We must fight back against sugar

dr-nina-sugar-image-2

Dr Nina Byrnes

Ireland is grappling with sugar addiction. If we don’t wean ourselves off it, we risk an uncontrollable Type 2 diabetes epidemic affecting hundreds of thousands of people. This will put immense financial and infrastructural pressure on our health service.

Beyond tooth decay, headaches, mood swings and upset stomachs, long-term, unmoderated sugar consumption can lead to serious conditions like obesity. Obesity, in turn, can lead to heart disease, liver disease, cancers of the digestive system and Type 2 diabetes. I see this on a regular basis in my practice.

Type 2 diabetes, which impairs the body’s ability to create the hormone insulin, is on the rise in Ireland. Unlike Type 1 diabetes, an autoimmune condition caused by genetic and environmental factors, Type 2 diabetes is caused, in the main, by an unhealthy diet with poor food and drink choices, and sedentary lifestyles.

In 2015, the International Diabetes Federation released some startling statistics. That year, 171,800 Irish adults, or more than 5.5 percent of the population, were found to have the disease, and more than 1,200 died from it or diabetes-related diseases. The findings also estimated that almost 65,000 people were living with undiagnosed diabetes.

The prognosis for 2017 and beyond does not look much better. Irish men already have the highest BMI in Europe and Irish women the third. According to the World Health Organisation, we are on course to become Europe’s most obese country by 2030. Obesity, as we know, is the perfect kindling for Type 2 diabetes.

I am delighted to be supporting LloydsPharmacy’s diabetes awareness campaign as it is vital that people are educated on the adverse effects of sugar, the benefits of a healthy lifestyle and diet, and the importance of screening for diabetes.

As part of the initiative, LloydsPharmacy conducted a survey on attitudes to diabetes and sugar consumption among 1000 Irish people over the age of 16. The survey revealed some shocking trends.

80 percent of Irish adults do not know their daily recommended sugar intake, and almost half never check the sugar content of their food. 37 percent eat sugary confectionery on a daily basis, and 18 percent admit to drinking soft drinks—which are laden with sugar—every day.

Children and young adults are at high risk of developing obesity and developing lifestyle diseases like Type 2 diabetes. Primary and secondary school pupils need continuous education in healthy eating and exercise, but particularly the latter who have far more personal control over their own nutrition. It must be made crystal clear to them that crisps and cans of Coca-Cola cannot be consumed on a daily basis without detrimental health effects. Government-supported initiatives are essential in this area.

Thankfully, when Type 2 diabetes is diagnosed, it can be treated with a mixture of diet, exercise and medication. Most diabetic patients lead perfectly healthy lives. Prevention is, of course, preferable, and in high-risk individuals, diabetes can be staved off with lifestyle changes, like frequent exercise, dietary modification and weight loss. In addition, the HSE also recommends limiting alcohol consumption and not smoking.

Colleagues at 84 LloydsPharmacy stores nationwide have received extensive training from Diabetes Ireland to help support those at risk and living with diabetes.

For more information or if you are concerned about developing diabetes, call into your local LloydsPharmacy store.

 

LloydsPharamcy diabetes information events

To help customers understand, prevent and manage diabetes, LloydsPharmacy will be hosting four information events in pharmacies nationwide in partnership with Diabetes Ireland and bestselling author Jules Coll. Diabetes Ireland will also provide free diabetes screening before each event. The events are free to attend, and all are welcome.

 

LloydsPharmacy, Blackrock, Co Dublin – 7 February at 6 pm

Free diabetes screening 2pm-6pm

LloydsPharmacy, Ballincollig, Co Cork – 28 February at 6:30 pm

Free diabetes screening 2pm-6pm

LloydsPharmacy, Northside Shopping Centre, Dublin 17 – 7 March at 6 pm

Free diabetes screening 2pm-6pm

LloydsPharmacy, Castletroy, Co Limerick – 21 March at 7:30 pm

Free diabetes screening 3pm-7pm

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.

The Bitter Reality – 4 Reasons to Eat Less Sugar!

