In March 2015, the World Health Organization (WHO) released its new recommendations on guidelines for sugar intake in adults and children, stating that added sugar intake should be reduced to less than 10% of total daily calories (WHO, 2015). In addition, the WHO suggests that intake should really be further reduced to less than 5% for the most benefits, due to the overwhelming evidence that consuming added sugars leads to health problems such as obesity and other noncommunicable diseases (WHO, 2015). One reason sugar may be so detrimental to health is likely because of its ability to induce and promote inflammation throughout the body.
This doesn’t mean that eating fruits and vegetables or even drinking milk will cause health problems—in this case, we are looking at added sugars not otherwise found in whole foods, fresh produce, or fresh foods such as fish. Soda, cake, cookies, fruit juice, candy, and other snacks with refined sugars are to blame. Several studies have shown strong evidence linking a Western diet (high fat/carb, high salt, and high animal protein) to an increase in systemic inflammation, which in turn increases one’s risk for chronic inflammatory and autoimmune diseases (Riccio & Rossano, 2015). Obesity, now considered a disease by the American Heart Association, is a state of chronic inflammation, which may be a reason why obesity has so many co-morbidities such as metabolic disease, depression, and cancer (Vieira-Potter, Zidon, & Padilla, 2015; Zagotta et al., 2015).
There is a growing body of evidence that intake of added sugars, particularly refined sucrose and fructose, contributes significantly to inflammation and exacerbates conditions such as cardiovascular disease (Zagotta et al., 2015; DiNicolantonio & Lucan, 2014). A recent review on cardiovascular disease suggests that intake of processed foods, which tend to be the source of refined sugars, should be reduced or eliminated in the diet and that specifically a reduction of added sugar intake may attenuate symptoms or prevent cardiovascular disease as a whole. DiNicolantonio & Lucan, 2014). In another study, a low fructose diet has been shown to specifically reduce inflammation in patients with chronic kidney disease (Brymora et al., 2012).
Although it is difficult to study carbohydrate-induced inflammation independently of weight gain, it appears that everyone may benefit from reducing overall added sugar intake. There are a couple of reasons that support this claim. First of all, a diet that is high in added sugars likely means that an individual is consuming too many processed foods and not enough whole foods. Processed foods not only have added sugars, but they also often contain substances that are added as a preservative and/or to enhance color, flavor, and texture. In addition, the more processing or handling a product goes through before reaching your shelf, the more chance there is for exposure to harmful chemicals and substances that are either a by-product of processing or are from agricultural use and not necessarily meant for human consumption (e.g. pesticides, antibiotics, etc.). This can be especially problematic for someone who is already overweight or obese because some chemicals are not broken down so easily or at all in the body and can accumulate in adipose tissue.
Second, processed foods cannot replace whole foods and the nutritional content that whole foods provide. Yes, most processed foods are fortified or enriched, but we cannot equate health to individual nutrients. It is the combination and type of nutrients naturally found in whole foods that prevent diseases and help us live long, healthy lives. We still don’t even know what all of the beneficial chemicals and molecules are that plants contain. Although carbohydrates are present in whole foods (like potatoes, for example), they will not cause the same inflammatory response as added/refined sugars do because of the presence of other nutrients such as fiber.
The Mediterranean diet has been studied extensively for its apparent ability to prevent and decrease risk of several diseases including obesity, cancer, heart disease, and diabetes. More recently, the Mediterranean diet has been referred to as an anti-inflammatory diet, on the basis that reducing inflammation reduces risk of chronic diseases, promotes weight loss, and improves overall health and well being. The Mediterranean diet is mostly free of added sugars, and the emphasis is on intake of plants (fruit, vegetables, nuts, seeds, legumes, whole grains, plant oils etc.), with some intake of seafood, and even less intake of animal protein (meat, eggs, dairy). The most important takeaway is that the Mediterranean diet represents a diverse intake of whole foods, free of added sugars, to ensure adequate intake of all essential vitamins and minerals, in addition to all the other beneficial enzymes and molecules found in plant-based foods.
With this in mind, there is no better time than the now to think about or begin cutting down on your refined/added sugar intake and increase fruit and vegetable consumption, regardless of weight status. Sugar-induced inflammation goes beyond obesity and is detrimental to health in every regard. Reducing inflammation may prove to be the key to promoting a healthy weight, decreasing risk of chronic diseases, and drastically improving overall quality of life.
WHO. (2015, March 4). WHO calls on countries to reduce sugars intake among adults and children. Geneva, Switzerland: Author.
Riccio, P., & Rossano, R. (2015). Nutrition facts in multiple sclerosis. ASN Neuro, Jan-Feb, 7(1).
Vieira-Potter, V. J., Zidon, T. M., & Padilla, J. (2015, April 22). Exercise (and estrogen) make fat cells ‘fit’. Exercise and Sport Sciences Reviews. doi: 10.1249/JES.0000000000000046
Zagotta, I., Dimova, E. Y., Debatin, K. M., Wabitsch, M., Kietzmann, T., & Fischer-Posovszky, P. (2015). Obesity and inflammation: Reduced cytokine expression due to resveratrol in a human in vitro model of inflamed adipose tissue. Frontiers in Pharmacology, 6, 79.
DiNicolantonio, J. J., & Lucan, S. C. (2014). The wrong white crystals: Not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart, 1(1), e000167.
Brymora, A., Flisinski, M., Johnson, R. J., Goszka, G., Stefanska, A., & Manitius, J. (2012, February). Low-fructose diet lowers blood pressure and inflammation in patients with chronic kidney disease. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association – European Renal Association, 27(2), 608-12.