Fructose and High Blood Pressure

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

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

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

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.

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