Imagine pouring a 5-pound bag of sugar down your throat. Absurd, right? Wrong. New research shows that this is how much sugar each American man, woman, and child gets each month—and most of it doesn’t come from the sugar bowl. Sweeteners go by more than 50 names and hide out in virtually all processed foods, from your morning doughnut to those lunchtime baked beans, from fruit-flavored yogurt to the ketchup on your burger.
Added sugars in the American diet have grown exponentially since the early 1900s—by more than 2,100 percent—adding calories and edging out more nutritious fare. Researchers say it’s no coincidence that as the food we eat grows sweeter, rates of overweight and blood sugar problems—including insulin resistance, metabolic syndrome, prediabetes, full-blown type 2 diabetes, and even pregnancy diabetes—have soared.
Sugar entwines us in a love-hate relationship. Your body needs a steady supply of blood sugar, the primary fuel burned by your cells. It plays a central role in physical and mental well-being. Your brain, for example, runs almost entirely on blood sugar. Your muscles can burn fat in a pinch, but they prefer blood sugar (glucose) for zip. A baby growing in a mother’s womb relies on it, too.
But the carbohydrates we eat and drink—the source of virtually all blood sugar—are more treacherous than ever before. Refined carbs (white bread, cakes, and snack foods) can make blood sugar skyrocket to dangerous levels. And there’s growing evidence that high-fructose corn syrup (HFCS), now the most ubiquitous sweetener in the American food supply, is directly linked to the nation’s twin epidemics of overweight and diabetes. HFCS’s role? This sweetener seems to bypass the body’s “I feel full” mechanisms. In a study of 93,000 women, Harvard School of Public Health researchers recently linked a 10-pound weight gain and 83 percent higher diabetes risk directly to the consumption of HFCS.
Add other 21st-century factors that also pack on pounds and disrupt blood sugar levels—including big portions, fatty fast foods, and inactivity—and you’ve got a blood sugar crisis. Up to half of Americans have a prediabetic condition called insulin resistance—a serious, early stage blood sugar control problem that won’t even show up on a blood sugar test. As many as 41 million have prediabetes (above-normal blood sugar levels), and 21 million have full-blown type 2 diabetes. Meanwhile, the number of children and teens with type 2 diabetes has increased six- to tenfold since 1994, mirroring the childhood obesity epidemic.
The bottom line for you: Blood sugar problems can zap your energy levels, make weight loss difficult or nearly impossible, and put you at risk for an astonishing variety of serious health problems, including heart attack, stroke, Alzheimer’s disease, some cancers, infertility, blindness, kidney failure, amputation, and sexual difficulties. And that’s not sweet.
We encourage you to call your doctor soon to schedule a fasting blood sugar test, one of the easiest in-office screenings (and one that’s covered by most insurance plans). Far too many Americans live with undiagnosed type 2 diabetes and unrecognized prediabetes—uncontrolled high blood sugar that accelerates your chances of serious, life-threatening complications. Here’s what you need to know.
• Family history of type 2 diabetes
• Overweight
• History of diabetes during pregnancy (gestational diabetes) or having a baby weighing 9 pounds or more at birth
• Low HDL cholesterol level (under 50 for women, below 40 for men), high total cholesterol (above 200), or triglycerides above 150
• High blood pressure (over 130/85)
• Age over 45
• Inactive lifestyle
• African American, Latino, Asian, Native American, or Pacific Island ethnicity
The Sugar Solution recommends a fasting plasma glucose test for most people. For this check, you will first fast for 8 to 12 hours, then visit the doctor’s office or a lab to have your blood drawn. Your blood sugar is normal if the result is 99 milligrams of glucose per deciliter of blood (mg/dl) or lower; prediabetic if your sugar level is between 100 and 125 mg/dl; or potentially diabetic if it’s over 125 mg/dl (your doctor will retest, on another day, before diagnosing type 2 diabetes).
