Nutrition evangelists are everywhere. These are the people who don’t hesitate to preach about their “this worked for me, so you should do it too” nutrition advice. I’ve heard it all. And in fact, fearmongering about sugar is not a new thing as I wrote about this topic five years ago. But lately, claims about sugar that have been creeping into friendly conversation, or that my clients have been bombarded by, deserve some debunking.
If you happen to identify as one of those nutrition evangelists, please know that I have been in your shoes and sympathize with your passion for wanting to share your concern for health and your new-found nutrition knowledge!
I was part of the “fat-free” crusade in the early 90s that preached about analyzing every food label and item we consumed for the grams of fat hiding in our food. I was a pro at substitutions and swapping out fat for applesauce in muffins, replacing cream in sauces with a concoction of evaporated skim milk and cornstarch, straining yogurt to make cream cheese for cheesecake (I don’t recommend it!), and tossing out perfectly nutritious egg yolks for watery egg whites. Interestingly, many of these tricks have persisted in today’s diet culture despite a few decades of solid research that have informed us that immersing in these behaviors is unnecessary and misleading health messaging.
But frankly, today’s “sugar-free” evangelism is not any different.
Amidst a sea of recipes for flourless, sugar-free baked goods to “low calorie” dairy-free ice cream, and numerous processed powders added to drinks and coffee, the crusader’s sugar-free agenda surprises their listeners with the idea that they are one bite away from the onset of disease – or unwanted weight gain if they don’t reduce their sugar intake.
And, god forbid you enjoy your grandmother’s heirloom Christmas cookies containing butter, sugar, and flour dunked in a tall glass of cow’s milk.
The anti-sugar advocates claim that foods like oatmeal, bread, pasta, yogurt, salad dressings, cocktail sauce, or ketchup are laden with a pile of hidden and harmful sugar and that if more people would simply follow the rules of limiting their intake to a certain number of grams per day, then everyone would be healthier – and happier.
My message is not for people to simply over-indulge on sugar. But you won’t find a recipe for the latest sugar-free, gluten-free, artificially sweetened, beet juice “healthy” version of a cookie here either. And when it comes to people’s concerns about the sugar in ketchup, I’m curious how much ketchup are you consuming anyway? In other words, is this a meaningful thing to worry about?
So, if you’ve made it this far, hopefully, the following points will help you assess the questions and concerns you might have about that bowl of oatmeal or sugar in general so you can make an informed decision about food and your food choices.
The Problem with “Good” vs “Bad” Food Labels
Like the “dietary fat is bad” movement of the ’80s and ’90s, the “sugar is bad” nutrition advice is tangled up in labeling foods as “good” vs “bad” or “healthy” vs “unhealthy.” Food rules like this provide limits that help the eater feel more in control and promote a feeling that you are eating correctly. Of course, this is helpful when you feel like your food choices or eating behaviors are questionable or concerning to you for whatever reason – most often related to weight or body dissatisfaction.
The downside of rigid food rules is that they often backfire.
Simple, healthful guidelines become complex, demanding, and disruptive to normal daily life. To argue that sugar is the exception and that “if a person simply reduces their intake, then their desire or cravings will decrease” is debatable and not entirely what the scientific literature shows.
Deprivation or obsessing about food rules has been shown to increase desire. When you give in to the desire “to just enjoy one cookie”, feelings of guilt and shame often lead to a “what the heck response”, overeating or compensatory behaviors. This is often when someone will tell me, “See, I can’t even have just one.” And then the restriction, obsessiveness, or excessive exercise ensues – and the cycle continues. Eventually, a person’s eating habits become dependent on food rules, exacerbate dieting behaviors, increase anxiety and guilt about food and eating, and ultimately prevent the development of confidence and trust in your body and your ability to decide what food or amount is best for you.
But, Isn’t Too Much Sugar Bad?
What exactly is “too much?” Dietary sugars have been under scrutiny for years and have been blamed for causing just about every condition. However, nutrition science is challenging and any well-informed researcher will tell you that it’s impossible to prove that one food, including sugar, causes disease.
Health (and weight) is the outcome of many biological dispositions and behaviors. Numerous factors are correlated with body weight and disease risk including genetics, early life experience (including undernutrition), weight stigma, unequal access to healthcare, limited social connection, food insecurity, and trauma.
Nevertheless, as a guide, we could certainly look to The Dietary Guidelines for Americans 2020-2025 which recommends “that Americans 2 years and older keep their intake of added sugars to less than 10% of their total daily calories.”
What does that mean exactly? It pains me to look at this from a calorie standpoint because biology and metabolism are so much more complex than these generalizations and simplistic calculations. Moreover, this generic advice doesn’t consider physical activity, growth, stage of life, disease, individual nutrition needs, cultural food preferences, or what else a person consumes daily. Also, if you are practicing intuitive eating, you don’t likely eat the same thing or the same calories every single day – nor do you need to.
With all that said, bear with me as we look at the following illustration of a sample day for meeting the predicted energy and basic nutritional needs of a 50-year-old female who casually exercises and enjoys some commonly consumed foods.
