Too Much Can Make Us Sick

Eating too much added sugar doesn't just expand our waistlines

Heart disease. Diabetes. These chronic conditions are among the leading causes of death worldwide.¹ Increasingly, scientists are focusing on a common set of underlying metabolic issues that raise people's risk for chronic disease. It turns out that the long-term overconsumption of added sugars is linked to many of these dysfunctions.

Making sense of metabolic syndrome

The broad term for those dysfunctions is metabolic syndrome (MetS). MetS involves a cluster of symptoms that, when present together, increase the chances of acquiring a chronic disease, such as diabetes, heart disease and liver disease. MetS has been a topic of active study in medicine since the 1980s,² in part due to the increasing impact of these diseases on health worldwide. Today, research is increasingly focused on how the standard American diet – heavy in processed, packaged foods – impacts MetS and chronic disease.

MetS is composed of the following five symptoms:³

 - Large Waist Size: 35” or more for women and 40” for men 

 - High triglycerides: 150 mg/dL or higher (or use of cholesterol medication)

 - High total cholesterol, or HDL levels under 50 mg/dL for women, 40 mg for men

 - High blood pressure: 135/85 mm or higher

 - High blood sugar: 100 mg/dL or higher^{6, 7}

According to the American Heart Association, 56 million Americans have metabolic syndrome, or roughly one in five people (22.9%) over age 20, placing them at higher risk for chronic disease. The syndrome runs in families and varies across racial-ethnic groups.

"Sugar belly" may be a warning sign

One of the most obvious signs of metabolic syndrome is a “sugar belly.” This is the “apple” body shape, in which the waist measurement is larger than the hips. If you or a family member tend to carry extra weight around the waist, it’s especially important to discuss metabolic syndrome with a health provider, so they can take the blood-pressure and blood tests needed to confirm it. 

How does added sugar lead to MetS? Over time, consuming large quantities of added sugar can stress and damage critical organs, including the pancreas and liver. When the pancreas, which produces insulin to process sugars, becomes overworked, it can fail to regulate blood sugar properly. Large doses of the sugar fructose also can overwhelm the liver, which metabolizes fructose. In the process, the liver will convert excess fructose to fat, which is stored in the liver and also released into the bloodstream. 

This process contributes to key elements of MetS, including high blood fats or triglycerides, high cholesterol, high blood pressure and extra body fat in the form of a sugar belly.⁸

Many, but not all, people with metabolic syndrome are overweight or obese. People who consume too many added sugars are more likely to become obese^9,4 and to get MetS. But you don't have to be overweight to have metabolic syndrome. This puts all of us at risk for MetS and for chronic disease.

MetS is linked to heart disease and diabetes

Sixteen million Americans have heart disease,¹¹ which is the #1 killer in the United States. Growing scientific evidence is helping identify the various ways that sugar is implicated. We know that metabolic syndrome is a strong predictor of heart  disease.^12,5,6,7 Consuming too many added sugars also can lead to excess weight gain, which strains the heart.

Diabetes, which affects 25.8 million Americans, is of equal concern to public health. Diabetes can cause kidney failure, lower-limb amputations, and blindness, and doubles the risk of colon and pancreatic cancers.^8,9,10 Diabetes is strongly associated with coronary artery disease and Alzheimer's disease. It's also a discriminatory disease: compared to white adults, the risk of being diagnosed with diabetes is 18% higher among Asian Americans, 66% higher among Hispanics and 77% higher among African-Americans.

Emerging areas of research

Scientists are actively studying a wide range of health problems that may be linked to the overconsumption of added sugars, including the following:

- Cancer: High intakes of sugars and refined carbohydrates have been linked to increased risk of some cancers, as well as to higher rates of recurrence and lower rates of survival after cancer therapy.^11,12

 - Alzheimer's disease and memory loss: Excess sugar consumption was linked to deficiencies in memory and overall cognitive health.^13,14

 - Aging: Scientists have observed links between sugar consumption and the aging of our cells, as well as skin wrinkling. ^23,15,16

While it is still too soon to confirm whether these are also linked to the overconsumption of added sugars, new findings are being published all the time. Stay tuned to SugarScience for the latest research as it emerges.

