When many of us think of sugar, empty calories and weight gain come to mind. But last week, new study findings added to mounting evidence that excess sugar does a lot more harm than adding inches to your waistline: Consuming too much added sugar can substantially increase the likelihood of dying from cardiovascular disease.
Added sugars are defined as those added during food processing or preparation (e.g., adding sugar to coffee or cereal). On labels they go by names such as brown sugar, corn syrup, brown rice syrup, cane syrup, dextrose, high fructose, fruit-juice concentrate, glucose-fructose, honey and molasses. They're not naturally occurring sugars like those in fruit and pure fruit juice.
The main sources of added sugars are sugar-sweetened soft drinks (e.g., pop, iced tea, lemonade, energy drinks, sports drinks), candy, cakes, cookies, pastries, fruit drinks, dairy desserts (e.g., ice cream, sweetened yogurt and ready-to-eat breakfast cereals.
The study, published in JAMA Internal Medicine, investigated the link between sugar intake and cardiovascular death using a national database that collected information on 42,000 adults for 14.6 years. The conclusion: People who consumed 25 per cent or more of their daily calories from added sugars – the highest limit set by the U.S.-based Institute of Medicine – had nearly triple the risk of dying from heart disease, heart attack or stroke compared with those whose diets had less than 10-per-cent sugar calories.
People with a moderate intake of added sugars were also more likely to die from cardiovascular disease. The risk of cardiovascular death became elevated once sugar intake exceeded 15 per cent of daily calories (equivalent to drinking a 20-ounce soft drink on a 2,000-calorie diet). From there, the risk rose exponentially.
Regular consumption of sugar-sweetened beverages – one 12-ounce serving a day – increased the risk of cardiovascular death by one-third, even after accounting for total calories, body weight, smoking status and other risk factors for heart disease. How much sugar is 25 per cent of one's daily calories? For a 2,000-calorie diet, one-quarter of sugar calories is equivalent to 125 g of sugar or 31 teaspoons worth (one tsp of table sugar has 4 grams of sugar). For a 1,500-calorie weight-loss diet, 25-per-cent sugar calories equates to 94 grams of sugar (23 teaspoons).
You might be thinking that's a lot of sugar, far more than you consume each day. But you'd be surprised to see how quickly refined sugar adds up considering that it lurks in so many everyday foods, including breakfast cereals, salad dressings, pasta sauces, unflavoured non-dairy milks, even peanut butter and bread.
Even if you don't quench your thirst with a can of Coke or indulge in a sugary dessert, it's easy to consume 110 grams of added sugars. Factor in a sugary drink and a cookie and the 25-per-cent ceiling is easy to reach.
According to these new findings, it's safest to consume less than 15 per cent of your daily calories from added sugars. The American Heart Association advises adults to limit sugar intake to 5 per cent of daily calories – about 100 calories (25 g sugar) for women and 150 calories (37 g) for men. Health Canada doesn't give a specific guideline for added sugar intake, instead recommending only that we limit "foods and beverages high in calories, fat, sugar or salt."
My advice: Pay attention to your added sugar intake and, if need be, take steps to cut back. Growing evidence suggests too much sugar is an independent risk factor for cardiovascular disease.
Avoid sugary drinks
Replace soft drinks, fruit punch, iced tea, energy drinks and sports drinks with water, low-fat milk, vegetable juice or unsweetened tea or coffee.
Reset your taste buds
Cut the usual amount of sugar, honey, agave syrup, maple syrup etc. you add to foods and beverages by half. Gradually, use even less. Sweeten foods with spices (e.g. ginger, cinnamon, nutmeg) instead of sugar.
Go for natural sweetness
Choose fresh fruit or plain yogurt with berries instead of candy, cakes, cookies and pastries. Add fruit to breakfast cereal instead of sugar.
Choose breakfast cereals that have no more than 6 grams of sugar per serving. Look for cereals with no sugar added. Look for snack bars with no more than half the total carbohydrate from sugars. Buy unsweetened non-dairy milks, unflavoured instant cereals and tinned fruit in its own juice (versus syrup).
Reduce sugar in recipes
As a rule, you can cut the sugar in most baked goods by one-third. Or, substitute unsweetened applesauce for sugar in recipes (use equal amounts).
How sugar and calories add up:
Quaker Weight Control Instant Oatmeal Maple & Brown Sugar: 5 g added sugar;150 calories
Country Harvest 12 Grain toast, 1 slice: 3 g; 120 calories
Peanut butter, 1 tbsp: 1.5 g, 95 calories
Strawberry Greek yogurt, 0% MF, ¾ cup: 15 g; 170 calories
Green tea, 1 tsp honey: 5.5 g; 20 calories
Starbuck's tall non-fat vanilla latte: 11 g; 126 calories
Ham Sandwich and Side Salad
3 oz honey-roasted ham: 7 g; 92 calories
2 slices Country Harvest
12 Grain bread: 6 g;
Honey mustard, 2 tbsp: 6 g; 60 calories
Side Green salad: 0 g; 30 cal.
Balsamic vinaigrette (commercial), 2 tbsp: 3 g; 90 cal.
Green tea, 1 tsp honey: 5.5 g; 20 calories
Fibre 1 Chewy Granola Bar, Oats & Chocolate: 9 g; 130 calories
1 apple: 0 g; 90 calories
Green tea, 1 tsp sugar: 5.5 g; 20 calories
Post Workout Protein Shake
1 scoop (28 g) whey protein: 1 g; 120 calories
1 cup Original Almond Milk (unflavoured): 7 g; 60 calories
Salmon (5 oz.), baked with maple-orange glaze (1 tsp): 4.5 g; 310 calories
Steamed green beans, 1/2 cup: 0 g; 22 calories
Sweet potato, baked, 1/2 medium: 0 g; 51 calories
Water: 0 g; 0 calories
3 squares (30 g) 70% dark chocolate: 8 g; 160 calories
Green tea, 1 tsp honey: 5.5 g, 20 calories
TOTAL 109 grams, 2,150 calories
= 26 tsp worth of sugar
= 20% calories from added sugars
Swap the green tea for an iced tea at lunch and you'll add 32 g of refined sugar to your daily intake. And if you succumb to that chocolate chip cookie during the office meeting, you'll pile on another 12 g of sugar. Your grand total for the day: 145 g of sugar (36 tsp). You've now consumed 25 per cent of your daily calories from sugar. Ouch.
Leslie Beck, a registered dietitian, is based at the Medisys clinic in Toronto. She can be seen every Thursday at noon on CTV News Channel's Direct lesliebeck.com.