Which Sugars Are Healthier, And Which Are Just The Same?
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From Apples to Bees, and high-fructose C’s
We asked you for your (health-related) policy on sugar. The trends were as follows:
- About half of all respondents voted for “I try to limit sugar intake, but struggle because it’s in everything”
- About a quarter of all respondents voted for “Refined sugar is terrible; natural sugars (e.g. honey, agave) are fine”
- About a quarter of all respondents voted for “Sugar is sugar and sugar is bad; I avoid it entirely”
- One (1) respondent voted for “Sugar is an important source of energy, so I consume plenty”
Writer’s note: I always forget to vote in these, but I’d have voted for “I try to limit sugar intake, but struggle because it’s in everything”.
Sometimes I would like to make my own [whatever] to not have the sugar, but it takes so much more time, and often money too.
So while I make most things from scratch (and typically spend about an hour cooking each day), sometimes store-bought is the regretfully practical timesaver/moneysaver (especially when it comes to condiments).
So, where does the science stand?
There has, of course, been a lot of research into the health impact of sugar.
Unfortunately, a lot of it has been funded by sugar companies, which has not helped. Conversely, there are also studies funded by other institutions with other agendas to push, and some of them will seek to make sugar out to be worse than it is.
So for today’s mythbusting overview, we’ve done our best to quality-control studies for not having financial conflicts of interest. And of course, the usual considerations of favoring high quality studies where possible Large sample sizes, good method, human subjects, that sort of thing.
Sugar is sugar and sugar is bad: True or False?
False and True, respectively.
- Sucrose is sucrose, and is generally bad.
- Fructose is fructose, and is worse.
Both ultimately get converted into glycogen (if not used immediately for energy), but for fructose, this happens mostly* in the liver, which a) taxes it b) goes very unregulated by the pancreas, causing potentially dangerous blood sugar spikes.
This has several interesting effects:
- Because fructose doesn’t directly affect insulin levels, it doesn’t cause insulin insensitivity (yay)
- Because fructose doesn’t directly affect insulin levels, this leaves hyperglycemia untreated (oh dear)
- Because fructose is metabolized by the liver and converted to glycogen which is stored there, it’s one of the main contributors to non-alcoholic fatty liver disease (at this point, we’re retracting our “yay”)
Read more: Fructose and sugar: a major mediator of non-alcoholic fatty liver disease
*”Mostly” in the liver being about 80% in the liver. The remaining 20%ish is processed by the kidneys, where it contributes to kidney stones instead. So, still not fabulous.
Fructose is very bad, so we shouldn’t eat too much fruit: True or False?
False! Fruit is really not the bad guy here. Fruit is good for you!
Fruit does contain fructose yes, but not actually that much in the grand scheme of things, and moreover, fruit contains (unless you have done something unnatural to it) plenty of fiber, which mitigates the impact of the fructose.
- A medium-sized apple (one of the most sugary fruits there is) might contain around 11g of fructose
- A tablespoon of high-fructose corn syrup can have about 27g of fructose (plus about 3g glucose)
Read more about it: Effects of high-fructose (90%) corn syrup on plasma glucose, insulin, and C-peptide in non-insulin-dependent diabetes mellitus and normal subjects
However! The fiber content (in fruit) mitigates the impact of the fructose almost entirely anyway.
And if you take fruits that are high in sugar and/but high in polyphenols, like berries, they now have a considerable net positive impact on glycemic health:
- Polyphenols and Glycemic Control
- Polyphenols and their effects on diabetes management: A review
- Dietary polyphenols as antidiabetic agents: Advances and opportunities
You may be wondering: what was that about “unless you have done something unnatural to it”?
That’s mostly about juicing. Juicing removes much (or all) of the fiber, and if you do that, you’re basically back to shooting fructose into your veins:
- Effect of Fruit Juice on Glucose Control and Insulin Sensitivity in Adults: A Meta-Analysis of 12 Randomized Controlled Trials
- Intake of Fruit, Vegetables, and Fruit Juices and Risk of Diabetes in Women
Natural sugars like honey, agave, and maple syrup, are healthier than refined sugars: True or False?
True… Sometimes, and sometimes marginally.
