By Dr Kate Little
Ever had that feeling that you really need to eat? Where you feel lightheaded and shaky?
This happened to me recently on my way to the shops after eating a bagel. It didn’t pass until I ate something. I looked at the sugar content of my bagel and was staggered to see that each bagel (even wholemeal) contained 6.6g sugars, four times the amount of a standard slice of wholemeal bread. Of course, a bagel weighs double a slice of bread, which explains some of this extra sweet stuff. And while, if I thought about it, I knew that bagels were an “unhealthy” food option, they had somehow slipped into our family staples without me really thinking about it.
Given the explosion of adult and childhood obesity (according to recent data from Public Health England, 1 in 3 children in the UK now leave primary school overweight or obese), the increase in cancer and Type 2 Diabetes globally, what we eat and the way we eat is clearly important, as well as how much or little we move.
Most of us know that if we want to lose weight, we need to reduce calories and exercise more. We know that reducing sugar is part of reducing calories, as sugar equals calories.
Many (but not all) are also aware that there are many hidden sugars, particularly in processed food, and that complex carbohydrates, such as rice, pasta and bread are all metabolised into sugar. So reducing our carb intake makes total sense.
Many high profile people, such as comedian Eddie Izzard and actress Gwyneth Paltrow, have given up sugar and claim to feel better for it. However, given the propensity of the rich and famous to make increasingly wild and wacky lifestyle decisions, is this just another celebrity fad?
And are not all calories in equal? If, for example, I ate a chocolate bar and skipped dinner, would that be enough to offset the chocolate?
“Sugar – the bitter truth”
For years, the focus has been on eating low-fat foods and reducing calories, yet in the last decade there has been more and more interest in and increasing evidence on the harms of sugar, in particular, fructose.
Table sugar (and most fruits that we eat) contain sucrose, which is made up of one glucose molecule and one fructose molecule joined together. High fructose corn syrup, commonly used in the States previously, has a ratio of 55% fructose to 45% glucose.
Fructose, unlike glucose, which can be metabolised almost anywhere in the body, can only be metabolised by the liver. Whilst the rest of the body burns the glucose, the liver works on any excess glucose and all the fructose, resulting in a high sugar load concentrated within the liver. Once the liver stores are full, the surplus gets converted to fat. Fatty liver then develops which then leads to type 2 diabetes and we all know the rest of the story.
High sugar diets have also been linked with poor behaviour in children, worsening seizures in epilepsy and Alzheimer’s dementia with some going as far as to call Alzheimer’s “Type 3 Diabetes“. Public Health England suggest that around one third of Alzheimer’s dementia might be attributable to lifestyle factors, including diet, exercise and smoking.
Armed with this information, the idea that all calories are equal can no longer hold sway. Perhaps we should be taking the harms of sugar more seriously.
So how do we start reducing sugar in our diet?
The first step we can all take, is not to add extra sugar to any food or drink, like tea or coffee, and to reduce our intake of sugary drinks and obvious sweet foods.
The next step, which is harder, is to limit processed foods, many of which have high concentrations of hidden sugars, often listed under different names such as glucose, dextrose, molasses, which many of us may not recognise as sugar. Many ready-made savoury sauces are very high in sugar for example. The Public Health collaboration has some excellent infographics here and here to help us to identify which foods are the worst offenders.
According to that reliable dietary resource, the Daily Mail, nearly half of all ready meals eaten in Europe last year were consumed in the UK.
“On average, people in the UK consume at least one ready meal a week – twice as often as the French and six times the number consumed by the Spanish.”
So if the Daily Mail is anything to go by, our fast food consumption is also something to be mindful of. If you prepare your own food from scratch, you can control the amount of sugar that goes into it. Another tip is to try to avoid food products that contain more than five ingredients.
“I’m a fat man in a thin person’s clothes”
This is what a friend’s husband told me once, after successfully losing weight and maintaining it.
And he’s right. According to Charles Duhigg, the author of “The Power of Habit”, bad habits don’t really disappear. We can ignore, change or replace them, but the pathways are “always lurking there, waiting for the right cues and rewards”. This is clearly beneficial for learned skills like driving and riding a bike, as we don’t need to re-learn them after a break, but not so good when we actually want to get rid of unhealthy habits. The slippery slope is a very real and risky path that is open to all of us.
Duhigg adds that “most people don’t set out to eat fast food on a regular basis. What happens is that a once-a-month pattern slowly becomes once-a-week, and then twice-a-week – as the cues and rewards create a habit – until the kids are consuming an unhealthy amount of hamburgers and fries.”
For me as a parent, this is really important information. It has made me sit up and consciously think about what we eat and how we eat at home and outside, to make sure that we keep treats as treats, and not allow them to creep into everyday life – like the bagels!
Given #Health is one of my #3 words this year, let’s hope this new habit lasts!
The Case Against Sugar by Gary Taubes chronicles “Americans’ history with sugar: its uses as a preservative, as an additive in cigarettes, the contemporary overuse of high-fructose corn syrup. He explains what research has shown about our addiction to sweets. He clarifies the arguments against sugar, corrects misconceptions about the relationship between sugar and weight loss; and provides the perspective necessary to make informed decisions about sugar as individuals and as a society.”
Sugar by Half – an Australian site with resources and ideas on how to make sugar swaps for healthier alternatives.
You can download this for free from the app store. It scans the bar code of your product and tells you how much sugar equivalent there is.
A You-tube film of a lecture by Professor Robert Lustig, an American paediatrician. Not easy viewing as it does go right down to metabolic level in some depth, but if you like detail and have 90 minutes to spare, this video is amazing. As well as learning loads about the harms of high fructose corn syrup which has been introduced en masse in the States as an attempt to stabilise sugar prices in the 50’s, we learn how coca-cola has changed its recipe over the years to include more and more sugar to hide the added salt and caffeine to make us more thirsty.
The Diet doctor – a great resource on low carb diets
The 4 Pillar Plan by Dr Ragan Chaterjee – I will be writing more on this later