ADDED SUGARS: TOXIC WAIST? Presented by Brandon Lee, B.S.

ADDED SUGARS: TOXIC WAIST? Presented by Brandon Lee, B.S.

WHAT DOES HEALTHY MEAN? Health is defined by the World Health Organization as a state of complete physical, mental, and social well-being, not merely the absence of disease.

SUGAR= CARBOHYDRATES CARBOHYDRATES = SUGAR Simple carbohydrates- a monosaccharide or disaccharide. Monosaccharide- The simplest of carbohydrates; consists of one sugar molecule Glucose Fructose Galactose Disaccharide- A carbohydrate compound consisting of two sugar molecules joined together Lactose Maltose Sucrose

MONOSACCHARIDES Glucose- the most abundant sugar molecule, found in combination with other sugars. The preferred source of energy for the brain and an important source of energy for cells. Fructose- the sweetest natural sugar; is found in fruits and vegetables. Also called fruit sugar. In many processed foods, it is in the form of high fructose corn syrup. High fructose corn syrup is made from corn and is found in soft drinks, candies, jellies and desserts.

MONOSACCHARIDES CONT. Galactose- a sugar that joins with glucose to create lactose. This sugar is not found in food alone.

DISACCHARIDES Lactose- consists of one glucose molecule and one galactose molecule, also called milk sugar. Found in milk, including human breast milk. Maltose- consists of two molecules of glucose. Seldom found in food alone but results as a by-product of digestion. Also called malt sugar. Maltose is also the sugar that is fermented during production of beer and liquor products.

DISACCHARIDES CONT. Sucrose- composed of one glucose molecule and one fructose molecule. It is sweeter than lactose or maltose. Found in honey, maple syrup, fruits and vegetables. Sucrose is also the base sugar for table sugar, brown sugar and powdered sugar.

COMPLEX CARBOHYDRATES Defined as a nutrient compound consisting of long chains of glucose molecules. Starch Glycogen Fiber

STARCH Defined as polysaccharide stored in plants; the storage form of glucose in plants. Food sources include grains (wheat, rice, barley), legumes (peas and beans), and tubers (potatoes and yams). Starch is broken down to monosaccharides during digestion.

FIBER & GLYCOGEN Fiber is defined as the nondigestible carbohydrate parts of plants that form the support structures of leaves, stems, and seeds. Two types: Insoluble and soluble Found in citrus fruits, berries, wheat and brown rice. Glycogen is defined as a polysaccharide stored in animals; the storage form of glucose in animals. Stored in the liver and muscle. Seldom found in food items.

WHAT IS ADDED SUGAR? Added sugars can defined as any sugar that is not naturally occurring in the food and has been added manually. The most common source of added sugars in the U.S. diet is soda and soft drinks; Americans drink an average of 40 gallons per person per year. Those who drink the average amount, consume more than 16,420gms of sugar (about 267 cups) every year. Other common sources of added sugars include cookies, cakes, pies, fruit drinks, fruit punches and candy. In addition, non-dessert food items also have excess sugar such as peanut butter, yogurt, and even salad dressing.

SUGAR MATH Divide the total grams of added sugar by 4 to get teaspoons. Multiple the total grams of added sugar by 4 to get calories.

DIETARY GUIDELINES ADVISORY COMMITTEE (DGAC) DGAC express that there is strong evidence that diets high in added sugars are associated with overweight, obesity and type 2 diabetes. DGAC express that there is moderate evidence that diets high added sugars are associated with dental caries, hypertension, stoke and cardiovascular disease. The upper limit (UL) set by DGAC is 10% of energy (calories) to come from added sugars in the diet. Note: Insufficient evidence exists to asses the effect of added sugars and low calorie sweeteners contained in foods and beverages on individuals from diverse populations who have high risk for adverse health outcomes.

EVIDENCE-BASED RESEARCH: OBESITY In three studies, scientists randomly assigned people to consume either sugary beverages (made with sugar or high fructose corn syrup) versus sugary beverages (usually made with aspartame). The study lasted from three-ten weeks. Result: Only those who consumed sugar or high-fructose corn syrup gained weight.

EVIDENCE-BASED RESEARCH: OBESITY CONT. Calories from fructose are more likely than other calories to add fat around the waist. In one study, researchers gave 32 overweight or obese middle aged men and women 25% of their calories from beverages sweetened with either fructose or glucose for the course of ten weeks. Results: Both groups gained an average of about three pounds. However, their was an increase in visceral fat in people fed fructose. Visceral fat has a positive connection with a higher risk of heart disease and diabetes than subcutaneous fat.

EVIDENCE-BASED RESEARCH: OBESITY CONT. Researchers at the University of Minnesota studied about 800 men and women. Result: Those who drank the most sugar sweetened beverages had more visceral fat and larger waists.

EVIDENCE-BASED RESEARCH: DIABETES The fructose in added sugars appears to increase liver, muscle and visceral fat. Excess fat anywhere in the body increases the risk of insulin resistance and diabetes. However, a fatty liver and visceral fat may increase a person s risk the most. High intake of added sugars in the diet can lead to increased risk of developing metabolic syndrome, which can lead to type 2 diabetes or heart disease.

