Added sugar intake and its associations with incidence of cardiovascular disease

Paradoxical findings on treats vs beverages

• Thread centers on the study’s headline result: sweetened beverages correlate with higher CVD risk, while low intake of “treats” (pastries, ice cream, chocolate, sweets) correlates with higher risk.
• Some commenters jokingly celebrate this as validation of pastry/ice-cream habits, but most treat it as suspicious or confounded.

Reverse causality and confounding

• Strong theme: people with existing disease or known high risk may drastically cut treats and sugar, overpopulating the “lowest intake” category.
• Even after exclusion of previously diagnosed individuals, commenters note this doesn’t remove those aware of high risk (family history, abnormal labs).
• Others point out that very low intake of many substances often reflects underlying ill health in observational studies (e.g., alcohol).

Cultural and cohort specifics (Sweden)

• Swedish practices like “fika” (social coffee + pastry) and once‑weekly candy (“Saturday candy”) may make treats a proxy for social integration rather than unhealthy lifestyle.
• Some argue Swedish diet and food culture have become more Americanized and ultra‑processed since the 1990s–2000s, complicating interpretation over time.

Sugar type, medium, and metabolism

• Long debate over whether HFCS is worse than sucrose; some say composition is similar, others emphasize fructose metabolism and potential harms.
• Several note that “medium matters”: soda is fast-absorbed sugar water, while pastries/ice cream pair sugar with fat and/or fiber, slowing absorption and altering glycemic response.
• Distinction made between added sugars and naturally occurring sugars in whole fruit (with fiber and micronutrients).

Methodological limits of the study

• Critiques of food‑frequency questionnaires: recall bias, social desirability (“moralizing” food), poor quantity estimates, old baseline data.
• Concerns about unmeasured confounders (body fat %, sodium, overall diet quality, social factors) and that results may not generalize beyond this Swedish cohort.

Broader views on sugar and health

• Many still favor minimizing added sugar for reasons beyond CVD (energy stability, dental health, liver effects, metabolic disease).
• Others caution against over-focusing on sugar type vs overall dietary pattern and ultra‑processed foods.

Calories, weight, and metabolism

• Side debate on “calories in vs calories out” versus more complex influences (medications, aging, microbiome, macronutrient composition).
• Some insist energy balance fully governs weight; others stress that different foods with the same labeled calories can have different metabolic and satiety effects.

Practical diet observations

• Several share strategies of removing “hidden” sugar (e.g., in peanut butter, mayonnaise), preferring minimally processed foods.
• Discussion of how ubiquitous sugary, ultra‑processed options (school meals, offices, highways) make low‑sugar eating difficult in practice.