SUGAR!

It was recently recommended to me that I watch the movie “That Sugar Film” which also has a book, "That Sugar Book" which I also read.  I’ve spent many periods in my life avoiding sugar or carbohydrates or dairy. I always feel better without these things in my diet, but tend to have a backlash after they find their way back into my meals. I'm not currently restricting anything, but I always like to learn about nutrition to make more informed choices about what I'm eating, so I figured I'd check them out.  I've previously written about nutrition here and with the Whole 30 here. I'm DEFINITELY NOT recommending anyone restrict sugar or try these diets - but if you're interested in learning the science behind how sugars interact with your body, these are entertaining and eye-opening resources you can check out.  I've spoiled the story a little bit here, but the details and imagery were worth it if the topic interests you.

Australian movie actor and writer Damon Gameau met a girl and took refined sugar out of his diet to get healthier... plus that's how she ate and cooked.  He later decided to do a self experiment eating the average daily sugar intake for 60 days to see how his body reacted. He filmed the experience - making the movie- and kept a diary which he then used to write the book.  In summary, the addition of 40 teaspoons of sugar (about 160 grams per day) made him sick, but here are some of the highlights.  

• If you removed all the items containing sugar from a supermarket, only 20% of items would remain.  That's because it's added to pretty much all processed foods.  
• In the 1970's, there was a sugar versus fat battle around the world and ultimately it was decided to remove fats from the diet, resulting in a sugar boom. Low fat everything became available, but to make better flavor once fat was removed, sugar was needed.  It was suggested throughout both of these resources that the negative outlook towards fat was created by the sugar industry.  This ultimately led to massive creation of fad diets, like the Atkins diet, which believed the opposite was true and restricted sugar and carbohydrates instead.
• One teaspoon of sugar is roughly 4 grams.  So you can figure out by looking at nutrition labels how many teaspoons of sugar you're consuming based on the grams listed. 
• Sugar has a long list of alternative names on labels which sometimes make it easier for manufacturing companies to hide it.  Fruit juice concentrate = sugar.  High fructose corn syrup = sugar.  Agave = sugar.  Nutrition labels list ingredients in order from highest content in the product to lowest.  By using a variety of these (and fake sugars like maltodextrin), the concentration of each one is lowered so the ingredient gets bumped later in the list.  Tricky.

So the narrator, who has been off sugar, starts consuming sugar with a team of supporters including physicians and dieticians to watch his blood levels, body weight, and nutrition. He does this challenge without touching any candy, baked goods, soda, or chocolate.  He only consumes foods marked as healthy like yogurt, cereal bars, and juice and chooses low fat options whenever possible. He gets blood markers taken before, during, and after the experiment monitoring for changes of the heart and liver as well as tracking his blood pressure and heart rate. 

Different types of sugar are explored in these resources and the basic science of how the body processes sugars is outlined.  For example, glucose is the sugar that is used by the brain, cells, and organs for energy.  Lactose is the sugar that is found in dairy product. Sucrose is table sugar that is added to numerous foods we easily have access to.  It is composed of two different sugars - half glucose (the one I just mentioned is used as energy by the body) and half fructose. Fructose is the sugar in fruit and vegetables, including from corn as high fructose corn syrup and was previously very rare as fruit was not available year-round and to acquire honey, you'd have to fight the bees.  Fructose makes food very sweet, and it is considered to be the problem sugar because we have made it so much more readily accessible.

So Damon starts his sixty day journey of 40 tsp of sugar that are primarily fructose and sucrose.  He maintained his same exercise routine and overall had a consistent caloric intake from his non-sugar diet.  Some people he met along the way would say that his experimental diet looked healthier than their own typical diet.  Based on his study - that's a problem.  

It was obscenely easy to hit the target of 40 tsp per day. Cereal with yogurt and apple juice for breakfast on the first day totaled 20g (5 tsp) at breakfast. A 12 oz glass of apple juice has 33g of sugar (about 8 tsp).  Serving sizes really mattered because usually packages were multiple servings and could be far more sugar than he expected.  He noted many times throughout the experiment that beverages were a huge source of sugar intake and how this could impact your health in a variety of ways. 

