Diet high in added sugars also high in cardiometabolic risk
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Key takeaways:
- A diet high in added sugar may increase risk for metabolic syndrome.
- Diets high in added sugar are low in whole grains, fruits, vegetables, nuts, poultry and seafood.
High consumption of foods and beverages with added sugars such as syrups and caloric sweeteners was associated with increased risk for metabolic syndrome, according to data published in the European Journal of Preventive Cardiology.
“Americans typically consume over 25% of total energy from snack foods and sugar-sweetened beverages, according to National Health and Nutrition Examination Surveys 2015-2016. Moreover, intakes of sugar-sweetened beverages and sweetened coffee and tea contribute about 35% of total added sugar consumed by U.S. adults, with the remaining added sugar intake from food sources, including sweet bakery products, ready-to-eat breakfast cereals, refined grain desserts, bread, rolls, tortillas, and candy, and sugar products,” Rae K. Goins, MPH, BS, nutrition educator in the division of epidemiology and community health at the University of Minnesota School of Public Health, and colleagues wrote. “The objective of this study is to investigate the associations of added sugar and added sugar-rich carbohydrate food and beverage intakes with the risk of developing metabolic syndrome in adult Black American and white American women and men enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study.”
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Added sugar-rich foods and beverages contain sugars, syrups and caloric sweeteners added to them during production or preparation, according to the study.
Data from the CARDIA study
To better understand the relationship between added sugar intake and risk for metabolic syndrome, Goins and colleagues used data from 3,154 Black and white adults aged 18 to 30 years at baseline with health and dietary data gathered during the CARDIA study. Data on metabolic syndrome components were gathered at three separate time points over 20 years.
Participants reported foods and beverages consumed in the past month, including brand name, amount consumed and frequency of consumption.
Metabolic syndrome was defined as the presence of at least three of the following risk factors:
- fasting plasma glucose of at least 100 mg/dL or receiving treatment for high glucose or diabetes;
- HDL level (< 40 mg/dL for men; < 50 mg/dL for women);
- fasting triglycerides of at least 150 mg/dL or receiving treatment for elevated triglycerides;
- waist circumference more than 102 cm for men or more than 88 cm for women; and
- systolic BP of at least 130 mm Hg or diastolic BP of at least 85 mm Hg or receiving treatment for hypertension.
Added sugars and metabolic risk
Participants were stratified into quintiles of daily added sugar and sugar-sweetened beverage intake. The lowest quintile of added sugar intake was approximately 30.5 g per day compared with 167.6 g per day in the highest quintile. The lowest quintile of sugar-sweetened beverage intake was approximately 0.07 servings per day compared with 3.49 servings per day in the highest quintile.
Compared with the lowest quintile, individuals in the highest quintile of daily added sugar intake had an approximately 51% greater risk for metabolic syndrome (HR = 1.51; 95% CI, 1.2-1.91; P for trend = .003).
Individuals with the highest intake of daily added sugar had lower intake of whole grain products, fruit and fruit juice, vegetables, legumes, nuts, poultry, fish and seafood and higher intake of red/processed meat and dairy products, according to the study.
Compared with the lowest quintile, individuals in the highest quintile of daily sugar-sweetened beverage intake had an approximately 38% greater risk for metabolic syndrome (HR = 1.38; 95% CI, 1.09-1.75; P for trend = .02).
Eating habits were similar among individuals in the highest quintile of sugar-sweetened beverage intake compared with daily added sugar intake.
In an analysis that combined added sugar from both food and beverages, high intake was associated with a more than 50% increased risk for metabolic syndrome (14.4 servings per day vs. 2.9 servings per day; HR = 1.51; 95% CI, 1.16-1.97; P for trend = .001).
In addition, increased metabolic syndrome risk was observed at as low as 4.6 servings per day of added sugar from food and beverages (4.6 per day vs. 2.9 per day; HR = 1.24; 95% CI, 1.01-1.53; P for trend = .001)
Moreover, low HDL, elevated BP, elevated glucose or diabetes prevalence and elevated triglycerides were associated with elevated daily consumption of added sugar-rich food and beverage intake, according to the study.
“Excessive consumption of these added sugar-rich carbohydrate foods and beverages may result in a higher risk for metabolic syndrome and its components due to overall poor diet quality, as opposed to healthy diet patterns, including a Mediterranean, [Dietary Approaches to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)] or other plant-based diet pattern, that protects cardiometabolic health,” the researchers wrote. “This type of low-quality diet pattern characterizes a ‘Western diet’ pattern and is known to promote gut dysbiosis, a condition that disrupts intestinal homeostasis resulting in metabolic disorders, obesity, dyslipidemia, inflammation and insulin resistance. This could explain why in our study, we found higher intake of added sugar-rich carbohydrates consisting of carbohydrates low in fiber (high carbohydrate-to-fiber ratio) was significantly associated with metabolic syndrome even after adjusting for BMI.”
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