Fructose and Ethnic Differences Study (FED Study)
Fructose and Ethnic Differences Study (FED Study)
In the UK, people of black West African and Caribbean's tend to have healthier blood
 cholesterol and blood fat levels, as well as lower incidence of heart disease/heart attack.
 But rates of heart disease are now rising in young African-American populations with
 diabetes, for the first time exceeding the rate in their white European-American peers. One
 possible culprit is the increasing consumption of fructose which can lead to high blood fat
 levels. Fructose is a natural sugar found in fruits and table sugar but is also used the food
 industry as an ingredient and sweetener. Because fructose intakes are lower in the UK than in
 North America we are studying the effect of fructose intake in UK black West African and
 Caribbean people, to understand if fructose intake is indeed a reason for these ethnic
 differences.
The overall nature of this study is to conduct an investigation into the metabolic effects of
 acute high fructose versus high glucose feeding in people of Black African (BA) compared to
 age and BMI-matched control subjects of White-European (WE) origin . The research question of
 our study is: do people of BA metabolise fructose differently than people of WE when
 challenged with a high sugar diet? Therefore, our specific aims are to determine the
 following in both people of BA and WE consuming both high fructose and high glucose meals: 1)
 the postprandial pattern of blood insulin, glucose, triglyceride and cholesterol
 concentrations; 2) ambulatory blood pressure measures during the postprandial period and 4)
 postprandial and 0-24-hour fasted serum and red blood cell membrane cholesterol and
 non-cholesterol sterol concentrations.

 Potential participants will attend the scheduled screening session where the requirements of
 participation will be described and the participants will be given an opportunity to ask any
 questions they may have. Those still willing to participate will sign the informed consent
 form before the screening assessment is performed. Screening will require a fasted blood
 sample to be taken as well as a brief questionnaire to ascertain ethnicity (self-declared),
 medications and health status. An assessment of weight, height and waist circumference will
 also be taken to confirm they meet the inclusion criteria. It is expected that the results of
 the screening blood sample will be available within 1-2 weeks. Those participants meeting the
 inclusion criteria will be contacted and scheduled for the first study visit. Those not
 meeting the criteria will be notified by their preferred means of contact, a copy of their
 results will be provided.

 Prior to attending participants treatment order will be randomized. Participants will report
 to the Metabolic Research Unit (MRU) at 08.00 following an overnight fast. A catheter will be
 inserted into an antecubital vein for collection of blood samples and a baseline blood sample
 collected at this time. Participant will be asked to undertake minimal physical activity
 during the remainder of the study period. A breakfast meal will be given at 0min, the lunch
 meal at 240min and meals will be consumed within 15 minutes. Participants will be fitted with
 a portable continuous blood pressure and heart rate monitor (arteriograph) and instructed on
 what to expect as it functions. Further blood samples will be taken at -30, -15, 0, 15, 30,
 45, 60, 90, 120, 180, 240, 300, 360, 420min and at 24hrs (1440min, fasted). The energy
 content of the meals will be the estimated energy requirements of the participant (to the
 nearest 100kcals), with 20% of total daily energy coming from glucose or fructose. The
 glucose or fructose will be given dissolved water with added colour and orange/fruit flavours
 and provided at breakfast, lunch and supper. The remaining daily caloric requirement for each
 participant will be given a standardized evening meal to take away and consume at home.
Inclusion Criteria:

 -  Self-reported healthy, confirmed by blood tests (i.e. liver enzymes, full blood count,
 lipids, glucose); ethnicity White European participants had at least 3 grandparents
 originating from countries of Europe and Black African participants had at least 3
 grandparents originating primarily from countries of West Africa (Economic Community
 of West African States (ECOWAS) and central African countries (e.g. Cameroon, Uganda,
 etc).

 Exclusion Criteria:

 -  fasting glucose in the diabetic range (fasting glucose >7 mmol/l); hypertension
 (medically diagnosed or >140/90 mm Hg at screening); hyperlipidaemia deemed to require
 immediate medical intervention (defined as: total cholesterol >6.0 mmol/l;
 LDL-cholesterol >4.5 mmol/l; fasting TG >3 mmol/l).