Too much sugar... how harmful?

1) The American Heart Association has concluded that there is a correlation between high sodium diets and CVD and hypertension
2) The American Diabetes Association concludes that sugar consumption highly correlates with type 2 diabetes
3) I have family members (including my dad) that have CVD, hypertension, and are pre-diabetic. Their physicians also agree with the AHA and ADA that it was critical that they reduce the sodium and sugar in their diets. My dad went on a low sugar / low sodium diet and is no longer pre-diabetic and his blood pressure has returned to normal.

So forgive me if I don’t buy that high sodium and high sugar diets don’t potentially lead to detrimental health effects in most people - I tend to trust the opinions of the AHA, ADA, and MDs when it comes to this one.

I don't think anyone is saying EAT JUST SUGAR.
The thing is, if you are meeting your macros, you should not have to worry about things like sugar.
Further, sodium has been shown to have no effect on blood pressure except when people already have high blood pressure.
You have a dated view of sugar and sodium.

My "dated view" of sugar and sodium comes directly from the AHA, ADA, and medical professionals. Forgive me if trust those sources more than message board professionals..Feel free to review CURRENT data found on the AHA & ADA websites, it may be instructive.

Interesting! I've only ever looked at research concerning the reversal of Type 2 diabetes, haven't tried to search for any papers on sugar driving diabetes. Do you have a link maybe? I'd like to find the actual paper to see what's really going on.

Edit: Found it Looks complicated but going to try and understand it.

1) The American Heart Association has concluded that there is a correlation between high sodium diets and CVD and hypertension
2) The American Diabetes Association concludes that sugar consumption highly correlates with type 2 diabetes
3) I have family members (including my dad) that have CVD, hypertension, and are pre-diabetic. Their physicians also agree with the AHA and ADA that it was critical that they reduce the sodium and sugar in their diets. My dad went on a low sugar / low sodium diet and is no longer pre-diabetic and his blood pressure has returned to normal.

So forgive me if I don’t buy that high sodium and high sugar diets don’t potentially lead to detrimental health effects in most people - I tend to trust the opinions of the AHA, ADA, and MDs when it comes to this one.

You can't buy it, because I'm not selling anything. I don't particularly care what you do, specifically.

The problem is that the AHA and ADA are as much political organizations as they are health-focused organizations. You cannot expect them to be flexible enough to respond immediately to novel science, nor should you. Unfortunately, given that we have based a huge amount of public health policy on their recommendations, they're also very slow to reposition themselves in the face of evidence that flies in the face of their public recommendations. Especially in the case of something like sodium -- eating their recommendation (2400mg a day, I believe) is not harmful, so their recommendation is still somewhat valid, even if the related inference (that over 2400/day is harmful) is not.

Your primary care physician likely took one or two nutrition classes, back when they were in med school. The nutrition classes likely used books that were a couple years old then, and most physicians are likely not ravenously digesting novel science. They'll get their recommendations from the AHA. So the 2,400mg sodium myth propogates.

The ADA is the organization that recommends diabetics eat 40-60g of carbs per meal for blood sugar control. That alone should tell you something.

That settles it, I'm firing my doctor who went to medical school and spent thousands of hours practicing medicine, and I'm getting my health advice solely from anonymous users on internet message boards.

That settles it, I'm firing my doctor who went to medical school and spent thousands of hours practicing medicine, and I'm getting my health advice solely from anonymous users on internet message boards.

The Cochrane Collaboration has repeatedly found no evidence of mortality benefit in low-salt diets. This might be problematic for you, because it's staffed by Doctors doing actual research, who also went to medical school, and have spent thousands of hours practicing medicine.

I'm not giving you any advice. Continue to do whatever it is makes you happy. Luckily, what makes you happy can also be completely wrong!

Sugar = carbs = sugar = carbs = GOOD

Its not a happiness issue. There is no down side to going low sodium - so therefore, I attempt to control my sodium. If others want to consume additional sodium, go for it.

