A recent investigation, detailed in a new publication within the journal Frontiers in Public Health, scrutinizes the correlations between the ingestion of added sugars, various sugar-sweetened comestibles, and specific beverages, and the propensity for developing seven distinct cardiovascular ailments. The research encompassed 69,705 individuals, aged between 45 and 83, with 47.2% of participants being female, drawn from the Swedish Mammography Cohort and the Cohort of Swedish Men. The findings indicate that excessive consumption of added sugar elevates the likelihood of experiencing a stroke or an aneurysm. Conversely, moderate indulgence in certain sweet items appears to be linked with a diminished risk of cardiovascular conditions. Concurrently, the intake of sweetened beverages corresponds to an increased risk of stroke, heart failure, and atrial fibrillation.
Cardiovascular afflictions encompass a spectrum of disorders affecting the heart and vascular system, currently standing as the foremost contributor to mortality and disease burden across Europe, predominantly attributed to strokes and ischemic heart disease.
While dietary habits represent a principal modifiable determinant of numerous cardiovascular diseases (CVDs), the existing body of evidence concerning the impact of added sugar consumption on CVD risk remains limited and equivocal.
Moreover, the majority of prior investigations have concentrated predominantly on the intake of sugar-sweetened beverages, rather than the overall consumption of added sugars, despite these beverages constituting merely 14% of added sugar intake in Sweden and 25% in the United States.
“The most striking finding from our study is the divergent relationship between different sources of added sugar and CVD risk,” stated Suzanne Janzi, a PhD candidate at Lund University.
“This surprising contrast highlights the importance of considering not just the amount of sugar consumed, but its source and context.”
To elucidate the mechanisms by which sugar consumption influences CVD risk, and to ascertain whether variations in sugar types alter these risks, Janzi and her research associates compiled data from two substantial cohort studies: the Swedish Mammography Cohort and the Cohort of Swedish Men.
These longitudinal studies incorporated dietary questionnaires administered in 1997 and 2009, enabling the researchers to meticulously track participants’ dietary patterns over an extended period.
Following the implementation of exclusion criteria to ensure uniformity in inclusion parameters between the two cohorts and to mitigate the influence of independent risk factors for CVDs, the researchers finalized their analysis with a dataset comprising 69,705 participants.
Their examination focused on three categories of sugar consumption: toppings (e.g., honey), treats (e.g., pastries), and sweetened beverages (e.g., carbonated drinks), in relation to seven specific cardiovascular conditions: two distinct types of stroke, myocardial infarctions, heart failure, aortic aneurysms, atrial fibrillation, and aortic stenosis.
Participants were under observation until their demise, a diagnosis of one of the specified CVDs, or the conclusion of the follow-up period in 2019.
Throughout this observational duration, 25,739 individuals were diagnosed with a cardiovascular ailment.
The scientific team then leveraged this gathered information to dissect the specific effects of varied sugar intake patterns on the risk profiles for different cardiovascular diseases.
The outcomes revealed that the consumption of sweet beverages exerted a more detrimental impact on health compared to any other form of sugar intake; a higher consumption of sweetened drinks was found to significantly augment the risk of ischemic stroke, heart failure, atrial fibrillation, and abdominal aortic aneurysm.
“Liquid sugars, found in sweetened beverages, typically provide less satiety than solid forms — they make you feel less full — potentially leading to overconsumption,” Janzi explained.
“Context also matters — treats are often enjoyed in social settings or special occasions, while sweetened beverages might be consumed more regularly.”
The differential impact on various cardiovascular diseases by increased sugar intake may be attributed to the varied ways in which additional sugar consumption affects participants’ individual risk profiles.
An escalation in sugar intake, generally, was associated with an increased risk of ischemic stroke and abdominal aortic aneurysm, in addition to elevating the risk of heart failure among individuals with a normal Body Mass Index (BMI).
However, the most pronounced risks for adverse health outcomes were identified within the lowest intake category for treats. The consumption of occasional treats was, in fact, associated with more favorable outcomes than complete abstinence from treats.
“This might reflect underlying dietary behaviors — individuals consuming very little sugar might have very restrictive diets or might be limiting sugar due to pre-existing health conditions,” Janzi posited.
“While our observational study cannot establish causation, these findings suggest that extremely low sugar intake may not be necessary or beneficial for cardiovascular health.”
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Suzanne Janzi et al. 2024. Added sugar intake and its associations with incidence of seven different cardiovascular diseases in 69,705 Swedish men and women. Frontiers in Public Health 12; doi: 10.3389/fpubh.2024.1452085
