Americans have become more conscious about the evils of eating sugary foods: We’ve reduced our sugar intake from nearly 17 percent of our total calories about a decade ago to fewer than 15 percent of our calories in the latest government nutrition surveys. It turns out that was a wise move since a new study today confirms that eating too much sugar is bad for our heart and could lead to an earlier death.
The research, published online Monday in the journal JAMA Internal Medicine, examined nutrition surveys from nearly 12,000 Americans and found that those who reported consuming the greatest percentage of calories from added sugar were twice as likely to die from heart disease over a 14-year period compared to those who consumed the least.
“We have emerging evidence to suggest that added sugar may play a role in multiple pathways in heart disease deaths,” said study leader Quanhe Yang, a senior scientist at the federal Centers for Disease Control and Prevention. Eating too much sugar can contribute to Type 2 diabetes, which is associated with a higher heart disease risk, and it may increase the likelihood of hypertension and elevated cholesterol levels—both heart risk factors.
While the researchers couldn’t prove that eating excess sugar lead to more heart disease deaths, they controlled for other factors that may have contributed such as obesity, poor overall diet, and lack of exercise. Likely, sugar has a host of negative effects on the body beyond providing “empty calories leading to weight gain and obesity,” wrote Laura Schmidt, a University of California, San Francisco epidemiologist, in a commentary that accompanied the study.
Those in the lowest sugar intake group ate an average of 7 percent of their calories from added sugar—about 140 calories or 35 grams for a 2000 calorie a day diet; those in the highest intake group ate an average of 25 percent of their calories each day from added sugars—about 500 calories or 125 grams. Most of the study participants fell somewhere in the middle of that range and had a moderate 10 to 40 percent increased risk of dying of heart disease.
A 12-ounce can of Coke (39 grams of sugar), 14 jelly beans (27 grams) and three Oreo cookies (14 grams) would bring your daily sugar tally to 80 grams—about what the average American eats each day.
Gleaning practical value from this finding, however, may be tough. That’s partly because health groups can’t agree on how much we should limit added sugars. The Institute of Medicine recommends that added sugar make up less than 25 percent of total calories, the World Health Organization recommends less than 10 percent, and the American Heart Association recommends limiting added sugars to fewer than 100 calories daily for women and 150 calories daily for men.
Even if you picked one recommendation to follow, you’d still have a hard time complying since food labels currently include total sugar content, rather than added sugar. Fat-free milk, for example, has 12 grams of sugar listed on its label—but it’s all milk sugar and none of it is added—so it should not be counted in your daily sugar tally, Yang said.
Ditto for orange juice and other pure fruit juices, though nutritionists recommend eating whole fruits instead.
Sweetened dairy foods like yogurt and ice cream often have a mixed of added sugar and natural milk sugar, so it’s hard to know how much added sugar they contain. (Best to stick with brands that have the lowest sugar content.)
It’s safe to assume that the sugar content listed on the labels of sugary soft drinks, cereal, candy, cookies, and cakes is mainly all added sugar, according to study co-author Dr. Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health.
“You really need to read the ingredients listed on the label,” Hu said. If sugar is listed as one of the top three ingredients, the produce likely has a lot of added sugar. So, too, if it has: cane sugar, evaporated cane juice, honey, corn syrup, sucrose, honey, maple syrup, molasses, and fruit juice concentrates. There are dozens of caloric sweeteners added to foods that healthwise have the same effects as added table sugar, he added.
Hopefully, the US Food and Drug Administration will soon clear up some of this confusion by revising food labels to distinguish added sugar from total sugar. New food labels are expected later this year, but what they will require manufacturers to list hasn’t yet been revealed.