This week, our in-house nutritional coach, Nichola Flood, speaks plainly about Sugar and provides some easy ways to improve our diets. Nichola was responsible for developing our 8 Week Weight-Loss programme and she approves all of the recipes on our Recipe Blog as being appropriate for weight-loss and sugar levels.

Did you know that sugar is one of the most highly addicted substances to mankind? It can cause all sorts of diseases and has harmful effects on our metabolism. In order to understand why sugar is so bad for our bodies, it helps to understand what it is made of:

  • Glucose is found in every living cell on the planet. If we don’t get it from the diet our body produces it.
  • Fructose, present in ripe fruit and in many other manufactured products, and is not produced by our bodies because our bodies do not really need it! But when it’s consumed, our livers metabolise it anyway. If we eat small amounts from fruit, the fructose will be stored in the liver until we need energy, energy we could get from glucose. However if the liver is already full of glycogen (glucose), eating a lot of fructose overloads the liver and it will turn the fructose into fat. If we are constantly eating large amounts of sugar it can eventually lead to fatty liver and more serious problems.

Here are some reasons why you should avoid sugar in your diet;

  1. Heart disease – For many years, even decades, we blamed fats and saturated fats for heart disease. However new studies have shown that sugar, not fat, maybe one of the drivers of heart disease.
  2. Cancer – If our insulin levels are constantly elevated (a side effect of sugar consumption) this can contribute to cancer. Inflammation is a potential cause of cancer and sugar consumption can cause inflammation within the body.
  3. Sugar is highly addictive – Sugar releases dopamine in the reward centre of the brain, the same as the effect of abusive drugs. Processed foods are full of hidden sugars and when consumed, they can cause massive dopamine release much more than when we consume foods found in nature. This is one of the main causes of how people become addicted to junk food.
  4. Type II diabetes – This is another disease that is caused by sugar. Diabetes is when the pancreas fails to produce adequate amounts of insulin when the blood sugar levels rise. When sugar in concentrated amounts enters the system the body goes into shock from the rapid rise in blood sugar levels. Eventually the pancreas will wear out and diabetes will set in.

How to cut sugar from your diet

  1. Be a food label detective
    • Sugar can be disguised as sneaky names: molasses, sucrose, brown rice syrup, honey, fructose, invert sugar, corn syrup. Look out for these on food labels and avoid!
  2. Be wary of foods labelled as ‘low-fat’, ‘diet’, ‘low-calorie’
    • A lot of these products take out fats but replace with sugar to improve the taste.
    • Sneaky sugar substitutes can also be contained in these products in high quantities.
  3. Use protein and fat in your diet
    • Avoid white carbohydrates as they are loaded with sugar that can cause our blood sugar levels to rise quickly and drop even quicker.
    • Always ensure to have good quality slow releasing carbs in your diet: sweet potatoes, brown rice and pasta, brown bread.
    • Always have protein, a good quality fat source and fibre with each meal. This will slow down the blood sugar release in your body and keep you fuller for longer. So for breakfast make sure to have your porridge but add a teaspoon of nut butter/nuts or seeds to it. For your snack add a piece of turkey with your piece of fruit or have a small handful of nuts with it.

Check out this sample day’s food plan that should show how to ensure you get the appropriate amounts of sugar to sustain your energy levels more effectively:

Breakfast:

  • Porridge made on water with almond milk added after cooking.
  • Top with blueberries, raspberries and a teaspoon of seeds.

Morning Snack:

  • One piece of fruit and a small handful of nuts (not processed, dry roasted or salted).

Lunch:

  • One filet of wild salmon.
  • Small portion of cooked brown basmati rice.
  • Green salad and/or vegetables.

Afternoon Snack:

  • 2 wholegrain rice cake.
  • 1 tablespoon hummus.

Dinner:

  • One chicken breast marinated in soy/ginger/garlic and lime juice.
  • One medium sweet potato.
  • Spinach and sweet corn.

Dessert:

  • Two tablespoons Greek yogurt.

Strawberries and grated 70% dark chocolate.