A Month Without Sugar

David Leonhardt, NY Times, Dec. 30, 2016

It is in chicken stock, sliced cheese, bacon and smoked salmon, in mustard and salad dressing, in crackers and nearly every single brand of sandwich bread. It is all around us–in obvious ways and hidden ones–and it is utterly delicious.

It’s sugar, in its many forms: powdered sugar, honey, corn syrup, you name it. The kind you eat matters less than people once thought, scientific research suggests, and the amount matters much more. Our national sugar habit is the driving force behind the diabetes and obesity epidemics and may be a contributing factor to cancer and Alzheimer’s.

Like me, you’ve probably just finished a couple of weeks in which you have eaten a whole lot of tasty sugar. Don’t feel too guilty about it. But if you feel a little guilty about it, I’d like to make a suggestion.

Choose a month this year–a full 30 days, starting now or later–and commit to eating no added sweeteners. Go cold turkey, for one month.

I have done so in each of the last two years, and it has led to permanent changes in my eating habits. It wasn’t easy, but it was worth it. It reset my sugar-addled taste buds and opened my eyes to the many products that needlessly contain sugar. I now know which brands of chicken stock, bacon, smoked salmon, mustard and hot sauce contain added sugar and which do not.

I know that Triscuits and pita bread are our friends. They have only a few ingredients, and no sugar. Wheat Thins and most packaged sandwich breads, on the other hand, have an ingredient list that evokes high school chemistry class, including added sugars.

If you give up sugar for a month, you’ll become part of a growing anti-sugar movement. Research increasingly indicates that an overabundance of simple carbohydrates, and sugar in particular, is the No. 1 problem in modern diets. An aggressive, well-financed campaign by the sugar industry masked this reality for years. Big Sugar instead placed the blame on fats–which seem, after all, as if they should cause obesity.

But fats tend to have more nutritional value than sugar, and sugar is far easier to overeat. Put it this way: Would you find it easier to eat two steaks or two pieces of cake?

Fortunately, the growing understanding of sugar’s dangers has led to a backlash, both in politics and in our diets. Taxes on sweetened drinks–and soda is probably the most efficient delivery system for sugar–have recently passed in Chicago, Philadelphia, Oakland, San Francisco and Boulder, Colo. Mexico and France now have one as well, and Ireland and Britain soon will.

Even before the taxes, Americans were cutting back on sugar. Since 1999, per capita consumption of added sweeteners has fallen about 14 percent, according to the Agriculture Department.

Yet it needs to drop a lot more–another 40 percent or so–to return to a healthy level. “Most public authorities think everybody would be healthier eating less sugar,” says Marion Nestle of N.Y.U. “There is tons of evidence.”

A good long-term limit for most adults is no more than 50 grams (or about 12 teaspoons) of added sugars per day, and closer to 25 is healthier. A single 16-ounce bottle of Coke has 52 grams.

You don’t have to cut out sugar for a month to eat less of it, of course. But it can be difficult to reduce your consumption in scattered little ways. You can usually find an excuse to say yes to the plate of cookies at a friend’s house or the candy jar during a meeting. Eliminating added sugar gives you a new baseline and forces you to make changes. Once you do, you’ll probably decide to keep some of your new habits.

My breakfasts, for example, have completely changed. Over the past few decades, typical breakfasts in this country have become “lower-fat versions of dessert,” as Gary Taubes, the author of a new book, “The Case Against Sugar,” puts it.

Mine used to revolve around cereal and granola, which are almost always sweetened. Now I eat a combination of eggs, nuts, fruit, plain yogurt and some well-spiced vegetables. It feels decadent, yet it’s actually healthier than a big bowl of granola.

How should you define sugar during your month? I recommend the definition used by Whole 30, a popular food regimen (which eliminates many things in addition to sugar). The sugar that occurs naturally in fruit, vegetables and dairy is allowed. “Nobody eats too much of those,” Nestle says, “not with the fiber and vitamins and minerals they have.”

