Guest Post

by: Le’Vena Tan, Nutrition Masters Student & Guest Post Writer

From sugar taxes, listing added sugar on nutrition labels, to words like ‘’toxic”, ”poison”, ”evil” constantly being used to describe sugar, sugar gets a lot of bad press from public health professionals and the media as being the food to avoid. Recently, I saw a social media post about dietitians being advocates for carbohydrates/sugar, because of misconception and fear surrounding sugar propagated by diet culture.

What is sugar and why is it important?

Sugars are broken down forms of carbohydrates. They supply our body with energy necessary to perform our day-to-day activities, resting, eating, thinking, moving etc. Sugar is a great quick source of energy to help restore our blood sugar, especially when it is low. An added bonus, sugar tastes good! There are three different types of sugars: simple sugars (monosaccharides), disaccharides (containing 2 sugar molecules) and complex sugars (polysaccharides). 

The science behind sugar metabolism

Glucose

Glucose is the simplest form of carbohydrate and the preferred form of energy for most cells in our body, especially the brain. After being absorbed into the body via the intestinal lining, glucose is broken down by the cells in our body to provide energy for essential metabolic processes and our daily activities. In excess, glucose is stored as glycogen, the storage form of glucose, or as fat in our body. 

Fructose and Sucrose

Fructose and sucrose are found naturally in fruits, vegetables, and nuts. Fun fact: table/granulated sugar are examples of sucrose, manufactured from sugar beets or sugar cane. Fructose is a simple sugar just like glucose with a different chemical structure. Sucrose consists of equal parts glucose and fructose. The body has to break down sucrose into glucose and fructose molecules in order to use it for energy. It’s important to note that most sugars are typically consumed with fiber, vitamins, minerals, antioxidants and phytochemicals, which helps our body fight against diseases. 

High Fructose Corn Syrup

High Fructose Corn Syrup (HFCS) is typically found in packaged foods and beverages. It is commonly 55% fructose and 45% glucose in beverages and 42% fructose and 58% glucose in baked goods and other foods. Similar to sucrose, HFCS needs to be broken down into its glucose and fructose molecules. 

Our body processes sugar the same way, regardless of its source (naturally occurring or from manufactured, processed foods). But, there are some differences in the metabolic pathways glucose and fructose undergo in our body, even though the end-product of both are basically the same.

How do our bodies break down fructose?

• First, fructose is mainly broken down in the liver.
• Second, fructose has to undergo additional steps before entering the same metabolic pathway as glucose to provide energy to the body.
• Third, unlike glucose, fructose doesn’t trigger insulin secretion, whose role is to regulate our blood sugar and hunger and fullness cues. Fructose intake can affect our hunger and fullness cues by increasing our desire and appetite for food and decreasing the satiety signal of our brain ^1,2. 

A word of caution:

it is helpful to know the science behind how sugars are metabolised in our body. But, it is even more important to note that we do not consume sugar in isolation and our diets typically consist of a variety of foods. The mechanisms of how food is broken down in our body is highly complex and hinges on many factors. For example, eating an apple with peanut butter (adding protein and fat), our body processes the fruit sugar differently than eating an apple alone. More reasons to not agonize over our sugar consumption.

What does this all mean? 

I think this means that we shouldn’t go around labeling some sugars as good or bad. It doesn’t serve us to make rules about which sugars are better to avoid or worry about how much glucose or fructose we are taking in, or avoid sugar all together. These actions have the effect of making sugar all the more desirable, which contradicts the initial motivation in the first place. Black and white rules make us feel guilt and shame about our eating, which doesn’t lead to increased health and well being. 

Instead of Using Rules

If sugar isn’t all bad, then how can we think about sugar? 

Remember that everybody’s biology, genetic make-up and history with food is different, so you can have very different reactions to different types of sugar to your friends or family.

Instead of thinking about food in a dichotomous, (good or bad) way, you can decide how sugar fits into your food intake. Trust your body. It has a lot of wisdom – and internal information is just as important as the external information we get from science, if not more so. Explore how your body and mind feel when you eat different sugar-containing foods.

