On Food Labels, What Is The Difference Between “Total Sugars” And “Added Sugars”?

Many who are trying to manage their weight or improve their health are looking to reduce sugar in their diet. Food labels are a bit confusing, because they have two categories for sugars: Total Sugar and Added Sugars.

Total Sugars are all sugars in the product. This includes naturally occurring and those added in the manufacturing process.

Added Sugars just includes those added in the manufacturing process.

Total sugars can be a bit misleading. For example, a glass of plain low-fat milk has 12 grams of total sugars. However, this is all lactose, a naturally occurring sugar that does not have much of an effect on blood sugar. Added sugars are 0.

When looking at food labels, focus on the Added Sugars column. Keep this at 0 or close to 0 if you are trying to limit refined sugar.

Nut Consumption And Brain Insulin Sensitivity

The Study

Improvements in brain insulin sensitivity may prevent cognitive decline and reduce risk of Alzheimer’s disease. In this randomized crossover study, 28 healthy overweight adults consumed 60 grams (359 calories) of mixed nuts for 16 weeks and then no nuts for 16 weeks. 

Brain insulin sensitivity was measured by MRI. Other risk factors for cardiovascular disease were also taken.

After consuming the nuts, subjects showed statistically significant improvements in brain insulin sensitivity. These subjects also had improvements in triglycerides, systolic blood pressure and LDL cholesterol.

American Journal of Clinical Nutrition 2024; 119:314-23

Take Home Message

Nuts are a nutrition powerhouse that have previously been associated with reductions in risk of heart disease, stroke, type 2 diabetes and obesity. They may also have a nice impact on cognition and reduce risk of cognitive decline.

The researchers were not sure of the potential mechanisms at play here, so more research is needed in this area. I try to have nuts with breakfast and lunch just about every day and recommend my clients do the same.

How Variety And Portion Size Can Influence Food Consumption

The Study

In this interesting crossover trial, 42 women ate a lunch once per week for 4 weeks that varied in 2 properties:

Low Variety: Consisting of 3 bowls of their favorite dish.

High Variety: Consisting of 3 different main dishes.

Small Portion: 450 grams

Large Portion: 600 grams

The results were interesting:

-When women ate the high variety lunch, they consumed significantly more food (15 more grams per meal).

-When women ate the large portion size lunch, they also consumed a significantly higher amount of food (57 more grams per meal).

https://doi.org/10.1016/j.appet.2023.107089

Take Home Message

If you are trying to cut calories, don’t include too many kinds of food in your meals. Keep it simple.

It is also a good idea to serve yourself a reasonable portion in your kitchen and bring it out to your table rather than having a huge serving dish right in front of you.

Book Review: The Longevity Diet

Next up for review is The Longevity Diet, by Valter Longo, PhD. The author is the Director of the Longevity Institute at University of Southern California. I recently heard him give a talk at the Harvard School of Public Health and was so impressed that I went out and bought his book.

Introduction

The main focus of this book is about increasing longevity. It contains nutrition, exercise and modified fasting tips based on the author’s research. The book is 317 pages. It is very well written and I enjoyed reading it.

5 Things I Really Liked About The Longevity Diet

1) In an effort to reduce conflict of interest, the author donates all of the proceeds of this book to charity. I think this is terrific.

2) The author does not promote fasting because of the side effects, including an increased risk of heart disease. I could not agree more. The research literature has shown some serious problems with fasting and our health.

3) I really like the discussion on glycemic index and glycemic load. He mentions that glycemic load is the more important of the two and I totally agree with this.

4) There is a really good section on the health and longevity benefits of cardiovascular exercise. This part of the book is really well done.

5) His longevity diet is largely based on a nice Mediterranean diet. The research has consistently shown that this is the best diet to reduce risk of chronic disease.

5 Things I Didn’t Agree With In The Longevity Diet

1) A major issue I have, and one the author freely admits, is that most of his research is in mice. There needs to be randomized trials in humans before you can really have confidence in a lot of these recommendations.

