Is it possible to control sugar consumption?

Ice cream and fried bananas. (Dr. Noorali Bharwani)
Ice cream and fried bananas. (Dr. Noorali Bharwani)

I call sugar a sweet slow poison, a weapon of mass destruction. We use the poison on ourselves, our families and our friends, but not on our enemies.

It is reported the North American diet contains about 20 per cent sugar. This is equivalent to 30 teaspoons a day! Most of it is hidden in different kinds of juices and food. The major sources of added sugars are in beverages, desserts, sweet snacks, sweetened coffee, sweetened tea and candy.

Like alcohol, sugar has no nutritional value. It has no vitamins, minerals or fiber.

North American children’s consumption of sugar per day is reported to be between 25 to 35 per cent of total calories. The World Health Organization recommends daily dietary sugar intake of no more than 10 per cent of total calories.

Consumption of excess sugar raises blood pressure and makes us overweight. Our risk of becoming diabetic increases and it damages our liver by causing fatty liver. There is increased risk for heart attack and stroke.

Several provinces in Canada have imposed extra tax on sweetened beverages. A new tax on sugary drinks sold in Newfoundland and Labrador has come into effect since September. This is Canada’s first per litre sugar sweetened beverage tax.

In Ontario, anyone who buys sugar-sweetened beverages including energy drinks, iced teas and pop will pay an extra 20 cents per litre in sales tax. Quebec has some laws as well. Around the world about 40 nations have imposed beverage tax.

Should Canada have nationwide beverage tax?

A new University of Alberta study suggests Canada could save $2.5 billion a year if everyone followed international guidelines for sugar intake. That would mean eating the equivalent of 2.2 Kit-Kats of sugar a day instead of our current three (The economic burden of excessive sugar consumption in Canada: should the scope of preventive action be broadened? By Liu et al Canadian Journal of Public Health volume 113, pages 331–340, 2022).

The article suggests increasing tax on sweetened beverages is not going to solve the problem. It says, “Public health interventions to reduce sugar consumption should therefore consider going beyond taxation of sugar-sweetened beverages to target a broader set of products, in order to more effectively reduce the public health and economic burden of chronic diseases.”

Is this possible? Sugar is hidden (for taste and preservation) in so many products that it makes the task of controlling sugar consumption almost humanly impossible. Just like controlling smoking, alcohol consumption, drug abuse, over-eating and obesity.

What’s the solution? Self-control is the only way. Here is a collection of some ideas. There is nothing new in the list. These are the things we all think about and talk about but forget to implement.

  1. Eat a healthy balanced diet with lots of fruits, vegetables, whole grains and proteins.
  2. Replace juice and sweetened drinks with sugar free options.
  3. Do not give kids pop or juice outside of meal times (stick with water).
  4. Check nutrition labels.
  5. Government should tax all sugar-containing foods and use the funds to promote healthy eating and good health.

Sugar is one temptation we should do without! Do you think taxing sugar containing drinks and foods will change much?

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Stop flirting with your enemies by eating smarter and healthier.

Cruise ship in St. Martin. (Dr. Noorali Bharwani)
Cruise ship in St. Martin. (Dr. Noorali Bharwani)

Let us start with a question – What is the best way to lose weight? Is it intense exercise or less eating? Or both?

You cannot lose weight just by exercising. Regular exercise will make your heart and muscles strong. To lose weight you have to eat less and eat healthy. This has to be a lifelong strategy. Scientific evidence shows most people (who lose weight) will regain their weight over a period of time as they revert to their old eating habits.

There are many challenges faced by people who try to lose weight and maintain the loss. The challenges are to avoid foods containing sugar, salt and fat.

When you start cooking or sit down to eat, ask yourself – am I flirting with my enemies? How grave are the consequences? Let us look at the answers in more detail.

Your enemy number one – sugar.

Today, our diet is packed with huge amounts of added sugars.

Sugar is used as an ingredient in many packaged foods. Statistics from the National Health and Nutrition Examination Survey shows Americans eat about 17 teaspoons of added sugars per day. That’s significantly more than the American Heart Association’s recommendation of not to consume more than nine teaspoons a day. We are consuming twice the amount of sugar than recommended.

