We all know that heart disease is the No. 1 killer of women and the leading cause of death worldwide. One in three women die each year from this disease, more than all forms of cancer combined. For decades we believed saturated and trans fats were the primary offenders for heart disease, until now. Sugar, not fat, is the culprit, and this is shifting our whole philosophy on cardiovascular health.
In a report published this past spring, the Journal of the American Medical Association (JAMA) linked excess sugar intake to a dramatic increase in cardiovascular disease and mortality rates. The association also linked sugar intake to all sorts of health hazards, such as cancer, dementia, and Type 2 diabetes.
It isn't often that an entire medical consensus changes, and it has certainly created quite a stir. But it actually isn't bad news. It's important to understand the root causes of life-threatening diseases and implement effective strategies and treatment plans to save lives.
Sugar is delicious and satisfying. In fact, I'd be hard pressed to find one of my patients who doesn't have a love affair with chocolate. But sugar wreaks havoc in our bodies when consumed in large quantities over long periods of time. A diet high in sugar contributes to obesity, which is linked to many problems such as insulin resistance, kidney disease, hypertension, rheumatoid arthritis, asthma, and a multitude of harmful diseases related to inflammation.
Here are some not-so-sweet statistics:
- Subjects with the highest sugar intake had a 400 percent higher risk of heart attack, according to the JAMA study.
- The risk of heart attack nearly triples when 25 percent or more of our daily calories come from sugar.
- The risk of dying from cardiovascular disease directly correlates to consuming 12 ounces per day, seven days a week, of a sugar-sweetened beverage.
Given the statistics, we know we should cut back on sugar. But that's not as easy as it sounds, because sugar is hidden in just about everything we eat. It goes by many names, including dextrose, high fructose corn syrup, malt syrup, glucose, sucrose, and evaporated cane juice, just to name a few.
It's found on more food labels than you would believe -- fruit drinks, yogurts, ready-to-eat cereals, even ketchup and salad dressings. Foods labeled "low fat" are especially deceptive. While the fat may be reduced, the sugar is increased to make up for lost flavor. Just look at low-fat salad dressings and try to find one with no sugar; it's almost impossible.
To make matters worse, sugar is highly addictive both biochemically and emotionally. The more we eat it, the heavier the impact, not only on our body -- including our hearts -- but also our brains. When the brain is continually overloaded with refined sugar, it essentially re-wires the mind, creating a dependency much like a drug addiction.
It can be hard to kick the sugar habit, even if we are aware of what we are eating because sugar is addictive, and both our bodies and our minds come to rely on it. Nicole Avena, a neuroscientist at Princeton University, has shown in numerous lab experiments that overeating palatable foods (like sugar) can produce changes in the brain and behavior that resemble addiction.
Mood-enhancing neurotransmitters such as serotonin and endorphins are released when we eat sugar, sending positive messages through our bodies, which helps lower our anxiety, making us feel more calm and relaxed. Sugar beckons us, but the more sugar we consume, the more we want. Even artificial sweeteners without calories trick our brain into wanting that sweet flavor.
We love sugar, but it's a very tough love. Chronic stress is also a key factor when it comes to sugar cravings. Patients tell me every day how difficult it is to balance work, home life, and self-care. Taking care of our families while trying to manage a career, put nutritious meals on the table, get enough exercise, the right amount of sleep, and tend to our health, is not easy.
When we are tired or unhappy, where do we turn? To sugar -- a relationship that feels almost seductive. There is definitely a correlation between a lack of joy and a craving for sugar, so it's very important to find wholesome sweetness in your life on a daily basis, no matter how small.
So with all of this information, how do we improve our odds against one of the many life-threatening conditions deriving from excessive sugar? For a long time, the use of statin drugs as a solution to heart disease was advised. But we knew in our practice, the real solution was right in our kitchens. Changing our diets can have a huge impact on our hearts, and our risk factors. It's important to eat organic, locally grown, seasonal fruits and vegetables, and consume low-fat, lean meats and fish.
Staying away from processed, refined foods, trans fats, and foods laden with sodium is critical. Limiting alcohol, which contains lots of sugar, is equally important. Eating several small meals throughout the day that contain protein can help keep blood sugar levels stabilized, reducing cravings. Adding dietary supplements can also help round-out nutrient deficiencies that often accompany diets teeming with sugar-overload.
The American Heart Association recommends women consume no more than 6 teaspoons, or 30 grams, of sugar each day. Men should have no more than 9 teaspoons, or 45 grams per day. Unfortunately studies show the average American consumes nearly 140 pounds of sugar in a year, so we have a long way to go.
The JAMA report may have changed a long-held belief system, but we can successfully learn to take small steps each day to achieve better heart -- and overall -- health.
The recommendation from the AHA may be too high, as the best option may be to avoid it completely, as to date, we have little to show us it has benefit to the body, just the palate.