Sugar – more sour than sweet?

Donal ClarkeHow sweet is your tooth? Are you addicted to sugar? A lot of us may be. Too high an intake of sugar is undoubtedly linked to the global increase in diabetes and obesity. One of our pharmacists, Donal Clarke, tells us about his journey towards ‘free-sugar-free’ living and shares some tips on how to reduce your sugar intake.

I work as a supervising pharmacist in LloydsPharmacy Greystones. About two years ago I noticed I was getting very dry-mouthed at night over three consecutive days. I regularly help patients in the pharmacy with the use of their blood sugar monitors and I confirmed that my overnight or morning fasting sugar level was above the established range of a healthy person. My slightly elevated sugar levels put me on the road to entering the bracket of people who would be considered prediabetic.

Type II Diabetes is a chronic disease affecting ever more of the world’s population and is one which carries a series of painful and life-impeding complications. It is chiefly characterised by the body’s inability to maintain normal sugar levels following the ingestion of food. I was motivated to begin researching how to reverse or halt the progression of elevated blood sugars from turning into prediabetes or eventually Type II Diabetes. There are individual cases and a growing number of actual studies which have shown that losing a significant amount of body weight and maintaining this lower weight can at least temporarily reverse both conditions.

I was determined to recover my own normal blood sugar levels and did so over a long month of reduced calorie intake and strict avoidance of sucrose. In four weeks I lost about half a stone in weight and by the end of week two of the “diet” my blood sugar levels returned to a normal range.

The problem with any crash diet is that statistically most people return to the same or a higher weight within a year. This is most likely due to the difficulty we encounter in maintaining healthy behaviours. It can be difficult to keep to a regular exercise regime and eating only ‘good food’ unless there is the correct environment to encourage those behaviours. For exercise this might be an obligation or commitment to a club or society to show up to practice. For food it might mean cooking the vegetable-based meal in larger batches for the rest of the working week.

How much sugar should we be taking in?

Last year the World Health Organisation (WHO) finally made a recommendation for the daily intake of ‘free sugars’. ‘Free Sugars’ is a term coined by the WHO and basically means any food which sugar is added to, i.e. not naturally containing sugar. They recommended less than 10% of your daily intake of calories to be from ‘free sugars’ and that if only 5% of your daily calories were from such sugars this would be great for your health. 5% calorie intake from sugar equates to approximately 25 grams of sugar. The WHO applies these recommended restrictions to processed foods rather healthy foods (since people who only eat fruit and vegetables usually have no health problems!). However to put these figures in perspective, you would get 25 grams or more of sugar in a day from eating:

Sugar Table

The reason they have given a recommended intake for free sugars is that these sugars have been shown to be directly attributable to the growth of obesity and Type II Diabetes. Specifically, soft drinks alone are thought to have contributed to the death of 25,000 people in America in 2010 due to complications of metabolic syndrome related disease like diabetes and heart disease.

Eggs, meat, nuts, vegetables, quinoa and many of the other healthy foods we can eat are all low in sugar, often less than 5% of their weight, and more importantly the sugar they contain is wrapped up in fibre that the body must break down before absorbing. The problem with modern packaged food products is that the natural fibre has been removed. The labels on processed food will show them containing anywhere from 15 to 80% sugar content depending on food type and brand. The sugar content can be immediately absorbed, overwhelming the liver which has to process it. The “sugar hit” that modern processed food gives us is the reason you will hear more and more about visceral fat, the fat that builds up between your organs, which is a result of the body’s attempt to store the high peaks of sugar it cannot process quickly enough. The answer is to eat whole and unprocessed food.

Most natural foods contain fibre, and any sugar or fat also contained is bound up with that fibre. The traditional Japanese diet was very high in carbohydrates (rice, fish, beans and vegetables). They ate food in its original form. Most packaged food, which has an expiry date of more than a few days from its manufacture, has had its fibre removed and sugar added as a useful preservative and sweetening agent. The traditional Japanese culture had some of the lowest heart disease and cancer rates in the world. Now that they consume the same processed food we eat that is rapidly changing. There were roughly 7.2 million diabetics in Japan last year.