This is partly because of the glycemic index and glycemic load. The glycemic index scores tail off thus:
- table sugar = 65
- maple syrup = 54
- honey = 46
- agave syrup = 15
So, that’s a big difference there between agave syrup and maple syrup, for example… But it might not matter if you’re using a very small amount, which means it may have a high glycemic index but a low glycemic load.
Note, incidentally, that table sugar, sucrose, is a disaccharide, and is 50% glucose and 50% fructose.
The other more marginal health benefits come from that fact that natural sugars are usually found in foods high in other nutrients. Maple syrup is very high in manganese, for example, and also a fair source of other minerals.
But… Because of its GI, you really don’t want to be relying on it for your nutrients.
Wait, why is sugar bad again?
We’ve been covering mostly the more “mythbusting” aspects of different forms of sugar, rather than the less controversial harms it does, but let’s give at least a cursory nod to the health risks of sugar overall:
- Obesity and associated metabolic risk
- Main contributor to non-alcoholic fatty liver disease
- Increased risk of heart disease
- Insulin resistance and diabetes risk
- Cellular aging (shortened telomeres)
- 95% increased cancer risk
That last one, by the way, was a huge systematic review of 37 large longitudinal cohort studies. Results varied depending on what, specifically, was being examined (e.g. total sugar, fructose content, sugary beverages, etc), and gave up to 200% increased cancer risk in some studies on sugary beverages, but 95% increased risk is a respectable example figure to cite here, pertaining to added sugars in foods.
And finally…
The 56 Most Common Names for Sugar (Some Are Tricky)
How many did you know?
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Burn! How To Boost Your Metabolism
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Let’s burn! Metabolic tweaks and hacks
Our metabolism is, for as long as we live, a constantly moving thing. And it’s not a monolith either; there are parts of our metabolism that can speed up or slow down independently of others.
If we talk about metabolism without clarifying context, though, this is usually about one’s “basal metabolic rate”, that is, how many calories we burn just by being alive.
Why do we want to speed it up? Might we ever want to slow it down?
We might want to slow our metabolism down in survival circumstances, but generally speaking, a faster metabolism is a better one.
Yes, even when it comes to aging. Because although metabolism comes with metabolizing oxygen (which, ironically, tends to kill us eventually, since this is a key part of cellular aging), it is still beneficial to replace cells sooner rather than later. The later we replace a given cell (ie, the longer the cell lives), the more damaged it gets, and then the copy is damaged from the start, because the damage was copied along with it. So, best to have a fast metabolism to replace cells quickly when they are young and healthy.
A quick metabolism helps the body to do this.
Most people, of course, are interested in a fast metabolism to burn off fat, but beware: if you increase your metabolism without consideration to how and when you consume calories, you will simply end up eating more to compensate.
One final quick note before we begin:
Limitations
There’s a lot we can do to change our metabolism, but there are some things that may be outside of our control. They include:
- Age—we can influence our biological age, but we cannot (yet!) halt aging, so this will happen
- Body size—and yes we can change this a bit, but we all have our own “basic frame” to work with. Someone who is 6’6” is never going to be able to have the same lower-end-of-scale body mass of someone who is 5’0”, say.
- Sex—this is about hormones, and HRT is a thing, but for example, broadly speaking, men will have faster metabolisms than women, because of hormonal differences.
- Medical conditions—often also related to other hormones, but for example someone with Type 1 Diabetes is going to have a very different relationship with their metabolism than someone without, and someone with a hypo- or hyperactive thyroid will again have a very different metabolism in a way that that lifestyle factors can’t completely compensate for.
The tips and tricks
Intermittent fasting
Intermittent fasting has been found to, amongst other things, promote healthy apoptosis and autophagy (in other words: early programmed cell death and recycling—these are good things).
It also has anti-inflammatory benefits and decreases the risk of insulin resistance. In other words, intermittent fasting boosts the metabolism while simultaneously guarding against some of the dangers of a faster metabolism (harms you’d get if you instead increased your metabolism by doing intense exercise and then eating a mountain of convenience food to compensate)
Read the science: Intermittent Fasting: Is the Wait Worth the Weight?
