Fitness & Nutrition Priorities: Where do they Fall?

If I asked you to tell me what the most important thing in your life was, what would you say?  Most likely your answer would involve your spouse, kids, family or job.  How many of you would say fitness or nutrition is the most important thing in your life?  Fitness and nutrition is important to the vast majority of us, but how many of us truly make fitness and/or nutrition one of our top priorities?  How many of you could also rate yourself as your top priority?  You know what we call people who always make himself or herself their own top priority?  Selfish!  There is a certain stigma to putting your own needs ahead of others.  Yet, putting ourselves first is exactly what we need to do when it comes to our own fitness and nutrition. 

Where do Fitness and Nutrition fall on your everyday priority list?

Everyday we have tens and even hundreds of things that are required of us to just make it through the day.  If we were to create an itemized list of some of the activities we perform on a daily basis and the importance of each of those activities it might look something like the list shown below.  The top of the list (starting at #1) would be the most important item and the importance of each item decreases as the list continues until you reach the bottom of the list and the least important items.  Note: Importance does not always equal time consumption.  Some of the least important activities (i.e., watching TV) are the most time consuming for some people, so don’t just order your list by the amount of time you spend on any one given activity.

1. kids
2. family
3. work
4. driving
5. grocery shopping
6. watching television
7. watching sporting events
8. watching movies
9. Internet surfing
10. Facebook
11. Twitter
12. Instagram
13. walking dog
14. laundry
15. eating out/entertainment
16. cleaning house
17. exercising
18. shopping
19. reading
20. video games
21. reading blogs
22. yard work
23. cooking
24. dentist appointments

In this list, exercise is ranked 16th and cooking comes in at 23rd.  Fitness and proper nutrition are not required to make it through the day and are therefore oftentimes put on the backburner while we put out our other daily fires.  Before long fitness and proper nutrition become “long term goals” rather than daily necessities.  Many of you have to get yourself ready for the day, get the kids ready for the day, take the kids to school, pick them up from school, take them to extracurricular activities, help with homework, and make dinner...........all this without even mentioning outside work responsibilities!  Fitness and good nutrition are not required to get through the day and is thus continually moved down to the bottom of our “to do lists”.  Now I realize that some sort of nutrition is necessary to get through the day because we all have to eat, but for many of us making it the best possible nutrition IS NOT a top priority.

Most of us want to be thin and fit, but as stated above we oftentimes do not prioritize fitness and nutrition high enough on our “to do lists” to achieve the results we desire.  When our fitness and nutrition priorities and time spent exercising and meal planning do not match the expectations we have set for meeting our ideal body weight and fitness level, big-time frustration ensues because goals are not being met.  On the other hand, some individuals make fitness and nutrition his/her top priorities and achieve great fitness and nutrition results, but other parts of their lives may suffer.  We only have so much time and capital to put towards daily tasks and putting exercise and nutrition first and second may come at the expense of friends, family, work, sleep, and other fulfilling activities such as reading.  It is a delicate balance, but surely one that we can achieve with some careful thought.

As a nutrition professional, I often hear about how mothers, fathers, and other caregivers put the needs of others ahead of, and at the expense of, their own needs.  I am sure you have all heard the saying that “one must love oneself before loving another”.  One must also take care of his/her fitness and nutrition needs before being able to help others.  Fitness and nutrition are basic needs, not extravagances for the sake of pleasure.  Watching out for your own basic fitness and nutrition needs does not have to involve time consuming marathon training, intense Crossfit workouts, or eating gourmet home cooked meals.  Rather, it means incorporating physical activity into your daily lives and eating balanced meals at home, work, and on the run.  Once you have met your own basic fitness and nutrition needs, you will be better prepared and equipped to help those around you.  

If you haven’t already done so, I encourage you to make a priority list to see where exercise and nutrition fall for you.  I’m not asking you to put nutrition and exercise first and second on your list, but for most of us it wouldn’t hurt to be aware of where they do fall and to try to move them up a few spots!

Todd M. Weber, PhD, MS, RD

Identify Obstacles, Not Excuses

As a society, we like to make excuses.  We have reasons why we don’t get certain things done or why we don’t accomplish certain tasks.  We are a society of “well buts”.  Well, I would have gotten that done, but.....................  To oppose the “well, but” attitude, the health and fitness industry oftentimes forces the mantra of “NO EXCUSES” upon us.  To them it does not matter what is going on in your life, nutrition and fitness must be your number one priority.  Although this type of no excuses philosophy does have merit for some individuals and some people do respond to it, the no excuses mantra is a bit too harsh and militaristic for my liking.  The no excuses mantra fails to consider the complexities of an individual’s life.  For example, how many children do you have, what are their ages, what are their activities/requirements, what type of profession are you in, how many hours do you work, what type of culinary skills do you possess, what kind of nutrition and exercise knowledge do you have, what is your stress level...........the list goes on and on.  Instead of ignoring the complexities of an individual’s life by perpetuating the “no excuses” mantra, why don’t we take a slightly different viewpoint?  Let’s identify obstacles, not excuses!

