Added Sugars in the Diet, not Fruit, Related to Increased Risk of Heart Disease

One of the great debates for decades has been what nutrients cause atherosclerosis like coronary heart disease (CHD). The major players argued back and forth have been saturated fat, mainly from animal foods, versus dietary sugars. Most studies have shown both are a risk with saturated fats found in dairy, meat and egg yolk being the greater risk. Yet, the debate is not fully resolved.

Higher intake of total sugar has been linked with CHD risk, but the role of individual sugars, particularly fructose, is uncertain. Therefore a research group at the Harvard School of Public Health published a new study on the role of sugars and CHD. 


In prospective cohort studies, we followed 76,815 females (Nurses’ Health Study, 1980-2020), and 38,878 males (Health Professionals Follow-up Study, 1986-2016). Sugar and carbohydrate intake, including total fructose equivalents (TFE, from fructose monosaccharides and sucrose), total glucose equivalents (TGE, from glucose monosaccharides, disaccharides, and starch), and other sugar types, was measured every 2-4 years by semiquantitative food frequency questionnaire.


We documented 9,723 incident CHD cases over 40 years. The risk for CHD risk was 1.3 times higher for TGE and NOT higher for TFE.

TFE from fruits and vegetables was not associated with CHD risk but TFE from added sugar and juice was associated with CHD risk. 

Intakes of total sugars and added sugar were positively associated with CHD risk. 


Intakes of TGE, total sugar, added sugar, and fructose from added sugar and juice were associated with higher CHD risk.

In contrast, fructose from fruits and vegetables were not associated with CHD risk. 

These data are particularly important with another new study indicating that even "pre-diabetes" range labwork is associated with CHD.  Skipping the added sugars with careful attention to hidden sources like ketchup and BBQ sauces is a wise plan. 

Dr. Joel Kahn

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