Episode 120: Clearing Up The Confusion Around Sugar And Natural Sugar Substitutes

Thanks for joining us for episode 120 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering following question from a listener:

“Hey! Could you do an episode discussing natural sweeteners? What do you think about things like stevia or sugar alcohol? I also recently found some isomalto-oligosaccharide syrup, which seems to be a natural fiber. Do you think that’s a good one?”

With sugar being targeted as the villain at the root of all disease, many try to avoid sugar at all costs and turn to natural sugar replacements for a healthier option. If this sounds like you, get ready for a shift in perspective as we dispel common fear based myths about sugar and guide you to make an informed decision about whether caloric or non-caloric sweeteners are right for you.

You’ll gain insight into different types of non-caloric sweeteners, learn the negative effects of an anti-sugar mentality, and discover to ways to improve insulin sensitivity besides strict sugar restriction.

As we clear up the confusion around sugar and natural sugar alternatives, you’ll be on your way toward cultivating a more realistic mindset around and approach to sugar.

Here’s what Laura and Kelsey will be discussing in this episode:

  • [00:03:57] The importance of understanding that the assumption that sugar is bad for health is not true for everyone
  • [00:05:43] The difference between caloric and non-caloric sweeteners
  • [00:08:54] Kinds of prebiotic type sweeteners and the negative digestive effects caused by overconsumption
  • [00:15:08] The dichotomous relationship with sugar in America that leads to a disordered approach to sugar and sugar replacements
  • [00:19:08] Dispelling the myth that sugar is a toxin
  • [00:22:00] Clearing up the myth that sugar is as addictive as cocaine, and why pleasure responses to food are not dangerous
  • [00:24:55] How having the mindset that you have a sugar addiction can feed into disordered eating behavior
  • [00:30:46] How the empty calories in sugar containing foods can cause malnourishment or overeating of calories
  • [00:36:12] How energy status in the cell is the main factor that affects the cell’s ability to use glucose for energy, and ways to improve insulin sensitivity beyond sugar avoidance
  • [00:44:04] Potential causes of sugar cravings or sugar intolerance
  • [00:45:48] How choosing either a caloric or non-caloric sweetener as a small percentage in a caloric appropriate diet can be part of a healthy lifestyle

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TRANSCRIPT: 

Laura: Hi everyone! Welcome to episode 120 of The Ancestral RDs podcast. I’m Laura Schoenfeld and with me as always is my cohost Kelsey Kinney.

Kelsey: Hey everyone!

Laura: We are Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me, Laura, at LauraSchoenfeldRD.com, and Kelsey over at KelseyKinney.com.

Over the next 30 to 45 minutes, we’ll be answering your questions about health and nutrition and providing our insights into solving your health challenges with practical tips and real food.

Kelsey: If you’re enjoying the show, subscribe on iTunes so that you never miss an episode. And while you’re there, leave us a positive review so that others can discover the show as well. And remember, we want to answer your question, so head over to TheAncestralRDs.com to submit a health related question that we can answer on an upcoming show.

Laura: Today on the show we’re going to be discussing natural sweeteners and how to choose one that works best for you. We’re going to talk a little bit about sugar in general as well, so I think this will be one you guys really enjoy. Before we get into our question for the day though, here’s a quick word from our sponsor:

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Laura: Welcome back, everybody. I think we have a really good question for today that has come up I’m sure, Kelsey, with you with lots of clients.

Kelsey: Yes.

Laura: I feel like every time I mention something about sugar in general on either Facebook, or social media, or whatever it’s like there’s always some level of controversy about it. I think it’s good that we’re answering this question today.

The question that we got submitted, it’s not exactly on sugar, but I feel like it’s important to bring it all into the context of sugar. But here’s the question that we have:

“Hey! Could you do an episode discussing natural sweeteners? What do you think about things like stevia or sugar alcohol? I also recently found some isomalto-oligosaccharide syrup, which seems to be a natural fiber. Do you think that’s a good one?”

Like I said, the question is kind of more about just natural sweeteners. It sounds like they’re kind of focusing more on those natural non-caloric sweeteners like stevia, sugar alcohol. So we’ll have to talk a little bit about what a natural sweetener even is and kind of the main differences between them.

But I do want to try to branch this question out a little bit more into just sugar in general because I feel like again, if we’re going to answer a question about even natural non-caloric sweeteners, we need to talk about it in the context of sugar in general.

Because I think, and Kelsey, tell me if you feel the same way, that a lot of times people are really interested in these non-caloric sweeteners that get brought out or released into the public that are a way to avoid caloric sugar, like just normal sugar or other things that kind of work like sugar. And we’re operating from the premise that sugar is bad in that situation, so the goal is to avoid it and here’s these products that can help you avoid it.

I think that’s why we need to talk about sugar in general because I feel like coming from that premise for the average person is actually not appropriate, and so that kind of issue is going to affect whether or not you choose these kind of new products.

