Let's discuss added vs. natural sugars, including how to read food labels to find out if there's any hidden sugars.

Note: We cannot provide medical advice. Please contact your doctor directly for specific questions about your care.

Topics

• How to read food labels
• Added vs. natural sugars
• Tips & tricks for balancing sugar intake

Transcript

Scott K. Johnson - Hey, thanks for tuning into another episode of Coaches Corner. It is great to see you again. We would love to know where you're watching from. Let us know in the comments. One small way that mySugr is giving back is by hosting these short conversations with our diabetes coaches to talk about staying healthy in body and mind. We really appreciate you sharing some time with us. Now, I do have to give the standard disclaimer. We cannot provide medical advice. Please contact your doctor directly for specific questions about your care. Today we check in with mySugr coaches, Kristen and Maggie with the common question, "Should I stop eating sugar altogether?" Kristen, hi Maggie. Great to see you both again. Today we're talking about sugar and diabetes and looking at the question, "Should I stop eating sugar altogether?" There are a lot of common misconceptions about sugar and diabetes. Let's dive into some of those. Where should we start?

Kristen Bourque - I think this is such a common area of confusion for people with diabetes is, well eating foods that contain, of course, carbohydrates, which break down into sugar impact my blood sugar so therefore I should avoid all those foods. So I think that we hear this common myth a lot and we'll kind of dive through a little bit and explain why that's not the case. But it is something that we hear so often. It does kind of make sense, but at the same time we have to realize that again the importance of a balance in our lives. And we'll talk more about that in a little bit.

Maggie Evans - Another common one that I tend to hear from people especially some people maybe who are newly diagnosed or it's more recent is "I have diabetes because I ate too much sugar." And I think it can be very common to want to simplify a lot of things down to these singular nutrients or singular things that cause diabetes. And what we'll talk about for sure too is that it's a very complex condition. And so it's not just one thing honing in on sugar, is not the only thing that kind of leads to diabetes.

Scott K. Johnson - Yeah, I think that's very, very important to talk about and clarify because there's so much guilt and shame and stigma around diabetes. Diabetes is something that no one has done to themselves. Of course, lifestyle factors contribute. There's a lot of contributing factors, but there's also so much that's just not yet understood, because if it were that simple everyone that weighed a certain amount over their acceptable weight or ate a certain amount of XYZ would be diagnosed with diabetes and that's just not the case. We don't see that. So I'm so glad that we're kind of diving into this topic a little bit. Can we also talk a little bit about when people think about sugar, they're thinking about sweets and candies and stuff like that and not necessarily carbohydrates. And what is this whole deal with carbohydrates?

Kristen Bourque - Yeah, so carbohydrates are one of the macro nutrients. So along with things like, again, protein and fat, carbohydrates again, are an essential nutrient that we need. But I think again, when we kind of break down what carbohydrates are there is the ones that are kind of more nutrient-dense that essentially provide a lot more nutritional value for us. So we oftentimes refer to them as unrefined carbohydrates. So those are going to be things like whole grain bread or oatmeal or again beans and things like that that have a lot more nutritional value for us, whereas our refined carbohydrates still have, again, they provide carbohydrates, but they are again, refined. They have very little nutritional value for us. And they impact our blood sugar a lot differently oftentimes. So again, it's important to remember is not all carbohydrate foods are bad and the types that we have are very important. So now when we say the term sugar, all carbohydrates essentially break down into sugar or glucose which is the form our body uses for energy. But again, it goes back to the types that we choose are essentially kind of where that difference lies. So again, a little bit of those refined sugars and sweets and stuff is of course okay, but we know that they're not going to be as healthy for us. They're not going to be as ideal for our blood sugar values. So we have to kind of keep that in mind as well as the types of carbohydrates we choose are very important.

Scott K. Johnson - And are there some guidelines that we should think about as far as living with diabetes and thinking about sugar?

Maggie Evans - Yeah, that's a great question, Scott. So when we think of added sugars, that's kind of what we tend to refer to as more of these sugar-sweetened type foods. So Kristen brought up a great point of more of the unrefined foods, but when we think of maybe more refined processed foods or things that have sugar in them, we tend to refer to those as added sugars. So things like basically sugar that the manufacturer adds to their foods. And when it comes down to it, typically we look at the American Heart Association's guidelines for added sugars. For men, that tends to be no more than nine teaspoons of added sugar per day And then for women, no more than six teaspoons. And to put that into perspective, four grams of sugar typically equals about a teaspoon. So if we're looking at a label when you see added sugars on the label, that can kind of give us an idea of the amount of teaspoons of added sugar that we're getting per day.

