The effects of sugar on heart disease

by Carolyn Thomas  ♥  @HeartSisters

“I’m beginning to wonder about the effect of sugar on heart disease. I’ve heard about new studies being done on sugar raising triglycerides and high blood pressure. If this is the case, I am truly in trouble!”

I can hardly believe I haven’t addressed this topic here yet (out of 328 previous Heart Sisters posts written so far) but this woman’s comment got me thinking about sugar. Not that I need much prompting to think about sugar. I’m a recovering choc-a-holic who, many years ago, once ate half a box of Turtles just to get them out of the house.  (Anybody else out there relate to this kind of choco-fueled craziness?)

I thought so. A landmark report in the journal Circulation called Sugar and Cardiovascular Disease reminds us that well over half of North Americans consume a tooth-rotting, belly-busting 40+ teaspoons of sugar per day. 

And this isn’t all from the sugar bowl, of course.

In fact, most of that sugar consumption comes in the form of soft drinks and the hidden added sugars like high-fructose corn syrup, honey, molasses, brown rice syrup, agave syrup and other caloric sweeteners in prepared and processed foods –  for instance, in candy, pastries, cookies, spaghetti sauce, ketchup, canned fruits etc. The list is endless. READ YOUR LABELS!

There is actually considerable research out there linking this kind of added sugar consumption to heart disease, starting back in the 1960s.

The Nurses’ Health Study(1) showed that women who consumed diets with a high glycemic load (increased blood glucose levels associated with intake of sugars, starches and highly processed sweets) had up to twice the risk for coronary heart disease during 10 years of follow-up.

A 2010 Italian study(2) similarly found that women who consumed a higher intake of high-glycemic foods had about twice the incidence of heart disease as those who consumed the least. Oddly enough, this was not true for the men in this large study of over 47,000 participants.

Last year, Emory University research published in the Journal of the American Medical Association suggested we need to scale back our intake of added sugars. People with the highest – versus the lowest – intake of refined sugar had higher blood triglycerides (fat) and triple the risk of having a low level of HDL (good) cholesterol.

Soda and other sugar-sweetened beverages such as fruit drinks are associated with higher blood pressure levels in adults (a known risk factor for heart disease).  Researchers reported in Hypertension: Journal of the American Heart Association that sugar intake in the form of glucose, fructose and sucrose was highest in those consuming more than one sugar-sweetened beverage daily.  They also found that people consuming more than one serving per day of sugar-sweetened beverages generally consumed more calories on average than those who didn’t (typically almost 400 more calories per day).

Dr. Ian Brown, research associate at Imperial College London, explained:

“People who drink a lot of sugar-sweetened beverages appear to have less healthy diets in general, so they are consuming empty calories without the nutritional benefits of real food.”

The original comment that started this post, however, still bothers me.

Do we really need Dr. Oz, peer-reviewed clinical research, or powerful Sugar Association lobbyists to tell us whether or not sugar is actually good for the human body?

Most of us admit to a sweet tooth, and as occasional treats (like birthday cake!) sugar is a wonderful part of life – as long as it’s only a relatively tiny part. But keep in mind that just one Dairy Queen Mr. Misty Slush contains 28 teaspoons of sugar – and that’s an everyday beverage for way too many consumers.

Sugar provides only empty calories, displaces other more healthy foods in our daily diets, and is generally bad for our waistlines, our complexions, our teeth, and (likely) our hearts. Blah, blah, blah…

Why are we even having a discussion about the goodness or badness of sugar?

Because there are forces at work out there to convince consumers and government regulators that not only is sugar harmless, but that, yes, indeed, it’s actually good for you!

This year, the powerful industry lobby group called The Sugar Association described government recommendations to reduce consumers’ daily sugar consumption limits “impractical, unrealistic, and not grounded in the body of evidence.”  But these are also the folks who recommend pouring sugar onto your toddler’s vegetables to make them more palatable. Really. Seriously. (Read more on this in “Sugar Is Good For You! – And For the People Who Make Sugar” at The Ethical Nag: Marketing Ethics for the Easily Swayed)

Such nutritional advice, by the way, might make perfect sense to the parents pouring Coke into their baby’s bottle, as I once observed in the Minneapolis airport while en route to Mayo Clinic.

Make no mistake – the declared mission of the Sugar Association lobbyists is: “to promote the consumption of sugar”, ergo:

• Getting mothers to feed Coke to their infants is actually in the best interests of their stakeholders.
• Convincing you that Froot Loops (over 50% sugar by weight) is a healthy fibre-added breakfast cereal to give your kids is also in the best interests of their stakeholders.
• Their stakeholders will be especially happy if you agree to feed Organic Similac baby formula to your infant, because it is sweetened with cane sugar. (More on this at “Snake Oil In Your Snacks”).

