Is Sugar a Killer?

I know that too much sugar isn’t good for us, but I was surprised to hear that diets high in sugar can lead to heart disease and death. What’s the connection here?

– April 21, 2014

You’re likely referring to results of a report published in February, 2014, showing that diets high in sugar increase the risk of fatal heart attacks. The researchers found that Americans whose diets are highest in added sugar – the sugar manufacturers add to processed foods and drink, not the natural sugars in fruit or fruit juices – are twice as likely to die from heart disease as those whose daily sugar intake is low. The amount of sugar you would have to consume to put yourself at risk totals much more than you would get from adding a teaspoon of sugar to your coffee or tea. The increased risk applies to those whose daily sugar intake comes to about 500 calories – one quarter of a 2,000 calorie a day diet – compared to the 160 calories per day typical of people on the low end of sugar consumption in this study (those 160 calories translate to 10 teaspoons of sugar, which is still too much).

The report showed that the average American consumes an astonishing 22 teaspoons of sugar a day. Most of that comes from sugar-sweetened sodas and baked goods as well as candy, ready-to-eat cereals and yeast breads. An average can of regular (sugar-sweetened) soda provides 140 sugar calories.

We’ve long known that excessive amounts of sugar present a threat to health. Earlier research has linked added sugar to the development of high blood pressure, increased triglycerides, low HDL ("good") cholesterol, and fatty liver problems. It also makes insulin less effective in lowering blood sugar.

For this new analysis, researchers from the U.S. Centers for Disease Control and Prevention (CDC) looked at data from more than 31,000 people who were interviewed in connection with the National Health and Nutrition Examination Survey. On the basis of these compiled findings, they reported that 71 percent of adults derive 10 percent or more of their daily calories from added sugar and that about 10 percent of this group consumes an astounding 25 percent or more of their daily calories from added sugar.

In an editorial accompanying the report, researcher Laura A. Schmidt, Ph.D., M.S.W., M.P.H. of the University of California, San Francisco, wrote that the new results add to a "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 death due to cardiovascular disease and as well as a source of empty calories that lead to weight gain and obesity.

This report reinforces our knowledge that sugar’s negative impact on health can slowly and insidiously accumulate over the years. In my view, the best way to satisfy a sweet tooth is via foods in which the sugar is part of a whole food, such as in fresh or dried fruit (not fruit juice). Here, the sugars are bound in a matrix of fiber that slows digestion and limits rapid increases in blood sugar. You should read labels carefully and consciously avoid foods or drinks containing copious amounts of added sugar.

Andrew Weil, M.D.

Quanhe Yang et al, "Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults," JAMA Internal Medicine doi:10.1001/jamainternmed.2013.13563

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