ONLINE DRIVERS MEDIA

Remember: If anything fructose from beverages (including juices), yet not fructose from whole fruit is a problem. In fact eating whole fruits will decrease your blood lipids and high sensitivity C reactive protein (hs-CRP) inflammation markers.

Fructose is bad for you, right? Right. According to the latest study from the University of Newcastle, the consumption of only one drink containing containing 50 g of either fructose or glucose or sucrose dissolved in water will have detrimental effects on the #1 indicator of whole body inflammation, which is high sensitivity C-reactive protein (hs-CRP).

Much to the researchers surprise, though, the same amount of fructose had significant beneficial effects on the plasma lipid levels of the healthy male and female adults (n = 14) between the ages of 18-60 years who were recruited by advertisement and underwent study procedures at the Nutraceuticals Research Group Clinic rooms at the University of Newcastle in Australia.
Since the exclusion criteria were: diagnosed hyperlipidaemia, diabetes, gastrointestinal disorders, currently on fructose/sugar restricted diet, vegan diet or weight loss program, undergone any surgical procedure for obesity, pregnant or lactating mother, taking lipid-lowering or anti-inflammatory drugs and BMI >30kg/m², the results may well be different in "sicker" individuals, but for the guys and gals who drank the three 50g "sugar" solutions on three different occasions after an overnight fast, the "negative effects" of fructose were far from being conclusive.

Figure 1: Changes in hs-CRP, HDL and LDL in response to the ingestion of the test drinks (Jameel. 2014).

Even if you belong to the ever-increasing numbers of brainwashed fructose haters who believe that fructose and not a general overconsumption of energy was to blame for the obesity epidemic, you will have to admit that the data in Figure 1 leaves the significance of concomitant increases in hs-CRP and significant improvements in the HDL/LDL ratio, as the scientists phrase it, "to be delineated when considering health effects of feeding fructose-rich diets" (Jameel. 2014).
Well, yes, but (a) its only an acute response and (b) while increased levels of hs-CRP have been found to be associated with heart disease (Rifai. 2001; Danesh. 2004), the same can be said for a high LDL/HDL ratio (Fernandez. 2008).

Figure 2: CRP-dependent risk levels for cardiovascular disease according to the American Hear Association.

If we also take into consideration that the baseline hs-CRP level of the subjects was 1.5mg/L and thus low to mid-range for the average Westerner (depending on his or her ethnicity | Albert. 2004), an increase of 10% to a maximal value of 1.65mg/L would not bring them to critical heights of which the Farmingham study says that they start at 3mg/L for Westerners (Wilson. 2005). Thats not ana optimal level, but considering the fact that we are talking about "average Joes and Janes" who probably dont work out, eat whatever they like and give a damn about their sleep hygiene (all three factors have previously been linked to elevated hs-CRP levels) thats not astonishing and has absolutely nothing to do with the ingestion of 50g of fructose.

Furthermore, a comparison of the predictive value of different risk markers for cardiovascular disease by Folsom, et al. (2006) indicates that the hs-CRP values did not add to the prognostic value of the standard risk factors which are age, race, sex, systolic blood pressure, smoking status, diabetes and - you guessed it - total and high density lipoprotein cholesterol, which increased by almost 7% while the amount of LDL dropped by maximally 6%. Thus the LDL/HDL ratio decreased from 1.84 to 1.62. Thats a 12% decrease that would be health relevant if the subjects LDL/HDL ratio was not far away from the danger-zone (>5 | see Manninen. 1992), already. Similarly, the total cholesterol to HDL ratio dropped by -1.97 but wasnt in the danger zone before, either.
References:

• Danesh, John, et al. "C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease." New England Journal of Medicine 350.14 (2004): 1387-1397. 
• Fernandez, Maria Luz, and Densie Webb. "The LDL to HDL cholesterol ratio as a valuable tool to evaluate coronary heart disease risk." Journal of the American College of Nutrition 27.1 (2008): 1-5.
• Folsom, Aaron R., et al. "An assessment of incremental coronary risk prediction using C-reactive protein and other novel risk markers: the atherosclerosis risk in communities study." Archives of internal medicine 166.13 (2006): 1368-1373. 
• Hermsdorff, Helen Hermana M., et al. "Research Fruit and vegetable consumption and proinflammatory gene expression from peripheral blood mononuclear cells in young adults: a translational study." (2010).
• Jameel, Faizan, et al. "Acute effects of feeding fructose, glucose and sucrose on blood lipid levels and systemic inflammation." Lipids in Health and Disease 13.1 (2014): 195.
• Manninen, Vesa, et al. "Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentrations on coronary heart disease risk in the Helsinki Heart Study. Implications for treatment." Circulation 85.1 (1992): 37-45.
• Oliveira, A., F. Rodriguez-Artalejo, and C. Lopes. "The association of fruits, vegetables, antioxidant vitamins and fibre intake with high-sensitivity C-reactive protein: sex and body mass index interactions." European journal of clinical nutrition 63.11 (2009): 1345-1352. 
• Ravn-Haren, Gitte, et al. "Intake of whole apples or clear apple juice has contrasting effects on plasma lipids in healthy volunteers." European journal of nutrition 52.8 (2013): 1875-1889.
• Rifai, Nader, and Paul M. Ridker. "High-sensitivity C-reactive protein: a novel and promising marker of coronary heart disease." Clinical chemistry 47.3 (2001): 403-411.
• Wilson, Peter WF, et al. "C-reactive protein and risk of cardiovascular disease in men and women from the Framingham Heart Study." Archives of internal medicine 165.21 (2005): 2473-2478.

