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Heart Group: Limit Added Sugars in Diet

American Heart Association Issues Guidelines on How Much Added Sugar Is Too Much

By Miranda Hitti
WebMD Health News

Reviewed By Louise Chang, MD

Aug. 24, 2009 -- The American Heart Association today released new recommendations on limiting intake of added dietary sugars.

Back in 2006, the American Heart Association (AHA) recommended minimizing consumption of beverages and foods with added sugars.

Now, the AHA is getting more specific, with recommendations detailed down to the teaspoon based on a person's age, sex, and activity level.

In its statement, published online in the journal Circulation, the AHA states that "excessive consumption of sugars has been linked with several metabolic abnormalities and adverse health conditions, as well as shortfalls of essential nutrients."

The sugar industry takes issue with the AHA's paper. In a statement emailed to WebMD, the Sugar Association says that the AHA's emphasis on sugary foods is "misplaced" and "may have unforeseen detrimental consequences."

Added Sugar Guidelines

How much added sugar does the AHA suggest? Maybe less than you get on a typical day.

The AHA's new guidelines depend upon a person's "discretionary calories" -- their calorie budget beyond what they need to run their bodies without overindulging. Your discretionary calorie allowance depends on your age, sex, and activity level.

"Most American women should eat or drink no more than 100 calories per day from added sugars, and most American men should eat or drink no more than 150 calories per day from added sugars," states the AHA.

The AHA's paper includes examples of upper limits on added sugars for various groups of adults, but not for children. Here are those examples:

  • Active man aged 21-25: up to 18 teaspoons (288 calories)
  • Sedentary man aged 46-50: up to 9 teaspoons (144 calories)
  • Moderately active woman aged 51-55: up to 5 teaspoons (80 calories)
  • Sedentary woman aged 71-75: up to 3 teaspoons (48 calories)

The AHA notes that one 12-ounce can of cola contains about 8 teaspoons of sugar, or about 130 calories. That's more than the AHA suggests for a moderately active woman in her early 50s.

The AHA's new guidelines don't include sugar found naturally in fruits, vegetables, whole grains, or milk. By "added sugars," the AHA means sugars that you add to food yourself, and also to sugars and syrups used to make foods or drinks.

The experts who wrote the new guidelines aren't against sugars. They write that sugars are found naturally in many healthy foods, and that adding sugars to foods makes them tastier. Their point is about overdoing it.

"Deleterious health effects may occur when sugars are consumed in large amounts," write the AHA panelists, who included Rachel Johnson, PhD, MPH, RD, of the University of Vermont.

Johnson's team is talking about extra weight and its health risks, effects on metabolism, and missing out on nutrients that may be lacking in sugary fare.

Cutting Back on Added Sugars

Added sugars may be more common than you think, notes Kathleen Zelman, MPH, RD, LD, WebMD's director of nutrition.

"Most people are aware of the sugar they add to their coffee and when they eat sweet treats, but beyond sweetened drinks and treats, it is used extensively in our food supply in foods like bread and ketchup," Zelman writes in an email. "Become a label reader and check out the list of ingredients in search of foods with added sugars."

Drinks are another source of added sugar. "One of the easiest ways to cut back on added sugars is to curtail your consumption of sweetened beverages like soft drinks, sweet tea, alcoholic mixers, and juice drinks," says Zelman, noting that other drink choices include water, diet drinks, 100% fruit juice, and nonfat milk.

Zelman notes that limiting added sugars to 100-150 calories is roughly equal to "one soft drink, a small candy bar, a few plain cookies, or a small portion of light ice cream or frozen yogurt."

Industry Responds

In a statement emailed to WebMD, the Sugar Association says it is "very disappointed that a premier health organization such as the [AHA] would issue a scientific statement titled 'Dietary Sugars Intake and Cardiovascular Health' without a higher standard of evidence to support its contentions and therefore mislead the average consumer."

The Sugar Association notes that "simply reducing sugars in the diet, as this paper contends, is counterproductive if a reduction in total caloric intake is not achieved ... If one consumes more calories -- no matter the source -- than one burns, weight gain is inevitable."

The Sugar Association also states that "every major systematic review of the body of scientific evidence exonerates sugar as the cause of any lifestyle disease, including heart disease and obesity." And the association argues that other organizations -- including the European Food Safety Authority and an expert panel convened by the Institute of Medicine in 2002 -- declined to set an upper limit for total or added sugars.

The Corn Refiners Association -- the national trade group for the U.S. corn refining industry, which makes corn sweeteners including high-fructose corn syrup -- also issued a response to the AHA's guidelines.

In a statement emailed to WebMD, the Corn Refiners Association states that "sweeteners are found in many foods, and when consumed in moderation, often serve a useful role in making nutrient-rich foods, like yogurt and flavored milk, palatable. Like all sugars, high fructose corn syrup should be enjoyed in moderation as part of a balanced diet."

SOURCES: Johnson, R. Circulation, Aug. 24, 2009; online edition. Kathleen Zelman, MPH, RD, LD, director of nutrition, WebMD. Sugar Association. Corn Refiners Association.

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