Read our prior article: Fasting Without Crashing? We Sort The Science From The Hype
Enjoy plenty of protein
This one won’t speed your metabolism up, so much as help it avoid slowing down as a result of fat loss.
Because of our body’s marvelous homeostatic system trying to keep our body from changing status at any given time, often when we lose fat, our body drops our metabolism to compensate, thinking we are in an ongoing survival situation and food is scarce so we’d better conserve energy (as fat). That’s a pain for would-be weight-loss dieters!
Eating protein can let our body know that we’re perfectly safe and not starving, so it will keep the metabolism ticking over nicely, without putting on fat.
Read the science: The role of protein in weight loss and maintenance
Stay hydrated
People think of drinking water as part of a weight loss program being just about filling oneself up, and that is a thing, but it also has a role to play in our metabolism. Specifically, lipolysis (the process of removing fat).
Because, we are mostly water. Not only is it the main content of our various body tissue cells, but also, of particular note, our blood (the means by which everything is transported around our body) is mostly water, too.
It’s hard for the body to keep everything ticking over like a well-oiled machine if its means of transportation is sluggish!
Check it out: Increased Hydration Can Be Associated with Weight Loss
Take a stand
That basal metabolic rate we talked about?
- If you’re lying down at rest, that’s what your metabolism will be like.
- If you’re sitting up, it’ll be a little quicker, but not much.
- If you’re standing, suddenly half your body is doing things, and you don’t even notice them because they’re just stabilizing muscles and the like, but on a cellular level, your body gets very busy.
Read all about it: Cardiometabolic impact of changing sitting, standing, and stepping in the workplace
Time to invest in a standing desk? Or a treadmill in front of the TV?
The spice of life
Capsaicin, the compound in many kinds of pepper that give them their spicy flavor, boosts the metabolism. In the words of Tremblay et al for the International Journal of Obesity:
❝[Capsaicin] stimulates the sympathoadrenal system that mediates the thermogenic and anorexigenic effects of capsaicinoids.
Capsaicinoids have been found to accentuate the impact of caloric restriction on body weight loss.
Some studies have also shown that capsinoids increase energy expenditure.
Capsaicin supplementation attenuates or even prevents the increase in hunger and decrease in fullness as well as the decrease in energy expenditure and fat oxidation, which normally result from energy restriction❞
Read for yourself: Capsaicinoids: a spicy solution to the management of obesity?
You snooze, you lose (fat)
While exercising is generally touted as the road to weight loss, and certainly regular exercise does have a part to play, doing so without good rest will have bad results.
In fact, even if you’re not exercising, if you don’t get enough sleep your metabolism will get sluggish to try to slow you down and encourage you to sleep.
So, be proactive, and make getting enough good quality sleep a priority.
Eat for metabolic health
Aside from the chilli peppers we mentioned, there are other foods associated with good metabolic health. We don’t have room to go into the science of each of them here, but here’s a well-researched, well-sourced standalone article listing some top choices:
The 12 Best Foods to Boost Your Metabolism
Enjoy!
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Breakfasting For Health?
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Breakfast Time!
In yesterday’s newsletter, we asked you for your health-related opinions on the timings of meals.
But what does the science say?
Quick recap on intermittent fasting first:
Today’s article will rely somewhat on at least a basic knowledge of intermittent fasting, what it is, and how and why it works.
Armed with that knowledge, we can look at when it is good to break the fast (i.e. breakfast) and when it is good to begin the fast (i.e. eat the last meal of the day).
So, if you’d like a quick refresher on intermittent fasting, here it is:
Intermittent Fasting: We Sort The Science From The Hype
And now, onwards!
One should eat breakfast first thing: True or False?
True! Give or take one’s definition of “first thing”. We did a main feature about this previously, and you can read a lot about the science of it, and see links to studies:
The Circadian Rhythm: Far More Than Most People Know
In case you don’t have time to read that now, we’ll summarize the most relevant-to-today’s-article conclusion:
The optimal time to breakfast is around 10am (this is based on getting sunlight around 8:30am, so adjust if this is different for you)
It doesn’t matter when we eat; calories are calories & nutrients are nutrients: True or False?
Broadly False, for practical purposes. Because, indeed calories are calories and nutrients are nutrients at any hour, but the body will do different things with them depending on where we are in the circadian cycle.
