Sugar-Sweetened Beverage, Sugar Intake of Individuals, and Their Blood Pressure

Abstract

Abstract-The obesity epidemic has focused attention on relationships of sugars and sugar-sweetened beverages (SSBs) to cardiovascular risk factors. Here we report cross-sectional associations of SSBs, diet beverages, and sugars with blood pressure (BP) for United Kingdom and US participants of the International Study of Macro/Micronutrients and Blood Pressure. Data collected include four 24-hour dietary recalls, two 24-hour urine collections, 8 BP readings, and questionnaire data for 2696 people ages 40 to 59 years of age from 10 US/United Kingdom population samples. Associations of SSBs, diet beverages, and sugars (fructose, glucose, and sucrose) with BP were assessed by multiple linear regression. SSB intake related directly to BP, with P values of 0.005 to Ͻ0.001 (systolic BP) and 0.14 to Ͻ0.001 (diastolic BP). SSB intake higher by 1 serving per day (355 mL/24 hours) was associated with systolic/diastolic BP differences of ϩ1.6/ϩ0.8 mm Hg (both PϽ0.001) and ϩ1.1/ϩ0.4 mm Hg (PϽ0.001/Ͻ0.05) with adjustment for weight and height. Diet beverage intake was inversely associated with BP (P 0.41 to 0.003). Fructose-and glucose-BP associations were direct, with significant sugar-sodium interactions: for individuals with above-median 24-hour urinary sodium excretion, fructose intake higher by 2 SD (5.6% kcal) was associated with systolic/diastolic BP differences of ϩ3.4/ϩ2.2 mm Hg (both PϽ0.001) and ϩ2.5/ϩ1.7 mm Hg (both Pϭ0.002) with adjustment for weight and height. Observed independent, direct associations of SSB intake and BP are consistent with recent trial data. These findings, plus adverse nutrient intakes among SSB consumers, and greater sugar-BP differences for persons with higher sodium excretion lend support to recommendations that intake of SSBs, sugars, and salt be substantially reduced. (Hypertension. 2011;57:695-701.) • Online Data Supplement Key Words: sugar-sweetened beverages Ⅲ sodium Ⅲ nutrition Ⅲ blood pressure Ⅲ epidemiology Ⅲ population study A dverse blood pressure (BP), prevalent worldwide, is an independent major risk factor for cardiovascular diseases. 1 Public health measures are needed to address this problem, with an emphasis on primary and primordial prevention. 2 Established modifiable risk factors for elevated BP are high sodium intake, inadequate potassium intake, high body mass index (BMI), and excessive alcohol intake. 3,4 Other dietary factors possibly related to adverse BP levels include lower intakes of calcium, magnesium, phosphorus, 5 iron, 6 vegetable protein, 7 glutamic acid, 8 polyunsaturated fatty acids, 9,10 and starch 11 and higher intakes of cholesterol, 12 animal protein, and red meat. 6,7 The Western obesity epidemic has focused attention on the relationships to cardiovascular disease risk factors of diets rich in added sugars, particularly glucose, sucrose, and fructose, for example, as high-fructose corn syrup, abundant in sugar-sweetened beverages (SSBs). [13][14][15] Animal data indicate direct pressor effects of glucose, fructose, and sucrose on BP. 16 -20 Limite...

Influence of High Glycemic Index and Glycemic Load Diets on Blood Pressure During Adolescence

“…4,5 More recently, there are data to suggest that dietary factors, such as high consumption of carbohydrates, including sugars and soft drinks, could adversely influence BP levels. 6 A recent meta-analysis of intervention studies involving adults 7 shows that diets rich in carbohydrates may be associated with slightly higher BP. In contrast, dietary fiber intake was shown to be inversely associated with BP in adults 8 and with reduced risk of incident cardiovascular disease.…”

“…6,10 In addition, the National Health and Nutrition Examination Survey found that, in a sample of 4867 adolescents aged 12 to 18 years, higher sugar-sweetened beverage consumption was associated with higher serum uric acid levels and systolic BP.…”

“…6 A recent meta-analysis of intervention studies involving adults 7 shows that diets rich in carbohydrates may be associated with slightly higher BP. In contrast, dietary fiber intake was shown to be inversely associated with BP in adults 8 and with reduced risk of incident cardiovascular disease.…”

“…6,10 In addition, the National Health and Nutrition Examination Survey found that, in a sample of 4867 adolescents aged 12 to 18 years, higher sugar-sweetened beverage consumption was associated with higher serum uric acid levels and systolic BP. 11 However, this study had a cross-sectional design, and currently there are no prospective data during adolescence examining this relationship.…”

Is consumption of sugar‐sweetened soft drinks during pregnancy associated with birth weight?

“…A likely mechanism may be that rapid uptake of sugar results in glycemic spikes which, if occurring frequently, may decrease vascular function by inducing oxidative stress, inflammation, and endothelial dysfunction (Node & Inoue, 2009). In other circumstances, intake of soft drinks with sugar has also been negatively associated with vascular function in terms of elevated blood pressure and increased risks of coronary heart disease (Brown et al, 2011, Huang, Huang, Tian, Yang, & Gu, 2014), preeclampsia (Borgen et al, 2012; Clausen et al, 2001), and preterm delivery in some (Englund‐Ogge et al, 2012, Petherick, Goran, & Wright, 2014), but not in another study (Halldorsson, Strom, Petersen, & Olsen, 2010). Women who exercise little or smoke may be more vulnerable to such effects (Di Francescomarino, Sciartilli, Di Valerio, Di Baldassarre, & Gallina, 2009, Gordon, Lavoie, Arsenault, Ditto, & Bacon, 2008).…”