The Dangers of Sugar Substitutes

With all of the recent news about avoiding refined sugar and high fructose corn syrup (HFCS), it’s hard to know what’s safe to use to sweeten foods and drinks. And it is a question to be concerned with, because there can be dire health consequences even when a sweetener is marketed as “healthy.” 

Recently, a National Geographic article[1] compared eight sugar substitutes, which they separated into four categories:

1. Artificial sweeteners

2. Sugar alcohols

3. Natural sweeteners

4. Dietary supplements 

While National Geographic made a good start, its review of these products lacks any information about the adverse effects of many of them. Despite all the evidence of the harm sugar substitutes do to the human body, they are often still promoted by “experts” because they allegedly aren’t digested. 

According to Dr. Joseph Mercola, a well-known osteopathic physician and best-selling author, all artificial sweeteners should be avoided because all of them present their own harmful side effects. From his research, he concluded that aspartame (NutraSweet, Equal) may be the most dangerous of all the sugar substitutes. It has the largest number of reports of adverse effects, which may be because it is the most widely used substitute. 

You must be mindful of the advertisements and promotions that big companies like Coca-Cola use in an attempt to convince consumers that aspartame is okay. In response to Coca-Cola’s new advertisement, Center for Science in the Public Interest’s (CSPI) Executive Director, Michael F. Jacobson, made the following statement:

“Aspartame has been found to cause cancer—leukemia, lymphoma, and other tumors—in laboratory animals, and it shouldn’t be in the food supply. We certainly want Coca-Cola to shift its product mix toward lower- and no-calorie drinks, but aspartame’s reputation isn’t worth rehabilitating with this propaganda campaign. The company would be better off phasing out its use of aspartame and accelerating its research into safer, natural sweeteners such as those extracted from the stevia plant.” [2]

Drinking diet sodas and other diet drinks not only fails to lead to weight loss—studies have actually shown that they can cause greater weight gain than regular sugar. In addition, artificial sweeteners have been linked on more than one occasion with increased hunger.

A recent report also showed that artificial sweeteners can cause many of the same harmful effects of high sugar consumption (which defeats the purpose of consuming them, really). These effects include, but are not limited to, excessive weight gain, cardiovascular disease, type 2 diabetes, and stroke. According to the authors of this report, “consuming sweet-tasting but noncaloric or reduced-calorie food and beverages interferes with learned responses that normally contribute to glucose and energy homeostasis. Because of this interference, frequent consumption of high-intensity sweeteners may have the counterintuitive effect of inducing metabolic derangements.”[3]

If aspartame and similar sugar substitutes cause these problems, what about the “all natural” sweeteners? Despite what you may think, sweeteners like honey and agave are high in fructose and many are highly processed. Agave “nectar” or “syrup” can have anywhere from 70-97% fructose content, depending on the brand. Honey averages about 53%, which is obviously an improvement, but unlike agave, it is natural in its raw form and actually has health benefits when used in moderation. Still, remember that it’s rare to find high-quality, raw honey in just any grocery store. 

“Regardless of the source (be it HFCS, honey, or agave), refined fructose:

• Tricks your body into gaining weight by fooling your metabolism, as it turns off your body's appetite-control system. Fructose does not appropriately stimulate insulin, which in turn does not suppress ghrelin (the "hunger hormone") and doesn't stimulate leptin (the "satiety hormone"), which together result in your eating more and developing insulin resistance.

• Activates a key enzyme that causes cells to store fat; this is the so-called “fat switch” revealed in Dr. Richard Johnson’s book by the same name.

• Rapidly leads to weight gain and abdominal obesity ("beer belly"), decreased HDL, increased LDL, elevated triglycerides, elevated blood sugar, and high blood pressure—i.e., classic metabolic syndrome.

• Is broken down in your liver just like alcohol, and produces many of the side effects of chronic alcohol use, including non-alcoholic fatty liver disease (NAFLD). Interestingly enough, research has shown that soft drinks increase your risk of NAFLD independently of metabolic syndrome⁹.

