When Sugar Isn’t Sweet

Now there’s another reason to encourage clients to limit their sugar intake: Eating added sugar is associated with increased risk of death from cardiovascular disease, according to a study published February 3 online in JAMA Internal Medicine. The study focuses on sugar added in the processing or preparing of foods, not naturally occurring sugars in fruits and fruit juices.

Recommendations for added sugar 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% of total calories, the World Health Organization recommends less than 10% (but in March 2014 proposed a further reduction to below 5% for additional benefits), 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.

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

Study results indicated that the average percentage of daily calories from added sugar increased from 15.7% in 1988–1994 to 16.8% in 1999–2004, but decreased to 14.9% in 2005–2010.

In 2005–2010, most adults (71.4%) consumed 10% or more of their calories from added sugar, but for about 10% of adults it made up 25% or more of their calories.

The risk of heart-related death increases 18% for people consuming an average American diet with about 15% of daily calories from added sugar, compared with those whose diets contain little to no added sugar, the study authors found.

The risk is 38% higher for people who receive 17%–21% of their calories from added sugar, and more than double for people who get more than
21% of their daily diet from added sugar, Yang said.

Another key point: The study found that the added sugar that Americans consume as part of their daily diet can—on its own, regardless of other health problems—more than double the risk of death from heart disease.

So what is a good general guideline for sugar consumption? “Until federal guidelines are forthcoming, physicians may want to caution patients that, to support cardiovascular health, it is safest to consume less than 15% of total calories as added sugar,” according to Laura
A. Schmidt, PhD, who wrote commentary on the published research.