Saturday, February 11, 2012

Fructose and High Blood Pressure

If you have high blood pressure, your doctor has probably told you a dozen times to cut way back on salt (sodium). But this works only for people who have a "salt-sensitive phenotype," which results from both genetic makeup and environmental influences.New preliminary research offers another strategy...
11/ 8/09 8:18pm

One thing that annoys me is that talking can raise BP. Yet every nurse I've ever had has tried to start a conversation before she takes the BP (never had a male nurse). I don't answer, but I'm sure the annoyance at getting the question raises the BP.

 

I've never had anyone give me time to sit quietly for 5 minutes as they say you're supposed to.

11/ 8/09 10:21pm

Dear Gretchen,

 

When I remind them of the 5 minute rule, the nurses ruefully shut up and wait. We have to insist!

 

Best regards,

 

David

11/ 9/09 9:12am

For me the problem is that insisting would make my BP go up.

11/11/09 4:08pm
this is pretty funny- for some, thinking of whiskers on kittens helps
Anonymous
Helen Coxe
11/ 9/09 10:32am

David, would you clarify something for me?  Is fructose the sugar in fresh fruit?  If I have hypertension, should I not eat fruit?

11/ 9/09 11:19am

Dear Helen,

 

Great question! The answer to the first one is easy. Yes, fructose is indeed the sugar in fresh fruit.

 

The answer to the second one is more of a judgement call. But the top two experts that I know of on the dangers of fructose say that the benefits of eating fruit outweight the costs. They are Robert Lustig, M.D., and John P. Bantle, M.D., and I have written about there work and recommendations here in several articles. They say that the nutrients and fiber in fruit makes their digestion of the small amounts of fructose in fruit an order of magnitude different from consuming added fructose. But they are, of course, talking about other dangers of fruit and not specifically about high blood pressure.

 

Dr. Jalal, whose work I reviewed in this article, researched the dangers of added fructose -- not any supposed dangers of eating fruit.

 

Note that not all fruit has fructose or any other sugar. Avocados don't have any. Green peppers, lemons, and limes have little or none.

 

Those are the fruits that Dr. Richard K. Bernstein allows on his very low-carb diet. Fructose is, of course, carbohydrate whether it is added or in fruit. Personally, I am following a very low-carb diet and generally follow Dr. Bernstein's advice. But sometimes I do eat a little fruit, especially organically grown berries (if we are to eat any organically grown food -- and I eat it when I can get it -- berries must come at the top of the list, because otherwise growers use so many pesticides on them).

 

The bottom line is if you avoid all or essentially all added fructose, such as in the foods that Dr. Jalal researched, I don't think that we have any evidence to suggest avoiding fruit.

 

Best regards,

 

David

Anonymous
Helen Coxe
11/ 9/09 2:07pm

Thank you so much for clarifying that for me.  It's kind of what I thought, but having you tell me makes me feel better about it.  You realize you have become the "diabetes guru" for thousands of us.Smile

11/11/09 4:15pm

i feel that this answer is murky- while you are correct in pointing out the link between Na sensitivity and HTN, the better indicator is potassium/Na ratio- that is, the higher the ratio in the diet, the lower the BP- i think that potassium has been the stepchild in public education on HTN- the more the better, and so fruits and veggies that are high in potassium will be healthy staple foods for lowering BP- for DM, my advice would be to incorporate fresh high K fruit if high BP with good GLC control, but if poor GLC control, other sources are better

Anonymous
Ted Hutchinson
12/13/09 11:14am

Child diabetes blamed on food sweetener

 

You can read the free full text of the research on which the above article was based here

 

Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans

 

It was a comparison trial in which overweight and obese people consumed glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks.

 

Although both groups put on weight visceral adipose volume was significantly increased only in subjects consuming fructose.

 

Fasting plasma triglyceride concentrations increased by approximately 10% during 10 weeks of glucose consumption but not after fructose consumption.

 

In contrast, hepatic de novo lipogenesis (DNL) and the 23-hour postprandial triglyceride AUC were increased specifically during fructose consumption.

 

Similarly, markers of altered lipid metabolism and lipoprotein remodeling, including fasting apoB, LDL, small dense LDL, oxidized LDL, and postprandial concentrations of remnant-like particle-triglyceride and -cholesterol significantly increased during fructose but not glucose consumption.

 

In addition, fasting plasma glucose and insulin levels increased and insulin sensitivity decreased in subjects consuming fructose but not in those consuming glucose.

 

These data suggest that dietary fructose specifically increases DNL, promotes dyslipidemia, decreases insulin sensitivity, and increases visceral adiposity in overweight/obese adults. 

Anonymous
reindeer0022
5/ 7/10 8:55pm

It sounds like you are one of the researchers on the right track. Thank you. I have been diagnosed with borderline hypertension. I am one who will change diet first before pills. Here is something else to research. I have had mine on the average down to 114 to 77 at times now. Yesterday after 1 big cup of coffee it shot up to 174 over 148. This confirms what I had been watching is that coffee, at least for me causes high blood pressure. Everyone says caffeine. Tea with caffeine does not do this. There must be some type of chemical (man made or natural) which causes this. Or the possibility that I am somehow allergic to something in coffee. Chocolate and cokes seem to elevate mine slightly. I avoid nearly all of these things and have had it pretty well under control.