How Sugar Impacts Cardiac Health

How Sugar Impacts Cardiac Health
 

ABSTRACT

The overconsumption of sugar is now established to be an independent cardiovascular disease (CVD) risk factor. This article explains the pathophysiological pathways by which increased consumption of sugar is implicated in cardiovascular disease through obesity, insulin resistance, dyslipidemia, and hypertension. It discusses in greater detail the role of sugar in lipid metabolism and in metabolic syndrome and endothelial dysfunction, and preventive measures in public health to avoid these risks. As consumption of added sugars is increasingly rising worldwide, these pathways should be known to avoid cardiovascular disease.

 

The consumption of sugar is an emerging cardiovascular disease (CVD) risk factor. This paper is following an etiologically related physiological substrate for cardiac disease in the form of obesity, insulin resistance, dyslipidemia, and hypertension. This article is discussing about sugar in metabolic syndrome and lipid metabolism, endothelial dysfunction brought about by consumption of sugar, and reducing risk through public policy. As consumption of added sugar is increasingly rising globally, awareness about these impacts can avoid cardiovascular diseases.

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Keywords

sugar, cardiovascular disease, metabolism, inflammation, insulin resistance
 

I. Introduction

Cardiovascular disease (CVD) is presently the leading cause of mortality worldwide with >37% mortality in the United States.9 The pathophysiology is multifactorial with diverse pathophysiological pathways contributing to pathogenesis. Evidence is accumulating regarding diet influencing increased incidence of CVD with particular emphasis in relation to added consumption of sugar. Dietary sugars have been implicated in several cardiovascular disease risk factors including obesity, dyslipidemia and metabolic syndrome. We present an overview of current literature regarding consumption of sugar and cardiovascular disease with particular emphasis upon metabolic pathways, clinical outcomes, and implications in public health.

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II. Sugar Consumption and Cardiovascular Risk
 

2.1 Pathophysiology of Sugar and the Heart

The overconsumption of sugar has negative impacts upon cardiovascular health through an intricate interplay of various metabolic pathways. Hyperconsumption has been strongly related to an increased prevalence of numerous major cardiovascular disease (CVD) risk factors in the forms of hypertension, dyslipidemia, obesity, and type 2 diabetes. All these diseases have been consistently revealed to have an established connection to overconsumption of sugar in various scientific studies.

 

It has been established through epidemiological studies that added sugar consumption is a key determinant in increased rates of obesity and diabetes prevalence, both in turn contributing to cardiovascular vulnerability. One of the pathways through which these impacts act is in fructose and glucose metabolism by the body. While glucose can be metabolized to provide instant energy needs, fructose is metabolized predominantly in the liver to yield triglycerides and fatty acids. This leads to augmented deposits in fats causing visceral fat accumulation and development of insulin resistance. Chronic insulin resistance ultimately interferes with glucose metabolism, leads to ongoing inflammation, and amplifies cardiovascular complication vulnerability to metabolic syndrome.

 

In consideration of the established connection between added sugar consumption in greater amounts and undesirable metabolic results, reducing added sugar consumption is a key component in programs to prevent obesity incidence, diabetes, and cardiovascular illness. Dietary programs to reduce added sugar consumption in sweetened beverages and processed meals can be an effective way to prevent these cardiovascular threats in the long term.​

 

2.2 Obesity, Metabolic Syndrome, and Cardiovascular Disease

It is generally known that obesity is an established cardiovascular disease risk factor, and extensive scientific documents have elaborated upon its strong connection to overconsumption of added sugars. Consuming added sugars in excess in the form of sugar sweetened beverages (SSBs) has been implicated in causing body weight gain, insulin resistance, and dysregulation in metabolism leading to cardiovascular complication. Systematic review and meta-analysis carried out to establish the effect of added sugar consumption on body weight indicated that those who actively reduced added consumption decreased body weight by an average of approximately 0.8 kg. On the contrary, those who increased added consumption gained an average body weight of approximately 0.75 kg, giving clear indication of body weight regulation following added consumption. Among dietary sources of added sugars, added sugars in SSBs have been particularly regarded with suspicion because these have been implicated in high caloric content, little effect in suppressing appetite (satiety effect), and negative associations with unfavorable metabolic outcomes. Consuming these products regularly has been implicated in obesity development, development of metabolic syndrome, and development of type 2 diabetes, both of which are major contributors to cardiovascular disease. Addressing overconsumption of added sugars, particularly in SSBs, is thus an imperative part in reducing obesity rates in order to counter related cardiovascular disease threats.

