Univ. Lille, Inserm, CHU Lille, U1286-INFINITE and CIC-1403, F-59000 Lille, France.
Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, B-9000 Ghent, Belgium.
Nutrients. 2021 Oct 15;13(10):3608. doi: 10.3390/nu13103608.
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.
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.
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); = 0.015) after adjustment for cofounding factors.
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.
高果糖摄入与血压升高之间的关联一直存在争议，尤其是在青少年中。本研究旨在评估欧洲青少年人群中果糖摄入与血压升高之间的关系。
本研究共纳入了来自欧洲八个国家的“健康生活方式与青少年营养（HELENA）”研究中的 1733 名青少年（平均年龄 ± 标准差：14.7 ± 1.2 岁；女生比例：52.8%）。使用经过验证的设备和方法测量收缩压（SBP）和舒张压（DBP）。通过重复 24 小时回忆（使用专门开发的 HELENA-DIAT 软件）记录饮食数据，并使用特定的果糖成分数据库将数据转换为纯果糖（单糖形式）和总果糖暴露量（纯果糖+来自蔗糖的果糖）摄入量。在后验分析中，将食物类别分为天然食物和非天然食物。根据第 90 百分位截断值定义高血压，并根据果糖摄入量的三分位数进行比较，使用单变量和多变量混合逻辑回归模型考虑混杂因素：中心、性别、年龄和 BMI-Z 分数、中等到剧烈体力活动（MVPA）持续时间、烟草使用、盐摄入量和能量摄入量。
仅来自非天然食物的纯果糖与升高的 DBP 相关（最高摄入组女孩的 DBP 高于第 10 百分位（OR=2.27（1.17-4.40）；=0.015），调整混杂因素后）。
大量摄入非天然食物与青春期女孩的 DBP 升高有关，部分原因是非天然食物类别中的高果糖含量。食用含有果糖的天然食物，如完整水果，不会影响血压，应继续保持健康的饮食习惯。
