Food/Nutrition Columnist
The Connection Between Sugar and Heart Disease Gets Stronger
Feb 17, 2014 - 12:03:00 AM

( - Americans eat far too much sugar. How does this affect heart disease risk, you wonder?  When the low fat eating craze took effect, experts hoped that people would lower their intake of high fat foods by substituting healthy carbohydrates instead - whole grains, beans, fruits and vegetables. This did not happen. Instead we piled on refined carbohydrates with limited fiber and lots of sugar - white bread, cookies, cake, white rice, candy, soda and sweetened fruit drinks.

We have tipped the carbohydrate pattern in this country away from whole grains and toward too much sugar. Ninety-six percent of Americans don't eat enough fiber each day and most of us eat far too much sugar, as much as 300 to 400 sugar calories daily. This equals 19 to 25 teaspoons of sugar a day!

Americans have a love affair with sugar. As sugar intake goes up, the quality of the diet goes down - more calories, less fiber, fewer vitamins and minerals, and more unhealthy fats are eaten. This is the exact opposite of what you want to be eating to prevent heart disease.

Eating too much sugar can increase the risk for:

A study published this month in JAMA Internal Medicine ( confirmed that people who eat 15% of their total daily calories as added sugar have a 18% greater risk for heart disease. Eat 17% to 21% of your daily calories as added sugar and the risk for heart disease jumps to 38%.

Added sugar was not a significant part of our diets until modern food processing began in the last 75 years. From the perspective of health, sugar can be divided into 2 main groups - natural sugars and added sugars. Grains, fruits, vegetables, milk and plain yogurt all contain natural sugars. These sugars come packaged along with the vitamins, minerals and fiber also found in these foods. Soda, candy, fruit drinks, cakes, cookies, ice cream, jelly and syrup offer little more than sweetness and calories. These foods are loaded with added sugar. We should aim to eat foods with natural sugars more often and those foods with added sugars less often.

The nutrition label does not help you sort out natural from added sugar because all sugars are lumped together. The nutrition label on a quart of milk will tell you that one cup has 14 grams of sugar. The label on fruit punch tells you that one cup has 30 grams of sugar. The difference, however, is significant. All of the sugar in milk comes from naturally occurring lactose or milk sugar, but almost all the sugar in the fruit punch is added.

So, how can you tell the difference between natural sugars, which are good for you, and added sugars, which could increase your risk for heart disease? Check the ingredient listing. If a food contains little or no milk or fruit, the sugar number listed on the nutrition label will be a good estimate of the amount of added sugar in each serving.

Next look for ingredients that mean sugar, perhaps by another name. See the box below, if any of these terms appear it means sugar has been added to the food. Ingredients are listed in descending order by volume, so the closer sugar is to the beginning of the list, the more added sugar is in each serving of food.

Sugar By Another Name

Agave syrup or nectar                         High fructose corn syrup

Barley malt syrup                                Honey

Beet juice                                           Invert sugar

Brown rice syrup                                 Jaggery

Brown sugar                                       Maltodextrin

Cane syrup                                         Maple sugar

Confectioners (powdered) sugar          Maple syrup

Corn sweetener                                  Molasses

Corn syrup                                          Muscavado

Crystalline fructose                              Raw sugar

Demarara sugar                                  Rice syrup

Dextrose                                            Sorghum

Evaporated cane juice                         Sucrose

Fructose                                             Sugar in the raw

Fruit juice                                            Turbinado

Fruit juice concentrate

Bottom line: We still have a lot to learn about the connection between sugar and heart disease. But we do know that eating too much sugar provides no health benefits; eating less will have a positive effect on your health. Everyone should aim to eat less.

To learn more about the connection between sugar and heart disease look at my latest book The Fat and Cholesterol Counter (Pocket Books, 2014) ( which looks at all the players in the heart disease game - fat, cholesterol, trans fat, fiber and sugar - and provides sugar values for more than 10,000 foods.

© NRH Nutrition Consultants, Inc.
Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of the nutrition counter series for Pocket Books with sales of more than 8.5 million books.

Look for:

The Diabetes Counter, 5th Ed., 2014

The Fat and Cholesterol Counter, 2014

The Most Complete Food Counter, 3rd ed., 2013

The Calorie Counter, 6th Ed., 2013

The Complete Food Counter, 4th ed., 2012

The Protein Counter, 3rd Ed., 2011

The Ultimate Carbohydrate Counter, 3rd Ed., 2010

The Healthy Wholefoods Counter, 2008

Your Complete Food Counter App:

For more information on Jo-Ann and her books, go to:


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