Showing posts with label Sugar. Show all posts

Thursday, February 20, 2014

Learning to Cut the Sugar

Dr. Robert Lustig

Dr. Robert Lustig became widely known as “the anti-sugar guy” after a lecture of his called “Sugar: The Bitter Truth” was posted on YouTube and gained widespread attention. In his talk, Dr. Lustig explains why all calories are not created equal, and why he believes those from sugar in particular are driving an epidemic of obesity and chronic disease.

But Dr. Lustig, a pediatric endocrinologist who runs a weight management clinic for children and families at the University of California, San Francisco, says that “anti-processed food guy” would be a more appropriate nickname, since sugar — while his biggest concern — is just one of a number of ills he sees in the modern American diet. I recently sat down with Dr. Lustig to talk about his newest book, “The Fat Chance Cookbook,” which he wrote with his friend Cindy Gershen, a chef, as a follow-up to his 2012 bestseller “Fat Chance.” Every recipe was vetted by students at Mount Diablo High School in Concord, Calif., where Ms. Gershen teaches healthy cooking.

To find out more about how children (and their parents) can learn to eat better, why sugar is not banned from his cookbook and why polenta patties are, hands down, Dr. Lustig’s favorite recipe in the book, read our edited conversation.

Your lecture on sugar spread quickly and was viewed by millions of people. Were you surprised?

It blows my mind. I didn’t think anyone was going to watch it. I didn’t even know it was being taped. If I had, I would’ve worn a better tie.

A lot of studies lately have extolled the health benefits of the Mediterranean diet. Do you favor one diet or cuisine over another?

I don’t have any money on any specific cuisine or diet. I think they could all work, and they all did work at one time. But now they don’t because they’re processed.

Pioppi, Italy, is where the Mediterranean diet was centered. Did they have pasta? No. It was meat and vegetables, and some red wine and olive oil. The bottom line is every country has its cuisine, and every cuisine works for that country. But there’s one thing that doesn’t work for any country: processed food. And any country that adopts processed food, which is now everywhere, is getting sick. This is why I want to be known as the anti-processed food guy, not the anti-sugar guy.

What are your thoughts on diets that focus on calories?

I’m not against reducing calories. But if that’s all you’re doing, it can’t work. It depends what those calories are. Everything that comes in a 100-calorie container, half of it is sugar, whether it’s yogurt, or cookies, or whatever. If a calorie is a calorie, then it should work. But it doesn’t, because a calorie is not a calorie. And this is the thing that we have to get past. That’s why I wrote the cookbook. Because the question is, once you realize that all calories are not the same, what do you do?

You treat many obese children in your clinic. Do you ever end up treating parents as well?

Almost always, we see an obese kid come in with an obese parent. And when the kid loses weight, the parent loses weight, because the parent actually changed what’s going on in the home. They made the home safe for the kid and safe for themselves as well. But if the parent is hooked on sugar and they won’t get it out of the house, then the kid can’t get better. If a parent says, ‘Oh, it’s my kid’s problem, but I’m going to eat the cookies,’ then nobody gets better. We see a lot of that.

How do you change behavior?

We do one thing at our clinic that nobody else does, and it’s the key to our success. We do something called “the teaching breakfast.” Every kid comes in fasting because we’re drawing blood. So they’re all hungry. They go to the teaching breakfast with their parents – it’s six families all at a communal table – and our dietitian spends an hour with them. The dietitian narrates exactly what’s on the table and teaches the parent and the kid at the same time.

We make sure four things happen. No. 1, we show the parent the kid will eat the food. No. 2, we show the parent that they will eat the food. No. 3, we show the parent that other kids will eat the food, because they have other kids at home and they have to be able to buy stuff that they know other kids will eat. And No. 4, we show them the grocery bill, so they see that they can afford the food. If you don’t do all four of those, they won’t change.

What are the foods you put on the table?

