High-Sugar Diet Linked to Cholesterol

Added Sugars in Diet Triple Risk of Having Low Level of "Good" Cholesterol

By Salynn Boyles
WebMD Health News
Reviewed by Elizabeth Klodas, MD, FACC

April 20, 2010 — The average American eats the equivalent of about 21 teaspoons of added sugar a day — about 2 1/2 to 3 times more than new heart disease prevention guidelines say they should.

Excess sugar is known to contribute to obesity, diabetes, and other conditions linked to heart disease, and now new research links it to unhealthy cholesterol and triglyceride levels.

People in the study who ate the most added sugar had the lowest HDL, or good cholesterol, and the highest blood triglyceride levels. People who ate the least sugar had the highest HDL and the lowest triglyceride levels.

Eating large amounts of added sugar more than tripled the risk of having low HDL, which is a major risk factor for heart disease.

The study appears in this week’s issue of the Journal of the American Medical Association.

Added Sugar, Empty Calories

Added sugar is defined as any caloric sweetener used in processed or prepared foods. Beyond increasing calories, added sugars have no nutritional value.

In guidelines released late last summer, the American Heart Association recommended limiting added sugar in the diet to no more than 100 calories a day for most women and 150 calories for most men.

That’s about 6 teaspoons of sugar a day for women and 9 teaspoons for men.

To put this in perspective, the average 12-ounce can of regular soda has between 8 and 10 teaspoons of sugar. A breakfast cereal with 16 grams of sugar per serving has about 4 teaspoons.

In the newly published study, daily consumption of added sugars averaged about 360 calories a day, or 16% of total daily calories.

That is an increase of about 6% in just over three decades, researcher Miriam Vos, MD, of Atlanta’s Emory University tells WebMD.

“This is a dramatic increase, but it is not too surprising given the proliferation of processed foods with large amounts of added sugar,” she says.

Vos and colleagues analyzed data on 6,113 adults who participated in the large, ongoing National Health and Nutrition Examination Survey (NHANES) from 1999 to 2006.

The lowest consumption group got less than 5% of their daily calories from added sugars, while the highest consumers got 25% or more of their daily calories from sugar.

Sugar consumption appeared to be directly related to HDL and triglyceride levels. The more sugar the participants ate, the lower their HDL and higher their triglycerides.

Compared to people who ate the least sugar, people who ate the most sugar were three times more likely to have low HDL levels.

“Our findings strongly support the AHA recommendations to limit added sugar,” Vos says.

Sugar Hiding in Drinks, Processed Foods

University of Vermont nutrition professor Rachel K. Johnson, PhD, the author of the AHA sugar guidelines, says only a small minority of Americans meet the goal of eating no more than 100 to 150 calories a day of added sugar.

Reading food labels can help, but because labels don’t distinguish between added sugars and those that occur naturally in foods like fruits, vegetables, and dairy products, they can be misleading, she says.

“When a label has the word ‘syrup’ or words that end in ‘ose’ like sucrose, fructose, and dextrose, these are added sugars,” she says. Another ingredient that represents added sugar is “evaporated cane juice.”

Johnson says anyone who wants to limit the sugar in their diet should start by examining what they drink.

“We know that beverages are the No. 1 source of added sugar in the diet, and we aren’t just talking about soft drinks,” she says. “Most fruit drinks and sports drinks are full of added sugar.”

Eating fewer processed foods is also key, she says.

“The old mantra to shop the perimeter of the grocery store is as true today as it ever was,” she says. “A diet based of fruits, vegetables, whole grains, low-fat dairy, and lean meats will be low in added sugars.”