• Viranda H Jayalath, John L Sievenpiper, Russell J de Souza, Vanessa Ha, Arash Mirrahimi, Ingrid D Santaren, Blanco Mejia Sonia S, Marco Di Buono, Alexandra L Jenkins, Lawrence A Leiter, Thomas M S Wolever, Joseph Beyene, Cyril W C Kendall, and David J A Jenkins.
• a Toronto 3D Knowledge Synthesis and Clinical Trials Unit , Clinical Nutrition and Risk Factor Modification Center , Toronto , Ontario , CANADA.
• J Am Coll Nutr. 2014 Jan 1; 33 (4): 328-39.

ObjectivesAlthough most controlled feeding trials have failed to show an adverse effect of fructose on blood pressure, concerns continue to be raised regarding the role of fructose in hypertension. To quantify the association between fructose-containing sugar (high-fructose corn syrup, sucrose, and fructose) intake and incident hypertension, a systematic review and meta-analysis of prospective cohort studies was undertaken.MethodsMEDLINE, EMBASE, CINAHL and the Cochrane Library (through February 5, 2014) were searched for relevant studies. Two independent reviewers reviewed and extracted relevant data. Risk estimates were aggregated comparing the lowest (reference) quintile with highest quintile of intake using inverse variance random effect models and expressed as risk ratios (RR) with 95% confidence intervals (CIs). Interstudy heterogeneity was assessed (Cochran Q statistic) and quantified (I(2) statistic). The Newcastle-Ottawa Scale assessed study quality. Clinicaltrials.gov NCT01608620.ResultsEligibility criteria were met by 3 prospective cohorts (n = 37,375 men and 185,855 women) with 58,162 cases of hypertension observed over 2,502,357 person-years of follow-up. Median fructose intake was 5.7-6.0% total energy in the lowest quintile and 13.9-14.3% total energy in the highest quintile. Fructose intake was not associated with incident hypertension (RR = 1.02, 95% CI, 0.99-1.04), with no evidence of heterogeneity (I(2) = 0%, p = 0.59). Spline curve modeling showed a U-shaped relationship with a negative association at intakes ≤50th percentile (∼10% total energy) and a positive association at higher intakes.ConclusionsTotal fructose intake was not associated with an increased risk of hypertension in 3 large prospective cohorts of U.S. men and women.

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