High fructose intake and the route towards cardiometabolic diseases

Lelis, Deborah de Farias; Andrade, João Marcus Oliveira; Almenara, Camila Cruz Pereira; Broseguini-Filho, Gilson B.; Mill, José Geraldo; Baldo, Marcelo Perim

doi:10.1016/j.lfs.2020.118235

Cited by 26 publications

(18 citation statements)

References 149 publications

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“…Fructose decreases satiety, increases adipogenesis, oxidative stress, reduces insulin sensitivity, favors ectopic fat accumulation especially in the skeletal muscle and liver, increases arterial blood pressure, and causes vascular damage. 29 Taken together, these findings indicate that, like alcohol, information regarding sugar and SSBs consumption should be part of the NAFLD patient medical history, and its elimination from diet should be one of the main treatment goals.…”

Section: Added (Free) Sugarsmentioning

confidence: 89%

Dietary Treatment for NAFLD: New Clinical and Epidemiological Evidence and Updated Recommendations

Zelber‐Sagi

2021

Semin Liver Dis

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The key factor in preventing and treating nonalcoholic fatty liver disease (NAFLD) is a holistic lifestyle modification approach, encompassing diet based on healthy eating patterns of unprocessed foods, exercise, balanced drinking, and smoking habits. The Mediterranean diet and other healthy dietary patterns can reduce liver fat and may be related with lower disease progression. The type of diet should be tailored to the patient's cultural and personal preferences. Changing dietary composition without reducing caloric intake may offer an additional and sometimes more feasible alternative, so that the nutritional treatment incorporates, but is not focused on, weight reduction goals. The growing global consumption of ultra-processed foods, which is the polar opposite of the Mediterranean diet and its concept of home-based cooking, poses a great challenge in the prevention of NAFLD and probably hepatocellular carcinoma.This review will cover the most updated clinical and epidemiological evidence for lifestyle treatment in NAFLD and provide practical treatment tools.

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Section: Added (Free) Sugarsmentioning

confidence: 89%

Dietary Treatment for NAFLD: New Clinical and Epidemiological Evidence and Updated Recommendations

Zelber‐Sagi

2021

Semin Liver Dis

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“…Fructose in its pure monosaccharide form was computed using fructose content data from several studies/databases described in Supplementary Table S1 [ 44 , 45 , 46 , 47 ]. As fructose is also made available through the consumption of sucrose (a disaccharide made of α-D-glucopyranosyl (1→2)-β-D-fructofuranoside), commonly appearing as an added sugar in processed foods [ 2 , 3 ], fructose was also expressed as fructose total exposure. Total fructose exposure was calculated as fructose from monosaccharide form plus fructose from sucrose (0.5 × sucrose per 100 g), in accordance with Ramne et al [ 48 ].…”

Section: Methodsmentioning

confidence: 99%

“…For centuries, the main source of fructose in humans was the consumption of natural foods containing fructose such as honey, fruits and vegetables intrinsically rich in the pure monosaccharide form (α-D-glucopyranose) [ 1 ]. Since the substitution of sucrose for fructose in many foods and beverages, the consumption of extrinsic fructose has increased in parallel with increasing industrially manufactured or confectionary foods commonly appearing as an added sugar [ 2 , 3 ]. This high use in industrially manufactured or confectionary foods can be attributed to the low cost of fructose compared to sucrose.…”

Section: Introductionmentioning

confidence: 99%

“…For nearly two decades, the overconsumption of pure fructose has been reported as a potential unique dietary risk factor because of links to obesity risk, the preeminent epidemic and health concern in the US and worldwide [ 4 , 5 ]. The overconsumption of pure fructose is also associated with risk of chronic metabolic noncommunicable diseases such as hypertension [ 6 ], cardiovascular diseases [ 3 , 7 ], type 2 diabetes [ 8 ], metabolic syndrome [ 9 ], steatohepatitis [ 10 ] and inflammatory conditions [ 11 ]. In this context, overconsumption of pure fructose became an important public health issue in both the scientific and public domain [ 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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High Fructose Intake Contributes to Elevated Diastolic Blood Pressure in Adolescent Girls: Results from The HELENA Study

