and one of fructose); however, HFCS (formed by 55% fructose and 41% glucose) is now more commonly used due to ease of production, economic viability, as well as the powerful sweetening effects, Perspective