High Sugar Intake May Affect Cholesterol

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High Sugar Intake May Affect Cholesterol

Content provided by the Faculty of the Harvard Medical School

A lot of sugar in your diet may lead to unhealthy cholesterol levels, a new study finds. Researchers looked at sugar intake and blood fat levels for more than 6,100 adults. They consumed an average of 21.4 teaspoons of added sugars each day. Added sugars do not include natural sugars, such as those in fruit. People who took in more added sugar had lower levels of HDL ("good") cholesterol. They also had higher triglycerides, another blood fat. Added sugars amounted to about 16% of total calories. That's up from an average of 11% in the late '70s. The study appeared in the Journal of the American Medical Association. USA Today wrote about it April 21.

What Is the Doctor's Reaction?

When you think about a diet that's good for your heart, do you try to avoid deep-fried foods, red meat and those with lots of butter? It makes sense. Most heart attacks are caused by cholesterol plaques that build up in the arteries of the heart. And a "high-risk" lipid profile — high total and LDL cholesterol, high triglycerides, and low HDL cholesterol — is linked with the risk of future heart attack.

But a new study suggests we also ought to focus on added sugar. These "empty" calories are added during food preparation or at the table. The study appears in this week's Journal of the American Medical Association.

It's the first study to assess a possible connection between how much added sugar people consume and blood fats (lipids). It was based on a survey and physical examinations of more than 6,000 people. They were chosen to represent the demographic breakdown of the U.S. population.

The study found that:

• Average intake of added sugar totaled 359 calories a day. This is equal to 22 teaspoons of sugar, or 15.8% of total daily calories. It's a big increase from 10.6% of calories in the 1970s.
• The higher the intake of added sugar, the lower the person's HDL ("good") cholesterol. Someone who got at least 10% of total calories from added sugar was up to 3 times more likely to have low HDL as someone who took in half that much sugar.
• People with higher intake of added sugar tended to have higher triglyceride levels as well.
• Women who took in more added sugar also had higher LDL ("bad") cholesterol.

Because of these effects on blood lipids, a lot of sugar in the diet might increase the risk of heart and blood vessel disease. But this study did not assess actual disease (such as heart attacks or stroke). Therefore, more studies will be needed to show how important sugar is for heart and artery disease risk.

How much added sugar is too much? That's not clear. In fact, current advice varies widely. Depending on whom you ask, the portion of daily calories provided by added sugar should be limited to:

• 25% or less (says the Institute of Medicine)
• 10% or less (says the World Health Organization)
• 6% or 7% (says the American Heart Association)

For many years, the factors known to increase the risk of heart and blood vessel disease have remained the same. Some, such as family history, cannot be changed. But if added sugar is added to the list, it's one factor that can be changed.

What Changes Can I Make Now?

Know what things increase the risk of heart and artery disease. Then do what you can to lower your risk.

• Don't smoke.
• Get your blood pressure, blood sugar and blood lipids checked regularly. If one or more of these is not ideal, talk to your doctor about treatment options.
• Learn about your family history. You can't change it, but it may help you decide about preventive treatment.
• Maintain a healthy body weight. Regular exercise, a heart-healthy diet and portion control can help.

Pay attention to how much added sugar you consume. Reading nutrition labels is a good place to start. The top source of added sugar in the U.S. diet is sweetened beverages, such as soft drinks. The average full-calorie soft drink provides 130 calories. It contains the equivalent of 8 teaspoons of sugar. So reduce or cut out sweetened soft drinks. Choose other drinks, such as water or diet sodas.

 As you read nutrition labels, cut back on foods containing:

• Corn syrup
• Cane or beet sugar
• Sucrose
• Fructose

This doesn't mean you can't have anything sweet. Plenty of naturally occurring sugars make foods sweet. Grapes, strawberries and apples are good examples. But it does make sense to "use" your sugar calories wisely. If you want something sweet, choose foods with other nutrients. A high-fiber, lightly sweetened cereal would be a better choice than candy.

You may wonder why food makers add so much sugar to their products in the first place. It's because it makes them taste "better." Of course, our taste in foods is affected by what we're used to. During the last several decades, we've become used to foods with more and more sugar. It may take time, but we can get used to foods with less sugar.

What Can I Expect Looking to the Future?

Researchers will continue to learn more about ways to prevent diabetes, obesity and heart disease through changes in diet. And you will hear more about efforts to encourage healthful eating. People may not actually make those changes. But recently there have been hopeful signs. For example, many schools are taking full-calorie soft drinks out of their vending machines.

You can expect to hear much more about measures to get people to improve their diets. This new study gives us one more reason to act.

Last Annual Review Date: Apr 21, 2010

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