Identify Obstacles, Not Excuses:  when obstacles inevitably come up, work on finding solutions!

By definition, excuses are an “attempt to lessen the blame attaching to (a fault or offense)” or to “seek to defend or justify”.  The implications of an excuse is that it is your fault and you are to blame.  When people are fat or overweight, they tend to feel really ashamed of themselves.  People will often tell me that “I know I am fat” or “I know what I should be doing, I’m just not doing it” and “I need to be better”.  There is a tremendous amount of guilt associated with being overweight or obese and there SHOULD NOT BE.  Being overweight or obese IS NOT A REFLECTION OF YOUR CHARACTER.  It may be a reflection of what you have been doing, but it is by no means who you are as an individual.  The blame that society places on overweight and obese individuals (if they would just eat less or move around more) and the guilt that overweight and obese individuals feel (I am weak willed and ashamed of my weight) leads us down the road of excuses and justifications.  No one wants to be to blame for something they feel like they are not in control of.  It is only natural to come up with an excuse. 

As a society, we have come up with a number of different reasons that we can blame for our condition without implicating ourselves.  There are numerous theories and proposed causes of weight gain including highly processed foods, sugar sweetened beverages, the fast food industry, reduced fat oxidation, menopause, hypothyroid, slow metabolism, poor genetics, endocrine disrupting chemicals in our food supply and environments, medications, injuries, disabilities, pain, food addiction, a lack of time, our built environments, stress, cortisol, leptin, insulin, antibiotics, gut microbiota, low birth weight, and so on.  On some level, all of these factors do play a role in weight gain; however, when they are viewed as excuses, they promote victimization and do not help us live happier, more fulfilled lives.

Instead of the “no excuses” mantra of many health professionals, I would like to reframe the issue as identifying obstacles, not excuses.  By identifying obstacles (and not excuses) we remove the victimization, stop focusing on what we cannot control, and identify the obstacles that we can control.  These obstacles are definitely real and they definitely contribute to whether we lose or gain weight; however, by identifying and characterizing these items as obstacles and not excuses we know what we are up against and we can come up with a gameplan for defeating them.  If you see a road closed sign, do you turn around, give up, and go home, or do you find an alternative route to get to your destination?  We are faced with many obstacles in our lives and some people have many more obstacles and a steeper, more daunting challenge to get to the top than others.  That is a biological fact.  But you must have the courage, confidence, and stamina to create a path, stay on course, and when you get knocked off course and need to adjust, improvise and continue on your way. 

The “no excuses” philosophy of nutritionists and trainers is good intentioned but fails to consider the complexities of 21st century life.  Identifying obstacles, rather than excuses, removes the blame from the individual and thereby releases them to focus on what they can control.  Losing weight is hard enough without having your doctor, nutritionist or personal trainer reinforce the blame you are feeling.  Once we can all accept (health professionals and clients alike) that there is no room for the blame game, shame, or excuses we will all be better off.  Identifying obstacles, problem solving, and personal empowerment are the keys to weight loss.  The next time you find that you are struggling, identify the obstacle, not the excuse, create a gameplan, and crush that obstacle!  I know you can.

Todd M. Weber, PhD, MS, RD

There is a Diet Book for Everything!

There is a diet book for everything and to some degree every diet book is based on exactly the same principles (more on this below).  The pictures of the diet books shown below is by no means an exhaustive list, but represents the many types of diet books marketed today.  In general, these diet books fall into the following twenty categories (reading left to right on the picture):

1. Good Calories versus Bad Calories
   
2. Paleo/Primal Diets
   
3. Detox Diets
   
4. Brain Foods
   
5. Raw Foods
   
6. Juicing
   
7. Ultra Metabolism/Secret code
   
8. Food for your Body Type
   
9. Anti-Sugar
   
10. Blood Sugar/Glycemic Index
    
11. Anti-Grain
    
12. Anti-Fat (Omni Diet)
    
13. Optimal Nutrient Distribution
    
14. Calorie Counting
    
15. Specific Food Type
    
16. Big Food/Food Addiction
    
17. pH Based Diets
    
18. Fasting/Alternative Day Fasting
    
19. Superfoods
    
20. Another Country’s superior food patterns (not pictured here)

There is a diet book for everything imaginable, yet they are all essentially the same.

