Sugar Consumption And Its Relationship With Heart Disease: An Evidence-Based Analysis

Mechanisms of Sugar’s Negative Impact on Cardiovascular Health

Discuss about the Understand The Relationship Between Blood Glucose Level Of Individuals And The Risk Of Suffering Heart Diseases.

Considerable research has been undertaken in the recent past to understand the relationship between blood glucose level of individuals and the risk of suffering heart diseases. It has been well known that increased consumption has a detrimental impact on the health of individuals, and the direct link with heart disease has gained more attention in the medical field. Numerous studies have claimed that individuals suffering from high blood glucose level due to increased sugar consumption are at more risk of cardiovascular disease as the same is a predictor of atherosclerosis. The underlying principle is that sugar is a carbohydrate providing energy to the body with no other additional nutritional benefits. The present paper evaluates the claim that ‘sugar causes heart disease’ and builds an evidence based argument. The analysis is done on the basis of empirical evidence gathered through research of suitable articles. Research conducted in the past ten years have been included for this paper to make it up-to-date and noteworthy.

A close association between diabetes and cardiovascular disease was pointed out by Leon and Maddox (2015). Factors that act as the risk driving ones for cardiovascular disease like obesity, hypertension and dyslipidemia are mostly to occur in individuals who suffer from diabetes mellitus, thus increasing the risk for cardiac events. Higher level of free fatty-acid release present in insulin-resistant fat cells is the underlying mechanism. Increased free-fatty acid level are responsible for promoting triglyceride production, thereby stimulating the secretion of apolipoprotein B (ApoB) and very LDL (VLDL) cholesterol. Augmented levels of both of these are associated with chances of developing CVD. In case of diabetic patients, renal cells are known to get stimulated through hyperglycemia, becoming the cause of release of cytokine, humoral mediators and growth factors. This change is thereby known to lead to alterations in structural bodies in the glomeruli such as including hyaline arteriolosclerosis. The changes are responsible for increasing filtration pressure and renin-angiotensin system (RAAS). Chronic activation progresses to hypertension, and subsequently cardiovascular conditions.

Szablewski (2016) studied diabetic heart condition and realized that type 1 diabetes brings changes in the expression and translocationof GLUT4 and GLUT8 in the atria which are glucose transport proteins. In patients with diabetic atria, there is a deregulation of the content of the cell surface of the transporters. There is an increase in the expression of SGLT1 with end-stage cardiomyopathy secondary to type 2 diabetes. The research by von Haeling (2016) brought into limelight that diabetes and heart failure are interlinked. The mechanisms for the influence of high blood sugar level include atherosclerosis, increased lipid accumulation and oxidative stress, altered insulin signaling and mitochondrial dysfunction in the myocardium. Shah et al., (2015) had mentioned some of the pivotal cardiovascular outcomes for type 2 diabetes. These were heart failure, peripheral arterial disease, abdominal aortic aneurysm, and ventricular arrhythmias. Another study in this topic is that of de Mattos Matheus et al., (2013). The review paper mentioned that cardiovascular disease is more prominent in those having obesity and poor glycemic control. The proposed mechanisms that support the accelerated risk of atherosclerosis in diabetic patients revolve around epigenetic factors that lead to interactions between the environment and the genes of the individual.

Economic and Health Benefits of Decreasing Sugar Intake

Al-Nozha et al., (2016) published a valuable research on relationship between diabetes mellitus and coronary artery disease. Patients with diabetes present with lipid-rich atherosclerotic plaques, and the chances of these to rupture is more in such individuals as compared to those who are not diabetic. In diabetic patients, there is increased thrombus formation, a result of blood coagulability and platelet activation.

According to Huang et al., (2013) habitual consumption of sugar-sweetened beverages (SSB) has a detrimental impact on the human body, such as obesity, diabetes, hypertension, stroke and metabolic syndrome. The researchers carried out a meta-analysis with research studies assessing the relationship between the consumption of such beverages and risk of cardiovascular heart disease (CHD). Four prospective studies were considered for the analysis comprising of 7396 cases of CHD. The relative risks for CHD in the highest category of SSB consumption as compared to the lowest category was 1.17. Further, a one-serving per day increase in the SSB consumption had a link with 16% increase in the risk of CHD. The mechanisms this negative impact was well explained. High content of carbohydrate leads to high glycemic load and increased inflammation. High level of inflammatory factors leads to the higher chances of developing metabolic disorders, contributing to atherosclerosis and thus higher risk of CHD. Ma et al., (2015) highlighted that regular sugar-sweetened beverage consumption was associated with greater risk of fatty liver disease, which increased the risk of heart disease and type 2 diabetes.