But I digress.

Here’s why the naturally-occurring sugar (like in fruit) is better for you than table sugar is. Regular table sugar or sucrose is processed in the body extremely fast. In doing this, the body tells the pancreas to pump out insulin, creating a big spike in blood sugar levels.

But the sugar present in fruit – or fructose –  is broken down more slowly, which allows the body more time to react to the fruit sugars that have just been consumed. This puts less stress on the pancreas.

Consider that diets high in sugar can adversely affect your overall nutrition when sugary foods replace healthy foods. Choosing that big slice of gooey double-fudge chocolate marble cheesecake means you’re not choosing instead a heart-healthy fresh fruit salad for dessert, for example. And kids heading off to school with a high-glycemic lunch like a white-bread-sandwich of PB and J, a sugary lemonade drink-box and some sugary cookies might as well be packing a handful of sugar cubes for lunch instead. And a Coke.

Many fat-free processed ‘lite’ foods are often high in calories because of the inclusion of high amounts of sugar to take the place of that missing fat. Jell-O Fat Free Pudding Snacks, for example, contain 17 grams sugar per serving. Again, READ YOUR LABELS!

The Circulation report on sugar explained:

“High-sugar foods displace whole foods (e.g. soft drinks displace milk and real-juice consumption in children) and contribute to nutritional deficiencies, adding empty calories that few people need. Among children in the Bogalusa Heart Study,⁽³⁾ a linear decrease in the intake of many essential nutrients was associated with increasing total sugar intake.”

The American Heart Association recommends consuming no more than six teaspoons of sugar per day (100 calories).

Just one can of soda, however, can have up to 11 teaspoons of sugar in it.  Sugar is converted into triglycerides which have been linked to the production of omentum fat, one of the contributors to high cholesterol levels.  After just a single such serving, your triglycerides shoot up.

All sugars and sweeteners are high in calories and low in overall nutritional value, says Canada’s Heart and Stroke Foundation, so we need to watch the total amount of added sugar consumed, regardless of the type.  The H&SF recommends:

“If you must use a sweetener, opt for maple syrup, honey or molasses, since they have more antioxidants than corn syrup or white sugar. “

The Circulation report concluded:

“Shorter-term studies show consistent adverse effects of sugar consumption on HDL and triglyceride blood levels, which could accelerate coronary artery disease. High sugar consumption may worsen diabetes control. High-sugar foods, which are sweet and calorie-dense, may also increase calorie consumption and lead to weight gain. And replacement of whole foods with high-sugar foods compromises attaining adequate dietary vitamin and mineral intake from whole food sources.”

Finally, Toronto-based dietician Leslie Beck, suggested these tips in her Globe and Mail column for reducing sugar in our diets:

• Limit sugary drinks. Replace soft drinks, fruit punch, iced tea and Vitaminwater with water, low-fat milk, vegetable juice or tea.

• Satisfy your sweet tooth naturally. Choose fruit, yogurt or homemade smoothies over candy, cakes, cookies and pastries.

• Choose breakfast cereals that have no more than 6 to 8 grams of sugar per serving. Exceptions include cereals with dried fruit.

• When buying packaged baked good or cereal bars, choose products with no more than half the total carbs from sugars.

• Sweeten foods with spices instead of sugar. Add cinnamon to hot cereal, a dash of vanilla to lattes, and grated fresh ginger to fruit and vegetables.

• Reduce sugar in recipes. As a rule, you can cut the sugar in most baked goods by one-third.

(1) Liu S, Willett WC, Stampfer MJ, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. American Journal of Clinical Nutrition.  2000; 71: 1455–1461.

(2) Sabina Sieri et al. Dietary Glycemic Load and Index and Risk of Coronary Heart Disease in a Large Italian Cohort: The EPICOR Study. Archives of Internal Medicine. 2010; 170(7): 640-647

(3) Farris RP, Nicklas TA, Myers L, et al. Nutrient intake and food group consumption of 10-year-olds by sugar intake level: the Bogalusa Heart Study. Journal of the American College of Nutrition. 1998; 17: 579–585.

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NOTE FROM CAROLYN:  I wrote much more about the slow progress along this bumpy road from diagnosis to feeling better in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use the JHUP code HTWN to save 20% off the list price).

See also:

How Eating Simple Carbs Raises Heart Risks for Women – But Not for Men

“Sugar is Good For You!” – and for the People Who Make Sugar

What Overweight Women May Have in Common with Drug Addicts

First Greenwashing, then Pinkwashing – Now SUGARWASHING!