A MONTH WITHOUT SUGAR – A Critique.

This is the thing. As a dietitian, it is 100% our jobs to help guide clients through all the science and junk science around nutrition. It is our jobs to critically assess all dietary protocols so we can ascertain which ones are scientifically sound, and which ones are not, so we can then make suitable and responsible recommendations to our clients.

Our jobs are to educate, to inspire and to promote good health, and healthy habits.

Yes, we get lots of clients who complain about “how difficult it is to” do something, like cut out sugar, or grains, or dairy, or gluten – and whilst not all people NEED to cut these foods out, some do, and for those that need to, we need to be there to support them, not give them a way out of achieving optimal health.

Unfortunately, this dietitian chose to ignore sound science in an attempt to bro-down with complainers and rather than take on the role of educating and inspiring, she did exactly the opposite.

Here, I assess what her experiences were, bit by bit, quoting her verbatim, then providing a running commentary of my thoughts at every turn. Perhaps these views are just that of my own, perhaps they are shared by many who have read her article – but alas, here is what went through my head.

 

Day 1: While eating whole-wheat crackers with my super-healthy salad (feeling great about my food choices), I check out the crackers’ ingredients label. WTF? Cane sugar! Day 1=fail.

Eating whole-wheat crackers, this dietitian realised, mid-bite, that her cracker has cane sugar in it.

WTF – was her reaction.

WTF – was my reaction to her reaction.

Label reading is a valuable tool we teach to our clients, to help them identify nutritional composition and nutrient value and quality from looking at the ingredients. Since her entire goal over the 30 days was to cut out added sugar, I would have assumed that her first step would be to ensure that her food for those 30 days fit the criteria?

The other part of this that confused me was the need to include crackers with an otherwise “super healthy salad”? I don’t even know what “super-healthy” is supposed to mean – to me that means a salad that has an abundant amount of healthy fats and quality proteins – which, if you were to consume, you will realise that the crackers become quite redundant, both from a satiety perspective and from a nutrition perspective (crackers are REALLY NOT that nutritive!).

 

Day 2: My oatmeal definitely tastes a little bland without a scoop of brown sugar, so I head to the store and pick up some naturally sweet foods, such as dates, bananas, red grapes, and papaya. Problem solved.

Or so I thought… until lunchtime, when I add Sriracha to my rainbow grain bowl. Surprise—Sriracha has sugar. I guess I need to read EVERY single food label.

See, the problem I have with this is the fact that she genuinely believes that replacing brown sugar with a piece of fruit is the real answer to this problem. She completely fails to address the fact that her meal has a disproportionate amount of total carbohydrates and sugars to any of the other nutrients (pretty much zero protein or fats), and rather than using her 30 day challenge as a way to see how she could improve her diet, she uses this as a way to completely take the piss. She replaces one source of sugar with another. Whether she is deliberately misleading and misguiding her readers or not, I don’t know – but if she was out to actually educate, she will admit that adding brown sugar or fruits is not helping her increase her total protein in that meal, which is a key nutrient to help stabilise blood glucose levels and improve satiety. Sure, she didn’t need to swap the oats out for bacon and eggs (although I would, and I don’t know any of my clients who wouldn’t!) but she could have at LEAST tried to replace her brown sugar with nuts, seeds and add some natural full fat Greek yoghurt, no?

And then at lunch – again I have no idea if she is taking the piss (which is irresponsible in any case) or she is serious, but adding a sugary sauce to a high-carb meal which is extraordinarily void of proteins and fats AGAIN???

So hang on a sec – her usual diet would have consisted of this so far:

Breakfast – oatmeal with brown sugar

Lunch – rainbow grain salad with sriracha

So, let me ask: where exactly is the protein or the fats in this day?

Why are we not adding some chicken or some tuna to that salad with some avocado and olive oil (or, even better, some Primal Kitchen Mayonnaise)?

And again on the label reading – if you’re going to essentially eat all packaged foods, then it is a good idea to read your labels. The alternative is to opt for fresh produce without food labels.

 

Day 5: I’m getting the hang of this no-sugar thing, but I have a dilemma. Today I’m running the Brooklyn Half. Since this is my 10th half-marathon, I have a pretty standard fueling routine that consists of water for the first six to seven miles, followed by a sports drink for the second half of the race and a CLIF Shot Blok around mile eight or nine. In other words, my usual fueling plan is loaded with sugar because sugar (a.k.a. glucose) powers muscles during endurance activity.  Luckily, another dietitian (and marathoner) told me to try dates, stuffed with peanut butter and sprinkled with sea salt, for the right mix of sugar and sodium. Although I don’t like to try anything new on race day, I make an exception and opt for the dates instead of the Shot Bloks. They worked pretty well. The only problem was I got an annoying cramp around mile seven that wouldn’t go away, so I gave in and reached for a sports drink.

