You see lots of products that say “no added sugar” and apparently that means they’re better for you, right? Not really. I’m here to tell you that added sugar or sugar that’s naturally in the food is the same.
What does it mean when the label reads “no added sugar”?
I’m not speaking about sugar alcohols and artificial sweeteners – those are very different from sugar. If you have sugar that naturally occurs in food like fruit, honey, agave, and things like that, it still gets digested and absorbed as sugar. I’m here to say that added sugar is something you want to avoid but there also may be lots of sugar lurking in the foods that say “no sugar added,” so be careful. I always tell my patients to look at the nutrition facts label. Look at total carbohydrates because they will include the added sugars and natural sugars in that number. That number is in grams.
What about honey?
My patients will come in and say, “I know I can’t have sugar, but can I have honey?” Honey is sweet. Naturally occurring things that are sweet generally have some sort of sugar in them. If you’re trying to get rid of all the sugar from your diet you wouldn’t want to have honey. If you wanted to have a little bit, moderate the amount of sugar and starch you eat. Not everyone has to do a strict keto diet, but you still want to be mindful and moderate the amount of honey you consume because there is still sugar there. If you’re doing a strict keto diet, then honey or agave would not be allowed because they contain sugar. Even though they’re natural sugar, they still have the same effect on the bloodstream – on your blood sugar level. That’s really the key.
What is insulin?
I’ve been teaching low-carb and nutrition for over 20 years now at Duke University and I’m a past president of the Obesity Medicine Association, so I know there are lots of different ways to be healthy. There are lots of ways to lose weight and be healthy while you’re losing weight. It seems to me that the common denominator of all the approaches that we have that are effective and healthy is to keep the sugar and the insulin effect from the food you eat as low as you can. You really want to eat to keep the insulin levels low. Insulin is a hormone in the body that goes up after you eat carbohydrates. One of its jobs is to lower the blood glucose but it also tells the body to make fat out of the glucose, send the fat to the fat cells, and lock it up for when the famine comes. The cruel joke is that there’s never a famine these days so you just keep storing up the fat. You want to keep the blood glucose low and the insulin low.
What is the big picture?
If you’re being treated for a condition of elevated blood sugar (like diabetes or pre-diabetes), then of course we want to keep the carbohydrates low in the foods. “No added sugar” doesn’t mean that there are no carbs. It doesn’t mean there can’t be natural sugar in it, so always look at the total carbohydrate on the label, on your app, or on the internet, when you’re trying to decide how much something will raise your blood sugar. In the big picture, carbohydrates are the foods that raise blood sugar. Sugar that occurs naturally or sugar that is added has such a similar effect that I really consider them to be one and the same in the big picture view. There may be a little nuance to fruit absorption, fair enough, and so, that kind of fine-tuning can happen so that you can partake and eat some fruit or natural sugar and starches (which get digested into sugar). Remember, part of a healthy lifestyle is that you can eat these things – you just have to be careful about the glucose and insulin response. Everyone’s response is different, but I know that for everyone who doesn’t eat many carbohydrates, the glucose and insulin response is very low or as low as it can be.
If you’re on a keto diet and your blood sugars aren’t normal, that’s okay. If you have extra weight to lose and extra insulin resistance, the blood sugars might not be totally normal yet. You’ve got to hang in there, and like landing a plane, you have to wait until you’re on the ground, meaning the weight has totally gone, to expect the blood sugars to be basically back to normal.
Watch the full video here.