The Keto Prescription – THE TRUTH ABOUT SUGAR

Dr. Jodi Nishida
Hawai‘i Herald Columnist

Editor’s note: I am happy to introduce our new columnist, Dr. Jodi Nishida, to readers of The Hawai‘i Herald. She is here to share her knowledge and insight on how to attain a healthy and thriving sense of well-being through nutrition. You can look forward to “The Keto Prescription” column in the second issue of the Herald each month. Dr. Nishida also hosts “The  Ket-Oh! Show” on The Keto Prescription YouTube channel.

There are two white crystals in our lives when it comes to food. The first is salt, and the second is sugar. Yes, sugar is sweet and makes everything taste good, but understanding what it does to your body is uber important when it comes to health. The discovery and domestication of sugar date back to 4000 B.C. During the medieval period, sugar was costly and considered a “fine spice.” For most of the 13^th-19^th centuries, sugar was one of the top commodities. Sugar reached Hawai‘i in significant amounts in the mid-1800s. Many of our ancestors moved here from different parts of Asia to work on the sugarcane plantations, and in 1906, C&H Sugar came to be. In the United States today, the largest sources of sugar are sugar cane and sugar beets.

1. Sugar consumption. In 1915, the average sugar consumption per person per year was 17.5 pounds. In 2011, that number rose to 150 pounds per person per year. In 2021 alone, 11 million metric tons of sugar were consumed by Americans … 11 million metric tons! Congruently, obesity rates rose. In 1960, only 12% of adults were considered obese, and only 5% of children were considered overweight. As of 2018, 42.4% of adults in the U.S. are considered obese, as well as 20% of children under the age of 19. Because of the COVID-19 pandemic in 2020, those numbers rose even higher as people stayed home and ate more than usual.
2. Hidden sugar. Now you may be sitting there thinking, “That can’t be me. I don’t add that much sugar to my food!” Did you know that all carbohydrates turn into sugar in your body? Carbohydrates include rice, pasta, potatoes and bread. Even brown rice, wheat bread, whole grain bread and sprouted breads turn into sugar. Grains turn into sugar such as oatmeal, wheat and quinoa. Even beans turn into sugar.
   • There is a straightforward calculation to figure out how much sugar turns into in your body. Total grams of carbohydrates ÷ 4 = teaspoons of sugar. Grab the bag of rice or loaf of bread from your cupboard and find the nutrition label. Go to where it says total carbohydrates expressed in grams, divide that number by four, and that will tell you how many teaspoons of sugar per serving. If you were to check your blood sugar after eating a serving of any of the foods above, you would notice an increase.  
3. Fruit sugar. I used to think that fruit sugar, also called fructose, was good for you. That’s what we were told. Through my recent education and experience over the last four years, I’ve learned that’s far from true. Fructose has detrimental effects on the human body, including insulin resistance, obesity, increased bad cholesterol and a condition called non-alcoholic fatty liver disease.  
   • Have you ever noticed that our Dietary Guidelines for Americans (dietaryguidelines.gov) recommend 5-7 servings of fruits and vegetables per day? That’s way too much fructose. And so many of our genetically modified vegetables contain more sugar than people realize. One corn on the cob has the same amount of sugar as two donuts. Quantity means everything when it comes to fruit and starchy vegetables. Tropical fruits like bananas, mangoes, pineapple, papaya and even grapes contain the most sugar, while berries such as strawberries, blackberries and raspberries have the least sugar. Aim to eat no more than ½ cup of these berries per serving and not every day. 
4. Artificial sugar. Here’s where the critical info comes in. Did you know that there are over 120 names for sugar in our food industry? There are over 120 clever ways food companies hide sugar and are allowed to put “sugar-free” on their labels. Some of the more common names for chemical sugars are maltodextrin, sucralose, dextrose, aspartame, acesulfame potassium, xylitol and maltitol. I don’t know about you, but most people I know can’t memorize a list of 120 names, and most people don’t read ingredients. These hidden sugars find their way into your body, causing tons of damage over time.