• ^[1]Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., & Ahn, S.Y. (2013). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet , 380(9859), 2095-2128. Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961728-0/abstract
• ^[2]Sarafidis, P.A., & Nilsson, P.M. (2006). The metabolic syndrome: a glance at its history. Journal of Hypertension , 24(4), 621-626. doi:10.1097/01.hjh.0000217840.26971.b6. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16531786
• ^[3](2001). Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA: The Journal of the American Medical Association , 285(19), 2486-2497. Retrieved from http://circ.ahajournals.org/content/106/25/3143.long
• ^[4]Go, A.S., et al. (2014). AHA Statistical Update:Heart Disease and Stroke Statistics - 2014 Update: A Report From the American Heart Association . Circulation , 129, e28-e292. doi:10.1161/01.cir.0000441139.02102.80 . Retrieved from http://circ.ahajournals.org/content/129/3/e28.extract
• ^[5]Tadic, M., Ivanovic, B., Celic, V., & Cuspidi, C. (2013). Are the metabolic syndrome, blood pressure pattern, and their interaction responsible for the right ventricular remodeling?. Blood Pressure Monitoring , 18(4). doi:10.1097/MBP.0b013e3283631af4
• ^[6]Vyssoulis, G., Karpanou, E., Adamopoulos, D., Kyvelou, S.-M., Tzamou, V., Michaelidis, A., & Stefanadis, C. (2013). Metabolic syndrome and atrial fibrillation in patients with essential hypertension. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD , 23(2), 109-114. doi:10.1016/j.numecd.2011.03.011
• ^[7]Ben, Q., Xu, M., Ning, X., Liu, J., Hong, S., Huang, W., & Li, Z. (2011). Diabetes mellitus and risk of pancreatic cancer: A meta-analysis of cohort studies. European Journal of Cancer (Oxford, England : 1990) , 47(13), 1928-1937. doi:10.1016/j.ejca.2011.03.003. Retrieved from http://www.sciencedirect.com/science/article/pii/S095980491100147X
• ^[8]Aranceta Bartrina, J., & Perez Rodrigo, C. (2013). Association between sucrose intake and cancer: a review of the evidence. Nutr Hosp , 28(Suppl 4), 95-105. doi:10.3305/nh.2013.28.sup4.6802. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23834098
• ^[9]Garcia-Jimenez, C., Garcia-Martinez, J.M., Chocarro-Calvo, A., & De la Vieja, A. (2014). A new link between diabetes and cancer: enhanced WNT/beta-catenin signaling by high glucose. Journal of Molecular Endocrinology , 52(1). doi:10.1530/JME-13-0152
• ^[10]Linden, G.J., Linden, K., Yarnell, J., Evans, A., Kee, F., & Patterson, C.C. (2012, October). All-cause mortality and periodontitis in 60-70-year-old men: a prospective cohort study. J Clin Periodontol , 39(10), 940-6. doi:10.1111/j.1600-051X.2012.01923.x. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/22834905
• ^[11]Meyerhardt, J.A. (2013). The impact of glycemic levels in patients with colon cancer. Clinical advances in hematology & oncology , 11(2), 93-94.
• ^[12]Agrawal, R., & Gomez-Pinilla, F. (2012). The Journal of Physiology , 590(10), 2485-2499. doi:10.1113/jphysiol.2012.230078. Retrieved from http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.2012.230078/abstract
• ^[13]Crane, P.K., Walker, R., Hubbard, R.A., Li, G., Nathan, D.M., Zheng, H., & Larson, E.B. (2013, August 8). Glucose Levels and Risk of Dementia. New England Journal of Medicine , 369(6), 540-548. doi:10.1056/NEJMoa1215740. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa1215740
• ^[14]Cassidy, A., De Vivo, I., |Liu, Y., Han, J., Prescott, J., Rimm, D.J., & Hunter, E.B. (2010, March 10). Associations between diet, lifestyle factors, and telomere length in women. The American Journal of Clinical Nutrition , 91(5), 1273-1280. doi:10.3945/ajcn.2009.28947. Retrieved from http://ajcn.nutrition.org/content/91/5/1273
• ^[15]Danby, F.W. (2010, July). Nutrition and aging skin: sugar and glycation. Clinics in Dermatology , 28(4), 409-411. doi:10.1016/j.clindermatol.2010.03.018. Retrieved from http://www.sciencedirect.com/science/article/pii/S0738081X10000428
• ^[16]Mikulikova, K., Eckhardt, A., Kunes, J., Zicha, J., & Miksik, I. (2008). Advanced glycation end-product pentosidine accumulates in various tissues of rats with high fructose intake. Physiological Research / Academia Scientiarum Bohemoslovaca , 57(1).