Sugar blamed for pumping up blood pressure

From The Sunday Times
London, UK
14 September, 2014

IN 2004 Sid the Slug fronted a government campaign to persuade people to cut back on salt. It was hailed as one of the most successful health campaigns of recent years. 

Now a new report questions the very basis for the policy, suggesting that sugar rather than salt may be the real culprit. 

Following the Sid campaign average salt intake fell by about 15% between 2003 and 2011 while the number of deaths from heart disease and strokes fell by 40%. It was claimed the policy had helped to save 9,000 lives a year, although other risk factors for heart disease, such as smoking, also declined during that period. 

Some experts had already suggested that researchers had overplayed the extent to which reduced salt intake could account for the reduction in fatalities from heart disease and strokes. 

Now, in a commentary in The American Journal of Cardiology, Dr James DiNicolantonio claims the focus on salt is misguided . He says it would be better to persuade people to cut their sugar intake, rather than salt, to protect against high blood pressure. 

In the article DiNicolantonio says: “The fructose component of commonest sugars has been shown to increase blood pressure in a manner independent of sodium intake. 

“Encouraging consumers to hold the sugar, not the salt, may be the best dietary strategy to achieve blood pressure control.” 

DiNicolantonio’s article — written with two colleagues — is the latest salvo in an acrimonious debate within the scientific community over the effects of specific nutrients and food types on health. Some scientists are questioning whether saturated fat and salt — the main targets of public health campaigns — are as harmful as once thought. 

DiNicolantonio is supported by a report published last week which analysed data from 8,670 French adults and found no statistically significant association between blood pressure and salt in the diet. The study in the American Journal of Hypertension said the link between salt and blood pressure may be “overstated”. 

High blood pressure — dubbed the “silent killer” by the World Health Organisation — affects 1bn people worldwide leading to heart attacks and strokes. It is estimated to kill 9m people a year. 

DiNicolantonio, a cardiovascular research scientist at Saint Luke’s Mid America Heart Institute in Kansas City, Missouri, said excessive salt consumption is linked to blood pressure, but he considers sugar may play a greater role. 

He believes the public health initiative to reduce salt consumption to as little as 3g a day is misguided. He said the fact that there had been a reduction in deaths from cardiovascular disease in countries which had reduced their salt intake did not “prove causation”. 

DiNicolantonio highlights an analysis published last May in The American Journal of Clinical Nutrition which found that higher levels of sugars “influence blood pressure independently of the effects of body sugar on body weight”. 

Dr Aseem Malhotra, a cardiologist and science director of Action on Sugar which is campaigning to reduce sugar intake, said cutting salt had saved lives but the threat to public health from sugar had been underestimated. 

“We know that sugar does not provide any nutrients and there is growing evidence that it is an independent risk factor for many diseases,” he said. 

Many consumers are now trying to cut down on sugar. Eva Lawrence, 20, a student at Cambridge University, is among those who have been persuaded to restrict their sugar intake. She said she was concerned about the reported links between sugar and poor health. “I wasn’t eating so unhealthily that I felt my body was at risk, but I wanted to lead a healthy lifestyle and keep fit,” she said. 

Professor Graham MacGregor, who founded Consensus Action on Salt and Health, said he considered DiNicolantonio was relying on “incredibly weak” evidence to justify the claim that sugar was linked to high blood pressure. 

He said there was good evidence over several decades showing the link between salt intake and high blood pressure. He said the work that had been done to cut salt consumption in Britain was now being copied around the world. 

Advice turned on its head 

Decades of dietary advice have been challenged or overturned in recent years. 

Butter: It has long been thought that consuming too much saturated fat, such as that found in butter, increases the risk of heart disease but a recent study found no significant link. 

Cheese: Once seen as a risk for heart disease, some experts now consider it is rich in fats that may be good for the body. One study found eating cheese might reduce the risk of diabetes. 

Low-fat yoghurts: The public health campaign against fat led to a huge range of lower fat products but many contained added sugar and are often not the healthiest option. 

Red wine: It contains the chemical resveratrol which has been considered to have long-term health benefits. However, a report published earlier this year found no evidence that it stops heart disease or prolongs life. 

Coffee: Once considered detrimental to heart health, it is now thought to have health benefits, including protection against type 2 diabetes and liver disease. 

Chocolate: Dark chocolate is believed to improve cardiovascular health by acting like a natural anti-inflammatory to reduce blood pressure.

http://www.thesundaytimes.co.uk/

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