Tag Archive | added sugar

Define: “Healthy Eating”

When I see patients in the office we often start discussing “healthy eating,” as if we both are on the same page! However, I follow-up my question by asking “What exactly do you believe is healthy?” The majority of the time, the conversation feels like we are speaking two different languages.

The truth of the matter is, everyone’s definition of “healthy eating” is different!!

Not a difficult choice here!

Not a difficult choice here!

Now, what exactly is “healthy eating” or “eating clean?” How can this be accomplished?

Although eating healthy comes in all shapes and sizes, I personally follow a “Personal Paleo Code” as described by Chris Kresser. This isn’t necessarily the only “eating healthy” lifestyle change that exists, but I do believe that a “Personal Paleo Code” is a good basis for people to start on. I have seen excellent results from friends and patients that adhere to the principles.

A great basis to start on!

A great basis to start on!

I believe that “eating healthy” starts on the premise of removing processed foods, sugar, and grains from someone’s lifestyle.

Removing sugar sweetened beverages is a great start!

Removing sugar sweetened beverages is a great start!

The biggest issue I find when I discuss lifestyle modification is the last part of this lifestyle change – the grains. People look at me dead in the face and say, “Why can’t I have grains?” Well, the short story is that bread, pasta, and any other grain-laden product is easily converted into sugar. Once this process happens (the Krebs Cycle, etc.), the laws of adiposity take hold. Insulin is released from the pancreas to regulate blood sugar. Once insulin is released, sugar is broken down into immediate energy where needed by the body, and into fat stores for the excess. People look at me and say, “Sugar makes us fat?” The simple answer is yes. Insulin is a “fat storage hormone” If our bodies can’t immediately use the energy from food (which is usually the case), we store the sugar as fat. This is the fat most commonly seen stored in our abdomen.

Visceral Fat is the biggest enemy!

Visceral Fat is the biggest enemy!

A few weeks ago I had the pleasure of coming home to Florida, and witnessing my family try and transition to a “healthy eating” lifestyle. I have seen some of the common pitfalls and that I will discuss a few of them in depth.

Juices (yes, even “Naked” smoothies) are a huge pitfall. The best way to tell if the juice is real juice is if you juice it yourself, or you look at the nutritional label to see how much dietary fiber is in the beverage. Most juices will have no dietary fiber – this means the beverage is simply pure sugar water. Avoid all juices unless you can reliably say that they have dietary fiber in them. In theory, fiber slows the digestion of the sugar in the intestinal tract so as to not inundate the pancreas with a huge amount of sugar for processing. Drinking beverages like the ones I described above are the same as, or even slightly worse than drinking a Coca-Cola or Pepsi.

Popular beverage nutritional facts.  Notice the absence of Dietary Fiber!

Popular beverage nutritional facts. Notice the absence of Dietary Fiber!

Processed foods are generally laden with ADDED SUGAR. Check out my previous blog for these pitfalls. Take the time to look at the nutritional label, and if you can’t pronounce the ingredient, you probably shouldn’t eat that item. Companies like to break up the amount of sugar in the ingredients label by using sugar synonyms such as but not limited to:
Brown Rice Syrup, High Fructose Corn Syrup, Cane Sugar, Coconut Sugar (just because it is from a coconut doesn’t make the sugar any better for you), Brown Rice Syrup, Sucrose, etc. This concept is discussed extensively in Robert Lustig’s book “Fat Chance”. My summary of his analysis of all the “Diets” of the 21st century breaks down to this:

All successful lifestyle modifications/diets have one thing in common, they eliminate SUGARS and PROCESSED FOODS from them!!

In general, labels with a laundry list of ingredients are usually processed and composed of unhealthy ingredients. The closer from the earth the item is, the better it is for you.

Since I will be publishing this just before we all gobble down a few pounds of Thanksgiving Turkey here is my method to having a healthy, fun, and fulfilling Holiday!

Number one priority: TURKEY (Probably a pound or two for myself… lol)
Number two priority: Veggies
Number three priority: Everything else

Fill up on meat and veggies before you get into the sugar laden sweets!!