• Over time leads to insulin resistance, which is not only an underlying factor of type 2 diabetes and heart disease, but also many cancers.”[4]

Sugar alcohols (which you can usually recognize by the “ol” at the end of their name: xylitol glucitol, sorbitol, maltitol, mannitol, glycerol, and lactitol) aren’t as sweet as sugar, but they do contain fewer calories and can be a better choice than highly refined sugar. Of the sugar alcohols, xylitol is reasonably safe and is the best choice of the sugar alcohols.

The three safest alternatives to sugar are Stevia (not Truvia, which only uses certain active ingredients of the South American stevia plant and not the entire plant), Lo Han Guo/Lo Han Kuo, and pure glucose. Lo Han Guo/Kuo comes from the Lo Han fruit, which has been used as a sweetener in China for centuries and is much, much sweeter than sugar. Interestingly, it received FDA GRAS (Generally Recognized as Safe) status in 2009. Pure glucose is not as sweet as regular sugar, so you will likely use more of it and, thus, it is more expensive. Still, it contains no fructose at all and can be used “directly by every cell in your body and as such is a far safer sugar alternative.”[5]   

It should go without saying that any sweetener at all can lead to harmful side effects for your body. The best option is to avoid sweet foods and beverages altogether, but if you have a hard time doing this, try to use the three safest sugar alternatives mentioned above. If you’d like to do further reading on this topic, I suggest Dr. Mercola’s book, Sweet Deception.

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[1] Anderson P. “How Sugar Substitutes Stack Up.” July 17, 2013. National Geographic. http://news.nationalgeographic.com/news/2013/07/130717-sugar-substitutes-nutrasweet-splenda-stevia-baking/

[2] Michael F. Jacobson. “Coke Shouldn’t Bother Rehabilitating Aspartame’s Image, Says CSPI.” August 14, 2013. http://cspinet.org/new/201308141.html

[3] Swithers SE. “Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements.” 2013. Trends in Endocrinology and Metabolism: pp.1-11.

[4] Mercola. “Sugar Substitutes—What’s Safe and What’s Not.” October 7, 2013. http://articles.mercola.com/sites/articles/archive/2013/10/07/sugar-substitutes.aspx#_edn2

[5] Id.

Tips for Daily Life to Improve Your Spinal Health (Part 3: Exercise and Nutrition)

When I ask my patients for their definition of good health, most of them say something along the lines of “not being in any pain.” But pain and symptoms, or the absence of them, are not true measurements of health. In fact, sometimes symptoms are a good thing. For instance, if your body gets an infection, the healthy bodily response is to get a fever. The fever may make you feel like you’re unhealthy, but actually it just means that your body is fighting the infection, as it is supposed to do. In the same way, if you ingest something harmful and get food poisoning, for example, your body should respond by vomiting. This is its way of protecting you. And on the other side of the coin, if you have a heart attack one day and had no symptoms the day before, that hardly means that you were healthy the day before. It simply means you didn’t have any symptoms. Because of this, it’s important to remember that just because you’re not in pain doesn’t mean that you’re functioning at the optimum level of health. 

The World Health Organization’s definition of health, which I happen to personally agree with, is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”[1] In the third installment of this blog series, I will address the importance of exercise and proper nutrition in the journey to reaching your best health.

When it comes to strength and endurance, the phrase “Use it or lose it” truly is accurate. If you do not exercise your body, it will inevitably get weaker and, therefore, less healthy. You should do at least 40 minutes of moderate exercise per day. Taking a brisk walk is an excellent form of exercise, because the human body is designed to walk for long distances, just as our ancestors once did. Though running may work up more of a sweat than walking, too much cardio actually breaks down muscle and slows the metabolism (which is the last thing you want to do!). Weight-bearing exercises with resistance, on the other hand, build up lean muscle and continue to burn calories even once you finish your workout. 

Proper nutrition is another huge component of good health, and I can’t stress its importance enough. First, don’t think that you can possibly overdose on vegetables. Vegetables have the nutrients we need in our diets, and even higher-calories vegetables have such high nutrient levels per calorie that they are all beneficial. In contrast, think about drinking a can of Coke, which has 139 calories, and ask yourself how many nutrients you’d find in that same can. In terms of nutrients per calorie, vegetables can’t be beat. Fruits are a close second, but you should eat them mainly in the morning hours, and definitely not within 4 hours of your bedtime. This is important because you want to be able to burn off the sugars that are found in fruit before going to sleep.

