Postprandial pile-up with fructose

Heart disease is likely caused in the after-eating, postprandial period. That's why the practice of grazing, eating many small meals throughout the day, can potentially increase heart disease risk. Eating often can lead to the phenomenon I call triglyceride and chylomicron "stacking," or the piling up of postprandial breakdown products in the blood stream.

Different fatty acid fractions generate different postprandial patterns. But so do different sugars. Fructose, in particular, is an especially potent agent that magnifies the postprandial patterns. (See Goodbye, fructose.)

Take a look at the graphs from the exhaustive University of California study by Stanhope et al, 2009:

From Stanhope KL et al, J Clin Invest 2009. Click on image to make larger.

The left graphs show the triglyceride effects of adding glucose-sweetened drinks (not sucrose) to the study participants' diets. The right graphs show the triglyceride effects of adding fructose-sweetened drinks.

Note that fructose causes enormous "stacking" of triglycerides, meaning that postprandial chylomicrons and VLDL particles are accumulating. (This study also showed a 4-fold greater increase in abdominal fat and 45% increase in small LDL particles with fructose.)

It means that low-fat salad dressings, sodas, ketchup, spaghetti sauce, and all the other foods made with high-fructose corn syrup not only make you fat, but also magnifies the severity of postprandial lipoprotein stacking, a phenomenon that leads to more atherosclerotic plaque.

Comments (20) -

  • KENNY10021

    11/12/2009 2:01:55 PM |

    What if spaghetti sauce is NOT made with HFCS? I love my spaghetti sauce over my moderation.

  • LynneC

    11/12/2009 2:58:34 PM |

    Nice find.... this really demonstrates the insidious nature of HFCS, on multiple fronts.

  • homertobias

    11/12/2009 3:04:43 PM |

    Dr. Ron Krauss again.  Any research with his name on it is superb in my book.  I wonder if he knows Dr. Lustig (UCTV Fructose lecture).  They are neighbors.  So is BG.  Thanks for the whole reference.

  • LPaForLife

    11/12/2009 3:50:40 PM |

    Dr. Davis,

    Given this information. If someone has a good BMI and good overall diet without grains, how much fruit should they limit themselves to in a day. Should they only eat this fruit with a meal and not eat it alone between meals?

  • Anonymous

    11/12/2009 5:47:48 PM |

    Is Grazing on protein and vegetables also bad?


  • Will

    11/12/2009 9:42:57 PM |

    Wow. I guess fructose of any source would be bad, not just HFCS but eating an apple as well? It's hard to rationalize why something that is found in nature, is a whole food, and appeals to our sense of taste, would be bad for us. Maybe the fact that the fructose in the the study was in liquid form, versus being held up in some fiber, had something to do with the results but this isn't the first time that I have read that fruit is bad for you.

  • Dr. William Davis

    11/12/2009 10:32:50 PM |

    Keep in mind that the design of studies like this are often meant to yield exagerrated effects for the purposes of clean observations. It does not necessarily mean that every time you eat, you get similar postprandial phenomena.

    Nonetheless, I believe there are important lessons from such studies.

  • Anonymous

    11/12/2009 11:39:36 PM |

    This study suggests that a rice cracker or a potato (converted directly to gluclose) might be more healthful than a piece of fruit

  • pmpctek

    11/13/2009 3:33:20 AM |

    I've been able to adapt relatively easily to everything in your TYP program Dr. Davis, but this one seems to be the toughest for me.

    I don't think I can eat one meal a day.  I have always been blessed with a fast metabolism and need at least 3,000 (LC) calories even on a moderately active day, or I start to lose weight, which at 5' 9" 165# @ 8% BMI, I don't want to do, and probably shouldn't.

    3,000 calories is simply too much for me to eat in one meal.  Plus, it seems so counter-intuitive to good health, like maintaining a good energy/thermogenic/glucose/insulin/nitrogen balance throughout the day.  It just seems a perfect recipe for storing fat at the expense of lean mass, which is the complete opposite of paleolithic man's highly muscular, lean composition. I don't know, maybe just I wouldn't survive well back then...