Eat plenty of Turkey and Veggies!

Eat plenty of Turkey and Veggies!

Finally, just because the box says “low fat”, “low sugar”, or “low carb” doesn’t necessarily mean it is good for you. Always read the nutritional labels on the boxes!! “Low fat” typically = loaded with sugar!! “Low carb” or “Low sugar” may mean that the food is packed with fat. Fats can be good or bad (I will discuss this in a future blog), but sugar is responsible for the epidemic of obesity.

As they say, “Eat to live, but don’t live to eat!!”

Redefining “HEALTHY” Snacking!!

I spoke with my mother on the phone yesterday (boy do I love her!! ☺), and she happens to be one of my inspirations to help America combat our food addiction. She was talking to one of her friends, who mentioned that she had just done a colon prep for a colonoscopy. For those of you who don’t know what is required for a colonoscopy, let me sum this up for you: Prior to the procedure, you take a very potent laxative to rid your body of any waste left in your gastrointestinal tract. After drinking this laxative a person can lose up to about 15 pounds of weight, mostly because the person is left extremely dehydrated. After being completely cleaned out, you have a scope inserted into your rectum to inspect for any suspicious lesions. We as physicians recommend you do this once every 10 years after the age of 50 (Based on findings this recommendation can change). If we find any suspicious lesions, we will then biopsy them and determine the etiology of the lesion. This is not a risk free procedure and is not intended for lasting weight loss.

Getting back to the topic, – it seems that everyone in America wants the “Lose Weight Quick” diet. Let me say one thing, there isn’t one. Most fad diets have a person regaining the weight they dropped during the diet within the following week to month after the diet (1). The real trick to losing weight fast and keeping it off is true, unadulterated lifestyle change.

Lifestyle modification can be hard, but if you follow a “Personal Paleo Code” or some other sustainable change this can be done. When I was talking with my mother I knew one thing, she definitely has a sweet tooth and a carb addiction. (If this sounds like something your battling, keep reading!!) I know that out of any modification that I can do for my mother, I need to make sure that she has options for healthy snacks for between meals. In the next few paragraphs I am going to discuss common “healthy snacking” options, as well as truly healthier alternatives for them, which will abide by “Your Personal Paleo Code.” Just because the packaging on foods says it is “heart healthy”, and or “low-fat” does not make the item good for you! I am going to take a look at a salty snack, a sweet snack, and one that is both sweet and salty!!


Pita chips, potato chips, or any sort of chips:

Bad Example:
Stacy’s Simply Naked Pita chips: Enriched wheat flour (Wheat flour, niacin, reduced iron, thiamin mononitrate, riboflavin, folic acid), Sunflower Oil and/or Canola Oil (High in omega-6 fatty acids and/or trans fat), sea salt, whole wheat flour, and less than 2% of: Organic Cane Sugar (ADDED SUGAR), oat fiber, yeast, malted barley flour, rosemary extract, and ascorbic acid. If you are going to add any flavoring, then add more calories and ingredients.

Stacy's Pita Chips

Stacy’s Pita Chips

Good Substitute:
Original Black Bean Beanitos: Whole black beans (Big improvement from Enriched wheat flour), whole grain long brown rice and/or long grain white rice, pure sunflower and/or safflower oil (See above, good oils are expensive), guar bean gum, sea salt

Original Black Bean Beanitos

Original Black Bean Beanitos

For the person with a Sweet tooth:
Chocolate Chip Cookie or brownie
The Bad Example:
Nestle Tollhouse Chocolate Chip Cookie (one serving): White Flour (Processed), whole raw eggs, unsalted butter, semisweet chocolate, brown sugar, granulated sugar (SUGAR, SUGAR, SUGAR), vanilla extract, salt, and baking soda.
Nutrition Facts

Tollhouse Chocolate Chip Cookie: Happens to be Pinterest's most popular pin!!

