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home : columns : dr. k April 29, 2016

8/13/2014 10:41:00 AM
High sugar consumption increases cardiac risk factors

DEAR DOCTOR K: I've read that sugar increases the risk of heart disease. How does it do that? Also, any advice for those of us with a sweet tooth?

DEAR READER: So far as we know, sugar doesn't directly harm the heart. But it sure indirectly harms the heart, by promoting the following cardiac risk factors -- problems that lead to heart disease:

OBESITY: Excess calories contribute to obesity. Added sugar is a major source of excess (and empty) calories. Overweight and obese people are at greater risk for heart problems. Today, we're discovering that the cells containing fat make hormones that travel in the blood and have many harmful effects on the heart. The more fat cells, and the more fat in each fat cell, the higher the blood levels of these nasty hormones.

DIABETES: Sugar-sweetened drinks appear to play an important role in the increase of Type 2 diabetes. One reason for that is that the sugar is rapidly digested. Suddenly all that sugar that was in your stomach and gut now is in your blood. Sugar levels spike up. That puts a strain on your pancreas.

The pancreas is a gland in your abdomen that has many functions, one of which is to make insulin, a hormone that lowers blood sugar levels. Repeated surges of blood sugar whip your pancreas. When that happens, day after day and year after year, the pancreas gets exhausted.

CHOLESTEROL: Like obesity and diabetes, cholesterol is a major cardiac risk factor. Excess sugar lowers HDL ("good") cholesterol and increases harmful triglycerides.

BLOOD PRESSURE: Two major studies have tied sugar to blood pressure. One linked sugar-sweetened beverages to increased blood pressure. The other found that cutting out just one sugary drink a day lowered blood pressure.

METABOLIC SYNDROME: The metabolic syndrome is a cluster of risk factors that signals a sharp increase in heart disease risk. Sugar-laden soft drinks substantially increase the risk of metabolic syndrome.

Sugar clearly impacts cardiac risk factors. But does that translate into actual heart attacks? It does. A long-term Harvard study of nearly 90,000 people found that those who averaged one sugary drink a day were 23 percent more likely to have heart attacks than people who drank no sugary drinks. The risk was even higher in those who had two or more sugary drinks per day.

Try these strategies to tame your sweet tooth:

-- Give up sugar-sweetened drinks. Quench your thirst with sparkling or tap water. Add an ounce or two of 100 percent fruit juice, a slice of lemon or lime, or a sprig of mint for flavor.

-- Think fruit, not juice. Eat a piece of fruit instead of drinking fruit juice or drinks.

-- Read the cereal box. Choose one with minimal added sugar.

-- Choose healthy snacks and treats. Reach for fruits, nuts or fresh veggies.

-- Read food labels. Many processed and packaged foods contain added sugars. Sugars may be labeled as glucose, dextrose, fruit juice concentrates, maple syrup, molasses and high-fructose corn syrup.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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