The story on sugar hasn’t been so sweet lately. Recently, there was a flurry of publicity over a study published in the Journal of the American Medical Association (JAMA) that linked sugar to heart disease. Let’s look at the connection between added sugars and heart disease—past the news-hour sound bite, however, and examine what the report actually showed, and what it might mean for your diet and health.
 
What Did the Study Show?
The JAMA study looked at the sugar consumption habits of about 43,000 Americans, as reflected in data collected from an ongoing national nutrition and health study. The purpose? To see if added sugar consumption over time (as a percent of daily calories) was associated with cardiovascular mortality. This study did not include natural sugar, such as that in fruit. According to the study, those participants who obtained 17-21% of their daily calorie intake from added sugar had a 38% higher risk of dying from heart disease compared to those who consumed just 8% of their daily calories from added sugar.
 
Interestingly, the researchers showed that the risk of cardiovascular death became elevated once added sugar intake surpassed 15% of daily calories. How much is that, approximately? Well, if you consume a 2,000-calories/day diet, that amount is equivalent to drinking one 20-oz. soda. What the study showed was an association, a correlation or a link between increasing sugar consumption and risk of death from heart disease. It did not show that the sugar content of the diet caused the increased risk. Is this just quibbling over terminology? Not really. This type of study is observational—not experimental. Observational research never shows cause-and-effect.
 
How Much Added Sugar Are We Getting?
Most Americans exceed the expert recommendations for added sugar intake. The World Health Organization recently lowered its recommendation from 10% of calories to 5% of daily calories from added sugar. This is on par with recommendations from the American Heart Association that suggests women get no more than 6 teaspoons of added sugar per day (that’s around 100 calories) and men get no more than 9 teaspoons (or about 150 calories). The vast majority of Americans consume substantially more than these amounts.
 
According to the Centers for Disease Control (CDC), adults in the U.S. get approximately 13% of their total calories from added sugars (as of 2010). Men consume a larger total amount of added sugars, but not more than women in terms of percentage of total caloric intake. Interestingly, for adults, one-third of the added sugar came from beverages and the rest was from food. For children and teens, beverages accounted for 40% of added sugar calories.
 
What’s the Problem with Too Much Sugar?
Consuming too much added sugar can be detrimental to your health in several ways.

·      Too many added sugar from foods and beverages can lead to too many calories, which can contribute to weight gain.

·      Lots of foods and beverages with high amounts of added sugars provide few nutrients. These are sometimes called “empty calorie” foods. Eating too many empty calorie foods means you have less of an appetite for more nutritious food choices, which short-changes you in the nutrition department.

·      Sugar on teeth promotes bacteria growth that can lead to increased tooth decay and cavities.

·      Finally, even though the recent study did not prove that added sugar causes increased death from heart disease, there is another link between sugar and heart disease. Excess sugar in the diet also increases the level of triglycerides in the blood, and high triglycerides may increase heart disease risk.
 
7 Ways to Slash Added Sugars
1)   Switch regular soda to diet soda—or better yet, water or seltzer (if you want bubbles). Wean yourself from sugary foods and beverages—your taste buds will get used to it!

2)   Bake your own treats. Chances are, if you have to make your own cookies, cakes, pastries and granola bars, you’ll eat substantially less of them. Plus, at home you control how much and which sweeteners you use. Check out these easy ways to swap fruit for some of the sugar when baking.

3)   Find a lower-sugar breakfast cereal (Guiding Stars shelf tags can help you choose a healthful cereal—shoot for 2- and 3-star cereals), then add only as much sugar as you “need. ” In many cases you will add far less than the amount used in sugary cereal varieties because the sugar is on top of the cereal, and therefore can have a bigger taste impact.

4)   Forget about swapping one sugar for another (such as honey for granulated sugar)—it’s all sugar. Instead, bump-up perceived sweetness with spices and extracts that are typically associated with sweet foods: cinnamon sprinkled onto coffee grounds before brewing (or choosing a flavored coffee such as vanilla or hazelnut), a dash of pumpkin pie spice over yogurt or vanilla, almond, lemon or orange extract in your morning smoothie are easy ideas

5)   If you “must” use chocolate chips in a recipe, choose the mini chips (or finely chop regular sized chocolate chips) and decrease the amount called for by 1/3 to ½. You’ll still get plenty of chips—and therefore plenty of chocolaty taste, so stretch them out!

6)   Sweeten fruit with a dash of balsamic vinegar. If your fruit isn’t quite ripe, skip the sprinkle of sugar and use a dash of balsamic vinegar instead. Tossed in a bit of this sweet-tasting vinegar, the fruit’s sweetness is enhanced (be aware that it will darken the color of the fruit a little unless you are using white balsamic). This works well with lots of different fruits, though strawberries with balsamic are a favorite.

7)   Experiment with alternative sweeteners such as stevia or monk fruit sweetener (Nectresse is one brand, though several are available). Some of these can be used in cooking and baking; others don’t work in recipes but are fine in coffee, tea, plain yogurt, etc.

Kit Broihier, MS, RD, LD is a member of the Guiding Stars Scientific Advisory Panel. As part of the panel, she works collaboratively on reviewing the latest nutrition guidelines and scientific research as it relates to the Guiding Stars algorithm. The Guiding Stars program is an at-a-glance nutrition guidance program that rates the nutritional quality of food using information from the Nutrition Facts Panel and the ingredients list. Foods are rated and receive a score of 0, 1, 2 or 3 stars. The more nutritional value a food has, the more Guiding Stars it receives. If a food doesn’t receive a star, it means it doesn’t meet the rigorous criteria.