Added sugars in diet linked to heart disease deaths

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Consuming too much sugar can increase the risk of premature death from heart disease, a finding that is fuelling calls for the Canadian and U.S. governments to offer dietary limits on sugar.

For an adult consuming 2,000 calories a day, drinking the equivalent of a bottle of pop sold in vending machines would exceed the level that a new U.S. study suggests raises the risk of death from cardiovascular disease (CVD).


Excess sugar added not only to desserts but many other processed foods isn’t as benign as once thought. (Canadian Press)

“A higher percentage of calories from added sugar is associated with significantly increased risk of CVD mortality,” lead author Quanhe Yang of the U.S. Centers of Disease Control and Prevention in Atlanta and co-authors conclude in this week’s issue of the journal JAMA Internal Medicine.

The researchers analyzed national health and diet surveys between 1988 and 2010 of more than 30,000 Americans with an average age of 44. They found the fatal heart risk became elevated once added sugar intake surpassed 15 per cent of total calories.

“Too much sugar does not just make us fat; it can also make us sick,” said Laura Schmidt, a health policy specialist at the University of California, San Francisco, who wrote a commentary accompanying the study.

Previously, sugar used in processed or prepared foods, such as sugar-sweetened beverages, dairy desserts, candy, ready-to-eat cereals and yeast breads, has been linked to increased risks for non-fatal heart problems and with obesity. Naturally occurring sugars in fruit aren’t included.

Sugar is hugely important to the trillion-dollar processed food industry, said Michael Moss, a journalist in New York and author of the book, Salt Sugar Fat.

“They’re a very powerful lobby,” Moss said in an interview Tuesday.

“It’s very frustrating for consumers, especially when you go in and buy a product, look at the label and there’s a blank spot next to sugar. There is no government recommendation on how much sugar you should be capping yourself on and consuming in a day.”

The Canadian and U.S. governments don’t provide dietary limits for added sugar and there isn’t a consensus on how much is too much.

“What we really need as Canadians is more information,” said Dr. Yoni Freedhoff, an obesity doctor in Ottawa. “We need food labels that don’t allow for sugar synonyms and actually list the amount of added sugar there.”

To get a sense of sugar amounts, Freedhoff suggests that consumers take the number of grams of sugar on a package and divide by four to get the number of teaspoons.

Yang’s findings add to a growing body of rigorous studies that demonstrate added sugar “is not as benign as once presumed,” Schmidt said.

“Proponents of sugar taxes and sugar controls have a new arrow in their quiver and it’s this linkage to deadly heart disease,” Moss said. “That’s a very powerful tool in the hands of policymakers.”

Schmidt notes that the American Heart Association recommends no more than 25 grams a day or six teaspoons of sugar for women (five per cent of a 2,000-calorie a day diet) and 38 grams or nine teaspoons a day for men (7.5 per cent of daily calories).

In 2005, a panel at the Institute of Medicine, which advises the Canadian and U.S. governments, recommended added sugar make up less than 25 per cent of total calories. The World Health Organization (WHO) recommends less than 10 per cent.

Expert committees from the Institute of Medicine have concluded there’s no evidence of harm attributed to current sugar consumption levels, the Canadian Sugar Institute said in a statement to CBC News.

A spokeswoman for the trade group said Canadian sugar intakes are about 11 per cent of total calories. “There is no magic number because our age, gender and activity levels are all different.”

In the study, 831 people died from heart disease during the 15-year followup. The researchers took
other factors that contribute to heart problems, including smoking, inactivity and excess weight into account.


Apple a day vs. statins produces similar outcomes

Prescribing an apple a day to all adults could reduce deaths from heart disease and strokes about as well as cholesterol-lowering statins, research into the Victorian-era health slogan suggests.

In Tuesday’s online holiday issue of the British Medical Journal, researchers modelled the effect of prescribing an apple a day or a statin for people over the age of 50 in the U.K.

Portugal Fighting Waste

Victorian-era health advice to eat an apple a day seems to stand the test of time, researchers say. (Armando Franca/Associated Press)

“With similar reductions in mortality, a 150-year-old health promotion message is able to match modern medicine and is likely to have fewer side-effects,” Adam Briggs of the BHF Health Promotion Research Group at Oxford University and his co-authors concluded.

They estimated that offering a daily statin to 17.6 million adults not currently taking the drugs would reduce the annual number of vascular deaths from heart disease and stroke by 9,400. In comparison, offering a daily apple to 70 per cent of the U.K. population over age 50 (about 22 million people) would avert 8,500 deaths a year.

But prescribing statins to everyone over the age of 50 could also lead to 1,200 more cases of muscle disease and more than 12,000 cases of Type 2 diabetes.

“No side-effects were modelled for increased apple consumption; aside from the distress caused by a bruised apple, and the theoretical risk of identifying half a worm inside, apple-related adverse events are not widely recognized,” they joked.

Modelling studies include many assumptions. In this case, the researchers assumed apples weigh 100 grams and that there would be no other diet changes. Compliance could also change over time for both models, they said.

The researchers also assumed the same treatment effect for all ages, sexes and cardiovascular risk level, which they said could differ in reality.

In 2012, nearly 41 per cent of Canadians aged 12 and older said that they consumed fruit and vegetables five or more times per day, according to Statistics Canada. Canada’s Food Guide recommends that people age four and older should eat five to 10 servings of fruits and vegetables per day.