These 20 seemingly different diet types can be summarized as having two primary properties: 1) they attempt to maximize micronutrient density (high amounts of vitamins and minerals) and/or 2) reduce caloric intake.  Micronutrient density has ZERO impact on weight loss;  however, in general, if you consume foods with high micronutrient densities (fruits and vegetables) you will be reducing your caloric intake.  For example: there is nothing inherently special about the “juicing diet” that will automatically lead to weight loss.  For those of you unaccustomed to “juicing” it involves placing fruits and vegetables into a blender and blending these solid foods down to a liquid and drinking said liquid.  Juicing proponents claim that “juicing” is beneficial for weight loss due to the associated high intake of vitamins and minerals found in the fruits and vegetables you are consuming, when in reality, weight loss is almost 100% due to a reduction in the number of calories you are consuming, not a magical property of micronutrients.

When you stop and think about it, how many calories can you possibly consume if you were to only eat fruits and vegetables (which is what many of these diets tell you to do in one way or another)?  If you were to eat an entire 32 ounce bag of baby carrots you would be consuming 1320% of your daily value of vitamin A, 110% of your daily value of vitamin C, 88% of your daily value for dietary fiber, and 88% of your daily value for potassium.  You would also be consuming 385 calories or to put it another way, 135 fewer calories than a McDonald’s Quarter Pounder with cheese (which by the way is only 7 ounces by weight with a bun compared to 32 ounces of carrots).  If you follow the juicing diet strictly, it is virtually impossible to eat enough calories to maintain your body weight.  Negative caloric intake, not micronutrient content is the key to losing weight while juicing and this theme holds true for most fad diets.  Maintaining this weight loss is another story and is dependent upon long term dietary adherence, something that is nearly impossible for most fad diets.  Dietary adherence is another complicated issue that we will save for another day.

If you are an avid reader of my content (which I hope you are) you will notice what you may perceive to be a tired theme for my articles: energy balance.  Provided you are in a negative energy balance, it does not matter what type of diet you choose to eat you will lose weight.  Low carbohydrate, high-carbohydrate, low-fat, high-fat, high-protein, or any of the 20 diet types listed above, provided you are in a negative energy balance you will lose weight.  I realize there are many biological, psychological, and social factors that affect what you eat, when you eat, how much you eat, and why you eat.  These factors definitely play a role in energy balance, but energy balance is still the ultimate guide and the ultimate decider of whether you lose weight or gain weight. 

As long as there is a demand for diet books, publishers will continue printing them and making money from them.  I do not know what the next diet craze will be.  Maybe it will be the “aquatic diet” where we only eat food from the oceans, maybe it will be the “small game diet” where we only eat squirrels and rabbits and vegetation they typically eat, or maybe we will eat the “tree diet” only consuming foods that grow on trees such as almonds and various fruits.  Whatever that diet may be, know that it is only going to be another passing fad.  Energy balance is here to stay!

Todd M. Weber, PhD, MS, RD

The Building Blocks of Your Nutrition and Health

This week Energy Balance Nutrition Consulting (EBNC) is officially releasing its new logo.  The EBNC building blocks represent one of the key principles of our company: simplicity. 

Energy Balance Nutrition Consulting (EBNC) Logo: The Building Blocks of Your Nutrition and Health

Wooden building blocks are among the simplest and earliest toys for infants and toddlers to use to help them explore their environments.  No directions are required, there are no jagged edges, every piece is interchangeable, you do not have to know how to use them.  No special tools or knowledge is required.  There is no right or wrong way to build and explore.  The blocks are intuitive and simple.  The blocks also represent the first step in being able to build something bigger and better.  Once you master the building blocks you can move on to something more fun like Legos!

Legos are "advanced' building blocks.

The nutrition principles at EBNC are like building blocks: extremely simple.  The EBNC principles beg you to go back to the basics and back to the fundamentals of nutrition.  Some have suggested that the nutrition concepts put forth by EBNC are too simple, that people already know what I am trying to teach them.  Isn’t that part of the point?  Everyone claims they know how to eat, but if everyone already knows how to eat then why do we have so many self-help diet books (not to mention that they are on the best-sellers list!), why are ~70% of us overweight or obese, and why are so many of us frustrated by the way we feel about our bodies?  I believe it is because we are too concerned with the trees rather than the forest, that we are paralyzed by micromanaging our nutrition rather than focusing on the big picture, that we are distracted by the cacophony of information marketed and advertised to us rather than the important items, the fundamentals and basics of nutrition: energy balance!  You cannot build a house without first laying the proper foundation.  If you can master energy balance (the building blocks) the rest of your nutrition will be easy to get right.

