In March 2015, the World Health Organization (WHO) released its new recommendations on guidelines for sugar intake in adults and children, stating that added sugar intake should be less than 10 percent of total daily calories.
In addition, WHO suggests that intake really should be further reduced to less than 5 percent to achieve the greatest benefit, due to the overwhelming evidence that consuming added sugars leads to health problems such as obesity and other noncommunicable diseases.
One reason sugar may be so detrimental to health is likely because of its ability to induce and promote inflammation throughout the body.1
Added Sugars At Issue
This doesn’t mean that eating fruits and vegetables or even drinking milk will cause health problems.
In this case, we are looking at added sugars not otherwise found in whole foods, fresh produce or fresh foods such as fish. Soda, cake, cookies, fruit juice, candy and other snacks with refined sugars are to blame.
Several studies have shown strong evidence linking a Western diet (high fat/carbohydrates, high salt and high animal protein) to an increase in systemic inflammation, which in turn increases one’s risk for chronic inflammatory and autoimmune diseases.2
Obesity, which the American Heart Association now considers a disease, is a state of chronic inflammation, which may be a reason why obesity has so many co-morbidities, such as metabolic disease, depression and cancer.3
There is a growing body of evidence suggesting that an intake of added sugars, particularly refined sucrose and fructose, contributes significantly to inflammation and exacerbates conditions such as cardiovascular disease.4
A recent review on cardiovascular disease suggests that an intake of processed foods, which tend to be the source of refined sugars, should be reduced or eliminated in the diet and that, specifically, a reduction of added sugar intake may attenuate symptoms or prevent cardiovascular disease as a whole.5
In another study, a low fructose diet has been shown to specifically reduce inflammation in patients with chronic kidney disease.6
Why Reduce Sugar Intake?
Although it is difficult to study carbohydrate-induced inflammation independent of weight gain, it appears that everyone may benefit from reducing overall added sugar intake, for two reasons.
First, a diet that is high in added sugars likely means that an individual is consuming too many processed foods and not enough whole foods.
Processed foods not only have added sugars, but they also often contain substances that are added as a preservative and/or to enhance color, flavor and texture.
In addition, the more processing or handling a product goes through before reaching your shelf, the more chance there is for exposure to harmful chemicals and substances that are either a by-product of processing or are from agricultural use and not necessarily meant for human consumption (e.g., pesticides, antibiotics, etc.).
This can be especially problematic for someone who is already overweight or obese, because some chemicals are not broken down so easily or at all in the body and can accumulate in adipose tissue.
Second, processed foods cannot replace whole foods and the nutritional content that whole foods provide.
Yes, most processed foods are fortified or enriched, but we cannot equate health to individual nutrients.
It is the combination and type of nutrients naturally found in whole foods that prevent diseases and help us live long, healthy lives.
We still don’t even know all the beneficial chemicals and molecules that plants contain. Although carbohydrates are present in whole food, such as potatoes, they will not cause the same inflammatory response as added/refined sugars because of the presence of other nutrients, such as fiber.
Consider the Mediterranean Diet
The Mediterranean diet has been studied extensively for its apparent ability to prevent and decrease risk of several diseases, including obesity, cancer, heart disease and diabetes.
More recently, the Mediterranean diet has been referred to as an anti-inflammatory diet, on the basis that reducing inflammation reduces risk of chronic diseases, promotes weight loss and improves overall health and well-being.
The Mediterranean diet is mostly free of added sugars, and the emphasis is on the intake of plants (fruit, vegetables, nuts, seeds, legumes, whole grains, plant oils, etc.), with some intake of seafood and even less intake of animal protein (meat, eggs and dairy).
The most important takeaway is that the Mediterranean diet represents a diverse intake of whole foods, free of added sugars, to ensure adequate intake of all essential vitamins and minerals, in addition to all the other beneficial enzymes and molecules found in plant-based foods.
No Time Like the Present
With this in mind, there is no better time than now to advise patients to begin cutting down on their refined/added sugar intake and increase fruit and vegetable consumption, regardless of their weight status.
Sugar-induced inflammation goes beyond obesity and is detrimental to health in every regard.
Reducing inflammation may prove to be the key to promoting a healthy weight, decreasing risk of chronic diseases and drastically improving overall quality of life.
1. World Health Organization. WHO calls on countries to reduce sugars intake among adults and children. Geneva, Switzerland: Author. March 4, 2015.
2. Riccio P, Rossano R. Nutrition facts in multiple sclerosis. ASN Neuro 2015;7. doi: 10.1177/1759091414568185.
3. Vieira-Potter VJ, et al. Exercise (and estrogen) make fat cells â€ ̃fit.â€TM Exerc Sport Sci Rev 2015;43:172-178.
4. Zagotta I, et al. Obesity and inflammation: Reduced cytokine expression due to resveratrol in a human in vitro model of inflamed adipose tissue. Front Pharmacol 2015;6:79.
5. DiNicolantonio JJ, Lucan SC. The wrong white crystals: Not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart 2014. doi: 10.1136/openhrt-2014-000167.
6. Brymora A, et al. Low-fructose diet lowers blood pressure and inflammation in patients with chronic kidney disease. Nephrol Dial Transplant 2012;27:608-612.