The Link Between Dietary Sugar Intake and Cardiovascular DiseaseMortality An Unresolved Question

there was relatively little change in the consumption of added sugar in terms of the proportion of total calories consumed. At the beginning of the study period (1988-1994), 15.7 % (95 % CI, 15.0%-16.4%) of the total calories consumed were from added sugar (approximately 350 kcal/day), and 14.9 % (95 % CI, 14.2%-15.5%) of calories consumed were from added sugar (approximately 326 kcal/day) at the end of the observation period (2005-2010). With nearly 15 years of follow-up, there was a significant dose-dependent relationship between reported ingestion of added sugar and cardiovascular (CVD) mortality. These findings were consistent across subpopulations, and after adjusting for con-founding factors, the associations were strengthened. These observations are interesting because during a time period when the prevalence of obesity was increasing,2 added sugar consump-tion was relatively stable. However, individuals who reported more than 25 % of their total intake as added sugar did have greater CVDmortality (adjusted hazard ratio of 2.75). The Institute of Medicine (IOM) recommendation3 is that less than 25 % of total kilocalories come from added sugar. This crite-rionwasmet by 83.4 % to 91.9%of the participants in the study b