Tollhouse Chocolate Chip Cookie: Happens to be Pinterest’s most popular pin!!

Serving Size: 1 Cookie
Amount Per Serving
Calories 147.9
Total Fat 7.8 g
Saturated Fat 4.7 g
Polyunsaturated Fat 0.3 g
Monounsaturated Fat 2.4 g
Cholesterol 24.3 mg
Sodium 101.1 mg
Potassium 60.2 mg
Total Carbohydrate 19.4 g
Dietary Fiber 0.7 g

Sugars 8.8 g
Protein 1.5 g
Vitamin A 4.0 %
Vitamin B-12 0.6 %
Vitamin B-6 0.6 %
Vitamin C 0.0 %
Vitamin D 0.3 %
Vitamin E 1.2 %
Calcium 1.0 %
Copper 4.3 %
Folate 3.8 %
Iron 4.2 %
Magnesium 3.4 %
Manganese 6.8 %
Niacin 2.4 %
Pantothenic Acid 0.9 %
Phosphorus 2.7 %
Riboflavin 3.6 %
Selenium 5.5 %
Thiamin 4.3 %
Zinc 1.6 %
*Based on a 2,000 calorie diet

Let’s be honest with ourselves, no one can eat just one Chocolate Chip COOKIE!!

The Better Substitute:
Chocolate Chip Cookie Dough Quest Bars: Protein Blend (Whey Protein Isolate, Milk Protein Isolate), Isomalto-Oligosaccharides (Prebiotic Fiber), Almonds, Water, Unsweetened Chocolate, Cocoa Butter, Erythritol. Contains Less than 2% of the following: Sea Salt, Stevia (Low calorie Natural Sugar), Natural Flavorings, Sucralose (Small amount of added sugar).

Quest Chocolate Chip Cookie Dough Bar

Quest Chocolate Chip Cookie Dough Bar

Nutrition Facts
Serving Size 1 (60g)
Calories 190
Calories from Fat 70
*Percent Daily Values are based on a 2,000 calorie diet
%Daily Value*
Total Fat 8g 12%
Saturated Fat 3g 15%
Trans Fat 0g
Cholesterol 5mg 2%
Sodium 280mg 12%
Vitamin A 0%
Vitamin C 0%
Magnesium 8%
Phosphorus 10%
%Daily Value*
Potassium 125mg 4%
Total Carbohydrate 21g 7%
Dietary Fiber 17g 68%
Sugars 1g
Erythritol 1g

Protein 21g
Calcium 10%
Iron 10%
Contains almonds and milk-derived ingredients.
With the pre-biotics and the high dietary fiber the carbohydrates here are virtually all but negated.

Sweet and Salty

Granola Bars:
These items are definitely not part of “Your Personal Paleo Code”, they are usually chock-full of added sugars.
Bad Example:
Kashi Crunchy Granola & Seed Bars, Chocolate Chip Chia: You may think, as many others do, “Oh this bar has CHIA, it must be good for me!” But let’s take a closer look at the ingredients – this bar is loaded with sugar and soy.
Whole Grain Oats, Whole Grain Blend (Whole: Barley, Buckwheat, Hard Red Wheat, Rye, Triticale And Quinoa), Dried Cane Syrup (ADDED SUGAR), Semisweet Chocolate Chips (Dried Cane Syrup, Chocolate Liquor, Cocoa Butter, Soy Lecithin, Vanilla Bean), Expeller Pressed Canola Oil (High in Poly-unsaturated Fatty Acids and possibly contains trans fat), Invert Cane Syrup (ADDED SUGAR), Unmodified Cornstarch (ADDED SUGAR), Chia Seeds (Moderate benefits), Brown Rice Flour, Coconut, Whole Oat Flour, Evaporated Salt, Molasses (MORE SUGAR at least natural source), Vanilla Extract, Sodium Bicarbonate, Soy Lecithin (a lot of problems to be discussed later), Spice Extractives.

