Resolutions - Is Sugar the Problem?
Donuts, cupcakes, lattes, and cookies–sometimes it seems like the best things in life are full of it: the sweet, delicious thing we call sugar. It’s one of the first places we look to when we’re trying to make a “lifestyle change,” and also one of the first places we look to when we need a pick-me-up. Some scientists say that sugar is akin to a poison, giving rise to diseases like diabetes and metabolic syndrome. Others say, it’s not actually that bad. So what’s the truth? This week, we talk to Professor Jim Mann from the University of Otago in New Zealand. Is sugar bad for us? Are all sugars the same? Should we even be giving up sugar at all? Find out on our sweetest episode yet.
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Guest
Jim Mann is a professor of Human Nutrition and Medicine at University of Otago in New Zealand. He studies sugar, lipids and carbohydrates in relation to coronary heart disease, diabetes, and obesity.
Academic Profile | Publications
The Takeaways
There are many types of sugars (fructose, glucose, lactose, sucrose, etc.). From a health perspective, it is important to distinguish the difference between free sugars and intrinsic sugars.
Free sugars are sugars that are rapidly absorbed into the body. Examples: Cane sugar, maple syrup, date syrup, agave nectar.
Intrinsic sugars are incorporated within the cell walls of plants such as fruit, and are absorbed over a longer period of time.
Check out more names for added sugars.
Sugar’s adverse health effects were first researched in the 1950s in the Vipeholm study in which children were given toffee. Sweets, which was shown to be linked to more dental caries, or tooth decay.
In the 1960’s, sugar began being researched as a cause of diabetes by scientist John Yudkin.
By the 1970’s and 80’s Americans’ sugar intake increased, as processed foods containing high fructose corn syrup became more popular, and as saturated fat was being demonized because it was suspeted of causing coronary heart disease. The fat that was previously in the food was replaced by sugar.
Because sugar is so tasty, people are more likely to overeat sugary treats, leading to excess calories and weight gain.
Studies have shown that giving up sugar does cause weight loss, simply because you are not eating as many calories.
It is more debated whether or not sugar within calorie balance still has adverse health effects, but some evidence suggests that sugar may be unhealthy regardless.
Being overweight or obese is one of the biggest risk factors associated with insulin resistance.
Insulin is necessary for life and good insulin control is needed for a healthy metabolism.
Insulin resistance is when the body becomes resistant to insulin, which allows for blood sugar to get to dangerous levels in the bloodstream.
The reason we can eat fruit sugars without experiencing a very dramatic sugar rush and subsequent crash is because we have to digest the plant cell wall to release the sugar into the bloodstream, which takes more time.
Exercise is a great way to increase your insulin sensitivity, the opposite of insulin resistance.
In summary, if you are eating the whole fruit, you don’t need to be worried about sugar. (Recommendations may vary for individuals who have diabetes.)
Sneaky sources of free sugars: fruit purees, fruit juice, dried fruit, foods and drinks with added sugars, and sugar sweetened beverages.
Artificial sweeteners may not be much better: they only cause temporary weight loss, but more importantly, they do not change peoples’ desire for sugar. They also disrupt the gut microbiome.
The CDC recommends to keep your intake of added sugars to less than 10% of your daily caloric intake. For women, 10% of their daily 2,000 calories, allows for 200 calories from added sugars, ~50 grams or 10 teaspoons.
Studies
Free sugars and human health: sufficient evidence for action?
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Juna [00:00:03] Welcome back to our New Year's Resolution series today. We have an extra sweet episode for you.
Eddie [00:00:08] Hold on. You let me just finish my pre-recording peanut butter cup. Just one second.
Juna [00:00:13] Eddie. Unbelievable. He is having a peanut butter cup on our episode about sugar. And on that note, I'll take one too.
Eddie [00:00:22] I Just need a little fuel before we record the episode. Hmm.
Juna [00:00:26] I mean, it is a mini peanut butter cups, so maybe it's not that bad.
Eddie [00:00:29] It'll be fine.
Juna [00:00:29] I'm good. Okay, well, we'll see how you feel at the end of the episode. One of the most common New Year's resolutions that we make is giving up sugar. So we wanted to find out whether or not sugar is actually unhealthy. On today's episode, sugar, is it as bad as people make it seem? Or maybe it's fine? I don't know. How bad is that sneaky caramel macchiato that you have once a week asking for a friend? Of course. I'm Juna Gjata.
Eddie [00:00:58] And I'm Dr. Eddie Phillips, associate professor at Harvard Medical School.
Juna [00:01:02] And you're listening to Food, we Need to Talk the scientifically proven, sweetest podcast around. Let's kick off by reading one of our favorite reviews of the week.
