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Nutrients 2017, 9(8), 872; doi:10.3390/nu9080872

Longitudinal Associations of High-Fructose Diet with Cardiovascular Events and Potential Risk Factors: Tehran Lipid and Glucose Study

1
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran 1985717413, Iran
2
Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4741, Tehran 19816-19573, Iran
3
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran 1985717413, Iran
4
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran 1985717413, Iran
*
Author to whom correspondence should be addressed.
Received: 9 July 2017 / Revised: 3 August 2017 / Accepted: 9 August 2017 / Published: 21 August 2017
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Abstract

The relationship between fructose and cardiovascular disease (CVD) remains controversial. In this study, we aimed to assess possible association of dietary intakes of fructose with the risk of CVD events in a prospective population-based study. Participants without CVD (n = 2369) were recruited from the Tehran Lipid and Glucose Study and followed a mean of 6.7 years. Dietary data were collected using a validated 168 item semi-quantitative food frequency questionnaire. Dietary total fructose (TF) intake was calculated by sum of natural fructose (NF) in fruits and vegetables and added fructose (AF) in commercial foods. Multivariate Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate the risk of CVD across tertiles of dietary fructose. Linear regression models were used to indicate association of fructose intakes with changes of CVD risk factors over the study period. The mean age of participants (43.5% men) was 38.1 ± 13.3 years at baseline. During an average of 6.7 ± 1.4 years of follow-up, 79 participants experienced CVD outcomes. The mean daily intake of TF was 6.4 ± 3.7% of total energy (3.6 ± 2.0 from AF and 2.7 ± 1.8 from NF). Higher consumption of TF (≥7.4% vs. <4.5% of total energy) was accompanied with an increased risk of CVD (HR = 1.81, 95% CI = 1.04–3.15); higher energy intake from AF was also related to incidence of CVD (HR = 1.80, 95% CI = 1.04–3.12), whereas NF was not associated with the risk of CVD outcomes. Both AF and TF were also related to changes of systolic and diastolic blood pressures, waist circumference, serum insulin and creatinine levels, as well as HDL-C. Our data provides further evidence regarding undesirable effects of fructose intake in relation to risk of CVD events. View Full-Text
Keywords: fructose; cardiovascular diseases; insulin resistance; creatinine; blood pressure fructose; cardiovascular diseases; insulin resistance; creatinine; blood pressure
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Bahadoran, Z.; Mirmiran, P.; Tohidi, M.; Azizi, F. Longitudinal Associations of High-Fructose Diet with Cardiovascular Events and Potential Risk Factors: Tehran Lipid and Glucose Study. Nutrients 2017, 9, 872.

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