Visceral Fat – the body’s way of dealing with too much sugar

Visceral fat is one of the signs of what is being called ‘metabolic syndrome’, which is a grouping of symptoms of high blood pressure, high cholesterol, high blood sugars which lead to diabetes, heart disease and many other diseases. Visceral fat does not show on the outside of your body. It builds up around the liver, heart, kidney and pancreas and stops them from working properly, which can manifest itself in medical issues such as insulin resistance (rising sugar levels), increasing blood pressure and cholesterol.

80% of obese people have unhealthy amounts of visceral fat but what isn’t common knowledge yet is that 20% of normal weight people have unhealthy levels of visceral fat as well. How can you test of visceral fat? Not easily. The Body Mass Index (BMI) which is used worldwide to give people an indication of their overall body to fat content does not distinguish between bad (visceral), not-so-bad (subcutaneous) fat or increased muscle mass. An MRI scan or liver ultrasound can indicate what level of visceral fat you have but neither is cheap by any means. A better and less expensive option is to look at what you are eating and how much physical activity you are getting. For 18 to 64 year olds the WHO recommends a minimum of 30 minutes of moderate exercise (walking, swimming, dancing, cycling) a day, 5 days a week, or 15 minutes of intense exercise a day (running, wall climbing, heavy weight lifting) and to consider doing twice this amount for increased health benefits. You can also have your blood pressure, cholesterol and fasting sugars tested. LloydsPharmacy offers free blood pressure checks and your GP can test for cholesterol and fasting blood sugar levels. If your fasting blood sugar levels are only slightly raised you have some insulin resistance and taking steps to improve your diet, weight and exercise regime can reverse these stats and prevent diabetes developing at a later date.

I find it helps to know the ‘how’, the ‘what’ and the ‘why’ of how sugar affects our health but until the government can change the nature of our food industry, each adult needs to try to control their own personal food environment and that of their children.

What can you do to improve your diet?

Here are some hopefully helpful tips and rules to follow to try and achieve healthier eating:

  • If you don’t stock a food at home you can’t eat it so never shop when you are hungry; you’ll have lost the game before the first item gets into your shopping basket. Consider anything in packaging to be processed. It should on your avoid or reduce list.
  • The portion sizes we eat have slowly increased in size over the decades. Studies have shown that most people will eat a large portion of what is on the plate regardless of the actual amount of food presented to them. So simply putting smaller amounts onto your plate can work. “Hara hachi bun me” or “hara hachi bu” is a teaching of the Okinawans in Japan meaning ‘eat until 80% full’. They have the highest number of centenarians (people living to be 100 years) in the world.
  • Keep food intact when you’re cooking or eating it. Boil, grill or steam it. This preserves the fibrous frame of the food and means the sugar, fat and nutrients are slowly released in the gut. For the same reason avoid juicing and smoothies of fruit and vegetables. This destroys the fibrous mesh that enables us to digest slowly and drinks like orange juice can end up having the same effect on our livers as a Coca Cola can due to the free sugar content.

Watch out for the obstacles!

I still struggle to keep to a good diet and exercise regimen. I do well at keeping chocolate and sweets out of the home which is essential since anything I buy regardless of size would be consumed in a few hours or days. However I find I inevitably allow myself a cookie here or there when I shop (such as from the bakery in Lidl). They rarely make it to the car.

A lot of the entertainment I watch is online and I have found it a good rule to not allow myself to simply sit and watch anything. Thanks to the modern technology of tablets (the Samsung make as opposed to the pharmaceutical kind) I try to keep to this rule:

  • If I am going to watch something for 40-60 minutes after work I have to still do something for that period of time. Either I cook or do housekeeping while I watch a program or else I exercise at the same time. An indoor cycling machine is the easiest way I find to keep this promise and means I do between half an hour to two hours cycling a week whether I’m watching a movie or a TV series.

