Vice President of Worksite Wellness
The Basics: Halloween kicks off the holiday season that’s inevitably filled with lots of sweet treats. As you stock up, it’s important to remember that most Americans already consume substantial amounts of added sugar in their diet. Sugar finds its way into the diet through prepared foods, during meal preparation, and by consumption of sugared beverages. Major sources of added sugar in American adults’ diet include soft drinks and other sugared beverages, fruit drinks, grain-based desserts, dairy desserts, and – you guessed it – candy. Exactly how much sugar is “too much”? Recommendations about maximum sugar consumption vary widely among respected organizations:
It has been established that consumption of higher amounts of added sugar, especially sugared beverages, leads to weight gain and higher risk levels for obesity, type 2 diabetes, hypertension, lipid abnormalities, and cardiovascular disease. Cardiovascular disease is when the heart’s blood vessels become narrow or blocked, a disease that can lead to stroke, heart attack, heart failure, and other serious conditions that can cause death.
A study published in the journal JAMA Internal Medicine looks more closely at the relationship between calories consumed as added sugar and cardiovascular death. Their results suggest that the average percentage of calories from added sugar consumed by American adults increased from 15.7% in 1988-1994 to 16.8% in 1999-2004 and then decreased to 14.9% during 2005-2010. But, in 2005-2010, almost two-thirds (71.4%) of American adults consumed more than 10% of their total calories from added sugar and just under 10% of adults consumed a whopping 25% or more of calories from added sugar!
Compared to the group that consumed less than 10% of calories from added sugar, cardiovascular death increased as sugar calories increased. Those who consumed an average of about 15% of calories from added sugar had an 18% increase in risk of cardiovascular death. The trend continued upward with more sugar intake – consumption averaging about 19% increased risk of cardiovascular death by 38%, and at 25%, the risk was 103% higher – more than doubled!
This is yet another study from the scientific literature that reinforces the simple message of movement, nutrition, and balance. Keep active, eat fresh, unprocessed foods (“colorful foods that rot”), and keep balance in your life.
More Detail: The authors of this study were very careful to eliminate confounding variables. To ensure that differences in the groups were the effect of sugar consumption, they adjusted for age, sex, race/ethnicity, level of education, smoking status, alcohol consumption, physical activity level, antihypertensive medication use, family history of cardiovascular disease, Healthy Eating Index score, body mass index, systolic blood pressure, total serum cholesterol, and total caloric intake.
Why does sugar intake lead to cardiovascular death? What is the mechanism? Certainly, the additional calories predispose to obesity, hypertension, and diabetes, but there seems to be more to the story. Some studies in both animals and humans suggest that refined sugar intake, independent of weight gain, lead to hypertension. Other studies show that sugar may contribute to elevated triglycerides and a deleterious effect on the balance between LDL (“bad”) and HDL (“good”) cholesterol types. Finally, there may be an association between intake of sugared beverages and inflammation that promotes vascular disease. Over time, the reasons why refined sugar consumption leads to heart disease, stroke, and vascular disease will be understood. In the meantime, there is good reason to decrease sugar intake.
Bottom Line: Keep Halloween candy out of sight and reach; instead, keep sweet treats of fruit in a bowl. Your heart will thank you later!
Yang, Q. et al. Added sugar intake and cardiovascular disease mortality among US adults. JAMA Intern Med. doi:10.1001/jamainternmed.2013.13563