There is a measurable downside to going low sodium -- electrolyte imbalance, a host of organ problems, and in extreme cases, death. Sodium is essential. From a public health policy, we currently focus on upper bounds -- given that research doesn't support the position that a reasonable upper bound actually promotes health, and that the focus on the upper bound can cause some people to eat below the medically justified lower bound, our policy should change to focus on ensuring that people eat at least the lower bound.

Taken alongside your protein, quick carbs can actually be helpful, as they cause a temporary insulin spike, which enables your body to make better use of the protein. This applies to the other macronutrient too, unfortunately, so sugar + fat is not so great. Hence ice cream being fattening...

The previous posters are quite right, though: in the great scheme of things, 23g of fast carbs such as fruit sugar over your MFP guidelines won't break the bank. :flowerforyou:

Carbs with some fat are a great way to start my morning. They wake me up and keep me going until lunch. I go back and forth on the protein, but my morning carbs are what do it for me personally.

The GDA for 2000 cals a day is 90g of sugar so MFP sets sugar quite low ratio wise. I customised my settings and don't sweat it when I go over as long as the vast majority of that is natural sugars.

I disagree with above poster about 'ignoring' sodium though because MFP has set that way too high IMO. Most lit I read recommends never going over 2400mg on a 2000 cal/day diet (between 1500-2400 is 'healthy') whereas MFP sets to 2500 and I see people going over all the time.

What reasons would there be for tracking sodium in a healthy individual?

The obvious one is "to ensure that you're getting it", given that it's an essential nutrient.

I honestly don't know anyone in today's world that is sodium deficient.
If you are then you aren't a healthy individual.

True. The only people I have ever heard of that were sodium deficient were those lacking in electrolytes in general, completely dehydrated from excessive alcohol use, among other things.

Its not a happiness issue. There is no down side to going low sodium - so therefore, I attempt to control my sodium. If others want to consume additional sodium, go for it.

There is a measurable downside to going low sodium -- electrolyte imbalance, a host of organ problems, and in extreme cases, death. Sodium is essential. From a public health policy, we currently focus on upper bounds -- given that research doesn't support the position that a reasonable upper bound actually promotes health, and that the focus on the upper bound can cause some people to eat below the medically justified lower bound, our policy should change to focus on ensuring that people eat at least the lower bound.

Given that the average American consumes 3,400 mgs of sodium per day and 9 out of 10 exceed the RDA of sodium, I'm not sure why we would expend a lot of effort addressing sodium deficiency.

And while I admire your faith in research studies, none of the these researchers have reviewed my medical history, my family's medical history, my test results, or physically examined me in their office. Only my physician has done this regularly over the course of many years - so it would be illogical to disregard my doctor's advice and rely on generalized recommendations from group studies.

You don't seem to be following this conversation, so let's baseline:

1. You said there's no health impact to going low sodium (without defining what "low sodium" is). I gave you an example of some legitimate health impacts that going low sodium can cause. Your refutation of that is that most Americans don't eat low sodium. :noway:

2. My faith in research studies is because everything I've said in this thread is at a population level. No one here has discussed whether a low sodium diet is appropriate for you. You are the one using your personal experience to make overarching claims about the effects of sodium. I have repeatedly told you that you should do whatever you think is best. The only time I even addressed a physician is to point out the flaw in your belief that primary care doctors are somehow all nutritional experts -- they normally rely on the recommendations of groups such as the ADA, AHA, etc. Those recommendations are poor, or at least unsupported, based upon a view of the total collection of research available.

Your stance: eating low sodium is healthy, eating high sodium is not.

My problem with your stance: you don't define low sodium, you don't define high sodium, and you have no support to your second conclusion aside from what your doctor told you for your specific situation. You are the one drawing wide conclusions from narrow data.