Do you feel the same way where we can’t really just talk about natural sweeteners, or I should say natural non-caloric sweeteners?

Kelsey: Yeah. There’s that inherent assumption with this question that sugar is bad, I’m trying to avoid it. What are my options if I’m looking beyond caloric sugars that I can choose from?

I think that it’s a question that people don’t even think they need to ask because, like what I just said, it’s an assumption that sugar is bad. And I think to challenge that assumption, yes, it gets controversial. But I think it’s a really important thing to do because like you just said, sugar is not something that is necessarily evil for the average person. I think it’s really important to have that conversation.

Laura: Like I said, I want to distinguish between the idea of a caloric versus a non-caloric sweetener. This person asked about natural sweeteners, so we’re not going to cover things like artificial sweeteners like sucralose, or aspartame, or anything like that that stuff. I mean we could definitely do a podcast on that, but we’re assuming that most people understand that those artificial sweeteners are not something you want to be using.

We’re going to talk more about the “natural” which the word natural is always kind of like a little arbitrary in general, but essentially things that come from nature, like stevia for example, which comes from a plant whereas something like aspartame is created in the lab. So we’re not going to cover those artificial sweeteners today. But we can talk about caloric versus non-caloric sweeteners because I think that’s again kind of the inherent assumption in this question that caloric sweeteners are something to be avoided.

We’re not saying this person should be eating sugar. We don’t know anything about this person’s health, so I’m not going to say that this person doesn’t need to avoid sugar, and maybe they have a health condition that really benefits from minimizing sugar and using non-caloric sweeteners is actually a good thing for them.

So I just wanted to make that clear that we’re not saying you should be eating sugar, this person asking this question. But we just want to open it up to the average population that’s listening to our show.

Basically caloric versus non-caloric sweeteners, that just means that they either provide calories as a source of energy, or they don’t provide calories, so that’s non-caloric sweeteners. Some of those examples include just sugar in general, so cane sugar, that comes from the sugar cane plant. There’s other things like honey, maple syrup, molasses, coconut sugar, agave. Of course fruit can be considered a caloric sweetener if you’re using it as a jam or something like that. But basically any of these sweeteners that actually have calories in them would be considered a caloric sweetener.

Whereas the non-caloric sweeteners are things like stevia. The sugar alcohols that this person was mentioning includes things like erythritol, xylitol, sorbitol. Anything that ends in “-al” is generally a sugar alcohol when we’re talking about sugars. When we say alcohol, we don’t mean the same thing as ethanol, like drinking alcohol. But there are chemical structures of these sugars that make them technically an alcohol. That’s a lot of the common non-caloric natural sweeteners that are being used in a lot of health food products these days.

There’s one called monk fruit that is somewhat new. I don’t know a ton about it. I’ve used it before just to try it, but I don’t know a lot about like the actual potential problems with it or the benefits. I know you’ll be talking a little bit about the yacon…how do you even say that? Yacon?

Kelsey: That’s what I say, but I’m actually not sure.

Laura: We’re going to call it yacon, and if we’re wrong, sorry. I think yacon has a little bit of calories in it. Technically you wouldn’t call it 100 percent non-caloric the way you would stevia, but it’s so low that it’s potentially considered non-caloric.

Kelsey: I was going to say that there’s sort of this middle ground of natural sweeteners that have started to come out with this whole idea that gut health is really important. There’s a trend I think with these prebiotic sweeteners and that’s sort of in the middle between caloric and non-caloric. Because they have some calories, but it’s very, very few really because the carbohydrate that you’re getting in that is really a fiber or a prebiotic. So you’re not digesting it, it’s your gut bacteria that’s digesting it. So I would say it’s sort of a middle ground, but more towards the non-caloric side for sure.

Laura: I think that’s a good segue to talk a little bit about these prebiotic sugars because that product, the yacon syrup and then the sugar alcohols, they are all high in FODMAPs, which FODMAPs, we talk about those a lot for gut health concerns like IBS, SIBO that kind of thing. But FODMAPs are just basically fermentable carbohydrates that your gut bacteria can break down for food.

And most people can do fine eating FODMAPs. If you have a healthy gut, you really actually should consume FODMAP foods because those prebiotics help feed beneficial flora. So for the average person who has a healthy gut, having sugar alcohols in small amounts even though they’re pretty high FODMAP generally isn’t an issue.

I don’t know if anyone’s ever looked up that Amazon erythritol sweetened…

Kelsey: Yeah, the gummy bears.

Laura: Gummy bears, right. If you go way too high on sugar alcohol sweetened products…you can look up…is it erythritol? I’m trying remember. Or xylitol maybe? There’s some sugar alcohol gummy bear.

Kelsey: Yeah, it’s a sugar alcohol.

Laura: Yeah, It’s kind of a running joke where you look at the reviews on Amazon and it’s like basically just talking about these gummy bears like they’re a colon cleanse or something. So when we talk about small amounts, we’re not talking about like a pound of erythritol sweetened gummy bears, we’re talking about little amounts in foods that you have one serving and it’s a small amount.

