This post is part of my “Know Better, Do Better” series, in which I revisit an old blog post that makes me cringe because my thinking has evolved substantially since I wrote it. The text of the original post is in italics, with my somewhat snarky current notes in plain text.
This post looks at content from three posts that I wrote in 2011. I was five to six months away from starting my Master of Public Health program in Nutritional Sciences at the University of Washington.
As mentioned in previous “Know Better, Do Better” posts, I was fully on the healthism train and deep in my disordered eating. I also felt extremely judgmental toward people who didn’t work “hard enough” to eat healthy.
I could really hate my 2011 self, but I’m extending my past self some compassion, because I clearly had a lot to learn. Also, I’ve had many clients who have similar thoughts and beliefs about food to what I had back then, and I know how it makes your world smaller.
Synergy in cancer prevention (March 2011)
I start out by talking about an online lecture about preventing cancer through nutrition by a researcher who subsequently died from cancer.
One element of his talk that I particularly liked was synergy. In other words, it’s not enough to just eat broccoli OR eat dark chocolate OR drink a glass of red wine OR exercise OR eat healthy fats. While many foods and behaviors have anti-cancer benefits, they work in synergy with each other. He said this is actually similar to conventional drug therapy: whether you’re treating cancer or AIDS or tuberculosis, a combination of drugs (often three) is generally used.
The synergy part is true. We’ve since learned that the health benefits of red wine, and even moderate alcohol intake in general, have been overblown.
Too often, people latch onto the latest news story about how dark chocolate is good for you or whatnot, and think that if they start chomping away, that they are being healthy. It’s not about a single healthy action, it’s about a healthy lifestyle. The whole is greater than the sum of its parts.
Again, true. I don’t really like some of my word choices, though. For example, “chomping away”? I can read the judgement in those words.
Another thing he mentioned was that sugar feeds cancer. True in a petri dish, true in our bodies. [Update 8/9/14: I now know that this is not precisely true. Cancer does use sugar for fuel, but what is really a problem is having high blood sugar, for two reasons. One, more sugar floating around in the blood means more sugar that can be used by cancer cells. Two, high blood sugar generally goes hand in hand with insulin resistance, and when you are insulin resistant you have more insulin floating around in your blood, and cancer cells have insulin receptors that are often functional even when the insulin receptors on your normal cells are not. Insulin encourages cell growth, which is not something you want with cancer cells!]
I wrote that update at the very beginning of a brief stint working as an oncology (cancer) dietitian and still had stuff to learn. It’s true that insulin resistance—when the insulin your body produces has trouble moving blood sugar from your blood to your cells—is a significant risk factor for several types of cancer, which is one reason why effective management of type 2 diabetes is important.
Sugar Shock, Part 1 (April 2011)
Having watched two online lectures in as many days about nutrition and cancer prevention, I’m noodling heavily over the notion that a diet that helps prevent cancer may be awfully similar to a diet that promotes optimal health. I’m not saying that this is absolutely so, but the concept has a lot of merit, and it’s something I intend to explore further in the coming weeks.
🙄 The idea that what we eat is the primary driver in whatever the hell “optimal health” is false. There are many, many contributors to health, including genetic, social and environmental factors. And what “optimal health” looks like in one person is different from what it looks like in the next person. I can tell you that back in April 2011 I totally bought into the idea that if we work hard enough, we can attain “optimal health,” and that looked one way: perfect health and freedom from chronic disease. I can hardly stand my 2011 self right now.
One chunk of information I learned that really hit me over the head was that cancer cells thrive on glucose. Biochemist Otto Heinrich Warburg won the Nobel Prize in Physiology or Medicine for this discovery in 1931. Research published last year suggests that while cancer cells thrive on glucose, they divide and proliferate more readily in fructose. Table sugar (sucrose) is 50 percent glucose and 50 percent fructose. High fructose corn syrup is about 45 percent glucose and 55 percent fructose. Honey contains about 60 percent fructose. Yes, you read that right.