But every single added sweetener is verboten. No sugar, no corn syrup, no maple syrup, no honey, no fancy-pants agave. Read every ingredient list, looking especially for words that end in “-ose.” Don’t trust the Nutrition Facts table next to the ingredient list, because “0 g” of sugar on that list really means “less than 0.5 g.” Get comfortable asking questions in restaurants. And avoid the artificial sweeteners in diet sodas, too.

Part of the goal, remember, is to relearn how a diet that isn’t dominated by sweeteners tastes. I’ve always liked fruit, but I was still pleasantly surprised by how delicious it was during the month. When I needed a midday treat, a Honeycrisp apple, a few Trader Joe’s apricots or a snack bar that fit the no-sugar bill saved me.

Finally, be careful not to violate the spirit of the month while sticking to the formal rules: Have only one small glass of juice a day, and eat very little with added fruit juices.

There were certainly times when I didn’t enjoy the experience. I missed ice cream, chocolate squares, Chinese restaurants and cocktails. But I also knew that I’d get to enjoy them all again.

The unpleasant parts of a month without sugar are temporary, and they’re tolerable. Some of the benefits continue long after the month is over. If you try it and your experience is anything like mine, I predict that your new normal will feel healthier and no less enjoyable than the old.

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The 8 Health Habits Experts Say You Need in Your 20s

By Tara Parker-Pope, NY Times, Oct. 17, 2016

If you had just one piece of health advice for people in their 20s, what would it be?

That’s the question we posed to a number of experts in nutrition, obesity, cardiology and other health disciplines. While most 20-year-olds don’t worry much about their health, studies show the lifestyle and health decisions we make during our third decade of life have a dramatic effect on how well we age.

Staying healthy in your 20s is strongly associated with a lower risk for heart disease in middle age, according to research from Northwestern University. That study showed that most people who adopted five healthy habits in their 20s–a lean body mass index, moderate alcohol consumption, no smoking, a healthy diet and regular physical activity–stayed healthy well into middle age.

And a disproportionate amount of the weight we gain in life is accumulated in our 20s, according to data from the Centers for Disease Control and Prevention. The average woman in the United States weighs about 150 when she’s 19, but by the time she’s 29, she weighs 162 pounds–that’s a gain of 12 pounds. An average 19-year-old man weighs 175 pounds, but by the time he hits 29 he is nine pounds heavier, weighing in at 184 pounds.

But it can be especially difficult for a young adult to focus on health. Young people often spend long hours at work, which can make it tough to exercise and eat well. They face job pressure, romantic challenges, money problems and family stress. Who has time to think about long-term health?

To make it easier, we asked our panel of experts for just one simple piece of health advice. We skipped the obvious choices like no smoking or illegal drug use–you know that already. Instead we asked them for simple strategies to help a 20-something get on the path to better health. Here’s what they had to say.

Weigh yourself often.–Susan Roberts, professor of nutrition at Tufts University and co-founder of the iDiet weight management program.

Buy a bathroom scale or use one at the gym and weigh yourself regularly. There is nothing more harmful to long-term health than carrying excess pounds, and weight tends to creep up starting in the 20s. It is pretty easy for most people to get rid of three to five pounds and much harder to get rid of 20. If you keep an eye on your weight you can catch it quickly.

Learn to cook.–Barbara J. Rolls, professor and Guthrie Chair of Nutritional Sciences at Penn State

Learning to cook will save you money and help you to eat healthy. Your focus should be on tasty ways to add variety to your diet and to boost intake of veggies and fruits and other nutrient-rich ingredients. As you experiment with herbs and spices and new cooking techniques, you will find that you can cut down on the unhealthy fats, sugar and salt, as well as the excess calories found in many prepared convenience foods. Your goal should be to develop a nutritious and enjoyable eating pattern that is sustainable and that will help you not only to be well, but also to manage your weight.