I’d say for the average person with normal health, a little bit of that is probably going to be fine. I really get concerned though when I see either we have people with gut issues, so the idea that people have a perfectly healthy gut I think is taken for granted. I think there’s probably a lot of people out there that may not have obvious got issues, but if they’re potentially dealing with some good imbalances and they’re doing a lot of sugar alcohols, they may actually be contributing to those or worsening them.

Or like I said with that gummy bear, not really a joke, but kind of like the gummy bear example, even if you have a normal gut flora and you eat a ton of the sugar alcohol or like high FODMAP sugar replacement at a time, this could actually just lead to a gut flora disturbance. It’s not that you have to necessarily start with one, but if you introduced this like massive amount of sugar alcohol into your diet all at once, that could actually cause problems.

I’m mostly thinking about, like the gummy bear example is kind of extreme, but I’d say the more typical example I see is a lot of these like low calorie ice creams for example or other desserts that are considered “healthy” that are sweetened with sugar alcohols. There’s some of those ice creams that they say it’s like 250 calories for the whole pint, and so people will end up eating an entire pint of it because it’s like oh, it’s 250 calories. But really you’re still supposed to only eat a quarter technically of that pint as a serving.

Seeing these people eating a ton of that kind of stuff, I do get concerned that that could contribute to gut issues or just exacerbate ones that already exist. Do you see that happening with your clients at all?

Kelsey: Yeah. I mean I will say that the people that I work with generally they’re not consuming a ton of these things, but it’s certainly something that I warn people about. And I agree, I think the reason that it’s so concerning is that if you are swapping sugar alcohols or other prebiotic-like sweeteners for regular sugar because you were eating tons and tons of sugar and you wanted to switch that to a “healthier” option, that’s when you’re going to get yourself into trouble.

But if you’re just eating a small amount, a normal serving that’s just a small percentage of your overall caloric intake every day, it’s not going to cause a huge issue unless you already have gut problems that are exacerbated by eating FODMAPs or prebiotics.

So exactly what you just said, yes, I definitely agree. You do need to be careful with those. I feel very conflicted about this, honestly, because I think it’s really great that we’re putting prebiotics into the food supply because a lot of people just don’t get them in their diet enough normally. If you can swap some sugar and get some prebiotic, and it’s a double whammy of benefit for you in that it tastes sweet, so it’s good, you want to eat it, and it’s also helping to feed your good gut bacteria, to me that’s like, okay, that sounds really good. I really like that. That’s a good swap.

But at the same time, if you are eating tons of these prebiotics, which is just not very natural, I do worry what that’s doing over time, and especially acutely of course if you’re eating a ton and you’re just getting massive diarrhea or something like that and that’s clearing out a lot of that bacteria from your large intestine anyway, I worry about that.

So I think it can be good in small amounts, but if you’re swapping it for large amounts of sugar trying to make that a healthier choice, I think you can get yourself into trouble there.

Laura: Right, and I think a lot of this comes down to some of the disordered relationship with sugar in our culture. We have kind of this extreme dichotomy in the United States where I would say the average American probably has way more sugar than they need. They’re eating tons of it, it’s a lot of high fructose corn syrup. It’s not like they’re eating tons of fruit, and honey, and maple syrup, and stuff. It’s a lot of processed food that has a lot of sugars added. Even things that don’t taste sweet still have sugar added to it.

Obviously there’s a concern about just unnecessarily large amounts of sugar consumption in America and other Western cultures, really the standard American diet is what we’re talking about. But there’s also this kind of opposite trend that I see in a lot of the people I work with that sugar is kind of given this like evil… I mean whatever the opposite of like a health halo is, like evil devil horns or something on it where it’s compared to things like a drug like cocaine, or poison, or toxin, whatever like these kind of ideas that no one should ever touch sugar, it’s terrible for you, and anything you can do to eliminate sugar out of your diet is a good thing.

I think that kind of extreme end of the sugar question ends up driving people to use a lot of these non-caloric sweeteners, which again, small amounts or like if you really don’t tolerate sugar very well and you want to switch over to a little bit of these non-caloric natural sweetener, not a big deal. But I think you just kind of swing from like too much sugar intake and sugar…I don’t want say addiction… but like just bingeing I guess would be what a lot of people end up doing when they just go have as much sugar as they want. And that will swing to basically bingeing on the sugar alcohols and non-caloric sweeteners because it’s still a disordered approach to food.

It’s still kind of not really addressing the issues that actually cause sugar cravings. It’s not addressing the blood sugar imbalances that often make people want sugar in the first place. It’s really just saying instead of having real sugar, I’m going to replace it with this stevia, or this yacon syrup, or whatever. And like you said, if they’re already eating a lot of sugar and then they just start eating a lot of these prebiotic sugar replacements, that’s not necessarily going to turn out super well for them.

