Ep #15: The Impact of Eating Too Much Sugar

You are listening to the Strong as a Working Mom podcast, Episode # 15. Do you have a love-hate relationship with sugar? Let’s talk about it.

Welcome to the Strong as a Working Mom podcast. If you’re balancing career, family, wellness, and some days sanity, you are in the right place. This is where high achieving, busy working moms get the tools they need to eat, move, and think. I’m your host, physician, personal trainer and Certified Life Coach Carrie Holland. Let’s do this.

Hey, how are you? What’s new? What’s good? So, what’s good here is that we have been doing some math. Both of my kids really love math, and they talk about it pretty often, which I think it’s awesome, considering I generally find a way to sneak math in pretty much anywhere, including most every time that I hang out with you.

And you know, I used to hide my nerdiness. But now I just totally own it. And what is cool, is that I am seeing the trickle-down effect as my kids are now into it, too. So, it’s good stuff. But the math that we did as a family, was enlightening. So, I have been trying to learn as much as possible about the food industry. And what it led me to was sugar.

So, the more I read, the more I realized that added sugar is really everywhere. And despite my assertion that we eat pretty healthy, I started to second guess myself, once I saw how added sugars sneak into so many foods. A few nights ago, we each thought through a day-in-the-life, and we all added up how much sugar we eat in a day. And when I say sugar, I mean added sugar.

If you look at the nutrition label of your foods, it will give you the breakdown of macronutrients, carbs, fat, and protein. And under the heading of carbs, it will list how much sugar and added sugar is in the food. So, each one of us did this. And we were all above the daily recommended limit for sugar intake, and it was totally eye opening.

I have been doing a ton of reading about this and digging into literature. And when we did this exercise, it lit a fire under my booty, really, to create this episode about sugar. So, here it is.

Before we even dive in, let me set the record straight. I am not about swearing off foods. I am not about giving up sugar for life. Let me make that crystal clear from the outset. However, it is no secret that we are a sugar filled society. And the more I learn about it, the more I think that we have some work to do, especially creating awareness about just how much sugar we are all taking in.

So, today we are going to dive in, specifically, we’re going to talk about a number of things. First, we’re going to talk about the problem that sugar creates in our diets. And why it’s only getting worse. We’re definitely gonna get into some science, including the effects that sugar has on you. And then, we are most definitely going to talk about sugar substitutes, because this is in vogue, and it is something that comes up commonly. And then last, we are going to put this all together.

And I have an idea for you, to address you and your family’s sugar intake. All right, so let’s go. Let me just start first by clarifying. There are natural sugars, and then there are added sugars. So, we need to make this distinction from the get-go because it can get confusing. I have been asked, on more than one occasion, if you should be limiting your fruit because there’s sugar in fruit, and won’t all that sugar make you gain weight? No. So, if you go totally crazy and eat 12 bananas every day, sure, maybe. But the average person, taking in an average amount of fruit, is not going to make herself gain weight, or develop diabetes from eating apples and berries.

Okay, so natural sugars are exactly that; they are found naturally in foods. Examples of this are fructose, which is found in fruit. And lactose, which is found in milk. It is also found in starchy vegetables and some carbohydrates, like brown rice. Your body converts starch, things found in potatoes, pasta, bread, rice, and beans, your body converts that into glucose, which is a simple sugar. And, your body uses that glucose for energy. Okay, so that’s natural sugars.

Added sugars, are the sugars that are added to your foods. These sugars don’t occur naturally in the food itself. It can be a seemingly innocent as the honey you throw into your yogurt, or the syrup you smear on your pancake, or the agave that you throw in your smoothie.

Or, on the extreme end, are the refined sugars. And these are things that show up in foods like candy, cakes, cookies, and pretty much most ultra-processed foods. And, soda is another example. Okay, so the sneaky part about this, is that added sugar can show up in the ingredient list of your foods under all kinds of names. Too many to list off here, but go Google® it.

In medical school, I learned that any compound that ends with of letters O-S-E at the end of it, is a sugar. And that applies here, too. So, if you see sucrose on the ingredient list, that is the fancy name for table sugar, as an example, okay. But this list of added sugars is really long. Know that, if there is syrup on the ingredient list, or nectar, or juice, or use of the word sweetener, that’s all added sugar.

Try this out the next time you head to your pantry or your refrigerator, pull something out and look at the nutrition label. So first, take a look at how many grams of added sugar are in the food. Then, take a look at the ingredient list and see how it’s named. Because you might be surprised. So, things like ketchup, pasta sauce, your fruit flavored yogurt, salad dressings, they can all be loaded with added sugar. But you won’t know it unless you’re on the lookout for it.

