**EP337: High Fructose Corn Syrup and Red Wine Headache**
**Dr. Auric Bishop:** Welcome, my name's Dr. Auric Bishop. I'm a cardiologist, an author, and a keynote speaker. I'm the CEO of the Healthy Heart Network. I'm all about trying to help people live as well as possible for as long as possible. Heart disease is huge in Australia. Every 20 minutes, someone suffers a heart attack. Most of these could probably have been avoided if only we knew what to do. This podcast is all about helping you understand blood pressure, weight, cholesterol, for better health. If you enjoy this podcast, I would be honoured for a five-star review. You can share it with your family and friends. It may well save someone you love.
**Warwick Bishop:** G'day, Warwick Bishop here and welcome to my podcast and videocast station. I really do appreciate you tuning in. Today, I'd like to talk about a couple of things which I think are interesting, and I hope you find them interesting as well. The first is around sugary sweetened beverages and the use of high fructose corn syrup.
Now, more and more attention is starting to be swung around to the use of high fructose corn syrup, particularly in sugary sweetened beverages and in association with the development of obesity and all the consequences of that. One of the papers that came across my desk in recent times pointed to there potentially being a genetic survival mechanism which involved fructose having an impact on adenosine triphosphate, leading to energy imbalance and a change in energy regulation.
Well, as I mentioned to you, high fructose corn syrup has been central to some of the debate in the US around worsening obesity. And although sugary sweetened beverages have not yet been shown to prove... which is almost incomprehensible, they have been linked to increased levels of type 2 diabetes, cardiovascular disease, and really importantly, non-alcoholic fatty liver disease.
Well, this relationship between sugary sweetened beverages and obesity has been tracked back to when high fructose corn syrup started to make its appearance into regular consumption through sugary sweetened beverages. The reason this has been the case is because these beverages are using a cheap form of sweetening. It turns out high fructose corn syrup is exactly that. It's really generated through industrial processes and drives a very cheap and effective way for obtaining a sugary outcome in the drinks.
Now, one of our problems is obviously more research is needed in this space, but logically it sounds like if this high energy flavouring, if you wish, this sugary additive is being put in drinks, it makes perfect sense that it could well be having an impact on energy balance. But really importantly, underlying that could be a suggestion that's being teased out that fructose has a direct impact on the way the body metabolises fat. I think we will just watch this space.
I think most of us listening to this would probably not be devotees of high fructose corn syrup anyway, so I'm probably preaching to the choir. But it's an interesting space. The importance of trying to link this high fructose corn syrup that's within these sugary sweetened drinks with a change in the way the body responds to that energy could lead to the sort of changes that occurred with trans fats.
The trans fats, as well, were formed from an industrial process, and it was subsequently identified that these trans fats were shown to increase low-density lipoprotein and decrease high-density lipoprotein, and were linked to an increased risk of myocardial infarction and stroke. So let's watch this future, hoping that there's a chance that we get more information that really informs a better decision around potentially banning high fructose corn syrup or severely limiting the use of high fructose corn syrup in these sweet sugary drinks. We were able to get to that position of legislation when it came to trans fats. Let's hope we can do it with corn syrup as well.
So the other thing I wanted to touch on today was red wine headaches. I think we've all had... well, I know I've had one or two headaches from alcohol in the past. But many would say that it's quite likely that you're more likely to have a hangover with red wine than with other alcohols.
A desk towards the end of last year flagged the possibility that red wine could be specific in terms of its generation of a hangover headache. Well, let's start with what it's all about. When alcohol is consumed, it is the compound ethanol that is converted into aldehyde by the enzyme alcohol dehydrogenase, and then that aldehyde is converted to acetate. Acetate is basically excreted out through the urine.
Now, ethanol being converted to acetaldehyde uses an enzyme called alcohol dehydrogenase. No problem there; most of us have that. When it comes to acetaldehyde being converted to acetate, well, it turns out acetaldehyde is probably the metabolic component that drives the side effects of a hangover. It's the acetaldehyde that makes us feel terrible. Acetate's pretty benign. So if we can convert our acetaldehyde using our acetaldehyde dehydrogenase through to acetate, and we can do that effectively, we should have a relatively low risk of hangover symptoms.
Well, it turns out that East Asian ancestry can be linked with a genetic predisposition to having that gene mutated and just not working well, giving rise to a really significant intolerance of alcohol consumption in those populations. Interestingly, there's also a drug called disulfiram. There you go, I'll get my tongue around it eventually. Disulfiram, and disulfiram is a blocker of the acetaldehyde dehydrogenase.
Disulfiram, also known as Antabuse, is used to stop people who have alcohol abuse. It works by increasing that acetaldehyde level, stopping metabolism to acetate, and the accumulation of that acetaldehyde makes people feel so terrible that they want to abstain from drinking.
Back to the story: do we really observe, or is there a reason why we might observe a greater risk of development of hangover symptoms with red wine? Well, some researchers, believe it or not, actually looked at this closely and pulled a whole lot of compounds that are within red wine. If you like, the red bits of the red wine, or the colors, or the stuff from the pressings, and looked at different components of that. They found that one of the components, quercetin glucuronoride, which is basically a compound that gives color to that red wine, in fact has an effect to inhibit that acetaldehyde dehydrogenase, therefore potentially driving it to build up.
Now, relatively small levels of this should end up in the bloodstream, but this subcompound of the compounds within the red wine that give it its redness, that come from the grapes, etc., can have a direct effect on this enzyme, which could push up the acetaldehyde and make us feel generally miserable the day after.
Are there compounds on the horizon that may block this interaction? I don't know. You'll have to watch and see. And really, how much do you have to drink? Well, I guess it depends a little bit on your own sensitivities, but for what it's worth, it's a very interesting thought bubble. For me, it just raises that possibility of how do we potentially explain how some of these effects from alcohol can vary. And they may vary between different wines and certainly between different alcohols.
So, ethanol to acetaldehyde via alcohol dehydrogenase, acetaldehyde to acetate, and passed out through the urine through acetaldehyde dehydrogenase. And that enzyme can be impacted by the components of red wine.
Well, there you go. It's been a podcast of beverages: sugary sweetened drinks, high fructose corn syrup, quercetin, and red wine. I hope I haven't given you a headache. I hope you've enjoyed today's podcast. If you've got any queries or questions, drop us a note. If you've enjoyed it, please share it with someone else and maybe leave a nice review.
Till next time, I wish you the best and hope you live as well as possible for as long as possible. Take care and bye for now.
**Dr. Auric Bishop:** Hi. Ever wondered what your risk of heart attack is? You should. It's the single biggest killer in the Western world. We're talking one death less than every 30 minutes in Australia. One death less than every 60 seconds in the United States. Nine million deaths globally per annum.
Well, how do you check your risk? You can go to www.virtualheartcheck.com.au. You'll find out about your risk and what can be done beyond that to be even more precise.