Cut back on sugar.–Steven E. Nissen, chairman of cardiovascular medicine at the Cleveland Clinic Foundation

I suggest that young people try to avoid excessive simple sugar by eliminating the most common sources of consumption: 1) sugared soft drinks 2) breakfast cereals with added sugar and 3) adding table sugar to foods. Excessive sugar intake has been linked to obesity and diabetes, both of which contribute to heart disease. Sugar represents “empty calories” with none of the important nutrients needed in a balanced diet. Conversely, the traditional dietary villains, fat, particularly saturated fat, and salt, have undergone re-examination by many thoughtful nutrition experts. In both cases, the available scientific evidence does not clearly show a link to heart disease.

Live an active life.–Walter Willett, chairman of the nutrition department at the Harvard School for Public Health

While many people can’t find time for a scheduled exercise routine, that doesn’t mean you can’t find time to be active. Build physical activity into your daily life. Find a way to get 20 or 30 minutes of activity each day, including riding a bike or briskly walking to work.

Eat your veggies.–Marion Nestle, professor of nutrition, food studies and public health at New York University

Nutrition science is complicated and debated endlessly, but the basics are well established: Eat plenty of plant foods, go easy on junk foods, and stay active. The trick is to enjoy your meals, but not to eat too much or too often.

Practice portion control.–Lisa R. Young, adjunct professor of nutrition at New York University

My tip would be to not to ban entire food groups but to practice portion control. Portion control doesn’t mean tiny portions of all foods–quite the opposite. It’s okay to eat larger portions of healthy foods like vegetables and fruit. No one got fat from eating carrots or bananas. Choose smaller portions of unhealthy foods such as sweets, alcohol and processed foods. When eating out, let your hand be your guide. A serving of protein like chicken or fish should be the size of your palm. (Think 1-2 palms of protein.) A serving of starch, preferably a whole grain such as brown rice or quinoa should be the size of your fist. Limit high-fat condiments like salad dressing to a few tablespoons–a tablespoon is about the size of your thumb tip.

Adopt a post-party exercise routine.–Barry Popkin, professor of global nutrition at the University of North Carolina at Chapel Hill

If you engage in a lot of drinking and snacking, ensure you exercise a lot to offset all those extra calories from Friday to Sunday that come with extra drinking and eating. We found in a study that on Friday through Sunday young adults consumed about 115 more calories than on other days, mainly from fat and alcohol.

Find a job you love.–Hui Zheng, associate sociology professor, population health, Ohio State University

Ohio State University research found that work life in your 20s can affect your midlife mental health. People who are less happy in their jobs are more likely to report depression, stress and sleep problems and have lower overall mental health scores. If I can give just one piece of health advice for 20-year-olds, I would suggest finding a job they feel passionate about. This passion can keep them motivated, help them find meaning in life, and increase expectations about their future. That in turn will make them more engaged in life and healthier behaviors, which will have long term benefits for their well-being.

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The sugar industry funded one of the biggest misconceptions in modern nutrition

Kate Taylor, Business Insider, Sept. 12, 2016

New research reveals that a dangerous cornerstone of American nutrition in the 20th century was funded by the sugar industry.

The sugar industry worked with scientists in the 1950s and 1960s to downplay sucrose’s role in causing coronary heart disease and other nutritional risks, according to a paper by UC San Francisco researchers published in JAMA Internal Medicine on Monday.

In other words, the move to single out fat and cholesterol as the biggest problems in American diets was a coordinated effort by trade association Sugar Research Foundation, intended to increase the consumption of sucrose.

The crux of the new research is a 1965 paper that played a major role in making low-fat diets the nutritional norm in the US. The Sugar Research Foundation paid the modern equivalent of $50,000 to fund the project, which argued cholesterol–not sucrose–was the sole relevant factor in studying and preventing coronary heart disease.

However, this funding was not disclosed when the literature review was published in 1967, despite the fact that the sugar industry set the review’s objective, contributed articles, and read drafts prior to publication.

“The literature review helped shape not only public opinion on what causes heart problems but also the scientific community’s view of how to evaluate dietary risk factors for heart disease,” lead author Cristin Kearns said in a statement.

UCSF researchers concluded that the sugar industry had a hand in guiding researchers to recommend low-fat diets after analyzing more than 340 documents between the sugar industry and two scientists, Roger Adams and D. Mark Hegsted.