Why does this even matter? It matters because all of that extra sugar adds up really, really fast. Let’s talk some numbers here, so you have an idea of what the daily limits are. And notice, I’m not saying daily recommendation, okay? I say that on purpose. Your body does not need any added sugar. Your body does not require added sugar in food, in order for your body to function properly.

The sugar that you get from food that occurs naturally, go for it. Most of us don’t get disease from eating too many apples, bananas, berries, as part of a whole food diet, right? But your body is not going to give out on you if you don’t add sugar to your grapefruit. Your body is not going to stop functioning if you stop eating Pop-Tarts®, right?

Okay, so what are the upper limits for sugar consumption? According to the American Heart Association, it is 36 grams for men and 25 grams for women and kids over the age of two. And the CDC goes so far as to say, no more than 10% of calories from added sugar. So, I don’t love the CDC recommendations as much, because that’s a little harder to calculate. Especially since so many of us just don’t know how many calories we’re actually eating every day.

And I’ve said it before, we humans are not the best at estimation. I go with the AHA recommendations, especially now that nutrition labels are clearly marked with the amount of added sugars they contain. And it’s listed in grams.

Okay, so as a frame of reference, your average 12-ounce can of regular Coke® has 39 grams of sugar. All right, and the upper limit for men is 36 grams. So, you’ve already hit your limit and that one can have regular Coke. And then for more reference, 4 grams of sugar is 1 teaspoon, there abouts.

Okay, so imagine drinking a glass of water and then eating almost 10 teaspoons of sugar: that’s your can of Coke. Okay, how about a 20-ounce bottle of Gatorade? So, on average, that’s 34 grams of sugar, or about 8 ½ teaspoons of sugar. Again, imagine a 20-ounce glass of water and then pounding 8 ½ teaspoons of sugar.

And while it may be kind of weird to think of it this way, I’m encouraging you to think of it this way because truly, that’s what it is; that sugar is hidden. It is dissolved into the brown water of your soda, or the red water of your fruit punch Gatorade. And it has been shown, over and over and over again, that sugar sweetened beverages are a major contributor to weight gain and obesity.

I mentioned all this not to freak you out, but to simply say that in America, sugar sweetened drinks, like soda, fruit drinks, sports drinks, those make up almost 50% of our added sugar intake. So, we’re literally drinking our sugar.

And as for our kids, the same is true. I may get some pushback for this and I am okay with it; I will stand by it. Your kids do not need fruit juice. Even if it is 100% fruit juice, they just don’t need it. The only drink that any of us need, truly need, is water; straight-up water, period.

Okay, so after sugar sweetened beverages, the next largest source of added sugar in our diets, comes from desserts and sweet snacks. Things like cookies, cake, brownies, donuts, pastries, ice cream. And then after that, it’s coffee, tea, candy and cereal. There are estimates that 20% to 25% of the calories in the average American adult diet come from added sugar. One quarter. One quarter of our calories come from added sugar. That’s an estimate.

But why does this matter? What does this added sugar do to you? Added sugar does a lot of things to you. So, certainly, it impacts your teeth and your risk for cavities. Lots of other body systems are affected though. If you’ve got joint pain, it can worsen it. It affects your skin, and can cause it to age faster. It may be associated with an increased risk for acne. It can lead to the accumulation of fat within your liver or fatty liver disease. It can impact the small vessels in your kidney.

Almost every organ system can be impacted by excess added sugar intake. And, I wanted to go over some of the big ones now. So first, it increases your risk for heart disease. And the literature suggests that this is dose dependent. Meaning, the more added sugar you eat, the higher your risk of dying from heart disease.

There are a number of mechanisms that are thought to be responsible for this. I’m not going to get into all of them because it’s pretty technical, but suffice it to say, that eating excess sugar can ultimately lead to heart disease. Okay.

And then of course, excess sugar can increase your risk for diabetes. So again, I’m not going to go into all of the details here. But what happens is that eating excess sugar can ultimately lead to insulin resistance and diabetes. It is much more complicated than that. And, I’ll spare you that. But know that eating too much added sugar increases your risk for Type 2 diabetes.

Okay, so let’s also talk about how eating excess sugar affects your brain. Okay, so first, it messes with your mood. So, eating excess added sugar can cause you to have a higher risk for depression. There’s a number of mechanisms that are responsible for this, including blood sugar swings, the effect on dopamine, the pro-inflammatory effects on your blood vessels, all of those things can impact your brain. All right?

Second, eating sugar can cause you to crave more sugar. So, refined sugar that is added to processed foods is highly concentrated. This is an important point. There aren’t substances in nature that are as highly sweet and concentrated as processed sugars. And the impact of these sugars on your body is real.