Find out more

If you are interested in reading up more on sugar, diet and prediabetes, here are a few of my recommendations:

  • Fat Chance: The hidden truth about sugar, obesity and disease. Book by Robert Lustig. This book was one of the first I read about sugar and its health impact and was a huge eye-opener for me. Robert featured heavily as a commentator in the recent Sugar Crash documentary on RTE.
  • http://thatsugarfilm.com/ That Sugar Film was a documentary, briefly mentioned in the Sugar Crash documentary on RTE. A healthy Australian actor ate only foods perceived as being healthy (smoothies, muesli bars, fruit juice, cereal, low fat yogurt and salad dressings) for two months and developed a fatty liver, the first signs of heart disease.. all within 60 days.
  • Visit http://www.who.int/ and you can find the official recommendations for sugar in your diet as well as the exercise recommendations for children and adults for maintaining a minimum level of health.

Change Your Health Direction: Week 5

We’re now over 5 weeks in to our Change Your Health Direction campaign. Delightfully, we can confirm that hundreds of you are still active in the programme, losing weight or quitting smoking with the support of our colleagues in pharmacy.   Well done for sticking with it!! Only 3 weeks left to reach your goals.

avrilOur resident CYHD expert, Avril Reilly, Pharmacist in our Governey Square branch, is back this week with an update, this time focused on a particular range of products that are making a significant difference to her CYHD participants…

‘I have mentioned on previous occasions that some of our CYHD participants are using two great Irish products from True-Life to help them along their weight loss journey – Heart Up and Shake Up. Heart Up is a low GI wholegrain barley which delivers high levels of fibre and beta-glucan and it has been scientifically proven to both lower cholesterol and reduce blood sugars and in doing so it helps to sustain energy, fill you up and prevent cravings. It comes in three varieties; blueberry, red berries and original and a scoop of the product can be conveniently added to porridge, soups, salads, scrambled eggs, mashed potatoes etc. A very worthwhile product and we are receiving excellent feedback from those who are using it regularly. Definitely worth a try!!

During the first couple of weeks of the CYHD weight loss program I had been noticing that some of the participants were not eating regularly as they were on the go and found it difficult to bring snacks with them to keep them going in between their main meals. I recommended that they try True-life Shake up as it provides a balanced, convenient snack that they could take anywhere with them and as it contains protein it helps to sustain energy and maintain balanced blood sugars. This daily protein shake also helps to maintain healthy bones, muscles and joints. It comes in three delicious flavours; strawberry, chocolate and vanilla. As it is sweetened with the natural sweetener stevia it won’t upset blood sugar balance, and it is packed full of goodness – even the protein it contains is 100% Irish whey protein from outdoor grass fed cows! It is so much more than a protein shake as it is also high in calcium, low in fat, gluten free, high in fibre and contains 100% RDA vitamin D! The participants who have been using this product have been finding it excellent and even though it is not a weight loss product it has really helped them throughout the past number of weeks on the program and several of them have mentioned that they plan to stay on it long term as it is very affordable and the benefits are outstanding!!’

Fantastic advice as usual from Avril in Carlow; keep it up!!

Change Your Health Direction: Week 4

It’s over 5 weeks now since we kicked off our Change Your Health Direction programme here at LloydsPharmacy and we’re just so proud of the results so far. Hundreds of customers across the country are being supported by our pharmacy teams in losing weight or quitting smoking. And with fantastic results!! We’ve lots to share with you this week after hearing some of the amazing stories from our teams.

CYHD Carlow

Avril Reilly, Pharmacist in our Governey Square branch, is back this week and she has some very real advice for us based on her experience supporting customers through this 8 week programme…

avril‘Can you believe we are over half way through the program already?! Over the past week I realised the true value of our weekly consultations and I’m pretty certain that without this program many of the participants would have thrown in the towel by this stage. I’m sure you will all agree that whenever we try something new or try to implement changes in our lifestyles, it can be very difficult to maintain the momentum and the motivation over the longer term.

