The not-so-sweet truth about sugar — a risk choice?

More and more people have become aware of the dangers of excessive fructose in diet. A new review on fructose in an upcoming issue of the Journal of the American Society of Nephrology (JASN) indicates just how dangerous this simple sugar may be.

Richard J. Johnson, MD and Takahiko Nakagawa, MD (Division of Renal Diseases and Hypertension, University of Colorado) provide a concise overview of recent clinical and experimental studies to understand how excessive amounts of fructose, present in added sugars, may play a role in high blood pressure, diabetes, obesity, and chronic kidney disease (CKD).

Dietary fructose is present primarily in added dietary sugars, honey, and fruit. Americans most frequently ingest fructose from sucrose, a disaccharide containing 50% fructose and 50% glucose bonded together, and high fructose corn syrup (HFCS), a mixture of free fructose and free glucose, usually in a 55/45 proportion. With the introduction of HFCS in the 1970s, an increased intake of fructose has occurred and obesity rates have risen simultaneously.

The link between excessive intake of fructose and metabolic syndrome is becoming increasingly established. However, in this review of the literature, the authors conclude that there is also increasing evidence that fructose may play a role in hypertension and renal disease. “Science shows us there is a potentially negative impact of excessive amounts of sugar and high fructose corn syrup on cardiovascular and kidney health,” explains Dr. Johnson. He continues that “excessive fructose intake could be viewed as an increasingly risky food and beverage additive.”

Concerned that physicians may be overlooking this health problem when advising CKD patients to follow a low protein diet, Dr. Johnson and Dr. Nakagawa recommend that low protein diets include an attempt to restrict added sugars containing fructose.

Disclosures: Dr. Johnson and Dr. Nakagawa are listed as inventors on several patent applications related to lowering uric acid for the treatment or prevention of hypertension, diabetes, and fatty liver. Dr Johnson has also published a book, The Sugar Fix that covers this topic for the general public.

The article, entitled “The Effect of Fructose on Renal Biology and Disease,” will appear online at http://jasn.asnjournals.org on November 29, 2010, doi 10.1681/ASN.2010050506.

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Founded in 1966, the American Society of Nephrology (ASN) is the world's largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.