Kashi Chocolate Chip Crunchy Chia Granola and Seed Bar

Kashi Chocolate Chip Crunchy Chia Granola and Seed Bar

Good Substitute:
Paleokrunch Bar:
Raw almonds, almond meal, shredded coconut, raw sunflower seeds, raw pumpkin seeds, coconut oil (high in good saturated fats), honey, vanilla extract, and baking soda.

Steve's Paleogoods Original Krunch Bar

Steve’s Paleogoods Original Krunch Bar

Original Krunch Bar

Original Krunch Bar

They also make a Dark chocolate espresso version very similar to this.

Here are some other “HEALTHY” (not really) options that I came across in the store the other day:

Skinnygirl Tasty Nutrition Bar: Looks good for you until...

Skinnygirl Tasty Nutrition Bar: Looks good for you until…

Skinnygirl Tasty Nutrition Bar nutritional information shows the amount of added sugar!

Skinnygirl Tasty Nutrition Bar nutritional information shows the amount of added sugar!

Brown Rice Syrup is another name for added sugar. Organic sugar, even though it is organic is still added sugar. The food industry does a great job at deceiving the public!

My alternative to this bar:

Larabar is a healthy alternative: Blueberry Muffin is not paleo but still very nutritious

Larabar is a healthy alternative: Blueberry Muffin is not paleo but still very nutritious

Nutritional Information for the same Blueberry Muffin Larabar with ingredients:Dates, cashews, unsweetened blueberries, blueberry juice concentrate, lemon juice concentrate, vanilla extract.

Nutritional Information for the same Blueberry Muffin Larabar with ingredients.

This is not exactly a paleo example, but many especially the cherry pie are paleo friendly.

Also, anyone can grab fresh fruit or vegetables for consumption if they need a boost! You would be amazed at how few calories are in some of the vegetables we consume everyday. In one bag of spinach there are roughly 100 calories. I hope you read this mother, I love you ☺!!

My mother and I!

My mother and I!

If anyone has any specific weakness for a certain snack, feel free to e-mail me @ Ronald.Torrance@med.lecom.edu and I will try and find some healthy alternative for you!

Now that you have the alternatives, go throw out those “healthy snacks” and pick up some of my good alternatives!!

Swallowing fire shortly after meals?

Do you or someone you know suffer from pain in your chest that starts in your stomach and moves all the way to your throat? Do you have a sour or bitter taste in your throat after eating, a wet burp per say? Do you get a sour stomach, nausea after eating, stomach fullness or bloating, upper abdominal pain or discomfort? When you eat something spicy does it feel like your swallowing fire shortly after? If you or someone you know has said yes to any of these symptoms you may suffer from gastroesophageal reflux (aka GERD for short) Take a few seconds to read my post and I will walk you through a great way to rid yourself from this condition forever!!

Chest feels like your swallowing fire?

Chest feels like your swallowing fire?

Recently I have noticed that a lot of my friends complain of these symptoms, hopefully they are not literally swallowing fire, but you get the point! Most of my friends tell me that they usually pop a Pepcid, Prilosec, Zantac, Tums, or (insert your personal antacid). This is healthcare’s response to reflux, even though the success rate for complete reduction of symptoms is 60%. (1) Conventional wisdom/medicine tells us that since our stomach’s contain acid (pH of about 2) that when this acid refluxes up into the esophagus that this is the prime culprit for causing symptoms such as epigastric chest pain shortly after eating, that metallic taste in your mouth, or a fire coming up through your chest. We can reduce these symptoms by decreasing the acidity of the stomach or raising the pH of the stomach. This is what we are trying to do by popping our over the counter antacids, as I said earlier with relatively low success. (1) With a few lifestyle modifications I have been having great success quelling this ailment.

My reading and research has led me to believe that our conventional thinking as physicians is completely wrong! I first read about this approach in Chris’s ebook on GERD. More information can be found in the books Heartburn Cured: The Low Carb Miracle by Norm Robillard or Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and GERD by Jonathan Wright M.D.