et al. 2021

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Background: The association between high fructose consumption and elevated blood pressure continues to be controversial, especially in adolescence. The aim of this study was to assess the association between fructose consumption and elevated blood pressure in an European adolescent population. Methods: A total of 1733 adolescents (mean ± SD age: 14.7 ± 1.2; percentage of girls: 52.8%) were analysed from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study in eight European countries. Blood pressure was measured using validated devices and methods for measuring systolic blood pressure (SBP) and diastolic blood pressure (DBP). Dietary data were recorded via repeated 24 h recalls (using specifically developed HELENA–DIAT software) and converted into pure fructose (monosaccharide form) and total fructose exposure (pure fructose + fructose from sucrose) intake using a specific fructose composition database. Food categories were separated at posteriori in natural vs. were non-natural foods. Elevated BP was defined according to the 90th percentile cut-off values and was compared according to tertiles of fructose intake using univariable and multivariable mixed logistic regression models taking into account confounding factors: centre, sex, age and z-score–BMI, MVPA (Moderate to Vigorous Physical Activity) duration, tobacco consumption, salt intake and energy intake. Results: Pure fructose from non-natural foods was only associated with elevated DBP (DBP above the 10th percentile in the highest consuming girls (OR = 2.27 (1.17–4.40); p = 0.015) after adjustment for cofounding factors. Conclusions: Consuming high quantities of non-natural foods was associated with elevated DBP in adolescent girls, which was in part due to high fructose levels in these foods categories. The consumption of natural foods containing fructose, such as whole fruits, does not impact blood pressure and should continue to remain a healthy dietary habit.

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“…In early stages of life, various systems undergo substantial ontogenetic changes, some of which are susceptible to modulation by external stimuli. Several studies have demonstrated the effect of excess fructose consumption on cardiovascular systems in adults [ 8 , 9 , 10 ]. However, little is understood regarding the impact of fructose-rich diets during adolescence on cardiovascular parameters later in life [ 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Fructose plus High-Salt Diet in Early Life Results in Salt-Sensitive Cardiovascular Changes in Mature Male Sprague Dawley Rats

et al. 2021

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Fructose and salt intake remain high, particularly in adolescents and young adults. The present studies were designed to evaluate the impact of high fructose and/or salt during pre- and early adolescence on salt sensitivity, blood pressure, arterial compliance, and left ventricular (LV) function in maturity. Male 5-week-old Sprague Dawley rats were studied over three 3-week phases (Phases I, II, and III). Two reference groups received either 20% glucose + 0.4% NaCl (GCS-GCS) or 20% fructose + 4% NaCl (FHS-FHS) throughout this study. The two test groups ingested fructose + 0.4% NaCl (FCS) or FHS during Phase I, then GCS in Phase II, and were then challenged with 20% glucose + 4% NaCl (GHS) in Phase III: FCS-GHS and FHS-GHS, respectively. Compared with GCS-GCS, systolic and mean pressures were significantly higher at the end of Phase III in all groups fed fructose during Phase I. Aortic pulse wave velocity (PWV) was elevated at the end of Phase I in FHS-GHS and FHS-FHS (vs. GCS-GCS). At the end of Phase III, PWV and renal resistive index were higher in FHS-GHS and FHS-FHS vs. GCS-GCS. Diastolic, but not systolic, LV function was impaired in the FHS-GHS and FHS-FHS but not FCS-FHS rats. Consumption of 20% fructose by male rats during adolescence results in salt-sensitive hypertension in maturity. When ingested with a high-salt diet during this early plastic phase, dietary fructose also predisposes to vascular stiffening and LV diastolic dysfunction in later life.

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High fructose intake and the route towards cardiometabolic diseases

Cited by 26 publications

References 149 publications

Dietary Treatment for NAFLD: New Clinical and Epidemiological Evidence and Updated Recommendations

Dietary Treatment for NAFLD: New Clinical and Epidemiological Evidence and Updated Recommendations

High Fructose Intake Contributes to Elevated Diastolic Blood Pressure in Adolescent Girls: Results from The HELENA Study

Fructose plus High-Salt Diet in Early Life Results in Salt-Sensitive Cardiovascular Changes in Mature Male Sprague Dawley Rats

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