Reasons This Dietitian Refuses to Cut Out Sugar

On the heels of the anti-carb movement is the notion that sugar is bad and to feel good, look good, lose weight, and be healthy, you just need to cut out sugar! Advocates of a sugar-free diet proclaim that people need to remove table sugar, sweeteners such as honey and maple syrup, condiments, dressing, refined flour, soft drinks, sweets, dairy products, and often fruits such as bananas and apples.

I don’t agree! Here’s some reasons why…

#1. I love food. All food.  And…”cutting out” a particular food “for the sake of health” would actually compromise health.

Health is more than just a physical state of being or defined by the mass of your body tissue. For any individual – especially a health provider – who believes otherwise, consider spending some time working with individuals struggling with all types of eating disorders. I have worked with plenty of people who have a healthy weight and BMI, and are far from “healthy” or able to enjoy life.

Mental and psychological well-being matters for overall health too and enjoying a variety of nutritious and enjoyable food supports this important aspect of health.

Yes, it’s true. Food is fuel and what we eat matters! As such, I’m a huge proponent of cooking at home (most of the time), and enjoying a variety of wholesome and nutrient-dense foods.

…But, there’s more to food and eating, such as food memories; heirloom recipes; favorite foods; celebrations; holidays; social events – many of which happen to include sugar. I prefer not to minimize the fact that there’s something special about food and how it brings us together. Whether it’s religious, ethnic, holiday or family traditions, food has a meaningful role.

Christmas hors d’oeuvres…my mom and daughter (making her famous fried pickles!)

For those who play the “I just enjoy these foods occasionally-card,” but you still believe the forbidden food is “bad”, or that your health will suffer because of eating these foods, that’s just a recipe for shame, guilt, stress, and anxiety. Research, Research, and more research demonstrate that people who worry about food are more likely to get caught in a cycle of restrict, eat, overeat, guilt, repent, and repeat; and, consequently gain more weight in the long run.

Most important is that some of my everyday “favorite foods,” that I’d rather not give up, contain natural or added sugar (yogurt, milk, fruit, bread, crackers), and happen to provide important nutrients (calcium, vitamin D, B vitamins, fiber, etc). Consumed in moderation, these foods make it easy to combine nutrition with convenience, affordability – and pleasure.

#2. I love to cook and bake – and sugar happens to be important ingredient for a quality food product.

One of my favorite recipes for Pecan Lassies…clearly it’s been used a bit!

I learned the hard way when fat was the “evil dietary villain”, that removing fat from cooking (i.e. replacing oil in muffins with applesauce; cream cheese in cheesecake with strained yogurt, or half-and-half with nonfat evaporated skim milk) resulted in poor food quality. At the time,  somehow I “believed” that the food was “good”. But, when I was really honest with myself, the truth was that the food and these cooking methods sucked!

The sugar-free diet explosion and food substitutions are no different. When boredom sets in after removing all the offending foods, efforts to replace sugar in recipes with Stevia or artificial sweeteners, sugar alcohols; or, the example of making a pancake with nothing more than an egg, some banana and a little cinnamon is, well, just history repeating itself.

Yes, sugar is valued (or demonized) for it’s sweet taste, but it also performs many other essential functions in cookies, cakes, and other baked goods. In addition to adding flavor, sugar affects the texture of food by creating tenderness and keeping baking goods soft and moist, while adding color and crunch in a recipe.

I’ve worked with folks who’ve tried to bake a so-called “healthy” dessert, i.e. leaving out sugar, and what resulted was a poor quality product that triggered a binge. No, this doesn’t happen to everyone, but the point is that when your experience with a particular food (taste, mouthfeel, aroma) is less than your expectations (or what your brain remembers), there can be an impulsion to keep eating hoping that eating more will provide the satisfaction you desired.

#3. I’ve been doing this “nutrition thing” for more than a couple decades and have helped many people over this time achieve their weight and health goals without needing to follow this particular “rule” and become worried or obsessed about sugar in food. I’m sensitive to the fact that we all have a unique relationship with food, so perhaps “cutting out sugar” seems like the right thing for some folks. It just seems a bit extreme and with a disrespect for the potential long term consequences of restricting or forbidding sugar – or any particular food.