We tell them that they can make things like steel cut oats and eggs. And on the table we’ll have whole grain muffins, whole grain breads, cheeses. And we have plain yogurt with real fruit mixed in, not the standard American flavored yogurt, which is super high in sugar. And we say, ‘Look, breakfast is not the time for your sugar fix. The more sugar you eat at breakfast, the more trouble you’re going to be in.’ Sugar is the one thing you need to get out of your breakfast.

So these foods on the table are not what these children are used to eating?

If you get your breakfast through the national school breakfast program, which 25 percent of school kids do, guess what you’re getting: a bowl of Fruit Loops and an eight-ounce glass of orange juice. That’s 11 teaspoons of added sugar. This is what we have to fix. But it costs money to fix, and no one wants to do that. So as a country we’re spending it on the tail end, on diabetes, heart disease and everything else.

A lot of the recipes in your book use fruit to add sweet flavors. Was this a way to limit refined sugar?

Exactly. People always say to me, “What about fruit? It has sugar.” But I have nothing against fruit, because it comes with its inherent fiber, and fiber mitigates the negative effects. The way God made it, however much sugar is in a piece of fruit, there’s an equal amount of fiber to offset it.

There’s only one notable exception: grapes. Grapes are just little bags of sugar. They don’t have enough fiber for the amount of sugar that’s in them. But I have nothing against real food, and that includes real fruit. Eat all the fruit you want. It’s only when you turn it into juice that I have a problem with it, because then it loses its fiber.

You have two children at home. Do you let them eat sweets?

So, first of all, my wife is Norwegian. She bakes for therapy. When she’s mad at me, she bakes. That’s how she gets her aggression out. But she only bakes once a week, and the kids only get fresh cookies. We never buy store-bought. Ever. And when my wife bakes five-dozen cookies, she gives them out to the rest of the block. We keep about a dozen cookies for ourselves and for the kids.

My wife has learned by experimenting that she can take any cookie recipe, any cake recipe, and reduce the amount of sugar by one third, and it actually tastes better, and it doesn’t ruin the texture. If you go down by a half, then it does. But if you go down by a third, the cookies still come out just as good. And you can taste the chocolate, the nuts, the oatmeal, the macadamia – whatever is in it. So it’s actually better, and the kids get it as a treat. On weekdays, when they want something sweet, it’s fruit. On the weekends, they’re allowed cookies. So we’re not militant. We’re toeing the line.

What is your favorite recipe in the new book, and why?

Polenta patties with sautéed greens, poached eggs, Roma tomatoes and basil salsa. Hands down winner. It’s vegetables for breakfast. Even though it has carbohydrate, it’s unrefined. It’s high in fiber and micronutrients. It’s the highest quality protein: eggs. And it’s just downright amazing.

Here’s the recipe.

Polenta patties with sauteed greens, poached eggs, Roma tomatoes and basil salsa

“The Fat Chance Cookbook”
Polenta Patties With Sauteed Greens, Poached Eggs, Roma Tomatoes and Basil Salsa

Polenta is corn, but coarse and unrefined. Team it with some vegetables and you can get children to eat veggies for breakfast.

INGREDIENTS
1 batch polenta (see below)
2 tablespoons olive oil
6 cups greens: spinach, chard or kale, rinsed
6 eggs
1 teaspoon distilled white vinegar
1/2 cup Roma Tomato Basil Salsa (see below)

FOR THE POLENTA:
1 cup corn grits or cornmeal
4 cups water
Salt to taste

Bring water and salt to a boil in a large pot over high heat. Once the liquid is boiling, slowly add the grits or cornmeal, stirring constantly with a whisk to keep lumps from forming. When the grain is mixed smoothly into the liquid, reduce the heat to low and simmer gently for 30 minutes until very thick. Stir occasionally to keep the polenta from sticking. Allow to cool in an oiled 8-inch square pan or loaf pan.