  • Anonymous

    11/13/2009 9:43:58 AM |

    This is an excellent point- the reverse of intermittent fasting and variation in calorific consumption. Excess macronutirent calories, in the wrong form, at frequent intervals. No surprise there are adverse implications. OB

  • moblogs

    11/13/2009 10:40:00 AM |

    It rings a bell. My maternal grandfather died not long after a meal.

  • LynneC

    11/13/2009 2:29:51 PM |

    Re fructose from fruit vs HFCS, I don't think that there's much comparison.

    There are benefits to eating fruit (antioxidants, fiber, vitamins).  There is no benefit to consuming HFCS.

    Choose your fruits carefully and eat in moderation...

  • Helen

    11/14/2009 12:27:30 AM |

    I doubt that eating fruit is the same as eating refined fructose.  Not all fruit is high in fructose, for instance.  Also, the fiber in the fruit slows absorption, and this may give time for the fructose to be fermented by bacteria in the gut, producing, for instance, acetic acid, which may be beneficial to fat deposition patterns. (This is just a personal theory of mine.)  

    Furthermore, fruit contains vitamins, minerals, antioxidants, and flavoniods, which can benefit glucose metabolism, prevent lipid oxidization, and dampen the tide of free radicals and advanced glycation end-products (AGEs) produced by glucose and fructose metabolism.

    Those concerned with the effects of fructose from fruit should focus on eating whole fruits only (no juice), and eat mostly berries (low in fructose, high in flavonoids).

    I think it would be wise to separate the valid concerns about refined fructose from fruit.  We could be as off-base about vilifying fruit as people were about eggs.

    Just because a food contains a substance that can is harmful when it's been refined from its source doesn't mean that it has the same effect when found in a whole food.  The digestion and metabolism of whole foods is far more complex than can be understood by studying a single factor.

    If it's something humans have eaten for millennia, and it's safe to say that fruit is, I think it's probably innocent until proven guilty.  Just don't eat refined stuff (including juice), and you'll be fine.

  • Jim Purdy

    11/14/2009 11:13:36 AM |

    I am now trying to eat a diet that is very low in carbohydrates, moderate in protein, and high in fats like butter, omega-3 eggs, and cream cheese.

    This kind of diet seems to prevent the blood glucose spikes and the very unpleasant tachycardia that I get from high-carb meals.

    And it is frequent small meals that best control my blood glucose and the tachycardia.

  • Dr. William Davis

    11/14/2009 1:47:09 PM |


    Eating once a day was not the intended message.

    This discussion is simply part of a larger discussion on the effects of various foods on postprandial patterns. We must all eat and preferably do so 3 times a day.

  • camilynn

    11/19/2009 7:08:46 AM |

    Good one on "Postprandial pile-up with fructose".I'm using the methods from to reduce weight and it really works.

    Edwin-   Lose 20 - Losing weight may save your life

  • Walter

    11/27/2009 6:00:10 AM |

    Hey, not all  spaghetti sauce has added fructose. Those made with sugar and or fructose cost more, because they are cheating on the ingredients.

    And yes, sugar is (half) fructose.

    Dr. William Davis, do we have any studies that show 3 times a day is optimal? One could hardly do a double blind study on this.

  • Anonymous

    10/19/2010 10:29:18 PM |

    I ate 50 grams of grapefruit (with extra fiber), with my last meal of the day and it spiked my blood sugar from 120 to 170 in 1 hr and I think I felt the beta cell damage for several hours - fruit is worse than oatmeal WITH sugar! I am pre-diabetic. I am trying to give up all bad things, but I am starving and I have to eat. I have chewing problems, so this complicates things. I tried soymilk, but it seemed to destabilize me, which is not good - I'll try it with fiber next time. I am underweight now. I am in a real bad place. I can't eat fruit anymore and even veggies give me problems. I hope I can avoid scurvy. Does anyone know if vitamin C pills truly prevent scurvy?

  • Documentaries

    11/1/2010 9:06:16 PM |

    I don't think I can eat one meal a day. I have always been blessed with a fast metabolism and need at least 3,000 calories

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