The Nanny Police are actually doing something right...
Last week, Ireland's Supreme Court ruled that Subway's bread has too much sugar to be called bread. Instead, according to the court, what Subway sells is closer to confectionary items like cake.
The ruling came after Subway sought a tax break in Ireland for selling a staple food. In Ireland, companies get tax breaks on certain foods, like bread, that are considered essential.
When the news broke, folks were shocked at how much sugar is in Subway's bread. According to the judges, "sugar makes up 10% of the weight of the flour." Here in the U.S., a single serving of some Subway breads contains up to 5 grams of sugar.
It might not seem like much... The American Heart Association ("AHA") suggests men limit their daily sugar intake to 36 grams. For women, the AHA recommends no more than 25 grams.
But Subway's example shows there's a lot of sugar in your diet you're probably not aware of... In fact, one study published in the Journal of the Academy of Nutrition and Dietetics found that 74% of packaged foods purchased in the U.S. contained added sweeteners.
Some surprisingly sweetened foods include salad dressings (71% of the products sampled), so-called 100% fruit juice (66%), and yogurt (61%).
I've warned about the dangers of added sugar for years.
It's one of what I call "white killers."
Sugar, white rice, and white bread increase blood-sugar levels. When you eat these so-called "high glycemic index" foods, your body signals the pancreas to produce extra insulin.
The insulin secreted into the blood stream triggers a host of things – a decrease of magnesium and an increase of sodium in the blood. Insulin also increases inflammatory molecules in the blood.
Insulin even results in fat production. The extra fat leads to high blood sugar and keeps metabolism stuck in "storage mode." Lots of insulin causes the vessels to oxidize and stiffen... leading to higher blood pressure. Over time, this can cause strokes and heart disease.
Studies show eating lots of sugar lowers your "good" cholesterol, known as high-density lipoprotein ("HDL"). HDL cholesterol inhibits excess levels of harmful fats and "bad" cholesterol, known as low-density lipoprotein ("LDL"), from sticking to arteries. That keeps your blood flowing easily. Thus, folks with low levels of HDL have a greater risk of heart disease.
Elevated blood glucose also leads to immune system problems, including white blood cell dysfunction and clotting issues.
In 2016, the U.S. Food and Drug Administration ("FDA") ordered new food labels to appear on pre-packaged foods. The new labels would include "added sugars" so folks could see exactly how much of the sweet stuff is naturally occurring and how much is added.
For the most part, we were happy to hear it. More transparency means you're better able to know exactly what you're eating and how much sugar you're consuming.
Here's the thing, though... Manufacturers don't actually have to list all added sugars.
That's right. The FDA doesn't require manufacturers to list additives like sugar alcohols, artificial sugars, and plant-based sugar substitutes. The FDA considers these to be "safe" alternatives to sugar. Since they contain so few calories, they don't factor into the added-sugar calculation.
The problem is that there just isn't enough solid evidence that these chemical replacements are safe. Studies tend to run small or only on non-human subjects. And rarely do they last for long periods of time.
With that in mind, here are the three sweetener groups not included in the nutrition label and why you still need to check for them in the ingredients list...
1. Sugar alcohols are partially broken-down carbohydrates. They taste sweet, but our small intestine can't absorb them well. That means they generally pass through our bodies without disturbing much. No studies point to increased blood sugar or higher insulin levels.
However, some folks report diarrhea, nausea, and similar bowel issues when eating large amounts of sugar alcohols. Researchers believe the inability of our intestines to absorb the sugar substitute means it passes through too quickly. That leads to loose stools. (Symptoms also depend on each person's tolerance.)
2. Plant-based sugar substitutes include monk fruit extract and stevia. Unlike other artificial sweeteners, stevia is an extract from the stevia plant... So it's a more natural form of sweetener.
As we've written before, our colons effectively break down stevia. What's more, stevia seems to reduce blood-sugar spikes after meals and improves overall blood-sugar breakdown.
The problem with stevia, however, is blood pressure. Some research suggests that stevia lowers your blood pressure. This can be problematic if you're already on blood-pressure-lowering medication. Unfortunately, there aren't enough studies yet for us to know just how dangerous this is.
3. Artificial sweeteners are the worst offenders. They include acesulfame potassium, aspartame, saccharin, sucralose, neotame, and advantame.
Artificial sweeteners trick your body. They provide a taste of sweetness, but don't deliver the calories expected. Now, that sounds great for satisfying your sweet tooth without all the extra calories and potential problems with weight gain... But it's not that simple.
In fact, we know the human body reacts to fake sugars as if they were real sugars. Research from the journal Diabetes Care demonstrated that artificial sugar can in fact raise insulin levels as well.
There's also some evidence that artificial sweeteners alter the bacteria that live in the gut. Our gut bacteria (called our microbiome) are responsible for a number of things, from breaking down certain foods to regulating our moods and immune system. A paper from the University of Calgary showed that even low doses of aspartame changed the gut microbes in rats. And the gut changes led to higher levels of blood sugar.
Finally, the most contentious of all the research is this: Artificial sweeteners cause metabolic disease. There's growing evidence that the more we consume these chemical sweets, the more we develop conditions like Type 2 diabetes and obesity.
Do what I do... Avoid sweeteners at all cost. And check how much added sugar is in your food – you might be surprised to find sugar lurking in everything from frozen pizza to canned soup. If I see sugar listed, I put it down.
What We're Reading...
- An oldie, but a goodie: My war on diet soda.
- Something different: McDonald's is going after breakfast with baked goods.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
October 8, 2020