Implement and Out

If you’re only here for practical and actionable tactics, here are this week’s sugar takeaways:

1. Avoid liquid sugar (juice, soda, sports drinks, high fruit smoothies, etc.) and dried fruit at all costs. 

2. If you’re going to eat fruit, stick with blueberries, raspberries, strawberries, kiwi, lemon, and lime.

3. Diet soda is healthier than sugar-containing soda. Drinking soda with sugar is about the worst thing you can do when it comes to sugar consumption. 

4. “Naturally occurring” and “No sugar added” on food packaging is a marketing ploy. They mean nothing. Read the nutrition information and ingredients before buying. 

If you’re interested in learning more, read on.

Defining Sugar

Sugar is a blunt term. Using the word sugar to describe something we eat is equivalent to pointing at a maple tree and calling it a tree. It is indeed a tree, but so is a coconut tree. They sit in the same class of objects but produce completely different leaves and fruits. 

Sugar only exists to the extent that it classifies a group of sweet-tasting, soluble carbohydrates. Glucose, galactose, fructose, sucrose, and allulose are all types of sugar, however, how our bodies process, or metabolize, types of sugar differs. For this reason, it’s worth making a few differentiations. 

Glucose vs. Fructose

“Is glucose a sugar? Yes. Is fructose a sugar? Yes. Are they the same? Not even close.” — Dr. Peter Attia

Glucose and fructose, terms you’ve probably heard before, are common types of sugar and the building blocks of carbohydrates including other sugars.

Glucose, also called dextrose, is essential to life as it’s the primary sugar our bodies use to make energy. It can be stored in our muscles, liver, and kidneys in the form of glycogen which is simply the word for stored glucose. 

The type of sugar referred to when discussing blood sugar in a medical context is glucose. Hence the term ‘blood glucose.’ If blood glucose is consistently too high (hyperglycemia), one can develop diabetes. If it dips too low then one has hypoglycemia. 

Fructose is a type of sugar that is naturally found in fruits and honey. While glucose is used in energy production, fructose plays a role in energy storage. When we consume glucose, we use it to produce energy but when we eat fructose it triggers a pathway in our body that favours the storage of energy. 

This is the reason why The Slow Carb Diet eliminates fruit…

… the principal sugar in fruit, fructose, is converted to glycerol phosphate more efficiently than almost all other carbohydrates. Glycerol phosphate → triglycerides (via the liver) → fat storage.

We rarely consume fructose by itself as foods that contain fructose generally also contain a dose of glucose. For example, honey is made up of 40% fructose and 30% glucose (the rest is a combination of water and vitamins). Conversely, we often consume glucose by itself in more complex starches such as rice and pasta which we break down into glucose.

Table sugar (sucrose) is made with a 50/50 ratio of glucose and fructose, making it sweeter than glucose on its own. As a rule of thumb, the sweeter something is the more fructose it contains as fructose is sweeter than glucose. 

High Fructose Corn Syrup (HFCS)

HFCS, a combination of 55% fructose and 45% glucose, is derived from corn syrup which is processed from corn. It’s used widely to sweeten processed foods and soft drinks. Although some food manufacturers would like to have you think otherwise, being derived from a natural product, corn, does not make HFCS healthy.

How to Consume Sugar

Three Key Variables

Although there are both pro and anti arguments to every nutrition topic, the narrative we hear most often is that sugar is harmful to us. While this is a more accurate statement to make than ‘sugar is good for us,’ a more nuanced perspective will provide us with far greater insight.  Looking at sugar consumption through this lens will allow you to better analyze sugar-containing products and classify risk.

There are three key variables that determine the impact of sugar on our health: density, volume, and velocity.

Density

Compare dried mango to a whole mango or a prune to a plum. The density, or quantity, of sugar contained within the dried fruit is much higher because you have the same amount of sugar as the non-dried fruit at a lower total volume. 

Volume

This is simply the quantity you consume. Sipping a thimble of Coca-Cola will do you no harm but downing a litre of it will wreak havoc on your body. Unless you have the discipline of GI Joe and can be satisfied with a thimble of Coke or one piece of dried mango (once started I personally wouldn’t stop until the sides of the bag were licked clean), then it’s easier to just steer clear of these products.

Velocity

This is the speed at which sugar leaves your stomach and enters the upper segment of the first part of the small intestine (the duodenum). A perfect example of when velocity is an issue without even realizing it is someone who’s trying to be healthy by drinking fruit-heavy smoothies. 

If you load up a smoothie with fruit that would otherwise be impossible to consume in its whole form and blend it into a liquid, the velocity at which the sugar is traveling through your system is tremendous. This is a big issue and is not advisable if your aim is longevity. 

Another case is dried fruit. Not only is it an issue because of its high density, but by consuming it over opting for its whole fruit counterpart you’re also changing the speed (velocity) at which it might hit the liver. In addition, you can consume much more dried mango (volume) than whole mango. 

The two key takeaways are to avoid all dried fruit and sugar-containing beverages (high fruit smoothies, sports drinks, sugary soft drinks, etc.). The density, volume, and velocity of these products are just too high and too fast. 

TIP: Drink carbonated beverages, such as sparkling water, instead. 