Eddie [00:01:19] Oh, here we go. It's from Ali Go. "Look forward to this show weekly. I love this podcast. After 30 years of chronic dieting and finally developing an eating disorder over COVID. This podcast was a critical rung on the ladder that helped me climb out of that hole. This show actually helped me realize I needed professional help. I've been without eating disorder behaviors for over two years now, and in tough moments I turn on one of these episodes and hear some sanity and joy. I love hearing more great facts and even Eddie's dad jokes weekly. Thanks so much, you guys, for the hard work you put into the show. Thankfully, she spelt weekly as in Eddie's Dad jokes weekly w e k l y not wea k l y.
Juna [00:02:07] While your dad jokes are strong, Eddie, and jokes are really, really strong. Ali, thank you so much for that review. It is very, very important to me to hear reviews like that and makes me really, really happy. It makes the show worth doing. Right, guys? Hearing from you guys. So absolutely. If you guys want to get your review, shout it out on the show. Feel free to leave us a five star rating and review it wherever you get your podcasts. And there's a pretty good chance that will be shouted out on the show and added bonus. It helps other people find the show. So we really, really appreciate it and it makes our day. Now to the show, let's meet today's guest.
Jim Mann [00:02:42] My name is Jim Mann and my title is Professor of Medicine in the University of Otago New Zealand.
Juna [00:02:49] Now, normally we would start with a definition which you'd think would be pretty easy here.
Eddie [00:02:55] Right, Like define sugar.
Juna [00:02:56] Yeah, exactly. But it turns out that this is actually quite, quite complicated.
Jim Mann [00:03:02] Is glucose, there's fructose and galactose are the three common bodies that first monosaccharides to deal with is galactose, because that is the monetary, slightly more complicated sugars, which are disaccharides. Ominous. There is sucrose. Everybody has heard of lactose, which is the milk, sugar.
Eddie [00:03:24] Either way, it's sweet But I feel like we're back in 10th grade biology class.
Juna [00:03:28] Right? Luckily for us, it's actually not that important that we know the names of sugars.
Jim Mann [00:03:33] Perhaps what is important, particularly from a health perspective, is that there are free sugars which are much more rapidly absorbed by the human body. And then there are intrinsic sugars, which are the sugars that are incorporated within the cell wall of the plant or fruit. And from a health perspective, there is an enormous difference between those two groups of sugars, between free sugars and intrinsic sugars.
Juna [00:04:07] Right. So the point here is that not all sugars are created equal. And I'm guessing the peanut butter cup does not include intrinsic sugars.
Eddie [00:04:16] So plants like fruit or even vegetables, they all contain sugar. But that's very different from the types of sugar that Professor Manns talking about. Those are the ones that you find in sweets in my favorite ice cream or even in maple syrup.
Juna [00:04:30] I guess where people can get really confused is when sugar is marketed as being healthier for you because of where it comes from. So I'm thinking of all the trendy new sweeteners like date syrup or maple syrup.
Eddie [00:04:44] Which are really not new. Okay. Just being marketed them.
Juna [00:04:47] Yes. Yes, they are in a lot of new health foods or like quote unquote, healthy desserts. And when something is removed from the original plant packaging it came in, it actually becomes a free sugar. So even table sugar, if you go far enough back to the table, sure came from even table sugar comes from a plant.
Jim Mann [00:05:05] Table sugar is pretty much sucrose. It's a disaccharides consisting of glucose and fructose, which comes traditionally from sugar cane, but also sugar beet produces sucrose. And that is a perfect example of a free sugar because it hasn't seen a plant for a long time during the processing. So it is a free sugar which is very quickly absorbed and that accounts for some of the reasons why it's not the healthiest form of food.
Juna [00:05:40] Now, I'm sure I don't have to tell anybody this, but there's something very special about sugar, and that is that we just love it. Guys. It tastes so good.
Jim Mann [00:05:49] Sugar is a useful source of energy. For example, babies. Would they drink milk if it wasn't sweet? Baby Infant formula is also sweet. Animals who will raid a hive to try and get the honey out of it. And certainly the history of sugar, which goes back to ancient times. I mean, if you look at. The ancient writings on which I'm not an authority, I might say, but in China and India, there's a lot of writing about sugar. In Europe, It came to Europe for the first time during the Crusades in the 11th century, and people were very enthusiastic about it. That does seem to be an inherent human and animal taste that people like sweet things.
Juna [00:06:42] Guys, I'm so glad that we have this podcast to be able to bring you the breaking news. The really in-depth information of sugar tastes good, and we have a really fancy expert to corroborate this to all of us.
Eddie [00:06:55] Go Professor Mann.
Juna [00:06:56] I know, right? But keep it in mind, because it's going to be something really important that we're going to come back to later. That has to do with one of the problems with sugar. So let's talk about when sugar first started to get associated with adverse health outcomes, because it may not be for the reason you think.
