Dietary Sugar, Salt and Fat in Human Health

Harry G. Preuss, Debasis Bagchi

• Publisher: Academic Press
• Year: 2020
• Print ISBN: 9780128169186
• eBook ISBN: 9780128169193
• Topic: Technology & Engineering
• Subtopic: Nutrition, Dietics & Bariatrics
• Index: Technology & Engineering

Divided into four main sections, Dietary Sugar, Salt and Fat in Human Health explores the biochemical, pharmacological and medicinal aspects related to the overindulgence of dietary salt, sugar, and fat, along with possible remedies. Beginning with a general overview, the text outlines aspects associated with advancing age and human physiology, such as different aspects of insulin resistance, the advancing age phenomenon, central fat accumulation and metabolic perturbations and the role of the modern Western diet and the influence of dietary sugar, salt, and fat, with particular focus on their relation to multiple biochemical pathophysiological pathways. The second section of the book focuses on the roles of dietary sugars and their correlation with the chronic disease epidemic, with an emphasis on carbohydrate metabolism and its biochemistry, GI absorption, the glycemic index and the influence of fructose. The historical background of dietary sugars is discussed alongside Atkin's hypothesis, and an overview of the correlation between dietary fibre and the glycemic index, including a chapter on sugar addiction. Section three contains an exhaustive review of the influence of dietary salt and its diverse mechanistic aspects, including salt-sensitive hypertension, contribution of two steroid receptor pathways, vascular NO, intrarenal RAAS system and angiotensin. The fourth section highlights the biochemistry of dietary saturated, polyunsaturated and trans fat and its influence on human health and various diseases, and further explores NAFLD and gender specific problems. Chapters in this section also investigate the benefits of the Mediterranean diet as well as myths related to cholesterol. Collected and carefully organized for researchers in nutrition, physiology, epidemiology, or sensory science, this book will also benefit general practitioners, surgeons, nurses, health professionals and practitioners, and students studying the role of diet in cardiometabolic disorders and disease. - Demonstrates how a healthy lifestyle impacts lifespan - Provides a general overview and outlines aspects associated with advancing age and human physiology - Focuses on the roles of dietary sugars and their correlation with the chronic disease epidemic - Contains an exhaustive review of the influence of dietary salt and its diverse mechanistic aspects - Highlights the biochemistry of dietary saturated, polyunsaturated and trans fat and its influence on human health and various diseases

Dietary sugar and health

Outline

• Chapter 10 Influence of dietary sugars on blood pressure regulation: historical, epidemiological, laboratory, and clinical considerations
• Chapter 11 Glycation-induced protein aggregation and cellular toxicity: an insight into the disease realm of high dietary sugar intake
• Chapter 12 Probing various pro and con health aspects of the glucose–insulin system in non-diabetics: focusing on insulin resistance and dietary implications
• Chapter 13 Evaluating proposed surrogates to estimate insulin resistance in non-diabetics: emphasizing the ratio triglycerides/HDL-cholesterol versus fasting blood glucose
• Chapter 14 Associations of high blood sugar with oxidative stress and inflammation in patients with type 2 diabetes
• Chapter 15 Assessing the triglyceride/HDL-cholesterol ratio as a surrogate for insulin resistance and its link to the metabolic syndrome in Hispanics and African-Americans
• Chapter 16 The benefit of Indian jaggery over sugar on human health
• Chapter 17 Linking fasting blood glucose quartiles of nondiabetic volunteers ages 21–84 years to metabolic syndrome components: focusing on the aging paradox

Chapter 10

Influence of dietary sugars on blood pressure regulation: historical, epidemiological, laboratory, and clinical considerations

Harry G. Preuss¹ and Debasis Bagchi², ¹Department of Biochemistry, Georgetown University, Medical Center, Washington, DC, United States, ²Department of Pharmacological and Pharmaceutical, Services, University of Houston, Houston, TX, United States

Abstract

• • Modestly elevated blood pressure (BP) readings, even in the so-called normal range, provide serious cardiovascular complications throughout the world.

• • Among dietary constituents, just excess intake of table salt (NaCl) for the most part and to a lesser extent lack of sufficient dietary potassium are consistently linked to BP elevations.