We know added sugars are bad for us. It is associated with an increased risk of overweight and obesity. That is directly linked to the development of type 2 diabetes. Studies have shown odds of being overweight or obese were 54 percent greater among individuals with the highest intake of sugars compared with those with the lowest intake.

Those who like to eat sweet stuff also increase the risk of heart disease. Several studies have shown a higher sugar intake also meant higher levels of total cholesterol, LDL (bad) cholesterol, and triglycerides irrespective of your weight.

Your enemy number two – salt.

We know too much sodium (salt) is bad for your heart. And yet, most North Americans consume about 50 per cent more than the maximum of 2,300 mg per day of salt. Reducing salt intake reduces the risk of heart disease.

Sodium is present in all types of food as a preservative or to improve the taste. It is lurking in some foods you wouldn’t necessarily suspect.

According to the Centers for Disease Control and Prevention, 10 categories of food (breads, pizza, sandwiches, cold cuts and cured meats, soups, burritos and tacos, savory snacks, chicken, cheese, eggs and omelets) account for 44 per cent of our overall sodium intake.

Best thing is to cook at home. Restaurant foods are heavily loaded with salt. Eating at home is always healthier and safer.

Your enemy number three – fat.

If you eat the right kind of fat then fat is good for you. Studies show different types of fats -monounsaturated, polyunsaturated, and saturated – had varied effects on health.

Saturated fat is the bad one. Instead of consuming saturated fat, eat unsaturated fats (fish, nuts, olive oil) or healthy carbs (grains, legumes). This way you can protect your heart. You want your heart to pump forever!

Avoid trans fats. American Heart Association says, “Doughnuts, cookies, crackers, muffins, pies and cakes are examples of foods that may contain trans fat. Limit how frequently you eat them. Limit commercially fried foods and baked goods made with shortening or partially hydrogenated vegetable oils.” Trans fat is really bad fat.

Eat more foods that contain unsaturated fat. Avocados, nuts, olive oil, and fatty fish should all appear regularly on your plate. Keep an eye on the calorie intake. Otherwise these foods are good.

My favourite diet: heart-healthy Mediterranean diet with a four-point plan.

According to Mayo Clinic website, if you’re looking for a heart-healthy eating plan, the Mediterranean diet might be right for you.

The main components of Mediterranean diet include:

  1. Daily consumption of vegetables, fruits, whole grains and healthy fats
  2. Weekly intake of fish, poultry, beans and eggs
  3. Moderate portions of dairy products
  4. Limited intake of red meat

Sounds pretty simple! Enjoy!

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Here are some reasons for eating the heart-healthy Mediterranean diet.

Kananaskis Country (Dr. Noorali Bharwani)
Kananaskis Country (Dr. Noorali Bharwani)

In a 2012 study, 52 per cent of Americans (that were polled) believed doing their taxes was easier than figuring out how to eat healthy.

When you are hungry it is so easy to find unhealthy fast junk food. Junk food easily satisfies your hunger and craving for sweet, salty and oily food. But junk food can cause lot of damage to your heart, liver, brain, bones and other vital organs.

Heart and Stroke Foundation of Canada encourages Canadians to eat a healthy diet, control salt intake, and be physically active to lower blood pressure. The latest result from the DASH study (Dietary Approaches to Stopping Hypertension) has confirmed these recommendations, providing more encouragement for people to choose a healthier diet.

My favourite is Mediterranean diet – a traditional cooking style of countries bordering the Mediterranean Sea. The Mediterranean diet incorporates the basics of healthy eating – plus a splash of flavorful olive oil and perhaps a glass of red wine.

Mediterranean and DASH diets are considered to be the most effective diets for good health.

In Mediterranean diet you are encouraged to eat fresh fruit and vegetables, wholegrain cereals, nuts, the odd glass of red wine, fish and dairy, and olive oil as the main source of fat. Mediterranean diet is well known as one of the world’s healthiest. DASH diet also recommends a higher level of vegetable and fruit intake.