FOR THE SALSA:
1 pound Roma tomatoes, diced into 1/4-inch pieces
1 tablespoon garlic, peeled and minced
1/2 cup chopped fresh basil
1/2 cup extra-virgin olive oil
1/4 cup balsamic vinegar
1 tablespoon cracked black pepper
1 teaspoon salt

Mix the tomatoes, garlic, basil, oil, balsamic vinegar, pepper and salt together in a bowl. The salsa is best when used immediately. Yield: 2 cups.

PREPARATION:

1. Remove the polenta from the pan and divide into six servings.

2. Heat 1 tablespoon olive oil in a large pan over medium-high heat. Add the polenta slices and fry until golden brown on both sides, about 3 minutes per side. Transfer the polenta slices to a plate and keep warm.

3. Add the remaining 1 tablespoon of oil to the pan and sauté the greens until wilted and tender.

4. Heat 2 inches of water just to a boil in a separate medium-size frying pan, add the white vinegar, then reduce the heat to low. Crack the eggs into the water and poach them until desired doneness, 2 to 3 minutes for soft yolks. Using a slotted spoon, remove the eggs from the water, being careful not to break the yolks. Transfer the eggs to a plate.

5. Place a polenta patty on each of six plates. Top each patty with greens and a poached egg. Pour salsa over all. Or, place all the polenta slices on a platter, top with greens, poached eggs and salsa.

Yield: 6 servings

Nutritional information per serving: 450 calories; 18 grams fat; 3.5 grams saturated fat; 165 milligrams cholesterol; 61 grams carbohydrates; 3 grams dietary fiber; 330 milligrams sodium

Reprinted by arrangement with Hudson Street Press, a member of Penguin Group (USA) LLC, a Penguin Random House Company, from “The Fat Chance Cookbook” by Dr. Robert Lustig. Copyright 2013 by Dr. Robert Lustig.http://well.blogs.nytimes.com/2014/02/19/learning-to-cut-the-sugar/?action=click&contentCollection=Opinion&module=MostEmailed&version=Full&region=Marginalia&src=me&pgtype=article

Tuesday, January 14, 2014

How to give up sugar in 11 easy steps

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Many of us are addicted to sugar. Want to break the habit and get those no-good empty calories out of your life? This is how to conquer your cravings in 11 easy steps – even if you really, really fancy a Mars bar

Photograph: Christopher Hope-Fitch/Getty Images/Flickr RF

1 Know thine enemy

It is droll to observe nutritional advice at the public health level; governments and their agencies always approach obesity as though it were a problem of information or – in the popular phrasing – "awareness". If people only knew how much sugar there was in a Twix, they would simply eat something else.

This knowledge deficit doesn't exist: you won't meet anybody on Earth more intricately apprised of calorie content than someone who is obese. The only people who genuinely don't know shit from sherbet are the authorities themselves, who make a mistake we can recognise from other spheres, viz, they conflate the problem behaviour – in this case, excess sugar – with the people they perceive as causing them a problem. People, for instance, who drink fizzy drinks (except prosecco). So they'll preach two behaviours that are near identical, nutritionally speaking, as the opposing pillars of good and evil. "Drink a fruit juice; do not drink a Lilt. Drink a smoothie; do not drink a McDonald's milkshake." Finally, some exasperated nutritionist will pop up and say, to be honest: "This is all sugar that doesn't fill you up and doesn't even slake your thirst particularly well." And everybody pounces on them and calls them a quack, even though they are right.

Photograph: Alamy

It is all sugar; it all does the same thing to your bloodstream, and it all begets an appetite for more of itself, as do fags and booze. Leaving aside the thumping idiocies of the Department of Health's Change4Life campaign, the only real fault line is: do you think of it as an addiction or not? If you merely think of it as a matter of self-control, something you like a bit too much and have to master, there is no more a need to excise it from your diet than there is to stop using Twitter just because it drains your time and means you'll never amount to anything. There is only one step necessary for you, the step of "less".

If you do see it as an addiction, then cutting down won't be enough, and I refer you to steps two through 11.