Jim Mann [00:07:11] The first adverse health effects of sugar really were not anything to do with overweight or diabetes or metabolic disease. It was really all about dental caries.
Juna [00:07:23] Dental caries Alert, I have found out, is not British for dental cavities. It actually means tooth decay. And I'm so glad I looked up because I was honestly very confused. Anyways, Eddie, I think that this is a good time for.
Eddie [00:07:38] Yes. And now for a brief historical side note. Cue the music.
Jim Mann [00:07:45] The first study, which is a very interesting study, was actually done in Sweden. It's called the Vipeholm Study, and I think it was done sometime in the 1950s.
Eddie [00:07:56] And in another installment of Unfortunate Things From Our Past, they conducted this study on children with intellectual disabilities.
Jim Mann [00:08:03] I mean, it's a study that would never be ethical now, but they gave half these children, I think, lots of toffee kind of things to chew, and others were kept free of these dense sugary products. And those who had these sticky, sugary sweetie kind of things got more dental caries than the others. And that was really the start of modern evidence that sugars were bad for you.
Juna [00:08:36] So it may have started with dental caries and cavities and caries, but obviously the link between sugar and health goes much deeper than that, and it gets a lot more complicated.
Jim Mann [00:08:47] The story about diabetes and metabolic disease really started to become widely discussed in, I think, the 1960s. And in particular there was a professor of nutrition in London called John Yutkin, and he was one of the first people to really start suggesting that sugar was bad for diabetes in terms of cause and if you had diabetes. And the really interesting thing about his research is that actually a lot of his experiments and his studies were very bad science. They would never pass in terms of today's science. But he came up with conclusions which, despite the question of whole nature of the science, were actually correct. Because, I mean, I think there certainly is very good evidence now that sugar is a significant determinant of ill health.
Juna [00:09:51] Now the story of sugar would not be complete without talking about food processing.
Eddie [00:09:56] Some of our listeners may remember this from past episodes, but back in the 1970s and eighties, right around the time that we started to see an increase in metabolic diseases like diabetes, there was also a massive shift in the American food supply.
Juna [00:10:11] So this was kind of the golden era of introducing mass processed food manufacturing. And what does processed food contain a ton of?
Eddie [00:10:18] I know, I know.
Juna [00:10:19] I will pick you.
Eddie [00:10:20] Thank you, sugar.
Juna [00:10:22] Wow, you are so smart. It contains a lot of sugar. But not just sugar. It contains a lot of super sugar, a.k.a. high fructose corn syrup.
Advertisement [00:10:32] Life savers. Candy isn't, like, delicious.
Eddie [00:10:36] Okay, So a lot of new ultra processed foods are entering the market during that time, and they're filled with this high fructose corn syrup. Yeah. And we start to see a big increase in Americans’ sugar consumption.
Juna [00:10:48] And there's also something else happening at the exact same time, which is the demonization of dietary fat.
Jim Mann [00:10:54] Fat consumption was identified, particularly saturated fat. Consumption was identified as a cause of heart disease. And so there has been, particularly in the second half of the 1900s, the second half of the last century, a modest increase in carbohydrate in association with some reduction of fat, particularly saturated fat.
Eddie [00:11:22] So Americans are told reduce your fat, so they increase their sugar.
Juna [00:11:27] The American way, baby. So not only did we increase our sugar intake, we also just started eating more in general. So from the 1970s to the late 20th century, we started eating on average 500 calories more a day. So a typical woman eats about 2000 calories a day, a typical man about 2500, 500 more calories a day is basically one fourth or one fifth more of your total calories a day. So it's a lot. And the biggest problem with this might not be the fact that those calories were just sugar and fat, but also just the fact that they were more calories.
Jim Mann [00:12:03] I think it is very important to start with the calories because there is absolutely no argument about the calorie thing. There is very strong evidence that a high intake of free sugars predisposes to an excess calorie intake. An excess calorie intake will lead to overweight and obesity, which is the single biggest driver of diabetes and associated metabolic disease. I would defy anybody to disagree with that statement.
Eddie [00:12:40] Now, obviously, we want to make clear that, yes, there are problems with the BMI, that's the body mass index. And yes, excess weight does not result in health problems for everyone. But if you look at the population level, excess weight is associated with an increased risk for metabolic diseases like diabetes.
Juna [00:12:59] Right. So back to the sugar. It's not that sugar contains more calories than other forms of carbohydrates.
Eddie [00:13:04] Right. One gram of sugar has the same four calories as one gram of carbohydrates, like from a potato.
Juna [00:13:11] But remember when we had an expert corroborate how sugar tastes so good?