EVIDENCE-BASED RESEARCH: LIPID PROFILE In 2010, researchers at Emory University that took a sample of 6,000 adults. Those who drank more sugar from drinks and foods had lower HDL ( good ) cholesterol and higher triglyceride levels in their blood. When there is more sugar in the body than the liver can process, it converts the sugar to fat. Some of the fat goes into the bloodstream, hence high triglyceride levels.

EVIDENCE-BASED RESEARCH: TOOTH DECAY Simple carbohydrates play a role in dental problems The bacteria that cause tooth decay thrive on simple carbohydrates. These bacteria produce acids that eat away at tooth enamel and can eventually cause cavities and gum disease.

IS HIGH-FRUCTOSE CORN SYRUP WORSE THAN TABLE SUGAR??? High fructose corn syrup= 55% fructose and 45% glucose Sucrose= 50% fructose and 50% glucose Overall, added sugars, whether they come from sucrose, high fructose corn syrup or fruit juice concentrate all have equal adverse effects metabolically. One study reported that people who were given 24 ounces of Dr. Pepper sweetened with high fructose corn syrup had higher blood sugar levels over the next six hours than those who got sucrosesweetened Dr. Pepper. Other studies have found no difference. The sugars in juices are natural but is still are large contributor. Evidence shows that there is an increased risk of developing type 2 diabetes with consumption of fruit juices but not with whole fruit. Fiber in fruit provide protective benefits from risk of diabetes.

EMPTY CALORIES In a nationally representative survey of 16,000 people, about 78% of women and 67% of men ate too much added sugar. Not so fun fact: A slice of Starbucks Reduced Fat Cinnamon Swirl Coffee Cake has 10 teaspoons of added sugars.

SPORTS DRINKS When inactive people drink sports beverages, a common consequence is inappropriate weight gain. Drinking a 12fl. Oz (1.5 cups) of Gatorade adds 90 calories to a person s daily energy intake. When looking for a good sports drink make sure it has 50-70% of calories from carbohydrate (13-18g of carbohydrate per 8 oz, or 240 ml). Alternative options: Low fat or skim milk. Milk will have electrolytes that enhance fluid retention and restore normal fluid balance. All at a lower cost ($) and with significantly less added sugars.

RECOMMENDATIONS Limit sugar intake to 10% or less of total energy intake each day. Consume a maximum of 100 calories (6 ½ teaspoons) a day of added sugar for women and 150 calories (9 ½ teaspoons) a day for men. Limit fruit juices to no more than 1 cup a day. Drink/eat milk, fruit and plain yogurt without worry about sugar. Limit intake of high fructose corn syrup, cane or beet sugar, evaporated can juice, brown rice syrup, agave syrup and honey.

THE MANY NAMES OF SUGAR Barley Malt Brown Rice Syrup Brown Sugar Cane Syrup Crystalline Fructose Dextrose Fructose High Fructose Corn Syrup Honey Invert Sugar Lactose Maltodextrin Maltose Mannitol Sorbitol Xylitol Maple Syrup Molasses Muscovado Sugar Barbados Sugar Sucanat Sucrose Turbinado White Grape Juice Mannitol, sorbitol and xylitol are considered sugar alcohols and do not contribute to total carbohydrates.

WAYS TO REDUCE ADDED SUGAR INTAKE Add cinnamon and dried fruit to plain cooked oats instead of using instant flavored oatmeal. Switch from sweetened to unsweetened applesauce. Eat jams and jellies with no sugar added. Quench your thirst with water, low-fat milk, or beverages, like low sugar sports drinks.

WAYS TO REDUCE ADDED SUGAR INTAKE CONT. Sweeten low-fat plain yogurt with fresh, frozen, or canned (in its own juice) fruit in place of fruit-flavored yogurt. Trade out 100% fruit juice for fruit punch and other fruit-flavored drinks. Drink plain low-fat milk instead of chocolate milk. Make a homemade smoothie with frozen fruit, low-fat milk, and yogurt in place of ice cream.

ADDED SUGAR ACTIVITY Instructions: Please form groups of two to three people. This activity will require collaboration and teamwork. Please no cell phone use for this activity.

CREDIBLE SOURCES FOR NUTRITION INFORMATION Academy of Nutrition & Dietetics eatright.org Food and Nutrition Information Center usda.gov American Heart Association heart.org American Diabetes Association diabetes.org

REFERENCES A. (2017). Eating Right with Less Added Sugars [Pamphlet]. Chicago, IL: Academy of Nutrition and Dietetics. Boyle, M. A. (2017). Community Nutrition in Action: An Entrepreneurial Approach (7th ed.). Boston, MA: Cengage Learning. Clark, N. (2014). Nancy Clarks Sports Nutrition Guidebook (5th ed.). Champaign, IL: Human Kinetics. Liebman, B. (2012). Sugar Belly: How Much is Too Much Sugar?. Nutrition Action Health Letter, 39(3), 1-7.

REFERENCES CONT. Part D. Chapter 6: Cross-Cutting Topics of Public Health Importance - Continued. (2017, September 18). Retrieved September 18, 2017, from https://health.gov/dietaryguidelines/2015-scientific-report/11-chapter- 6/d6-3.asp Wolfram, T. (2016, November 7). Processed Foods: What's OK, What to Avoid. Retrieved September 18, 2017, from http://www.eatright.org/resource/food/nutrition/nutrition-facts-andfood-labels/avoiding-processed-foods Thompson, J., & Manore, M. (2016). Nutrition For Life (4th ed.). Boston: Pearson Education, Inc.