Added sugars linked to cardiovascular disease

by Keith Nunes
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ATLANTA – A study published in the April 20 issue of the Journal of the American Medical Association titled “Caloric sweetener consumption and dyslipidemia among U.S. adults,” draws a link between the consumption of added sugars in foods and beverages to an increased risk of cardiovascular disease.

“In the United States, total consumption of sugar has increased substantially in recent decades, largely owing to an increased intake of ‘added sugars,’ defined as caloric sweeteners used by the food industry and consumers as ingredients in processed or prepared foods to increase the desirability of these foods,” the authors write.

The authors said this is the first study to examine the association between the consumption of added sugars and lipid measures, such as high-density lipoprotein cholesterol (HDL-C), often referred to as good cholesterol, and low-density lipoprotein cholesterol (LDL-C).

Jean A. Welsh, a researcher at Emory University, and colleagues assessed the association between consumption of added sugars and blood lipid levels in U.S. adults. The study included 6,113 adults from the National Health and Nutrition Examination Survey (NHANES) 1999-2006. Respondents were grouped by intake of added sugars using limits specified in dietary recommendations (less than 5% of total calories, which was the reference group, 5% to less than 10%, 10 percent to less than 17.5%, 17.5% to less than 25%, and 25% or more of total calories).

The researchers found that daily consumption of added sugars averaged 3.2 ounces, equal to 21.4 teaspoons or 359 calories, which represents 15.8% of total daily caloric intake.

“This represents a substantial increase from 1977-1978, when added sugars contributed only 10.6% of the calories consumed by adults,” the authors write.

Adjusted average HDL-C levels were lower among respondents consuming higher amounts of added sugars: 58.7 mg/dL among those consuming less than 5% energy from added sugars, 57.5 mg/dL among those consuming 5% to less than 10%, 53.7 mg/dL among those consuming 10% to less than 17.5%, 51.0 mg/dL among those consuming 17.5% to less than 25%, and 47.7 mg/dL among those consuming 25% or greater. Among higher consumers, those in the 10% or greater added sugars categories, the odds of low HDL-C levels were 50% to more than 300% greater compared with the reference group (less than 5% added sugars).

“Just like eating a high-fat diet can increase your levels of triglycerides and high cholesterol, eating sugar can also affect those same lipids,” said study co-author Miriam Vos, assistant professor of pediatrics at the Emory School of Medicine. “It would be important for long-term health for people to start looking at how much added sugar they're getting and finding ways to reduce that.”

Responding to the study, The Sugar Association, which works closely with the American Sugar Alliance, said government officials should rely on “sound science, not emotion or opinion,” to make decisions about dietary guidelines involving sugar or caloric sweeteners.

“At 15 calories per teaspoon, all-natural sugar has been a healthy part of diets for more than 2,000 years,” the Sugar Association said. “We continue to encourage Americans to consume sugar, as well as all foods and beverages, in moderation.”

The association said severely limiting sugar consumption “is neither practical nor realistic,” and cautioned that even the JAMA study pointed out that its data “can be used only to assess associations” and not to “determine causality or even to assess directionality or temporality of the associations observed.”

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