Food For Thought: Sugar
Some of the most frequent questions I receive involve food/nutrition for Hudson. This encouraged me to start Food for Thought Fridays. Each Friday, I will cover various topics as they relate to food, nutrition and health.
Today's topic is a big one. I am going to try and condense/highlight a lot of information into a semi-short overview. If you have any questions about a specific highlight or need recommendations, please do not hesitate to shoot me an email, message or text.
As always, if you have a medical question about you or your child, you should also speak with your team of doctors.
Background:
Due to immunosuppression medication, post-transplant patients have an increased risk of developing many long-term chronic illnesses. There are a myriad of reasons but today we will focus on one: immunosuppressed individual system's are constantly inflamed. Examples of chronic illnesses associated with consistent inflammation include insulin resistance, cardiovascular disease, depression & other mood disorders, asthma, arthritis, cancer, IBS and allergies.
Since taking immunosuppressants is a requirement for all transplant patients, there are other things we can do to try and minimize the inflammation in the body. One of the most effective ways to do this is monitor the body's sugar intake.
Certain foods, such as sugar, can exacerbate an already inflamed system magnifying the risk for any potential chronic illness.
Several studies have shown that a diet high in added sugar leads to obesity, insulin resistance and increased gut permeability (leaky gut). All of these things contribute to constant, low-grade inflammation in the body - on top of the inflammation caused by the anti-rejection medicine transplant patients are required to take.
What is it about sugar that causes inflammation and increases the risk of other illnesses?
The 30,000 foot answer is this: When you consume too much sugar, the extra insulin enters your bloodstream and affects your arteries. This causes their walls to get inflamed, grow thicker than normal, causing stress on your organs. For those visual learners, (like myself) I have included two short YouTube videos that explain the impact simply and effectively.
Click below to view:
University of California - What Does Sugar Actually Do To Your Body?
Ted Ed with Nicole Avena - How Sugar Affects the Brain
Not All Sugar is Created Equal...
It is important to note that there is a difference between added sugar & natural sugar.
Added Sugar is added to foods and drinks to serve as sweetner or preserve shelf life of a food. Added sugar is found mostly in processed foods and drinks. Some of the most common added sugars are: high-fructose corn syrup, sucrose, fructose, glucose and corn sugar.
Natural Sugars are not linked to inflammation. Whole foods such as fruits & vegetables are known to have anti-inflammatory properties. When whole foods are consumed, they contain not only natural sugar but other nutrients such as protein and fiber. These additional nutrients steady the body's absorption of natural sugar, minimizing the spike in blood sugar.
What Now?
According to the CDC, "Empty calories from added sugars and solid fats contribute to 40% of daily calories for children and adolescents age 2–18 years—affecting the overall quality of their diets. Approximately half of these empty calories come from six sources: soda, fruit drinks, dairy desserts, grain desserts, pizza, and whole milk."
The WHO (World Health Organization), AAP (American Academy of Pediatrics) and the AHA (American Heart Association) recommend that daily sugar intake for children should not exceed 25 grams or 6 teaspoons. Added sugar should account for no more than 10% of a child's total daily calorie intake.
Simply put, we need to start learning how to swap out for options with less sugar. This step is the single most effective measure we can take to minimize inflammation and potential chronic illnesses.
The Honor List(s)
The best way to make good choices is to educate ourselves on the items that are both the best and worst for us. Below are some of the top foods with added sugar in them. Some might surprise you! I think you will start seeing trends in terms of the foods that contain the least and the most.
Most Common Foods:
Added Sugar (these are approx. amounts/servings and ranges based on brand/type of food)
Reminder: The recommended daily limit is 25g or 6 teaspoons for children.
