When I begin working with a new client, he or she first fills out a lengthy, very detailed Nutritional Wellness Questionnaire. Part of the information this provides me with is a general description of the daily diet; breakfast, lunch, dinner, snacks, etc. Oftentimes, I see a pattern of eating that reveals an intention of making very good choices, but misinformed.
In such cases I like to do a nutritional analysis. My clients are usually shocked when they see what their health-conscious food choices really add up to. For example, a young woman I recently worked with noted that for breakfast she often had low-fat yogurt with low-fat granola and apple. Sometimes toast. She became hungry often throughout the day and had to snack frequently. She didn’t like junk-food, mind you, so she wasn’t grabbing cookies or chips; usually cheese, crackers, that kind of thing. Not a big meat-eater, she usually relied on chicken for protein at dinner, sometimes salmon, usually eaten with a grain of some kind and vegetables. No soda, artificial sweeteners, etc. The diets of many in our population don’t come close to being that “healthy,” but…
The data regarding the function of this young woman’s pancreas and insulin – i.e., blood sugar regulation – indicated ups and downs; wide fluctuations between highs and lows. This pattern is a pattern that sets one on a path to ill health. It begins here, with foods containing high amounts of sugar, frequent hunger and the need to eat often, moves on to weight gain, insulin insensitivity, metabolic syndrome – and over time can eventually end in full-blown type 2 diabetes.
“But wait a minute!…” you might be saying. “Where are you finding so much sugar in her daily diet? It looks pretty reasonable to me.”
Are you ready? Here’s the nutritional analysis for the breakfast of low-fat yogurt, low-fat granola, and a raw apple:
- Low-fat plain yogurt 8 oz – 13 gm protein, 17 gm sugar, 17 gm carbs (the same, so all the carbs are from sugar), 4 gm fat. Remember, this is plain – not flavored – yogurt.
- Granola. Granola is made of grains and usually some kind of sweetener. I took a look at the nutritional analysis of Kellogg’s Low-Fat Granola Without Raisins, halving the serving size because of its part in the breakfast. Protein 4 gm, sugars 15 gm, carbohydrates 44 gm, fat 3 gm, fiber 4.5 gm. So here, again, is a food very high in sugar and in other carbohydrates (the grains) that will very quickly convert to glucose and enter the bloodstream.
- Apple. Now, you’re probably saying “WHAT? What could possibly be wrong with an apple??” I checked the nutritional analysis for one cup of raw apple with peel on: no protein or fat, naturally; 3 gm of fiber and a whopping 13 gm of sugar, and in the form of fructose (and don’t believe the “sugar is sugar” people, no matter what you hear in television ads).
So… in this breakfast that on the surface looks like a healthy choice, there are approximately 45 gm of sugar! By comparison, 8 oz of regular root beer contains 24 gm of sugar. Then, there are still 29 more gm of carbohydrates from the grains in the granola, which will all convert to glucose once they make it to the small intestine, which will be fast, remember, because there is not much fat or protein or even fiber present to slow digestion and release of sugar into the bloodstream. Make sense?
Now…I’m going to take you on a journey through the body as this food is ingested and digested!
- Carbohydrate digestion begins in the mouth with the enzyme amylase present in saliva.
- Digestion continues in the stomach and then moves to the small intestine.
- In the small intestine carbohydrate is converted to various forms of sugar (maltose, lactose, sucrose). As these sugars travel further into the small intestine they are broken down in size and are all eventually converted to glucose (except for fructose, which enters the liver as 100% fructose) so that they pass through the intestinal walls and…
- Enter the bloodstream. The bloodstream carries the glucose to the liver. If cells in the body need the glucose for energy, the liver will send it where needed. If not, the excess glucose is stored as glycogen – liquid glucose. Glycogen is stored in the muscles and in the liver.
- When all the space for glycogen is occupied, the liver begins converting excess glucose to fat. This is how “sugar makes us fat.” The fat cells are stored under the skin and in various organs throughout the body.
On the flip-side, this is how fat is burned for energy, promoting healthy weight loss:
- When blood sugar levels fall too low (because there is minimal sugar/carbohydrate in the food eaten), the liver will first trigger the release of glycogen from the muscles and liver for conversion back into glucose. This is not to be confused with the protein in muscles being burned for energy. The liver will convert protein from muscle into glucose only in emergencies; this is what happens when people starve – when glucose and fat stores are depleted.
