Sucrose sensitivity of patients with coronary-artery disease

Abstract

Various loads of simple carbohydrates were fed to 148 patients with known coronary-artery disease (CAD) for 4 days in the Clinical Research Center. The 148 patients were grouped according to the diet regimen tested-sucrose (low and high), glucose, and fructose. A high-sucrose diet was fed to 29 control subjects. Diets containing 2 g of simple carbohydrate (predominantly either sucrose or glucose) per kilogram of body weight per day had no significant effect on fasting plasma glucose, serum triglycerides, or serum free fatty acids. However, diets containing 4 g of simple carbohydrate (predominantly sucrose) or 2 g fructose per kilogram of body weight per day produced a significant rise in serum triglycerides with decreases in fasting plasma glucose and free fatty acids. Serum cholesterol diminished in all the diet groups, probably because of the decrease fat and cholesterol intakes. The increase of serum triglycerides in CAD patients receiving simple carbohydrate at the 4-g/kg rate was significantly greater than in the normal control subjects fed the same diet, suggesting a sensitivity of CAD patients to this stimulus. No significant correlation could be demonstrated between changes in serum triglycerides and the extent of CAD (one, two, or three vessels) as determined from coronary angiograms.

Effect of Fructose on Blood Pressure

“…13,16,18 The present meta-analysis, however, shows a significant DBP-and MAP-lowering effect and a trend favoring SBP in the overall analysis and in the nondiabetic stratum when fructose was exchanged isocalorically for other carbohydrates. Given the small participant pool in our analyses, larger and longer human trials are needed to gain a better assessment of the effect of fructose on BP.…”

“…The present study is in agreement with prospective cohort studies 12 in failing to demonstrate an adverse effect of fructose on BP but at odds with acute clinical studies and animal models. Acute clinical studies have reported an increase in BP after fructose intake, 13,16,18 and rat studies have consistently shown that chronic high fructose intake raises SBP. [7][8][9][10] This discrepancy between the results of our study and those of observational and intervention studies may be explained by heterogeneous conditions of BP measurement.…”

“…[13][14][15][16][17][18] Few nutrition guidelines address fructose directly. BP guidelines have not addressed the effect of fructose or any other sugars on BP in their guidelines.…”

Use of Alternative Sweeteners in Diabetic Diet

“…It has been implicated as the component of sucrose responsible for elevation of plasma triglycerides (38,39), and this suggestion has been supported by studies in animals and in hypertriglyceridemic (32,40,41), hyperinsulinemic (42), diabetic (43), and normal (44) subjects, in which fructose feeding (40-300 g/day) led to hypertriglyceridemia. Other studies have found that ingestion of fructose (33-154 g/day) in normal (35,36,45), diabetic (44), and hypertriglyceridemic (46) subjects did not produce an increase in fasting triglyceride level.…”

Nutritional management of diabetes mellitus: rationale, ethics and practicability.

“…However, according to some studies, fructose is the component in sucrose responsible for increased blood lipid [70][71][72][73][74], but the effect of fructose on plasma triglycérides remains controversial. Plasma triglycérides are high in nontreated dia betics given fructose [75], but remain unchanged in insulin-dependent diabetics [76,77].…”