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​2.3 Sugar and Lipid Metabolism

Diets rich in added sugars have an intense impact upon lipid metabolism to result in an increased cardiovascular disease risk. Consumption of added sugars in high quantity has been shown to elevate concentration of low-density lipoprotein (LDL) cholesterol, otherwise referred to simply as "bad" cholesterol, while rising in proportion to an increased concentration of triglycerides. This is done in tandem while causing decreased concentration of high-density lipoprotein (HDL) cholesterol to aid in body cholesterol removal in excess. Among dietary sources of sugars, fructose has been implicated to have especially detrimental effects owing to its unique metabolic effects. Unlike glucose, fructose has been shown to cause an inferior response to insulin to disrupt regular glucose regulation and lead to development of insulin resistance. Furthermore, processing fructose in the body by the liver results in increased production of triglycerides to accelerate dyslipidemia—abnormal concentration of fats in the body. This dysregulation in body results in an accelerated process in developing atherosclerosis—fatty deposits accumulating in artery walls to result in increased cardiovascular attack and stroke. As these detrimental impacts have been confirmed, added sugars in dysregulation in this context emphasizes dietary management to decrease consumption of added sugars to alleviate cardiovascular risk.​

 

2.4 Hypertension and Sugar Intake

High consumption of sugar has been strongly related to raised blood pressure, an independent cardiovascular disease risk indicator. One of the most significant pathways through which this relationship exists is through the role that increased consumption of sugary products plays in producing insulin resistance, where body tissues respond to less insulin, causing changes in metabolism that lead to raised blood pressure. Additionally, increased consumption of sugary products has been shown to have an effect on sodium handling in the kidneys to worsen raised blood pressure by causing fluid volume to rise and vascular resistance to rise. In addition to influencing blood pressure regulation, increased consumption of sugary products has been shown to have an effect to cause raised arterial stiffness, an entity where decreased elasticity in arteries exists. Arteries with decreased elasticity impose greater stress upon the cardiovascular system to pump blood efficiently through the body while causing greater overall cardiovascular risk through greater hypertension. Long-term raised blood pressure over time significantly raises cardiovascular complication development through greater cardiovascular disease, including greater cardiac disease, greater incidence of stroke, and greater cardiac failure. As this powerful connection between increased consumption of sugary products and raised blood pressure exists, dietary ways to decrease added consumption of sugary products can be an effective way to reduce vascular disease while minimizing cardiovascular risk.

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2.5 Inflammation and Endothelial Dysfunction

Both systemic inflammation and oxidative stress have been confirmed to be key factors in cardiovascular disease development and exacerbation. Elevated consumption of added sugars has been confirmed to exacerbate these pathways through numerous pathways in glucose metabolism. Perhaps most significantly, increased added sugar consumption fuels systemic inflammation by leading to insulin resistance. As the body becomes increasingly non-responsive to insulin, this creates raised glucose in the blood, leading to an inflammatory response through increased production of pro-inflammatory cytokines.

 

Aside from this, greater consumption of added sugars has been revealed to rise lipid peroxidation in which free radicals attack fats to induce cellular damage through oxidative stress. This redox dysregulation fuels vascular inflammation and interferes with cardiovascular function in an unhealthy way to further elevate cardiovascular disease risk. Epidemiological studies consistently validate an augmented cardiovascular disease mortality risk among populations with increased added sugar consumption. Long-term trends suggest that consumers with high added sugar consumption have considerably increased rates of fatal cardiovascular outcomes in comparison to populations with lower added sugar consumption. As an established link is present between added sugar consumption, inflammation, and oxidative stress, dietary modifications favoring reduced added sugar consumption are an effective way to alleviate cardiovascular disease risk factors while optimizing cardiovascular health in general.

