It's Sugar, Not Salt that Causes Heart Attacks

December 22, 2014The Wrong White Crystals for High Blood Pressure Reference : OpenHeart Dec 2014 Ask anyone with heart disease what they have to avoid and they will answer, “Salt”. Right? Well, they are wrong.   It’s time to think carefully just what happens with our physiology and how heart disease develops. This article is an elegant discussion of the issue.   It’s not salt, it’s sugar.   We Americans eat about 15% of our calories from table sugar.   The American Heart Association has already come out with guidelines to reduce sugar intake to under half of our discretionary calories in a day. (6 teaspoons for women and 9 for men) That’s too complicated for me. Their earlier comment was simply less than an ounce a day. But is about a quarter of what we are eating today. Why so stringent?   The evidence continues to accumulate that sugar causes trouble. DiNicolantonio, the author of this review, from Kansas City, has written a beautiful review article that details the problems with sugar. For example, “Compared to patients who consume less than 10% of their calories from added sugars, those who consumed 10.0-24.5% of their calories from added sugars have a 30% increased risk of mortality from heart disease and those who consume more than 25% have an almost threefold risk increase.” An intake of over 75 grams of fructose a day (table sugar is half fructose) is independently associated with 26%, 30% and 77% higher risk for blood pressures of 135/85, 140/90 and 160/100.   Consumption of 150 grams a day of table sugar will lead to a blood pressure rise of 3.8/4.1 mm Hg in just 10 weeks. Ok, ok! I concede. The data is huge and convincing.   In fact, just one 24 ounce sugared soda will raise your blood pressure by 15/9 and your heart rate by 9 bpm. What happens if you eat all your fructose in the form of fruit?   One study showed that 200 grams a day of fructose from 20 servings of whole fruit lowers blood pressure.   Way too many carbs, and you will gain weight, but at least your blood pressure doesn’t go up. DiNicolantinio details several mechanisms by which fructose causes trouble. I like the NEJM review article on Uric Acid and fructose the best.   The steps of trouble go like this: 1. Fructose floods into your liver, that can’t resist taking it up.   2. Your liver must burn one ATP to phosphorylate the fructose.   3. You burn up all your available ATP. 4. Your liver tries to regenerate ATP desperately by turning two ADPs into one ATP and on AMP.   5. AMP degrades to uric acid.   6. Uric acid soaks up nitric oxide in your blood vessels. 7. Without NO, your vessels constrict – that’s called high blood pressure. Most Americans are eating 2-8 times the generous American Heart Limits. We are in deep doodoo. WWW. What will work for me? Wow. Sugar is just poison. The problem is, we are all sugar junkies. Our lizard brains were designed to go after sugar because for most of human history, it meant valuable fruit. But if your blood pressure is anything higher than 115/60, you will likely benefit by cutting the sugar.   And this is sugar season.   Hold on!   Pop Quiz
  1. Sugar is more dangerous for me than salt when discussing heart disease? T or F
Bingo!
  1. The Average American gets 15% of their calories from sugar? T or F
True
  1. Drinking one large 24 ounce of sugared soda will raise my blood pressure some 9 points.
Yup
  1. The way fructose causes trouble is via uric acid that soaks up nitric oxide.   T or F
Yup again. That’s a nice simple summary.
  1. And Nitric Oxide lowers my blood pressure, so I want it around. T or F
Now you’ve got it.  

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