Written by Angeline A. De Leon, Staff Writer. Analysis of a five-year average follow-up of 26,190 Swedish volunteers revealed a trend towards increased risk of coronary events and consumption of sweets, sugar-sweetened beverages, and sugar and jam for the highest versus the lowest intake groups.

sugarSugar, both in its natural form (vegetables, fruits) and as an extrinsic additive to foods, is widely known for its detrimental effects on human metabolism. By promoting inflammation and altering the metabolism of fat, sugar intake has been directly linked to higher risk of cardiovascular disease (CVD), including coronary events such as stroke and myocardial infarction 1. Consumption of sugar-sweetened beverages, for example, has been linked to higher risk of type 2 diabetes 2 and unhealthy weight gain 3. Although guidelines vary on the recommended amount of daily sugar intake, the US Institute of Medicine suggesting less than 25% of energy to come from added sugar and the World Health Organization recommending no more than 10% 4,5, what is clear is the world-wide increase in overall consumption of sugar-rich foods. Sucrose, consisting of glucose and fructose, is the most common added sugar in the Swedish diet, and recent Swedish studies indicate that when less than 10% of energy is sourced from sucrose, risk of CVD may be lowered by almost 15% 6. In a study published in the British Journal of Nutrition (2016), investigators sought to examine the association between sucrose intake and coronary event risk based on intake levels in different subgroups of the Swedish population.

A five-year prospective analysis was conducted on 26,190 Swedish volunteers (between 44 and 73 years of age) who were free from diabetes and were without a history of CVD. A baseline questionnaire was administered to collect information on smoking status, obesity status, leisure-time physical activity, and alcohol consumption. Dietary data was collected using an interview-based modified diet history method, and sucrose intake was evaluated based on 7-day records of prepared meals and cold beverages.

Over a 17-year average follow-up period, 2,493 cases of coronary events were reported. Although the association between sucrose intake and coronary event incidence was found to be non-linear, quantitative analyses revealed that participants who consumed more than 15% of their energy intake from sucrose had a 37% (95% Confidence Interval: 13, 66%) increased risk for a coronary event, relative to the lowest sucrose consumers who consumed less than 5% of their energy intake from sucrose, after adjusting for confounding variables. None of the sucrose-containing foods or beverages were significantly associated with coronary event risk, indicating that increased risk was not associated with any single food source alone. However, there was a trend towards increased risk of coronary events and consumption of sweets (HR 1·17; 95% CI 0·99, 1·39; Ptrend =0·07), sugar-sweetened beverages (HR 1·12; 95% CI 0·97, 1·28; Ptrend =0·06), and sugar and jam (HR 1·12; 95% CI 0·96, 1·32; Ptrend =0·50) for the highest v. lowest intake groups.

Data from the study confirms a link between sucrose intake and coronary event risk, independent of any modifiable lifestyle factors. Specifically, a sucrose intake exceeding 15% of daily energy intake was found to significantly increase the probability of a coronary event, re-affirming the importance of properly managing sugar intake in the diet. Future studies using more reliable estimates of sucrose intake (e.g., biomarkers) are still needed, and the influence of genetic factors on individual susceptibility to CVD remains to be explored.

Source: Warfa K, Drake I, Wallsteom P, et al. Association between sucrose intake and acute coronary event risk and effect modification by lifestyle factors: Malmo diet and cancer cohort study. British Journal of Nutrition. 2016; 116: 1611-1620.

© The Authors

Posted December 28, 2017.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

References:

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