Todd M. Weber, PhD, MS, RD

What are Your Nutrition Rules?

I do not “diet”, but I do have a number of self-prescribed nutrition rules that help me to maintain my body weight and prevent any unwanted pounds.  Establishing your own set of nutrition rules are an important part of both losing and maintaining body weight.  In addition to my healthy nutrition rules I also have some other nutritional tendencies that could be viewed as “unhealthy behaviors”.  The key is that the healthy and unhealthy habits even each other out (or tend to lean towards the healthy side).  The point is that you need to set your own personal set of nutrition rules and pick and choose the “unhealthy behaviors” you wish to engage in to create the perfect balance that will work for you in the long run.

Orange juice (6 ounces maximum), diet soda, and light yogurt are examples of my personal nutrition rules.

Here is a sampling of some of my traditional nutrition rules.  I try to follow these all the time – but we all know, no one is perfect!  Keep in mind these work for me and may not be right for you, everyone is different!

• I never drink regular sodas (only diet).
• I eat brats on smaller hot dog buns rather than larger brat buns to conserve calories.
• I very rarely buy donuts because I cannot refrain from eating them all.
• I only buy hamburger meat that is > 90% lean.
• I drink skim milk, not 1%, 2%, or whole milk.
• I buy light yogurt, not full sugar, regular yogurt.
• When drinking orange juice, I limit myself to 6 ounces maximum.
• I usually do not buy reduced fat products unless they save me calories.  For example, I do not see the point in buying reduced fat peanut butter since it has the same number of calories as regular peanut butter (and does not taste as good).
•  I usually eat out less than once/wk.
• When eating out, I consciously do not finish my entire plate of food.
• I eat whole grains instead of refined grains.
• I eat small servings, but allow myself seconds (or thirds) if I am still hungry.
• I do not eat many baked goods (donuts, muffins, cake) even though I love them.
• I seldom use oil to prepare my food.
• I grill year round.
• I eat breakfast everyday.

Some other nutrition rules I have heard from friends:

• Use mustard instead of mayo/miracle whip on sandwiches you make at home.
• Substitute other sides for fries when eating out.
• Don’t add bacon to burgers or other menu items unless it REALLY adds to the flavor of the dish.
• Drink water or unsweetened ice tea instead of soda.

Bacon is an example of something I "occasionally" fit into my diet.

A sampling of my ‘unhealthy’ behaviors are the following:

• I drink diet sodas.
• I do not always eat balanced meals (not every meal has fruits, veggies, etc).
• I love Doritos.
• I drink a fair amount of regular beer and liquor.
• I like bagels and cream cheese.
• I do not eat the recommended amount of fruits, vegetables, or nuts.  I may go days without eating any fruit.
• I eat more red meat than white meat.
• I eat more than a fair amount of light Ranch dressing.
• I like frozen pizzas.
• When I eat out, I do not make an attempt to make a healthy choice.
• The only way I eat raw veggies is with regular, full fat dip.
• I only eat fish or seafood once every two weeks (I wish this were not the case).
• I do not eat enough “healthy” fats and eat too many “bad” fats.
• I really, really like bacon.
• I eat regular brats instead of turkey or soy brats because they taste better.
• I also eat regular chips instead of baked chips for the same reason.
• I have no problem eating after 8:00 pm.

Overall, I feel like I have more healthy behaviors than unhealthy behaviors but it is always a bit of a struggle.  I would never tell you to follow “Todd’s golden eating habits of success” because there are no golden eating habits of success.  Nobody’s diet is perfect.  Well, there may be a few of you out there, but the point is that you don’t have to be perfect.  However, you do need to negotiate some nutrition rules for your own diet; rules that you have built for yourself and that you are comfortable with.  No one can tell you exactly what to eat, when to eat, where to eat, and how to eat for every given situation.  But, if you set some ground rules for yourself, while at the same time allowing yourself some dietary freedom, it increases your chances for success.  I encourage you to find out what works for you.  Sometimes it is difficult to decipher good habits from bad habits (many can go on both lists) and you may need some help from a friend or two.  If you’d like some help from me, by all means, contact me.  Good luck in finding and establishing your dietary rules for success!

