In the last couple of months there has been a lot of buzz about the new documentary, Fed Up. The film, narrated by Katie Couric, takes a hard look at some of the factors that are driving preventable chronic diseases in our country. It's no secret that we are seeing dramatic increases in chronic metabolic diseases — like obesity, diabetes, lipid disorders and hypertension. But is our approach to dealing with these problems on target? The answers may surprise you.
Obesity gets a lot of attention because it is a visible disease. From the outside, people can't see if someone has diabetes, high blood pressure, or high cholesterol. Obesity can increase someone's risk for these conditions, but it is also important to know that people can be at risk even if they don't have a high body mass index (BMI). Body mass index can be useful information, but it doesn't distinguish between lean and fat tissue. You can actually be "thin on the outside but fat on the inside" (TOFI). In fact, an Italian study published in 2009, found that BMI tended to underestimate someone's risk for metabolic disease.
So how does this apply to us? First of all, we need to realize that when it comes to preventing metabolic disease our focus should be on body composition rather than weight. Body composition affects how we store and use energy, and it is strongly affected by our food choices. This is where added sugar comes into the picture.
The average U.S. adult eats about 22 teaspoons of added sugar a day. The American Heart Association (AHA) recommends a maximum of 6 teaspoons a day for women and 9 teaspoons a day for men. Added sugar, because it rapidly absorbed, is toxic to our body at high doses. When we take in too much, too fast, it goes straight to our liver where it alters our hormones and gets turned into fat. There are different kinds of fat, but the most dangerous kind is the fat that you can't see — the visceral fat that surrounds our organs and alters our metabolism. This is the kind of fat that is may be present even in thin people, is linked to an "apple" body shape and raises the risk of metabolic diseases.
It's not easy to change our sugar habit. In fact, we are wired to like sugar and sugar activates the same centers in the brain as cocaine. Animals studies suggest that sugar and sugar substitutes may be even more addictive than cocaine!
Here are a few ideas to move towards a healthier sugar intake:
1. Learn to read food labels - Be mindful of how much sugar you're consuming. You'll see that sugar is listed in grams and that there is no daily allowance listed (thanks to a strong food industry lobby — another point raised in the film). There are four grams of sugar in one teaspoon. Notice the portion size listed on labels and do the math. Remember, the AHA recommends 6-9 teaspoons a day!
2. Eat small frequent meals - Try to include "protein and produce". Protein and the fiber in produce help prevent blood sugar spikes. Blood sugar spikes work against you because they lead to unhealthy metabolic changes and cravings.
3. Avoid processed foods - Processed foods often are low in fiber and contain added sugar. Both of these can cause blood sugar spikes.
4. Just say "no" to soft drinks — This is hard for a lot of folks, but the painful truth is that soda has no nutritional value whatsoever. A medium fast-food soda has about 11 teaspoons of added sugar! In addition to the sugar, soda is very acidic and harmful to your teeth. Some evidence suggests that even diet sodas may adversely affect metabolism.
5. Eat whole fruit or drink smoothies instead of juice — Remember, fiber is your ally in preventing blood sugar spikes!
6. Be compassionate with yourself (and others) — Habits take time to form, and they take time to change. Focus on taking small steps forward, celebrate your accomplishments, and forgive yourself if you get off track. Wellness is a lifetime journey!
7. Get help if you need it — Habits can be hard to break and food addictions are real. If you find yourself stuck or struggling, get support. Family, friends, support groups, healthcare providers, coaches, and counselors can all be powerful allies as you develop new habits. We are all stronger when we work together!
I'd love to hear your thoughts about this topic. Have you seen the movie, Fed Up? Are you concerned about the amount of sugar that you or your family eat? Please share your comments with me below!