For example, this study in the Journal of Nutrition found…
❝Our results suggest that in relatively healthy adults, eating less frequently, no snacking, consuming breakfast, and eating the largest meal in the morning may be effective methods for preventing long-term weight gain.
Eating breakfast and lunch 5-6 h apart and making the overnight fast last 18-19 h may be a useful practical strategy.❞
Read in full: Meal Frequency and Timing Are Associated with Changes in Body Mass Index
We should avoid eating too late at night: True or False?
False per se, True in the context of the above. Allow us to clarify:
There is nothing inherently bad about eating late at night; there is no “bonus calorie happy hour” before bed.
However…
If we are eating late at night, that makes it difficult to breakfast in the morning (as is ideal) and still maintain a >16hr fasting window as is optimal, per:
❝the effects of the main forms of fasting, activating the metabolic switch from glucose to fat and ketones (G-to-K), starting 12-16 h after cessation or strong reduction of food intake❞
~ Dr. Françoise Wilhelmi de Toledo et al.
So in other words: since the benefits of intermittent fasting start at 12 hours into the fast, you’re not going to get them if you’re breakfasting at 10am and also eating in the evening.
Summary:
- It is best to eat breakfast around 10am, generally (ideally after some sunlight and exercise)
- While there’s nothing wrong with eating in the evening per se, doing so means that a 10am breakfast will eliminate any fasting benefits you might otherwise get
- If a “one meal a day, and that meal is breakfast” lifestyle doesn’t suit you, then one possible good compromise is to have a large breakfast, and then a smaller meal in the late afternoon / early evening.
One last tip: the above is good, science-based information. Use it (or don’t), as you see fit. We’re not the boss of you:
- Maybe you care most about getting the best circadian rhythm benefits, in which case, prioritizing breakfast being a) in the morning and b) the largest meal of the day, is key
- Maybe you care most about getting the best intermittent fasting benefits, in which case, for many people’s lifestyle, a fine option is skipping eating in the morning, and having one meal in the late afternoon / early evening.
Take care!
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Caramelized Caraway Cabbage
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Cabbage is an underrated vegetable for its many nutrients and its culinary potential—here’s a great way to make it a delectable starter or respectable side.
You will need
- 1 medium white cabbage, sliced into 1″ thick slabs
- 1 tbsp extra-virgin olive oil
- 1 tbsp caraway seeds
- 1 tsp black pepper
- ½ tsp turmeric
- ¼ tsp MSG or ½ tsp low-sodium salt
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 400℉ / 200℃.
2) Combine the non-cabbage ingredients in a small bowl, whisking to mix thoroughly—with a tiny whisk if you have one, but a fork will work if necessary.
3) Arrange the cabbage slices on a lined baking tray and brush the seasoning-and-oil mixture over both sides of each slice.
4) Roast for 20–25 minutes until the cabbage is tender and beginning to caramelize.
5) Serve warm.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Curcumin (Turmeric) is worth its weight in gold
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Avocado Oil vs Olive Oil – Which is Healthier?
Take care!
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Fennel vs Artichoke – Which is Healthier?
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Our Verdict
When comparing fennel to artichoke, we picked the artichoke.
Why?
Both are great! But artichoke wins on nutritional density.
In terms of macros, artichoke has more protein and more fiber, for only slightly more carbs.
Vitamins are another win for artichoke, boasting more of vitamins B1, B2, B3, B5, B6, B9, and choline. Meanwhile, fennel has more of vitamins A, E, and K, which is also very respectable but does allow artichoke a 6:3 lead.
In the category of minerals, artichoke has a lot more copper, iron, magnesium, manganese, and phosphorus, while fennel has a little more calcium, potassium, and selenium.
One other relevant factor is that fennel is a moderate appetite suppressant, which may be good or bad depending on your food-related goals.
All in all though, we say the artichoke wins by virtue of its greater abundance of nutrients!
Want to learn more?
You might like to read:
What Matters Most For Your Heart? ← appropriately enough, with fennel hearts and artichoke hearts!
Take care!
