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Link found between added sugar and death from heart disease

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Most US adults consume more added sugar than is recommended

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The American Heart Association (AHA) recommends limiting the amount of added sugars you consume to no more than half of your daily discretionary calories allowance. For most American women, that’s no more than 100 calories per day, or about 6 teaspoons of sugar. For men, it’s 150 calories per day, or about 9 teaspoons.

The major sources of added sugars in American diets are regular soft drinks, sugars, candy, cakes, cookies, pies and fruit drinks (fruitades and fruit punch); dairy desserts and milk products (ice cream, sweetened yogurt and sweetened milk); and other grains (cinnamon toast and honey-nut waffles), according to the American Heart Association .

All that added sugar American adults are consuming has been shown to be significantly linked to dying from heart disease.

Dr. Quanhe Yang, PhD, Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, and colleagues examined time trends of added sugar consumption as percentage of daily calories in the United States and investigate the association of this consumption with CVD mortality.

For the study researchers used data from the National Health and Nutrition Examination Survey (NHANES, 1988-1994 [III], 1999-2004, and 2005-2010 (31,147 participants) for the time trend analysis and NHANES III Linked Mortality cohort, 1988 to 2006, (11,733 participants) a prospective cohort of a nationally representative sample of US adults for the association study.

The study’s results showed the average percentage of daily calories from added sugar increased from 15.7 percent in 1988-1994 to 16.8 percent in 1999 to 2004 and decreased to 14.9 percent in 2005-2010.

Most adults consumed 10% or more of calories from added sugar (71.4%) and approximately 10% consumed 25% or more in 2005-2010.

During an average follow-up period of 14.6 years the team documented 831 CVD deaths during 163 039 person-years.

These findings were largely consistent across age group, sex, race/ethnicity (except among non-Hispanic blacks), educational attainment, physical activity, health eating index, and body mass index.

In their conclusion the researchers write “Most US adults consume more added sugar than is recommended for a healthy diet. We observed a significant relationship between added sugar consumption and increased risk for CVD mortality.”

In a invited commentary Dr. Laura A. Schmidt, PhD, MSW, MPH, Professor of Health Policy in the School of Medicine at the University of California at San Francisco and Co-Director of the Community Engagement and Health Policy Program for UCSF’s Clinical and Translational Sciences Institute stated “We are in the midst of a paradigm shift in research on the health effects of sugar, one fueled by extremely high rates of added sugar overconsumption in the American public.”

“The new paradigm views sugar overconsumption as an independent risk factor in CVD as well as many other chronic diseases, including diabetes mellitus, liver cirrhosis, and dementia—all linked to metabolic perturbations involving dyslipidemia, hypertension, and insulin resistance.”

"In sum, the study by Yang et al contributes a range of new findings to the growing body of research on sugar as an independent risk factor in chronic disease. It underscores the likelihood that, at levels of consumption common among Americans, added sugar is a significant risk factor for CVD mortality above and beyond its role as empty calories leading to weight gain and obesity," she adds.

Dr. Schmidt noted Yang et al underscore the need for federal guidelines that help consumers set safe limits on their intake as well evidence-based regulatory strategies that discourage excess sugar consumption at the population level.”

This study is published in JAMA Internal Medicine.

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