HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Johnson, R. J Articles by Sánchez-Lozada, L. G Search for Related Content PubMed PubMed Citation Articles by Johnson, R. J Articles by Sánchez-Lozada, L. G Agricola Articles by Johnson, R. J Articles by Sánchez-Lozada, L. G

Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease^1,2,3

¹ From the Division of Nephrology and Department of Medicine, University of Florida, Gainesville, FL (RJJ, MSS, YS, TN, and MSG); the Division of Pediatric Nephrology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX (DIF); the Division of Nephrology, Ewha Woman's University College of Medicine, Seoul, Korea (D-HK); the Foundation for Applied Molecular Evolution, Gainesville, FL (SB); and the Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico (LGS-L)

Currently, we are experiencing an epidemic of cardiorenal disease characterized by increasing rates of obesity, hypertension, the metabolic syndrome, type 2 diabetes, and kidney disease. Whereas excessive caloric intake and physical inactivity are likely important factors driving the obesity epidemic, it is important to consider additional mechanisms. We revisit an old hypothesis that sugar, particularly excessive fructose intake, has a critical role in the epidemic of cardiorenal disease. We also present evidence that the unique ability of fructose to induce an increase in uric acid may be a major mechanism by which fructose can cause cardiorenal disease. Finally, we suggest that high intakes of fructose in African Americans may explain their greater predisposition to develop cardiorenal disease, and we provide a list of testable predictions to evaluate this hypothesis.

Key Words: Fructose • uric acid • sugar • arteriosclerosis • endothelial dysfunction • hypertension • obesity • chronic kidney disease • metabolic syndrome

This article has been cited by other articles:

				G. Livesey Fructose Ingestion: Dose-Dependent Responses in Health Research J. Nutr., June 1, 2009; 139(6): 1246S - 1252S. [Abstract] [Full Text] [PDF]

				T. J. Angelopoulos, J. Lowndes, L. Zukley, K. J. Melanson, V. Nguyen, A. Huffman, and J. M. Rippe The Effect of High-Fructose Corn Syrup Consumption on Triglycerides and Uric Acid J. Nutr., June 1, 2009; 139(6): 1242S - 1245S. [Abstract] [Full Text] [PDF]

				T. T Fung, V. Malik, K. M Rexrode, J. E Manson, W. C Willett, and F. B Hu Sweetened beverage consumption and risk of coronary heart disease in women Am. J. Clinical Nutrition, April 1, 2009; 89(4): 1037 - 1042. [Abstract] [Full Text] [PDF]

				P. Cirillo, M. S. Gersch, W. Mu, P. M. Scherer, K. M. Kim, L. Gesualdo, G. N. Henderson, R. J. Johnson, and Y. Y. Sautin Ketohexokinase-Dependent Metabolism of Fructose Induces Proinflammatory Mediators in Proximal Tubular Cells J. Am. Soc. Nephrol., March 1, 2009; 20(3): 545 - 553. [Abstract] [Full Text] [PDF]

				S. Barone, S. L. Fussell, A. K. Singh, F. Lucas, J. Xu, C. Kim, X. Wu, Y. Yu, H. Amlal, U. Seidler, et al. Slc2a5 (Glut5) Is Essential for the Absorption of Fructose in the Intestine and Generation of Fructose-induced Hypertension J. Biol. Chem., February 20, 2009; 284(8): 5056 - 5066. [Abstract] [Full Text] [PDF]

				R. J. Johnson, S. E. Perez-Pozo, Y. Y. Sautin, J. Manitius, L. G. Sanchez-Lozada, D. I. Feig, M. Shafiu, M. Segal, R. J. Glassock, M. Shimada, et al. Hypothesis: Could Excessive Fructose Intake and Uric Acid Cause Type 2 Diabetes? Endocr. Rev., February 1, 2009; 30(1): 96 - 116. [Abstract] [Full Text] [PDF]

				C. H Halsted Perspectives on obesity and sweeteners, folic acid fortification and vitamin D requirements Fam. Pract., December 1, 2008; 25(suppl_1): i44 - i49. [Abstract] [Full Text] [PDF]

				L. G. Sanchez-Lozada, M. Le, M. Segal, and R. J Johnson How safe is fructose for persons with or without diabetes? Am. J. Clinical Nutrition, November 1, 2008; 88(5): 1189 - 1190. [Full Text] [PDF]