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Hospitals worldwide are short of saline. We can’t just switch to other IV fluids – here’s why
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Last week, the Australian Therapeutic Goods Administration added intravenous (IV) fluids to the growing list of medicines in short supply. The shortage is due to higher-than-expected demand and manufacturing issues.
Two particular IV fluids are affected: saline and compound sodium lactate (also called Hartmann’s solution). Both fluids are made with salts.
There are IV fluids that use other components, such as sugar, rather than salt. But instead of switching patients to those fluids, the government has chosen to approve salt-based solutions by other overseas brands.
So why do IV fluids contain different chemicals? And why can’t they just be interchanged when one runs low?
Pavel Kosolapov/Shutterstock We can’t just inject water into a vein
Drugs are always injected into veins in a water-based solution. But we can’t do this with pure water, we need to add other chemicals. That’s because of a scientific principle called osmosis.
Osmosis occurs when water moves rapidly in and out of the cells in the blood stream, in response to changes to the concentration of chemicals dissolved in the blood plasma. Think salts, sugars, nutrients, drugs and proteins.
Too high a concentration of chemicals and protein in your blood stream leads it to being in a “hypertonic” state, which causes your blood cells to shrink. Not enough chemicals and proteins in your blood stream causes your blood cells to expand. Just the right amount is called “isotonic”.
Mixing the drug with the right amount of chemicals, via an injection or infusion, ensures the concentration inside the syringe or IV bag remains close to isotonic.
Australia is currently short on two salt-based IV fluids. sirnength88/Shutterstock What are the different types of IV fluids?
There are a range of IV fluids available to administer drugs. The two most popular are:
- 0.9% saline, which is an isotonic solution of table salt. This is one of the IV fluids in short supply
- a 5% solution of the sugar glucose/dextrose. This fluid is not in short supply.
There are also IV fluids that combine both saline and glucose, and IV fluids that have other salts:
- Ringer’s solution is an IV fluid which has sodium, potassium and calcium salts
- Plasma-Lyte has different sodium salts, as well as magnesium
- Hartmann’s solution (compound sodium lactate) contains a range of different salts. It is generally used to treat a condition called metabolic acidosis, where patients have increased acid in their blood stream. This is in short supply.
What if you use the wrong solution?
Some drugs are only stable in specific IV fluids, for instance, only in salt-based IV fluids or only in glucose.
Putting a drug into the wrong IV fluid can potentially cause the drug to “crash out” of the solution, meaning patients won’t get the full dose.
Or it could cause the drug to decompose: not only will it not work, but it could also cause serious side effects.
An example of where a drug can be transformed into something toxic is the cancer chemotherapy drug cisplatin. When administered in saline it is safe, but administration in pure glucose can cause life-threatening damage to a patients’ kidneys.
What can hospitals use instead?
The IV fluids in short supply are saline and Hartmann’s solution. They are provided by three approved Australian suppliers: Baxter Healthcare, B.Braun and Fresenius Kabi.
The government’s solution to this is to approve multiple overseas-registered alternative saline brands, which they are allowed to do under current legislation without it going through the normal Australian quality checks and approval process. They will have received approval in their country of manufacture.
The government is taking this approach because it may not be effective or safe to formulate medicines that are meant to be in saline into different IV fluids. And we don’t have sufficient capacity to manufacture saline IV fluids here in Australia.
The Australian Society of Hospital Pharmacists provides guidance to other health staff about what drugs have to go with which IV fluids in their Australian Injectable Drugs Handbook. If there is a shortage of saline or Hartmann’s solution, and shipments of other overseas brands have not arrived, this guidance can be used to select another appropriate IV fluid.
Why don’t we make it locally?
The current shortage of IV fluids is just another example of the problems Australia faces when it is almost completely reliant on its critical medicines from overseas manufacturers.
Fortunately, we have workarounds to address the current shortage. But Australia is likely to face ongoing shortages, not only for IV fluids but for any medicines that we rely on overseas manufacturers to produce. Shortages like this put Australian lives at risk.
In the past both myself, and others, have called for the federal government to develop or back the development of medicines manufacturing in Australia. This could involve manufacturing off-patent medicines with an emphasis on those medicines most used in Australia.
Not only would this create stable, high technology jobs in Australia, it would also contribute to our economy and make us less susceptible to future global drug supply problems.
