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This was a study out of Sweden, where they looked at 69,705 people, their sugar intake, and the risk of seven different types of cardiovascular diseases. It started because of people talking about sugary beverages and the adverse health effects. This is a study Dec 2024, Frontiers, “Added sugar intake and its associations with incidence of seven different cardiovascular diseases in 69,705 Swedish men and women”. Average age was 60, BMI 25, 47% female. They did this study to try to figure out if the source of sugar mattered to the heart risk. Nordic, US, and WHO recommendations state to limit added sugar and free sugar (all added sugars and naturally sugars in honey/syrup/fruit juice) to less than 10% of energy intake.
Study:
- Added sugar was determined by an extensive food questionnaire, looking at frequency, portion size, frequency of beverages (sweetened, tea, or coffee), table sugar and honey. To find “added sugar” they subtracted sugars in fruit, vegetables, and fruit juices from their total intake. Added sugars were different by category: treats (pastries, ice cream, sweets, chocolate), toppings (table sugar, honey, jam, marmalade), and sweetened beverages (soda, fruit juice)
- The 7 Cardiovascular diseases: ischemic stroke, hemorrhagic stroke, heart attack, heart failure, aortic stenosis, Afib, and an abdominal aortic aneurysm.
- They excluded those with diabetes, prevalent cardiovascular disease, extreme energy intakes.
Findings:
- Sugar intake was positively associated with ischemic stroke, abdominal aortic aneurysm
- Positive linear associations were found between toppings intake: aortic aneurysm
- Positive linear association between sweetened beverages: ischemic stroke, heart failure, Afib, and aortic aneurysm
- Negative linear associations between treat intake and all outcomes
- Negative linear association between toppings intakes and heart failure, aortic stenosis
They conclude that added sugar intake associations with heart issues vary by disease and added sugar. They conclude that sweetened beverages seem to be higher risk than treats. The heart issues are likely linked to those heart diseases caused by atherosclerosis. They talk about other studies- one showed a U shaped association between added sugar and overall stroke risk. Another showed free sugar intake was linearly associated with overall stroke risk. This current study separated out ischemic stroke from hemorrhagic stroke. Their nonlinear findings of sugar relation to Afib and aortic stenosis echos those of other studies.
There are many theories as to why this sugar is bad. The obvious is the increased risk of high cholesterol, obesity, high blood pressure, and diabetes.
With respect to artificial sugar, there are studies that seem to indicate they are bad for heart health because they alter the gut microbiome, but the authors state the collected body of evidence does not indicate bad effects by artificially sweetened beverages on heart risk.
They noted that their population over time consumed less sugar. When comparing 2009 and 1997, sugar intake went from 9% to 6.7%.
They acknowledge the complexity of diet and that there may be confounders.
Our thoughts at Biohackr Health?
This is good information for those at risk for heart disease, atherosclerosis, and diabetes. This study seems to confirm sweetened beverages are the biggest risk factor for added sugar. They advocate keeping added sugar to a max of 10% of your calories, and treats (yay!) seem to be a better source.