Scott K. Johnson - That sounds like awful lot of math to think about when I'm looking at a nutrition label. Are there any good rules of thumb when I'm examining a nutrition label, I'm out at the grocery store or I'm looking at something I'm interested in buying or eating, is there other easy ways to look at this nutrition label and make some decisions?

Kristen Bourque - Scott, you're not pulling out your phone to do these calculations that we're discussing.

Scott K. Johnson - Only if I have to.

Maggie Evans - So typically when you're looking at a label, you want to, there's going to be the nutrition facts label that gives you all those dirty little details about grams of carbohydrate and the sugars and things like that. But there's also going to be a food ingredient list. And so that can be a really easy way of just looking at the food and seeing how much of what each ingredient is in that food product. So a common thing, typically it's by weight. So the first kind of top ingredients are going to be the most by weight in that food product. So sugar or any type of sugar name shows up within the first couple of ingredients, you can pretty much guarantee that that's going to contain a lot more added sugars than those natural sugars that we are talking about. So that can be one way of examining a label or a food ingredient list to kind of decipher that for yourself, whether that's something that you want to consume.

Kristen Bourque - And also just to kind of add to what Maggie said too, is I think companies kind of are a little bit savvy on this sometimes too. So you might see different forms of sugar on your ingredient list too. So that's also something to be aware of too when you're looking at it. It might not make those top numbers or the top three, say, on your ingredient list, but you may see multiple sources. But all of those added up can equal to a lot of added sugar too. But yeah, I think the ingredient list is one of the best ways to go because it is very simple and most people can kind of have an idea if their food is full with a lot of added sugar by just checking that list out.

Scott K. Johnson - Great. So let me make sure I understand this as best I can. The nutrition facts. So that's the table that lists the macronutrients and the grams and percentages, right? That's going to break down, under the carbohydrates, it will have a breakout for added sugar and that'll give me the grams, which I can do some math and convert into the recommended teaspoons for men and women. But if I want to get an idea on if sugar or a sugar alias, I'm going to call it and I'll ask you about those in a second, is one of an ingredient that is very highly used in the product. The list of ingredients, if it's highly used, will be listed higher up in that list or closer to the front than products or ingredients that are not as highly used in there. I feel like I made that more complicated than I was trying to, but either way. As you, I think Kristen, you mentioned a really important thing that sugar can go by many different names. Can you share some of the different things that sugar goes by?

Kristen Bourque - Yeah, so, I think that's a great question. So a couple of things off the top of my head, I'll have Maggie chime in here, but I would say high fructose corn syrup is probably a very common one because it's used in a lot of our processed packaged items. You may also see of course just regular table sugar. You could see fructose is another word also honey may be used as a sweetener sometimes too. So there's quite a few, those are just coming at the top of my head. But Maggie if you would chime in with any more.

Maggie Evans - Yeah, I usually have patients look out for the ending -ose, so glucose, sucrose, that's usually going to be indicative of some type of sugar. Another one is syrups. So,

Kristen Bourque - Yes.

Maggie Evans - like Kristen has said before, high fructose corn syrup, that's a sweetener. They might get away with calling it brown rice syrup. So things like that, syrups and those types of endings might kind of clue you into it. It's funny though 'cause even as dieticians and diabetes educators, there're so many different names for sugar. I think I saw one time a list that was like 50 different names for sugar and I was just like scratching the surface. So do the best you can, it's not going to be a perfect process, but yet again, that total added sugars label area on the food nutrition label will also give you some good information. If the total amount of carb or total added sugars is a higher amount of the total carbohydrates, that's going to be kind of a clue to that. It's mainly going to be added sugars.

Kristen Bourque - Yeah, and I think even just to kind of even simplify it if you're watching this and kind of still a little confused is just try to make the ingredient list as short as possible, even if the food actually is a little bit higher in carbohydrates. Again, portion size is still to going to be the number one thing that we encourage. And also I'd rather, I think Maggie would agree, we'd rather have you choose something that was kind of a simpler ingredient list, less additives and maybe it's a little bit higher in carbs, but a lot of times they're not cutting corners where some of these kind of low fat or fat free products, may seem better, but they oftentimes have more added sugar, other additives and they'll have a lot lengthier of ingredient list too. So again, trying to also go more towards the idea of more whole foods that's going to really be a good way to limit a lot of that confusion about added sugars too.

Scott K. Johnson - Yeah, that makes a lot of sense. And along those lines, so let's jump into the kind of quick tips or tricks that I can keep in mind. Let's say I'm kind of navigating my daily life and it's busy, chaotic. I'm overwhelmed by the idea of analyzing my food labels, but there are some easy, quick tips and tricks I can use to help me in this journey as far as sugar goes, right?

