Study examines consumption of added sugar, death for cardiovascular disease

Many U.S. adults consume more added sugar (added in processing or preparing of foods, not naturally occurring as in fruits and fruit juices) than expert panels recommend for a healthy diet, and consumption of added sugar was associated with increased risk for death from cardiovascular disease (CVD), according to a study published by JAMA Internal Medicine.

Recommendations for added consumption vary and there is no universally accepted threshold for unhealthy levels. For example, the Institute of Medicine recommends that added sugar make up less than 25 percent of total , the World Health Organization recommends less than 10 percent, and the American Heart Association recommends limiting added sugars to less than 100 calories daily for women and 150 calories daily for men, according to the study background.

Major sources of added sugar in Americans' diets are sugar-sweetened beverages, grain-based desserts, fruit drinks, dairy desserts and candy. A can of regular soda contains about 35g of sugar (about 140 calories).

Quanhe Yang, Ph.D., of the Centers for Disease Control and Prevention, Atlanta, and colleagues used national health survey data to examine added sugar consumption as a percentage of daily calories and to estimate association between consumption and CVD.

Study results indicate that the average percentage of daily calories from added sugar increased from 15.7 percent in 1988-1994 to 16.8 percent in 1999 to 2004 and decreased to 14.9 percent in 2005-2010.

In 2005-2010, most adults (71.4 percent) consumed 10 percent of more of their calories from added sugar and about 10 percent of adults consumed 25 percent or more of their calories from added sugar.

The authors note 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 associated with increased risk of dying from CVD.

"Our results support current recommendations to limit the intake of calories from added sugars in U.S. diets," the authors conclude.

In a related commentary, Laura A. Schmidt, Ph.D., M.S.W., M.P.H., of the University of California, San Francisco, writes: "We are in the midst of a paradigm shift in research on the health effects of sugar, one fueled by extremely high rates of added sugar overconsumption in the American public."

"In sum, the study by Yang et al contributes a range of new findings to the growing body of research on sugar as an independent risk factor in chronic disease. It underscores the likelihood that, at levels of consumption common among Americans, added sugar is a significant risk factor for CVD mortality above and beyond its role as empty calories leading to weight gain and obesity," Schmidt continues.

"Yang et al underscore the need for federal guidelines that help consumers set safe limits on their intake as well evidence-based regulatory strategies that discourage excess sugar consumption at the population level," the author concludes.

More information: JAMA Intern Med. Published online February 3, 2014. DOI: 10.1001/jamainternmed.2013.13563
JAMA Intern Med. Published online February 3, 2014. DOI: 10.1001/jamainternmed.2013.12991

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