I feel like getting into that middle ground of understanding more about your body, like how you handle sugar, why you may not handle sugar, and working on the kind of things that can help your body tolerate sugar better, I think that’s a much healthier approach than like you said, just replacing sugar with these non-caloric options.

And like I said earlier, I do want to talk about just sugar in general because I really feel like there’s this belief that sugar is awful. And like you were saying earlier when we first started, it’s not accurate and it really affects how people approach sugar, and I think it really leads to the development of this like binge and restrict mentality around sugar.

First of all, that’s not healthy. We know that having sugar binges and then restricting it most of the time is not a healthy way to approach sugar, and it also really I think gives people a lot of anxiety around eating sugar. They’ll still do it because I mean realistically most people are still going to have some sugar in their life as an enjoyment food, but then they don’t even enjoy it because it’s like they can’t stop thinking about how terrible it is for them or how it’s going to get them addicted or something.

Sugar right now in the health food world has this terrible reputation as being a toxin or like a poison essentially. You’ll see a lot of these blog posts that have that like skull and crossbones photo next to sugar cubes or something and they’ll talk about how it’s as addictive as cocaine and all this stuff about it being awful.

First of all, I just want to kind of talk about those myths because I feel like that’s something that super is just taken as fact right now, and it’s not. It’s not a fact at all. First of all, sugar is not a toxin at all. If we’re looking at the true definition of a toxin, which is a substance that causes disease when present at low concentration in the body, sugar does not qualify as a toxin. We always have sugar in our body. We always have a circulating glucose amount. If it was a toxin, we wouldn’t be having it just all the time at a concentration on our bodies.

It doesn’t qualify for the definition of a toxin in the first place. And even if we were looking at like if somebody is going to say, oh well, you know water can become toxic if you overdo it. I don’t really know of any acute sugar intake level that would cause either a disease or death. I don’t know if they’ve ever established somebody dying from a too high of a sugar intake the way that people can actually become seriously ill or they can die from too much water intake.

But regardless of whether it’s happened or not, it’s really borderline impossible for somebody to have so much sugar in a single intake that they would actually react to it the way you would react to an actual toxin or a poison.

Kelsey: Right.

Laura: Our bodies are really good at handling sugar. Basically when sugar comes into our body, we have a couple of different options for dealing with it. One is it can be stored as glycogen either in the liver or the muscles. It can be stored as fat if we don’t need to be storing it as glycogen, or burning it for fuel. It’s essentially going to be used as energy. It can be stored as glycogen or it’ll be stored as fat. It doesn’t just circulate around the body and cause harm in the average person.

Now this isn’t necessarily covering someone that has diabetes. Obviously someone with a severe either type 1 or type 2 diabetes, that could become dangerous for the person to have a lot of sugar at once. We’re talking about normal human physiology right now.

This is something that I think people really need to understand because if you have generally normal blood sugar control and insulin response, you’re not going to be able to eat enough sugar for it to actually become toxic where could really cause harm in the short term. So that’s one thing I think we need to like just eliminate this definition of sugar as a toxin, because it’s not a toxin.

And then with this question about it being as addictive as cocaine, that’s actually not really an accurate representation either. That research is more based on the way that sugar activates the pleasure centers in our brain the same way that drugs do. That doesn’t necessarily mean sugar acts the way a drug does.

Definitely there are some people that can get behavioral addiction to food and overeating in general, and sugar is certainly one of those foods that is a pleasure center actor activator, but so is fat.

Kelsey: Right.

Laura: Fat in food does also activate these pleasure centers. But that doesn’t mean that food works the same way as drugs do in terms of how it affects those pleasure centers, how it builds up tolerance and causes like that withdrawal if you don’t have it.

And really these pleasure responses to food, this is the way that our bodies drive the seeking out of necessary nutrients. It’s not like this is some pathological thing that if your food that you’re eating activates your pleasure circuits in your brain, that’s dangerous. That’s actually the way our bodies work to actually promote food consumption. It also drives us to seek out variety, which again, getting necessary nutrition, you need a lot of variety because you can’t just eat the same food all the time.

And this is actually a normal thing that happens in every person that eats food. They’re going to have some level of pleasure response to food because anything that is necessary for survival relies on that pleasure circuitry to promote the behavior. This innate drive for sugar or glucose is actually a survival mechanism. It’s not a pathology. It’s not an addiction.

Cocaine is not something that the body is going to seek out naturally. If you get exposed to cocaine and it triggers those pleasure centers, then yeah, you’re going to start getting addicted to it, and that’s why they kind of compare it to cocaine. But drugs are going to tap into that reward circuit in a much more powerful way that supports that true addiction and it causes extreme withdrawal when the person stops taking the drug.

Whereas with food it’s like yeah, you’re going to get a response, but you have to keep eating food. You can’t say I’m going to quit food because it’s like I’m addicted to food. It’s just stupid.

Kelsey: Right.

