Better think twice before adding that spoonful of sugar

Friday, February 7, 2014. The conclusion of a study described online on February 3, 2014 in JAMA Internal Medicine suggests that adding sugar to the diet could significantly increase the risk of dying from cardiovascular disease, the leading cause of death in the developed world.

Quanhe Yang, PhD, at the Centers for Disease Control and Prevention in Atlanta and colleagues evaluated data from participants in the National Health and Nutrition Examination Surveys (NHANES) of the US population. Added sugars were defined as those used in processed or prepared foods, including sugar-sweetened beverages, desserts, candy, packaged cereals and breads, but not those that occur naturally in fruit and vegetables.

While 71.4% of adults consumed at least 10% or more of their calories from added sugar during 2005-2010, sugar counted for at least 25% of the calories among 10% of the group. When the researchers examined the association between added sugar and the risk of cardiovascular death over a median 14.6 years of follow-up, subjects whose intake was among the top one-fifth of participants had an adjusted risk that was twice that of participants whose intake was among the lowest fifth. An intake of sugar that accounted for 25% or more of one's calories was associated with a 2.75 times greater risk of cardiovascular disease mortality in comparison with an intake of less than 10%.

Analysis of sugar sweetened beverage intake revealed a 29% greater adjusted risk of cardiovascular disease mortality among those who consumed seven or more beverages per day in comparison with those who drank less than one.

Increased sugar intake can lead to weight gain, hypertension, elevated triglycerides, and increased markers of inflammation. In an invited commentary in the same issue of the journal, Laura A. Schmidt, PhD, MSW, MPH, of the University of California, San Francisco, notes that "Overconsumption of added sugars has long been associated with an increased risk of cardiovascular disease. However, under the old paradigm, it was assumed to be a marker for unhealthy diet or obesity."

"The new paradigm views sugar overconsumption as an independent risk factor in cardiovascular disease as well as many other chronic diseases, including diabetes mellitus, liver cirrhosis, and dementia—all linked to metabolic perturbations involving dyslipidemia, hypertension, and insulin resistance," she observed. "Too much sugar does not just make us fat; it can also make us sick."

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