Todd M. Weber, PhD, MS, RD

Why 99.999% of the Nutrition and Fitness Articles in the Media are Incorrect

These days the number of nutrition and fitness related articles in print, online, and on television is booming and there is definitely no shortage of opinions.  In the spirit of unfounded opinions, I have an opinion for you: 99.999% of the nutrition and fitness information you view online, read in magazines, or see on television is factually incorrect.  Here is why: 

1) News must be headline grabbing.  The best headlines and news stories are often sensationalized and/or controversial: recent reports have come out stating that strenuous running increases your risk of death, sugar is as addictive as cocaine and heroin, and consuming wheat may cause you to develop Alzheimer’s disease.  The statement that “99.999% of nutrition and fitness related material is factually incorrect” is a little bit of an exaggeration.  Really only 99.9% of this information is factually incorrect...of course I’m kidding, but saying that 99.999% of information is incorrect is much more attention grabbing than being more conservative and saying that only 80% is factually incorrect.

99.999% of Nutrition & Fitness Articles in the Media are Factually Incorrect.

2) Editors are the gatekeepers of content.  Ultimately the editor’s job security in today’s day and age is based on page clicks and depends upon what the readers are interested in and thirsty for.  There is no appetite for mundane facts: simply stating that “diet and exercise are the keys to weight loss success and/or weight maintenance” is probably going to get no play.  If, on the other hand, you report that “Big Food has taken advantage of our hunter-gatherer physiology to get us addicted to food and fatten us up,” you might be interested in reading further.  Oftentimes, but not always, the content written in the media is completely incongruent with the scientific consensus (please see the Forbes article on high fructose corn syrup and the NY Times article on autism).  Furthermore, if the authors do not know the editor, or do not have a connection to the publication, then how do they get their content published or their voice to be heard?  You could have the most compelling story ever, but it may not matter because the editor is the gatekeeper of content and may squash your story rather than letting the facts get out.

Editors are the gatekeepers of content.

By restricting content, the editor is simply doing his/her job of looking out for the best interests of his/her company.  Every health & wellness company has a nutrition agenda or a fitness policy to promote.  If the facts in a particular article don’t jive with this policy it is far easier to sweep it under the rug than to engage in a full discussion of the topic, let alone think about changing that policy altogether.

3) People writing about exercise and fitness my not be qualified to do so.  I recently saw a job posting for a health content writer for a corporate wellness company.  One would think that to be a health content writer for a wellness program you may have experience in nursing, nutrition, exercise science, psychology, public health or the like.  What you may not expect to see as a preferred qualification is a bachelor’s degree in marketing, communication, or creative writing.  What this tells me is that we value the ability to sell and communicate more than we care about the quality of the actual product.  A dietetics major at Metro State University will take Anatomy and Physiology I and II, Organic Chemistry, Food Science, Human Nutrition, Nutrition and Weight Management, Nutrition Education and Counseling, Advanced Human Nutrition, and Medical Nutrition Therapy I and II (and that is not all).  On the other hand, a marketing major at Metro State University will take none of these courses.  Something does not quite add up here.  Would you hire a dietetics major to be in charge of marketing your business?  Now, I know that it would make no business sense to hire a well-educated person for a communication position no matter how much they know if they have no communication skills, but excluding those without formal education in this area is a public disservice.  You do not have to have a degree in communications to be a good communicator, just as these companies are assuming you do not need a degree in a health or nutrition related field to teach the public about their health and how they should manage it.

4) There is no peer review process in the fitness media.  In the science world, the peer review process is equivalent to a system of checks and balances.  When a scientist submits his/her manuscript to a journal, that manuscript is reviewed by a minimum of two experts within that particular field.  If the manuscript is weak, it may be rejected outright, if the manuscript is good, but in need of some clarifications and revisions, the reviewers will request these revisions to be made before reviewing the manuscript for a second time.  In general, at this point, one of three things may happen: 1) the reviewers may ask for further revisions, 2) the manuscript may be rejected, or 3) the manuscript may be accepted.  There are also occasions where the review process may take three, four, or even five cycles of revisions before the manuscript is accepted.  This is a far from perfect process, but it does help to prevent authors from making outlandish, non-evidenced based claims. 

In the fitness industry, there is no such system of checks and balances and authors are free to express their opinions, regardless of their factual value.  Just because you state something in a published article, it does not mean that your opinion is fact.  Moreover, just because you have credentials behind your name (MD, DO, PhD, whatever) does not mean that you are an expert on a certain topic.  There are many nutritionists and personal trainers that know WAY more about exercise and nutrition than many MDs do and vice versa.  I don’t really care what one rogue MD says about nutrition when the bulk of the evidence and the majority of the experts in that field disagree with him or her.  There are times when the rogue expert turns out to be correct, but until there is a consensus in the field, your rogue craziness is just your opinion, one that may gain you publicity and money, but is not necessarily fact, and should not be treated as so.