Look, this is the thing. When you have fuelled performance on glucose all your life and you are eating an exorbitant amount of carbs a day, sure, you will 100% struggle changing that up so close to a big race. However, there is something called fat-adaptation, where you can train your body to use fats as the primary fuel for endurance performance. Many marathon runners, triathletes and road cylists that I have worked with over the years have reported a significant improvement in performance, recovery and the lack of needing to constantly fuel during a race. This however is not an overnight feat. Usually we spend a few months helping them fat-adapt, but once they are adapted, they become unstoppable.

However, as a dietitian, we need to understand that there is more than one way to do anything, and for those who are metabolically flexible, fuelling with more carbs is 100% a way to go. However, for those who tend to struggle with central adiposity, insulin resistance or diabetes, fat-adaptation may just be the key for you.

 

Day 7: All in all, I feel like the first week was much harder than I anticipated. #fail. Between the added sugar in my crackers and Sriracha and my sports drink during the half-marathon, I’m beginning to understand how incredibly difficult it is to omit an entire ingredient from your diet.

No, just no. cutting out added sugars is really not that hard. There are a myriad of options and suitable ingredients to replace sugar with. And another thing – sugar isn’t just an ingredient. It is literally considered universally as a discretionary ingredient that we should be limiting or eliminating. However, when we have dietitians tossing in the towel to cutting out sugar, we can only imagine how many clients she will be inspiring to do the same, even if for them it is actually a valuable change to improve their overall health outcome. There is no morale or chance amongst the soldiers if the general has already succumbed to failure.

 

Day 12: I started this journey midweek, so day 12 is the beginning of my second weekend. Since I cook most of my meals during the week, I’m able to control what goes into my food. But on the weekends I enjoy an occasional brunch or dinner out.

Do you know how annoying it is to ask a waiter if there is any sugar in the food? They look at you like you are the worst person ever. Needless to say, I’m not able to tell if there is added sugar in some of the foods I don’t prepare myself, but I do try to stick to the foods I expect have less.

Do you also know how annoying it is to ask a waiter if there is gluten or nuts or egg if you had an allergy to any of those things? Sure, she isn’t allergic to sugar, but the sentiment is the same! And the answer is – it isn’t annoying at all!

When I am out, I ask for modifications all the time!

“Can I please get an extra egg with that, and no toast, please?”

We are usually met with a “yeah, sure!” and a massive smile. (Certainly not a look like I am the worst person ever….maybe she needs to find a new café!)

Cafes are so used to this now, they barely bat an eyelid. The reason this dietitian gets uncomfortable is because of her own fear – fear of being judged, fear of being ridiculed. But let me ask – could that be because she is judging and ridiculing those who are asking for these modifications at cafes? Probably so.

 

Day 15: Halfway there, and it’s finally starting to feel easier. I’ve become accustomed to sweetening my morning oatmeal with bananas and eating pre-workout snacks with natural sugar (dates and peanut butter, anyone?). I can definitely do this for two more weeks.

Good to hear…I guess? Although if I am to be completely honest, I don’t know how it feels easier- I mean, there has been no real reduction in total sugar intake, nor any improvement in protein or fat consumption – so honestly, I don’t know if the “easier” is a mental one (because she’s half way through her challenge of doom) more than it is a physical one, because I can’t see how she could actually be experiencing any metabolic improvements with her choices of “added sugar” replacements.

If she had actually replaced her added sugars with proteins and fats, she would likely, by this point, have an increased sense of fullness, meaning she won’t need snacks between meals, and improved mental clarity. This would have come about from not having such high glucose and insulin spikes and subsequent low dips throughout the day, keeping her energy levels, hunger levels and mental focus more consistent throughout the day.

If she had needed to lose any weight, she would have started to really notice it by this point too – not because of a reduction in calories, but by a reduction in insulin secretion.

 

Day 16:  Googles, “Does wine have added sugar in it?”
Can’t find a definitive answer.
Pours glass of wine.

Her Google: “Can’t find a definitive answer”

My Google: “100ml of wine has 0.6-0.8g of sugars depending on whether it is red or white”.

I think I like my Google better.

 

Day 17: Status quo. Omitting added sugar from my diet has made my already healthy diet even healthier. I have no choice but to eat plenty of fresh fruits, veggies, and whole grains. But tomorrow I’m traveling to California for vacation. My boyfriend looks at me and says, “You aren’t going to do this on our trip, are you?” I think he doesn’t want to listen to me complain.

Ok well it really depends on your perspective of what a healthy diet is and what you consider “healthier”.

Sure, if you are replacing added sugars with fruits, then yes, nutrient wise, it is 100% denser. But if you are looking at it from a is-this-going-to-help-her-sick-clients-feel-better sort of way, the answer is “no”. The problem here is not “which source of sugar is better” it is the fact that we need to start assessing the diet for whether or not it is nutritionally complete! Does this diet include adequate amounts of quality protein and fats? Does the diet have a rich and varied amount of vegetables?

