It’s the Sugar, Stupid!

It’s now generally accepted that too many carbohydrates in the diet cause unhealthy changes in the levels of different fats, or lipids, in the blood.  The main changes are reduced high-density-lipoprotein (HDL) cholesterol – the ‘good’ cholesterol - and higher triglycerides.  (Similar changes are also caused by eating a high-fat diet.)  These lipid changes are risk factors for cardiovascular disease.  Americans get about 16% of their total dietary calories from sugars that are added to the diet in processed foods during manufacture; this is equivalent to more than 21 teaspoonfuls of added sugar.  Now researchers have tried to quantify the effects of such added sugars, which are mainly sucrose from beets and cane and high fructose corn syrup.  Their findings are reported in the Journal of the American Medical Association.  

The study included some 6000 adults from the National Health and Nutrition Examination Survey (NHANES).  Dietary recall of the previous 24 hours was used to determine the consumption of added sugars; then the enrollees were grouped into 5 classes, based on their added sugars intake. 

The groups consuming the most added sugar were more likely to have higher cardiovascular disease risk, including higher triglyceride levels – over 150 mg/dL -and higher triglyceride to HDL-cholesterol ratios.  For instance, people getting 17.5% - 25% of their energy from added sugars were about twice as likely to have lower HDL levels – about 10 mg/dL lower - as those who got less than 5% of their energy from added sugars. (The highest added sugar group - 25% or more - was taking an average of 46 teaspoonfuls of added sugar a day.)  There was no consistent association between added sugars and LDL cholesterol, the ‘bad’ cholesterol.  It was notable, also, that people who consumed more added sugar in this population got a lower percentage of their daily energy from fats, protein and fiber.

Maybe we didn’t need this evidence, but the message deserves repeating – cut your sugar intake as far as possible, using artificial sweeteners, if necessary.  They are good substitutes, have no calories, and are not harmful.