Does Sugar Cause Heart Disease?


Does sugar cause heart disease? Evidence points to it.

A study published in the Journal of the American Medical Association found highly positive and graded correlations between sugar intake and death from cardiovascular (heart) disease (CVD). Comparing quintiles (fifths) of sugar intake, the highest consumers had more than double the risk of dying from CVD.

In the highest consumers, who ate >25% of their calories as sugar, the risk nearly tripled. Those who consumed >10% but <25% of calories as sugar, had 30% increased risk of death.

Most adults that this study looked at, 71% of them, consumed more than 10% of calories as added sugar, and around 10% of them consumed more than 25% of calories as added sugar.

Pathetic. And we wonder why there’s an epidemic of heart disease – and obesity.

The results were adjusted for “sociodemographic, behavioral, and clinical characteristics”.

I believe that these heart disease risks may be underestimates, when you compare the risks to people who consume no sugar at all. Since over 70% of adults consume more than 10% of calories as sugar, people who eat zero sugar must be hard to find, at least enough for a study. (Maybe they could study Rogue Health and Fitness readers.)

How sugar causes heart disease


Dietary sugar is associated with hypertension – high blood pressure, and that’s independent of weight gain. This may occur due to high levels of insulin, with subsequent increase in body water. Insulin is an anti-diuretic: it increases the retention of fluid.

Salt is only minimally related to hypertension. The correlation between processed foods and hypertension arises not from salt, but sugar.

Increased triglycerides

Sugar causes levels of triglycerides to increase, and triglycerides are associated with CVD. Sugar also causes HDL cholesterol to drop. In truth, since we don’t believe in the lipid hypothesis of heart disease around here, those are probably just markers for increased insulin resistance.

Increased inflammation

Sugar increases the levels of inflammatory markers, which are associated with CVD.

Insulin resistance

It’s likely that all of the above mechanisms and effects are due to insulin resistance.

Sugar (sucrose) is a molecule made of a fructose and a glucose molecule linked together. Hence, sugar is 50% glucose, 50% fructose. High-fructose corn syrup, which is increasingly used in place of sugar, is 45% glucose and 55% fructose – it’s not that different.

Fructose seems to be the bad element here. A high intake of fructose leads to hyperlipidemia (high fat in the blood) and to insulin resistance.

Some time ago, Gerald Reaven, M.D., of Stanford University, studied a group of men and classified them according to tertiles (thirds) of insulin resistance. (I discussed that study here.) He then followed them for a number of years and looked at the type and number of diseases they got, including hypertension, CVD, diabetes, cancer, and stroke. Results are in the chart below.


In the lowest tertile of insulin resistance, no one got sick.

Those in the lowest third of insulin resistance remained perfectly healthy, those in the highest third developed all kinds of nasty things, and those in the middle had an amount in between the others.

This likely explains how and why sugar is associated with heart disease.



Added dietary sugar is associated with cardiovascular disease.

So don’t eat sugar.

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  1. charles grashow says:

    You said – “Added dietary sugar is associated with cardiovascular disease. So don’t eat sugar.”

    All sugar is not added sugar. So – do you mean ALL sugar, like fruit for example, or added sugar as in soda for example?

    • P. D. Mangan says:

      Sugar from fruit should be limited for anyone with health problems.

      • charles grashow says:

        From Dr Robert Lustig

        Q.A lot of the recipes in your book use fruit to add sweet flavors. Was this a way to limit refined sugar?

        A.Exactly. People always say to me, “What about fruit? It has sugar.” But I have nothing against fruit, because it comes with its inherent fiber, and fiber mitigates the negative effects. The way God made it, however much sugar is in a piece of fruit, there’s an equal amount of fiber to offset it.

        There’s only one notable exception: grapes. Grapes are just little bags of sugar. They don’t have enough fiber for the amount of sugar that’s in them. But I have nothing against real food, and that includes real fruit. Eat all the fruit you want. It’s only when you turn it into juice that I have a problem with it, because then it loses its fiber.

        SO – Lustig says “eat ALL the fruit you want!!

        • B says:

          dude. get out of here lol

        • P. D. Mangan says:

          I’m not Lustig.

          • Rob H says:

            My take on the fruit intake issue is that Dennis hit it on the head when he said ‘with health problems’ e.g. If you have body fat to lose, bloods out of whack etc. If you follow the advice on this website to the tee you should be able to get to a point after about 6 months where your insulin sensitivity is high enough to deal with fruit easily. By that point the balance has shifted to the point where you can derive more value from the polyphenols etc in the fruit versus the negative effect of the fructose – if you choose wisely for the most part and go for low fructose fruit. I have blueberries, apples and grapefruit each day for example.

          • P. D. Mangan says:

            Rob, thanks. I’ll repeat what I said on Twitter: I keep hearing “carbs and sugar aren’t so bad” – from jacked bodybuilders with <10% body fat. If you're one of them , great, go for it. If you need to lose weight, and 80% of Americans do, or if you have any sort of chronic health problem, best cut that stuff way back. Most fruit is just bags of sugar; I would say not just grapes like Lustig said. Apples taste like candy bars to me now.

          • Nick says:

            You know, ‘lustig’ is German for ‘funny’.

          • P. D. Mangan says:

            I would have guessed it meant “horny”.

          • Nick says:

            From German “die Lust”? Logical. Almost correct: “die Lust haben” is more or less “horny”. With the definitive article “die”.

            Without that, “Lust auf … haben” is more or less to have interest or enthusiasm for something. Like “a pill” and “the pill”, the definitive article implies a specific colloquial meaning.

            When I was new here, just learning the language, I mixed “Lust” and “die Lust” up in a discussion with the service guy at the car dealership. He politely ignored it.

            Back to nutrients. My normal carb intake is well below 100 g a day, more like 60. Except for the beer and wine. Then it more than doubles, so typically 125 g a day, which I know is still not a *lot*.

            Anyway, my question is, if I go on a bender –like I will nearly 5 days next week at a huge beer fest and pub-crawl in England– and eat whatever I can get my hands on (burgers, sandwiches, probably some taters), how far will that set me back when I come back home? I mean, how long does it typically take one’s metabolism to return to a carb-independent state?

          • P. D. Mangan says:

            That’s a good question. I believe that if you’re previously fat-adapted, and don’t stray into carb-land too long, and then go without carbs, you’ll get back into fat-burning mode very quickly. However, whether there’s any actual research on that question, I don’t know.

            Oh, and thanks for the German lesson. I studied it once about 40 years ago, but of course I hardly remember a thing.

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