After 12 days, he went to get a check up.  He had gained 3.2 kg (7 pounds!) and it was all in his belly. Visceral fat around the organs rather than distributed around his body.  Three weeks in, watching the movie, he looked ill. His blood tests showed changes in his liver enzymes with fatty infiltration.  He was feeling moody, lethargic, and like an addict waiting on his next sugar dose.  Twenty one days of sugar and it was obvious that it was making him sick.

One area that I found really interesting was that he explored the history of the aborigines and their health changes as they started eating processed foods and sugars.  He went to visit a community that had eliminated coca cola and the health of the community dramatically improved. 

One experiment he tried was to swap out the sugary food choices for a non-sugary option and add the actual amount of sugar to the plate.  This had a dramatic visual effect.  AKA it looked really disgusting. For example, he had planned to eat some teriyaki chicken where the sauce packaging said it had the equivalent of 4 tsp of sugar in it. Instead he had chicken without sauce on it and poured 4 tsp of sugar over the chicken and consumed that. Instead of drinking a bottle of Powerade that had 8 tsp of sugar, he drank warm water with 8 tsp of sugar. Ultimately he still had the 40 tsp for the day but as straight up white table sugar. This made him throw up. 

A month into the experiment, Damon comes to America. (side note: if you haven't seen the movie Coming to America, you MUST!  Here's the trailer.)

Upon his arrival to the USA, he gets a Jamba juice that has 34 tsp (136 grams) of sugar in it. He then shows all the fruit he would have had to consume to make that smoothie and shows how it would be impossible to eat that many whole pieces of fruit.  I've never tried to eat four apples in one sitting... but I definitely don't think I could...and then throw in a banana and some berries and limes?  No way!

He realized quickly it would be super difficult to stay under 40 tsp sugar per day because of all the high fructose corn syrup in the USA, which is not produced in Australia. He meets with an Appalachian region of Kentucky dentist who does mobile home treatments educating kids on how much sugar and caffeine are in Mountain Dew and Pepsi (or Coke). They have considerable tooth decay and start drinking soda at age 2-3 out of their baby bottles! An almost 18-year old has a mouth full of rotten teeth and they plan to extract many of them on the movie.  Damon reached out to Pepsi who said, "In moderation, Mountain Dew is part of a balanced healthy diet." 

He meets with researchers and undergoes various tests. One test was to get his brain studied under fMRI so while sugar is fed to him, they monitor the effects in the brain and then they teach him the science of sugar on the brain and hormones. He also can see what happens to his brain when he is simply shown a picture of a milkshake.  After having so much sugar, even the image of a sugar intake lit up his brain like a Christmas tree.  The researches told him about a study that showed rats worked harder for sugar than for cocaine... it's that addictive!

At the end of 60 days, Damon completes the journey and goes for follow up tests. I won't go into the details... but all of them were bad.  He had a body weight increase of 8.5 kg (18.7 pounds), 7 percent body fat increase and 10 cm increase at waistline.  And the whole time he's eating foods marketed as  "healthy." The calorie intake was virtually the same, but the source of the calories was the problem. 

Then he goes through the change back to his healthy diet. The first week he felt withdrawals and horrible sleep.  It took almost a month to get over the addiction/cravings.  He quickly lost 6 kg just by changing back his diet. Blood tests also restored. Good news: this is a reversible problem! The palate took a while to readjust, but overwhelmingly his body recovered (in the short term).

The recommendations from the movie and book are to limit to 6 tsp of sugar per day which is 24 grams.  Some people are more sensitive and should restrict to less because it triggers them, others can probably tolerate more.  According to the book, in 2003, the World Health Organization was preparing to recommend limits of 10% of caloric intake be from sugar. The sugar industry attacked the WHO and threatened congressional acts that would pull $260 million in funding if they did it. That recommendation was never made public, which suggests that the government and politics interfere with health policies... isn't that sweet?

Happy 2019, everyone.  Stay healthy.