Ask yourself:

• How does this (sugar-containing) food taste on my tongue? 
• Does it taste good? Or is it just the idea of it that tastes good? 
• How do I feel (physically and emotionally) immediately or a few hours after consuming it? 
• Do I feel differently if I eat it with other foods? 
• Am I hungry to eat this or do I want it because I usually don’t allow myself to eat it? 

Giving yourself the opportunity to explore how you feel after eating sugars, helps you understand your response to them and, maybe, get more satisfaction out of your eating experience. Being curious, rather than using rules, helps us eliminate the guilt and shame that can come from black and white rules. Tuning in, may help you identify the sugar-containing foods that you love and maybe others that you don’t really enjoy at all. 

Le’Vena Tan is a graduate student in the Department of Nutrition at University of North Carolina at Chapel Hill. She is also a lactation student in the Mary Rose Tully Training Initiative (MRT-TI) under the Carolina Global Breastfeeding Institute. Her interests include pediatric and maternal nutrition, breastfeeding, responsive feeding, intuitive eating, Health at Every Size® and public health, especially food insecurity. She hopes to practice from a weight-inclusive lens and to utilize her knowledge in public health to help better the community. She enjoys engaging in creative pursuits and would like to incorporate some creativity in her work in the future. Le’Vena can be contacted via email at levena.unc@gmail.com.

Citations:

1. Lowette, K., Roosen, L., Tack, J., & Vanden Berghe, P. (2015). Effects of high-fructose diets on central appetite signaling and cognitive function. Frontiers in nutrition, 2, 5. 
2. Luo, S., Monterosso, J. R., Sarpelleh, K., & Page, K. A. (2015). Differential effects of fructose versus glucose on brain and appetitive responses to food cues and decisions for food rewards. Proceedings of the National Academy of Sciences, 112(20), 6509-6514.

by: Karen Manschot, MS, RDN, LDN
Guest Post Writer

Our lives have drastically changed over the last week.  We have gone from going to work, or school, or kids’ activities, or personal activities to being home juggling many things all at once.  There’s lots of uncertainty right now and this uncertainty can lead many people to focus on food and their bodies. Wellness and food marketers can prey on this fear and uncertainty with “tips” that aren’t based in science and can cause harm. Instead of latching on to nutrition tips that may not be helpful, let’s look at what food recommendations may help ground us during this time. 

1. Maintain a “flexible” structure.

It seems that so many news stories have focused on how to maintain structure with learning and school projects with kids who are home due to school closures. Even more importantly, consider keeping a “flexible” structure with meals and snacks. Focusing on a structure with food can help the rest of the day feel structured, if that’s helpful to you. Some days may be more structured than others, and that is okay. Be gentle with yourself and your loved ones, allow for flexibility. 

Although our schedules have changed, our bodies’ need for food has not. Our stomachs still empty every 3-4 hours. Continuing to set aside time for regular meals and snacks is a great way to care for yourself, and maintain a sense of normalcy, at a time when very few things feel normal. 

2. Check in with yourself.

Maybe you don’t have kids at home and are just providing for yourself, or are providing for you and a roommate, or you and a partner. This message still applies. Give yourself permission to check in with yourself (and whoever you are living with) every few hours and ask: 

• “When was the last time that I ate?”
• “How hungry am I right now?”
• “What food(s) sound good to me?”

Some days, implementing this kind of flexible structure and checking in with yourself may feel easy. Other days, it may not go as well. Be gentle with yourself, you are doing the best that you can. If you are struggling with these questions and are just providing for yourself, think of how you would want to feed a child or a loved one in a time such as this. What would you tell them about how they can nourish their bodies? How would you encourage them to make food a priority?