The peer-review process largely prevents unfounded opinions and weak research from being published, but this does not prevent the publication of conflicting results or mean that all scientists agree with all published works.  In the scientific community an additional system of peer evaluation for articles that are already published is the “point/counterpoint”.  In a point/counterpoint series, an author or group of authors will submit a letter to the editor (point) in response to a recently published article they feel may be incorrect or misleading to the readers of that publication.  The letter to the editor will contain a detailed point-by-point analysis of the original author’s work and will cite other scientific information to demonstrate why those points may be incorrect.  The author of the original article then gets a chance to defend himself/herself by writing a rebuttal (counterpoint) to the letter to the editor’s points (point).  This is a fantastic way for each author(s) to communicate his/her respective ideas on a particular issue.  The unbiased reader of the point/counterpoint discussion is fully exposed to both sides of the story and is then able to draw his/her own conclusions based on all the facts.  You would be surprised at how many times your opinion changes after reading the letter to the editor!  Together this system of checks and balances (peer-review and point/counterpoint) makes certain that the author must have his/her facts straight lest they be embarrassed and lose credibility within the field.

5) Information is oversimplified for the reader.  Information is oversimplified for the lay reader and this is oftentimes not due to the reader’s comprehension level or assumed limited knowledge of a specific topic.  In addition, when an article is written in print there are space limitations.  You are not allowed to “tell the complete story” because there simply is not enough page space.  If the article is online, this makes it easier, but now the article is at the mercy of our short attention spans (mine included).  The author may also be limited in his/her knowledge of the subject matter.  The author may be very familiar with the effects of antibiotics in meat production but has no clue about the physiology of hunger and satiety.  If the content is on television, there is a good chance that a 60-minute interview may be whittled down to a 2-minute clip.  Not exactly a comprehensive overview of the topic is being presented, and many times this actually leads to a story that, although started off with the correct intentions, has now been simplified down to one inaccurate or misleading conclusion.

It’s impossible to be an expert in all subject areas or to only have experts write nutrition and fitness articles.  However, the next time you are reading an article or watching a video on nutrition and fitness, take the advice they are offering with a grain of salt.  Try to take a step back and reflect on what is really best for you, not what the “experts” want you to believe.  I am not saying that 99.999% of articles out there are factually incorrect, but I wouldn’t argue with anyone who says 80% are flawed.

Todd M. Weber PhD, MS, RD

Added Sugar: Not All that Sweet?

The following article is a guest post written by one of EBNC's collaborators, Gina Battaglia, PhD.

In an effort to reduce the obesity epidemic in the United States and other westernized countries, the World Health Organization (WHO) has recently recommended added sugar intake to be less than 5 percent of total calorie intake—half of its previous recommendation.  According to the WHO, added sugar “may result in both reduced intake of foods containing more nutritionally adequate calories and an increase in total caloric intake, leading to an unhealthy diet, weight gain and increased risk of noncommunicable diseases.” (1)

As you probably know, added sugar—such as that in soda, baked goods, and even condiments like ketchup and barbeque sauce—is not really the healthiest thing you can eat.  However, lowering the WHO recommendations for sugar may not directly address the energy balance issue that is the central principle of weight loss and maintenance.  Simply put, you must burn more calories than you eat to lose weight.  Theoretically, you could eat nothing but cookies all day and lose weight if your total calorie intake is less than your energy expenditure (your nutrient intake would be woefully inadequate, but that’s a topic for another day).

Because calorie requirements to maintain or lose weight vary drastically between individuals and depend upon factors such as gender, activity level, and current body size; the amount of sugar “allowable” by these recent guidelines will vary accordingly.  Consider these four hypothetical individuals and their respective calorie requirements:

1) male construction worker trying to maintain weight (3700 kcal)

2) female office worker trying to lose weight (1800 kcal)

3) male nurse trying to lose weight (2400 kcal)

4) stay at home mom trying to maintain weight (2600 kcal)

And the amount of sugar each can eat based on these current guidelines:

1) male construction worker trying to maintain weight (3700 kcal*0.05 = 185 kcal sugar)

2) female office worker trying to lose weight (1800 kcal*0.05 = 90 kcal sugar)

3) male nurse trying to lose weight (2400 kcal*0.05 = 120 kcal sugar)

4) stay at home mom trying to maintain weight (2600 kcal*0.05 = 130 kcal sugar)

One 12-ounce can of Coca Cola contains 39 grams of sugar, which is equivalent to 10 sugar cubes or 4 Double Stuf Oreo cookies.