Eddie [00:13:16] You mean like 5 minutes ago?
Juna [00:13:17] Yeah, exactly. When we really came up with this groundbreaking conclusion that sugar is really yummy. The reason we have to linger on that is because it's actually very important. Because if something tastes really good, then obviously you're more likely to overeat it.
Jim Mann [00:13:30] One of the first pieces of research which I did relevant to Sugar, which goes back more years than I care to remember, and was published in The Lancet, which is one of the two world's leading medical journals. We actually showed quite without any doubt that if you asked people to reduce their intake of sugar and we're talking about what people identified as sugar and telling them that they could increase their amount of starch if they wanted to to make up for this reduction of sugar. They lost weight almost to a woman and man, they lost weight.
Juna [00:14:12] This is probably why low sugar diets are one of the most popular types of diets that people decide to go on.
Jim Mann [00:14:19] If people decide they're going to give up sugar, they will almost certainly lose weight unless they happen to belong to one of that very rare breed of humans that doesn't eat much sugar in the first place.
Juna [00:14:31] So to recap, it seems like the most direct link between sugar and poor health is basically excess calories, which is pretty straightforward.
Eddie [00:14:39] So here's my question. Let's say you're in calorie balance. You're not gaining weight, you're not losing weight. You're just getting enough calories that you need.
Juna [00:14:45] Yeah.
Eddie [00:14:46] But you're eating a lot of those calories in sugar. Is it still bad for us?
Juna [00:14:51] Eddie? That's such a great question. That's exactly what we're going to be talking about right after this break.
Eddie [00:15:01] And we're back.
Juna [00:15:03] Where we left off. We were discussing how sugar can often lead to excess calorie intake. But the question is, does sugar have adverse effects on our health regardless of calories?
Jim Mann [00:15:14] I do think there is evidence that sugar per say, even in the context of calorie balance, can make a difference. And I think it probably depends on individuals. There are some people that are sensitive to sugar. There is no doubt that some people, even on a modest intake of sugar, will have raised triglyceride levels, markedly raised triglyceride levels, which, as you know, is one of the levels of fat with cholesterol that you find in the blood. And it's certainly not good for one's health. And I have also seen individuals who can tolerate large amounts of sugar. So nobody is wrong here. There are undoubtedly some people and probably quite a lot of people who are sensitive to sugar, even in relatively small amounts.
Juna [00:16:10] Oh, man. Guys, that is not the answer any of us wanted to hear, I'm sure. But outside of promoting overeating, it seems like the link between sugar and poor health is actually more debated in the scientific community.
Jim Mann [00:16:23] There are some whom I know well who would say, If you want to be healthy, don't let another grain of sugar pass your lips. And there are others, some of them who receive a lot of money from the sugar industry, but not all of them. Some of them are very good scientists who say, no, we can't find any problems with sugar in the context of calorie balance.
Juna [00:16:48] I mean, Professor Mann himself, the man himself man, the man himself had different views on sugar in the past.
Jim Mann [00:16:56] I could produce for you by the end of today a study published in a good medical journal that would prove any one of the points we've made: that sugar is very bad, even in the context of caloric balance. That sugar isn't so bad in the context of caloric balance. And should I tell you that I have actually published research, which you could use to argue both ways? Actually, I can remember being on BBC television saying, Sugar's fine if you're in calorie balance on the basis of some of the earlier work that I did and I was actually criticizing the work of people that said the opposite. But then I've also published work showing how in some people you can get horrifically abnormal metabolic change. And I think the answer is somewhere in between.
Eddie [00:17:50] Oh, the nature of science. It is so rarely black and white.
Juna [00:17:54] So annoying. I think it'd be so much more awesome if it was black and white, just in my humble opinion. Anyways.
Eddie [00:18:00] So Juna getting back to this excess calorie point, which seems to be more or less uncontested. I think we should do a deep dive about how that can lead to health complications down the line.
Juna [00:18:11] So the biology here can be quite complex, but.
Jim Mann [00:18:15] At a simple level, being overweight or obese is a very major determinant of insulin resistance.
Juna [00:18:24] And again, we want to make this very clear. This can vary by individual.
Jim Mann [00:18:30] I mean, I have seen very overweight people who do not have any suggestion of diabetes or raised triglyceride levels or insulin resistance, and they must have very good genes.
Juna [00:18:46] But let's really break down what insulin and insulin resistance are, because I feel like they are these buzzwords that we hear all the time. Everybody's monitoring their glucose. And I don't even know if we understand what they are. You know.
Jim Mann [00:19:00] Insulin is one of the essential hormones in the body, and it really is responsible for normal metabolism. I mean, without incident, you don't have normal metabolism. And if you have no insulin at all, as in the case of type one diabetes, it's incompatible with life.
