Does Sugar Intake Raise Cholesterol Levels?
High blood sugar (sugar) levels are associated with a number of complications, including abnormal cholesterol. Binding factor: insulin resistance – when cells no longer respond appropriately to the hormone insulin. As a result, a person may have an abnormal cholesterol profile: low levels of high-density lipoprotein (HDL, or “good cholesterol”), low levels of low-density lipoprotein (LDL, or “bad cholesterol”), and high levels of triglycerides. These cholesterol abnormalities can increase the risk of heart disease and stroke. With this in mind, managing diabetes or diabetics is about more than just controlling blood sugar levels. It’s also about trying to protect your cardiovascular health.
Causes of unhealthy cholesterol in the body
There are two main forms of cholesterol. The first, LDL cholesterol, is often referred to as “bad” cholesterol. High levels of LDL cholesterol in the body are considered unhealthy. The other is HDL cholesterol, sometimes referred to as “good” cholesterol. High HDL cholesterol can be a sign of good health. If your doctor tells you that you have high cholesterol, he or she is usually referring to high LDL cholesterol or total cholesterol. Total cholesterol is sometimes called serum cholesterol. It is the sum of LDL and HDL cholesterol and 20% of triglycerides. Both LDL and total cholesterol can be used as indicators of your risk for cardiovascular disease and other complications. There are many risk factors for unhealthy cholesterol levels, including genetics, lifestyle choices, or a combination of both.
Insulin resistance and cholesterol changes
After eating, carbohydrates are broken down by the digestive system into glucose. This glucose is absorbed through the intestinal wall and enters the bloodstream. Once there, insulin – a hormone produced by the pancreas that is the primary regulator of carbohydrate metabolism – carries the glucose to individual cells so they have enough energy to function and do their jobs. Insulin also prevents the breakdown of fat into fatty acids (lipolysis). 1 When cells become less responsive to this process, insulin resistance occurs. This leads to elevated blood glucose levels and is considered a precursor to diabetes and type 2 diabetes. In particular, insulin resistance decreases HDL and increases triglycerides and LDL. The combination of low HDL or high LDL and high triglycerides is associated with the accumulation of plaque (fatty deposits) in the walls of the arteries. This condition is called atherosclerosis and increases the risk of heart attacks and strokes.
Metabolic syndrome, as the name implies, is not a specific disease or condition. Rather, it is a group of conditions that increase the likelihood of developing type 2 diabetes and heart disease. Often preceded by insulin resistance, it can be seen as a potential “next step” in what is essentially a higher risk to heart health from high blood sugar levels. The U.S. National Cholesterol Education Program defines metabolic syndrome as having three or more of the following characteristics5
- Abdominal obesity, defined as a waist circumference of 40 inches or more in men and 35 inches or more in women
- Triglycerides greater than 150 milligrams per deciliter (mg/dL) or treated for high triglycerides.
- HDL less than 40 mg/dL in men and less than 50 mg/dL in women, or treated for low HDL levels
- Blood pressure of 130/85 millimeters of mercury (mmHg) or higher, or you are being treated for hypertension.
- Fasting blood glucose level of 100 mg/dL or higher, or you are being treated for hyperglycemia
- Treatment of metabolic syndrome, especially to prevent the development of type 2 diabetes and/or heart disease.
- Weight loss. Weight loss of 5% is associated with improvements in cholesterol status, blood glucose levels and insulin resistance.
- At least 30 minutes of moderate intensity exercise (e.g., brisk walking, dancing, water aerobics) daily.
- Follow a healthy diet. The commonly recommended Mediterranean diet is rich in fruits, vegetables, nuts, whole grains and olive oil7.
- Quit smoking
- Lower blood pressure: through lifestyle changes and medication (if necessary), aim for a blood pressure below 130/80
- Lower cholesterol: this is done through lifestyle changes and medication (if needed) with the goal of getting LDL below 80-100 mg/dL.
- Improve blood sugar control: this is achieved through lifestyle changes and medication (if you are diabetic, of course.)
- Currently, the Food and Drug Administration (FDA) has not approved drugs to treat hyperglycemia caused by insulin resistance. However, studies have shown that taking metformin (a drug that lowers blood sugar) can help prevent the development of type 28 diabetes.
When to see your doctor
If you haven’t had your annual physical exam, or if you are experiencing symptoms that may indicate hyperglycemia (for example, frequent urination, unusual thirst or blurred vision), be sure to make an appointment with your internist or family doctor. Most people with hyperglycemia or insulin resistance do not have any symptoms. Therefore, it is important to have regular checkups with your doctor. Your doctor may perform blood tests, such as a fasting glucose test or a hemoglobin A1C test. He or she may also order a lipid test to check your blood cholesterol levels and to monitor your blood pressure and weight. Based on your doctor’s evaluation and test results, you can work together to develop a plan to reduce your risk of heart attack or stroke.
Symptoms And Complications Of High Blood Sugar
Control your sugar intake
The World Health Organization (WHO) recommends consuming no more than 10 percent of calories or 5 percent of sugar to improve health; the American Medical Association also recommends no more than 100 calories per day for women and no more than 150 calories per day for men from added sugar, which is 6 and 9 teaspoons, respectively. Unfortunately, this is far fewer calories than most Americans are currently estimated to receive. On a side note, 10 soy candy bars contain 78.4 calories of added sugar, or about 20 grams of sugar (4 teaspoons), which for women is almost all the pocket money you’ll ever need. Learn how to identify sugar on food labels. Sugar is not always listed as sugar on food labels. Ingredients such as corn syrup, honey, maltose, molasses, molasses, corn sweetener, and any word ending in “ose” (e.g., glucose, fructose) are all added sugars. Look for good substitutes. Not all sugar substitutes are created equal, and some come with their own set of risks. Stevia, a plant-based sweetener, is a true sugar substitute, unlike agave and honey, which still contain sugar molecules. Just as you control your alcohol, calorie and saturated fat intake, you need to control your sugar intake. It’s okay to have a few now and then, but sugar can be hard on your heart.