Sugar Damage

As I wrote in The Four Horsemen, metabolic diseases¹ contribute heavily to the development of atherosclerosis, cancer, and neurodegenerative disease which combined kill the vast majority of people in Western nations.

In regards to diet, sugar consumption is the largest contributing factor to the development of metabolic disease. The second-largest dietary factor is high glycemic² carbohydrates that can be converted to sugar, such as bread, potatoes, potato chips, and rice. The third dietary influence is the consumption of heavily salted foods, the risk of which can be mitigated by drinking water before eating salt.

The two largest dietary drivers of metabolic disease are related to sugar consumption. This is the reason that sugar is under a constant spotlight in the world of nutrition. 

What is metabolic disease?

Signs of metabolic syndrome include:

• Elevated blood sugar

• Elevated blood pressure

• Elevated waist circumference

• Elevated triglycerides

• Low HDL-C (High-density lipoprotein cholesterol)

If you’re interested in what constitutes “elevated” levels of these indicators, an article I wrote titled Battling Cardiovascular Disease contains a cheat sheet outlining unhealthy ranges. However, all concerns should be discussed with your physician. 

Understanding Nutrition Labels

“Naturally occurring” and “No sugar added” are complete and utter bull s**t. Let’s tackle them in order, shall we?

Sharks are naturally occurring in the ocean, but are you going to jump in a vat of blood and go for a dip in shark-infested waters? NO! This is a silly example but the point is that just because something is naturally occurring it DOES NOT mean it’s healthy for you. 

Next time you see this on food packaging, run for the hills or take a thorough look at the ingredients and nutrition information. 

Products with naturally occurring sugars provide a sneaky outlet for food companies to market an unhealthy product as healthy. Using our dried mango example, the only ingredient is, of course, mango. The food company can market it as organic, naturally occurring, and with no sugar added but this doesn’t change the negative health impacts of consuming it. 

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Dried mango has enough naturally occurring sugar that you don’t need to add sugar to make it hyper-palatable. This is a way of lying by omission. It’s true that the sugar is naturally occurring and no additional sugar has been added. However, the product is still unhealthy due to the extremely high density of naturally occurring sugar.

Just as products that are naturally occurring can be both healthy and unhealthy, synthetic or artificial products aren’t automatically bad for us. Some may be, but others are safe for consumption. 

In addition, it’s often the dose that makes the poison. Tylenol can cure our pains in the right dose and kill us if we take too much. Keep these points in mind if you read this comprehensive post about sugar substitutes I wrote. 

Don’t let sneaky marketing loopholes fool you. Read the nutrition label and ingredients before buying. 

What Sugar Can I Eat?

We’ve already covered that liquid sugar (juice, soda, sports drinks, high fruit smoothies, etc.) and dried fruit, which is basically the fructose from fruit without the good things in it, should be avoided. 

Dr. Rick Johnson has shown that individuals who transition from a low fructose diet to adding a single fruit into their diet did just as well as the group who ate no fruit. However, it’s best to stick with low fructose fruits. 

Kiwi, lemon, and lime have almost no fructose making them ideal options. Additionally, blueberries, raspberries, and strawberries contain low amounts of fructose which also make them great choices. 

In contrast, fruits such as apples, pears, and grapes are high in fructose and should be avoided when possible. Dr. Johnson also recommends not eating too much fruit at one time. 

If you eat a large amount of fruit, all of the fructose in your system can overwhelm the good things like vitamin C, epicatechin, flavonols, and potassium. 

Dr. Peter Attia recommends to his patients who have non-alcoholic fatty liver disease (NAFLD), a type of metabolic disease, to cap fructose at 10 grams per day which must be consumed in the form of whole fruit. In practice, this means fruits such as grapes, bananas, and large apples are off-limits. 

Diet vs. Regular Soda

“If a person says to me, ‘Oh doc, I’m afraid to drink this diet Coke because it’s got chemicals in it, I want to drink regular Coke because of that.’ That’s an error. Regular Coke is more dangerous than a diet Coke.” — Rick Johnson, M.D.

“Drinking coke is about the worst thing you can do… though I’m going to make the case that eating that bag of dried mango is a very bad thing to do… despite the fact that it’s pedaled as a health food.” — Peter Attia, M.D.

Need I say anymore? Whether something is natural or synthetic does not determine its health status. Diet Coke is a superior option to its sugar-filled alternative.

If you’re looking for more sugar hacks, this sugar substitutes guide I wrote will help you better understand and differentiate between sugar alternatives and address any general health concerns about sweeteners.

Sugar, Sugar

In the world of nutrition, there are many grave uncertainties to which the answer of what is best for an individual lies in their unique DNA makeup and daily environmental exposures. 

However, when it comes to sugar there is sufficient evidence that all humans who desire a long and healthy life must be cognizant of their intake. Using three variables (density, volume, and velocity) to assess the risk profile of sugar-containing products and following the advice in the Implement and Out section are steps towards a long life of vitality. 

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Stay safe and have fun.

Much love,

Jack

@jackrossdixon on Twitter

Want more on sugar? Check out this all-encompassing post on sugar alternatives:

Sugar Substitutes Guide