2 Cold turkey

"But what if," I said to Frankie from Pure Package, a company that sends perfectly balanced meals, daily, to people with money, "you just really, really fancy a Mars bar?" I have been calling diet people (for work!) since Atkins was fashionable. There will be those among you who don't even remember the outbreak of war against wheat, who weren't even alive in a time before bread was the enemy. Think on that.

Anyway, what always charms me is their presentation of preposterous alternatives. So you might say: "What I really love is a buttered crumpet," and they'll go: "That's easy! You can grind some cashew nuts into a sort of makeshift butter and spread it on some kale." That was my motivation in putting the Mars bar question to Frankie, but she wasn't biting. "The only way to stop sugar cravings is to treat it like an addiction and go cold turkey. There's nothing to soften that blow. If you really need to get sugar out of your life, you're going to have to go cold turkey."

3 Beware of fruit

Photograph: Michael Rosenfeld/Getty Images

Frankie again: "Fruit has been given a halo so we end up eating too much of it." In fact, there's nothing inherently great about fructose; I mean, you can get too far into these weeds and start sounding like a hippy. Sure, fructose is better than glucose because it comes accompanied by fibre and vitamins. But in and of itself, it is not better, and "should" (still Frankie), "be accompanied by seeds or nuts. The effect of that would be to slow down the insulin spike that the fruit brought to the bloodstream. Overall, it should be, not limited, but not seen as something you can eat all the time in any quantity." Generally, the higher the water content, the less the sugar hit, so oranges are better than bananas. Oranges are also better than mangoes. Oranges, it turns out, actually are the only fruit.

4 Also beware of (some) naturopaths

Carole Caplin. Photograph: Dan Chung for the Guardian

Some definitions: "dietitian" is the only term that is subject to professional requirements. Anyone can be a nutritionist. "Naturopath" is what nutritionists call themselves when they want to sound a bit more new-age than they already do. The middle term attracts the most scepticism, based on the presumption that just because your field isn't professionally accredited, you do not know anything and you can't process information. People make it about journalists quite a lot as well; this presumption is mistaken.

That said, I interviewed lifestyle guru Carole Caplin once, and she asked me to do something the next day, and I said: "Unfortunately, tonight I'm going to get completely drunk, so I most probably won't want to do Pilates/circuit training/zumba tomorrow." She fixed me with a beady eye and said: "I try not to eat too much chocolate, but sometimes I go mad. The other day, I ate something like eight squares of Green & Black's. And afterwards I felt terrible, I had a headache, the shivers, I couldn't get out of bed. Whereas if I'd only had two squares, I'm sure my body would have coped with it."

Here's the thing: I'm not convinced that really happened. I think she was using chocolate as a metaphor for booze, in an attempt to find some joint language that we would both understand.

5 Give up alcohol

Photograph: Jim Wileman/Alamy

Many drinkers think they don't have a sweet tooth; indeed, they are faintly derisive of people who do. In fact, they get all their sugar from alcohol and if they ever gave it a rest for even two days, they would realise they have an incredibly sweet tooth.

6 Gary Barlow

Gary Barlow. Photograph: David M Benett/WireImage

You know that joke, "how do you know when someone has an iPad? Because they tell you"? This adapts very well to the Take That tax avoider. How do you know how Gary Barlow lost five stone? Because he tells you. In precis, he realised, after years of trial and error, "that he doesn't have the kind of body that allows him to eat whatever he likes" and thereafter, cut out sugar, alcohol, any solids at all after 2pm, and refined carbohydrates. I know! As if he couldn't get any more charismatic.

The point is that Barlow is now at the dead centre of the sugar-free, wheat-free eating crowd, and if you ever want to know how to make a cake out of hemp, Google "Gary Barlow" + "cake out of hemp".

7 Grain differentiation

Spelt, an ancient wheat. Photograph: Alamy

The whole issue of carbohydrates and sugars has been maybe irredeemably muddied by people such as Sarah Ferguson eating spelt, and then going: "I went wheat-free and the weight fell off me," and everybody going: "Wow. That's some strange ju-jitsu, considering spelt is just a variety of wheat."

