Michelle A.J. van Oeteren^1,2, Jean L.J.M. Scheijen^1,2, Marjo P.H. van de Waarenburg^1,2, Alfons J.H.M. Houben^1,2, Casper G. Schalkwijk^1,2, Martijn C.G.J. Brouwers^1,2,3,*

1. Laboratory for Metabolism and Vascular Medicine, Division of General Internal Medicine, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands. 2. Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands. 3. Division of Endocrinology and Metabolic Diseases, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands. michelle.vanoeteren@maastrichtuniversity.nl

Population-based cohort studies have reported differential associations for different sources of fructose (e.g. fruits, fruit juice and sugar-sweetened beverages) with cardiometabolic outcomes. These findings could be explained by the food matrix, i.e. the complex assembly and molecular interaction of nutrients within a food that influence digestibility and metabolism. Currently, there is little experimental evidence to support the hypothesis that the food matrix affects serum fructose dynamics and cardiometabolic outcomes, such as blood pressure, in humans.

We performed a cross-over study in which healthy individuals were exposed to a fixed amount of fructose from different matrices, i.e. an apple, a mashed apple, apple juice and fructose dissolved in water, in random order. The fructose content of each matrix was measured prior to each experiment with enzymatic spectrophotometry to match a fructose content of 20 grams. Venous blood was collected, and blood pressure was measured every 15 minutes for 150 minutes. Serum fructose was quantified with UPLC-MS/MS.

Fifteen healthy individuals completed the study. The serum fructose area under the curve was lower for all fructose-containing matrices compared to fructose dissolved in water (mean difference -1914 (μmol/L)*min, 95%CI -3686;-142 for apple; -3058 (μmol/L)*min, 95% CI -4050;-2066 for mashed apple; and -1593 (μmol/L)*min, 95%CI -2751;-434, for apple juice). The change from baseline in diastolic blood pressure was statistically significantly lower for apple juice in comparison to fructose dissolved in water (mean difference -3.3 mmHg, 95%CI -6.1;-0.5).

In this study, we show that the food matrix affects systemic fructose dynamics. Moreover, the matrix exerts differential effects on diastolic blood pressure.