And not going to lie – if I was on a journey to improve my health, and my partner looks at me and essentially says “stop being healthy so I can feel good about eating crap with you overseas” I would not be with my partner today.

Instead, partners are meant to be supportive and understanding – my partner has Crohn’s disease, and after we changed his dietary protocol to reduce inflammation and heal his gut, he (after 17 years of being on fortnightly injections of Humira, and after 2 bowel resections) is now, for the last 12 months and counting, medication and inflammation free. Never once did I give him shit for not having a glass of wine with me, or not eating grains, or sugar. When he over did the cheese and got a mild flare, he subsequently cut dairy out and not once have I complained to him about doing that. His nutritional markers are all perfect. His bone density is perfect. His health is perfect. And the unexpected side effect? He’s lost 22kg and has amazing energy levels and mental clarity.

So the moral of this story? Support your partner, and FFS, support your patients! They don’t come to you for you to tell them how impossible it is to do something – what they want is for you to encourage them and always have their overall long term health as your best interest.

Day 23: All self-control goes out the window when I’m tired. We arrived in California last night, and I’m super jet-lagged. I need an afternoon cookie to make me feel better. And let me tell you… it worked.

Hate to break it to you guys – it’s not self control – it is hormonal. After a long flight, your body is under more stress than usual. Funnily enough it is the cortisol spike that has you wanting sugar – not a lack of self control 😉

A much wiser choice would be some cheese or salted macadamias that can help provide energy without the sugar spike.

And instead of a coffee, water at this point would have been a much wiser choice for hydration – but hey, we all love a good coffee!

 

Conclusion

1- This confirmed my right to roll my eyes at diets that eliminate entire food groups, because it’s nearly impossible to sustain that change for the long term. I’m a dietitian, and I wasn’t able to do it for longer than a week without a slipup. And the problem with slipups is they breed feelings of discouragement and kill your motivation to continue.

First – sugar is NOT a food group.

Being a dietitian doesn’t make you more intelligent, and clearly, not more resilient. However, cutting sugar properly would have stimulated a metabolic shift, which would have made keeping it up long term a walk in the park. The key is not to never have anything with sugar in it (added or natural), but it is about understanding fully the role sugar plays in disease and inflammation and being able to make the right recommendations around it.

2- To completely understand what you are eating, you must really dig into food labels. Sugar has many aliases, and it hides in foods you wouldn’t normally consider, such as tomato sauce, barbecue sauce, pickled veggies, and multigrain crackers. Look for ingredients such as high-fructose corn syrup, molasses, dextrose, glucose, malt syrup, corn syrup, or caramel on the label, and run from them if you’re avoiding added sugar.

Sure- and that is our jobs as dietitians to not only highlight this point, but educate on it, so our clients can walk away confident they know what they are looking for.

This really shouldn’t be a deal breaker.

3- It’s nearly impossible to know what’s in food you don’t cook, so be aware when you’re going out to eat. And good luck asking your waiter if they use sugar in their marinara sauce.

Here’s an idea – keep your choices as low in added sugars and total carb as possible, eat at home as often as possible – but otherwise, enjoy yourself when you are out for a meal! Life long healthy changes are not made or broken in a single meal out, but rather in our mindset, and our long term choices and behaviours.

4- Cutting out one food group made me crave it more. By the end of the 30 (or, well, 26) days, I was dying to eat a piece of chocolate (or a cone filled with coffee).

Again – sugar is NOT a food group and cutting it out was not making you crave it more lol – the truth is she really didn’t cut it out at all! Sure, no “added” sugar, but when your diet is mostly carbs and natural sugars, once it breaks down in your blood stream, physiologically, your body is not going to go “hmmm, this glucose came from a rainbow grain bowl…let’s metabolise this differently to that glucose she accidentally consumed from the sriracha”.

If she had actually reduced total carb (and limited to just a small amount of fruit and starchy veg), and subsequently increased her protein (which her protein count was next to ZERO before dinner time) and her healthy fats, her experiences with cravings would have played out much different to the way they did.

5- Rather than making incredibly difficult changes to your diet, it’s much easier to make small changes, like adding more fruits and veggies to what you already eat. A bunch of small changes add up to one big change over time.

If I had a client sitting in front of me with 19.2mmol/L fasting blood glucose – I would not be making any small changes – because by the time we made all these small changes, my patient would have ended up with no legs and on dialysis. Patient care will always be my number one, and part of that includes recommending what works, and what is right – not just what is “easy”. The other part is encouraging them, instead of deflating their hopes by smacking them over the head with your own failed attempt at something otherwise so simple.

Feng-Yuan Liu

Feng-Yuan Liu is the Founder, CEO and Senior Dietitian of Metro Dietetics.