Some of our participants are doing superbly whereas others are struggling at this point. I am doing my best to remind them of the goals that we set out at the beginning and to share as much advice and tips as I can. I have noticed one massive difference between the successful individuals and the ones who are finding the experience challenging – mind-set. Those who are doing really well have decided that this is a long-term lifestyle change and have really settled into a new way eating and nourishing their bodies. They are excited about the program and are reaping the benefits. If they have a slip, they get back on track straight away. Others are struggling at times because they have a “diet mentality” – rather than embracing the change, some of them are feeling deprived and see this as merely an eight week program. When these individuals fall off the wagon, they find it very difficult to get back on track again and think “well, I’ve blown the diet today; I may as well eat whatever I want and start again tomorrow!” Rather than having one unhealthy meal in the week, which would probably have had very little impact on their progress, it turns into several and then they also have to deal with the feelings of failure and guilt! Temptation is all around us, we are bound to indulge every now and again and when we do we should enjoy it, but it’s all about getting the right balance of course. My advice is to just get back on track straight away rather than waiting until the next day or the next week! Keep looking forward rather than worrying about those biscuits you really shouldn’t have had at 11am!

Organisation is another key to success. Meal planning sounds like such a pain but it really does help. If you are absolutely starving and you haven’t a healthy option to hand, it’s all too easy to grab something quick to satisfy the hunger. And we all know that if we allow ourselves to get hungry, we would reach for just about anything at times! Always try to have a healthy snack to hand and preparing meals in advance can really help too. A couple of hours a week of planning and prepping food is a seriously good investment of time and will definitely help keep you on track!

Finally, I just want to share a couple of successes from this week! I have one lady who has already reached her goal of one stone weight loss!! I cannot even express how happy I was to tell her how well she had done. Before I weighed her, I asked her how she was feeling and she replied “Amazing, I just feel so much happier and healthier. Aside from the weight loss, the best part is just how great I feel”. One of her goals was to feel happier and healthier and her second was to lose a stone. Phenomenal!!

I also had a lady who came in this week, feeling like she wasn’t doing great. She was really down in herself and thought that she wasn’t making progress. She had a great first week, followed by two weeks where she didn’t lose anything. On those weeks, she fell off the wagon but used it as an excuse to overindulge, promising herself that she would just try harder the following week. I had advised her not to feel bad if she had a slip and just to get back on track ASAP. This week she admitted that she had a takeaway and a bar of chocolate but unlike before, she didn’t let it ruin her week. She lost two more pounds this week which means she is bang on target to achieve her eight week goal. When I told her this, she was a new woman completely and left with a new sense of positivity and motivation. And it only took ten minutes to turn it all around for her.

Best of luck to everyone else still working hard on reaching their goals!’

Amazing!!! As usual, very awe-inspiring work going on in Carlow. It makes us so proud to hear about what a difference Avril’s support is making to the CYHD crew there – best of luck to all of you! Check out our recipe blog to learn about some healthy pancake Tuesday options!!

CYHD Limerick

Last Sunday, the team in LloydsPharmacy Castletroy held a rather wonderful event. The crew there wanted to do something extra to help motivate their CYHD participants so they held a group walk. Despite a horribly foggy morning, they had a great turnout. Customers were treated to some fresh fruit salad and yoghurt, and got the chance to try some of our favourite products, True Life Heart-Up and Oxylent – both of which were extremely popular.

The group are going to repeat this event at the end of the 8 weeks, and who knows; maybe this will become a regular event! Check out some of the great pictures the team sent in…

avr

CYHD in Cabra

Jessy Gallagher is our resident Change Your Health Direction Coach in LloydsPharmacy, Cabra, and her support is all the more valuable after she lost a significant amount of weight herself last year, abiding by the guidelines we work to as part of CYHD. Jessy is in the middle of a nutrition course and is providing some amazing support to her customers. The Cabra team is also losing lots of weight themselves with her weekly advice and motivation.

Jessy took some time to give us a snapshot of her own diet and sent us some pictures showing the Cabra team in action.

Jessy’s workday eats!

Lunch – wholemeal wrap, with red pepper hummus (no butter or mayo here!), chicken, baby spinach and red onion.

Snack – an apple with 6 almonds

Dinner – mini pizzas, made with a round wholemeal pitta bread cut in half, with tomato puree (slightly watered down), baby spinach, a sprinkling of cheese, chicken and top with chilli flakes!

acc

We’re so proud of you Jessy! Well done.

Make sure to check out our recipe blog, which includes one of Jessy’s recipes for cookies – who can say no to cookies?!

Best of luck to all of our CYHD participants!! We know that with the support of our amazing pharmacy teams, you will reach your target weight…