title: Sugar restriction: the evidence for a drug-free intervention to reduce cardiovascular disease risk.
abstract: OBJECTIVE
  Uncertainty exists about what dietary component is most likely to cause coronary heart disease. Over the last thirty years, attention has focused on saturated fat and salt as guilty parties. More recently, evidence suggests that excess sugar intake is more likely than either traditional factor to lead to atherosclerotic disease. Some researchers have also speculated that sugar is addictive, in a similar manner to caffeine and established drugs of abuse.
  
  
  METHODS
  Here we review the epidemiological, biochemical and psychological evidence that implicates excess sugar intake as an important cause of ill-health.
  
  
  RESULTS
  We found relatively consistent evidence of association between markers of sugar intake and risk factors for cardiovascular disease, or the disease itself. This evidence contrasted with rather weaker evidence which linked either saturated fat or salt with cardiovascular disease endpoints. We also found some evidence of a sugar addiction syndrome.
  
  
  CONCLUSIONS
  We suggest that advice to restrict sugar intake should be a routine part of clinical care, particularly when patients are being counselled about cardiovascular risk.
authors.affiliation: Section of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand. s.thornley@auckland.ac.nz
authors.forename: S
authors.initials: S
authors.lastname: Thornley
authors.forename: R
authors.initials: R
authors.lastname: Tayler
authors.forename: K
authors.initials: K
authors.lastname: Sikaris
mesh_terms: D016739:Behavior, Addictive / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control; D031204:Caloric Restriction / Q000379:methods; D002318:Cardiovascular Diseases / Q000178:diet therapy* / Q000453:epidemiology* / Q000517:prevention & control; D019422:Dietary Sucrose / Q000008:administration & dosage / Q000009:adverse effects*; D061345:Early Medical Intervention / Q000379:methods*; D006801:Humans; D012307:Risk Factors
chemical_list: D019422:Dietary Sucrose