If you are pregnant, experiencing infertility or miscarriage problems, or concerned about prediabetes despite a normal fasting check, your doctor will perform an oral glucose tolerance test. You’ll fast, then drink a sugary concoction of 75 grams of glucose (100 grams for a pregnant woman). Blood is drawn before you drink and up to four times afterward. Prediabetes is indicated when readings after 2 hours are between 140 and 199 mg/dl. Readings of 200 mg/dl or higher are considered indicative of full-blown diabetes. You’ve got gestational diabetes if you have any two of these results: fasting blood sugar over 95 mg/dl; blood sugar of 180 mg/dl 1 hour after drinking the sugary beverage; 155 mg/ dl after 2 hours; 140 mg/dl after 3 hours.
If you couldn’t fast or weren’t expecting a blood sugar check at your doctor’s appointment, your doctor may perform a random plasma glucose test. This nonfasting check is the least sensitive blood-sugar check; it can miss slightly elevated sugar levels, making it a poor choice for people concerned about prediabetes. Your blood sugar is considered normal if the result is 140 mg/dl or lower and diabetic at 200 mg/dl or higher. If you opt for this test, ask for a follow-up fasting check to confirm your results.
You’re apt to get a truer picture of where your blood sugar stands if you get tested in the morning as opposed to the afternoon. This realization emerged when scientists from the National Institute of Diabetes and Digestive and Kidney Diseases compared results of fasting plasma glucose tests given to 12,800 people. Only half the people with morning levels high enough to qualify as diabetic would have been detected if their tests had been done in the afternoon.
If your blood sugar is normal, your doctor will probably recommend rechecking it in 1 to 3 years. If you are at risk for diabetes, however, ask for annual rechecks to catch creeping sugar levels early, when lifestyle changes can do the most to control them. If you have prediabetes or diabetes, follow the steps in Chapters 21 and 22 to track and lower your levels.
“Our bodies are essentially the same as they were 40,000 years ago, but our eating and exercise habits have changed tremendously,” says Bryant Stamford, PhD, director of the Health Promotion and Wellness Center at the University of Louisville in Kentucky. “The same number of calories it might have taken our prehistoric ancestors an entire day to hunt and gather we can now have brought to our door with a phone call. We simply eat too much and exercise too little.”
The Sugar Solution can help you bring your lifestyle back into harmony with your body’s true needs. It’s a simple, delicious, and drug-free approach that supports your blood sugar control system, reducing your blood sugar and dampening elevated levels of insulin, a key blood sugar control hormone. The advantage: You can step off the sugar “spike and dip” roller coaster that contributes to stubborn weight gain, fatigue, moodiness, and cravings. You’ll protect yourself against the profoundly damaging effects of high insulin and high blood sugar. You’ll feel more energetic.
The Sugar Solution’s foundation is a smart, “good carb” eating plan recommended by top nutrition experts and Prevention magazine. It features whole grains, fresh fruits and vegetables, good fats, and sensible portions so that you can lose weight without feeling hungry. (And there’s still room for pasta, cheese, even chocolate!) You’ll also find a physical-activity routine customized to your fitness personality and schedule, as well as spa-quality pampering to soothe stress and help you sleep better. Each of these components can tame out-of-control blood sugar, research shows. By combining them, you get a powerful plan with enormous benefits—now and for years to come.
The quiz in Chapter 2 can help you size up your risk. But first, check out these compelling benefits of lowering and balancing your blood sugar.
1. Easier weight loss—without food cravings. If your blood sugar control system is out of whack, high levels of insulin may slow your body’s fat-burning ability even on a low-calorie diet. And low blood sugar levels—the result of insulin doing its job too well—can trigger food cravings. You’re stuck in a cycle of overeating and weight gain.
Bringing blood sugar and insulin down to healthier levels can stop cravings that prompt you to reach for another cookie at 3:00 p.m. or another handful of chips while you watch Jay or Conan or Dave late at night. And as Tufts University researchers discovered in a recent study, it helps overweight people with high insulin levels lose more weight—perhaps by allowing fat cells to release their stores so that the body can burn them at last. (For more details about this exciting study, turn to Chapter 3.)
2. Energy to burn. What you eat affects your energy levels as well as your weight. Overeating high-glycemic carbs such as white bread, sweet snacks, and sugary drinks floods your bloodstream with sugar, triggering a corresponding flood of insulin to move it out of the blood. The result: low blood sugar, which causes fatigue. Switching to better-quality body fuel like fiber-rich fruits and vegetables and healthy fats will keep you alert and energized for hours.