Laura: I feel like people have this belief that sugar acts like cocaine, and it definitely doesn’t. And that like toxin or addictiveness of sugar perspective, if people understand that that’s not actually accurate, I think they can take a much more realistic and reasonable approach to sugar if they’re not having all this anxiety about how dangerous it is.

Do you have any anything to add about that particular issue with sugar?

Kelsey: Yeah. I mean I just see that a lot, and I’m sure you do too, with in my clients that I work with, people just have this idea that they’re addicted to sugar in the first place. And I think that first of all, thinking about it that way almost feeds into that behavior because if you feel like you’re addicted to something, you’re just going to be thinking about it more and just kind of ruminating on it, and I think that in some people certainly can almost cause that sort of behavior. Just the way that you think about something can really make it a self-fulfilling prophecy.

I do a lot of education on this with the clients that I work with that like you just said, you can’t be addicted to sugar. That’s not how it works. It’s a necessary thing and so your body is not going to make you addicted to it.

It is going to be pleasurable of course, but that’s okay. You don’t have to feel bad that you want to eat something that tastes good because that’s just going to make you feel pretty much terrible about everything you eat, I think. And if you’re thinking that sugar is this evil thing and then you’re thinking oh man, I really want something sweet, of course you’re going to feel like you’re addicted to it. And again, it’s going to become a self-fulfilling prophecy. You’re going to feel like you want to eat it all the time or just think about it and feel bad about the fact that you ate it at one point.

This is something that I have to talk to people a lot about because once you stop thinking about it that way, it’s much easier to just say okay, I’m going to have a little bit of sugar. That’s fine. It’s a small piece of my diet and it’s not causing me any harm.

Of course this is a totally different conversation when we’re talking to people with diabetes, or with pretty severe blood sugar issues, or somebody with hypoglycemia maybe who really can’t have a lot of sugar at once because it’ll spike their blood sugar and then tank it down and they’re going to feel really poorly after that. That’s an entirely different conversation in those people. We do need to be very careful with their sugar intake.

But for the average person, that’s not the case, and like you said, they use sugar very well because the body has a lot of ways of using that that are perfectly normal. Once we change that mindset surrounding sugar, I feel like it’s a lot easier for them to just eat it in normal amounts and not be thinking about it all day or not beating themselves up over the fact that they’re “addicted to sugar.”

Laura: Yeah. I think like you said, it’s really disempowering if you approach sugar as this addictive drug essentially. Yeah, if you want to think about heroin as being something you probably shouldn’t mess around with because you might become addicted, yeah, I think that’s an appropriate way to approach drugs. Avoiding drugs because they really do significantly change your brain chemistry, a lot of times with like the first time people even try a drug, it just like totally alters their dopamine response and their pleasure circuitry so that they need this really powerful level of impact to actually get a normal response.

Sugar doesn’t work like that. And we’re not saying that there may not be some people out there who really feel better if they just avoid it, and they don’t struggle with it, and it’s fine. Kind of like overeaters anonymous model, it works for some people. If it’s working for you, we’re not saying that you’re unhealthy because you’re not eating sugar.

We’re really addressing those people who have a lot of anxiety about sugar and want to be able to enjoy it with a level of normalcy that is culturally acceptable. I’m not saying you have to go and have like Fun Dip every day or something, but being able to have some sugar here and there without stressing about it, I feel like there’s a lot of people out there that because they have these false beliefs about sugar, they can’t enjoy it.

I mean if you’re going to a party and someone’s like have some cocaine with us. And it’s like well, I don’t know. Maybe I shouldn’t have it, but I’m just going to have it because you know it’s socially acceptable. Yeah, I understand if you felt like a little anxiety about that. But it’s like if you’re going into a party and you’re looking at a cupcake as being that same experience, I think that’s definitely driving a level of disorder around food that is not really necessary for good health and causes people a lot of stress.

And like you said, sometimes, and I’ve been here where it’s like you’re so anti-sugar and anti that kind of like sweetened food, or even carbs in general, and then like the minute you let yourself have the stuff, you just like binge on it.

Kelsey: Right.

Laura: I think, like you said, it kind of sets people up for these really unhealthy approaches to sugar containing foods. Whereas if you’re able to look at it objectively, you’re able to look at it as it’s kind of a benign substance, it’s not a health food, sugar is not necessarily something that has tons of nutrition in it or anything like that, but in the context of an overall nutrient dense diet… and we talked with Chris Masterjohn about this a little bit in another podcast where it’s like having some sugar in the context of a diet that provides all the other nutrients that you need, it’s really not a problem for probably the vast majority of people.

That can actually be a good segue to another thing I wanted to talk about with sugar. Because again, we’re not saying sugar is some health food that you need to be having a ton of to be healthy. We just want to kind of clear the myths around sugar because it’s something that can definitely be included in a healthy diet with not any problem.

