Recently, the debate over the role of sugar, specifically fructose, in hypertension has started to intensify. In a recent article published in the British Medical Journal’s Open Heart, researchers reviewed both epidemiological and experimental studies regarding the role of processed foods in hypertension and found evidence that it is the added sugar in these foods that contributes to hypertension risk.¹ Another recent study reported in The Journal of Clinical Hypertension (JCN) by Angelopoulos et al. used experimental evidence to demonstrate that fructose-containing sugars do not raise blood pressure in humans.² But it doesn’t end there. The latter study invited a host of criticisms and led the American College of Nutrition (ACN) to publish a statement critical of the study. It also invited a pointed response from IFM faculty Deanna Minich, PhD, and Mark Houston, MD.

Mark Houston, MD

Deanna Minich, PhD

In a commentary published alongside the original article in the JCN, Houston and Minich point out several major issues with the study.³ The study used milk as the vehicle for administering added fructose to the diets of normotensive individuals for 10 weeks. Milk peptides have shown some evidence of lowering blood pressure in past studies. The amount of fructose added was intended to be at a “normal” level of consumption, but much of the research on the effect of fructose shows its association with hypertension begins at higher than normal intake levels. Additionally, they point out that the approach of attempting to add an additional nutrient in isolation is flawed at best: “Rather than focus research on one nutrient (such as an isolated sweetener), which is always difficult to truly extract from other dietary changes that occur (such as the increased calories, protein, carbohydrate, and decreased fat in this study), a better understanding of the development of hypertension can be best comprehended by bringing in the whole context of diet and lifestyle combined.” Links to the full text of both the original study and the commentary can be found below.

In addition, the American College of Nutrition published a statement regarding the study⁴ and issued an accompanying press release.⁵ The statement notes some additional shortcomings with the JCN study and urges caution in drawing any conclusions based on its results. Functional Medicine luminary Leo Galland, MD is quoted as noting that the study’s design does not add to the body of knowledge regarding long-term consumption of fructose and blood pressure. IFM faculty member David Perlmutter, MD, is also quoted, stating that any impact of fructose consumption may take years to manifest, especially subtle effects like changes in the microbiome, and thus would not show up in a 10-week study. Links to both the ACN statement and the press release are below.

At IFM’s Cardiometabolic Advanced Practice Module, Mark Houston and other IFM faculty present the cutting-edge research about diet and cardiovascular dysfunction. You’ll come away with nutritional, dietary, and pharmacological interventions that can help not only prevent, but even reverse cardiometabolic disease. In addition to detailed protocols for addressing hypertension, you’ll come away with effective treatment strategies for dyslipidemia, metabolic syndrome, and cardiovascular dysfunction, all based on the most up-to-date medical literature. 

References

– See more at: https://www.functionalmedicine.org/conference.aspx?id=2866&cid=0&section=t565#sthash.3OZrxbDS.dpuf

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