Hypertension, the most important
risk factor in cardiovascular disease, is most commonly controlled through the
restriction of dietary sodium. The Dietary Approaches to Stop Hypertension (DASH) diet
has been shown to be extremely effective in controlling hypertension. This is been attributed to its
focus on whole foods and low sodium content. A significant source of sodium in
the standard American diet, highly processed foods, also happen to be very high
in refined carbohydrates. These foods are eliminated in the DASH diet.
Sugar, particularly fructose, has
begun to overshadow salt as the major dietary cause of high blood pressure due
to its role in “metabolic dysfunction and increasing blood pressure variability,
myocardial oxygen demand, heart rate, and inflammation”.
Hyperinsulinaemia due to insulin resistance seems to
be directly correlated with hypertension. In a study comparing added sugar in
diets, those who consumed a higher percentage of added sugars were three times
more likely to die of cardiovascular disease. A study of 2700 showed that consuming sugar-sweetened
beverages is directly related to increased blood pressure. However, naturally occurring
sugar, such as in whole fruits, does not appear to have the same effect.
Although added fructose seems to be
the most damaging monosaccharide, there are no specific recommendations
regarding its consumption from the American Heart Association (AHA), World
Health Organization (WHO), or Institute of Medicine (IOM). In fact, IOM allows
up to 25% of the daily total calories to be made up of added sugars, enough to
increase the risk of cardiovascular mortality three times. Typically for blood pressure
control, recommendations are based on sodium consumption rather than sugar.
Future recommendations would do well to address this issue to best address and
prevent hypertension through diet.
Brown, I., Stamler, J., Van Horn, L., Robertson, C., Chan, Q.,
& Dyer, A. et al. (2011). Sugar-Sweetened Beverage, Sugar Intake of
Individuals, and Their Blood Pressure: International Study of
Macro/Micronutrients and Blood Pressure. Hypertension, 57(4),
695-701. http://dx.doi.org/10.1161/hypertensionaha.110.165456
DiNicolantonio, J., & Lucan, S. (2014). The wrong white
crystals: not salt but sugar as aetiological in hypertension and
cardiometabolic disease. Open Heart, 1(1), e000167-e000167. http://dx.doi.org/10.1136/openhrt-2014-000167
Mayoclinic.org,. (2016). DASH diet: Healthy eating to lower
your blood pressure - Mayo Clinic. Retrieved 12 February 2016, from http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456
Yang, Q., Zhang, Z., Gregg, E., Flanders, W., Merritt, R.,
& Hu, F. (2014). Added Sugar Intake and Cardiovascular Diseases Mortality
Among US Adults. JAMA Internal Medicine, 174(4), 516.
http://dx.doi.org/10.1001/jamainternmed.2013.13563
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