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

Abstract

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.

Identification of Lifestyle Risk Factors in Adolescence Influencing Cardiovascular Health in Young Adults: The BELINDA Study

“…Parameters recognized to have an impact on modifiable cardiovascular risk factors were identified [ 19 , 56 , 57 , 58 ]. Salt, EPA + DHA, and fructose intakes will be included in the multivariate linear regression to analyze their impact on the PDAY score ( Table 7 ).…”

“…Meals were converted into energy and macro/micronutrient intake primarily by using the German food code and nutrient database (Bundeslebensmittelschlüssel, BLS, version II3.1). The nutrients included in the main statistical analysis for the association with the primary end point (PDAY risk score) were salt (sodium chloride total intake, present in the food and added), long-chain polyunsaturated fatty acid (LC-PUFA), including eicosapentanoic acid (EPA) and docosahexaenoic acid (DHA) (using the German food code and nutrient database), and fructose (using fructose composition analysis [ 18 , 19 ]) intake, in gram per day. Data scoring was also performed to assess the Diet Quality Index (DQI), the Healthful Plant-based Diet Index (HPDI), and the NOVA classification for ultra-processed food (UPF) consumption.…”

High-Fructose Diet–Induced Hyperuricemia Accompanying Metabolic Syndrome–Mechanisms and Dietary Therapy Proposals

“…The study by Béghin et al examined the effect of consuming fructose from various dietary sources, both natural (e.g., vegetables, fruits, or honey) and industrial (e.g., cakes, confectionery, or sugar-sweetened drinks), on the level of diastolic blood pressure in young girls aged 12.5–17.5 years. It turned out that unlike fructose from natural sources, the one from industrial sources raises the value of blood pressure [ 58 ]. Studies in rats fed water enriched with fructose showed that increasing the amount of this sugar in the diet caused hypertension, hyperuricemia, and hypertriglyceridemia in the animals.…”

Development of a genetic risk score to predict the risk of hypertension in European adolescents from the HELENA study

“…Regarding the assessment of daily fructose intake, the variable created by Béghin et al, [35] in the HELENA study was used. Total fructose exposure was calculated as fructose from monosaccharide form plus fructose from sucrose (0.5 × sucrose per 100 g).…”