Eddie [00:19:20] That's medical talk for you'll die. Yeah. Yeah. Incompatible with life. So if you're a type one diabetic, unless you take insulin, you're not going to survive.
Juna [00:19:30] Right.
Eddie [00:19:31] But let's start and actually talk about what happens when we eat food because we have all those fancy sugar names.
Juna [00:19:37] Right? The glucose, fructose, galactose, trans like intergalactic sugar. It's like space, sugar, lactose. That's all I remember.
Eddie [00:19:45] I go to the head of the class, Juna.
Juna [00:19:46] Thank you.
Eddie [00:19:47] And eventually, no matter what form it's in, when they get into your body, it gets broken down into blood sugar.
Juna [00:19:53] Which goes into your bloodstream. Yes, because it's blood sugar. So food turns into blood sugar, which goes straight into the bloodstream.
Eddie [00:20:00] And then once you have the blood sugar in your bloodstream, it signals to the pancreas that's a little organ in your in your belly to release insulin. That's the messenger that helps the sugar get transported into the cells to be used for energy. Insulin also tells your liver "store this extra sugar. We may need it later."
Juna [00:20:19] Okay. So basically insulin is how the pancreas sends the message to your cells and your liver to take the sugar out of your bloodstream so the cells start taking up the sugar. That means there's less sugar in your bloodstream. So your insulin must then also decrease, right?
Eddie [00:20:38] Well, when it should no longer need it. Right. Or it's the blood sugar is not so high. The insulin should go down.
Juna [00:20:44] Right.
Eddie [00:20:45] Later.
Juna [00:20:46] Okay.
Eddie [00:20:47] If your blood sugar is low.
Juna [00:20:48] Okay.
Eddie [00:20:49] The fact that you have lower insulin now triggers the liver to say we need some sugar and it releases it.
Juna [00:20:57] Okay. So that's what it stored the sugar for before. When you keep saying it's towards sugar, it's for when your blood sugar gets low, your liver will pump it out. So it kind of seems like with everything in the body, it's like there's this complex system of checks and balances. Like the pancreas sends a signal, the insulin level tells the liver what to do. It tells the cells what to do. It's like all these things that are basically preventing your body from having too high blood sugar, but also from having too low blood sugar. So it wants the blood sugar to stay in a certain range.
Eddie [00:21:25] A lot of feedback loops are in there. And this whole system is one of the biggest reasons why free sugars and added sugars that we've been focusing on affect our body so differently than, let's say, the sugar in a fruit, the less processed a source of sugar is.
Juna [00:21:40] So like eating an apple.
Eddie [00:21:42] The more digestion and work your body has to do to get that sugar into the bloodstream. It just takes longer. Your blood sugar then never spikes to these high levels as might happen after, I don't know, eating a peanut butter cup.
Juna [00:21:55] Mm hmm.
Eddie [00:21:56] And when you eat the apple, your blood sugar stays elevated for maybe a longer time until it eventually gets absorbed into the cells.
Juna [00:22:04] So it seems like basically eating an apple because your body has to digest like the plant cell. It has to break down the plant cell wall to release the sugar to go into your bloodstream. It seems like not only does your blood sugar spike less, but it stays elevated for a longer time. It's more of an even keel yet process. It's not this crazy like super high up when you eat the peanut butter cup because there's like no fiber that you have to digest and then you super big sugar crash that people talk about.
Eddie [00:22:32] Mm hmm. Maybe that's what I'm feeling now.
Juna [00:22:36] No, time for another peanut butter cup. Go.
Eddie [00:22:39] Well, we'll get to that. You know, we've talked about the process that happens when your body is working properly, but what happens if you have insulin resistance? First of all, the name is pretty self-explanatory.
Juna [00:22:52] Okay. So just based on the name, it sounds like your cells are resistant to insulin. And that is why I went to college, ladies and gentlemen.
Eddie [00:23:01] Right. Blood sugar enters the bloodstream, as we talked about.
Juna [00:23:05] Yeah.
Eddie [00:23:06] Your pancreas pumps out insulin just like before. But this time your cells are not responding to it properly. To try to fix this. If my kids are not listening to me.
Juna [00:23:17] You scream louder. Absolutely.
Eddie [00:23:18] So the pancreas just starts sending out more insulin.
Juna [00:23:21] Okay, So it's like the cells are not listening to the messenger. Send out more messengers. Cells are not listening. Still.
Eddie [00:23:29] Pancreas screams louder and louder and it eventually goes hoarse. It cannot keep up. And the blood sugar in your bloodstream then, because you don't have enough insulin. Right. It just keeps on increasing. Your cells are not taking in the blood sugar fast enough. So now you have high blood sugar and that could be really damaging to your body.