My stance: eating too low sodium (i.e., none) will kill you, eating an exorbitantly high amount of sodium (i.e. a pound a day) will likely cause problems, but eating at a relatively normal amount of sodium (e.g., 1000mg to 4000mg a day) is unlikely to cause problems in an otherwise healthy individual. The data supports that theory.

Its not a happiness issue. There is no down side to going low sodium - so therefore, I attempt to control my sodium. If others want to consume additional sodium, go for it.

There is a measurable downside to going low sodium -- electrolyte imbalance, a host of organ problems, and in extreme cases, death. Sodium is essential. From a public health policy, we currently focus on upper bounds -- given that research doesn't support the position that a reasonable upper bound actually promotes health, and that the focus on the upper bound can cause some people to eat below the medically justified lower bound, our policy should change to focus on ensuring that people eat at least the lower bound.

Given that the average American consumes 3,400 mgs of sodium per day and 9 out of 10 exceed the RDA of sodium, I'm not sure why we would expend a lot of effort addressing sodium deficiency.

And while I admire your faith in research studies, none of the these researchers have reviewed my medical history, my family's medical history, my test results, or physically examined me in their office. Only my physician has done this regularly over the course of many years - so it would be illogical to disregard my doctor's advice and rely on generalized recommendations from group studies.

You don't seem to be following this conversation, so let's baseline:

1. You said there's no health impact to going low sodium (without defining what "low sodium" is). I gave you an example of some legitimate health impacts that going low sodium can cause. Your refutation of that is that most Americans don't eat low sodium. :noway:

2. My faith in research studies is because everything I've said in this thread is at a population level. No one here has discussed whether a low sodium diet is appropriate for you. You are the one using your personal experience to make overarching claims about the effects of sodium. I have repeatedly told you that you should do whatever you think is best. The only time I even addressed a physician is to point out the flaw in your belief that primary care doctors are somehow all nutritional experts -- they normally rely on the recommendations of groups such as the ADA, AHA, etc. Those recommendations are poor, or at least unsupported, based upon a view of the total collection of research available.

Your stance: eating low sodium is healthy, eating high sodium is not.

My problem with your stance: you don't define low sodium, you don't define high sodium, and you have no support to your second conclusion aside from what your doctor told you for your specific situation. You are the one drawing wide conclusions from narrow data.

My stance: eating too low sodium (i.e., none) will kill you, eating an exorbitantly high amount of sodium (i.e. a pound a day) will likely cause problems, but eating at a relatively normal amount of sodium (e.g., 1000mg to 4000mg a day) is unlikely to cause problems in an otherwise healthy individual. The data supports that theory.

Review above, you were the one that stated I should trust research studies more than a physician's advice.

Low sodium may kill you, but the fact is, the number of people suffering from low sodium is so statistically insignificant that it barely warrants mention. Per the AHA (2013 data) and my physician, America has a huge sodium consumption problem. With all due respect, if you don't feel that the AHA is a credible organization (one of the most reputable and trusted health organizations in the world), we've hit an insurmountable obstacle in this dialogue and should both just move on.

Even with regards sugar, the ADA may say that there is correlation between sugar consumption and diabetes. And they are correct. However, a correlation does not mean that sugar CAUSES diabetes.

There is a link between obesity and diabetes too. Most obese people eat foods that are high in sugar. So is it obesity that causes diabetes, or sugar?

Or is it that obese people don't tend to exercise much and diet per se is irrelevant?

And what if the link is the other way? What if diabetes causes people to eat more in general, and hence more sugar in specific? I'm not sure I buy this theory, but it is out there : http://blog.ted.com/2013/06/25/why-our-understanding-of-obesity-and-diabetes-may-be-wrong-a-qa-with-surgeon-peter-attia/

So, I don't think you'll find the ADA directly saying that sugar (or obesity) causes diabetes. It's more complicated than that, and we don't have all the pieces yet.

To be more on topic: I am prediabetic and I don't track sugar, just carbs. (Although I do avoid foods with added sugar for the most part).

