Cardiovascular Disease and Sugar

Chapter summary

Sugar consumption has a part in hypertension, adverse blood fats, inflammation and coronary heart disease (CHD).
Stop fructose consumption if you want to be healthy and manage your weight.

About 17 million people die of cardiovascular disease (CVD) each year, mostly from heart attacks and strokes.
Smoking increases the risk of dying from coronary heart disease and cerebrovascular disease two- to three-fold.
Over 80% of CVD deaths occur in low- and middle-income countries.
More than 300 risk factors have been linked to CHD and stroke. The major ones are common, have significant independent impact, and fall when treated.

High blood pressure: 75% of people with chronic heart failure have it, and half of adults with hypertension do not have it under control.
High cholesterol: double the risk of heart disease.
Diabetes: double the risk.
Depression: 25% to 40% more likely to die from heart disease.
Obesity: coronary artery disease is ten times more common with BMI over 30.

Framingham Offspring Study (6,154 adults, 4 years): one or more soft drinks a day gave 22% higher hypertension incidence.
Nurses’ Health Studies I and II: women drinking four or more SSBs a day had 44% or 28% higher hypertension risk.
Blood fats: similar trends, including about 22% higher incidence of high triglycerides.
Inflammation: in a ten-week intervention, markers such as C-reactive protein rose in the sucrose group and fell in the artificial sweetener group.
Nurses’ Health Study (88,000 women, 24 years): two or more SSBs a day carried a 35% greater risk of CHD.

The author: Over one SSB a day creates roughly 25% to 45% extra risk. Not as dangerous as tobacco, but close given the price.
The caution: These are observational studies. They show association. People who drink many SSBs often differ in other habits, and the studies cannot prove cause and effect. Most adjust for weight and lifestyle, and the link persists.

Maier, R. (2014) Heart disease statistics. Healthline.
World Health Organization (2014) Cardiovascular disease atlas: risk factors.
Dhingra, R. et al. (2007) Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation.
Winkelmayer, W. et al. (2005) Habitual caffeine intake and the risk of hypertension in women. JAMA 294:2330-2335.
Nguyen, S. et al. (2009) Sugar-sweetened beverages, serum uric acid, and blood pressure in adolescents. J Pediatr 154:807-813.
Sorensen, L. et al. (2005) Effect of sucrose on inflammatory markers in overweight humans. Am J Clin Nutr 82:421-427.
Liu, S. et al. (2002) Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. Am J Clin Nutr 75:492-498.