 

 

III. Discussion

The consequence of excessive consumption of sugar towards cardiovascular disease (CVD) is multidimensional in nature, representing an intricate interplay between various dysfunctions in metabolism. Strong correlations between rising consumption of sugar and key factors in CVD have been evidenced by an increasingly voluminous body of scientific work in obesity, hypertension, dyslipidemia, and type 2 diabetes. Sugar metabolism, particularly fructose consumption, is central to these ill outcomes. Unlike glucose to provide instant energy, fructose is metabolized in the liver to supply production of triglycerides, lipid deposits, and insulin resistance. All these dysregulations have an immense potential to result in augmented atherosclerosis and cardiovascular comorbidities.

 

The most notable among these is obesity and metabolic syndrome attributed to consumption of sugar-sweetened beverages (SSBs). Research has confirmed that overindulgence in added sugars in the form of SSBs leads to increased body weight since these products possess high caloric content but minimal to no value in bringing about fullness. Systematic review and meta-analysis have confirmed that decreased consumption of sugar brought about minimal body-weight reductions in individuals while increased consumption brought about increased body weights. This is an indication of the direct connection between consumption of sugar and body-weight management and eventually cardiovascular diseases.

 

Aside from this, overconsumption of sugar has powerful effects on lipid metabolism. Elevated consumption of sugar is correlated with raised LDL cholesterol and triglycerides and lowered HDL cholesterol, the latter being protective in cardiovascular diseases. Lipid balance is implicated in dyslipidemia, an obligatory etiology in atherosclerosis and cardiovascular disease. Additionally, fructose metabolism in the body potentiates lipid peroxidation, oxidative stress, and chronic inflammation, factors that speed vascular injury and endothelial dysfunction. Another major pathway through which consumption of sugar is implicated in CVD is through its effect on management of blood pressure. Consuming excessive amounts of sugar has been implicated in inducing hypertension through several pathways including insulin resistance, impaired sodium excretion by the kidneys, and increased artery rigidity. Persistent increased blood pressure significantly raises incidence rates of stroke, congestive heart failure, and cardiovascular comorbidities in general. As these outcomes suggest, dietary reductions in added consumption of sugar present an appropriate way to avoid hypertension and overall cardiovascular outcomes.

 

The role played by oxidative stress and inflammation in cardiovascular disease only serves to reinforce the danger of overconsumption of sugar. Systemic inflammation has been established to be stimulated by overconsumption of sugar by increased production of pro-inflammatory cytokines and increased oxidative stress leading to vascular dysfunction and increased cardiovascular mortality risk. Epidemiological proof always provides support to the connection between overconsumption of added sugar to increased cardiovascular mortality rates. This serves to reinforce the significance of public programs to reduce consumption to alleviate cardiovascular disease burden.

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IV. Conclusions

In conclusion, sugar overconsumption is an independent etiology of cardiovascular disease that has an effect on several pathways to increase the risk of dyslipidemia, obesity, type 2 diabetes, and hypertension. Liver fructose metabolism is to blame for inducing lipid accumulation, insulin resistance, and ongoing inflammation, which accelerate atherogenesis and cardiovascular diseases. Consumption of high amounts of sugar has been implicated in raised blood pressure and raised vascular stiffness, both of which increase cardiovascular risk.

 

The scientific proof is in support of reducing added sugars to have improved cardiovascular outcomes. Dietary interventions to especially reduce sweetened beverage consumption and processed meals can prevent obesity, metabolic syndrome, and diseases significantly. Education, regulation, and promotion through public policy to support healthier diets should be emphasized to balance the unfavorable impacts created by an overuse of sugar. Addressing this dietary determinant can prevent cardiovascular disease to an appreciable degree worldwide to have better overall health in future life.

 

 

 

V. References

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7. Tappy, L., & Rosset, R. (2017). Fructose metabolism and metabolic diseases: New findings, new questions. Nutrition, 34, 113–117.​​