When we start popping antacids, we are feeding into a vicious cycle. This cycle causes a couple of independent events to lead to a compromised lower esophageal sphincter, which is the area where stomach acid actually refluxes into the esophagus. Chris’ does an excellent job explaining this on his website but I am going to explain the physiology of this process in my own words to see if I can help anyone try to overcome this awful ailment.

Reflux is a complex problem that is primarily due to a compromised lower esophageal sphincter, or valve that connects the hollow esophagus to the stomach. To have stomach acid cause irritation in the esophagus we somehow need to have this valve separating the two hollow tubes compromised.

Lower Esophageal Sphincter (LES)

Lower Esophageal Sphincter (LES)

This is where Chris and I disagree with most mainstream medicine. Obviously this is my opinion and if you have serious problems with GERD you should speak with your physician.

We believe that an increase in the intra-abdominal pressure fueled by that multi-factorial issue is to blame. The factors contributing to this compromised lower esophageal sphincter are an increase in the pH in the stomach that leads to a decreased acidity of the chyme (food bolus) that passes from your stomach to your small intestine. This reduction in acidity of the food bolus causes a less than optimal release of the enzymes from the pancreas that is responsible for breakdown of carbohydrates. With decreased breakdown of carbohydrates this leads to 1. mal-digested carbohydrates that are now backing up into the stomach and leading to an increased intra-abdominal pressure and hence a more compromised valve/lower esophageal sphincter. This reduction in the pH or acidity of the stomach also leads to 2. growth of non-native bacteria in the stomach. These bacteria will feed off the mal-digested carbohydrates and produce gas. These two issues caused by lower pH contribute to the compromise of the lower esophageal sphincter.

If you are asking yourself right now, I have been taking antacids for years!! What can I do to fix my reflux? I will give you the same advice that I have given to my friends, I advocate stopping the antacids (a teaspoon of apple cider vinegar can be a great bridge), building up a good gut microbiota by diet if tolerable (probiotics can be of beneficial if unable to consume the probiotics in your food). My favorite recommendation is the active cultures found in Kombucha. If you tolerate yogurt well, than by all means have a bowl of unsweetened greek yogurt in the am. This will help replenish your gut microbiota. Any dish or item with active cultures can help with this. These recommendations coupled with a reduction in the refined carbohydrates (stay gluten-free, cut out added sugar) in your diet will definitely help with curing the symptoms of GERD!!

Check back next week for more ways to make changes that last!

Diet soda is okay though…Right?

In truth diet soda is the opposite of okay and may be more detrimental to your body than regular soda. This raises the most common question…how can diet soda be detrimental if it is “zero calorie” and/or “fat free?” These phrases are an example of a food/beverage industry that has very misleading national labels to the average consumer. Society has engrained in us that the more “zeros” on a nutritional label, the better. This could not be farther from the truth and the more you learn about real whole foods, the more you will understand. But let’s stay focused on the current topic.

First and foremost, diet soda leads to a state of mind that makes people believe that they are saving a little on the soda, so they can splurge more on other sweet indulgences. Wrong. Sweeteners are sweeteners whether in the form of sugar, aspartame, agave nectar, fructose, Splenda and the list goes on. There is no doubt that regardless of form or claim, these sweeteners are going to provoke a reaction from your body when consumed. There is evidence that suggests consuming artificial sweeteners only perpetuates the need to intake sugar. (1,2) Regardless of calories or effect on glucose levels, your taste buds are telling the brain you are consuming something sweet. The desire for sweet is not being eliminated but rather reinforced. There is a correlation that exists between a person’s regular intake of a flavor and the desired intensity or frequency to have that flavor (2). What America needs to do is eliminate the desire for “sweet” on a regular basis. It was never meant to be a daily staple in our diets!

So we can all agree that this is the extreme case, but what are artificial sweeteners doing to us that can have a short-term impact on our health? There is no question that diet sodas are causing an increase in the obesity rate. There have been numerous studies that have discredited strictly substituting artificial sweeteners for normal sweeteners such as cane sugar had no effect on weight loss (2). If anything these calories are negligible (empty-calories) and will never satisfy a nutritional need thus typically leading to the consumption of additional empty calories. I’ll toast some Doritos to that Diet Coke! This raises a question. Is the introduction of artificial sweeteners having a major influence on the current obesity epidemic in the United States? Let’s take a look at the graph below.