I do not subscribe to the “eat like me, look like me” style of nutrition counseling, so I suppose my habits and relationship with food shouldn’t matter. Perhaps my clients, family, and myself are just “an anomaly.” I’ve actually heard that before. On the other hand, there’s a chance that all these folks, including myself, share many of the the same busy and stressful life and food challenges that everyone else does, and are evidence that it is possible to trust your body, trust your instincts with food, use non-food ways to manage stress and emotions and ultimately find balance with all foods so that you can enjoy pleasurable foods, and still “be healthy.”

#4. It’s called “Balance, Variety and Moderation.”
I know. Not a popular (nor sexy) headline. The idea that the sugar industry is out to kill us (per the reputable Dr. Oz) and headlines claiming that “Sugar is as addictive as cocaine and heroine” gets more views, followers and sells more.

For those readers who believe any of that, you may want to read “No, Sugar isn’t the new heroin” by Traci Mann, researcher from the University of Minnesota.

With respect and without judgement, the truth is that some people struggle with over-consumption – for many different reasons. Some unknowingly, while others recognize an intense and persistent draw to highly palatable foods for reward, comfort, etc. The reality is that some folks really do struggle with over-consuming sugar/food; alcohol (and I’m not referring to those with a known alcohol addiction); they may also overspend; over-commit; over-exercise – hopefully you get the idea.

In the case of over-eating – or when sugar feels like an “addiction,” making healthy and sustainable behavior change is possible. When a particular food (i.e. highly palatable foods such as sugar-laden goodies) take up residency as the go-to for nutrition, then we need to work on changing the “mental channel.”

This may mean “taking a break” from a trigger food or foods to create a safe and healthy eating environment that focuses on nutrient-dense foods. But, this is NOT
…a 10, 20, or 30- day detox.
…the idea that XYZ food (that contains sugar) is fatal and should be forbidden
…believing fear based messages about XYZ food.
…giving into the idea that “you are a flawed person” and someone else can “eat whatever they want.”

Finally…

#5. Plain and simple, it’s disordered eating to have forbidden foods.
Disordered eating has become normalized in our culture – but that doesn’t make it right or healthy. It is well established that restrictive eating, eliminating foods/food groups, and dieting is an environmental trigger for pathological eating problems and all types of eating disorders.

Not everyone has an eating disorder and eating disorders are a complex mental illness, but restriction and worrying about food is certainly an important risk factor that shouldn’t be disregarded or minimized when making or receiving nutrition recommendations.

The statistics speak for themselves. The National Eating Disorders Association (NEDA) reports that 35% of “normal dieters” progress to pathological dieting and that 20-25% of those individuals develop eating disorders. Furthermore, hospitalizations involving eating disorders have increased for all age groups, but hospitalizations for patients aged 45-65 have increased the most, by 88 percent, from 1999 to 2009.

When one considers the common emotional and behavioral symptoms of an eating disorder, it’s worth questioning the “normalization” of dieting or food restricting – “for the sake of health”.

Common Emotional and Behavioral Symptoms of an Eating Disorder:

– In general, behaviors and attitudes that indicate that weight loss, dieting, and control of food are becoming primary concerns
– Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting
– Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)
– Appears uncomfortable eating around others
– Food rituals (e.g. eats only a particular food or food group [e.g. condiments], excessive chewing, doesn’t allow foods to touch)
– Skipping meals or taking small portions of food at regular meals
– Any new practices with food or fad diets, including cutting out entire food groups (no sugar, no carbs, no dairy, vegetarianism/veganism)
– Withdrawal from usual friends and activities
– Frequent dieting
– Extreme concern with body size and shape
– Frequent checking in the mirror for perceived flaws in appearance
– Extreme mood swings

Source: National Eating Disorders Association

Finally, an individual’s relationship with food, eating and weight is a very personal and even intimate topic.

Nutrition is a science that interprets the interaction of nutrients in food in relation to growth, development, health and disease in an organism. But, overall health is more than just how nutrients function in our body.

Enjoying a variety of pleasurable foods and understanding how the “joy of eating” feeds our soul and makes life interesting, adventuresome and fun is something I would encourage anyone to not miss out on!

Tips for Choosing a Nutrition Bar

Most individuals are able to meet their nutrition needs with a balanced diet. However, the focus on athleticism and wellness along with the necessity of convenience has propelled nutrition or energy bars to be one of the fastest growing food categories in America. With hundreds of nutrition bars to choose from, promising everything from performance gains to optimal health, it’s no wonder that consumers are more confused than ever about which bar is right for them.