As illustrated in my hypothetical examples, for most individuals the amount of sugar allowed by WHO standards is less than one can of regular soda per day (a 12-oz can of Coca Cola contains 140 calories of sugar).  Considering that added sugar is also present in unlikely places such as pasta sauce and sweetened yogurt, you may find yourself surpassing the guidelines by lunchtime even if you don’t drink soda.  According to National Health and Nutrition Examination Survey (NHANES) data, sugar consumption in the U.S. makes up ~22.7% of the calories in our diets (2).  This added sugar is heavily blamed by many researchers as the culprit for the epidemic proportions of obesity in the U.S.  Some, such as pediatric endocrinologist Dr. Robert Lustig, from University of California, San Francisco, even compare the toxic and addictive nature of sugar to drugs like cocaine and heroin.  Others are quick to criticize the nearly century-old tradition of selling Girl Scout cookies, suggesting that it is capitalizing on Americans’ love for high-sugar treats.

But high-sugar foods and drinks have been around much longer than this recent rise in obesity rates, which have skyrocketed to include about one-third of the U.S. population.  The portion size increase of these sugary foods may be to blame, as the rise in obesity has increased in parallel with the increase in portion sizes (3).  For example, a commercially sold blueberry muffin contains about 500 calories—nearly 300 more than the average blueberry muffin sold just 20 years ago (4).  And if you’ve ever seen the Big Gulp soda cups at 7-Eleven, you probably know that soft drink portion sizes have gotten a little out of control. 

As the WHO panel of experts indicates, added sugar may make it harder to maintain that calorie deficit, especially if your calorie needs are low.  Many foods high in added sugar are calorie-dense and not satiating, so they can be easy to overdo.  One Oreo Double Stuf cookie has 70 calories, approximately the amount of calories in a medium-sized apple.  If we ignore the nutritional profile of the cookie vs. apple, eating one cookie, in theory, will have the same impact as an apple on your calorie budget.  However, many people will reach for a second (or third or fourth) cookie immediately after eating the first one, whereas they typically don’t reach for a second or third apple.  This tendency to overeat sugar contributes to the obesity epidemic, not sugar in and of itself.

One Double Stuf Oreo cookie contains the same number of calories as an entire apple (note: these items are not sized to scale).

The concept of eating sugar also introduces the psychological element.  Eating sugar releases the feel-good brain chemicals serotonin and dopamine (5) that increases the likelihood that you’ll eat four (or ten) cookies in one sitting because they taste good, not because you need calories for energy.  Sugar releases the brain chemicals and activates areas of the brain (including the orbitofrontal cortex, caudate nucleus, hippocampus, and insula) where drug cravings are activated, (6) thereby supporting the opinion of experts such as Lustig.  You probably identify with this “addiction” if you are the type of person who can’t stop at just one or two cookies, or you cut yourself several slivers of cake until one-quarter of the entire cake is gone.  These habits can pack on the calories quickly and make it more difficult to maintain a calorie deficit, especially if your calorie needs are similar to the female office worker (1800 kcal) trying to lose weight.  Some individuals find that eliminating sugar completely reduces cravings and makes it easier to maintain a calorie intake suitable for their physical activity level and weight goals. 

However, completely banning sugar from your diet can exert negative psychological effects in other people.  If you’re the person who falls victim to sugar binges three days after complete sugar deprivation, a reasonably-sized portion of added sugar—whether it be a couple of small cookies after dinner or a doughnut at breakfast on Sundays—may help you stick to a healthy eating regimen the majority of the time.  Furthermore, cutting out sugar alone won’t magically result in weight loss if you overcompensate with healthy foods.  A 2012 study found that people who were instructed to eat the amount of fruits and vegetables recommended by the Dietary Guidelines for Americans actually gained weight, presumably because they neglected to compensate for this additional calorie load by reducing intake elsewhere (7). This finding further emphasizes that eating the recommended amount of fruits and vegetables is not a magic bullet to weight loss unless it helps you maintain an overall calorie deficit.

The key to successful weight loss/maintenance is to be aware of your overall calorie needs and to strategize how sugar will fit into your diet.  If you’re the male construction worker, your relatively high energy requirements (3700 kcal) allow you to get away with eating a few extra cookies whereas the female office worker (1800 kcal) will have a tough time fitting these cookies into her diet.  On its own, the WHO guidelines on added sugar intake (reducing sugar intake to < 5% of total calories) will not stop the obesity epidemic.  What these guidelines can do is highlight the role that empty calories (sugar intake) plays in promoting a positive overall energy balance and weight gain.  It is highly unlikely that Americans will reduce their current sugar intake of 22% down to the recommended 5%.  Five percent is a little ambitious, 22% is clearly too high, can we please meet somewhere in the middle?  Let’s try to focus on increasing our healthy behaviors by decreasing sugar consumption.  If we don’t hit the magical 5% and only get to 14% at least we are taking a step in the right direction!

