Sugar-sweetened beverage, sugar intake of individuals, and their blood pressure: international study of macro/micronutrients and blood pressure.

TitleSugar-sweetened beverage, sugar intake of individuals, and their blood pressure: international study of macro/micronutrients and blood pressure.
Publication TypeJournal Article
Year of Publication2011
AuthorsBrown IJ, Stamler J, Van Horn L, Robertson CE, Chan Q, Dyer AR, Huang C-C, Rodriguez BL, Zhao L, Daviglus ML, Ueshima H, Elliott P
Corporate AuthorsInternational Study of Macro/Micronutrients and Blood Pressure Research Group
JournalHypertension
Volume57
Issue4
Pagination695-701
Date Published2011 Apr
ISSN1524-4563
KeywordsAdult, Beverages, Blood Pressure, Cross-Sectional Studies, Diet, Diet Surveys, Dietary Sucrose, Female, Fructose, Glucose, Humans, Hypertension, Linear Models, Male, Middle Aged, Sodium, Sweetening Agents
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 <0.001 (systolic BP) and 0.14 to <0.001 (diastolic BP). SSB intake higher by 1 serving per day (355 mL/24 hours) was associated with systolic/diastolic BP differences of +1.6/+0.8 mm Hg (both P<0.001) and +1.1/+0.4 mm Hg (P<0.001/<0.05) 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 +3.4/+2.2 mm Hg (both P<0.001) and +2.5/+1.7 mm Hg (both P=0.002) 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.

DOI10.1161/HYPERTENSIONAHA.110.165456
Alternate JournalHypertension
PubMed ID21357284