The incidence of heart failure in young African-American adults is 20 times higher than that white age-matched counterparts, according to a study in last week’s New England Journal of Medicine.

Some black adults had actually died of heart failure a decade before the chronic illness even began to affect whites.

Kirsten Bibbins-Domingo and colleagues enrolled 5,115 18-30 year olds and managed to follow them for 2 decades in an effort to understand the causes and course of cardiac disease.

Because participants were so young at the time of enrollment, the scientists didn’t expect to see much at this juncture, but it turned out that 27 participants developed heart failure and all but one was black.

The scientists estimated the incidence of heart failure in blacks under the age of 50 to be 1%.

“Blacks in our study who were in their 30s and 40s had the same rate of heart failure as whites in their 50s and 60s,” Bibbins-Domingo told the New York Times.

“These people are in the prime of their life and should be contributing in all kinds of ways,” Bibbins-Domingo added. “So this disease has a devastating effect, not just on the individual but on the family, the community and society in general.”

Afflicted individuals of all races were more likely to have diabetes, hypertension, obesity and kidney disease. They also tended to have low HDL (good) cholesterol levels.

Eric Peterson, a Duke cardiologist who wrote an accompanying editorial on racial disparities in cardiac care thought the study was “remarkably important,” especially since heart failure is largely preventable.

“This shows you where having 20 years of uncontrolled blood pressure has effects, on kidney disease — and on the heart,” Peterson said. “It wears it out.”

Old-fashioned sugar, the nutritional pariah that has been reviled for 3 decades as a tooth destroying, hyperactivity provoking source of empty calories, is making a comeback as a healthful, natural ingredient.

The resurrection comes at the expense of high-fructose corn syrup, a sweetener that had found its way into baked goods, frozen foods, soda, spaghetti sauce, yogurt and a thousand other staples of the American diet.

Pizza Hut’s new pie, dubbed “The Natural,” is free of HFCS, as is newly released Pepsi Natural. ConAgra adds either sugar or honey to its new Healthy Choice All Natural frozen entrees and Kraft Foods cut the corn sweetener from its salad dressings.

And a limited-edition Coke produced annually for Jews who stay away from corn during Passover has become so popular that stores have been forced to ration it.

The reversal of fortune comes after HFCS had relentlessly gained market share on sugar for 30 years. By 2003, the former had pulled even according to the Department of Agriculture, but 4 years later US adults were consuming an average of 44 pounds per year of sugar compared with a mere 40 pounds of HFCS.

“Sugar was the old devil, and high-fructose corn syrup is the new devil,” Marcia Mogelonsky, a senior analyst at Mintel International told the New York Times.

Some shoppers prefer sugar because they perceive it to be less processed, which is the equivalent of saying, “I shot the sheriff but I didn’t shoot the deputy.” Others link HFCS to the epidemic of obesity which is patently unfair but that’s beside the point.

The battle is about marketing and consumer perception rather than actual nutritional differences. Both sweeteners are comprised of glucose and fructose. Fructose levels are a bit higher in HCFS, a difference that has no clinical significance.

Or as Robert Lustig, a pediatric endocrinologist at UCSF Children’s Hospital, explained to the Times, “the argument about which is better for you, sucrose or HFCS, is garbage. Both are bad for your health.”

Three years ago when Merck introduced Gardasil, the anti-HPV vaccine for the prevention of cervical cancer and genital warts in girls, the buzz focused on whether it might encourage girls to have sex.

Now, the vaccine maker wants to market the jab for boys and the tweets are all about vaccine safety and cost-effectiveness.

That seems fair.

Human papillomavirus causes cervical cancer, which strikes 10,000 and kills 3,700 US females per year. In males, HPV causes 7,500 cancers per year, involving primarily the penis and anus, and kills about 1,000. 

Gregory Zimet, a Indiana University professor of pediatrics marveled the hypocrisy. “I wonder if it was the reverse, and there was a vaccine for women that helped prevent prostate cancer in men, this would be as much of an issue.”

After the FDA green-lighted Gardasil in 2006 for girls aged 9 and up, medical groups recommended they should take the spike by age 12, or before they became sexually active.

At the time Merck tried to persuade states to add Gardasil to the list of vaccines required for children to attend school. It dumped that strategy after being scorched by critics who thought the decision should be left with parents.

Merck’s field tests of Gardasil in men show that it is safe in the short term, and that it prevents HPV infection, genital warts and precancerous growths.

Gardasil vaccination costs about $500 for the 3 shots and the related office visits.