Review above, you were the one that stated I should trust research studies more than a physician's advice.

Done. Don't see it. Please quote if you would like to. What I did state is that your physician is likely not an expert on nutrition, and is likely basing his recommendation off of old research and guidelines. Both of these things are very likely to be true. That's not saying you have a bad doctor, or that your doctor is going to harm you by his recommendation -- he obviously knows you best. If he prescribed a zero-sodium diet to you, you should likely switch doctors, because the one you have is trying to kill you, but if he prescribed mild sodium restriction (or sodium intake at a reasonable level), it's not going to damage you. Granted, the higher sodium, absent some very specific medical scenarios, is likely not going to damage you, either, but if neither is going to damage you, no reason not to prescribe it, especially if it's what he learned in med school.

Doctors, especially primary care doctors, cannot and should not be expected to be experts at everything.

Low sodium may kill you, but the fact is, the number of people suffering from low sodium is so statistically insignificant that it barely warrants mention.

That doesn't mean that we should arbitrarily set limits on the upper bound of sodium consumption.

Per the AHA (2013 data) and my physician, America has a huge sodium consumption problem.

If you're going to cite something, is it possible to include a link? I like to read primary sources. My guess is that their conclusion that America "has a huge sodium consumption problem" is based on the same guidelines that were issued back in the 70's and 80's, 2400mg or 2300mg or whatever the recommendation is. Compared to that recommendation, yes, we have huge problems. I'm saying that that original recommendation is highly suspect.

With all due respect, if you don't feel that the AHA is a credible organization (one of the most reputable and trusted health organizations in the world), we've hit an insurmountable obstacle in this dialogue and should both just move on.

My feelings about the AHA recommendations being incorrect have nothing to do with whether the AHA is credible as an organization or not. I think they're generally a good organization, they have low administration costs (meaning your charitable donations are going towards actual work, and not simply the existence of the charity). I donate to them yearly and participate in the Heart Walk both as a walker and as a volunteer for my company. I have no problems with the AHA as an organization.

However, having worked in the field and for organizations such as them, it's worth understanding the pressures that exist with regard to their recommendations and their operation. At the time the recommendations were being formed, they were being formed on the basis of work done by Lewis Dahl, who was performing experiments regarding sodium intake in rats. He was able to induce hypertension in these rats by giving them a bunch of salt. So, hypertension is caused by sodium, right?

Maybe, if these rats were humans, he would have been giving them the equivalent of 4 cups of table salt a day. That's insanely more than any of us take in and far higher than any reasonable recommendation should be. Work was also done on comparing countries with high levels of sodium intake, and correlating that with CVD, stroke, and all-cause mortality. There was a positive correlation. The problem with this is that the correlation often disappeared when comparing individuals within populations. So...problematic.

But, the findings had been released, salt can cause high blood pressure, CVD is rising, the two correlate, it's a reasonable conclusion to issue a recommendation, knowing that there's very little potential negative ramifications to doing so.

The problem with issuing a recommendation on things is exactly what has been evidenced in this thread -- "well, if the AHA says so..." Funding dries up. There's not a lot of momentum to do research that contradicts the recommendation. Every few years, they'll look at the current sodium intake (still higher than the recommendation), compare it to the initial recommendation, and say, "nope, still looks like salt's causing a problem!" There's no desire to research the initial recommendation.

Large organizations don't like to admit they were wrong -- and in the situation where the recommendation is not causing any problems healthwise (eating at 2300mg will likely cause no health problems at all), there's not a lot of push for them to do so. They can keep pointing back at the initial research (and their yearly papers comparing intake to those levels) and keep on truckin', as it were. That's just the nature of large organizations - they're conservative, and don't like to go out on a limb if it's not necessary.

Luckily, we're starting to get some science showing that the initial recommendation is likely incorrect, and my thought is that we will continue to see more if it over the years. I would guess that the AHA will reverse their sodium recommendation (or update it) within the next 10 years, but that's just a guess.