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By Dr. Liji Thomas, MD Reviewed by Benedette Cuffari, M.Sc. Dec 12 2024

Researchers uncover varying links between added sugar sources—like sweetened drinks, treats, and toppings—and risks for conditions such as heart failure, stroke, and aneurysms.

Study:  Added sugar intake and its associations with incidence of seven different cardiovascular diseases in 69,705 Swedish men and women. Image Credit: Sorapop Udomsri / Shutterstock.com

Cardiovascular disease (CVD) is a leading cause of disease and death in Europe. Multiple studies support the association between CVD and unhealthy dietary habits; however, the impact of added sugar and different types of CVD remains unclear.

A recent study published in Frontiers in Public Health examines the risk of seven different types of CVDs associated with added and free sugar in foods and beverages. The regulation of sugar intake

The incorporation of sugar into food products can cause consumers to overeat high-calorie, nutrient-empty foods at the cost of nutritious foods. Furthermore, added sugar increases the risk of tooth decay and weight gain.

Nordic guidelines recommend that less than 10% of total energy intake is provided by added and free sugar, including sugars naturally occurring in fruit juice concentrates, fruit juices, honey, and syrups. Likewise, both the American and World Health Organizations recommend less than 10% added and free sugar intake, respectively.

The European Food Safety Authority (EFSA) points to evidence that the risk of cardiometabolic disease rises with increased consumption of sugar-sweetened beverages (SSBs). Moderately strong evidence for obesity and high blood cholesterol levels with increased added and free sugar intake has also been reported.

Despite these observations, it remains unclear whether added and free sugar intake is directly associated with an increased risk of CVD. Moreover, the association with overall CVD risk does not correlate with the risk for individual cardiovascular conditions due to contradictory findings. Most studies that have examined this association have relied on a single measurement of added sugar consumption for their analyses and lack long-term follow-up data. About the study

The current study examines how the consumption of added sugar, sugar-sweetened foods (SSFs), and SSBs is associated with the risk of ischemic stroke (IS), hemorrhagic stroke (HS), myocardial infarction (MI), heart failure (HF), aortic stenosis (AS), atrial fibrillation (AF), and abdominal aortic aneurysm (AAA). Related StoriesBaycrest study discovers role of thalamus in post-stroke recoveryWomen skip post-stroke medications more often than men, study revealsStudy highlights disparities in stroke costs across healthcare services in Latin America

The study included 69,705 individuals in two Swedish cohorts. Data on added sugar intake (ASI) were collected in 1997 and 2009 in over 60% of study participants. The average body mass index (BMI) was 25.3 kg/m2, with a mean age of 59.9 years.

SSFs were classified as treats such as pastries, ice cream, and chocolates or toppings like marmalades, jams, sugar, and honey. SSBs included sweetened sodas and fruit drinks, excluding pure fruit juices.

The mean ASI was 9.1% of energy intake (E%) in 1997. Being male, doing more exercise, and having less education were associated with greater ASI, along with older age and higher energy intake. Low-to-moderate added sugar intake

After compensating for the effects of age, sex, and energy intake, ASI was associated with all seven CVDs; however, these associations were weakened after adjusting for lifestyle factors, BMI, and diet.

The highest category of ASI, over 20 E%, was associated with a 31% increased risk of AAA compared to the lowest intake category of five E% or less. At over 15-20 E%, the risk of IS was 9% higher.

For most outcomes, the lowest ASI was associated with the highest risk. The risk for most CVDs was lowest at 5-7.5 E%. Thus, MI, AF, IS, HF, and AS risks were reduced by 5-9% in this category compared to the lowest intake.

With ASI exceeding 7.5-10 E%, the risk of HF and AF was reduced by 6% and 4%, respectively. At over 10-15 E%, the risk of HF, AF, and AS decreased by 5%, 4% and 17% respectively. Higher ASI was associated with a greater AAA and IS risk among obese individuals, whereas higher HF risk was observed in normal-weight individuals. SSB intake

SSB intake was linearly associated with the risk of IS, HF, AF, and AAA. Consuming over eight SSB servings each week increased AF, IS, HF, and AAA risk by 11%, 18%, 19%, and 31%, respectively.

Analysis of the 2009 survey indicated an increased risk of IS and HF with greater artificially sweetened beverage consumption but not SSBs. This could be due to the small sample size for sweetened beverages, as current literature indicates a positive correlation of SSBs with increased CVD risk. SSF consumption

The lowest CVD risk was observed in the highest treat intake category, whereas the highest risk was observed among those who consumed two or fewer treats each week.

