Added sugars in diet related to high cholesterol and increased risk of heart disease, say researchers

By Dr. Ananya Mandal, MDApr 21 2010

According to researchers, an average American gets 16% of calories from the sugar in their diet. These may be sugars added to processed foods during manufacture.

The April 21 issue of the reputed Journal of the American Medical Association published a report by Miriam Vos, MD, of Emory University in Atlanta, and colleagues that said a high intake of such sugars -- mainly sucrose from beets and cane and high fructose corn syrup can be linked to high cholesterol which is a direct risk factor for heart disease.

This finding was earlier reported in August 2009 by the American Heart Association by Rachel Johnson, PhD, of the University of Vermont in Burlington, a nutritionist. She went on to say that, “Among the nutrition science community, we're certainly not shocked by these findings.” But this new study according to her “adds strength to the evidence base around this issue.”

Vos and colleagues emphasized that increased carbohydrate intake has been linked with dyslipidemia, but there has been no research on the links between added sugars and the condition. They have received help from National Health and Nutrition Examination Survey (NHANES) from 1999 through 2006. NHANES has been continuously surveying the US population for diet and health indicators. For this study 6,113 people were divided into five groups based on the proportion of total energy intake from added sugars:

• Less than 5% (serving as the reference group)
• 5% to less than 10%
• 10% to less than 17.5%
• 17.5% to less than 25 %
• 25% or more.

The measures studied were average high-density lipoprotein cholesterol (HDL-C) or good cholesterol, average geometric mean triglycerides, and average low-density lipoprotein cholesterol (LDL-C).

The calculations were based on odds of getting low HDL-C levels, high triglyceride levels, high LDL-C levels, and a high ratio of triglycerides to HDL-C also known as Dyslipidemia or derangement of lipid levels in blood. While analyzing they found that on an average, participants obtained 15.8% of their energy intake from added sugars -- 21.4 teaspoons a day containing 359 kilocalories.

The range of sugar consumption was astounding. The lowest group consumed three teaspoons of sugar per day and the highest as much as 46 teaspoons per day. Higher sugar intake was seen in the younger, poorer, and non-Hispanic black.

These people also derived lower energy from total, polyunsaturated, monounsaturated, and saturated fats, as well as from protein, fiber, and cholesterol. They had low levels of good cholesterol or HDL-C and three times likely to have high levels of bad cholesterol or LDL-C and 20% more likely to have high triglycerides. Women were more susceptible to Dyslipidemia if they consumed added sugars said researchers.

The authors concluded, “In conclusion, higher consumption of added sugars is associated with several important measures of dyslipidemia, an important risk factor for cardiovascular disease among U.S. adults. Although long-term trials to study the effect of reducing added sugars and other carbohydrates on lipid profiles are needed, our data support dietary guidelines that target a reduction in consumption of added sugar.”

Nutritionist Johnson also said, “We've always thought of saturated fat in the diet as the culprit in terms of the dietary risk factors for heart disease… Just lowering your fat and not thinking about what you replace it with is not putting you in a good place.” If carbohydrates and sugars are essential for diet, she said, there are “plenty of very delicious choices people can make.” This includes brown sugar, oat meals etc.