Sugar Reduction Could Save Lives, Study Shows


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Key Takeaways

  • Consuming too much sugar could be detrimental to health goals.
  • A new simulation study found that cutting sugar intake could prevent 2.48 million cardiovascular disease (CVD) events, almost 0.5 million CVD deaths, and save $160.88 billion in net costs.
  • While individuals can choose to limit high-sugar products, change is also needed with government regulations of food manufacturers to reduce sugar intake for all Americans.

Americans consume about 17 teaspoons of added sugars per day, which increases the risk of cardiovascular disease. A new simulation study published in Circulation shared a model of how reducing sugar may help protect the health of Americans.

A high intake of added sugar is linked to an increased risk of developing cardiometabolic diseases such as type 2 diabetes and cardiovascular disease (CVD), with the worst risk for those in lower-income brackets. Plus, CVD is estimated to cost the nation up to $318 billion and is a leading cause of mortality.

“Sugar consumption impacts the risk for heart disease,” says Lisa Andrews, MEd, RD, LD, owner of Sound Bites Nutrition. “Too much sugar can make arteries sticky, leading to plaque deposition.”

About the Study

In this study, researchers used a microsimulation model to estimate changes in type 2 diabetes, CVD, quality-adjusted life-years (QALYs), and cost-effectiveness of the U.S. National Salt and Sugar Reduction Initiative (NSSRI). A simulated nationally representative U.S. population was created and findings were evaluated over a 10-year span and over a lifetime.

Lisa Andrews, MEd, RD, LD

Sugar consumption impacts the risk for heart disease. Too much sugar can make arteries sticky, leading to plaque deposition.

— Lisa Andrews, MEd, RD, LD

Based on the modeling, the researchers estimated that achieving the NSSRI sugar reduction targets could:

  • Prevent 2.48 million CVD events
  • Prevent 0.49 million CVD deaths
  • Prevent 0.75 million diabetes cases
  • Gain 6.67 million QALYs
  • Save $160.88 billion net costs from a societal perspective over a lifetime.

Importantly, the policy could also reduce disparities. The greatest estimated health gains per million adults were among Black and Hispanic, lower-income, and less-educated Americans.

Sugar Reduction Initiatives

Most of the added sugar in the diet comes from packaged and commercially produced foods. The biggest contributor is sugar-sweetened beverages, such as soda. With this statistic in mind, it is clear that food manufacturers play a major role in any sugar reduction strategy.

In 2018, the U.S. NSSRI proposed voluntary national sugar reduction targets. The hope is that the food industry will implement a gradual reformulation of sweet foods and beverages.

The objective is to “promote voluntary, gradual, achievable, meaningful, and measurable reductions in sugar content in packaged foods and beverages.” The proposal laid out 13 food and beverage categories that could benefit from a 10% to 40% sugar reduction, including sugary drinks, cakes, cookies, candies, cereals, and chocolate.

This initiative also contains a second part that helps people remain accountable for their own sugar intake. It also suggests ways to help Americans reduce sugar consumption.

Reducing Sugar for the Population

Americans eat a lot of sweet foods, which are tasty, readily available, and convenient. But this pattern can come with both long-term health costs and financial costs. While everyone is accountable for their own healthcare and nutrition decisions, it is hard to resist sweets that are heavily marketed, ubiquitous, and great-tasting.

“The food industry has a huge role in reducing sugar intake in Americans' diets, and it mostly comes down to ethics,” says dietitian Erin Pettygrove, RDN, CSCS. “The reason sugar intake has increased so much in the last 50 to 100 years is almost entirely due to availability and marketing. It is important for food companies to focus not only on profits but also on the health of their consumers."

Plus, if the government mandates that food companies reduce sugar in their products, consumers may gradually eat less sugar and be less likely to suffer chronic health conditions, Andrews adds. In 2015, the FDA mandated the removal of partially hydrogenated oils (PHOs - a source of artificial trans fats) in food.

"I see sugar reduction as equally important," Andrews says.

Erin Pettygrove, RDN, CSCS

The food industry has a huge role in reducing sugar intake in Americans diets, and it mostly comes down to ethics.

— Erin Pettygrove, RDN, CSCS

How to Limit Sugar Intake

While the food industry needs to play a role in reducing sugar at a population level, there are also some things you can do to lower your own sugar intake.

“Kick the can,” says Andrews. “Sweetened drinks are one of the biggest contributors to sugar intake. Swap them out with flavored seltzer water or unsweetened tea.”

You should aim to eliminate or greatly reduce (less than 1 serving per week) soda or other sweetened beverages, such as iced tea, sugary cocktails, and fancy blended coffee drinks, suggests Pettygrove.

You also should get adequate sleep, Andrews adds. Lack of sleep can raise cortisol levels, which may increase cravings. Finally, she says to read labels for added sugar content.

“Every 4 grams of added sugar equals 1 teaspoon per serving,” says Andrews.

How Much Sugar Is Too Much?

The 2020 U.S. Dietary Guidelines advise Americans to eat less than 10% of total calories from added sugar, Andrews says.

“This equates to roughly 50 grams per day on a 2,000 calorie diet, or 12 ½ teaspoons of added sugar,” she says. “For those eating less than 2,000 calories daily, the recommendation would be for even less sugar.”

The American Heart Association (AHA) has even stricter sugar reduction guidelines to help prevent heart disease. Pettygrove says the AHA guidelines are as follows:

  • Men should consume no more than 9 teaspoons (36 grams or 150 calories) of added sugar per day.
  • For women, the number is lower. They should only eat 6 teaspoons (25 grams or 100 calories) per day. 

Added sugar does not include sugar from fruit and milk, which is considered naturally occurring. Instead, added sugar includes any sweetener (as well as syrup and honey) added to foods and beverages.

“It's important to note that this is different from total sugar intake, which can come from foods like fruit and dairy, which provide many beneficial nutrients as well,” says Pettygrove.

What This Means For You

While the government may eventually request voluntary sugar reduction for the food industry, there are things you can do now to reduce your sugar intake. Your best bet is to limit sugar-sweetened drinks like soda and fruit drinks and replace them with flavored seltzers, unsweetened tea, or even water. You can also limit your intake of sweets such as candy, chocolate, and baked goods, and enjoy them as occasional treats. If you are uncertain how best to go about reducing sugar, talk to a healthcare provider or a dietitian.

10 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Get the facts: Added sugars.

  2. Shangguan S, Mozaffarian D, Sy S, et al. Health impact and cost-effectiveness of achieving the National Salt and Sugar Reduction Initiative voluntary sugar reduction targets in the United States: a micro-simulation study. Circulation. 2021. doi:10.1161/CIRCULATIONAHA.121.053678

  3. Micha R, Peñalvo JL, Cudhea F, Imamura F, Rehm CD, Mozaffarian D. Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States. JAMA. 2017;317(9):912-924. doi:10.1001/jama.2017.0947

  4. Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation. 2019;139(10):e56-e528. doi:10.1161/CIR.0000000000000659

  5. Food Navigator-USA. What are the biggest contributors of added sugar to the US diet?

  6. New York City Health Department. Preliminary voluntary sugar reduction targets from the National Salt and Sugar Reduction Initiative.

  7. U.S. Food & Drug Administration. Trans fat.

  8. Cleveland Clinic. Here's the deal with your junk food cravings.

  9. USDA. Dietary Guidelines for Americans 2020-2025.

  10. American Heart Association. Added Sugars.

By Cara Rosenbloom, RD
 Cara Rosenbloom RD is a dietitian, journalist, book author, and the founder of Words to Eat By, a nutrition communications company in Toronto, ON.