The other White Death (you call it sugar)

Let’s have a talk about sugar.  (And you can blame John for the title.)

Previous research has shown that increased consumption of added sugars in foods and beverages can lead to hypertension, type II diabetes and obesity.

“Added sugars” are those that are placed in foods and beverages to help increase their consumption by making them sweeter. Examples would be sweetened teas, canned fruits packed in sugar syrup, ice cream, candy, desserts, sodas containing sugars and many other similar products.

In light of the fact that added sugars can contribute to the above diseases, various organizations like the World Health Organization, American Heart Association (AHA) and others have proposed that we limit our exposure to added sugar.

How much “added sugar” people eat today

The recommended amount varies per organization, from getting fewer than 25% of our total calories from added sugar, down to getting only about 5% or our total calories from added sugars. Five percent would be about 100 calories/day from added sugars.  That’s about the number of calories you’d find in 6 teaspoons of sugar.  Not very much considering that the average can of soda contains on the order of about 160-210 calories of added sugar per 12 ounce can.

Sugar, via Shutterstock

Sugar, via Shutterstock

This study took a look at added sugar and cardiovascular risk.  The researchers used data drawn from the National Health and Nutrition Examination Surveys (NHANES) for the periods 1988-1994, 1999-2004 and 2005-2010.  The NHANES data is drawn from a large number of US citizens who are aged 18 and older.  The intake of added sugar per person per day is around 16% of total calories.  Higher than what the AHA recommends.  About 10% of adults consumed as much as 25% of their daily calories from sugar.  Much of the added sugar intake came from sugar-added beverages and juices.

The health risks of eating too much “added-sugar”

The investigators looked at the NHANES data from all three time periods.  They focused on the amount of sugar consumed and the risk of dying from cardiovascular disease.

The data shows that the risk of dying from a heart attack increases substantially as added sugar consumption increases above 15%.

For someone who normally eats a 2000 calorie diet, a single 20-ounce bottle of sweetened soda would take them to the 15% level of added sugar.  That is, after drinking that bottle of soda, they should consume nothing else containing added sugar for that day.  Their data shows that the risk of death increases as the amount of added sugar increases.  The risk of cardiovascular death can be up to four-times higher in someone who eats or drinks about 700 calories or more of added sugar/day (about 30% added sugar).  Even increasing added sugar intake slightly over 15% can cause a substantial increase in risk of death.

Similar risks are seen in other countries, as well.  Previous studies have shown that those people who drink more sugary beverages are at higher risk of death from a variety of causes.  In Mexico, per capita consumption of sweetened beverages is high.  In Japan, it’s low.  In Mexico about 318 people/million die due to this increase in sugar consumption.  In Japan, the rate is about 10 per million.   It’s estimated that, worldwide, about 200,000 people die per year due to increased intake of sweetened beverages.

The upshot is that it is necessary to monitor how much added sugar that we consume to avoid increasing our risk of cardiovascular death.  One good thing is that the US Food and Drug Administration is proposing changes to the nutrition labels on foods and beverages.  The new labels will clearly show if there is added sugar and, if added sugars are present,  how much is contained in the product.  That should help us keep an eye on excessive sugar consumption.  And we need to because of its contribution to diabetes, obesity, hypertension and cardiovascular risk.

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Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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23 Responses to “The other White Death (you call it sugar)”

  1. caphillprof says:

    how micro of you, I’m talking volume, buy low, sell high, nothing is cheap in volume

  2. silas1898 says:

    Many, many years ago I worked in a lab developing new flavors. I would make 6 – 10 variations of the target flavor, then formulate the flavor into a 70% sugar syrup with a touch of citric acid. No salt.

    This was then diluted 6 : 1 with water that my boss would then taste. If the syrup/sugar level was not exactly the same; I had to redo the batch.

    This was around the time of the Great Pepsi Challenge campaign. Boss said it was simple. Pepsi is sweeter and people will always prefer the sweeter choice.

    It was quite an education.

  3. Zorba says:

    Yes, exactly, judy.
    Mr. Zorba gave up drinking Coca Cola years ago when they started using corn syrup. He would, however, buy a few “Kosher For Passover” Cokes each year (sweetened with sugar, corn syrup not allowed).
    He eventually gave even those up.