Health practitioners the world over constantly tell people how much water they should be drinking, and I’ll do the same thing. If you’re thirsty, you are already dehydrated. You should never feel the need to drink water, but in order to achieve this level of satisfaction, you must constantly be drinking it. For every 2 pounds you weigh, you should drink 1 ounce of water per day. For instance, if you’re 130 pounds, you should be drinking 65 ounces of water every day. That’s almost 2 liters. Do the math for your own weight and see if you’re getting anywhere close to the amount of water you should be. My guess is that you aren’t, because most people aren’t. Start carrying a reusable water bottle with you everywhere you go, drinking it throughout the day and refilling it as many times as possible. As I said, you shouldn’t ever feel thirsty.

Another important nutritional guideline to follow is to have some protein with every meal, preferably plant-based rather than animal-based. For support of this statement, I highly recommend picking up a copy of The China Study, a book written on a 30-year study conducted by the Chinese Academy of Preventive Medicine, Cornell University, and the University of Oxford.[2] The study “concluded that countries with a high consumption of animal-based foods…were more likely to have had higher death rates from ‘Western’ diseases” (such as coronary heart disease, diabetes, and breast, prostate, and bowel cancers) “while the opposite was true for countries that ate more plant foods…”[3] It’s an excellent, interesting book that will challenge your thinking. Even if you disagree with some of the claims the authors make, it is certainly a good way to start thinking about your nutrition in a new way.

In your diet, try to avoid transfatty acids, enriched flours (all nutrients, vitamins, and minerals are blended out of these and some are thrown back in again; buy whole wheat or stone ground wheat flours instead), hydrogenated oils, high fructose corn syrup, and any food item with sugar as one of its first three ingredients. If food is sold in a box, it is likely full of processed, reconstituted carbohydrates. Stay away from these! Instead, focus on whole, natural foods, and as many organic foods as possible. “Organic” may be the gold standard, but even they can still be processed, so be sure to check labels and see how “organic” a product really is. 

Lastly, make sure to get plenty of Omega-3 fatty acids in your diet (from foods like fish, or through good-quality, GMP-certified supplements, which should be sold in glass, amber bottles). Approximately 2.5 grams per day is adequate for maintenance purposes, but I also recommend taking a large dose of Omega-3 supplements instead of an anti-inflammatory like Advil or Tylenol. Omega-3s activate your body’s natural anti-inflammatories, and letting your body do things the natural way is always better! 

Our brains are 50% Omega-3 fatty acids, so when you start taking supplements or including more food sources with these acids in your diet, you should notice that you’re able to think more clearly. Interestingly, when man first learned to fish, the human brain tripled in size. While your brain won’t get any larger by taking these supplements or eating more fish, the synapses in your brain should actually begin to quicken. 

To sum up, take about 40 minutes each day to exercise, even if it’s just a brisk walk around your neighborhood. And the next time you’re in a supermarket shopping for groceries, remember the tips I’ve provided here and try to implement them into your—and your family’s—diet. If you do, you will be one step closer to embodying the true definition of good health.

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[1] Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

[2] “The China Study” Wikipedia page <http://en.wikipedia.org/wiki/The_China_Study>

[3] Id.

Tips for Daily Life to Improve Your Spinal Health (Part 2: Common Activities)

This post, the second in a series on how to improve your own spinal health, will focus on common daily activities. Likely, you don’t spend much time thinking about how you stand, sit, carry objects, talk on the phone, and other such things because it has become so second-nature to you over the years. I’d like to draw your attention to a few of these seemingly harmless activities, suggest some easy ways to tweak your habits and, ultimately, help prevent future damage to your spine.

