A recent study suggests that the type of sugary indulgence you opt for might influence its impact on your health. According to the lead researcher, Suzanne Janzi, a doctoral candidate in nutritional epidemiology at Lund University in Sweden, sugar-laden beverages appear to pose a greater risk for cardiovascular disease compared to desserts like baked goods.

The study, published in the Frontiers in Public Health journal, canvassed the dietary and lifestyle habits of nearly 70,000 Swedish men and women from 1997 to 2009. Data on their cardiovascular disease occurrences, including strokes, heart attacks, and heart failures, were gathered from national health registries up until 2019.

The researchers examined sugar intake across three categories: sugar-sweetened beverages, sweet baked goods, and sweeteners such as honey or sugar added to beverages like tea or coffee. They discovered that individuals who consumed sweet drinks—encompassing all sodas and non-pure fruit juices—had a higher risk of heart disease than those who indulged more in baked treats. Interestingly, participants with the lowest sugar intake did not exhibit the lowest risk of heart disease, as Janzi pointed out. It's important to note that the study's observational nature means that while correlations were identified, it cannot be conclusively stated that sugar consumption patterns directly caused the varying heart disease rates. The researchers did, however, control for other factors that could influence these associations, such as age, gender, alcohol consumption, smoking status, physical activity level, and body mass index (BMI). There may still be unaccounted factors in their analysis, Janzi added.

The study's findings are also constrained by the demographic of the population studied, which is predominantly of European descent, as noted by Dr. Robert Eckel, a professor emeritus of medicine at the University of Colorado Anschutz medical campus and a former president of the American Heart Association. Janzi suggests that external factors might account for the link between low added sugar intake and increased cardiovascular risk, as there are no biological mechanisms to support this association. "One hypothesis is that individuals with very low sugar intake might be substituting sugar with other unhealthy foods or nutrients," she elaborated. It's also possible that those who severely restrict their sugar intake do so due to a pre-existing health condition, or that they follow very restrictive diets that fail to provide all the necessary nutrients.

Janzi also highlighted a Swedish social custom known as "fika," where people come together for coffee and pastries. "This tradition is so deeply ingrained in Swedish society that many workplaces have scheduled 'fika breaks' daily," Janzi said. "It's plausible that the enjoyment of treats during these social interactions is strongly connected to social relationships, which have been previously associated with cardiovascular health." However, the connection between low sugar intake and higher cardiovascular risk warrants further investigation, she stated.

There are biological theories that explain why sugary drinks are more strongly associated with heart disease than pastries, according to Janzi. "Liquid sugars are absorbed more quickly in the digestive system as they do not require the same breakdown processes as solid foods," she explained. "Solid sugars are often part of foods that contain other nutrients such as fiber, proteins, and fats." These nutrients slow down digestion, leading to a more gradual release of sugar into the bloodstream, Janzi continued. While fats, fiber, and proteins in solid food can keep you feeling full for longer, liquid sugars often fail to satiate the appetite, potentially leading to appetite dysregulation and excessive calorie consumption, she added. "Different sources of added sugars also have varying consumption patterns, which could further explain why they associate differently with cardiovascular disease risk," Janzi noted.

The study indicates that it's not necessary to eliminate all sugar to prevent cardiovascular disease, Janzi said. "We all enjoy a dessert," Eckel concurred. "Should we forgo birthday cake and ice cream when celebrating with our children?" However, most Americans likely consume too much added sugar, and reducing sugary drinks is a good place to start, he suggested. The American Heart Association advises no more than 6 teaspoons of added sugar per day for women and 9 for men. A sustainable reduction might involve taking steps to decrease your sugar intake gradually rather than abstaining completely. "Reduce by one serving per day until you're down to one drink per day," registered dietitian and contributor Lisa Drayer advised in a previous article. "Then aim for one every other day until you can phase out soft drinks entirely. 'Alternating with seltzer/sparkling water can help you cut back,' she added. 'Eventually, you can replace soft drinks with seltzer or sparkling water if you crave carbonation.'"