So, when you eat foods that contain added sugar, what happens is you get a spike in your blood sugar followed by a crash, and it is this crash that leaves you grouchy, hangry, and ultimately craving more sugar to get you out of that crash.

The natural fruit that is found in your apple does not have the same effect, because the apple’s got fiber in it, which reduces the amount of sugar that is absorbed from your digestive tract. And in turn, what happens is you have a more gradual rise in your blood sugar, and there isn’t that same crash afterwards. And, the fiber will also leave you fuller longer. So, it’s a win-win.

Okay, so there’s also the impact that sugar has on dopamine in your brain. So, Dopamine is a feel-good neurotransmitter. It has other roles, but it is most known for giving you the sense of pleasure. Dopamine also gives you motivation to do something when you’re feeling pleasure.

Humans are wired to seek and find behaviors that cause the release of dopamine, like eating foods with added sugar. The response in your brain to natural sugar versus added sugar, is different. Meaning, the sugar found in your apple does not cause the same level of intensity of dopamine release that you get from eating a cookie.

When you eat the cookie, as an example, you get a dopamine rush and it tells your brain; hey, I like this. This makes me feel good. Do that again. So, think of it this way. The more concentrated and refined the sugar is, like what you would get from eating a cookie, the more concentrated your brain’s response will be to that food.

Calling in some habit science here, the more you do something, the more you practice it, the more that behavior becomes a hardwired habit. And especially for my emotional eaters, think about it. When you are under a tremendous stress, your primitive brain takes over and says, hey, I’m really stressed, hurry up and do something to make me feel better. So, the dopamine bumps up.

And if your typical response is to reach for a cookie, that is exactly what you will do. You get good at what you practice. And ,this is how the cycle of emotional eating perpetuates itself.

Okay, so let’s talk about, can you be addicted to sugar? All right, so this is most definitely the subject of wide debate. Okay, The hard part here, is that we’re talking about food. And, food is something you need to survive. Unlike alcohol, nicotine, heroin, or other recreational drugs. You don’t need added sugar to survive. So, there’s an important difference here.

Then, from a clinical standpoint, if you look it up, there are loads of schools of thought on sugar addiction, and as you would expect, none of them agree. Alright, so the American Psychiatric Association lists a number of factors that determine addiction. These things include intense cravings, intoxication, or the feeling of intense pleasure, calm or high, failed attempts to cut back, tolerance, withdrawal symptoms upon termination, and interference with activities or relationships.

So, if you were to ask yourself about these, in relation to sugar, you may find that some of them apply. You can also look at a commonly used tool in psychiatry, which is the DSM-5, to review 11 really specific criteria that determine the presence of substance abuse disorder. And you can certainly apply those to yourself.

As I was preparing for this episode, it is becoming apparent that more and more literature speaks to the addictive nature of added sugars. But there is still quite a bit of argument in science about this, big surprise, right? So, after combing through the literature, what I ultimately landed on was this: While the science and the experts most definitely do not all agree, I don’t know that it’s absolutely necessary to decide whether or not you are addicted to sugar. I don’t know that the label of “addicted” really matters.

And as I thought about it, the question I kept coming back to was this: How does labeling yourself a sugar addict change the outcome? If you are someone who has trouble controlling yourself around sugar, I think that is enough information. It’s data that tells you that something needs to change.

So, using the label of sugar addict, at this point, based on what we know in science, really doesn’t add anything. What I will also say is this; using the term sugar addict can be dangerous, depending on what you do with it. And I’ve seen this. If you overeat sugar, and you have a hard time giving it up, and you qualify it or let it go by saying, “Well, I’m addicted to sugar. That’s just how it is.” That’s a problem. So rather, I want to empower you, okay? Do not relinquish the control, by putting it outside yourself. Do not dismiss overeating sugar with the declaration, “Well, I can’t. I’m a sugar addict,” that is missing the point entirely. And honestly, it’s losing authority over yourself and your food choices. Okay?

What I also want to add here, is the very important role that big food companies have in this. So, I have said it before, I’m going to share it again here. The Oreos™ that you eat at the end of a super stressful day, they have been engineered by a team of really smart chemists, physicists, and neuroscientists to give you a reward that keeps you coming back for more.

Functional MRIs are being used to watch your brain’s response to the processed food that you eat. These MRIs will show you exactly what parts of your brain light up, in response to the foods you’re eating, with particular attention being paid to the reward centers.