- Once the glycogen stores are depleted, then the liver will begin to burn fat for fuel, and fat loss results. This is why on carbohydrate-restrictive diets it is not uncommon to experience an initial rapid weight loss during the first few days to a week; this is what we think of as “water weight” – not really water at all but liquid glycogen.
How does fructose fit into this entire equation? From ScienceDaily Limiting Fructose May Boost Weight Loss, Researchers Say – July 8, 2008:
“Our study shows for the first time the surprising speed with which humans make body fat from fructose,” Dr. Parks said. Fructose, glucose and sucrose, which is a mixture of fructose and glucose, are all forms of sugar but are metabolized differently.
“All three can be made into triglycerides, a form of body fat; however, once you start the process of fat synthesis from fructose, it’s hard to slow it down,” she said.”
What might my client eat for breakfast, then? If she doesn’t like the idea of switching to foods such as eggs, etc., here is a suggestion for a similar breakfast but “sugared down.” A really lowered-sugar/carb version might be:
- Full-fat cottage cheese – 4 oz contains 13 gm of protein, 3 gm of sugar with a total of 4 gm of carbohydrate, and 5 gm of fat. (4 oz instead of 8 oz yogurt, because it is hard to eat that much full-fat cottage cheese).
- Raspberries instead of an apple – 1/2 cup of raspberries contains 2.5 gm fructose, 7.3 gm carbs, 1/2 gm protein, 1/2 gm fat, 4.6 gm fiber. Another benefit of raspberries is the ketones contained in them. Stubborn belly fat is often stubborn because of the hormonal disruption that doesn’t allow thermogenesis to work as efficiently. Raspberry ketones cause hormone-signaling lipase to kick in, slicing up the fat cells in these hard-to-reach areas and preparing them to be burned off. Raspberries are also an excellent source of antioxidant rich ellagic acid.
- Hemp hearts and/or nuts instead of granola? A half- ounce of walnuts (7 halves) contain 2 gm carbs, > 2 gm protein, 9 gm fat, 1 gm fiber. One heaping tablespoons of hemp hearts contain 1.25 gm carbs, 3.5 gm protein, 4.5 gm healthy balance of Omega 3, 6, 9, 0.7 gm fiber.
Now, let’s contrast the two breakfasts:
- Low-fat yogurt, low-fat granola, apple:
Carbohydrates not from simple sugar: 29 gm
Sugar: 45 gm
Total carbs: 74
Protein: 17 gm
Fat: 7 gm
Fiber: 7.5 gm
- Full-fat cottage cheese, raspberries, hemp hearts, walnuts:
Carbohydrates not from simple sugar: 5.8 gm
Sugar: 5.5 gm
Total Carbs: 11.3
Protein: > 19 gm
Fat: 19 gm
Fiber: 6.6 gm
Wow! If we can wrap our Madison-Avenue brainwashed heads around the fact that it is sugar that makes us fat and not healthy fats, it is easy to see how astonishingly more healthy the second choice is. Further, this breakfast will stick with my client; she will not be hungry again until lunchtime, avoiding the rollercoaster of grabbing high-carb/sugar snacks and feeling hungry every couple of hours. Consuming whole-fat foods as found in nature ensures that the protein can be adequately used to build muscle – we can’t use the protein in protein foods without the fat-soluble vitamins in the fat to metabolize it. The protein and fat content of the second choice will cause the already low amounts of sugars and carbohydrates to be released into the bloodstream much more slowly, providing a gentle increase in blood glucose and keeping the need for insulin at a minimum. By the way, keeping blood glucose – and therefore insulin levels – within a narrow range is a key to longevity, but that will just have to wait until next time!
[i] Stanhope K.L., et al. “Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans” J Clin Invest. 2009 May 1;119(5):1322-1334
[ii] Le K.A., Ilth M., Kreis R., Faeh D., Bortolotti M., Tran C., Boesch C., and Tappy L. “Fructose overconsumption causes dyslipidemia and ectopic lipid deposition in healthy subjects with and without a family history of type 2 diabetes” Am J Clin Nutr. 2009 Jun;89(6):1760-5
[iii] Ouyang X., Cirillo P., Sautin Y., McCall S., Bruchette J.L., Diehl A.M. Johnson R.J., Abdelmalek M.F. “Fructose consumption as a risk factor for non-alcoholic fatty liver disease” J. Hepatol. 2008 Jun;48(6):993-9