Although the mechanism remains unclear, this association might be due to better social health. In Sweden, coffee and pastries are part of fika, customary social gatherings, and may not indicate an overall unhealthy lifestyle.

Topping intake showed a mixed pattern, as those who consumed toppings had a 10% reduced risk of HF as compared to the lowest intake category. AS risk was reduced by 14-20% with increasing ASI, whereas AAA risk increased by 34%. Conclusions

The study findings do not support lowering the recommendations for added sugar intake to below five E%.”

A low to moderate intake of added sugar is associated with lower CVD risk at 5-7.5 E% as compared to either over five E% or 10 E%. Both the sugar source and the studied clinical outcome affect the nature and direction of the association.

Future studies are needed to elucidate the mechanisms involved in these associations and the role of body weight. Furthermore, confounding factors like sodium intake, an independent CVD risk predictor, should also be considered. Journal reference: Janzi, S., Gonzalez-Padilla, E., Ramne, S., et al. (2024). Added sugar intake and its associations with incidence of seven different cardiovascular diseases in 69,705 Swedish men and women. Frontiers in Public Health. doi:10.3389/fpubh.2024.1452085.

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Politics

Norman Tebbit: Former Tory minister who served in Margaret Thatcher’s government dies aged 94

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Norman Tebbit: Former Tory minister who served in Margaret Thatcher's government dies aged 94

Norman Tebbit, the former Tory minister who served in Margaret Thatcher’s government, has died at the age of 94.

Lord Tebbit died “peacefully at home” late on Monday night, his son William confirmed.

One of Mrs Thatcher’s most loyal cabinet ministers, he was a leading political voice throughout the turbulent 1980s.

He held the posts of employment secretary, trade secretary, Chancellor of the Duchy of Lancaster and Conservative party chairman before resigning as an MP in 1992 after his wife was left disabled by the Provisional IRA’s bombing of the Grand Hotel in Brighton.

He considered standing for the Conservative leadership after Mrs Thatcher’s resignation in 1990, but was committed to taking care of his wife.

Prime Minister Margaret Thatcher and party chairman Norman Tebbit.
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Margaret Thatcher and Norman Tebbit in 1987 after her election victory. Pic: PA

Tory leader Kemi Badenoch called him an “icon” in British politics and was “one of the leading exponents of the philosophy we now know as Thatcherism”.

“But to many of us it was the stoicism and courage he showed in the face of terrorism, which inspired us as he rebuilt his political career after suffering terrible injuries in the Brighton bomb, and cared selflessly for his wife Margaret, who was gravely disabled in the bombing,” she wrote on X.

“He never buckled under pressure and he never compromised. Our nation has lost one of its very best today and I speak for all the Conservative family and beyond in recognising Lord Tebbit’s enormous intellect and profound sense of duty to his country.

“May he rest in peace.”

Lord Tebbit and his wife Margaret stand outside the Grand Hotel in Brighton.
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Lord Tebbit and his wife Margaret stand outside the Grand Hotel in Brighton. Pic: PA

Tory grandee David Davis told Sky News Lord Tebbit was a “great working class Tory, always ready to challenge establishment conventional wisdom for the bogus nonsense it often was”.

“He was one of Thatcher’s bravest and strongest lieutenants, and a great friend,” Sir David said.

“He had to deal with the agony that the IRA visited on him and his wife, and he did so with characteristic unflinching courage. He was a great man.”

Reform leader Nigel Farage said Lord Tebbit “gave me a lot of help in my early days as an MEP”.

He was “a great man. RIP,” he added.

Prime Minister Margaret Thatcher with Employment Secretary Norman Tebbit.
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Lord Tebbit as employment secretary in 1983 with Mrs Thatcher. Pic: PA

Born to working-class parents in north London, he was made a life peer in 1992, where he sat until he retired in 2022.

Lord Tebbit was trade secretary when he was injured in the Provisional IRA’s bombing in Brighton during the Conservative Party conference in 1984.

Five people died in the attack and Lord Tebbit’s wife, Margaret, was left paralysed from the neck down. She died in 2020 at the age of 86.

Before entering politics, his first job, aged 16, was at the Financial Times where he had his first experience of trade unions and vowed to “break the power of the closed shop”.

He then trained as a pilot with the RAF – at one point narrowly escaping from the burning cockpit of a Meteor 8 jet – before becoming the MP for Epping in 1970 then for Chingford in 1974.

Norman Tebbit during the debate on the second reading of the European Communities (Amendment) Bill, in the House of Lords.
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Lord Tebbit during an EU debate in the House of Lords in 1997. Pic: PA

As a cabinet minister, he was responsible for legislation that weakened the powers of the trade unions and the closed shop, making him the political embodiment of the Thatcherite ideology that was in full swing.