Nutrition bar basics. A nutrition or energy bar is a blend of simple and complex carbohydrates, protein, fat, fiber, vitamins and minerals. The size of each bar varies with brand and may contain anywhere from 100 to 300 calories. The primary source of protein usually comes from dairy, soy, or nuts. Fats may come from nuts, seeds, or coconut, but also less healthy sources such as hydrogenated fats and oils. Quality sources of carbohydrate in bars include fruit, oatmeal, rice, and other natural sugars (more on this later).

What type of bar do you need? To figure out which bar is best for you, it’s important to clarify what it is you’re hoping a nutrition bar will do for you.

Are you looking for an in-between meal snack? Choose a bar that provides around 150 to 200 calories and a balance of both protein (around 7 to 15 grams) and carbohydrate (15 to 30 grams). If your favorite bar is low in protein, consider adding a handful of almonds or glass of milk to promote satiety between meals.

For a post-workout recovery snack, look for a bar that provides around 20 grams of protein for repair and recovery of muscle tissue. Carbohydrate is also recommended for refueling glycogen stores with about 2 to 3 times as many grams of carbohydrates to protein, but will also depend on an individual’s overall energy and macronutrient needs.

When choosing a bar for fueling during exercise, easily digestible carbohydrates are needed to maintain energy and prevent fatigue. The American College of Sports Medicine recommends 30 to 60 grams of carbohydrate per hour of activity. However, the percentage of carbohydrate energy in the bar is also important depending on the duration of activity. For example, results from an Ohio State University study measuring the effect of two popular energy bars on blood glucose levels suggested that an energy bar with less protein and the majority of energy from carbohydrate (70% of calories) would be more beneficial for athletes involved in short-duration events who want a quick rise in blood glucose. Comparatively, a moderate amount of carbohydrate (40% of energy) was found more appropriate for athletes involved in longer duration events or for those individuals with diabetes.

What aspects of a bar are important to you? For example, do the ingredients need to be organic or free of certain allergens? Perhaps you are trying to avoid fructose or wheat-containing foods. For some individuals, such as a golfer or long-distance cyclist, it may be important that the bar is able to hold up in the heat.

“Food integrity” vs marketing claims. Marketers are well aware of trends and consumer demand for nutrition products that have attributes such as “no or reduced allergens”, “gluten free”, “low or no sugar”, “non-GMO”, and “all natural”. It is easy to make a nutrition label “look” a certain way, but what are you really consuming?

Check out the list of ingredients. Look for a short list of minimally processed ingredients. Some bars contain only a few items such as dried fruit, nuts, seeds, oatmeal, or rice, while other products can have over 30 ingredients. If you have trouble pronouncing an ingredient or don’t recognize what it is, then it may be worth finding another or making your own.

What is the source of sweetener? A little bit of added sugar isn’t the end of the world, but some bars are so loaded with refined sugars and syrups that you might as well be eating a candy bar. On the other hand, many believe that a high protein, low-carbohydrate product is healthier. Nutrition products that claim “low or no sugar” will likely have artificial sweeteners and/or sugar alcohols added that can have a laxative affect and contribute to gastrointestinal problems. A few examples of sugar alcohols include sorbitol, erythritol, mannitol, and glycerine.  Glycerine or glycerol, for example, is a common ingredient added to protein bars that provides bulk and sweetness. Since it is not metabolized as sugar in the body, it is often not counted as part of the total carbohydrate calorie count (even though it contains slightly more calories than sugar) thus rendering the nutrition facts misleading.

Final point: There are many high quality nutrition bars to choose from, but as with any food, it’s always a good idea to consume in moderation. To achieve optimal nutrition, plan to include a variety of wholesome fruits, vegetables, nuts, dairy and healthy fats in your snack and meal planning.

