Over the years epidemiologic studies have shown that individuals who consume higher amounts of added sugar tend to gain more weight and have a higher risk of obesity, type 2 diabetes mellitus, dyslipidemias, hypertension, and cardiovascular disease. However, most of these previous studies have focused on the effects of sugar-sweetened beverages and not total added sugar. Additionally none of these studies have used nationally representative samples to examine the relationship between added sugar intake and cardiovascular disease mortality.

In a new study published Feb. 3 in JAMA Internal Medicine researchers led by Quanhe Yang, PHD, Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, examined time trends of consumption of added sugar as percentage of totally daily calories using a series of nationally representative samples and investigating the association of this consumption with cardiovascular disease mortality.

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Using the National Health and Nutrition Examination Survey (NHANES) 1999-2004, and 2005-2010, for the time trend analysis and NHANES III (1988-1994) Linked Mortality Files, Yang and his co-authors found that the usual percentage of calories from added sugar among U.S. adults increased from the late '80s to 1990-2004 and decreased during 2005-2010, and that most adults consumed more than 10 percent of their total calories from added sugar, with approximately 10 percent of adults consuming 25 percent or more of calories from added sugar in 2005-2010.

Based on its analysis the study also found that participants who consumed greater than or equal to 10 percent but less than 25 percent calories from added sugar—the level below the Institute of Medicine recommendation and above the recommendation of the World Health Organization and American Heart Association—had a 30 percent higher risk of cardiovascular disease mortality, with this relative risk nearly tripling for those who consumed 25 percent more of calories from added sugar.

Calculating the major sources of added sugar in in American adults' diet—grain-based deserts (13.7 percent), fruit drinks (8.9 percent), dairy desserts (6.1 percent), and candy (5.8 percent)—the analysis found that regular consumption of sugar-sweetened beverages (37.1 percent) is significantly associated with increased incidence of cardiovascular disease, independent of other risk factors.

Ultimately, Yang and his team support current recommendations to limit the intake of calories from added sugars in U.S. diets.

Keywords: Centers for Disease Control and Prevention, U.S., Dyslipidemias, Stroke, Sweetening Agents, Diabetes Mellitus, Type 2, Epidemiologic Studies, Cardiovascular Diseases, Risk Factors, Diet, Nutrition Surveys, Hypertension, National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division

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