Essentially, your muscles are constantly either getting stronger or weaker, and chairs that don’t require you to do any work or use any strength are bad news. If you sit for 9 hours straight every day in one of these chairs (probably in an office work environment), what do you think the end result will be? We put approximately 30% more pressure on our low backs when sitting as opposed to standing, so, if you can, try to create a standing workstation for yourself, as I have in my own office. If you do this, make sure your keyboard is at elbow level and the bottom 1/3 of your monitor is at eye level. This will require you to look slightly up at the screen, which encourages a proper neck curve.  

For many of you that may not be possible, but that doesn’t mean there aren’t alternatives. If your boss allows it, you may sit on a large exercise ball. If you’re sitting up straight, as you should be, an exercise ball will engage your core and strengthen it. And if an exercise ball isn’t professional enough for your work environment, I also sell an excellent cushion that turns any chair into a simulated exercise ball and will still engage your core muscles (see picture below). Ask me if you’re interested in purchasing one. 

If you find that you’re stuck on a normal office chair, you should definitely get up and stretch every so often. I recommend moving for approximately 10 minutes every hour, if possible. Remember what I said earlier about where your computer monitor should be! And pay attention to your posture as you sit at your computer; if you find that you’re hunching over, force yourself to straighten up until good posture becomes a habit.

Even when work is over, most people spend lots of their free time sitting, so pay attention to the couches and chairs you use. It is important to have adequate lumbar support in these pieces of furniture the same way it’s important in a mattress, as I mentioned in the first post of this series. We can end up sitting for hours on end, and keeping your body in the same position with little to no support for the lower back is asking for trouble. If buying new, spine-friendly furniture isn’t in your budget, though, the next best thing is to put a pillow or two behind your lower back. Also, if you’re sitting in a recliner or in a reclined position, bend your knees and hips at 90°. You can put a pillow or other object to support them if that’s more comfortable for you.

Another thing to keep in mind is the fact that you put more weight on your discs when leaning, twisting, or rotating when sitting. I have seen patients who actually threw out their backs by picking up a pencil after a long day of sitting at a desk. Remember to turn your entire body when you need to reach for something, and above all, do not combine leaning, twisting, and rotating your body all at once. When you need to pick something up for any reason, in the workplace or not, try to do what infants do: squat, pick the item up, use your legs to stand up straight again, and then squat to set the item back down. Use this simple rhyme to remember: toes and nose. When you lift an item, you should point both your toes and your nose towards it. Using the strength of your back to pick things up—especially heavy things—is never a good idea.

Now, a note specifically for men (and women who carry their wallets in their back pockets). If you want to demonstrate what sitting on your wallet does to your back, try sitting half of your buttocks on the palm of your hand and see how it causes an imbalance to your spine. This simple, seemingly unimportant habit can eventually lead to spinal problems, so the next time you’re about to sit down with no regard for the  wallet in your back pocket, simply remove it and put it back when you stand up again. Easy, right?

And a note specifically for women (and men who carry over-the-shoulder bags or backpacks). Human hands are designed to carry things. Our shoulders aren’t. And yet, women constantly use their shoulders to bear the weight of heavy purses. The average American woman’s purse weighs a whopping 25 pounds! Regardless of whether you carry a purse on one side for your entire life, or switch sides every so often, just imagine the strain you’ll be putting on your body after years of this. Try lightening your purse by taking out anything non-essential, carry a handbag rather than a purse with a shoulder strap, and if you carry a backpack, use both straps to distribute the weight more evenly between your shoulders. 

The last, but certainly not least, important tip is to pay attention to how long you’re on the phone every day. If it’s any longer than 1 hour, you should seriously consider purchasing a headset with an earpiece instead. An even simpler option is to use your speakerphone instead of holding the phone directly to your ear for an extended period of time. And, contrary to popular opinion, switching which ear you use doesn’t lessen the damage to your neck—it only damages all the parts of your neck equally, and that’s hardly a positive choice to make!

As you can see, there are many variations to all the tips I’ve provided, and you may even come up with some of your own! The key is to never see these everyday activities as insignificant. Everything you do, from the moment you wake up to the moment you go to sleep at night (and when you’re sleeping, too!), may eventually add up to make the difference between a healthy or an unhealthy spine. Keep this in mind, and stay tuned for my next blog post, which will cover two very important topics: exercise and nutrition.