For me, I think the biggest issue I see with sugar is that it’s something that we would call empty calories. Empty calories just means it’s providing some kind of calorie or macronutrient, usually we’re going to talk about more fat and carbs as being empty calories as opposed to protein. I wouldn’t ever really consider a protein food empty calories. It’s very difficult to overeat on protein. But we’re generally talking about foods that are either high in carbs, high in fat, either, or both, or a combination, and they don’t have much micronutrition to them.

Generally if your goal is to eat a nutrient dense diet, then eating a lot of pure cane sugar for example is going to reduce the nutrient density of your diet overall because it doesn’t really have any nutrition in it other than just glucose and fructose essentially. That doesn’t mean it’s bad. It just means that it’s not going to promote high nutrient density.

Generally if your diet is full of a bunch of empty calories, it’s going to be more likely that first of all, that you’re not going to be nourished appropriately. If you have a lot of just processed foods or a lot of low nutrient density foods in general, you’re either going to be malnourished or you’re going to end up over eating in total calories because your body’s going to continue to seek out the nutrients it needs. Maybe you got enough of those micronutrients because you eat twice as many calories as you need for the day because your foods are so low nutrient density.

I’d say the second scenario is a lot more common than the first. But I do see a lot of…usually it’s a lot of kids that are not overeating total amounts of food, but they just eat such low nutrient quality food that they’re malnourished. You’re either going to be malnourished or you’re going to be basically over consuming calories if your diet is super low nutrient density.

Nutrient density, again, we’re just looking to maximize the amount of micronutrients and essential macronutrients that we need without going overboard in total calorie intake. If we’re within a context of a calorie appropriate diet that does contain adequate amounts of micronutrients and macronutrients… so micronutrients are things like vitamins, minerals, that kind of thing, certain let’s say essential fatty acids that technically are a macronutrient, but we could consider those more micronutrients because we need small amounts to get what we need.

Macronutrients are really more things like proteins, carbs, fats where we have some baseline needs of that. Like we have a certain amount of protein we need every day, we have a certain amount of fat, we do have a certain amount of carbs that we need. Our body can manufacture those carbs, but that doesn’t mean that’s the optimal way to do it.

But essentially if our diet is providing adequate amounts of micronutrients and macronutrients, once we’ve had our nutrient needs for the day within our food intake, whatever the rest of your calories come from assuming you’re not overeating on calories, it really doesn’t matter that much. I mean certainly you don’t want to be eating things that are causing food sensitivities or something, like if a celiac person is going to say I should have wheat for the rest of my calories. Obviously no, we’re not saying that. But generally if it’s foods you tolerate, getting 20 percent of our calories from foods that are not super high nutrient density is really not a big deal.

Just to kind of have a little side note about nutrient density, we always talk about things like sugar and processed foods as being low nutrient density. But there is a lot of Paleo foods that I would consider pretty much empty calories as well, like I hate to say it, but like coconut oil. I kind of look at that as like as empty calories.

Kelsey: Yeah.

Laura: Because other than just fat, it doesn’t really have any micronutrition to it. Bacon is one of those foods that I think Stephan Guyenet was talking about as being like one of those. I mean it gives you a little bit of protein, but really it’s pretty much empty calories if you’re looking at the total amount of calories it provides compared to the nutrients it gives you.

Things like bacon, and coconut oil, and tons of extra butter, that kind of stuff, that kind of counts for extra empty calories. You’re not getting a ton of nutrition from those foods. Whereas things like fruits and vegetables, meats, eggs, that kind of stuff, you’re getting a lot of nutrition in less calories total.

That’s why if you’re getting, let’s say like I said, 80 percent of your foods are super high nutrient density, and you’re getting all of the needs that you have for micronutrients in those foods, and you still have another let’s say 400 calories, you can eat whatever you want. And some of that, yeah, if it comes from sugar, you should be fine.

I feel like most people don’t approach sugar that way though, and that’s the problem.

Kelsey: Right.

Laura: Most people don’t eat a diet that’s super nutrient dense that the bulk of what they’re eating is a lot of high nutrient value and not a lot of calories. That’s when I was saying before about figuring out how to increase your sugar tolerance, having a lot of nutrients in your diet is a great way to increase your sugar tolerance because 1 – that’s going to help you have a higher metabolic rate, 2- you’re going to be a lot more insulin sensitive because you’re not going to have a ton of inflammation. You’re just going to basically function a lot more normally with the amount of calories that you’re burning just to be alive or to do the kind of activities that you do.

And then a side note is that…and this is something I was literally just listening to, gosh was it yesterday? It might have been yesterday. Driving home from a weekend away I was listening to like a bunch of Chris Masterjohn’s podcast and he has a great one that just came out on the insulin/obesity hypothesis. It’s like an hour long plus podcast. But the main conclusion he comes to that I think is really relevant to this conversation is that energy status in the cell is actually the main factor that affects our cell’s ability to use glucose for energy or to store it as fat.

A lot of people think insulin is the main driver of our bodies use of glucose or whether our cells take up glucose or not, but insulin is just part of the equation. Our cells can reject glucose even in the context of a higher insulin amount because they have other signals on a biochemical level that suggest that the cell has more energy available than it can use.

