Heart Health

Scientists have been studying the relationship between obesity and metabolic risk factors for decades. One specific relationship being evaluated is the relationship between sugar consumption and cardiovascular disease.

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Overall, the current literature suggests that singling out fructose as a contributor to cardiovascular disease is unfounded. Previous studies have simulated unrealistic situations that are unable to garner high generalizability. A limitation of many studies conducted to assess heart health and fructose consumption is that fructose is consumed alone and in very large amounts. Moreover, most experts agree that when consumed in normal amounts in the human diet, there is nothing unique about fructose consumption and health outcomes.  For example, one 10-week study that examined the relationship between high consumption of fructose and high cholesterol or high blood pressure concluded that “…consumption of sugars up to the 90th percentile population consumption level does not adversely impact cholesterol, LDL, blood pressure or glucose in the context of a well-designed, supervised, mixed nutrient diet program.” According to the authors, this study was the only one simulated free living environments that included regular consumption of sugar in addition to fructose. Researchers have also found that fructose does not adversely affect blood pressure. In a 2013 systematic review, Wang et al., found no link between fructose consumption and post-meal triglyceride levels, even when participants consumed high amounts of fructose.

It is important to note, however, that there is strong evidence to suggest that consuming excessive amounts of any energy dense nutrient, including added sugar, can increase the risk of cardiovascular disease.

Research Study Summaries

Important Food Sources of Fructose-Containing Sugars and Incident Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies

Liu Q, Ayoub-Charette S, Khan TA, et al. J Am Heart Assoc 2019; 8:e010977. DOI: 10.1161/JAHA.118.010977. Objective To assess the relation of important food sources of fructose-containing sugars with incident hypertension. Background Hypertension is a major risk factor for developing cardiovascular disease, and the global prevalence of hypertension has been increasing in the past decades. […]

Relation of Total Sugars, Sucrose, Fructose, and Added Sugars With the Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies

Mayo Clin Proc 2019; 94(12):2399-2414; https://doi.org/10.1016/j.mayocp.2019.05.034 Khan TA, Mobushra T, Agarwal A, et al. Objective To determine the association of total and added fructose-containing sugars on cardiovascular disease (CVD) incidence and mortality. Background Much of the evidence supporting recommendations and policies to set upper-limits for added or free fructose-containing sugars derives from data on sugar-sweetened […]

Dietary Fructose and the Metabolic Syndrome

Taskinen MR, Packard CJ, Boren J, et al. Nutrients 2019, 11, 1987; doi:10.3390/nu11091987 Download PDF Objective To review recent evidence linking excessive fructose consumption to health risk markers and development of components of the Metabolic Syndrome. Background Consumption of fructose, the sweetest of all naturally occurring carbohydrates, has increased dramatically in the last 40 years […]

Maternal Exposure to High Fructose and Offspring Health

Jia G, Hill MA and Sowers JR. Hypertension 2019; 74:499-501. DOI: 10.1161/HYPERTENSIONAHA.119.13017 Download PDF Objective This article is an editorial on a study recently published in the Hypertension journal entitled, “Maternal High-Fructose Intake Induces Multigenerational Activation of the Renin-Angiotensin-Aldosterone System”. Background Seong, et al. investigated whether maternal exposure to high fructose induces hypertension together with […]

Health outcomes of a high fructose intake: the importance of physical activity

J Physiol 597.14 (2019) pp 3561–3571 Luc Tappy and Robin Rosset Download Research Study PDF Objective To draft an overview of fructose metabolism, focusing on its potential detrimental effects for health on one hand, and on its potential beneficial effects during exercise on the other, and to propose a simple model to account for the […]

Short-Term Isocaloric Intake of a Fructose- but not Glucose-Rich Diet Affects Bacterial Endotoxin Concentrations and Markers of Metabolic Health in Normal Weight Healthy Subjects

Mol Nutr Food Res, 2019; //doi: 10.1002/mnfr.201800868 Nier A, Brandt A, Rajcic D, et al. Download Research Study PDF Objective To determine if an isocaloric exchange of complex carbohydrates with fructose or glucose affects surrogate markers of liver health and vascular endothelial function in healthy normal weight young male and female adults. If so, the […]

The role of dietary sugars in health: molecular composition or just calories?

J Clin Nutr 2019; //doi.org/10.1038/s41430-019-0407-z — Philip Prinz Eur — Download Research Study PDF — Objective: To conduct a review highlighting current literature to discuss the question of whether dietary sugars per se have an unfavorable health effect or if it is just the amount of calories that matters in the development of noncommunicable diseases […]

Study Summary of “Adverse effects of fructose on cardiometabolic risk factors and hepatic lipid metabolism in subjects with abdominal obesity”

For your information, a study entitled “Adverse effects of fructose on cardiometabolic risk factors and hepatic lipid metabolism in subjects with abdominal obesity” was recently published in the Journal of Internal Medicine. The purpose of this study by Taskinen et al. was to determine the effects of fructose on liver fat development, body composition, dietary […]

Early Life Fructose Exposure and Its Implications for Long-Term Cardiometabolic Health in Offspring

A review was recently published in Nutrients which examined the relationship between early life exposure to fructose and cardiometabolic outcomes in offspring. Reviewers cited a number studies which associated fructose intake with various health outcomes such as insulin resistance, elevated low density lipoprotein cholesterol, elevated triglycerides, obesity, type 2 diabetes, cardiovascular disease, non-fatal myocardial infarction, and […]

High Intake of Fructose Does Not Differentially Affect Health as Compared to Lower Intake Levels

According to a recent study, a high consumption level of fructose does not lead to high cholesterol or high blood pressure.

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Singling out fructose in liver and heart disease is not scientifically justified

A recent article published in Harvard Heart Letter recommended that readers cut back on fructose.

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Effect of Fructose on Blood Pressure

A Systematic Review and Meta-Analysis of Controlled Feeding Trials

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Calorie Control Council Response to Brown et al

Sugar-sweetened beverage, sugar intake of individuals, and their blood pressure: international study of macro/micronutrients and blood pressure

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Calorie Control Council Response to Cox et al

Circulating Concentrations of Monocyte Chemoattractant Protein-1, Plasminogen Activator Inhibitor-1, and Soluble Leukocyte Adhesion Molecule-1 in Overweight/Obese Men and Women Consuming Fructose- or Glucose-Sweetened Beverages for 10 Weeks

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Calorie Control Council Response to Jalal et al.

Increased Fructose Associates with Elevated Blood Pressure

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Fructose as cause of metabolic syndrome is poorly supported

In a recent paper, Perez-Pozo et al. concluded that high doses of fructose raise blood pressure and cause features of metabolic syndrome, and that fructose may therefore have a role in the current epidemics of obesity and diabetes.

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Sugar-sweetened beverages, serum uric acid, and blood pressure in adolescents

The conclusion by Nguyen et al that higher sugar-sweetened beverage consumption (as proxy for dietary fructose) may affect cardiovascular risk factors like serum uric acid and blood pressure lacks significance for three reasons.

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Postulated Fructose Influence on Myocardial Infarction is Unconvincing

In a recent paper, Gul et al. suggested that increased fructose concentration induces the aging process and myocardial infarction through production of advanced glycation endproducts (AGEs), however, their supporting evidence is unconvincing.

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Methodological problems invalidate sugars differences

In a recent paper, Le et al. reported finding differences between the two most commonly used sweeteners in the US, concluding that “compared with sucrose, HFCS [high fructose corn syrup] leads to greater fructose systemic exposure and significantly different acute metabolic effects.” Evidence in support of this conclusion was unconvincing, however, due to significant deficiencies in the experimental design.

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