A prospective UK cohort study suggested that higher free sugar intake was associated with higher cardiovascular disease (CVD) incidence and higher triglyceride concentrations within all lipoproteins. Higher fiber intake and replacement of refined grain starch and free sugars with wholegrain starch and non-free sugars, respectively, may be protective for incident CVD. The study included 110,497 participants with 4188, 3138 and 1124 cases of incident total CVD, ischemic heart disease (IHD) and stroke over a median follow-up of 9.4 years, respectively. Plasma triglycerides within lipoprotein subclasses were measured by nuclear magnetic resonance spectroscopy in 26,095 participants. Total carbohydrate intake was not associated with CVD outcomes. Free sugar intake was positively associated with total CVD (HR per 5% of energy 1.07), IHD (1.06), and stroke (1.10). Fiber intake was inversely associated with total CVD (HR per 5 g/d, 0.96). Modelled isoenergetic substitution of 5% of energy from refined grain starch with wholegrain starch was inversely associated with total CVD (0.94) and IHD (0.94), and substitution of free sugars with non-free sugars was inversely associated with total CVD (0.95) and stroke (0.91). Free sugar intake was positively associated with triglycerides within all lipoproteins. Free sugars include all monosaccharides and disaccharides added to foods as well as sugars naturally present in honey, syrups, and unsweetened fruit juices. The findings support the importance of the type and source of carbohydrate consumed for cardiovascular health. Source: https://bmcmedicine.biomedcentral.com/
