Added sugar intake and its associations with incidence of cardiovascular disease
New research on added sugar intake and cardiovascular disease finds that sugary drinks are linked to higher risk, while pastries, ice cream, chocolate and other “treats” show a surprising negative association with several heart-related outcomes. Commenters probe possible explanations including reverse causality (sick or high‑risk people cutting sugar), cultural patterns in Sweden such as social “fika” with pastries, and the role of fat and food structure in moderating sugar absorption. The thread broadens into debates over whether all calories are equivalent, how fructose and high-fructose corn syrup compare to other sugars, and how much observational nutrition data can really tell us about cause and effect.
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.