3. Improved fertility. Polycystic ovary syndrome (PCOS)—the leading cause of infertility among women—is a serious blood sugar control problem that involves insulin resistance (when cells ignore insulin’s signals to absorb blood sugar) and high insulin levels, experts now know. (Research also shows that PCOS can occur with or without ovarian cysts.) High insulin prompts your ovaries to churn out male hormones that disrupt ovulation, wreak havoc with your skin and hair, lock stubborn fat at your waistline, and raise your risk for diabetes, heart disease, and some cancers. Keeping your blood sugar steady and improving your insulin sensitivity can help right the balance.
4. A healthier pregnancy and baby. Balancing your blood sugar with a healthy diet and regular physical activity can help you avoid pregnancy diabetes, thus lowering your risk for full-blown type 2 diabetes later in life. You’ll also protect your baby from injury during delivery and from blood sugar problems of her own after birth. Following this plan before pregnancy will cut your risk for this condition.
5. Slimmer, healthier kids. Inactivity, fast food, and a sugar- and fat-laden diet are big reasons that the number of overweight kids in America has doubled since 1980—and the number with type 2 diabetes has skyrocketed. The Sugar Solution eating plan belongs on your family table. In Chapter 25, we’ll show you how to incorporate more activity into your child’s day to further cut her risks for overweight and blood sugar problems.
6. Lower risk for devastating health problems. High levels of circulating blood sugar and insulin can damage virtually every cell and organ in the body, significantly raising your odds for heart attack, stroke, high blood pressure, type 2 diabetes, cancer, blindness, kidney failure, amputation, and more. Controlling your blood sugar with the lifestyle strategies described in this book can reduce your risk for these potential killers and complications.
7. A sharper memory. People who don’t process blood sugar normally are likely to have memory problems and even shrinkage of the brain region crucial for recall. However, a healthy Sugar Solution lifestyle can help shield your brain from age-related memory loss and perhaps protect against Alzheimer’s disease.
Designed by a nutritionist from the prestigious Joslin Diabetes Center in Seattle with expertise in blood sugar management strategies, The Sugar Solution 30-Day Lifestyle Makeover is based on three key principles: good nutrition, regular physical activity, and stress management.
Healthy eating is one of the cornerstones of blood sugar control. Our meal plan uses the glycemic index (GI), which ranks foods based on how swiftly and how much they raise blood sugar. The GI is one of the most significant dietary findings of the past 25 years. In Chapter 7, you’ll learn how using the GI system can crush cravings, curb overeating, and jump-start weight loss.
You’ll find that healthy eating can be tasty and satisfying. Our menu plan features lower-GI foods and five delicious—and filling—meals and snacks a day, so you’ll never feel deprived. Many of the menus feature the mouthwatering recipes that begin on this page.
Physical activity is also a critical factor in blood sugar balance. For example, building muscle helps the body use insulin more efficiently, which lowers your blood sugar and insulin levels, encourages weight loss, and cuts health risks. The plan suggests easy ways to incorporate more movement into your daily life. If you’re a dedicated walker or would like to start, see Chapter 14 for a customized walking plan developed by Prevention magazine. And check out our resistance-training program designed by Prevention’s fitness director, Michele Stanten. Lifting weights has been proven to help lower blood sugar.
The third “leg” of blood sugar balance is adequate, restful sleep and stress reduction. Too little sleep and too much stress both raise levels of stress hormones that in turn raise blood sugar levels. Each day of our plan features one easy way to short-circuit stress and boost your well-being. A balanced life also requires the active pursuit of pleasure, not merely the avoidance of stress, so see Chapter 16 for ways to add more healthy joy to your life.
As you start your journey toward better health, keep in mind all the benefits of managing your blood sugar. You’ll have more energy. Lose a few pounds. Prevent the symptoms of elevated blood sugar that erode your quality of life, such as fatigue, lethargy, and mood swings. And that’s just for now. In the long run, you’ll lower your chances of diseases that can rob you of precious years, and you’ll ensure that you always live at peak energy and health.