Make your own…

Nuts and Oats Energy Bar 

Homemade Energy Bar

Ingredients:
1 ½ cup roasted mixed nuts (I used lightly salted)

1 cup old fashioned rolled oats

¼ cup ground or whole flax seed (or you could substitute sesame, sunflower or chia seeds)

2/3 cup light brown sugar

½ cup honey

4 tbsp. butter

½ tsp salt

2 tsp vanilla extract

2 cups rice krispie cereal or puffed brown rice cereal

½ cup dark chocolate chips (or dried raisins, cranberries or cherries)

Directions:

1. Lightly chop mixed nuts. Combine nuts, oats and flax seed in large bowl.
2. Line 9-inch square baking pan with parchment paper, extending the paper over the sides.
3. In a saucepan, bring the sugar, honey, butter and salt to a boil over medium heat. Simmer until the sugar dissolves and a light brown caramel forms, about 5 minutes or until the “soft ball” stage, if you have a candy thermometer. Remove from heat and stir in the vanilla.
4. Pour the caramel over the nut and oat mixture. Stir in the rice cereal and chocolate chips or dried fruit until evenly coated.
5. Pour the cereal mixture into the prepared baking dish and spread out into an even layer. Press down evenly and let the mixture stand until cool.
6. Use the “handles” of the parchment paper to remove the cereal square from the pan and cut into about 12 equal size bars.

Storage tip: Once bars are cooled and cut, wrap individually in plastic and keep in refrigerator. Bring to room temperature before serving.

Cycling Nutrition: Fueling a Long Ride

I love cycling! My happy place is getting out for a long ride on a nice summer day. But without proper fueling, even my recreational joyride can come to a screeching halt real fast!  Whether you are competing in an endurance race or heading out for an all day ride, proper nutrition and hydration can make the difference between fully enjoying or barely enduring a day of riding. Just as you wouldn’t take off on a road trip without enough fuel in your car, the same is true for your body’s fuel tank when you embark on a long ride. Eating the right foods before, during and after your ride will help provide for an enjoyable ride and optimal performance.

Carbohydrates: The Fuel of Choice

The body’s fuel of choice for an endurance sport like cycling is carbohydrate. Carbohydrate-containing foods, such as fruit, potatoes, rice, pasta, bread, milk, yogurt, honey, etc. are broken down in the body to glucose and stored as glycogen in the muscle. Therefore, for the recreational or competitive cyclist, eating enough carbohydrates at each meal and snack (not just the night before) is essential to ensure your “gas tank” (glycogen) is ready to go. The well-fueled cyclist should have enough energy stored as glycogen in muscles to support 90 minutes of moderate-intensity exercise.

Fueling Before You Ride

The ideal time for a carbohydrate-rich, pre-exercise meal is three to four hours prior to your ride. The amount of carbohydrate depends on a number of factors, such as body weight. For a 150-lb cyclist, aim for 80 to 100 grams of carbohydrate (i.e. 1 cup oatmeal, 6 oz Greek yogurt, 1 cup berries and a slice of whole wheat toast). In addition, consuming 100 to 300 calories of a low-fat, carbohydrate-rich snack (fruit and crackers) an hour before your ride will also provide muscles additional glucose to be used for energy, while sparing glycogen and delaying fatigue. Fluids are as important as food in preparing for a long ride. Prepare by drinking enough water the day before the ride (evidenced by pale colored urine) and sipping on a 16-oz sports drink the hour before going out.

Foods and Fluids during Long Rides

Dehydration is the leading cause of fatigue for the endurance athlete. Staying well-hydrated during a long ride is essential for having a good ride. A general rule of thumb is 20 ounces of fluid for every hour, ideally ingested in small frequent intervals for better absorption and utilization by the body (about 5 to 8 ounces every 15 minutes). Electrolytes, such as sodium and potassium, are lost in sweat and essential to maintain proper water balance in your tissues. Therefore, consider carrying two bottles, one with water and one containing an electrolyte solution. For rides longer than 4 hours or in very hot or humid weather, cyclists need to plan to include additional sodium and potassium-containing foods during the ride, such as bananas, tomato juice, pretzels, salted nuts or broth.

If your ride will include some high intensity riding, strenuous hill climbing, or will be more than 90 minutes, then you will also need to fuel with additional glucose during the ride. When glycogen stores get low you “hit the wall” and consequently run out of energy. For this reason, it is beneficial to consume easily digestible carbohydrates from a variety of sources, such as sports drinks, bananas, energy gels, etc. and see what works best for you. The American College of Sports Medicine recommends 50 grams of carbohydrate for a 150-lb cyclist each hour (again in small, frequent intervals). Unfortunately, some novice riders limit their consumption of carbohydrate calories during exercise for fear that a sports drink or carbohydrate gel “contains too much sugar” or “will cancel out the calories burned from training.” A study completed at Colorado State University demonstrated that this approach actually backfires. Researchers discovered that subjects who restricted carbohydrate intake during exercise ended up consuming more calories the rest of the day than subjects who ingested carbohydrate during activity (Melby et al., 2002).