  4. bejammin075 says:

    Meanwhile, there’s no farm subsidy for the farmer growing what we should eat more of, e.g. the veggies. And there’s no coupons for fresh vegetables either, only for boxes of processed food garbage.

  5. Naja pallida says:

    Buy cheap C and D grade products for pennies on the dollar.
    Sell them for just below your competitors prices for A and B grade products.
    Pay your employees slave wages so you can have a chunk of your costs offset by billions in government subsidies.

  6. bejammin075 says:

    The sugar is there for a few reasons, one reason being food preservation. Salt and sugar make it so that packaged food can sit on shelves longer without spoiling. The other reason is competition with other brands. Most people go with what tastes the sweetest and saltiest, which is why modern processed food is a race to the bottom.

    Besides the added sugar, the refined flour that is in all bread is so easily digestable that it’s like more sugar. When I see someone eating a hoagie, to my vision now, I see them eating a big pile of sugar.
    Bread also must have salt, just to bake properly. Most would be surprised how much salt is also in bread products. I eat breads, processed foods, and added sugars very sparingly now. I lost a lot of weight, without even trying, and weight stays off easily. I got to the ideal BMI range, and with smart eating habits, I’ve learned to like healthy food, and I can eat as much as I want while staing very lean and fit

  7. 4th Turning says:

    One additional note.

    New study puts final nail in the “saturated fat causes heart disease” coffin

  8. 4th Turning says:

    Actually white sugar has an evil twin-salt. The processed food godfathers long ago built state of the art “testing” labs and hired chemists to engineer the necessary incremental addition of sugar and salt (salt cuts that sickeningly sweet aftertaste) “to product” as our bodies got use to and bored with the cardboard it was devouring for no logical reason except that desiring it was becoming weirdly
    soldered into vulnerable brain-wiring. Thanks for this post. I think our family is already aware
    of this stuff but the fact that you (and all of us) care may provide an extra boost needed to
    stay faithful to those oh-so-difficult best intentions.

    Artificial sweeteners are hundreds to thousands of times sweeter than regular sugar activating our genetically programmed preference for sweet taste more than any other substance.

    They trick your metabolism into thinking sugar is on its way. This causes your body to pump out insulin, the fat storage hormone, which lays down more belly fat.

    It also confuses and slows your metabolism down, so you burn less calories every day.

    It makes you hungrier and crave even more sugar and starchy carbs like bread and pasta.

    In animal studies, the rats that consumed artificial sweeteners ate more, their metabolism slowed, and they put on 14 percent more body fat in just two weeks – EVEN eating less calories.

    In population studies there was a 200 percent increased risk of obesity in diet soda drinkers.

    I love Taylor Swift, I met her last summer. She is a wonderful person with great integrity. I don’t think she knows about this research and I hope someone shares it with her so she can save millions of children and fans from drinking Diet Coke because she endorses it.

  9. docsterx says:

    Interesting article on sugar addiction, obesity and sugar. Adding sugar may “hook” someone and cause them to prefer a certain brand, recipe, type of food (as in the muffin/pastry comments, below.) If Brand X uses a lot of high fructose corn syrup 90 and you try it, you’ll probably purchase Brand X again.

  10. Monophylos Fortikos says:

    I’ve not made whole wheat English muffins but I have made them with regular flour and there’s very little added sugar in the recipe I use. More sugar is sometimes added to doughs using coarser, less starchy flours, however, to give the yeast more of a kick in the beginning to help give the heavier dough more of a rise.

  11. That’s a very good question. I make bread too. Curious if english muffin recipes normally have that much sugar.

  12. Houndentenor says:

    When I was living in Europe, I had a piece of cake almost every afternoon (Kaffee und Kuchen or coffee and cake is the German equivalent of tea time around 4 pm.) The baked good there had far less sugar in them which allowed me to taste all the other flavors. When I got back to the US I was shocked at how everything I ate that was the least bit sweet was just sugar with a little other flavor rather than the opposite. It’s possible to cook things with a lot less sugar and a lot less flavor. (And those baked goods were a lot cheaper than their American counterparts because every neighborhood had at least one such bakery as opposed to the US where freshly baked goods are an expensive specialty item).