Kelsey: Interesting.

Laura: Yeah. I mean it all makes sense from a biochemical perspective. Kelsey and I did biochemistry pretty in-depth for our training as a Registered Dietitians. It’s not like there was anything new, well I shouldn’t say there wasn’t anything new. I feel like all of the different components of the cellular metabolism that he was talking about, I had heard of all of them and I was like remembering them from years ago when I learned about them and had to be able to spit them back out on a test. But I think it just kind of brought it into a context that made a lot of sense as far as how that actually plays out in the body.

Realizing that like, yeah, insulin does drive glucose uptake through certain transporters in the cell, but that doesn’t mean the cell has to either accept that glucose or keep it in the cell. It can also be kind of passively released from the cell if it’s not going to be used.

I just thought it was a really interesting adjunct to this conversation because anything that we can do to increase our body’s appropriate energy use is going to really improve our insulin sensitivity. That would be things like good micronutrient intake because our micronutrient status will affect how our body is able to actually even send these nutrients through the Krebs cycle, which is how we get energy from our food, or the amount of exercise that we’re doing, or let’s say like building muscle is going to increase how much energy your body uses to just even sit on the couch.

It kind of comes down to like a calories in/calories out question where if we’re not overeating, then we shouldn’t develop insulin resistance in just the way that the body works from a normal perspective. But that does require appropriate nutrition and micronutrient intake.

I just thought it was really cool. I think if you’re into that kind of biochemistry, then listening to that podcast would be awesome.

Kelsey: I’m going to have to listen to that.

Laura: Yeah, it’s good. I’m like loving what Chris is putting out lately. That’s like my little plug for Chris’ insane amount of content that he’s been putting out.

But I just think it’s really important because I think, again, with this whole sugar question, there is this assumption that if you raise your insulin ever at all for any reason that that’s going to create fat storage. And that’s just blatantly not true from a biochemical perspective.

So again, really just the summary of that podcast and how it’s relevant to what we’re talking about is that things like overeating total calories, under exercising or not moving enough, malnutrition which is going to affect your energy metabolism. I’m sure there’s other things like sleep, and stress, and all that stuff that affects the adrenals and cortisol is going to affect how well your body takes up glucose, that kind of thing.

There’s like a thousand different factors that affect our energy status in the cell, but insulin levels are not necessarily directly driven by the amount of glucose that we consume. It definitely affects it, but it’s not the only thing that affects our insulin sensitivity. And to just kind of over simplify it to that I think not only is scientifically inaccurate, but then it puts way more emphasis on avoiding sugar than it does on like getting a micronutrient rich diet, exercising appropriately, reducing stress, sleeping, all that other stuff that’s I think way more important than strictly avoiding sugar all the time.

Kelsey: Yeah, and I think that’s because it’s easy to tell a population at whole, just don’t eat sugar. That’s one thing where it’s exactly what you just said, that’s a lot of things to keep in mind. But I agree, they’re overall way more important than boiling it down to one specific thing being the problem and being the cause of all sorts of disease.

I think it’s important to think about it that way like disease is never caused by one specific thing usually. There’s all these environmental factors and things going on in your body that that play into developing any sort of disease state. I think it’s too simplified to just look at one thing, especially just one thing in your diet. That’s like looking at such a tiny piece of the overall puzzle that when you really think about it, it’s like yeah, that doesn’t make any sense. There’s so much more to this whole question. I think it’s really important to remember that because it helps to clear up that confusion about sugar and make you remember that it’s just one piece of the overall puzzle.

Yeah. I feel like the take home point here is that if you’re generally able to consume sugar without eating sugar causing overeating…and what I mean by overeating is just that you’re eating more calories than your actual body is burning for your energy needs. And again, in the context of a nutrient dense diet, sugar really shouldn’t cause any harm.

I’d say there are people out there that find that sugar does drive overeating and they don’t feel confident in their ability to stop eating when they’ve had enough. Then for those people, yeah, keeping sugar out or keeping sugar to just fruits and natural things that contain sugar may be necessary to maintain an appropriate calorie intake.

With our conversation with Stephan Guyenet a couple of weeks ago, that’s not just sugar. That may also be added fats. That may also be things like butter, like maybe adding butter to your food is going to cause just the same amount of overeating as adding sugar.

We need to kind of look at that as there are foods that do drive the hunger response and if you are someone that needs to lose weight or you’re generally overeating, then cutting out added sugars and added fats is a super easy way to reduce excessive calorie intake without really causing any sort of malnutrition.

But for the people out there that are listening, which I think a lot of our audience probably falls into this category, if you are someone who doesn’t have any sort of like binge eating issues…and again with the understanding that the bingeing may come from the restrictions, so it’s not necessarily just that like sugar immediately causes a binge in you… but if you are the kind of person that is either able to enjoy sweet or sugary foods in moderation or this is your desire to be able to do that as part of a larger healthy diet context, especially if you’re active because the more active you are, the more wiggle room you have with calorie intake, then I really don’t see any problem with including sugar in the diet.