Desserts (cookies, pastries, candy) (1 glazed donut = ~15g)
Table sugar (1 packet = 2 - 4g, 1 cube = 3g)
Bread (1 slice = ~5g)
Low-fat yogurt ( 1 container = ~11g to 21g)
Ketchup (1 tbsp = 4g)
Barbeque Sauce (2 tsp = 16g)
Fruit Juice ( 8 oz OJ = 21g)
Dried Fruit (Avg ~ 50% sugar)
Pasta Sauce (~1/2 cup = 10g)
Energy (sports) Drinks (20oz = 34g)
Granola Bars (1 bar = ~10g)
Granola (4 tsp = 17g)
Flavored Coffee (Grande Vanilla Latte = 35g)
Protein Bars (1 bar = ~25g)
Pre-made soups (1/2 cup = ~15g)
Cereal Bars (1 bar = ~12g)
Canned Fruit (1/2 cup = ~19g)
Canned Baked Beans (1/2 cup = ~12g)
Bottled, Pre-made smoothies (1 bottle = 58g)
Cereal (1 cup = ~15g)
Salad Dressings (1 serving = ~7-10g)
Alcohol Mixers (4 oz = ~11-19g)
Peanut Butter/Nut Spreads (2 tbsp = ~3-5g)
Most Common Foods
with Natural Sugar (these are approx. amounts/servings)
Reminder: The recommended daily limit is 25g or 6 teaspoons for children.
Strawberries (1 cup = 7g)
Peaches (1 large = 13g)
Blackberries (1 cup = 7g)
Raspberries (1 cup = 5g)
Lemons (1 slice = less than 1g)
Limes (1 slice = ~ 1g)
Honeydew (1 cup = 14g)
Oranges (1 medium = 9g)
Avocados (1 cup = 1g)
Cucumbers (1 cucumber = less than 2g)
Lettuce (1 cup = less than 1g)
Celery (1 stalk = less than 1g)
Mushrooms (1 cup = less than 2g)
Spinach (1 cup = less than 1g)
Swiss Chard (1 cup = less than 1g)
Broccoli (1 cup = ~ 1g)
Bell Peppers (1/2 cup = 3g)
Cauliflower (1 cup = 2g)
zucchini (1 cup = less than 3g)
Asparagus (1 cup = less than 3g)
Radishes (1 cup = less than 2g)
Arugula (1/2 cup = 1g)
The Bottom Line:
The bottom line is companies add sugar to most processed foods. The easiest way to reduce added sugar intake is to eat less processed foods.
This list should equip us all to make some easy swaps. Personally, the lowest hanging fruit for us to eliminate was condiments. Hudson eats a lot of vegetables so instead of a high sugar salad dressing, we stick to basics like olive oil and balsamic vinegar. We make a lot of our own dips and spreads. There are some tasty low-sugar ketchup alternatives out there for the french fry lovers out there.
Other Swap Suggestions:
Instead of buying flavored yogurt, try getting a plain yogurt and add fresh fruit to the top.
Swap out bread slices for rice cakes (0g of sugar per rice cake).
Load up pasta sauces with fiber and protein by adding tons of vegetables and a meat. This will help your body process/digest the sugar.
Instead of things like cereal bars or protein bars, try giving kids an apple or a bowl of berries.
Choose nut spreads without any additives. When looking at the ingredients, there should only be 1 ingredient (the nut).
Instead of fruit juice, try infusing water with fruit or mint. Not only will this be more satisfying (just compare the volumes of the two items), it will reduce the amount of added sugar our children are consuming.
Make smoothies at home with one fruit and pack it with veggies like spinach or cauliflower.
I get it, we hear about reducing our sugar intake from multiple sources. It is important to me to convey why reducing sugar is important to those that are most vulnerable to sugar's consequences. There is still so much that is unknown about the impacts of long-term immunosuppression so it is our job to control the things we can. Hopefully this helps make any adjustments a little more mangable.
Stay well and you can always contact me with questions!
xx
The Hills
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328850/
https://www.health.harvard.edu/newsletter_article/Inflammation_A_unifying_theory_of_disease
https://www.uchicagomedicine.org/forefront/transplant-articles/obesity-linked-to-inflammation-and-organ-transplant-rejection
https://www.cdc.gov/healthyschools/nutrition/facts.htm
https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-and-AHA-Endorse-Suite-of-Policies-to-Reduce-Kids-Consumption-of-Sugary-Drinks.aspx
https://www.medicalnewstoday.com/articles/326386
https://www.health.harvard.edu/heart-health/the-sweet-danger-of-sugar