• • Nevertheless, studies assessing cardiac dynamics among various populations suggest a significant role for other dietary factors in increasing BP.

• • At present, avoiding consumption of rapidly absorbed sugars, particularly sucrose, high fructose corn syrup, and fructose, is being recognized as possible means to prevent/treat/ameliorate elevated BP and avoid associated cardiovascular perturbations.

• • The deleterious effects emanating from dietary sugars appear to depend largely upon development of insulin resistance (IR)—an inadequate response to circulating insulin by muscles, fat, and liver.

• • In support, significant positive correlations between fasting blood glucose values and circulating insulin levels that are reasonable estimates of IR with BP have been consistently found in clinical evaluations.

• • An amplified interaction between common table salt and dietary sugars to raise BP has been reported and should be prudently considered when planning the most advantageous prevention and treatment regimens to ameliorate the global crisis arising from damaging pressure levels.

Keywords

Salt; hypertension; dietary sugars; sugar; insulin resistance; elevated blood pressure

Abbreviations

BP blood pressure

IR insulin resistance

10.1 Introduction

It is generally recognized that sustaining blood pressure (BP) within an acceptable range, not too low nor too high, is vitally important to achieve a long-term, healthy survival [1–3]. Despite this universal and common knowledge, unwanted high-pressure readings persist everywhere that provide a serious, ongoing challenge [4–8]. In an attempt to support a consistently healthful pressure range, dynamic regulation is modulated by a multitude of internal checks and balances [1–3]. Nevertheless, many common external factors such as certain dietary nutrients can significantly influence BP over a prolonged period [9–20]. Although major attention regarding the effects of various dietary constituents on BP was, and still is, focused largely on micronutrients such as sodium and potassium [14–16,21–24], decidedly more healthcare providers are realizing that vitamins, minerals, and macronutrients can also participate meaningfully in both favorably and unfavorably modifying BP [9,11,17,19,25,26].

Over the past few decades, a relatively small number of experts in the medical and nutritional fields have considered that excess consumption of refined carbohydrates, especially sucrose and fructose, plays a significant role in BP regulation [27–31]. It is only lately some real widespread attention has been given at both the clinical and public attention levels to the probable harm imposed from excess consumption of dietary refined carbohydrates like the popular table sugars [32–37]. This initial lack of sound reflection may have been propounded, at least in part, by two solid facts.

Considering the first, saturated fats, not refined carbohydrates, were on the minds of the majority of nutritionists and most professionals who, in turn, influenced public opinion [38–41]. Widespread awareness placed on the potential cardiovascular damage produced by too much saturated fat intake distracted attention from any harmful consequences created by simple dietary carbohydrates like sugars. Considering the current rational by many that sugars and other refined carbohydrates can be major dietary culprits in the quest for optimal health [42–45], it is ironic that the earlier recommendations to avoid saturated fats no doubt led to substitution of and increased use of refined carbohydrates to replace the recommended lower caloric intake from avoidance of saturated fats [41].

As a second fact, much of the early information on the subject of sugar-induced cardiovascular maladies, particularly elevated BP, was obtained from laboratory rather than clinical studies [29,30]. Unfortunately results from such studies were and still largely receive little recognition from most practitioners. Yet, in their defense, animal studies carried out in the laboratory can offer valuable information concerning mechanisms of action, safety, and efficacy that can be readily extrapolated to humans, whereas such investigations often cannot be conducted directly because of ethical and potential safety considerations. Further, animal studies substantiate and can also greatly expand information already derived from clinical studies.

A review article in the early 1980s assessed the existence of sugar-induced BP elevations by examining information gained principally from earlier laboratory rather than clinical findings [30,46]. It was shown that adding sucrose to drinking water free of additional sodium to three sub strains of rats (normotensive and hypertensive) caused marked, statistically significant increases in systolic BP in two of them [46]. Another important observation commonly reported when usin...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Dedication
• List of contributors
• Preface
• General background
• Food behavior, food addiction and metabolic syndrome
• Dietary sugar and health
• Overindulgence of dietary salt
• Dietary fat and cholesterol
• Dietary fiber, ketogenic diets, and benefits
• Appendix. Commentary: From the Editor’s desk Reflecting on changes in nutritional risk factors over time
• Index