Jim Mann [00:23:52] And the explanation for this is really quite a complex explanation, but it is most strikingly seen in people who are overweight. You can get resistance to insulin in people that are not overweight, but strikingly, that is where you see it. And the consequence of insulin not being able to do its job is type two diabetes. It is raised levels of triglyceride in the blood, which is the other very striking example of the metabolic phase, the two most obvious derangements of insulin resistance. And of course, most importantly, not only are you going to have diabetes, but you're going to have the complications of this in the longer term, which is an increased risk of heart disease.
Juna [00:24:48] And one thing I just want to say here, I just want to plug it for a second that the opposite of insulin resistance is insulin sensitivity. Right. And one of the best ways to increase your insulin sensitivity.
Eddie [00:24:59] Yes. Yes.
Juna [00:25:00] Regardless of your weight is exercise. We didn't talk about this whole episode, and I just felt like it had to be said that it's one of the most powerful ways. No matter what you weigh, no matter what's going on, it doesn't matter if you exercise, you will improve your insulin sensitivity. So hopefully this makes the idea of insulin a little less confusing for everyone. And now let's talk about this idea of reducing sugar intake. First of all, let's just be clear. Reducing your sugar intake does not mean reducing your whole fruit intake.
Jim Mann [00:25:30] I mean, I would never say to anybody they shouldn't have sugar. I mean, that's a nonsense. And I personally think that there are very few people that I would say don't have whole fruits, don't have whole vegetables which contain sugar because they are within the plant. So all.
Eddie [00:25:52] So just to be clear, as a physician, if I'm taking care of a diabetic patient, I might be talking to them about avoiding certain fruits like watermelon or grapes that have less fiber and sugar gets released a little bit quicker. But if you don't have diabetes, I would not worry about the sugar in your bananas.
Juna [00:26:10] Right. Also, when we're talking about not worrying about fruit, we are talking about whole unprocessed fruit.
Jim Mann [00:26:17] One of the things that's caused a lot of confusion is we've said, you know, fruits are okay if you're trying to keep your sugar down. But for goodness sake, remember that processed fruits, you know, fruit concentrates or fruit juices are very different. They are pretty much like free sugars.
Juna [00:26:38] And now, if you're really determined to reduce your sugar intake, here is Professor Man's recommendation.
Jim Mann [00:26:44] If you want to give things up, what you should give up are the sugar that you put in your tea or your coffee, the sugar that you add to anything, the sugar that the manufacturer adds to anything. That's what you should go for. And in terms of fruit limit, dried fruit, purre, fruit juice, because they are really no different from free sugars.
Juna [00:27:06] Because the dried fruit part broke my heart. It broke my heart because like my dried apricots, I knew I when I was eating them, I was like, these are like candy, These are awesome. And I was like, They're.
Eddie [00:27:17] Nature's candy, but they're still candy, right?
Juna [00:27:19] Yeah. Yeah. Only when they're dried, though. Only when they're dried anyways. For most people, the easiest way to reduce their sugar is going to be reducing their processed food intake.
Jim Mann [00:27:28] Absolutely. The first thing to suggest is that people, if they want to cut their sugars down, they look at processed foods. That's a very good start.
Eddie [00:27:39] And as we know, Juna, a big part of people's sugar intake, at least in this country, are sugar sweetened beverages. So we're looking at how much soda.
Juna [00:27:48] The.
Eddie [00:27:48] Sports drinks or sweet coffees or even sweetened teas are in your diet. It's going to be a big contributor to your sugar intake.
Juna [00:27:55] Oh, guys, every time we talk about soda, I'm like, Hey, hey, I don't drink any soda. And then I'm like, sweet coffee. Wait, what? Nooo, because I'm like, you know, the peppermint mochas, You know, the.
Eddie [00:28:07] Sugar.
Juna [00:28:07] In it. Oh, it has sugar. What, guys? No way. What if you think that it'll be impossible to live without your sugar or your peppermint mochas, or it'll be impossible to live with less sugar. The good news is that your body actually habituate or gets used to the amount of sugar you eat. So, for example, Professor Mann himself, the man Mann the man used to put a couple of teaspoons of sugar into his tea and coffee.
Jim Mann [00:28:34] And now if you give me a cup of tea with sugar in it, I absolutely can't drink it. And that's somebody who had a couple of teaspoons. If you give me with coffee, with sugar, I would drink it only to be polite, but I wouldn't enjoy it.