Nial Wheate, Professor and Director Academic Excellence, Macquarie University and Shoohb Alassadi, Casual academic, pharmaceutical sciences, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How To Out-Cheat “Cheat Days”
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Out-Cheating “Cheat Days” (Or Even Just “Cheat Meals”)
If you are in the habit of eating healthily, the idea of a “cheat day” probably isn’t appealing—because you simply don’t crave junk food; it’s not what your gut is used to.
Nevertheless, sometimes cheat days, or at least cheat meals, choose us rather than the other way around. If your social group is having a pizza night or meeting up at the burger bar, probably you’re going to be having a meal that’s not ideal.
So, what to do about it?
Well, first of all, relax. If it really is an exception and not a regular occurrence, it’s not going to have a big health impact. Assuming that your basic dietary requirements are taken care of (e.g. free from allergens as necessary, vegan/vegetarian if that’s appropriate for you, adhering to any religious restrictions that are important to you, etc), then you’re going to have a good time, which is what scientists call a “pro-social activity” and is not a terrible thing.
See also: Is Fast Food Really All That Bad? ← answer: yes it is, but the harm is cumulative and won’t all happen the instant you take a bite of a chicken nugget
Think positive
No, not in the “think positive thoughts” sense (though feel free, if that’s your thing), but rather: focus on adding things rather than subtracting things.
It’s said:
❝It’s not the calories in your food that make the biggest impact on your health; it’s the food in your calories❞e
…and that’s generally true. The same goes for “bad things” in the food, e.g. added sugar, salt, seed oils, etc. They really are bad! But, in this case you’re going to be eating them and they’re going to be nearly impossible to avoid in the social scenarios we described. So, forget that sunk treasure, and instead, add nutrients.
10almonds tip: added nutrients remain added nutrients, even if the sources were not glowing with health-appeal and/or you ate them alongside something unhealthy:
- Those breaded garlic mushrooms are still full of magnesium and fiber and ergothioneine.
- The chili-and-mint peas that came as an overpriced optional side-dish with your burger are still full of protein, fiber, and a stack of polyphenols.
…and so on. And, the more time you spend eating those things, the less time you spend eating the real empty-calorie foods.
Fix the flaw
We set out to offer this guide without arguing for abstemiousness or making healthy substitutions, because we assume you knew already that you can not eat things, and as for substitutions, often they are not practical, especially if dining out or ordering in.
Also, sometimes even when home-cooking something unhealthy, taking the bad ingredient out takes some of the joy out with it.
Writers example: I once incorrectly tried to solve the fat conundrum of my favorite shchi (recipe here) by trying purely steaming the vegetables instead of my usual frying/sautéing them, and let’s just say, that errant-and-swiftly-abandoned version got recorded in my nutrition-tracker app as “sad shchi”.
So instead, fix the flaw by countering it if possible:
- The meal is devoid of fiber? Preload with some dried figs (you can never have too many dried figs in your pantry)
- The meal is high in saturated fat? Enjoy fiber before/during/after, per what’s convenient for you. Fiber helps clear out excess cholesterol, which is usually the main issue with saturated fat.
- The meal is salty? Double down on your hydration before, during, and after. If that sounds like a chore, then remember, it’s more fun than getting bloated (which results, counterintuitively, from dehydration—because your body detects the salt, and panics and tries to retain as much water as possible to restore homeostasis, resulting in bloating) and hypertensive (which results from the combination of the blood having too much salt and too little water, and cells retaining too much water and pressing inwards because it is the cells themselves that are bloated). So, tending to your hydration can help mitigate all of the above.
- The meal is full of high-GI carbs? Preload with fiber, enjoy the carbs together with fats, and have something acidic (e.g. some kind of vinegar, or citrus fruit) with it if that’s a reasonable option. Yes, this does mean that a Whiskey Sour is better for your blood sugars than an Old Fashioned, by the way, and/but no, it doesn’t make either of them healthy.
- The meal is inflammatory? Doing all of the above things will help, as will eating it slowly/mindfully, which latter makes it less of a shock to your system.
See also: How To Get More Nutrition From The Same Food
Enjoy!
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