Last year, it was revealed that the Sugar Research Foundation similarly downplayed the role of sugar in cavity prevention and tooth decay.

As the low-fat diet trend took hold of the US, the sugar industry thrived. Food makers began replacing fat with sugar–which is exactly what the industry had wanted.

“This change would mean an increase in the per capita consumption of sugar more than a third with tremendous improvement in general health,” Sugar Research Foundation president Henry Hass said in 1954, addressing nutritional research that could encourage Americans to eat less fat.

Coca-Cola has been similarly accused of funding research that downplays the role of sugar-sweetened drinks in the modern obesity crisis.

However, the research that condemned fat while ignoring the role of sugar is now widely seen as misguided.

Americans consume 30% more sugar daily now than three decades ago, according to the Obesity Society. American children eat three times as much added sugar as they should.

While the paper studied the sugar industry’s influence on nutritional research in the 1950s and 60s, concerns that food makers still play an oversized role in scientific research remains today.

“We have to ask ourselves how many lives and dollars could have been saved, and how different today’s health picture would be, if the industry were not manipulating science in this way,” Jim Krieger, executive director of Health Food America, said in a comment about the paper. “Only 50 years later are we waking up to the true harm from sugar. Yet industry continues to use its time-honored tactics of creating doubt about valid science they deem damaging to its bottom line and deflecting blame from their products.”

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This Is What Happens When You Drink 10 Cans Of Soda Per Day for One Month

Laura Kenney, Yahoo Health, December 1, 2014

It’s not news that soda is bad for us. But it is jarring to witness the physical effects drinking too much of it has on our waistlines.

George Prior, 50, has guinea-pigged his body to do just that.

Following in the body-hacking footsteps of Morgan Spurlock—the “Super Size Me” filmmaker who in 2004 ate three McDonald’s meals for 30 days straight—Prior began guzzling down ten 12-ounce cans of Coca Cola daily for one month to see how the whopping dose of added sugar would affect his healthy physique. He documented it all on his website, 10 Cokes A Day.

“I got the idea because I read that Jude Law drank 10 Cokes a day to gain weight for his Dom Hemingway role, and I was joking with one of my brothers that that was probably a diet for some people,” Prior tells Yahoo Health. “But then we realized that amount of sugar isn’t that far from the norm for many Americans, so then I got really curious what would happen to me if I really drank ten Cokes, and it sounded like a fun experiment.”

On day one, Prior reported in the video, “I’ve just gotten back from the doctor where I’ve had a complete physical. I’m 50 years old and in good health.”

The Los Angeleno then began consuming 10 cans of Coke per day. That’s an additional 1,400 calories and 390 grams of sugar per day.

On day nine, Prior woke up weighing 176 pounds, eight pounds heavier than when he started. “I’ve gained 2 pounds since yesterday,” Prior reported. “I don’t feel good.”

By day 15, Prior’s body fat had jumped from 8 to 14 percent.

And after the full 30 days, he had gained 23 pounds. “I feel heavier, I can’t wear my long pants to work anymore,” said Prior in the video. “My clothes all fit tightly and I can’t bend over easily.”

Ten cans of soda seems excessive, but Prior was consuming just twice the amount of added sugar that the average American eats daily. According to the USDA, Americans eat 156 pounds of added sugar every year, which breaks down to 194 grams per day. During his challenge, Prior drank 390 grams of added sugar daily.

The Recommended Daily Allowance of sugar for men is 36 grams, and 24 grams for women.

“Most people know that soda is not good for them, but for some reason, they think the risk of excess sugar consumption is less than that of having too much saturated and trans fat, sodium or calories,” says Kristin Kirkpatrick, R.D, wellness manager at the Cleveland Clinic. “Perhaps it’s sugar’s lack of sodium or fat that make it the ‘lesser of several evils,’ or perhaps people are simply of the mind frame that what they don’t know won’t hurt them.”

Sugar not only makes us pack on pounds, but it also can damage your heart, is linked to cancer, is as toxic to your liver as too much alcohol and can even make your brain age quicker and accelerate memory loss.