The DASH diet had the greatest effect on blood pressure, lowering levels within two weeks of starting the plan. Not only was blood pressure reduced, but total cholesterol and low-density lipoprotein (LDL) or “bad cholesterol” was lower, too.

What is important to note is blood pressure was lower for everyone on the DASH diet. Less salt people consumed, the greater the decrease in blood pressure. People who already had high blood pressure had the largest decrease in blood pressure.

Five things to remember about Mediterranean diet:

  1. Eat fruits and vegetables, whole grains, legumes and nuts.
  2. Replace butter with healthy fats such as olive oil and canola oil.
  3. Use herbs and spices instead of salt to flavor foods.
  4. Limit red meat to no more than a few times a month.
  5. A glass of red wine per day – if you are confortable with that.

The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking.

There are other benefits of Mediterranean diet. It is associated with a reduced incidence of cancer, and Parkinson’s and Alzheimer’s diseases. Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts may have a reduced risk of breast cancer.

The focus of the Mediterranean diet isn’t on limiting total fat consumption, but rather to make wise choices about the types of fat you eat. The Mediterranean diet discourages saturated fats and hydrogenated oils (trans fats), both of which contribute to heart disease.

In 1999, the Lyon Diet Heart Study compared the effects of a Mediterranean-style diet with one that the American Heart Association recommended for patients who had survived a first heart attack. The study found that within four years, the Mediterranean approach reduced the rates of heart disease recurrence and cardiac death by 50 to 70 percent when compared with the heart association diet. That is remarkable.

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Eating the Right Kind of Protein

A rock formation in Barbuda! (Dr. Noorali Bharwani)
A rock formation in Barbuda! (Dr. Noorali Bharwani)

A balanced diet consists of carbohydrates, proteins, fats and fruits and vegetables to provide you with vitamins, minerals and other nutrients.

Proteins are considered essential nutrients for the human body. They are one of the building blocks of body tissue, and can also serve as a fuel source. The body needs protein for growth and maintenance. Aside from water, proteins are the most abundant kind of molecules in the body.

There are many sources of protein: grains, legumes, nuts, seeds as well as animal sources such as meats, dairy products, fish and eggs. Vegetarians and vegans can get enough essential proteins (amino acids) by eating a variety of plant proteins.

A recent study from Harvard University and Massachusetts General Hospital in Boston (published in JAMA Internal Medicine) shows people who eat more protein from plants and less from animals may live longer even when they have unhealthy habits like heavy drinking or smoking.

If you like to eat animal protein then you should avoid processed red meat and choose fish or chicken instead.

The Harvard researchers followed more than 130,000 nurses and other health professionals over several decades. Half of the participants were getting at least 14 per cent of their calories from animal protein such as meat, eggs and dairy and at least four per cent from plant protein sources such as pasta, grains, nuts, beans and legumes.

The researchers noted that previous studies have indicated eating fewer starchy foods and more protein can help people manage their weight, blood pressure, sugar and blood lipids. But the Harvard study shows animal protein is deadlier for individuals who were obese or heavy drinkers.

The researchers found that meat eaters with an unhealthy lifestyle and higher mortality risk tended to eat more red meat, eggs and high-fat dairy than the fish and poultry eaters favoured by those with a healthy lifestyle.

The new study also found that meat eaters with a healthy lifestyle tended to consume more fish and poultry, while those with an unhealthy lifestyle and higher mortality risk – such as those who were overweight and drank at least one alcoholic beverage per day – tended to eat more red meat, eggs and high-fat dairy.

The authors say the study cannot prove that the type of protein people eat directly influences how long they may live. It’s also possible that the eating and lifestyle habits of health-care workers (participants in this study) might not be representative of the broader population of adults.

The real risk of mortality from animal protein also appears largely tied to processed meat, such as bacon, salami and hot dogs.

The take-home message here is to eat specific healthier plant-based foods such as fruits, nuts, seeds, beans, and non-starchy veggies. Avoid dangerous plant-based foods such as French fries to soda to white bread and white rice. And pursue a healthier life-style.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!