2) There were a few references in the text that did not lead to any searchable citations. For example, on page 67, the author cites his own study showing an increased risk of mortality with higher protein intakes. When you click on the reference, it just says “Levine et al and Longo, Low Protein Intake”. This happens several times throughout the text. I was hoping to find a full citation in a peer reviewed journal so I could read this study.

3) The author mentions that all protein increases risk of disease. I fully agree that red meat, full fat dairy and processed meat promote a variety of chronic diseases. However, seafood, chicken, turkey, and vegetable proteins like beans, nuts, and legumes have not been shown to increase risk of disease and don’t really need to be reduced in our diets. I have my clients shoot for about 20% of their diet to come from these healthy protein sources.

4) I thought the section on resistant training was a little light. This is a really important part of aging well and I think the recommendation could have been a bit more comprehensive.

5) In the text, the author mentions some really sound dietary recommendations very similar to the Mediterranean diet. At the end of the book there are some meal plans and things go a bit sideways.  The meals have an abundance of high glycemic load carbs, including: bread, jam, pasta, dried fruit, smoothies, bagels, potatoes, honey and pizza. 

Is The Longevity Diet Worth Reading?

Absolutely! This book provides a lot of solid and research-based advice to increase the odds that you will live longer and better. 

I think we need to see a bit more data on humans before the merits of modified fasting are confirmed, but this is definitely an interesting line of research.

I like most of the dietary recommendation in this book, I just think we should be a bit tighter on the high glycemic load carbs and that healthy source of protein don’t have to be quite as restricted.

 

Can I Have Butter Again?

Several popular fad diets are spreading the idea that saturated fats are not harmful and butter is a perfectly fine food to be included in your diet every day, if not every meal.

Is this a good idea? In a word, no! The idea that saturated fats are harmless is not based on solid nutrition research.

The nutrition literature has always shown, and continues to show, that saturated fat increases risk of heart disease and stroke, especially when compared to other more healthy options.

For example, in a large well designed cohort study out of Harvard that included over 125,000 men and women, replacing saturated fat with either polyunsaturated fat, monounsaturated fat or whole grains significantly reduce risk of heart disease (Reference 1).

In conclusion, don’t believe the hype. Vegetable sources of fat such as olive oil, canola oil, nuts, nut butters and avocados are a much healthier choice than butter.

References

1) Journal of the American College of Cardiology 2015 66:1538-48

Mediterranean Diet And Mortality

The Study

The research literature consistently shows that the Mediterranean diet is the most effective diet for reducing risk of chronic disease. In this interesting study, 25,315 women from the Women’s Health Study had their diet measured and were watched for 25 years.

Subjects following a Mediterranean diet had an 11% lower risk of dying from any cause when compared to subjects not following a Mediterranean diet.

JAMA Network Open. 2024;7(5):e2414322

Take Home Message

The fact that the Mediterranean diet reduced mortality in this investigation is really not a surprise, many studies have shown this. What makes this study special is that the researchers took 33 biomarkers from each subject at baseline in order to get some insight into just why this diet is so effective at reducing disease.

The biomarkers that were most different for those strictly following a Mediterranean diet showed a reduced insulin resistance, body mass index, triglycerides and inflammatory markers. These are likely the ways that a Mediterranean diet offers protection from chronic disease. 

A Mediterranean diet is high in fruits, vegetable, legumes, whole grains, poultry, seafood and nuts and low in refined carbs, sugar, red meat and processed meats. This is a great way to eat for your health.

 

Can Statins Prevent Cancer?

The Study

Chronic inflammation is known to be a major cause of cancer. A groundbreaking study out of Massachusetts General Hospital in Boston was recently published that used both an animal model and an epidemiological study to show that statin drugs may block this inflammation and reduce the risk of developing cancer.

-In mice, a statin drug called Pitavastatin suppressed externally caused inflammation in the skin and pancreas and prevented inflammation dependent cancers.

-In humans, subjects taking Pitavastatin had a statistically significant reduced risk of pancreatic cancer. 

doi.org/10.1038/s41467-024-48441-8

Take Home Message

Tens of millions of Americans are taking statins to lower their cholesterol and reduce their risk of heart disease and stroke. A surprising and beneficial side effect of these meds may be that they help reduce the risk of cancer. More research is needed here, but this is exciting news.