What did Prior do on Day 31, when the challenge ended? He threw away his unused cans of Coke. “If I have to drink another Coke in 1,000 years it would be one Coke too soon,” he said in the video.

While the “feeling of constant fullness and the basic inconvenience” of drinking all that soda were not enjoyable, Prior tells Yahoo Health “the worst actual physical discomfort was in the two days after I stopped drinking the Cokes,” which is when he “felt nauseated and tired and without appetite.”

But Kirkpatrick cautions that while many of us strive to avoid the “normal” sugary culprits—soda joins a long list with candy, cookies, cake, etc.—we are often duped by secret sugar-packed foods. “Examples include tomato sauce, fat-free dressing, tonic water, marinades, crackers and even bread,” she says.

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Robert Lustig on ABC: Sugar - the Bitter Truth!

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Sugar Is Now The Number One Enemy In The Western Diet

Aseem Malhotra, The Guardian, Jan. 11, 2014

In 2012, the United Nations World Health Assembly advocated a significant new health goal: to reduce avoidable deaths from non-communicable diseases (NCDs) by 25% by 2025. Cardiovascular disease, diabetes, cancer and respiratory disease kill 35 million per year. The UN has identified tobacco, alcohol and poor diet as central risk factors. The first two have been regulated by governments in order to protect public health, but poor diet is actually responsible for more disease than smoking, alcohol and physical inactivity combined.

But what component of the western diet should be targeted? The evidence suggesting that added sugar should be the target is now overwhelming. Unlike fat and protein, refined sugars offer no nutritional value and, contrary to what the food industry want you to believe, the body does not require any carbohydrate from added sugar for energy. Thus it is a source of completely unnecessary calories.

Sugars are added to the majority of processed foods in the UK. Yet disturbingly, many consumers are unaware of its presence in such large quantities. In the UK and Europe guideline daily amounts for sugar have not been updated since 2003. These obsolete guidelines still suggest one can consume a staggering 22 teaspoons of sugar daily.

The World Health Organisation has recently been advised by scientific experts that added sugar or, more specifically, non-milk extrinsic sugar should constitute no more than 5% of energy. That would give a limit to the average man of a maximum of eight teaspoons a day and the average woman to six tea spoons a day. And that would include sugars from fruit juice and honey.

The misleading labelling and health claims on “low fat” foods that actually have shocking levels of sugar added is a scandal. Worse still, it has created the perfect storm for public health. Therefore, last Thursday, a group of UK and international experts, including myself, launched Action On Sugar. The main aim is to pressure the food industry to reduce added sugar in foods by 40% over four years. That would mean 100 fewer calories per person, which according to the UK Department of Health would reverse the obesity epidemic.

However, the industry remains in denial. Barbara Gallani, director of regulation at the Food and Drink Federation, made a statement of immediate resistance, denying sugar’s role in obesity and failing to acknowledge the multitude of scientific studies to the contrary. We mustn’t forget that it took 50 years from when the first scientific studies between smoking and lung cancer were made before any effective legislation was introduced through regulation. Why? Because Big Tobacco very successfully adopted a corporate strategy of denial. By planting doubt, confusing the public, bribing political allies and even buying the loyalty of rogue scientists.

We are all vulnerable, because you don’t have to be overweight to be affected by diet-related disease. Of all the chronic diseases, type 2 diabetes, which is entirely preventable, is perhaps the most damaging. Diabetes increases the risk of heart attack, stroke, kidney failure, eye disease and leg amputations. Up to half of all diabetic patients go on to suffer acute or chronic pain, and two-thirds will ultimately develop dementia. The direct and indirect costs to the UK of diabetes is over £24bn and projected to approach £40bn by 2030.

How does sugar compare to tobacco? A teaspoon of sugar or one cigarette will not harm you. But over time, the habit can be fatal. Unlike Big Tobacco, Big Sugar deliberately targets children. And added sugar has become so pervasive within the food environment that we can’t avoid it even if we wanted to. It is thus not simply a matter of personal choice. But perhaps most disturbing of all the similarities is the financial and political muscle that both industries have exerted to try and protect their profits, at the expense of our health. It’s time to wind back the harms of too much sugar, reverse the “diabesity” epidemic and the unspeakable suffering it causes.

