By Terry L. Schraeder, M.D.
In medical research, the “n” value is the number of people in a study. If n = 1, it is not generally considered a very powerful study. But when you are the “1” in “n = 1,” it somehow becomes more significant.
It all started with a can of soda disguised as sparkling orange juice. It had become my “go to” treat. My pick-me-up when I was low. In fact, it gave me a rush of energy every time I drank it. One day, I looked at the label to see if it contained caffeine. No caffeine, just added sugar. In fact, it contained 32 grams of sugar — eight teaspoons per can — with sugar second only to water as the largest ingredient. The World Health Organization recommends women not consume more than six teaspoons of added sugar per day — or about 5 percent of total calories as added sugar. Men can have up to nine teaspoons.
How much sugar was I consuming a day? I was also adding honey to my coffee, maple syrup to my oatmeal, consuming corn syrup in my “healthy” flavored yogurt (some brands add as much as 30 grams per serving) and enjoying muffins as a snack and dessert many evenings. Along with my routine stop for a drive-through flavored coffee drink, and occasional cookies or candy, I had officially joined our nation of fellow sugar addicts.
In the US, we are consuming on average 88 grams or 22 teaspoons of added sugar a day. (There are four grams of sugar per teaspoon.) My guess is that I was eating even more. Like many, I needed my fix of high fructose corn syrup or other sugar source every few hours.
For the last several years, there has been an increasing drumbeat of warnings linking sugar to obesity, diabetes, heart disease, cancer and nonalcoholic fatty liver disease from experts such as endocrinologist Dr. Robert H. Lustig at the University of California at San Francisco and media doctor Dr. Sanjay Gupta at CNN. But somehow the message had missed me. I did not think of myself, especially as a physician, as a high sugar consumer.
I have tried to stop the hourly IV drip of added sugar I was consuming throughout the day.
I have passed my 50th birthday and have a normal body weight and exercise regularly. I am not on any medication. My blood pressure and fasting blood glucose are normal. But last year, my triglyceride level was high. One reason might be that the high fructose corn syrup I was consuming is converted to triglycerides in the liver – hence the high level.
There were other concerns. I noticed that I felt shaky and had food cravings two hours after eating. I also noticed an afternoon slump of low energy, a growing bulge of belly fat, and plaque that needed to be vigorously scraped from my teeth every six months. How long had my sugar intake been so high?
Sugar consumption in the US has climbed into the stratosphere in the past three decades. Our added sugar consumption increased by 30 percent from 1977 to 2010, according to a study presented last week at ObesityWeek, a major obesity conference, in Boston. It seems we are slurping, sucking and chewing 300 calories of added sugar daily (up from 228) and far more than the recommended limit of 100 calories of added sugar per day.
Scientists know that sugar affects the neurotransmitters in our brains, the hormones and fat in our bodies, and feeds the bacteria causing decay in our teeth. But we may not know how much we are eating. It is not easy to figure out the “added sugar” by reading nutrition labels.
For years, we have easily deciphered the calories, fat, salt, fiber and vitamin content from food labels but not the added sugar. (See image at right).
What is the difference between the added sugar in our soda and the natural sugar in a piece of fruit? The ongoing debate between endocrinologists and the food industry continues. But there may in fact be more insidious effects of the added chemically altered sugars on our bodies than the natural sugar in our food.
The added sugars (fructose or sucrose) in processed foods are usually not accompanied by any fiber or vitamins. And when they're added to processed foods, we tend to consume much higher doses of sugar. A bottle of 20 ounces of soda contains 65 grams of sugar. A banana has 7 grams of sugar.
The World Health Organization wants us to limit the glucose, fructose and sucrose added to our processed foods as well as sugars naturally present in honey, syrups and fruit juices and fruit concentrates.
For the past eight weeks, I have tried to limit adding sugar in any form to my food and started searching nutrition labels for sugar content. If the food lists the grams of sugar on the nutrition label (these may be natural or added), then I check the list of added ingredients to see if there is any added sugar in the form of corn syrup, sucrose, fructose, brown sugar, juice concentrate, honey, molasses, etc. If there is, I know it is “added” sugar. I try to limit my added sugar to less than 24 grams (or six teaspoons) each day.
It has not been easy but it has been well worth the effort. For the first time in years, my moods and energy are more level, the sweet cravings are gone and I feel calmer. The fat around my belly has disappeared. My teeth feel smoother and cleaner despite the same oral hygiene. The late afternoon slump and brain fog are no more. I will have my triglycerides rechecked soon.
I feel great but I am still in shock. I had no idea I was consuming too much sugar. If you had asked me, I would have denied it. For years, I have railed against fat and calories, smoking and lack of exercise. I had not considered my own sugar intake.
So what do I eat now? For a snack, I eat protein and a carbohydrate without added sugar. I eat a small handful of raw nuts, a slice of cheese, plain yogurt with fresh berries, peaches and milk, or a banana and peanut butter. (Peanut butter can vary on the added sugar so read the label.) I no longer add sugar or honey to my coffee. Instead of a can of orange soda or sugar-laden snack or coffee in the afternoon, I drink water.
I still eat foods that have their own natural sugar such as milk, fruits and vegetables. A cup of milk can have 12 grams of sugar or a cup of plain yogurt can have 9 grams of sugar — but it is not added sugar, there is no sugar listed in the added ingredients.
I enjoy an occasional cup of ice cream or dessert. But I have tried to stop the hourly IV drip of added sugar I was consuming throughout the day.
The FDA is now proposing changes to the 20-year-old format of the nutrition labels on foods, including a requirement that companies clearly list the “added sugars.” (The image at right shows the proposed change.) I hope the proposal goes forward. As individuals and as a nation, we would all benefit from eating less sugar.
I often tell my patients to mimic how their grandparents moved and ate. Walking was a common mode of transportation. Physical household chores were a necessity. And sugar was an occasional treat. Sugar was not a staple in their diets or a constant drug in their bodies or their brains.
For me, my “n=1” study, proved that cutting the sugar was of significant value.
For more nutrition information about the specific foods you are eating go to nutritiondata.self.com or www.nutrition.gov. Readers, reactions? Please add to the "n" and share your own experiences with cutting sugar.