It takes some effort to avoid making the transition from the sofa to the ICU.

Whats better for heart disease protection - high or medium intensity exercise as it is still prescribed by the majority of doctors? A recent study from the University of Erlangen-Nürnberg (Germany) probed the effects of high vs. moderate intensity training on cardiovascular risk markers of 81 untrained, healthy not exactly lean (BMI 27.2kg/m²) men aged 30-50 years.

The subjects were randomized to either a high intensity interval training or a moderate intensity steady state training group who burnt the exact same amount of energy during their workouts.
In contrast to other studies, the groups did not train at the same time. The study started in September. From September to December, the HIIT group performed high intensity interval training

• at 80-100% of their maximal heart rate during 90s-120min intervals,
• with 1-3 min pauses at 70-75% of the maximal heart rate

so that 40% of the total training volume were performed at high heart rates, 35% at maximal heart rates, and 25% of the total volume at 25% of medium heart rates.

Figure 1: Overview of the study protocol (translated from Kemmler. 2015).

During the first three months, the medium intensity steady state group (MIST) group served as sedentary control (see Figure 1). A control group in which the markers of cardiovascular health rather deteriorated than improved.

Figure 2: Changes in left ventricular myocardial mass (LVMI), cardiovascular fitness (CV), intima-media thickness (IMT, associated with increased CVD risk), body fat, and lean mass (Kemmler. 2015).

What is of interest is thus not really the difference between the control and the HIIT group, but the difference between the HIIT and MIST group. A difference of which the data in Figure 2 indicates that there was a significant advantage of doing HIIT vs MIST training - at least as far as the cardiovascular disease markers are concerned.

What may come as a surprise is that despite the significant improvements in fitness and metabolic disease scores (-2.06 pts vs. -1.6 pts with HIIT vs. MIST, respectively), the amount of fat lost was more pronounced in the MIST group; and that in spite of the fact that they performed only 5% of their training at the maximal heart frequency, 10% at high intensities and the vast majority of exercise, i.e. 85%, at a moderate exercise intensity. In view of the fact that the design of the study required that all participants expended the same amount of energy, its quite interesting that the subjects in the MIST study burned more body fat than the subjects in the HIIT study. In the absence of a strictly controlled energy intake, its yet no reliable evidence that would disprove the rule that HIIT is - specifically for leaner folks - the more effective fat burner. The result of the study at hand should thus not be overrated.

Figure 2: Endothelial function measured as FMD (left); maximal oxygen uptake (right) before and after 12-week high intensity interval or moderate intensity steady state exercise in patients with heart failure (Wisløff . 2007)

Before I get to the conclusions, I would like to point out that having a exisiting heart condition is not necessarily a reason to refrain from high intensity exercise. On the contrary, a 2007 study by Ulrik Wisløff et al. clearly indicates that aerobic interval training is superior to moderate continuous training even in heart failure patients. More specifically, the scientists from the Norwegian University of Science and Technology in Trondheim found that "[e]xercise intensity was an important factor for reversing LV remodeling and improving aerobic capacity, endothelial function, and quality of life in patients with postinfarction heart failure" (Wisløff. 2007).

Yet in spite of the fact that the researchers  highlight that their results would have "important implications for exercise training in rehabilitation programs" - the impact on the real world prescriptions in such programs is negligible.,
References:

• Beniamini, Yael, et al. "High-intensity strength training of patients enrolled in an outpatient cardiac rehabilitation program." Journal of Cardiopulmonary Rehabilitation and Prevention 19.1 (1999): 8-17.
• Kemmler, Wolfgang, et al. "Hoch-versus moderat-intensive Laufbelastung–Einfluss auf kardio-metabolische Risikogrößen bei untrainierten Männern." DMW-Deutsche Medizinische Wochenschrift 140.01 (2015): e7-e13.
• Tanasescu, Mihaela, et al. "Exercise type and intensity in relation to coronary heart disease in men." Jama 288.16 (2002): 1994-2000.
• Tinkham, Michelle. "Health Promotion in Cardiac Rehabilitation Patients through the Use of a High-Intensity Interval Training Protocol." World Journal of Cardiovascular Diseases 4.10 (2014): 493.
• Warburton, Darren ER, et al. "Effectiveness of high-intensity interval training for the rehabilitation of patients with coronary artery disease." The American journal of cardiology 95.9 (2005): 1080-1084.
• Wisløff, Ulrik, et al. "Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients a randomized study." Circulation 115.24 (2007): 3086-3094.