Some basic tips for carrying and consuming fuel while riding:

• Be sure your fuel will hold up to weather conditions, such as heat and humidity.
• Partially open any small packages for easy access.
• On unsupported rides, carry snacks in a jersey or jacket with multiple easy-to-reach pockets.
• Portion your hourly food into separate baggies and consume one bag per hour.
• Carry powdered sports drinks and reconstitute when you have access to water

Restore, Replace and Repair from Your Long Ride

The goals of recovery nutrition are to: 1) Restore fluids and electrolytes lost through sweat during a long ride, 2) Replace glycogen stores (muscle fuel) depleted during activity, and 3) Repair muscle tissue broken down from high intensity activity.

Rehydration is vital to recovery following a long ride. Ideally, you have replenished water (sweat) lost during your ride. However, when you get off your bike, continue to drink water or a sports drink to quench your thirst or until urine is pale.

Within 30 to 60 minutes, have a snack that includes carbohydrates (to replace glycogen) and protein (to repair muscle tissue). Aim for a 3 to 1 ratio of carbohydrates to protein, i.e. 60 grams of carbohydrate along with 20 grams of protein. Examples of good recovery snacks include low-fat chocolate milk; fruit and yogurt smoothie; graham crackers with peanut butter and low-fat milk; apple or banana with nut butter and low-fat milk.  Finally, follow-up with a healthy meal that includes a balance of protein-rich meats, vegetables and whole grains that will continue to restore, replace and repair those essential nutrients lost during activity so you will be ready to ride again soon.

True or False: It’s Not Good to Eat Carbs After Dark

This question comes up a lot from my clients and from individuals attending my workshops. It seems to have morphed from another myth or food rule that states, “it’s not okay to eat after 7 pm”.

The short answer for both of these statements is False! There are many interesting theories and anecdotal evidence about this idea for weight loss. But, let’s understand where these myths come from and why they seem to work (at least at first).

The “real” problem often begins with over-eating at night when an individual is tired, bored, stressed, or overly hungry. This is especially true for the person who “diets at breakfast, diets at lunch and blows it at night.” By this time, cravings (usually for carbohydrate-containing foods) become very intense and they “give in” to eating, and often overeating, highly palatable, convenient, serotonin-producing, processed snack foods. Food rules, like “don’t eat after 7 pm” provide structure and and a sense of control when the person feels “out of control.”

So, what are food rules? Food rules often develop along with sincere efforts at eating healthy. Having a list of foods that state “eat this and don’t eat that” or labeling foods “good” vs “bad”, healthy/unhealthy, fattening/nonfattening, etc. provide very clear structure for an individual who is trying to lose weight. Basically, when a person can’t trust themselves with their eating and weight, they turn to something or someone else, like a “diet” or an “expert” with a list of “do’s” and “don’ts” that they believe they can trust.

Although food rules are meant to be helpful, they often backfire. When an individual follows a rule like “stop eating carbs at night” or “don’t eat after 7 pm”, and they lose weight, it’s easy to believe that the real culprit to their excess weight was because “carbs are bad” or that “late-night eating leads to weight gain.” Unfortunately, when the real problem of under-eating or emotional eating hasn’t been addressed, the individual will likely “give in” and break the rule. Since deprivation can increase desire, this may also contribute to overeating the forbidden food or eating at the forbidden time.

Subsequently, feelings of guilt or shame result because they weren’t able to “follow the rules” which again leads to more overeating…and more self-doubt. Sadly, the cycle continues when the person tries to regain control with even more “structure” – a stricter diet, more food rules, another “expert”, etc etc.

Most would proclaim they want to stop this food fight, but having unconditional permission to eat (at any time of the day) feels very scary. The only way to reduce fears of food is to discover the root cause of behaviors that may be leading to excess weight gain and develop strategies that address those behaviors. For some, that may be giving themselves permission to eat enough earlier in the day or it may be legalizing food and trusting that a healthy balance is achievable.

In either case, this usually means getting the appropriate support for positive behavior change with food, eating and weight. It may also mean setting aside unrealistic “rules” about weight and weight loss. Learning to trust yourself (and your body) with food and eating, rather than a diet, a food rule or a so-called “expert”, may be the real answer to a nourishing and healthy relationship with food, eating and weight.