Juna [00:28:50] Same guys. I definitely do not enjoy sweet coffees. Definitely do not. And it turns out that this is because your body will actually upregulate and downregulate your sugar taste receptors based on how much sugar you're eating. So, for example, my roommate, she does not eat a lot of sugar. She, like, never eats desserts or whatever. So then sometimes my girl try this thing, it's so good. And she's like, Oh my God, it's too sweet. And I'm like, Girl, why you be so dramatic all the time? This is not too sweet. And it's like, it's so annoying. I'm like, This is not too sweet. And now I get it, guys. Her body has downregulated her sugar receptors, so actually, it does taste a lot sweeter to her than it does to me.
Eddie [00:29:33] And I think we should also talk about something that people may try when they want to reduce their free sugar intake, and that's artificial sweeteners.
Juna [00:29:41] Oh, my God. I feel like we should do like a whole separate episode on those.
Eddie [00:29:44] Agreed. It's really important. But let's talk about it just briefly now. Okay. It's true. Artificial sweeteners may have zero calories, but that doesn't mean that they're doing what you want them to do.
Jim Mann [00:29:57] If you think that you're going to get long term health benefits from taking an artificial sweetener or the term is a non-sugar sweetener, that's the technical term. You probably are not.
Juna [00:30:12] There's actually very little evidence that artificial sweeteners lead to long term weight loss, even if they lead to a little short term weight loss.
Jim Mann [00:30:20] The problem is that it doesn't help you to alter your taste for sweeteners.
Juna [00:30:28] In other words, you'll still have the same desire for sugar, even if you replace your sugar with Splenda or stevia or whatever. So reducing sugar does not mean replacing soda with diet soda. It means like actually drinking less soda or actually drinking less peppermint mocha. In my case.
Eddie [00:30:46] Right now, if you're looking to reduce your sugar intake, you may need to be pretty savvy because there are a lot of names that sugar can take.
Juna [00:30:56] Here are some of the names for sugar.
Eddie [00:31:00] Cane juice. Corn syrup. Dextrose. Fructose. Fruit juice concentrates. Fruit nectar such as agave nectar.
Juna [00:31:08] Not agave nectar. No.
Eddie [00:31:10] It sounds so healthy, doesn't it?
Juna [00:31:12] Yeah, it does.
Eddie [00:31:12] Glucose, high fructose corn syrup, honey malt syrup. My favorite maple syrup. No molasses, raw sugar, sugar, sucrose sugar cane. If you want the whole list, we'll put it on our website. It's from the CDC.
Juna [00:31:32] So a useful place to look if you're buying something in the store would be on food packaging, where the FDA is now requiring food manufacturers to put, quote, added sugars on the label.
Eddie [00:31:44] The CDC recommends to limit added sugars to no more than 10% of our recommended daily caloric intake. So like Juna said before, 2000 calories for the average woman, that would translate to only 50 grams of sugar or ten teaspoons. This is a small fraction of what the average American consumes today of added sugars.
Juna [00:32:06] It's crazy because you don't think about it like I've never put a teaspoon of sugar into anything in my life, but it's because it's like hidden in everything that you eat, you know? Just a warning, though, since food manufacturers are very savvy, they have now started using things that they don't have to technically label as added sugars. So if they sweeten something with fruit juice or fruit puree, even though it acts like a free sugar in your body, it does not have to get labeled as an added sugar.
Eddie [00:32:32] So it's like looking for sugars, could be like a full time job or.
Juna [00:32:36] Like you have to like look in so many places. If look at the ingredients, yet look at the label you have, look at this, blah, blah, blah. So I think that we can simplify this a bit, which is don't worry about sweetness that is in a whole intact plant.
Eddie [00:32:50] Like an apple.
Juna [00:32:50] Like, okay, right, right. Like a banana. Okay. An orange, a grapefruit. We could go on. But if something is sweet and it's not a whole intact plant, chances are it had to have something added to it to make it sweet. Mm hmm. And regardless of what it is, whether it's table sugar, date syrup, agave nectar, stevia, it's probably not good for you, at least in excess.
Eddie [00:33:17] You know, Juna, I think even being aware of this is probably going to help us make behavior changes. You know, this thing I think we've talked about before that you ask someone, just do me a favor. Write down your food diary, everything you eat.
Juna [00:33:30] Yeah.
Eddie [00:33:31] And the results right away.
Juna [00:33:32] They eat better automatically.
Eddie [00:33:33] Right. And why do they do that? Because you're going to be looking at it. Or maybe just because you're a little bit more conscious.
Juna [00:33:39] Yeah.
Eddie [00:33:40] So a colleague of mine at Mass General, she's tries to illustrate to her patients how much sugar is in things like the coffees and the soda that we drink. So she has these empty soda bottles and she's got these empty coffee cups, except that she puts the sugar back into the cup to demonstrate that and I think she's trying to shock the patients into how much sugar they're drinking. But then one patient looks and he sees that almost two ounces of sugar in the bottom of the big cappuccino cup and says, yeah, that's about what I put into my coffee every day.