His tough approach was put to the test when riots erupted in Brixton, south London, against the backdrop of high rates of unemployment and mistrust between the black community and the police.

He was frequently misquoted as having told the unemployed to “get on your bike”, and was often referred to as “Onyerbike” for some time afterwards.

What he actually said was he grew up in the ’30s with an unemployed father who did not riot, “he got on his bike and looked for work, and he kept looking till he found it”.

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Politics

‘Oui’ or ‘non’ for Starmer’s migration deal?

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'Oui' or 'non' for Starmer's migration deal?

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The first European state visit since Brexit starts today as President Emmanuel Macron arrives at Windsor Castle.

On this episode, Sky News’ Sam Coates and Politico’s Anne McElvoy look at what’s on the agenda beyond the pomp and ceremony. Will the government get its “one in, one out” migration deal over the line?

Plus, which one of our presenters needs to make a confession about the 2008 French state visit?

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US

Benjamin Netanyahu nominates Donald Trump for Nobel Peace Prize – as Gaza ceasefire talks continue

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Benjamin Netanyahu nominates Donald Trump for Nobel Peace Prize - as Gaza ceasefire talks continue

Israel’s prime minister has nominated Donald Trump for the Nobel Peace Prize.

Benjamin Netanyahu made the announcement at a White House dinner, handing over the letter for the US president to read.

“Coming from you in particular, this is very meaningful,” Mr Trump said.

The Israeli leader said Mr Trump was “forging peace as we speak, and one country and one region after the other”.

Organisers award the prize to the person who does the most for “fraternity between nations, for the abolition or reduction of standing armies and for the holding and promotion of peace congresses”.

Benjamin Netanyahu showed President Trump the Nobel nomination letter. Pic: AP
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Benjamin Netanyahu handed Donald Trump the Nobel nomination letter. Pic: AP

Mr Trump took credit for stopping Iran and Israel‘s “12-day war” last month, announcing it with fanfare on Truth Social, and the ceasefire has so far held.

The president has claimed US strikes obliterated Iran’s purported nuclear weapons programme – and that the country now wants to restart negotiations.

“We have scheduled Iran talks, and they want to,” Mr Trump told reporters on Monday. “They want to talk.”

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Iran hasn’t confirmed the move, but its president told US broadcaster Tucker Carlson he believes his country can resolve differences with the US through dialogue.

Masoud Pezeshkian also said Iran would be willing to resume cooperation with the UN nuclear watchdog.

However, he said full access to nuclear sites wasn’t yet possible as US strikes had damaged them so badly.

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Netanyahu arrives in US for ceasefire talks

Away from Iran, fighting continues in Gaza and Ukraine.

Mr Trump famously boasted before his second stint in the White House that he could end the Ukraine war in 24 hours.

The reality has been very different – with Ukraine saying last week that Russia unleashed the heaviest aerial attack of the war so far.

Critics have also claimed Vladimir Putin is “playing” his US counterpart and that he has no intention of agreeing a ceasefire.

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Russia bombards Ukraine with drones and missiles

However, Mr Trump could try to take credit for progress in Gaza if – as he’s suggested – an agreement on a 60-day ceasefire is done this week.

Indirect negotiations with Hamas are taking place that could lead to the release of some of the remaining 50 Israeli hostages and a surge in aid to Gaza.

The White House said Middle East envoy Steve Witkoff is travelling to Qatar this week to try to seal the agreement.

Read more:
Israeli soldier describes arbitrary killing of civilians in Gaza

IDF troops ‘psychologically broken’ after Gaza – UN expert

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‘Some Israeli commanders can decide to do war crimes’

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Whether a temporary pause could open a path to a lasting peace remains uncertain, with the two sides’ criteria for peace still far apart.

Mr Netanyahu has said Hamas must surrender, disarm and leave Gaza – something it refuses to do.

He also told reporters on Monday that the US and Israel were working with other countries who would give Palestinians “a better future” – and indicated those in Gaza could move elsewhere.

“If people want to stay, they can stay, but if they want to leave, they should be able to leave,” he added.

“We’ve had great cooperation from… surrounding countries, great cooperation from every single one of them. So something good will happen,” Mr Trump said.

The president was widely criticised earlier this year when he suggested resettling Gaza’s population to countries such as Jordan and Egypt and turning it into the “Riviera of the Middle East”.

Human rights groups said the plan amounted to ethnic cleansing and most Gazans said they would never consider leaving.

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