Source:

Welsh
JA
,
Sharma
A
,
Cunningham
SA
, et al
.
Consumption of added sugars and indicators of cardiovascular disease risk among US adolescents
.
Circulation
.
2011
;
123
(
3
):
249
257
; doi:
https://doi.org/10.1161/CIRCULATIONAHA.110.972166

To determine if there is an association between known cardiovascular disease risk factors and daily consumption of added sugars, researchers from Emory University reviewed data from the National Health and Nutrition Examination Survey (NHANES). Information on 24-hour dietary recall of adolescents (aged 12–18) living in the United States between 1999 and 2004 were abstracted from NHANES along with measured markers of cardiovascular risk, including: HDL cholesterol, total cholesterol (TC), LDL, and triglycerides; insulin and glucose; anthropometric measures (height, weight, calculated BMI, and waist circumference); and blood pressure. The homeostasis model assessment (HOMA-IR), an estimate of insulin resistance, was calculated. The added sugar content of food items was determined using the My Pyramid Equivalents database (MPED) from the same time period.1 For the analysis, the study population was divided into six groups based on the percentage of their daily total caloric intake that consisted of added sugar. The association between markers of cardiovascular risk and added sugar intake was assessed with regression analyses. Covariates in regression models included race, age, gender, education level, self-reported physical activity level, and dietary nutrients (other than added sugar).

After exclusion of those with unreliable data, pregnant, with extremely high levels of triglycerides, and known diabetics, 2,157 adolescents were included in the study. The average daily consumption of added sugar was 118.9 grams which was 21.4% of total daily caloric intake. There were no differences in added sugar consumption based on race/ethnicity. There was a significant trend toward a greater percentage of total energy consumption from carbohydrates in those with a higher intake of added sugars. Higher sugar intake was associated with higher LDL (P=.08) and triglyceride (P=.07) and lower HDL (P=.001) levels. The correlation between added sugar intake and lipid levels was independent of race/ethnicity, body weight, and gender. Trends for total cholesterol as a function of added sugar consumption were not significant. Insulin resistance (HOMA-IR) and fasting insulin levels were positively correlated with added sugar consumption in overweight adolescents but not in those with a normal body weight. Fasting glucose levels, blood pressure, waist circumference, and BMI did not correlate with the amount of added sugar consumption.

The authors conclude that added sugar consumption by US adolescents is associated with cardiovascular risk.

Dr Seslar has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

The consumption of added sugar among American adolescents nearly doubled from 1977–1978 to 1999–2004.2,3 Changes in the American diet during this 30-year period, including increased intake of added sugars, are thought to have played a significant role in childhood obesity.4,5 There is a striking parallel between the prevalence of obesity...

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