Artificial Sweetner Graph

We can definitely see some correlation here. Artificial sweeteners became very popular in our diets towards the late 90’s and hasn’t looked back ever since. Neither has our BMI (body-mass index aka how much fat is on our bodies). A question I always like to ask is what is my food doing for me? I strive to answer this every time I eat or drink. This is not to insinuate we need to be fleshy robots that purely eat to fuel. There is always room for exceptions, but a good habit to form is questioning what the food or drink you are consuming is doing for you. Green tea for sure. Diet Soda, not a thing…

The cause for concern over artificial sweeteners is only growing and I haven’t even gotten into the detrimental effects that they can on our overall health. Hold tight though for more to come!

Pepsi and Coca-Cola killing us slowly?


I know that when I was growing up I had my friend’s houses that I always wanted to go to because the fridge was stocked with Pepsi, Coke, Mountain Dew, Orange soda, and/or Root Beer. I distinctly remember going back and forth from house to house on our sugar highs!  Why did I enjoy these houses more than the others?  The reason is simple, as a child you want to consume whatever tastes the best, and when the Smith’s were only serving us water, what kid in their right mind wants to go there?!?  Sugar tastes amazing and we all wanted to consume as much as we could. Now as adults, we all still wish we could consume sugar all day and every day, but is this added sugar actually killing us?

If soda was not liquid this is what it would look like!

Soda in solid form. (Above)

In our society it is difficult to consume any products that don’t have any added sugar. Go into a grocery store or even your own pantry and look at the ingredients on everyday products. I sometimes find the word “sugar”, but a majority of the time I will find some common added sweeteners such as sucralose, high fructose corn syrup, acesulfame potassium, aspartame (which has more issues that I will touch on in another blog), saccharin, sugar alcohols (sorbitol, xylitol, mannitol) and newly added neotame.  Take a look for yourself!

Why do we enjoy these sweeteners? We enjoy them for the same reason a child enjoys them, they taste great! However these added sugars are giving us empty calories.  What are empty calories? “Empty calories” are calories that after consuming them, give us little to no nutritional benefit. The major problem with this “empty calorie” consumption is that our bodies yearn for nutrients. If our bodies don’t obtain these nutrients they remain hungry. Our hunger will not be satiated until our body has met these nutritional demands. Drinking Pepsi, Coke and any other sweetened beverages will supply the body with plenty of empty calories, but also leave plenty of room for additional calories to be consumed. These empty calories will supply us with either quick energy stores, or they will be stored in our bodies as fat.

Why am I asking the question about Pepsi and Coca Cola killing us? Recent studies have shown a direct link of added sugars to cardiovascular disease. (1) I am not saying we need to cut out sugar all together. I am recommending that we try to keep added sugar out of our food as much as we can.  The American Heart Association (AHA) recommends between 6 and 9 teaspoons of sugar in female and males diets respectively.  As a country we average 22 teaspoons of sugar a day (2).

(Left) 8.5 Tablespoons of sugar.  The amount of sugar in one 12 ounce cola. (Right)

(Left) 8.5 Teaspoons of sugar. The amount of sugar in one 12 ounce cola. (Right)

I find that a good way to accomplish reducing our added sugars is by cooking meals from scratch or getting fresh vegetables instead of canned ones, even frozen vegetables are better for us. The more processed our food is the more likely our food has added sugar in it. If we continue to consume this added sugar we will continue to see heart disease rise. We will continue to see our waistline as a whole increase. We will continue to fight the epidemic of obesity and diabetes, which go hand in hand. These chronic diseases are now starting to creep into our youth and as individuals we can stop this if we start by eating less added sugar.

Follow this blog for weekly lifestyle modifications!!


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