Experts often call  sugar-laden drinks and sweets “empty calories" because they pack on pounds without providing any nutrition.  But a growing body of evidence is finding that sugar is not just empty — it’s downright dangerous. Studies have linked a high-sugar diet to heart disease, diabetes, liver disease and even dementia.

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A recent study, published in the journal JAMA Internal Medicine , found that the more added sugar people consumed in their diet, the greater their risk of dying from heart disease, even after accounting for other factors like lifestyle and obesity. The study found that if added sugars make up more than 15 percent of your daily diet, your risk of dying from heart disease starts to rise. On a typical 2,000-calorie daily diet, that’s equal to drinking one 20-ounce Mountain Dew soda. The heart risk rises exponentially, so that people who get 30 percent of their calories from sugar have a fourfold increased risk of dying from cardiovascular disease.

Based on these findings and what many American adults report eating, it may be no wonder that  heart disease is the number one killer of Americans. According to the JAMA study, most American adults get more than 10 percent of their calories from added sugar. And one in 10 get a whopping 25 percent or more of their calories from added sugars. The biggest sources of added sugars are sodas and sweetened beverages like iced tea, as well as desserts, ice cream, candy and sweetened cereals.

Starches such as white bread and pasta are digested quickly into sugars and cause a spike in blood sugar levels, but unless you have diabetes, they have not been shown to be as harmful as added sugars.

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It’s not clear why sugar on its own increases the risk of dying from cardiovascular disease. Some studies have shown that excessive sugar contributes to  high blood pressure, as well as high cholesterol and triglycerides, all risk factors for heart disease.

The American Heart Association (AHA) recommends limiting added sugars to less than 100 calories (about 6 teaspoons) daily for women and 150 calories (about nine teaspoons) daily for men. The World Health Organization recommends that calories from added sugars make up less than 10 percent of your total calories.

Though some sugars may be slightly more harmful than others, the AHA does not distinguish between sources of sugar, but recommends you focus on your overall intake. “All added sugars — sugars added during the processing or preparation of foods — are metabolized similarly,” says Rachel Johnson, PhD, MPH, a registered dietitian and professor of medicine at the University of Vermont. “However, the form of the sugar seems to matter when it comes to health risks. Consumption of sugary drinks such as soft drinks, sports drinks, energy drinks, fruit drinks and sweetened teas don’t result in satiety,” she says. In other words, they don't make you full.

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How to eat less added sugar

  • Drink water, not sweetened beverages, or the occasional diet drink. The AHA recommends that you consume no more than 36 ounces or 450 calories per week of sugary drinks.
  • Stop adding sugar (white and brown), syrup, honey and molasses. Try cutting in half the amount of sugar you add to coffee, tea, cereal, pancakes and other foods.
  • Limit 100-percent fruit juice to a small (6-ounce) glass a day.
  • Reduce sugar when baking. When baking cookies, brownies or cakes, cut the sugar called for in a recipe by one-quarter to one-third.
  • Get your sugar fix from fruits rather than candy or other sweets. Fruits contain beneficial antioxidants as well as fiber, which helps slow the digestion of sugar, minimizing blood sugar spikes. 

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Laurie Tarkan is an award-winning health journalist for the New York Times, national consumer magazines and websites.