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February 3rd, 2014
04:01 PM ET

Sugar not only makes you fat, it may make you sick

In recent years, sugar - more so than fat - has been receiving the bulk of the blame for our deteriorating health.

Most of us know we consume more sugar than we should.  Let's be honest, it's hard not to.

The (new) bad news is that sugar does more damage to our bodies than we originally thought.  It was once considered to be just another marker for an unhealthy diet and obesity.  Now sugar is considered an independent risk factor for cardiovascular disease, as well as many other chronic diseases, according a study published Monday in JAMA Internal Medicine.

“Sugar has adverse health effects above any purported role as ‘empty calories’ promoting obesity,” writes Laura Schmidt, a professor of health policy in the School of Medicine at the University of California at San Francisco, in an accompanying editorial. “Too much sugar doesn’t just make us fat; it can also make us sick.”

But how much is too much? Turns out not nearly as much as you may think.  As a few doctors and scientists have been screaming for a while now, a little bit of sugar goes a long way.

Added sugars, according to most experts, are far more harmful to our bodies than naturally-occurring sugars.  We're talking about the sugars used in processed or prepared foods like sugar-sweetened beverages, grain-based desserts, fruit drinks, dairy desserts, candy, ready-to-eat cereal and yeast breads. Your fruits and (natural) fruit juices are safe.

Recommendations for your daily allotment of added sugar vary widely:

- The Institute of Medicine recommends that added sugars make up less than 25% of your total calories
- The World Health Organization recommends less than 10%
- The American Heart Association recommends limiting added sugars to less than 100 calories daily for women and 150 calories daily for men

The U.S. government hasn't issued a dietary limit for added sugars, like it has for calories, fats, sodium, etc.  Furthermore, sugar is classified by the Food and Drug administration as "generally safe," which allows manufacturers to add unlimited amounts to any food.

"There is a difference between setting the limit for nutrients or other substances in food and setting limits for what people should be consuming," an FDA spokesperson wrote in an e-mail to CNN. "FDA does not set limits for what people should be eating."

"With regard to setting a regulatory limit for added sugar in food, FDA would carefully consider scientific evidence in determining whether regulatory limits are needed, as it would for other substances in food."

There is some good news. While the mean percentage of calories consumed from added sugars increased from 15.7% in 1988-1994 to 16.8% in 1999-2004, it actually decreased to 14.9% between 2005 and 2010. But most adults still consumed 10% or more of their calories from added sugar and about 1 in 10 people consumed 25% or more of their calories from sugar during the same time period.

Participants in the study who consumed approximately 17 to 21% of their calories from added sugar had a 38% higher risk of dying from cardiovascular disease, compared with those who consumed approximately 8% of calories from added sugar, the study authors concluded.

“This relative risk was more than double for those who consumed 21% or more of calories from added sugar,” they wrote.

The Sugar Association said in a statement there "are a number of major flaws with this new study and the sensationalism associated with targeting sugar is fueling the media." The authors conclude that "an observational study like theirs is not proof of cause and effect," the association noted, and "extensive knowledge gaps exist."

"Bottom line: All-natural sugar has been consumed safely for centuries, and when consumed in moderation, has been and should continue to be part of a balanced diet and healthy lifestyle," the statement said.

Schmidt writes in the study that these new findings “provide physicians and consumers with actionable guidance. Until federal guidelines are forthcoming, physicians may want to caution patients that, to support cardiovascular health, it’s safest to consume less than 15% of their daily calories from added sugar.”

That’s the equivalent, Schmidt points out, of drinking one 20-ounce Mountain Dew soda in a 2,000-calorie diet.

“From there, the risk rises exponentially as a function of increased sugar intake,” she writes.

In a statement, the American Beverage Association said the study "shows that adult consumption of added sugars has actually declined, as recently reported by the (Centers for Disease Control and Prevention).

"A significant part of that reduction is from decreased added sugars from beverages due, in part, to our member companies' ongoing innovation in providing more low- and no-calorie options. Furthermore, this is an observational study which cannot - and does not - show that cardiovascular disease is caused by drinking sugar-sweetened beverages."

Despite our changing scientific understanding and a growing body of evidence on sugar overconsumption as an independent risk factor in chronic disease, sugar regulation remains an uphill battle in the United States.  This is contrasted by the increased frequency of regulation abroad, where 15 countries now have taxes on sugar-sweetened beverages.

“‘Sin taxes,’ whether on tobacco, alcohol, or sugar-laden products, are popular because they are easy to enforce and generate revenue, with a well-documented evidence base supporting their effectiveness for lowering consumption,” writes Schmidt.

But forget about the short-term monetary cost.  Before you reach for that next sugary treat, think long and hard about the long-term cost to your health.


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