  13. Naja pallida says:

    Not only do we heavily subsidize corn production, we penalize foreign sugar producers to keep the price of real sugar in the US artificially high.

  14. judybrowni says:

    Yes it is: the government subsidizes corn production.

    The sweeter the product, the more the public buys.

    And corn syrup may even be less healthful than white sugar.

  15. sane37 says:

    How does walmart survive?

  16. caphillprof says:

    Nothing is cheap in volume

  17. 4th Turning says:

    Next slumming excursion across the M/D Line, remember to order “half and half”.
    And you all come back real soon. (old coke, white sugar/new coke was corn syrup-
    both birthed in Atlanta) Entertained white house advance team in our restaurant
    some yrs. back and they were absolutely giddy to find we offered sweet (p.c.) tea.

  18. Monophylos Fortikos says:

    Azodicarbonamide serves a very different purpose in baking: it is a mild oxidant that promotes the formation of disulfide bridges in gluten, therefore improving the mechanical properties of the dough. It’s got nothing to do with shelf life.

    EDIT: By the way, I really dislike the common rhetorical technique of insinuating that chemical X used in consumer products must be wicked and nasty because it’s also used in something else that’s not food. It reminds me of how every story about perchlorates found in groundwaters go out of their way to call it “rocket fuel” even though perchlorate salts are also found naturally in evaporite minerals.

  19. GarySFBCN says:

    I don’t know. Most of the English muffins only have about 1 gram of sugar and if they wanted to keep them softer/chewier, the could add the yoga mat stuff (azodicarbonamide). I think it is to make a whole wheat muffin appeal to children.

  20. Monophylos Fortikos says:

    I’m trying to work out why a whole wheat English muffin should have any significant amount of sugar in it. When making a yeast bread you might put in a small amount of sugar to give the yeast something to get started–maybe a tablespoon or two at most for the whole batch, not half a tablespoon for one lousy muffin.

    I wonder how much of this sort of thing has been conditioned into us over decades of eating commercial foodstuffs. For instance, we’re used to lots of salt in everything because salt is a cheap and effective preservative in manufactured foods, but as a result people don’t even really taste the salt any more and dislike the taste of meals cooked with only a little salt. I suspect that much the same is true of too much sugar in baked goods. I conjecture that there’s a practical reason for loading up baked goods with sugar: because it is somewhat hygroscopic sugar keeps bread products softer and chewier for longer. Everyone gets conditioned to the taste and so come to expect that everything should have that much sugar in it.

  21. sane37 says:

    Corn syrup is super cheap

  22. GarySFBCN says:

    I think there are two classes of added sugars: Those that we would expect in foods, such as ice cream, cakes, etc. and those that we don’t expect. I was saddened to discover that the Oroweat Whole Wheat English Muffins I just bought have 6 grams of sugar in each muffin.

    I have an app on my Android phone called Fooducate. You can scan the barcode of processed foods and it quickly returns all of the nutritional information about that product, a letter grade (healthy to unhealthy) and suggestions for healthier alternatives. I didn’t have my phone handy when I bought the muffins.

    Back to the topic: I’ve never liked sweetened drinks. I don’t eat that many processed foods. I do eat desserts, but not every day. While I am on the path to an ‘ideal’ weight, I am still obese. But all of my ‘numbers’ have always been good: Blood sugar, blood pressure, cholesterol, etc.

    I attribute those good numbers to not consuming much sugar and walking about 4 miles 4-5 days a week.

  23. caphillprof says:

    We live close to the sweet tea line, so waiters and waitresses ask whether one wants sweetened or unsweetened iced tea. You don’t have to go many miles further south before the option disappears and the tea becomes more like simple syrup on ice. I have long thought that this “cultural” change results in Coca Cola being way too sweet. What I don’t understand is why Coke hasn’t been able to wean its public off excess sugar. One would think it had an economic reason to minimize its sweetener costs year by year.

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