Maggie Evans - Of course. I'd say number one is avoid drinking sugar if you can. So avoid drinking kind of the more sugary beverages or limit it the best that you can. But things like soda and the juices, those things, that's just kind of a direct hit of sugar into the bloodstream. So the more we can avoid those and maybe choose more water or even if we need to have some flavor, maybe a calorie-free type beverage can also be another way of kind of managing that sugar intake. I think that tends to be one of, especially in America, that tends to be one of our highest intakes of added sugars is from our drinks. And we don't even realize that we're consuming all that excess sugar.

Kristen Bourque - Definitely. Yeah, and I think--

Scott K. Johnson - That you mentioned portion size, that's a big one.

Maggie Evans - Yes

Scott K. Johnson - I don't know if you want to talk a little bit more about that or, and another thing you also mentioned was like eating whole foods or foods in their most wholesome state. That's a good one too.

Kristen Bourque - Yeah, and I think it's important to remember, we're not telling you to cut out sugar altogether, right? But even added sugar because again those are delicious foods and we like to have them on occasion. So we don't want to feel like you are deprived or eliminating those foods because it's all about balance. But yes, so if you are going to have again something on occasion, say a birthday cake or something, enjoy it. But whereas the day to day stuff, that's where again, you can kind of look at making some healthier choices. So a plain yogurt for example, versus one that's got a sugar added and then you can add your own fresh fruit and doctor it up from there. So those daily changes are the big things versus those occasional splurges that we might have. But yeah, just a whole foods as much as possible, making simple swaps. So I love how Maggie mentioned juice. So if you still really love apple juice, I know it's not the same thing, but swapping out for an apple is a really great kind of example of providing more nutrient-dense option that is going to fill you up longer. It's going to have less of an impact on your blood sugar. But also again, you're not having that added sugar. It's just a source of natural sugar and we prefer those options for sure.

Maggie Evans - In a way, I like to explain it to people as well is don't let the manufacturer do the work that your body's going to do, right? If I'm going to eat a whole apple versus drink apple juice. My body is going to have to break down the fiber in the apple. It's going to have to, it's going to take a lot longer to digest and absorb that sugar from the apple versus if I ate something like apple sauce or drink apple juice, a lot of that mechanical processing that happens within our bodies, that manufacturer has done for you. And that's going to be a quicker hit into your bloodstream than if you ate that apple. So that kind of helps in terms of realizing the value in kind of eating more wholesome foods versus more of these processed food items as well.

Kristen Bourque - I love that.

Scott K. Johnson - Yeah, that makes a lot of sense. So we've covered an awful lot of stuff. Is there anything that you guys want to touch on a little bit more or anything we haven't covered you want to dive into?

Kristen Bourque - I think just the biggest takeaway is we're not, our goal is to make this as simple as possible. So try to not complicated whole foods, and again if you're starting to look at all these labels and getting confused, just going back to, okay, well, these different oatmeals and I'm not sure, we'll just go back to regular basic oats and doctor it up from there. So again, you can always find a simpler, less processed alternative with a lot of these food options and even though it might seem like it takes a little bit more time, your body will thank you for it too, so?

Maggie Evans - And I think going back to what Kristen said before, if you're in a situation and there is birthday cake or there is that treat or item that you really do love, there's no need to avoid that. But find a portion that works for you. Basically, what portion can you have that is still satisfying and doesn't affect blood sugar too much. But enjoying and savoring that, right? So there's more to food than just blood sugar and health and all that. It's comforting, it's enjoyable. So when you are eating, be mindful of that experience and enjoy and savor that food, and no need to vilify sugar solely, we just want to focus on balance and variety in our diet.

Scott K. Johnson - Great points. All right. Well thank you again both very much for this and we will be back soon for another session. All right, I hope that was helpful. I'd love to know if you have heard any of those questions or misconceptions of today's talk clarified anything for you. Carol, you had a great question talking about being confused around low sugar foods that yet have sugar alcohols in them. So sugar alcohols are often used because they don't typically increase blood sugar, so they can be included in these foods to add that sweetness without impacting blood sugars. But the trick with them is you have to be careful about how many you consume because they can upset your tummy and give you some gastric distress. And with that, I'm going to also ask Molly to record a little bit more deeper on that topic for us. So be sure to come back on Wednesday. If you have additional questions or want us to dive deeper on anything, go ahead and leave us those questions in the comments and we're happy to follow up and address them in an upcoming episode. On Wednesday, Molly and I are going to dig deeper on what exactly IS blood sugar. I know you hear it all the time. You see the numbers on your meters if you're checking your blood sugars, you hear your doctors talking about it. So Molly and I are going to chat for a bit on what exactly is blood sugar? I hope to see you there. Until then stay well and we'll see you next time. Bye.