In 1975, British nutritionist Dr. Judith Mazzeo published an early analysis of sugar consumption trends in the population. However, the historical trail leads elsewhere: As early as the 1960s, dentist Dr. Herta Hafer demonstrated through awareness campaigns in Europe how free sugar drives tooth decay—a watershed moment in health policy that later motivated the WHO to establish threshold values. While men dominated industrial policy, women advanced prevention in everyday practices, public health, and nutrition counseling. Today we know: The path from sweet to harmful does not stop at the teeth. It goes straight to the heart.

Sugar is not just sugar. Under added sugarsugar such as sucrose, glucose, fructose, syrups added to foods/beverages either industrially or at home, it refers to sweetness that exceeds natural occurrences. Especially problematic are sugar-sweetened beveragessodas, energy drinks, sweetened teas, and juices with added sugar, as they provide calories without satiety. Ultra-processed foodsheavily industrially processed products containing emulsifiers, flavorings, high sugar, fat, and salt combine high sugar amounts with low nutrient density. For the heart, not only the quantity matters, but also the source: Liquid sugar rapidly enters the bloodstream, spikes insulin levels, promotes insulin resistancereduced responsiveness of cells to insulin, and favors visceral fatfat tissue around internal organs, which is hormonally active and fuels inflammation. Fibers from fruits, vegetables, and whole grains act as a counterbalance: they slow sugar absorption, modulate gut flora, and improve blood sugar and blood lipid profiles.

The high consumption of sugar-sweetened beverages is linked to weight gain, type 2 diabetes, and an increased risk of cardiovascular disease ^[1]. Excess fructose—prominently found in many processed foods—contributes to metabolic dysregulation, inflammation, and vascular damage, which burden heart function and blood pressure ^[2]. A large cohort analysis from Sweden links added sugar, especially in beverages, with a higher risk of ischemic stroke, heart failure, atrial fibrillation, and abdominal aortic aneurysm; the authors explicitly emphasize the detrimental role of sweet beverages ^[3]. Conversely, plant-focused, minimally processed dietary patterns rich in fiber are associated with lower heart risk—they stabilize blood sugar and reduce blood pressure and inflammatory biomarkers ^[4]. Over decades, it also appears that the higher the intake of free sugars and SSBs, the higher the risk for metabolic syndrome—the metabolic precursor of many heart problems ^[5].

The evidence landscape paints a consistent picture. A comprehensive assessment of evidence-based nutrition research shows: Plant-dominated, minimally processed patterns (e.g., Mediterranean, DASH, vegetarian) reduce cardiovascular risk, while sugar- and UPF-rich patterns increase it. Food plants provide fiber and bioactive compounds that favorably influence blood lipids, blood pressure, and inflammation; supplements, on average, show no heart-protective effects ^[4]. Beyond the source of sugar, its delivery also matters: In a large Scandinavian cohort with repeated dietary assessments, sweet beverages were clearly associated with several cardiovascular endpoints, while the authors report heterogeneous findings for other sugar categories—pointing to the idea that liquid sugar is particularly problematic ^[3]. Long-term data from the CARDIA study over three decades additionally show that high intakes of added sugar, sugar-rich products, and SSBs are consistently associated with an increased risk of metabolic syndrome—a cluster of abdominal obesity, hypertension, dyslipidemia, and insulin resistance that burdens the heart in the long term ^[5]. Mechanistically, reviews on fructose underpin the role of oxidative stress, inflammation, and lipid metabolism disturbances as drivers of heart and vascular damage, especially with high fructose content in UPFs ^[2].

- Sustainably lower added sugar to below 10% of your daily calories. Start where it matters most: swap sugar-sweetened beverages for water, mineral water with citrus, unsweetened tea, or coffee. This reduction targets the source most strongly linked to heart events in cohorts ^{[3] [1]}.
- Fuel yourself with fiber to become "sugar-proof." Fill each meal with fruits, vegetables, and whole grains—like oats plus berries for breakfast, lentil salad at lunch, and vegetables and whole grains in the evening. Plant-based, minimally processed patterns lower blood pressure and CVD risk and stabilize blood sugar ^[4].
- Set measurable, realistic sugar goals for 30 days. Define a clear upper limit (e.g., aligning with WHO guidelines), plan specific “if-then” situations (If afternoon slump, then apple + nuts instead of a bar), and track daily. A brief, internet-based intervention with coaching drastically reduced sugar consumption within 30 days and improved well-being and self-efficacy—a practical blueprint for your daily life ^[6].
- De-sugar your environment. Store sweets out of sight, replace workplace snacks with nuts, plain yogurt, fruit; check labels for syrups and “hidden” sugars. This reduces unconscious impulses—particularly effective for liquid sugar ^{[1] [3]}.
- Plan “sweet anchors” deliberately. Set 2-3 moments of enjoyment per week, ideally after a fiber-rich meal. This smooths blood sugar spikes and keeps total intake below the 10% mark ^{[3] [4]}.

The next research steps will specify which sugar sources and meal contexts particularly drive heart risks—especially the long-term effects of specific beverages and ultra-processed products ^{[3] [7]}. Simultaneously, scalable digital short interventions with goal-setting and self-monitoring are needed to confirm and sustain the strong effects of pilot studies in everyday life ^[6].