CardioExchange Archive

A new study offers a broad overview of the use of sugar in the U.S. diet and its consequent health implications. The good news is that the growth in sugar intake appears to have stopped and may even have slightly declined. The bad news is that people still consume way too much sugar and that sugar is killing them.

In a paper published in JAMA Internal Medicine, Quanhe Yang, from the Centers for Disease Control and Prevention, and colleagues analyze data about sugar use and its health effects from the NHANES (National Health and Nutrition Examination Survey) studies. They report that the percentage of daily calories from added sugar grew from 15.7% in 1988-1994 to 16.8% in 1999 to 2004 but then fell back to 14.9% in 2005-2010.

But more than 7 out of 10 adults in the U.S. (71.4%) get more than 10% of their calories from added sugar, while 1 out of 10 get a full 25% of their calories from added sugar. (The Institute of Medicine recommends that added sugar compose less than 25% of total calories; the World Health Organization recommends a much lower 10%. The American Heart Association doesn’t recommend a specific percentage but their recommendations translate into even lower percentages of added sugar.)

The authors found a strong association between the amount of added sugar in the diet and cardiovascular mortality. The association persisted even after adjusting for other known risk factors. The authors estimated that people who consumed between 10% and 25% of their calories from added sugar had a 30% increase in cardiovascular mortality. For people who consumed more than 25% of their calories from added sugar the risk nearly tripled (adjusted HR 2.75).

In an invited commentary, Laura Schmidt writes that sugar used to be viewed benignly as a vehicle for empty calories. Its associated ill effects were because the sugar was “a marker for unhealthy diet or obesity.” But now a “new paradigm” has emerged in which sugar is an independent risk factor for cardiovascular disease and other diseases:

The new paradigm hypothesizes that sugar has adverse health effects above any purported role as ’empty calories’ promoting obesity. Too much sugar does not just make us fat; it can also make us sick.”