Juna [00:34:10] Yeah.
Eddie [00:34:11] And okay, you know, like maybe let's just start to talk about this and just be conscious of how much sugar there is in things or how much we're adding.
Juna [00:34:19] Yeah, I have to say, I have to say I think of myself as a person that doesn't eat too much added sugar, which is what I very arrogantly think of myself.
Eddie [00:34:27] But do me a food diary.
Juna [00:34:28] I know. And it creeps up on you. Because of the holiday season came, There was new flavors. I got to try the sugar cookie. I got to try the peppermint mocha. And then I was having it once a week, but then sometimes twice a week. But then also my sister makes a cookie box annually cookie boxes where she makes 12 different types of cookies at Christmas. There's 12 different types of I have to try each cookie and then it last for days and it's doesn't matter guys. The details are irrelevant. The point is, I'm really going to make an effort to have black coffee at least six days a week because I think the peppermint mocha were just getting a little out of control.
Eddie [00:35:05] But you'll enjoy that peppermint mocha on the seventh day.
Juna [00:35:08] Oh, yeah. I'm going to enjoy the heck out of it's going to be so good by my rest day. Peppermint mocha.
Eddie [00:35:14] So for me, I'm going to wrestle with the dried apple rings. They are inexpensive. They are easy to munch on all through the day. But I know that after eating them, my sugar spikes, my blood sugar spikes, my insulin comes in, it's doing its job, my blood sugar plummets and then I crash. Yeah, unless I reach for another apple ring. and all day. Rinse, lather, repeat.
Juna [00:35:39] It's like that's that's what leads to the overeating is like you keep reaching for more apple rings because your blood sugar goes up and down, up and down all day. Mm hmm.
Eddie [00:35:45] And I might eventually fall into some insulin resistance, and I definitely don't want that. Right. The other thing about these apple rings, Juna, is that I always look to them like a health food.
Juna [00:35:57] I know, guys, I know the marketing guys. It honestly gets the best of us. Truly. So to recap, the biggest reason why sugar is linked with adverse health outcomes seems to be that it promotes overeating or excess calories. Sugar within plant walls. So sugar in fruit, sugar in vegetables, it's not an issue. But where we run into problems is when free sugars come into the food. So during food processing, when people are adding date syrup and fruit purees and maple syrups. As well as, you know, regular table sugar. That's where we get problems with sugar intake. And there is also some evidence that outside of calories, excess, free sugars might still be bad for our health, for at least for certain people. So, of course, I had to ask, Professor Man is giving up sugar a good New Year's resolution? And here's what he said.
Jim Mann [00:36:52] I think it's a it's a good New Year's resolution, but it's not the most important one. I mean, from an eating perspective.
Juna [00:36:59] So instead of focusing so much on sugar types of sugar free sugars, added sugars, reading the ingredients, reading the labels, blah, blah, blah, blah, blah, it gets so complicated we can instead just focus on the food.
Jim Mann [00:37:11] Basically, if you're talking about carbohydrates, go for high fiber foods, whole grain foods, intact fruit and vegetables. I think intact is quite a good way of describing it.
Juna [00:37:25] And of course, I had to ask what would be a New Year's resolution that he thinks would make more of a difference?
Jim Mann [00:37:32] I would have part A and part B of my ideal New Year's resolution, and one would be eat the amount that you need. And as far as possible plant based intake. I don't think you have to be a vegetarian, but I think a mainly plant based diet is is the ideal one for one's health.
Juna [00:37:56] And that's a great place to end today's episode.
Eddie [00:38:00] With another peanut butter cup.
Juna [00:38:02] Yummy. Were you even listening to this episode? What are you doing? This whole episode? My goodness. We will link to Professor Mann's research on our website foodweneedtotalk.com. You can find us on Instagram @foodweneedtotalk. You can find me on Instagram @theofficialjuna and Juna Gjata on YouTube and Tik Tok. You can find Eddie being a bad influence.
Eddie [00:38:24] No I'm going to try to do a food diary.
Juna [00:38:26] Okay. Food, We Need to Talk. Is a production of PRX.
Eddie [00:38:31] Our producers are Morgan Flannery and Rebecca Seidel.
Juna [00:38:34] Tommy Bazarian s our mix engineer with production assistants from Isabel Kirby McGowan.
Eddie [00:38:39] Jocelyn Gonzalez is executive producer for PRX Productions.
Juna [00:38:43] Food, We Need to Talk was co-created by Carrie Goldberg, George Hicks, Eddie Phillips and me.
Eddie [00:38:48] For any personal health questions. Please consult your personal health provider to find out more go to foodweneedtotalk.com.
Both [00:38:57] Thanks for listening.