And again, from what I’ve been learning about just metabolism, and calorie needs, and all that, my theory is that most of the time when people are craving sugar, it’s either that their diet is insufficient in micro or macronutrients so maybe they don’t get enough B-vitamins, or maybe their protein intake is super low and that causes their energy needs to be different than what they should be, it causes their blood sugar to fluctuate. It just causes a lot of different things that cause dysfunction in the metabolism in their body and it either makes them crave sugar or makes them not tolerate sugar super well.

And then like we were saying before, the other reason why someone might be craving sugar is that they’re on such a restrictive diet that they end up bingeing on sugar whenever they allow themselves to have it.

I feel like we could do another podcast on this and we’re obviously getting close to the end of our time here, but my feeling is that we need to just have an accurate viewpoint of sugar. And I’m hoping that this podcast gave people a little bit more of a realistic…and I don’t even know what the word is…

Kelsey: Accurate.

Laura: Yeah, less hysterical viewpoint about sugar. It’s not that you have to have it. We’re not saying you have to. But we’re also saying that avoiding it 100 percent is not necessarily the answer to good health. And from a mental health perspective, I really feel like a lot of people, and I’ll put myself in that category, and Kelsey, you may as well, having some sugar as a treat maybe a couple of times a week, maybe once a week, maybe every day, it really does help support an overall healthy approach to food and doesn’t actually negatively impact health in any substantial way that it would be worth removing.

Kelsey: Yeah, absolutely. I’ll say too that there’s nothing wrong with those lower calorie sweeteners that we talked about at the beginning of the show. I know that’s originally what this person was asking about is things like that IMO Syrup, that isomalto-oligosaccharides syrup. Like totally fine, if that’s what you want to choose for your sweetener of choice, that’s okay.

Again, it’s going to be in a small enough amount that you’re not going to have concerns over the gut issues potentially unless you have some major digestive problems already and you really need to be careful with that kind of stuff. In the small amounts that you’re going to have in the overall context of a calorie appropriate diet for you, it doesn’t really matter what sweetener you’re choosing.

We’re just trying to say that you don’t need to choose those sweeteners for the sake of avoiding caloric sweeteners. I hope that that’s clear. If that means that you still want to do these lower calorie sweeteners, that’s totally fine.

Laura: Right.

Kelsey: But if you want to do something like maple syrup, honey, or even just cane sugar, that’s also completely fine as long as it’s that generally fairly small percentage of your overall calorie intake within the context of a calorie appropriate diet like Laura was talking about before and you’re getting proper micronutrition, you’re getting your sleep in check, your stress levels are good, you’re going to be fine.

I think that’s the takeaway here is that it’s not as big a deal as I think a lot of people think it is and sweeteners are completely okay to use.

Laura: Right. With the non-caloric options, I would say if I was going to recommend those, it would be for somebody who needed to be on a fairly low calorie diet. Like let’s say they’re trying to lose weight and based on their….It was sort of like that conversation we had about that shorter woman who was struggling to lose weight on 1,800 calories and it’s possible she needed a lower calorie amount. In that situation, yeah, maybe doing stevia as a little bit of a sweetener so that way you can cut out 100 calories from sugar for the whole day, that may help you reach your goals better.

Kelsey: Right.

Laura: And we’re not saying you have to. There may be some other changes you can do that would allow you to still have that sugar. Maybe you cut down on your rice portion at dinner instead or something. These are all totally valid choices to make and it’s really about what’s going to work best for the individual.

But like we said, I think we just wanted to address the really prevalent myth that every person who’s health conscious should be looking to replace caloric sweeteners with even just these natural, let’s even just say they’re harmless, which they may not be. Let’s assume that they, let’s say they’re harmless. The assumption that you’d have to do that I think is really a big problem and we wanted to address that in this podcast.

If you guys have more questions about sugar, please feel free to ask them. If the person who asked this question doesn’t feel like we actually covered their question, then please let us know and we’ll definitely do another episode on this topic.

But we just wanted to really set you guys up for a good understanding of sugar in general so that way when you do decide if you’re going to try out some of these non-caloric sweeteners, you’re making that decision from a place of appropriate scientific knowledge and not fear about sugar.

Kelsey: Absolutely.

Laura: I think that is a good place to stop for today. Thank you for joining us everybody. We are really glad to have you here.

Again, if you’re liking the show, go to iTunes and leave us a review so that way other people can find the show. If you want to ask us your question, go to TheAncestralRDs.com and we have a contact tab where you can submit your question. Again, we love talking about things like sugar, so definitely send us your follow-up questions to this episode.

Otherwise, we will see you here next week with I believe maybe an interview, but we’ll see what happens.

Kelsey: Alright. Take care, Laura.

Laura: You too, Kelsey.

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