Excess Sugar Intake Raises Risk of Death From CVD
By Lenora Dannelke
A recent study has the food industry and dietitians reexamining the health effects of excess sugar intake.
The JAMA Internal Medicine study published last month that found excessive added sugar consumption from foods and beverages was associated with an increased risk of death from cardiovascular disease (CVD) caused many experts in the food and nutrition industry to pause and reexamine how sugar intake affects overall health. It also prompted food and beverage associations to rebut the research findings.
According to the American Beverage Association, “This study’s findings do not establish causation but rather show an association. Importantly, demonstrating association is not the same as establishing causation.” The Sugar Association refuted the study’s findings, stating that “there are a number of major flaws with this new study, and the sensationalism associated with targeting sugar is fueling the media.”
Researchers used national health survey data to examine added sugar consumption as a percentage of daily calories and to estimate the association between consumption and CVD. The researchers noted that the risk of death from CVD increased with a higher percentage of calories from added sugar. Regular consumption of sugar-sweetened beverages (seven servings or more per week) was linked with a higher risk of dying from CVD.
Lead researcher Quanhe Yang, PhD, a senior scientist in the division for heart disease and stroke prevention at the Centers for Disease Control and Prevention, says the study used data from three national health surveys from 1988 to 2010 that included more than 31,000 people—to date the largest study of its kind. “This study identifies risk factors,” Yang says. “Americans are consuming too much sugar.” The recommended allowance for added sugar is 6 tsp/day for women and 9 tsp/day for men.
Study results indicate that the average percentage of daily calories from added sugar increased from 15.7% between 1988 and 1994 to 16.8% between 1999 and 2004 and decreased to 14.9% between 2005 and 2010. From 2005 to 2010, nearly 72% of adults consumed 10% or more of their calories from added sugar, and about 10% of adults consumed 25% or more of their calories from added sugar.
The World Health Organization recently issued new guidelines stating that only 5% of a person’s total daily calories should come from sugar, which is one-half of what the organization previously recommended. According to the JAMA Internal Medicine study background, the Institute of Medicine recommends that added sugar make up less than 25% of total calories, and the American Heart Association recommends limiting added sugars to less than 100 kcal/day for women and 150 kcal/day for men.
According to Kim Larson, RDN, CD, CSSD, a spokesperson for the Academy of Nutrition and Dietetics (the Academy), while the study didn’t find a causal relationship between added sugar consumption and heart disease, it will help dietitians better “understand dietary patterns by identifying risk factors independent of weight and links to obesity,” which means that a person with a healthy weight still has to limit added sugar consumption.
In light of these findings, Larson says she plans to modify how she counsels clients and patients about added sugar intake. “In the past, we might have said that if a person had a normal body weight and was active, they’d burn it off. But now I’ll be more inclined to say that your sugar level is too high and needs to be limited. It’s a risk factor for heart disease,” she explains.
This was an observational study, but it “gives us another leg to stand on, that added sugars can cause cardiovascular disease as well as obesity,” says Kelly Pritchett, PhD, RDN, CSSD, an assistant professor of sports nutrition at the University of Georgia and a spokesperson for the Academy. “I would incorporate this information into my basic nutrition class and when designing a healthful diet,” noting that from a weight management standpoint, the study is an effective tool, and that she’d like to see follow-up interventional studies done on the link between added sugar and CVD.
“Beverages can be a hidden calorie bomb,” she continues. “A lot of people aren’t aware of how much sugar is in sugar-sweetened beverages such as sodas, fruit drinks, even coffees, and what we put in our coffees. And we’re not talking about naturally occurring sugar we find in dairy and fruit.”
Yang says the emerging evidence of the association between excess sugar consumption and health issues, from obesity and type 2 diabetes to hypertension, now is compounded by the additional CVD risk factors. He hopes that the study will increase awareness about the dangers of excessive sugar intake and help dietitians better counsel clients. “It’s always a good idea to reduce sugars,” he says.
— Lenora Dannelke is a freelance writer in Allentown, Pennsylvania, who specializes in food, beverage, and travel topics.