Food makers and scientists are smart, they use this information to engineer a food that gives you just the right hit of feel-good chemicals that keep you coming back for more. So, all this is to say, while we have control over the foods we choose to eat, once we choose to eat foods with added sugar, we may be giving up some of that control. Okay, so more on this in a few minutes. Alright, so hang on.

Okay, so we should also spend some time talking about non-nutritive sweeteners. So, that’s a fancy word for sugar substitutes, and I’m just going to keep going with sugar substitutes here, okay. Sugar substitutes are everywhere. As the tides are starting to turn on the use of added sugar, one result is the onslaught of these sugar substitutes, or artificial sweeteners. They have exploded in the food industry.

So, sugar substitutes can be naturally occurring, plant derived products, or they can be entirely man-made synthetic substances. So, these are things like stevia, SPLENDA™, sugar alcohols, aspartame, saccharin, and there are so many more, they are all sugar substitutes. If you were to Google it, you will see a very impressive list, of all the names of the various compounds that can be used as sugar substitutes.

The fascinating thing about these sweeteners is that they provide a taste similar to table sugar, but they are often several 100 to several 1,000 times sweeter, and this sweetness can be achieved in your food with miniscule amounts.

So, as an example, SPLENDA or sucralose, it’s 600 times sweeter than sucrose, which is your standard table sugar. This would explain why you dump just one of those yellow SPLENDA packets in your coffee and it makes it taste like a Pixy Stix™.

Stevia and Truvia®, which are also very in vogue right now, are about 200 to 300 times sweeter than table sugar. What’s even more wonky, is that labeling requirements in the US make it easier for the sugar substitutes to sneak into your foods. If there is a small enough amount of the artificial sweetener in the food, it does not have to be listed on the label. So, it’s even easier for these things to get into your food and you don’t even know it.

Sugar substitutes are compounds that work by activating the sweet receptors on your tongue. But because they’re chemically different from true table sugar, your body isn’t able to break them down and process them. So, what this means is that your brain perceives the taste of sweet for zero calories. The problem with these sweeteners, is that it is unclear how this ultimately impacts your brain and your behavior. There are a couple of theories. There’s a theory that when your brain is exposed to the sensation of sweet, but without the calories to back it up, that a message is sent to your brain; hey, go find the food to satisfy the reward center in your brain.

So, it’s like closing a loop, your brain senses sweet from a sugar substitute, then it wants sweet, but it doesn’t get sweet in the form of actual calories. So, your brain tells you go find it. While this theory makes logical sense, it has not yet been proven, and it may not. Another theory suggests that because the sweeteners are so much sweeter than table sugar, these compounds are conditioning your sense of taste, and ultimately leading you to over-desire and preferentially choose sweeter foods, which can lead you to eat more sweet food than you intended. And again, this also has not been proven.

So, all of this is to say, the jury is still very much out, as to whether or not these compounds get an overall thumbs up or down for their impact on health and weight loss. There is, frankly, just a lot that we don’t know yet about these compounds, to come out and say for sure, go for it or stop altogether.

On the positive, these sugar substitutes have been shown to decrease the risk of cavities, science definitely backs that up. But on the flip side, these sweeteners may ultimately negatively impact your gut, your blood sugar, and your weight. The mechanisms that cause this are still not entirely clear.

But one prevailing hypothesis, that is current and widely investigated, is the impact of artificial sweeteners on your gut microbiome. So, your gut microbiome is basically the collection of trillions of good bacteria in your GI (gastrointestinal) tract. Those bacteria help you break down and process food.

But what is thought, is that these artificial sweeteners may negatively impact that environment, leading to funky signaling between your gut and your brain. But we’re still waiting for more evidence to really describe this. And it’s all related, because your gut microbiome also plays a role in insulin sensitivity, other hunger hormones, and appetite signals. So, this all runs together.

The evidence is equally mixed for the association between sugar substitutes, and the development of Type 2 diabetes. We just do not have enough high-quality evidence to say that sugar substitutes, and especially diet soda, are the magic bullet to keep you from developing diabetes, or to keep your diabetes from worsening.

Meaning, eating or drinking sugar substitutes is not the magic bullet that will protect you from disease. It is just not the panacea that some scientists, influencers, research, or news articles, would have you believe. All right.

Sugar substitutes are marketed as healthy alternatives to sugar for weight loss. But the evidence that backs this up is, at best, mixed. So, there are some studies that will show an increase in weight gain. Some will show no change in weight. Some studies will show weight loss. So, we just do not know the long-term impact yet.

And this is especially true in the case of diet sodas. There is a mix of studies; some show weight loss, some show weight gain, some show no change. It is literally all over the map, and it was giving me a headache. And ultimately, we just don’t know the answer. Okay.

