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Eating too much ‘free sugar’ has 45 negative health effects, study finds

A recent study has found evidence for at least 45 reasons to reduce the consumption of added sugar.

Extensive studies have consistently demonstrated the detrimental impact of excessive sugar consumption on one’s health, leading to recommendations of limiting the intake of “free” or added sugar to less than 10% of daily caloric intake.

However, researchers from China and the United States believed that a comprehensive evaluation of the current evidence was necessary before formulating specific guidelines for sugar reduction. The study, published in The BMJ, aimed to assess the quality of existing evidence in order to inform the development of effective policies regarding sugar restriction.

In a comprehensive analysis of 73 meta-analyses, encompassing 8,601 studies, a strong correlation was found between excessive consumption of added sugar and a significantly elevated risk of 45 adverse health outcomes. These included conditions such as diabetes, gout, obesity, high blood pressure, heart attack, stroke, cancer, asthma, tooth decay, depression, and premature death.

The authors of the study specifically focused on “free sugars,” which encompass sugars added during food processing, as well as those present in table sugar, sweeteners, syrups, honey, fruit juice, vegetable juice, purees, pastes, and similar products where the cellular structure of the food has been broken down. This definition, as stated by the US Food and Drug Administration, does not include sugars naturally occurring in dairy products or intact fruits and vegetables.

According to Dr. Maya Adam, a clinical assistant professor of pediatrics at Stanford University School of Medicine and director of Health Media Innovation, the study offers a valuable summary of the current scientific understanding of the relationship between sugar consumption and our health. Dr. Adam, who was not part of the research team, states that the study confirms the likelihood of encountering health issues due to excessive sugar intake.

Dr. Leana Wen, an emergency physician and public health professor at George Washington University, who also did not participate in the study, comments that studies like this are beneficial in advising patients. She highlights the significance of seemingly minor modifications, such as reducing the consumption of excess sugar found in sugar-sweetened beverages, which can result in substantial and positive improvements in overall health.

The available evidence of moderate quality indicates that individuals who consumed higher quantities of sugar-sweetened beverages tended to have a higher body weight compared to those with lower intake levels.

Linda Van Horn, a professor emeritus of preventive medicine at Northwestern University’s Feinberg School of Medicine, who was not part of the study, emphasized that as a nutrition researcher and a member of both the 2010 and 2020 US Dietary Guidelines Advisory Committees, it is evident that sugar intake in the US exceeds the recommended amount by more than double (less than 10% of total daily caloric intake). She added that while sugar itself provides minimal, if any, nutritional benefits, its consumption often leads to the displacement of more nutritious food choices. Van Horn shared her insights via email.

The association between free sugar and disease

According to the study’s authors, the existing evidence regarding the link between free sugar and cancer is limited and controversial, necessitating further research. However, the study suggests that this connection could be explained by the well-known impact of sugar on weight. High sugar consumption has been consistently associated with obesity, which is a significant risk factor for various types of cancer. The same pattern is observed in relation to cardiovascular disease.

Behavioral scientist Brooke Aggarwal, who was not involved in the study, explained that the intake of added sugar can induce inflammation in the body, leading to stress on the heart and blood vessels, ultimately resulting in elevated blood pressure. Aggarwal serves as an assistant professor of medical sciences in the cardiology division at Columbia University Irving Medical Center.

Inflammation, a risk factor for depression, has been found to increase in individuals consuming highly processed foods that contain substantial amounts of free sugar.

Dr. Maya Adam highlighted that whole food carbohydrates take longer to break down into simple sugars, and a portion of them, such as fiber, cannot be broken down at all. This characteristic of intact grains means they do not cause the same rapid spikes in blood sugar levels as observed with the consumption of simple sugars. Blood sugar spikes trigger insulin spikes, which can potentially disrupt blood glucose stability and contribute to long-term health problems.

To lower sugar intake

Based on the study’s findings, along with existing recommendations from reputable organizations such as the World Health Organization, World Cancer Research Fund, and American Institute for Cancer Research, it is suggested that individuals should aim to limit their consumption of free sugar to less than 25 grams, which is roughly equivalent to 6 teaspoons, per day. To put this into perspective, this amount of sugar can be found in approximately 2 ½ chocolate chip cookies, 16 ounces of fruit punch, or about 1 ½ tablespoons of honey. According to the Cleveland Clinic, a typical doughnut contains around 15 to 30 grams of sugar.

The authors of the study also advise reducing the intake of sugar-sweetened beverages to less than one serving per week, which amounts to approximately 200 to 355 milliliters. This is roughly equal to the size of a 12-ounce soda.

To bring about a shift in sugar consumption habits, the study’s authors emphasize the urgent need for a combination of comprehensive public health education and global policies.

However, there are certain changes that individuals can initiate on their own.

Start by being mindful of the ingredients we consume by reading nutrition labels while grocery shopping. This applies not only to obviously sweet items but also to foods that may not be perceived as sweet, such as bread, breakfast cereals, yogurts, or condiments. These seemingly non-sweet foods often contain significant amounts of added sugar, which can accumulate over time, as noted by Dr. Maya Adam.

Choose water flavored with slices of fruit as a healthier alternative to sugary beverages, and opt for fresh or frozen fruits as a dessert instead of cakes, cookies, or ice cream. Engaging in more home cooking and baking is also an effective way to reduce sugar intake.

Ensuring sufficient and good-quality sleep on a regular basis can also be beneficial, as fatigue often leads to a preference for high-sugar foods. Gradually cutting back on sugar can help train our taste buds to desire less sweetness.

Dr. Maya Adam suggests that our lives can potentially become sweeter overall with reduced sugar consumption in our diet.