I was already well-versed in the American Heart Association’s recommendations that people limit sugar intake, as the evidence linking sugar and heart disease has been accumulating for some time. With my current lifestyle behaviors, I feel pretty confident that I’m able to ward off heart disease.
Note to 2011 me: Disease-proofing is not a thing, you self-sanctimonious fool.
But cancer has always seemed a bit more nebulous, partly because cancer can happen anywhere in the body.
True
So, to coincide with the beginning of my company’s annual spring exercise and weight loss challenge on Monday, I’m giving up sugar. I’ll start with a two-week commitment, then reassess. Oh, I’m giving up alcohol, too, under the same terms. And peanut butter, because it’s high in the omega-6 fatty acids we get too much of (almond and other nut butters are higher in omega-3s, and thus are healthier choices).
Do. Not. Even. Get. Me. Started. This was the height of my disordered eating, which thankfully did not turn into a full-on eating disorder. (I’m clearly not genetically predisposed to one.) I was obsessive and not fun to be around, especially when I would have complete meltdowns over things like sharing food at campouts with extended family. (“But none of their food is healthy!!!”) I was doing a lot of big talking about health, but what lied beneath was the drive to control my body, and let’s be frank, that included controlling its size and shape. (Oh, and 🤬 to all workplaces who organize these “Biggest Loser”-type challenges.)
Why am I doing this? Because I can. Really, there is no good reason to eat sugar. It has no health benefit. Can eating sugar-containing foods be enjoyable? Absolutely. I don’t eat much sugar, and really don’t miss it when it’s not around, but I do have a raging sweet tooth that can rear its ugly head when treats are easily at hand and ripe for the plucking. However, I enjoy many foods, most of which don’t contain sugar. So I am confident that I can ditch the glucose and fructose and still enjoy my meals.
[Update 8/9/14: This was an interesting experiment, in part because it was a good lesson in how hard it is to avoid certain ingredients when you eat processed or manufactured food. While it’s good to keep sugar to a minimum, and be aware of the presence of added sugar, I don’t advocate going 100% sugar free on a long-term basis. It’s not necessary, and can turn into an obsession, which may be unhealthy in its own right.]
I rarely eat out and cook mostly from scratch, so keeping sugar out of my food will be pretty easy.
I was clearly virtue signaling and looking for a gold star. Also, I can see how badly I was fence straddling in 2014. I clearly had a more balanced mindset, but I don’t like that, reading between the lines, I seemingly advocated for going sugar free on a short-term basis.
Want to know what I will be eating more of? Kale! Turns out kale, which is a member of the cruciferous family of vegetables, shares broccoli’s cancer-preventive properties. But wait, there’s more! It’s also a dark leafy green, with all the folate-rich, cancer-fighting goodness that entails.
Yes, kale is super nutritious and I still eat and enjoy kale, but, again, I was also virtue signaling and looking for a gold star.
Sugar Shock, Part 2 (April 2011)
I used to be a big fan of [redacted] products. Then it occurred to me that they were just highly processed foods with an aura of health surrounding them. Just because a highly processed food product contains whole grains, doesn’t mean it’s not still a highly processed food.
OK, this is technically true, but I don’t love how judgy I was when writing this.
Most of the [redacted] bars have sugar as three of the first four ingredients. Sure, the sugar wasn’t just white sugar. It came in the “healthy” guise of brown rice syrup, evaporated cane juice crystals, evaporated cane juice syrup, etc. But it’s still sugar. It’s still highly processed. Let’s call a spade a spade.
Ditto.
I eat very few snack/energy/meal replacement bars (I get more ultimate satisfaction from real food, like a piece of whole fruit and a few nuts). But in a pinch, I feel very good about reaching for a [redacted], which is pretty darn close to real food.
