How a sugary diet may sabotage your heart health

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The start of a new year often feels like a good time to revamp your diet, especially after the indulgences of the holiday season. So, targeting the excess sugar in your daily fare makes good sense in light of a recent study about the detrimental health effects of sugar (see "Slashing sugar: Saving lives and health care costs?").

The average American consumes close to one-third of a cup of added sugar each day. Most of it comes from sugar-sweetened beverages, such as sodas, fruit juices, sports drinks, and sweetened coffee and tea drinks (including canned and bottled products as well as those served up at coffee shops). Desserts and sugary snacks — cookies, brownies, cakes, pies, ice cream, frozen dairy desserts, doughnuts, and the like — are the second biggest source.

"A sugary beverage adds a big dose of calories without any nutritional advantage," says Dr. Deirdre Tobias, an obesity and nutritional epidemiologist at Harvard-affiliated Brigham and Women's Hospital. Liquid calories are especially harmful because they don't make you feel as full, so your body doesn't perceive the calories the same way it does when you eat solid food, she explains. As a result, you don't compensate by eating fewer calories at meals. The additional 200 to 300 calories in just a single soda or coffee drink each day can contribute to the gradual weight gain that so many people experience.

Slashing sugar: Saving lives and health care costs?

Reducing the amount of sugar in packaged foods and beverages could prevent millions of heart attacks and other serious cardiovascular problems within a decade, according to a study in the Aug. 27, 2021, issue of Circulation.

For their work, researchers relied on data from a nationwide nutrition study, numerous studies of diet-related diseases, and health care costs. They then created a model to estimate changes in type 2 diabetes, obesity, and heart disease if proposed sugar reduction targets were initiated. Created by a partnership of more than 100 health organizations, the proposed targets involve cutting 20% of the sugar from packaged foods and 40% from beverages by the end of 2026.

The model's projections were based on people ages 35 to 79 in the United States. The results suggest that over a decade, a government-sponsored sugar reduction policy could prevent

2.5 million serious cardiovascular emergencies (strokes, heart attacks, and cardiac arrests)
750,000 cases of diabetes
500,000 deaths from heart disease.

The model also predicted health care cost savings of more than $4 billion a decade after the policy is implemented. That figure would rise to more than $118 billion over the lifetime of the current adult population.

The diabetes connection

In addition to contributing to weight gain, drinking and eating lots of sugar causes your blood sugar (glucose) to spike. Your pancreas responds by releasing insulin to help your cells take in the glucose, the universal fuel for all cells in your body. But if this glucose spike and insulin surge happens repeatedly, day after day, cells in your muscles and other tissues don't respond as strongly. They become insulin resistant, which spurs the pancreas to produce even more insulin. Over time, the pancreas can't keep up, and communication between your organs about what fuels are available begins to break down. Blood sugar stays high after and between meals, setting the stage for a type 2 diabetes diagnosis.

People with type 2 diabetes are two to three times more likely to develop heart disease than those without diabetes. What's more, a sugary diet also tends to raise blood levels of triglycerides and LDL (bad) cholesterol, both of which elevate heart disease risk.

Dietary trends: Sweet nothings?

If history is any guide, food and beverage manufacturers may eventually scale back on the amount of sugar in their products. "Companies that make processed foods will always reformulate their products to keep up with the latest diet trends," says Dr. Tobias. Whatever happens to be the current dietary demon — trans fat, gluten, or sugar — new products that contain none or reduced amounts of the culprit ingredient soon appear on shelves, she says.

Of course, diet sodas made with artificial or non-nutritive sweeteners have been around for decades, although these products make up just over a quarter of the market share of carbonated soft drinks. Other products, including some yogurts, cereals, baked goods, and ice creams, contain zero-calorie sweeteners in place of added sugar. But it's far from clear that eating such products offers any health advantages, Dr. Tobias says. Non-caloric sweeteners are hundreds to thousands of times sweeter than sugar and may train our taste buds to prefer super-sweet products, says Dr. Tobias. It's thought that people who consume them frequently may find naturally sweet foods like fruits less appealing. Some research even suggests that people make up for the lost sugar calories by eating more refined carbohydrates and fats. For now, there's no clear evidence that these fake sugars help or harm the weight-loss process, but research in this area is ongoing.

Curbing your sweet tooth

If your diet contains lots of added sugar, try to wean yourself off gradually. If you drink a large soda or sweetened tea or coffee every day, trim your portion size over time. Swap sodas for bubbly water with a splash of fruit juice. Make your own coffee and tea with just a little added sugar.

You don't have to give up desserts altogether, but a daily cookie and nighttime cup of ice cream is too much. Start by limiting yourself to one sweet per day, and cut back gradually over a few weeks until you're down to one or two treats per week.

"At the end of the day, the smartest choice is to eat more fresh, whole foods and not rely on processed junk food to improve your diet," says Dr. Tobias.