grain carbohydrates contributed to a
lower percentage of energy than carbohydrates from refines starches and
added sugars.
When it came to dietary changes
during the 2-4 year intervals, energy intake from saturated fatty acids was usually replaced with low-quality carbohydrates instead of polyunsaturated fatty
acids or high-quality carbohydrates.
Higher intake of polyunsaturated fatty
acids was associated with lower risk
of CHD, while intake of trans fat was
significantly associated with increased
risk. CHD risk was lower with consumption of whole grain carbohydrates
and significantly higher with consumption of refined starches and added
sugars. Replacing 5% of energy from
saturated fatty acids with 5% of energy
from polyunsaturated and monounsaturated fatty acids led to a significant
reduction in risk of CHD.
According to the authors, these
findings support current dietary guidelines. They add that good substitutions for saturated fats include such
polyunsaturated fats such as vegetable
oils, nuts and seeds. While the 2010
American Dietary Guidelines recommend “consuming at least half of all
grains as whole grains,” intake remains
low, with less than 5% of Americans
consuming the minimum recommended amount.
In an editorial comment accompanying the paper, Robert A. Vogel,
MD, writes that these findings show
that “it is time to set aside the low-fat
versus low-carbohydrate diet debate.
Healthfulness clearly lies in the quality
or type of both fat and carbohydrate.”
He concludes that from these results,
“[w]hat we are left with is a slightly
clearer message about food as heart
medicine. We in health care need to be
better informed about nutrition and
nutritional research and have a clearer
public health message. The challenge
will be to convince an increasingly
wary public that we know what we’re
talking about.”
A research paper in the same issue
of JACC, examines the effect highfructose corn syrup, particularly from
the consumption of sugar-sweetened
beverages, has on cardiometabolic
health. The authors, Vasanti S. Malik,
MSc, and Frank B. Hu, MD, PhD,—
the latter of whom also participated
in the previous study—conclude that
drinking sugar sweetened beverages
can lead to excess weight gain and an
ACC.org/CSWN
Sugar-sweetened
beverages are the
greatest source
of calories and
added sugars in
American diets.
increased risk of type 2 diabetes and
heart disease.
Sugar-sweetened beverages are the
greatest source of calories and added
sugars in American diets, accounting
for nearly half of all sugar intake. The
majority of these drinks are sweetened
with high-fructose corn syrup. While
intake has decreased slightly over the
past decade, the rate of consumption
still remains too high. In this review,
the authors examine past findings of
the association between sugar sweetened beverages and obesity, type 2
diabetes, and cardiovascular risk. They
also note that the weight gain from
these drinks is due to the liquid calories added to the typical diet, stating
that one can of soda per day may lead
to a gain of five pounds in 1 year. The
adverse glycemic response and unique
metabolic effects of fructose may also
lead to diabetes and heart disease.
Malik and Hu examine the public
policy and regulator strategies in effect
or being weighed to reduce the intake
of sugar sweetened beverages. They
write that areas that warrant future
research include the effects of different
sugars and sugar moieties on health
outcomes over a broad range of doses,
the health effects of solid versus liquid
sugar, and the long-term health effects
of consuming artificial sweeteners as
a substitute for sugar. Q