Good grief, how did I even put up with myself back then? It’s true that I don’t eat a lot of bars unless I’m out and about and need a handy non-perishable snack with me, but still…
As Dr. [redacted] says in the lecture I listened to last week, don’t pay too much attention to the grams of sugar listed in the Nutrition Facts box. But pay a lot of attention to sugar, in any of its forms, listed in the ingredients list. Why? Because many foods include some natural sugars. Look at the nutrition facts box on a carton of milk to see what I mean. The grams of sugar listed come from lactose, the natural sugar found in milk (unless you’re looking at a carton of chocolate milk, of course).
This isn’t not true, but reading this now makes me cringe because I know how utterly obsessed with label reading I was back then. I was not in a healthy headspace.
I was dismayed to find that my favorite [redacted] soup from [redacted] contains added sugar. That means it is verboten during my personal two-week no-sugar challenge. Since food manufacturers are (so far) not required to break out how many grams of sugar are from added sugars, there’s no way for me to know how much added sugar is really in the soup. Cane sweetener is third on the ingredient list, but reduced fat milk is first. So how many of those 10 grams of sugar comes from the lactose? I sure can’t tell.
What did I just say about how obsessed I was? News flash, I do eat that soup today.
Health experts have been calling for food labels to disclose grams of added sugar for well over a decade, so I’ll believe it will happen only when I see it happen. I am cautiously optimistic, and ever hopeful.
Golly, looks like I got my wish. I do think it’s a good idea to separate out total sugar from added sugar, but I am still constantly explaining to people that, for example, the total sugar in yogurt includes the natural sugar from lactose, and that we DO NOT NEED TO WORRY about natural sugar. At all. (That goes for the natural sugar in fruit, too.)
So what does a day of no sugar look like? Here’s what I ate today:
I’m not going to share this, because “what I ate in a day” content has real potential for harm. I will say that many of the meals/snacks in this day are eating are still meals/snacks I enjoy, but 15 years ago I had a very rigid almond-mom approach that thankfully I’ve released myself from. There was a lot of B.S. such as literally counting nuts and fruit servings, plus some silly-ass statement about how putting cinnamon on sweet potatoes practically makes them taste like dessert. (No shade to sweet potatoes…I love them, with or without cinnamon.)
As I mentioned, I’m also off alcohol for two weeks (to start). I’m also planning to cut back on caffeine. In addition to my morning 2-3 cups of joe (depending on the size of my mug), I’ve gotten into the habit of having a small cup in the afternoon and often a shot of espresso after dinner. That’s probably a shade too much…even if coffee is full of antioxidants!
Regarding the caffeine, I kind of want to say 🤬 to my overly obsessive and, once again, sanctimonious past self.I don’t drink that much coffee now, but I base my intake on what feels right…sometimes more than one cup in the morning feels like too much, but sometimes two feels just right.
Final thoughts
I’m so glad that my knowledge and understanding of nutrition and health has evolved since 2011, and that my thinking and beliefs were also able to shift. I don’t like to think of the harm I could have done to my clients if, as a dietitian, I still had those rigid beliefs.
Disclaimer: All information provided here is of a general nature and is furnished only for educational purposes. This information is not to be taken as medical or other health advice pertaining to an individual’s specific health or medical condition. You agree that the use of this information is at your own risk.
Hi, I’m Carrie Dennett, MPH, RDN, a weight-inclusive registered dietitian, nutrition therapist and body image counselor. I offer compassionate, individualized care for adolescents adults of all ages, shapes, sizes and genders who want to heal from an eating disorder, disordered eating or chronic dieting, cultivate an accepting, respectful relationship with their bodies, and gain the freedom to live an authentic, meaningful life without obsessing about food.
Need 1-on-1 help for your nutrition, eating, or body image concerns? Find out how to get started. I’m in-network with Regence BCBS, FirstChoice Health, Providence of Oregon Health Plan and United Healthcare, and can bill Blue Cross and/or Blue Shield insurances in many states. If I don’t take your insurance, I can help you seek reimbursement on your own. To learn more, explore my insurance and services areas page.
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