Is Sugar the New Fat?

After a morning aerobics class at the local YMCA, I was catching my breath in the locker room and chatting to two women from the class. They know I am a registered dietitian nutritionist so the conversation turned from our hard workout to what else….food. One of the women asked me about calcium and what were the best sources. She said she gave up drinking milk because it had too much sugar….11 grams of sugar in a cup of milk and didn’t I think that was outrageous?!  Before I could answer the other woman chimed in and started talking about the World Health Organization’s (WHO) recommendation that sugar intake should be halved to 5% of total calories or about 6 teaspoons or 25 grams a day for an average person.

So, back to the calcium question. I suggested a glass of 100% orange juice fortified with calcium as a good way to start the day. Fortified orange juice contains needed nutrients (130% of the daily value for vitamin C, 25% of the daily value for vitamin D, and 35% (or 350 milligrams) of the calcium daily value); that goes a long way in helping women meet the 1200 milligrams of calcium recommended for women of our age. Both women were surprised (shocked?) that a dietitian would suggest drinking fruit juice. “What about all that sugar?” was the reply. I wish I had my carton of OJ to show them that 1 cup of 100% orange juice has 22 grams of sugar and that the sugar is naturally occurring in fruit and fruit juice. These are same women who were sipping on post-exercise recovery drinks that were “all natural.” One had a Snapple Cranberry Raspberry (16 ounces = 51 grams of sugar) and Odwalla Mango Tango (16 ounces= 44 grams of sugar).

Sugar is becoming the new fat. Remember when we abhorred fat and removed fat from our favorite foods? That brought us such interesting foods as fat-free cookies (loaded with sugar and refined carbohydrates), fat-free cheese (scary stuff that tasted like plastic), and fat-free coffee cakes (remember Entenmann’s? Fat-free goodies but often with more calories than the original coffee cake). Now, sugar has taken fat’s placed as the new nutrient to be vilified.

Yes, we can all afford to decrease our sugar intake, but why eliminate healthy foods, like orange juice or pineapple juice or milk or yogurt that contain naturally occurring sugars? I work with athletes who are trying to gain weight and I recommended low-fat chocolate milk and 100% fruit juices like grape and orange and apple to boost calories while getting needed nutrients. I think it is better to get real foods with real nutrients than taking protein powdered drinks.

The WHO recommendation is meant to help curb obesity and reduce dental cavities but there are unintended consequences when we demonize one nutrient and try to find a replacement for it. The woman who questioned the sugar in low-fat milk said she read online that almond milk was lower in sugar. True, but did she also notice that almond milk is lower in protein? A cup of almond milk has 1-2 grams of protein yet a glass of low-fat milk has 8 grams of protein. We need the protein in the low-fat milk more than we need fewer sugar calories in almond milk.

So, if you want to reduce sugar intake (and, we all should), start reading labels and look for the hidden sugars in your favorite foods. Check out your brand of peanut butter, catsup, soup, and pasta sauce and see how much sugar is lurking in those foods. Find alternatives (take your reading glasses to the grocery store) but don’t give up healthy, nutritious foods just because there is some naturally-occurring sugars in them. I am not giving up my OJ despite the WHO recommendation.

Calcium and Vitamin D are still important!

The Institute of Medicine Report was published yesterday and I watched the national news outlets do the report a disservice–those darn sound bites just can’t capture the complexity of the report. (The complete report can be found on the IOM website http://www.iom.edu/).

The report concluded that there is not enough evidence to increase the recommended intakes for vitamin D or calcium but that is far from saying that we don’t need these 2 critical nutrients for bone health. Most people don’t get the recommended amounts of these nutrients in their diets but that message was lost in the reporting. I would not want women of any age to abandon their efforts to get calcium from their diet or supplements. I always recommend food first and there are more foods with added calcium–from orange juice to breakfast cereals–available in the grocery store. A recent study looked at calcium intake in post menopausal women and found that dairy foods were the number one source of calcium for white women but grains contribued the most calcium to the diets of black women.

Older women who don’t get enough calcium should use calcium citrate supplements–they are better absorbed than calcium carbonate supplements as we age. But, more isn’t better and I think that is what the report was trying to stress.

The more controversial part of the report was on Vitamin D; this nutrient is also crucial for bone health–nobody disagrees with that–but there are also claims that this sunshine vitamin also plays a role in diabetes, heart disease, auto-immune diseases and some cancers. It is not surprising to me that the report did not find a strong link with Vitamin D and other disorders because the research is emerging and no conclusions can be reached. Science moves slowly but the media reports every little study as if a cure for every disease was as simple as popping a supplement. The hype is often well ahead of the science.

So, don’t throw away your supplements–make sure to get adequate, not excessive, calcium and vitamin D in your diet and then add what is missing from supplements. Remember that supplements are meant to supplement diet–not replace it.

Nutrients for healing

After the recent blast of cold air that blanketed the country, including the deep south, I had planned to write about comfort foods and share my favorite soup recipes, but then I fractured my wrist and have been focusing on healing nutrition. Working with athletes for many years has given me a glimpse into the healing process, but I never had to experience it for myself.

Healthy bone needs more than calcium–it takes 17 different nutrients to make a strong bone. Let’s start with protein–a key building block of bone. Protein is needed for growth and repair so I am focusing on high quality protein that provides all of the essential amino acids–low-fat milk, yogurt, eggs, lean meat, and low-fat cheese. Soy protein is another complete source of protein, and beans, while not providing all 22 of the essential amino acids, has the highest protein content of vegetables.

Zinc and copper help heal bone by building collagen–the protein matrix for wound healing. Seafood, sunflower seeds, nuts, mushrooms, and wheat germ are all good souces of these trace minerals.

Two vitamins that are frequently overlooked in the healing process are vitamins A and C–vitamin A promotes bone growth and remodeling and vitamin C is also needed for collagen formation and bone repair. Citrus foods and dark red and green veggies and fruits provide both vitamins.

OK, we do have to recognize the superstar, calcium, since 99% of calcium is found in bone. I like low-fat dairy because not only does it give me needed calcium, but also vitamin D, protein, and vitamin A. Drink calcium-fortified orange juice for both calcium and vitamin C. A multi-vitamin mineral supplement doesn’t give you enough calcium, so take calcium carbonate or citrate every day. I prefer calcium citrate as it is well absorbed without food. The recent 2009 position paper from the American Dietetic Association recommends taking no more than 500 milligrams of calcium at one time, so split your dose.

My perfect bone healing meal? Lean beef fajitas with red and green peppers, mushrooms. and a side of black beans and citrus fruit salad. A big glass of cold low-fat milk–the margarita will have to wait until after the bone heals. Alcohol is not good for bones. Now, if only I could find a nutrient that would help me type faster with my left hand…..