Gina Battaglia, PhD

References:

1. Draft Guideline: Sugars intake for adults and children http://www.who.int/nutrition/sugars_public_consultation/en/
2. Austin GL, Ogden LG, Hill JO. Trends in carbohydrate, fat, and protein intakes and association with energy intake in normal-weight, overweight, and obese individuals: 1971-2006. Am J Clin Nutr. Apr 2011;93(4):836-843.
3. Young LR, Nestle M. The contribution of expanding portion sizes to the US obesity epidemic. American journal of public health. Feb 2002;92(2):246-249.
4. National Heart, Lung, and Blood Institute: Serving Sizes and Portions http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/eat-right/distortion.htm
5. Fortuna JL. Sweet preference, sugar addiction and the familial history of alcohol dependence: shared neural pathways and genes. Journal of psychoactive drugs. Jun 2010;42(2):147-151.
6. Benton D. The plausibility of sugar addiction and its role in obesity and eating disorders. Clinical nutrition. Jun 2010;29(3):288-303.
7. Houchins JA, Burgess JR, Campbell WW, et al. Beverage vs. solid fruits and vegetables: effects on energy intake and body weight. Obesity. Sep 2012;20(9):1844-1850.

The Human Brain & the Senses

If the human brain was unable to “filter out” nonessential incoming sensory information, we would become paralyzed by indecision, our sensory systems overwhelmed, and our brain unable to translate this information into action.  In the world of yesteryear this indecision would have caused us to be eaten by a lion or starve to death.  Our brain has a tremendous ability to filter incoming signals and determine which information is important and which is not.  If you stop what you are doing right now and focus on all the noises and sensations around you, you may notice that your furnace is running, the birds are chirping, the sound of a passing car, or a conversation on the street.  From an evolutionary standpoint, our auditory system was initially designed to alert us to danger.  Because none of these background sounds represent any real danger our brains allow us to easily ignore them.  But what if we couldn’t help but pay attention to every passing sound?  Would that not be paralyzing?

In today’s day and age our nutrition senses are overwhelmed with information.  We are bombarded with so much information on a daily basis that we are unable to decipher which information is important and which is not.  Even the experts do not have a grasp (or offer a consensus) on what we ‘should’ and ‘should not’ be eating.  This week a new large-scale research study was published stating that there is no association between saturated fat intake and heart disease!  This new analysis is HUGE because it flies in the face of the dietary advice medical professionals have been prescribing for the past 25 years and really causes us to reevaluate what we should and should not be eating.  Eventually we will all figure out that a diet based on obtaining the correct macro and micro nutrient requirements is of very little value, that this type of diet is nothing more than auditory noise alerting us to a danger that is no longer present in today’s nutrient rich society.  In fact all of this noise is leading us to ignore the very real danger of consuming too many calories, expending too few calories, and upsetting our metabolic balance.

We have created a medical nutrition therapy to treat and prevent every single diagnosed and/or conceived disease that we may or may not have.  What if we have multiple conditions?  Then what?  How are we supposed to eat?  What rule cancels out what rule?  What food exacerbates our condition(s)?  What food helps it?  Are the foods additive or detrimental to our health?  Although dietary interventions for the management of some diseases have been well studied and it is clear that certain changes are necessary for successful management of the disease (e.g., type 2 diabetes), this is not the case across the board.  Don’t you wish that instead of trying to micromanage your diet for the prevention of every single possible disease there was a simple means of eating that could cover all of your bases without having to follow strict guidelines and rules?  Well, call me a genie because I just granted you your wish.  It’s called energy balance.  Why not follow one rule, calories in = calories out.  This rule applies to the prevention of heart disease, diabetes, and some types of cancer.  By living according to the energy balance principles, you will prevent weight gain and the development of obesity – one of the major risk factors for the development of many of the preventable diseases we see today.  Instead of micromanaging your diet and being paralyzed by multiple dietary rules and indecision, why not follow one simple relatively easy rule, energy balance, and have the freedom to eat what you want, when you want?  Enough is enough.  I’m fed up with micromanaging miniscule dietary manipulations.  Filter out the noise and make the change today!

Todd M. Weber, PhD, MS, RD