In this regard Colchero et al., (2015) highlighted that there are myriad of studies suggesting that added sugars present in commonly consumed beverages are responsible for cardiometabolic concerns. The issue that arises is that sugar adds to the high inflammation of the arterial walls through generation of an insulin spike. In case the insulin spikes are in function in a continuous manner, the endothelial linings of blood vessels are rapidly ravaged. In case there is much damage to the endothelial linings, the chances of heart disease increases. Stroke and heart attack are the commonly occurring complications in individuals. The other issue is that increased sugar consumption is a driving factor for excessive weight gain. Weight gain, and sustained high insulin levels, can be linked with insulin resistance and diabetes, increasing the of cardiovascular disease.

As cited by Huang et al., (2013) fructose consumption impairs glucose metabolism and decreases insulin sensitivity. Further, fructose increases the uric acid level in the body, which acts as a risk factor for CHD. Ma et al., (2015) also pointed out that high fructose or sucrose corn syrup leads to development of fatty liver diseases.

The Need for Countries to Impose Sugar Control Policies

Effect of sucrose on the elevation of serum cholesterol level and elevation of serum triglyceride level

As highlighted by Kearns et al., (2016) early signs of coronary heart disease (CHD) have a link with sugar intake, particularly sucrose. Analyzing the Sugar Research Foundation (SRF) internal documents, statements and reports, it was found that sucrose contributes to elevation of serum cholesterol level and elevation of serum triglyceride level. Evidence is present to prove that a low-fat diet with high sugar content holds the potential to elevate the level of cholesterol. Studies were also mentioned that indicated that sucrose could aggravate carbohydrate-induced hypertriglyceridemia in more degree as compared to starches. While previous research was thought only to be theoretical, due to lack of studies, recent research is strengthening the evidence pool. The biological plausibility of sucrose having an impact on serum cholesterol is affected through the changes made to the intestinal microbiome. Further, fructose which is an element present in sucrose, affects the serum triglyceride level through lipogenesis carried out endogenously in adipose tissue, liver and some other human organs

Vreman et al., (2017) studied the economic and health benefits individuals gain when they of reduce sugar intake including the influence made through non-alcoholic fatty liver disease. A microsimulation model with Markov chains for NAFLD (including steatosis, non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma (HCC)), body mass index, T2D and CHD was constructed. The article has mentioned that a decrease in prevalence and incidence of heart disease is possible through control of sugar intake. Averted costs can be controlled in this regard and this is the main economic benefit. Disease attributable disability-adjusted life years (DALYs) could also be controlled to a significant extent when sugar intake was reduced by 50%.

Huang et al., (2018) highlighted that suboptimal diet is a reason behind economic burden through cardiometabolic diseases. Recent proposals to bring changes in the dietary polices have given increased attention to reformulation of food products. Recommendations have been put forward to include taxes on SSBs at different levels. Effectiveness of interventions related to tax polices has been indicated by Colchera et al., (2015) who concluded from their study that tax on SSBs lead to considerable reductions in the rate of purchasing taxed beverages. There is a need of monitoring such changes for understanding the potential impact and health implications on the longer term.

Conclusion

The present study established the argument that there exists a direct link between sugar consumption and increased risk of suffering poor heart conditions. The mechanism by which sugar has a deep impact on the cardiovascular health is well understood. It is to be mentioned in here that countries across the globe including Australia must levy sugar control policies and promulgate them in local and state venues. As the risk of cardiovascular heart disease is consistent across populations, the health consequences of sugar consumption are to be further assessed. The health departments must be ensuring that risk of heart diseases is under evaluation in risk assessments of increased sugar consumption. Research is required to understand the impact of sugar on multiple biomarkers of heart disease and development of such diseases. Committees for policymaking must also consider giving decreased importance to the studies that are funded by the food industry.

References

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