Extremely low sugar intake may not be necessary to prevent heart disease
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Key takeaways:
- High intake of added sugar, especially from sweetened beverages, was linked to elevated CVD risk.
- Moderate intake, specifically of treats such as pastries and ice cream, may not adversely impact heart health.
Swedish researchers reported that “extremely low” sugar intake may not be necessary to prevent heart disease, and some treats throughout the week may be acceptable as moderate intake was associated with reduced CV risk.
The association between added sugar intake and CVD risk varied by source of sugar intake — higher risk linked to sugar-sweetened beverages and lower risk linked to treats — and researchers noted that moderate intake was not associated with increased risk for CVD.
The study results were published in Frontiers in Public Health.
“The most striking finding from our study is the divergent relationship between different sources of added sugar and cardiovascular disease risk,” Suzanne Janzi, PhD candidate and researcher in nutrition epidemiology at Lund University in Malmö, Sweden, said in a press release. “This surprising contrast highlights the importance of considering not just the amount of sugar consumed, but its source and context.
“Liquid sugars, found in sweetened beverages, typically provide less satiety than solid forms — they make you feel less full — potentially leading to overconsumption,” Janzi said in the release. “Context also matters — treats are often enjoyed in social settings or special occasions, while sweetened beverages might be consumed more regularly.”
To test the association between added sugar, sugar-sweetened foods and beverages and risk for CVD, Janzi and colleagues used data from two prospective population-based Swedish cohorts: The Swedish Mammography Cohort and the Cohort of Swedish Men.
The analysis included 69,705 people in Sweden aged 45 to 83 years (47.2% women).
Diet and lifestyle questionnaires were administered in 1997 and 2009 and the researchers used national registers to identify occurrences of ischemic stroke, hemorrhagic stroke, MI, HF, aortic stenosis, atrial fibrillation and abdominal aortic aneurysm through 2019.
Total energy from added sugar and CVD risk
Compared with individuals with daily energy intake of 5% or less from added sugars, the researchers observed an approximately 31% higher risk for AAA (95% CI, 5-65) among individuals with daily energy intake of more than 20% from added sugar, and a 9% higher risk for ischemic stroke (95% CI, 0-19) with daily added sugar intake of 15% to 20%.
In contrast, daily added sugar energy intake of 5% to 7.5%, compared with 5% or less, was associated with 8% lower risk for ischemic stroke (95% CI, 2-13), 5% lower risk for MI (95% CI, 0-11), 9% lower risk for HF (95% CI, 5-13), 9% lower risk for aortic stenosis (95% CI, 0-18) and 7% lower risk for AF (95% CI, 3-11).
Results were similar when the researchers evaluated CVD risk among those with added daily sugar energy intake of 5% or less compared with daily intake in the 7.5% to 10% and 10% to 15% ranges, with lower risks observed for HF, AF and aortic stenosis.
There was no association between added sugar intake and risk for hemorrhagic stroke, according to the study.
Sweetened beverages, treats and CVD risk
For sweetened beverages, more than eight servings per week was associated with increased risk for ischemic stroke (19%; 95% CI, 11-27), HF (18%; 95% CI, 11-24), AF (11%; 95% CI, 6-17) and AAA (31%; 95% CI, 15-50).
For treats, including pastries, ice cream, chocolate and sweets, a negative association was observed for all outcomes (P for trend < .01), with highest risk experienced by consumers of two or less servings per week.
For toppings, such as table sugar, honey, jams and marmalades, intake of two or more per week was associated with lower risk for HF and aortic stenosis compared with lower intake; however, individuals with the highest weekly toppings intake — 28 or more per week — experienced an approximately 34% higher risk for AAA (95% CI, 18-51) compared with the lowest intake category.
“This might reflect underlying dietary behaviors — individuals consuming very little sugar might have very restrictive diets or might be limiting sugar due to preexisting health conditions,” Janzi said in the release. “While our observational study cannot establish causation, these findings suggest that extremely low sugar intake may not be necessary or beneficial for cardiovascular health.
“Our findings are based on a Swedish population, which may have dietary habits and lifestyle factors that differ from those in other populations,” Janzi said. “Particularly relevant in this context is the social custom of ‘fika’ — regular coffee and pastry breaks that are deeply embedded in Swedish culture. These results may not directly translate to other populations with different dietary cultures.”
Reference:
- Sugary drinks significantly raise cardiovascular disease risk, but occasional sweet treats don’t, scientists find. https://www.eurekalert.org/news-releases/1066328. Published Dec. 9, 2024. Accessed Dec. 9, 2024.
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