Clinical Research Strategies for Fructose Metabolism

Event Details

Background

This workshop is sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Heart, Lung, and Blood Institute (NHLBI), the National Institutes of Health (NIH), and the Agriculture Research Service (ARS) of the U.S. Department of Agriculture (USDA).

Meeting Objectives

Consumption of simple sugars (sucrose, glucose, and fructose) currently is estimated at 20 percent of the U.S. diet on average. This coincides with what has been described as an epidemic of obesity and its complications, such as fatty liver, heart disease, and diabetes. Although excess calories are clearly at fault, there is a great deal of public and academic interest in the particular roles, if any, played by simple sugars in the common health problems of Americans. There are some outstanding studies in the literature on the metabolism of fructose and its effects on health outcomes, and many more are being conducted. The current interest, combined with the difficulties of studying a nutrient consumed as a large part of a typical modern diet, led the National Institutes of Health (NIH) to propose a small, 2-day workshop at the NIH Campus in Bethesda, MD, focused on clinical design for studies of fructose and sugar ingestion. Participants from academia, government, advocacy groups, and industry will be invited.

This workshop will showcase studies of the effects of fructose on human whole-body metabolism, energy balance, and obesity as well as on the liver, kidney, and adipose tissue.

Participants will discuss the following:

• What questions concerning human health remain to be answered?
• How might clinical trials be designed to provide interpretable data?
• What are appropriate outcomes measures?

Planning Committee

Peter J. Havel, D.V.M., Ph.D.
Professor, Department of Molecular Biosciences
Department of Nutrition
School of Veterinary Medicine
University of California, Davis

John Bantle, M.D.
Professor of Medicine
Director, Division of Endocrinology and Diabetes
Department of Medicine
University of Minnesota

Elizabeth Parks, Ph.D.
Associate Professor
Center for Human Nutrition
University of Texas Southwestern Medical Center at Dallas

Edward Doo, M.D.
Director, Liver Diseases Research Program
Division of Digestive Diseases and Nutrition
NIDDK, NIH

Michael F. Flessner, M.D., Ph.D.
Director of Inflammatory Renal Diseases
Division of Kidney, Urological, and Hematological Diseases
NIDDK, NIH

Van S. Hubbard, M.D., Ph.D.
Director, NIH Division of Nutrition Research Coordination
Rear Admiral, U.S. Public Health Service (Ret.)

David M. Klurfeld, Ph.D.
National Program Leader, Human Nutrition
Human Nutrition Research Center
USDA-Agricultural Research Service

Maren R. Laughlin, Ph.D.
Senior Advisor for Integrative Metabolism
Division of Diabetes, Endocrinology, and Metabolic Diseases
NIDDK, NIH

Catherine Loria
Epidemiology Branch
Program in Prevention and Population Sciences
Division of Cardiovascular Sciences
National Heart, Lung, and Blood Institute, NIH

Padma Maruvada, Ph.D., M.Sc.
Program Director
Division of Digestive Diseases and Nutrition
NIDDK, NIH

Agenda

November 13, 2012

Session I: Dietary Fructose and Its Metabolism

Chair: John Bantle, University of Minnesota

8:30 a.m.

Welcome and Introductions
Griffin Rodgers, Director, NIDDK

Statement of Goals
Workshop Chair

8:40 a.m.

Epidemiology of Fructose Consumption
Bernadette Marriott, Medical University of South Carolina

9:05 a.m.

Effects of Fructose Intake on Body Weight-metanalyses
John Sievenpiper, University of Toronto

9:30 a.m.

Historical Overview of Fructose Metabolism
Rick Johnson, University of Colorado Denver

9:55 a.m.

Discussion - Statement of Workshop Goals

What questions remain to be answered that require clinical research?

10:15 a.m.

Break

Session II: Fructose and Energy Balance

Chair: Karen Teff, The University of Pennsylvania

10:45 a.m.

Fructose, Obesity, and Weight Gain
Luc Tappy, Universit de Lausanne

11:10 a.m.

Metabolic Rate and Fat Oxidation
Nancy Keim, University of California, Davis

11:35 a.m.

Fructose in the Brain
John Purnell, Oregon Health & Science University

12:00 p.m.

Pediatric Studies and Ingestive Behavior
Sonia Caprio, Yale University

12:25 p.m.

Distribution of Box Lunches

12:40 p.m.

Working Lunch and Discussion

What are the open questions concerning the role of fructose/sugar in energy balance, obesity, and ingestive behavior that can be answered with current technology?

1:10 p.m.

Break

Session III: Fructose Metabolic Effects in People and Non-human Primates

Chair: Peter Havel, University of California, Davis

1:30 p.m.

Short-term Feeding and Lipoprotein Production and Clearance
Elizabeth Parks, The University of Texas Southwestern Medical Center

2:00 p.m.

Long-term Effects of Consuming Sugar-sweetened Beverages on Lipids and Insulin Sensitivity
Kimber Stanhope, University of California, Davis

2:30 p.m.

Adipose Tissue Inflammation and Insulin Resistance
Mario Kratz, Fred Hutchinson Cancer Research Center

3:00 p.m.

Break

3:30 p.m.

Metabolic Pathways by Which Fructose Consumption Affects Lipid Metabolism and Insulin Sensitivity
Jean-Marc Schwartz, Touro University

4:00 p.m.

Very Long-term Effects of Fructose on Non-human Primates
Andrew Bremer, Vanderbilt University

4:30 p.m.

Discussion

What are the open questions concerning the role of fructose in metabolism (insulin resistance, lipid metabolism, other cardiovascular disease factors) that can be answered with current technology?

5:00 p.m.

Adjournment

7:00 p.m.

Organized Dinner (at personal expense)

November 14, 2012

Session IV: Fructose Effects on the Liver and Kidney

Chair: Elizabeth Parks, The University of Texas Southwestern Medical Center

8:00 a.m.

Fatty Liver and Liver Disease
Michael Goran, University of Southern California

8:25 a.m.

Fatty Liver in Childhood and Adolescents
Miriam Vos, Emory University

8:50 a.m.

Liver (ATP) in Response to Fructose Challenge as a Biomarker of Liver Function
Manal Abdelmalek

9:15 a.m.

Kidney Disease and Uric Acid and Hypertension
Miguel A Lanaspa, University of Colorado

9:40 a.m.

Break

10:10 a.m.

Discussion

What are the open questions concerning the role of fructose in organ dysfunction that can be answered with current technology? Does obesity play a role? What about diabetes or cardiovascular disease?

11:00 a.m.

Distribution of Box Lunches

Session V: Design and Outcomes Measures for Studies of the Health Effects of Fructose Ingestion

Chair: Meredith Hawkins, Yeshiva University

11:15 a.m.

Panel Discussion
Karen Teff, The University of Pennsylvania
Miriam Vos, Emory University
Sonia Caprio, Yale University
Jean-Marc Schwartz, Touro University
Kimber Stanhope, University of California, Davis
John Bantle, University of Minnesota
Elizabeth Parks, The University of Texas Southwestern Medical Center
Lisa Cooper Hudgins, The Rogosin Institute/Weill Cornell Medical College
Brian Soher, Duke University
David D'Allessio, University of Cincinnati
George Bray, Pennington Biomedical Research Center
Sam Klein, Washington University in St. Louis

Three study designs will each be designed, presented, and critiqued by a four-member team.

2:00 p.m.

Wrap-up
Workshop Chair

2:15 p.m.

Adjournment