5. Processed Food. In which food products do these sugars most commonly hide?  Let’s start with packaged foods: cereal, snack bars and protein bars, yogurt, cookies, crackers, ice cream, baked goods, chips, beverages, coffee drinks, frozen meals, diet food and diet soda are just some of the many examples. Fast food, packaged food and convenient foods are a danger zone almost 100% of the time. Additionally, products that say “sugar-free” and “zero-calorie” are often not good for you. 
6. Sugar Addiction. One of the most significant issues I deal with is sugar addiction in my medical practice. It’s interesting. Psychologists and psychiatrists are trained in drug addiction, alcoholism, sex addiction and smoking, but very few are trained in sugar and processed food addiction. I know when someone is addicted to sugar because they’ll say things like “I need my rice,” “I love my noodles,” or “I gotta have my ice cream every night.” I hear these phrases so often in those exact words.
   • Sugar addiction starts in the brain. Sugar lights up the exact same receptors that cocaine and heroin do, but brighter and more intensely on brain scans. Yikes!  Sugar causes the release of dopamine, the pleasure hormone. Dopamine makes you feel happy, satisfied and soothed. The craving for more kicks in as dopamine levels drop and the addiction cycle begins. One thing you can start to do is notice if you crave sweets or snacks, in the form of food or beverage, at the same time every day. If so, that signals an addiction. 
7. Insulin Resistance. When you eat sugar, your pancreas releases insulin to help shuttle glucose (sugar) into your cells. Insulin causes weight gain. It’s a biofeedback thing. As sugar levels come down, insulin sends signals to your brain that tell you you’re hungry — more biofeedback. And thus, the hunger-increased appetite-weight gain cycle begins. Over time, more insulin needs to be released to handle the same amounts of sugar. This not only weakens your pancreas but leads to insulin resistance. Insulin resistance is a massive problem for the human body and is the common denominator for most of today’s medical conditions. When we think of sugar, we often think of diabetes. Sugar toxicity goes way beyond that. 
8. Diabetes. I would be remiss if I didn’t mention diabetes in this article mainly because almost 60% of people in Hawai‘i have a condition called prediabetes (Hemoglobin A1c 5.7-6.4%) or Type 2 Diabetes (Hemoglobin A1c 6.5% or higher).  It’s all the rice, mac salad, noodles, fruit, baked goods and local treats that we love to eat here. Add sugary coffee drinks and fast food to the list, and you can see how so many people end up there. These conditions have a slight genetic component to them but are driven mainly by diet (carbohydrates and sugar) and the development of insulin resistance. Remember, increased blood sugar leads to insulin release, which leads to insulin resistance over time. Diabetes progressively worsens over time and will require more medications and insulin if you never remove these foods from your routine.

I hope this brief A to Z article about sugar was helpful. I see so many people struggle with weight gain, food addictions and diabetes. It’s disheartening because sugar causes poor health, and no one talks about it. I encourage you to start looking at your food differently in the new year. Here’s to your health, happiness and prosperity!

Dr. Jodi is a Doctor of Pharmacy and accredited Metabolic Healthcare Practitioner who’s been in healthcare for over 25 years. After experiencing the ketogenic lifestyle’s effect on her own autoimmune condition, she decided to build a keto-based medical practice so others could benefit from it too. Over the last few years, she’s helped almost 1000 patients realize the benefits of clean, medically-guided keto.

With certifications in ketogenic nutrition, cardiovascular disease management, pharmacogenomics, and medication management, she works closely with each and every patient to tailor keto to their medications, medical conditions, lifestyle and socioeconomic situation. Dr. Nishida is also in training for processed food addiction recovery. To learn more, or to contact Dr. Nishida, visit her website at theketoprescription.com.

The content of this column is not meant to be medical advice. Please consult your doctor before starting any diet or lifestyle change and understand that there is no blanket approach to keto. Keto should be tailored to each individual through the guidance of a trained professional.