All right. So, what do you do with this? What do you do about sugar substitutes? In the name of keeping it simple, here are my two suggestions: So, first and foremost, less is more. I know, I’ve said this before, and I will probably say it again in future episodes. But it really is the truth. We just do not know enough about these compounds to go off and consume them with abandon. So, until we really know, less is more.

All right, and then second, read your labels. It is really mind-boggling to read labels. So, look at the list of ingredients and see what you find. You might be surprised to discover that you are consuming all kinds of added sugars and sugar substitutes.

And if you don’t know what an ingredient is, I challenge you to look it up. I am advocating here, for you to know what you’re eating and drinking. And the only way to do that, is take a look at the label and look at what the ingredients are. Okay.

All right. So, we have covered the problem that sugar creates in our diets. We have talked about some science. And we have talked about sugar substitutes and the lack of reliable data to say whether they are good or bad idea. Okay.

So, what do you do with all of this? If your head is spinning, stay with me. We’ve got this. I have said this many times, and I will say it again here, you have to decide what you want your nutrition to look like? Is it reasonable to declare that you’re going to give up all sugar and sugar substitutes? Only you have that answer.

And I will say, I have most definitely done this with clients. I have coached them through giving up sugar and also giving up flour. And it is absolutely possible to give them up. And in fact, my clients who do this, often report they feel so much better. And that real food tastes so much better, once they have cut out sugar from their lives.

Does this mean that you never have sugar again? No, of course not. You get to decide; do you want to have a piece of birthday cake? Do you want to have ice cream with your kids? I am not at all telling you that you never, ever have sugar again.

But if you are someone who has a problem controlling yourself around sugar, you have to decide for yourself how much access you want to give. No one else can make that decision.

Okay, so another idea that I want to offer to you, is the concept of “crowding out”. I really love this idea. And I was introduced to it when I was a student at the Institute for Integrative Nutrition. So, while it sounds fancy, it is not fancy, at all. Crowding out simply means that you prioritize whole, real foods over ultra-processed foods. And, those ultra-processed foods are the ones that have all the added sugar.

Meaning, before you reach for a Little Debbie Star Crunch™, you have an apple. You simply decide for yourself that you’re choosing whole foods first, and then you stick to it.

Here’s a good analogy. Think about it this way: It is really hard to eat an entire bag of apples. It is really easy to eat an entire bag of chips. But when you crowd out and you commit to eating real, whole foods first, you are essentially filling yourself with fiber and micronutrients, that will keep you from overeating. That’s the idea. Okay.

And the best thing about crowding out is you don’t have to do any label reading. When you eat fruits or vegetables or drink water, there are no labels to be read. You are prioritizing foods that don’t have a label.

So, try this out at home; start with something small. Think of one ultra-processed food or soda, whether it’s diet or non-diet soda, and replace it with a whole food or water. That is it. Keep it small, keep it simple. And you may notice that you don’t miss the ultra-processed food, at all.

And once you’ve crowded out one thing in your diet, do it again. Maybe instead of a bag of chips at lunch, you cut up veggies instead. And all of these small changes build upon each other, to give you the result of eating healthier and feeling better. And, that is the goal.

Don’t overcomplicate it; the next time you reach for something that is ultra-processed, think of this, and think of crowding out, and give it a try. All right. So, I hope that this sheds some light on what is a really confusing and frankly a controversial topic.

Again, I am not here to tell you to give up sugar, all together. However, I am asking you to consider what role it plays in your diet, now? And what role you would like it to play going forward? Because you are in control.

Okay, so let me know what you think about this. I would love to know your thoughts. And if you try crowding out, share it with me on social media. Show me your before and after’s, tag me @CarrieHollandMD. I would love to see what you come up with. So, thank you, again, for hanging out with me and I look forward to catching up with you again next week.

If you like what you’ve been hearing, please review the show. I would love to get your feedback and ideas. Your suggestions have inspired episodes and will help me make the show better for you. And, share this podcast with a friend, text a show link, share a screenshot, or post a link to the show on your social media. And, be sure to tag me @CarrieHollandMD on either Instagram or Facebook, so I can follow along and engage with you.

This is how we get the word out to other working moms who want to feel strong, inside and out. If you know someone who wants to feel better, or eat and move differently, but she is too tired or too busy, it is time to change things up. And you know, making that change starts with how you think. And that, is what we do here on the Strong as a Working Mom podcast. I’ll see you next week.

Thanks for listening to Strong as a Working Mom. If you want more information on how to eat, move, and think, so you can live in the body you want, with the mind to match, visit me at CarrieHollandMD.com.