Breakfast: Oatmeal with milk, peanut butter, brown sugar, and sliced banana
Lunch: Deli meat and cheese sandwich on whole grain bread with mayo, spinach, and tomato slices and flavored yogurt with blueberries and mixed nuts
Afternoon Snack: Whole-grain crackers with cottage cheese
Dinner: Pasta with Rao’s marinara sauce and meatballs, and a mixed green salad tossed with a bottled balsamic vinaigrette
Evening Snack: Chocolate chip cookies and a glass of milk
This example illustrates how “added sugars” might fit into a “normal” daily eating pattern while remaining below what we would calculate as the recommendation according to the Dietary Guidelines, and also meeting other important nutritional targets, including protein, calcium, and fiber. As mentioned previously, your nutrition needs may be different than this example.
My concern (and experience) is that telling someone to restrict a particular food or limit the grams of anything as a simple fix to a person’s weight or health concerns is more likely to contribute to other nutritional deficiencies because food and eating become a chore, restrictive, or not pleasurable. Instead, it is meaningful for women (or anyone for that matter) to be more intentional about including a variety of all types of foods (including fruits, vegetables, dairy, bread, potato, pasta, rice, fish, meat, poultry, nuts, seeds, and so on), rather than fixating on reducing or eliminating certain foods.
Certainly, if a person dramatically changes their dietary intake (for whatever reason), it may feel like a positive outcome for that person and their goals. Although this may be a personal anecdote for that individual, it is not generalizable nutrition advice.
Individualized care takes into account whether a dietary change is safe – what is appropriate for that person’s medical, health and eating history? Do you know whether that person is vulnerable to disordered eating or an eating disorder? Probably not.
Is the recommended dietary intervention realistic, practical, and ultimately sustainable for that individual? If it’s not, then the short-term intervention is pointless and can result in unwanted consequences in the scheme of long-term health and weight outcomes.
So, what about oatmeal? Is it “healthy” or not?
The narrative about oatmeal is that “oatmeal just turns into a bunch of sugar in the body…so eating it for breakfast will cause all kinds of problems with blood sugars, increased hunger, cravings, weight gain, inflammation, etc.” Yikes! That doesn’t sound good. But the problem is that the person who made this claim exaggerated a normal metabolic process into something that sounds harmful when there are many important health benefits from eating oatmeal.
Oatmeal is a whole grain and therefore a source of complex carbohydrates. Complex carbohydrates are long chains of glucose molecules strung together like a long pearl necklace. When we eat food that contains carbohydrates, the body must break down these complex molecules in the process of digestion into a simple sugar, called glucose. Then (with the help of insulin produced by the pancreas) glucose can be absorbed and taken up into the cells and used for energy. Since glucose is an essential fuel for the brain, the nervous system, muscles and the body as a whole, this is a good thing!
Regarding claims that the resulting blood sugar causes increased hunger, cravings, and other problems, a 2023 review by Shehzad et al. on the impact of oats on appetite hormones and body weight management, outlined various studies demonstrating that oats provided a therapeutic benefit “for body weight management, appetite control, strengthening the immune system, lowering serum cholesterol, and gut microbiota promotion by increased production of short-chain fatty acid.”
Furthermore, in a 2022 meta-analysis of 74 random controlled trials, Llana et al. concluded that dietary oats supplemented in the diet resulted in lowered levels of blood lipids and improvements in anthropometric parameters (including weight and waist circumference) regardless of the participant’s dietary intake.
So, it’s reasonable to conclude that if you don’t like oatmeal, then find something else to enjoy for your breakfast. But, to avoid eating oatmeal (or yogurt, bread, pasta, ketchup, etc) because you have been led to believe in some scary health outcome, that is unfortunate.
The Bottom Line
It’s quite common to be bombarded by all types of nutrition information and advice these days. I always tell my clients to take what feels helpful and leave behind what doesn’t resonate or work for you. A lot of this information needs to be filtered through your own lived experience, values, and what makes sense for you at this stage of life.
If you are concerned about your sugar intake, then we may want to look at that and consider what, if anything, needs to be addressed.
- What exactly do you think you are consuming “too much” of?
- Do you believe that you are missing out on other nourishing foods?
- Do you have a health concern and need some direction on how nutrition plays a role?
- Are you wanting to increase your intake of other “nutritious foods” and are confused by what is meant by nutritious or “healthy” foods these days? You are not alone! Health, wellness, and the idea of eating “healthy” foods have been hijacked by diet culture and has left many people questioning their nutrition and food wisdom.
Honestly, the basics of nutrition, food, and eating well have not changed that much since I remember learning about “the 4 food groups” in 5th grade. So, if you find yourself overthinking your food and eating choices, as in the case of whether you are eating too much sugar, then it may be meaningful to consider (or reconsider) where you get direction on nutrition, health, and fueling your body – and remember that:
“A healthy eater is one who not only strives for a healthy balance of foods but also has a healthy relationship with food.”
~ Elyse Resch and Evelyn Tribole, The Intuitive Eating Workbook
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