Almost all carbohydrate converts to glucose, except fibre; the less fibre there is, the more will be converted, until you get, like, a Greggs bap that's basically just a glucose tablet without the mysterious wet-dryness.

If you are unsure whether a carbohydrate is refined or unrefined, ask yourself – have I ever thought: "I could murder an X"? Sausage roll, yes. Pearl barley risotto, no. Buttered crumpet, yes. Kale spread with cashew butter, no. The intensity of your desire is an index of the glucose it will deliver. This means a) all refined carbohydrates should be treated as sugars, in your sugar detox, and b) to avoid sugars, you simply avoid all the things you really want.

8 A life without sugar

Coconut oil can be used in cakes. Photograph: Alamy

What sugar brings is not, as you might think, sweetness, but texture. So if you have a cake that is wheat-free and sugar-free (there's no real point in being one without the other), it is possible to find alternatives, replacing the wheat with nuts and the sugar with fruit, coconut oil, agave, combinations thereof. The nuts bring clagginess and the fruit is too wet, so the result is soggy and mushy with a mouth-coating trace of clay, a sort of repulsive pabulum whose problem is not its flavour but its mouthfeel. It is better not to replicate your old life, in other words, but to find new hobbies, such as reading.

9 Paleo eating

Acceptable food in the Paleo diet. Photograph: Pal Hansen for the Guardian

The best catch-all diet to remove sugar without contravening the copyright of the Atkins diet, this involves eating like our ancestors – very little fruit, almost no grains, a lot of meat and a lot of exercise as you pound away at your treadmill, imagining yourself the predator of the steak you will later eat. Adherents point to the fact that our stone-age ancestors were much healthier than us, having no problems with obesity, cancer or any other diseases that beset our modern age. Pedants point out that the posthumous diagnosis of cancer was pretty patchy until the discovery of the disease in circa 1600BC (some time after the Paleolithic era); and, furthermore, that many ancestors were cut off in their prime by other factors (dinosaurs!), and it is impossible to tell how fat they would have become had they lived to our great age.

I mistook this for Palio eating, and thought it meant eating like a jockey, which would be a mixture of chips, power bars and Viagra.

10 Sugar-free alternatives

Sugar-free chewing gum containing xylitol

Sugar-free chewing gum. Photograph: Alamy

Basically, the trajectory of a sugar alternative goes like this: is discovered; is lauded by all; becomes available in Holland & Barrett; there are suggestions that it is not as wonderful as it was cracked up to be; is abandoned in favour of something else, which has conveniently come along in the meantime. Take stevia – nutritionist Amanda Ashy-Boyd describes this once-wonder ingredient: "It's supposed to be a natural substitute for sugar, but it's not so natural in the sense that it probably goes through multiple chemical processes to be able to add it to the food."

11 Just stop eating it. What are you, a baby?

Any food, as long as it's hummus. Photograph: Fotografiabasica/Getty Images

Or, more diplomatically put by Ashy-Boyd: "It's all about making sure you're eating a balanced diet, so you never get into a place where your blood sugar has dropped." This involves ceaseless snacking of foodstuff with a low glycaemic load, foods that are mainly hummus or things that remind you of hummus or things that are called "hummus" but aren't, in an attempt to appeal to people who only eat hummus (butterbean hummus. Seriously. How is that hummus?). You combine this with an oatcake, or something containing pumpernickel (note: not a German Christmas tree biscuit; these also contain sugar), and you ignore all the people who are looking at you and definitely thinking: "I wish she would just eat properly and not like some kind of idiot koala."

"That's one way of protecting yourself," Ashy-Boyd continues. "The other thing is, if you are a big sugar eater, you have to be conscientious about it. Maybe allow yourself a couple of days to go without it. And then once it's out of your bloodstream, it's so much easier to combat that desire."

Cold turkey, see? It's all about the cold turkey.