ArticleNutrition journal2020
Excess free fructose, apple juice, high fructose corn syrup and childhood asthma risk - the National Children's Study.
Article in Nutrition journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Fructose-Containing Dietary Exposures and Pediatric Atopic Disease: A Review of Epidemiologic Evidence.Nutrients · 2026Pooled it
- Dietary intake of different carbohydrate types and asthma risk: a systematic review and meta-analysis.Nutrition journal · 2025Pooled it
- A systematic review and meta-analysis of the association of all types of beverages high in fructose with asthma in children and adolescents.BMC nutrition · 2024Pooled it
- Close association between lifestyle and circulating FGF21 levels: A systematic review and meta-analysis.Frontiers in endocrinology · 2022Pooled it
- Low glycaemic index diet in pregnancy and child asthma: follow-up of the ROLO trial.The British journal of nutrition · 2026Trial
- Sugar Shockwaves: How the Fructose-Glucose-ChREBP Pathway Hijacks Liver Metabolism.Life (Basel, Switzerland) · 2026Review
- A Short-Term High-Sugar Diet Induces Glucose Intolerance, Visceral Adipose Tissue Inflammation, and Exacerbates Experimental Allergic Asthma.Nutrients · 2026Article
- Fructose Malabsorption, Gut Microbiota and Clinical Consequences: A Narrative Review of the Current Evidence.Life (Basel, Switzerland) · 2025Review
- Article
- Exploring Glyoxalase Strategies for Managing Sugar-Induced Chronic Diseases.Life (Basel, Switzerland) · 2025Article
- Disproportionately higher asthma risk and incidence with high fructose corn syrup, but not sucrose intake, among Black young adults: the CARDIA Study.Public health nutrition · 2025Article
- Rosuvastatin Attenuates Vascular Dysfunction Induced by High-Fructose Diets and Allergic Asthma in Rats.Nutrients · 2024Article
- 40 years of adding more fructose to high fructose corn syrup than is safe, through the lens of malabsorption and altered gut health-gateways to chronic disease.Nutrition journal · 2024Article
- Sugar and Dyslipidemia: A Double-Hit, Perfect Storm.Journal of clinical medicine · 2023Review
- High excess-free-fructose beverage consumption is not associated with prevalent allergy in US adults: a population-based analysis of NHANES 2005-2006.Journal of health, population, and nutrition · 2023Article
- Sugar-Sweetened Beverages andNutrients · 2023Article
- The association of pure fruit juice, sugar-sweetened beverages and fruit consumption with asthma prevalence in adolescents growing up from 11 to 20 years: The PIAMA birth cohort study.Preventive medicine reports · 2022Article
- Association between asthma and sugar-sweetened beverage consumption in the United States pediatric population.The Journal of asthma : official journal of the Association for the Care of Asthma · 2022Article
- Ultra-processed foods and allergic symptoms among children and adults in the United States: A population-based analysis of NHANES 2005-2006.Frontiers in public health · 2022Article
- Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent research provides consistent evidence that the unexplained doubling of childhood asthma prevalence (1980-1995), its continued climb and 2013 plateau, may be associated with the proliferation of high-fructose-corn-syrup (HFCS) in the US food supply. The HFCS used in soft drinks has been shown to contain a higher fructose-to-glucose ratio than previously thought. This coincides with a preference shift from orange to apple juice among young children. Apple juice naturally contains a high (≥2:1) fructose-to-glucose ratio. Thus, children have received high excess-free-fructose doses, the fructose type associated with fructose malabsorption. Unabsorbed excess-free-fructose in the gut may react with dietary proteins to form immunogens that bind asthma mediating receptors, and/or alter the microbiota towards a profile linked to lung disorders. Studies with longitudinal childhood data are lacking. Therefore, we tested the hypothesis that excess-free-fructose intake is associated with childhood asthma risk.
methodsCox regression models were used to analyze prospective early childhood data (12-30 months of age) from the National Children's Study. Intake frequencies for soda/sports/fruit drinks, and 100% juices were used for analyses.
resultsGreater consumption of 100% juice, soda/sports/fruit drinks, and any combination, was associated with ~two (P = 0.001), ~ 2.5 (P = 0.001), and ~ 3.5 times (P < 0.0001) higher asthma incidence.
conclusionsGiven these results, prior research and case-study evidence, it is reasonable to suggest that the two-fold higher asthma risk associated with 100% juice consumption is due to apple juice's high fructose-to-glucose ratio, and that the ~ 2.5/~ 3.5 times higher risk associated with soda/sports/fruit drinks intake is with the excess-free-fructose in HFCS.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.