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In Food Cravings, Sugar Trumps Fat

By Anahad O’Connor, NY Times, December 13, 2013

What makes a milkshake so irresistible?

Is it the sweet flavor that our taste buds are after? Or the smooth and creamy texture? Or perhaps it is the copious blend of fat and sugar?

An intriguing new study suggests that what really draws people to such treats, and prompts them to eat much more than perhaps they know they should, is not the fat that they contain, but primarily the sugar.

The new research tracked brain activity in more than 100 high school students as they drank chocolate-flavored milkshakes that were identical in calories but either high in sugar and low in fat, or vice versa. While both kinds of shakes lit up pleasure centers in the brain, those that were high in sugar did so far more effectively, firing up a food-reward network that plays a role in compulsive eating.

To their surprise, the researchers found that sugar was so powerful a stimulus that it overshadowed fat, even when the two were combined in large amounts. High sugar shakes that were low in fat ramped up the reward circuitry just as strongly as the more decadent shakes that paired sugar and fat in large quantities, suggesting that fat was a runner-up to sugar, said Eric Stice, the lead author of the study, which was funded by the National Institutes of Health and published in The American Journal of Clinical Nutrition.

"We do a lot of work on the prevention of obesity, and what is really clear not only from this study but from the broader literature over all is that the more sugar you eat, the more you want to consume it," said Dr. Stice, a senior research scientist at the Oregon Research Institute. "As far as the ability to engage brain reward regions and drive compulsive intake, sugar seems to be doing a much better job than fat."

The new findings add to a growing number of brain studies that are providing a more complex understanding of what drives people to overeat in the first place.

Heavily processed foods loaded with fat and sugar activate and potentially alter the same reward regions in the brain that are hijacked by alcohol and drugs of abuse. Though the extent to which these foods can provoke addictive behavior remains controversial, the results may help explain why millions of people who diet and struggle to lose weight ultimately fail.

"The obesity epidemic and the problems with overeating don’t have too much to do with people overeating fruits and healthy foods. They have a lot to do with people overeating excess sugars and fats," said Nicole Avena, a faculty member at the New York Obesity Research Center at Columbia University, who was not involved in the new study.

Dr. Avena said that people “can have all the willpower in the world. But if the brain reward system is being activated in a way that causes them to have a battle against their willpower, then it can be very difficult for them to control their intake.”

Dr. Stice said the bulk of brain research on fat and sugar was pointing to the idea that addressing societal problems with overeating should start with sugar.

"If you look at our American diet, most people are consuming considerably more sugar than fat," he said. "We’ve really ramped up the sugar in our diets, but we’ve backed off on fat."

In her own research, Dr. Avena has found that sugar and fat influence brain chemistry and behavior when consumed in large quantities. Animals given small amounts of each do not show many changes. But when they are given unlimited access to either, those that gorge on sugar in particular show changes in their opiate receptors—which help regulate pain, reward and euphoria—and when the sugar is suddenly taken away, they show signs of withdrawal.

Another researcher who has studied the impact of fat and sugar on the brain in people, Dr. David Ludwig, said it was not so much the “immediate hedonic response” to junk food that drives overconsumption, but its impact on the brain and the body over several hours.

Dr. Ludwig and his colleagues showed in brain imaging studies on adults that high sugar milkshakes stimulate reward regions but also cause spikes and drops in blood sugar levels. Four hours later, they showed, these blood sugar drops stimulate changes in brain activity that induce cravings—and those cravings are typically for foods that can quickly restore blood sugar levels, like desserts, starches and sweets.

"These foods themselves are not inherently addictive through their taste per se," said Dr. Ludwig, the director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital. "It’s the effects that they have on our metabolism. If our blood sugar is stable, we can walk by a bakery and be much less tempted than if our blood sugar is crashing. Your brain knows these foods are going to rescue low blood sugar. But then this sets up the next cycle."

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