				G. Livesey and R. Taylor Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies Am. J. Clinical Nutrition, November 1, 2008; 88(5): 1419 - 1437. [Abstract] [Full Text] [PDF]

				A. Shapiro, W. Mu, C. Roncal, K.-Y. Cheng, R. J. Johnson, and P. J. Scarpace Fructose-induced leptin resistance exacerbates weight gain in response to subsequent high-fat feeding Am J Physiol Regulatory Integrative Comp Physiol, November 1, 2008; 295(5): R1370 - R1375. [Abstract] [Full Text] [PDF]

				J. R. Vasselli Fructose-induced leptin resistance: discovery of an unsuspected form of the phenomenon and its significance. Focus on "Fructose-induced leptin resistance exacerbates weight gain in response to subsequent high-fat feeding," by Shapiro et al. Am J Physiol Regulatory Integrative Comp Physiol, November 1, 2008; 295(5): R1365 - R1369. [Full Text] [PDF]

				D. I. Feig, D.-H. Kang, and R. J. Johnson Uric Acid and Cardiovascular Risk N. Engl. J. Med., October 23, 2008; 359(17): 1811 - 1821. [Full Text] [PDF]

				O. Glushakova, T. Kosugi, C. Roncal, W. Mu, M. Heinig, P. Cirillo, L. G. Sanchez-Lozada, R. J. Johnson, and T. Nakagawa Fructose Induces the Inflammatory Molecule ICAM-1 in Endothelial Cells J. Am. Soc. Nephrol., September 1, 2008; 19(9): 1712 - 1720. [Abstract] [Full Text] [PDF]

				A. Brandstatter, S. Kiechl, B. Kollerits, S. C. Hunt, I. M. Heid, S. Coassin, J. Willeit, T. D. Adams, T. Illig, P. N. Hopkins, et al. Sex-Specific Association of the Putative Fructose Transporter SLC2A9 Variants With Uric Acid Levels Is Modified by BMI Diabetes Care, August 1, 2008; 31(8): 1662 - 1667. [Abstract] [Full Text] [PDF]

				M. N. Feinglos and S. E. Totten Are You What You Eat, or How Much You Eat?: The Case of Type 2 Diabetes Mellitus Arch Intern Med, July 28, 2008; 168(14): 1485 - 1486. [Full Text] [PDF]

				G. Marchesini, V. Ridolfi, and V. Nepoti Hepatotoxicity of fast food? Gut, May 1, 2008; 57(5): 568 - 570. [Full Text] [PDF]

				R J. Hine Time to get specific about dietary carbohydrates, affected populations, and diseases Am. J. Clinical Nutrition, April 1, 2008; 87(4): 1062 - 1062. [Full Text] [PDF]

				G. A Bray Reply to RJ Hine and JS White Am. J. Clinical Nutrition, April 1, 2008; 87(4): 1064 - 1065. [Full Text] [PDF]

				J. S White No unique role for fructose sweeteners in obesity or cardiorenal disease Am. J. Clinical Nutrition, April 1, 2008; 87(4): 1062 - 1063. [Full Text] [PDF]

				L. G. Sanchez-Lozada, E. Tapia, P. Bautista-Garcia, V. Soto, C. Avila-Casado, I. P. Vega-Campos, T. Nakagawa, L. Zhao, M. Franco, and R. J. Johnson Effects of febuxostat on metabolic and renal alterations in rats with fructose-induced metabolic syndrome Am J Physiol Renal Physiol, April 1, 2008; 294(4): F710 - F718. [Abstract] [Full Text] [PDF]

				E. Ritz Cardiovascular Literature--Beyond Nephrology Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 317 - 323. [Full Text] [PDF]

				R. Villegas, X. O. Shu, Y.-T. Gao, G. Yang, T. Elasy, H. Li, and W. Zheng Vegetable but Not Fruit Consumption Reduces the Risk of Type 2 Diabetes in Chinese Women J. Nutr., March 1, 2008; 138(3): 574 - 580. [Abstract] [Full Text] [PDF]

				Is High-Fructose Corn Syrup the New Trans Fat? Journal Watch Pediatrics and Adolescent Medicine, December 12, 2007; 2007(1212): 5 - 5. [Full Text]