3. Focus on adequacy.

There have been numerous news stories and social media posts dedicated to sharing information on which foods are “healthiest” for us to stock up on during this time of quarantine. If pouring over nutrition facts labels feels tiring and unnecessary, you are not alone in that feeling. This is not the time to get bogged down in nutrition facts. Some grocery stores are now changing their hours and limiting how many of a certain product you can purchase at one time. Consider being flexible with the food choices that you make at the grocery store, and instead of nutrition details, focus on eating adequately.

Ellyn Satter makes a case for eating adequately before considering the nutritional profiles of food. In her Hierarchy of Food Needs, Satter contends that eating enough food should be our first priority. Getting enough food is going to look different for all of us at this time. At some meals, maybe that looks like eating multiple food groups. Other meals, maybe that looks like eating just carbohydrate rich foods. It is a privilege to continue to be able to eat a variety of different foods during this time. Not everyone has the privilege of being able to go to the grocery store each week to buy fresh foods or being able to stock up on multiple weeks of food. Our bodies are better able to fight off infection when they are well fed, regardless of the type of food that we eat. Know that it is okay if your meals look different now than they did a few weeks ago. We are all doing the best that we can.

4. Consider how to be creative with the food on hand.

Since the quarantine started, I have had the privilege of having more time on my hands to cook and bake. I recognize that not everyone has the opportunity to cook new recipes during this time, nor is everyone interested in that. If you are someone who is interested in trying a new recipe (and maybe even involving your children in the cooking process!), search Sunny Side Up Nutrition’s recipes. These recipes are simple and many are designed for kids to help. Also, consider searching the Food Hero and Chop Chop Family websites. Food Hero allows you to search their recipe database by ingredient, and Chop Chop Family allows you to search recipes by category (e.g. breakfast, lunch, dinner). Chop Chop also outlines all of the kitchen gear that they think you will need for each recipe – making it easier for you to decide if you have what it takes to make a recipe, before you start cooking.

5. Support local restaurants, if able.

Starting to feel stir crazy when it comes to preparing meals at home? Consider supporting a local restaurant by ordering takeout, if your budget allows. Some restaurants are offering special deals in an effort to get more Americans to eat out and support the restaurant industry. If you are reading this and live in the Triangle area, consider checking out this list of local restaurants that are continuing to offer curbside pickup or delivery.

If you are feeling concerned about food safety when ordering out or cooking at home, consider that there is currently no evidence of food or food packaging being associated with transmission of COVID-19. Food safety experts recommend that you continue to wash your hands with soap and water for at least 20 seconds prior to preparing or eating food, or use hand sanitizer when soap and water are not available. For more information about best practices with food, review the tips listed here and here.

As a closing thought, I leave you with a message of encouragement that one of my former coaches would often share with me.

“Do what you can, with what you have, where you are.”

We are all trying to figure out this new normal. Please be patient with yourself and with others. Each day, or maybe even each hour, may look different than planned. Wishing you self compassion and peace as we work through this, together.

If you have nutrition questions or need nutrition support for yourself or your family, Karen and all the dietitians at Pinney Davenport Nutrition and Lutz, Alexander Nutrition Therapy are conducting sessions via telehealth. We’d love to help!

Karen Manschot, MS, RDN, LDN — Lutz, Alexander & Associates Nutrition Therapy

Guest Post Writer

Karen provides nutrition therapy for adolescents and adults with a variety of nutrition concerns, including disordered eating and sports nutrition. She also leads an Intuitive Eating group that provides both psychoeducation and support for adults on their Intuitive Eating journey. She completed her Bachelor of Science degree in Dietetics & Nutrition and Fitness & Health at Purdue University where she was a student-athlete competing in distance events for the Purdue Women’s Cross Country and Track and Field teams. Karen completed her dietetic internship and Master of Science degree in Nutrition & Dietetics at Northern Illinois University, where she also served as a volunteer assistant coach for the Women’s Cross Country and Track and Field teams. She utilizes motivational interviewing and a non-diet approach to assist clients in improving their relationship with food. Karen typically sees clients in Raleigh, NC and virtually. To contact Karen directly you can email her at karen@lutzandalexander.com