- The Washington Times - Tuesday, January 8, 2008

When registered dietitian Jodi Balis cut refined sugar out of her diet six years ago, she felt some lethargy and mental fogginess for the four to five months she kept to the diet.

“I remember the first bite of sugar I had, I couldn’t stop eating it,” says Mrs. Balis, nutrition educator with the University of Maryland Cooperative Extension in Clarksville.

For this reason, Mrs. Balis and other metro-area dietitians and nutritionists advise against eliminating refined sugar, but urge learning to eat it in moderation instead.

“There are other ways to bring more sweets into your life without having to take away the old ones,” Mrs. Balis says.

Moderate amounts of sugar fit into a healthy diet and active lifestyle, says Charles W. Baker, the U.S. Sugar Association’s executive vice president and chief science officer, in an e-mail interview.

“Repeated scientific analyses have proven that diet quality is determined by one’s total diet, not a single diet component like sugar,” says Mr. Baker, who holds a doctorate in biochemistry with a specialty in carbohydrates.

Nevertheless, whether eliminating sugar from the diet leads to withdrawal symptoms is up to debate.

“No food, including sugar, leads to clinically verified withdrawal,” Mr. Baker says. “Foods are not drugs, just like drugs are not foods.”

Research shows, however, that some of the same receptors in the brain triggered by opiates such as heroin and morphine also are triggered by sugar, says Dr. Robynne Chutkan, assistant professor of medicine at the Division of Gastroenterology at Georgetown University Hospital in Northwest. She is medical director of the Digestive Center for Women in Chevy Chase.

Craving sugar is not an addiction, although, as with an addiction, there can be increased intake of sugar over time, withdrawal symptoms when sugar is taken away, and relapse and return to eating it, she says.

Withdrawal symptoms, which last three days to two weeks, can include sugar cravings, irritability, fatigue, low energy level, cold intolerance and mild depression or anxiety, Dr. Chutkan says.

The symptoms are similar to but less intense than symptoms of caffeine withdrawal, says registered dietitian Rosanna Gibbons, consultant dietitian for the University of Maryland Center for Integrative Medicine in Baltimore.

“As blood sugar drops, you almost feel like you’re dropping in an elevator shaft. You can feel fuzzy and hazy,” Mrs. Gibbons says.

Cutting back on sugar can heighten the sensitivity of the taste buds to other flavors, such as sour or savory, she says.

“You can unteach your taste buds to crave supersweetness,” she says. “You can retrain [them] to enjoy moderate levels of sugar over a timeline of several weeks.”

A diet free of sugar is impossible at the physiological level because carbohydrates are broken down into simple sugars for fuel, says Meg Martin, a registered dietitian and clinical nutrition manager at Inova Alexandria Hospital.

Carbohydrates, both complex and simple, are broken down into their simplest form as glucose, Ms. Martin says.

Complex carbohydrates tend to take longer to break down and be digested and absorbed into the bloodstream than do simple sugars and simple carbohydrates, says Carine Nassar, a registered dietitian and site manager for the MedStar Diabetes Institute at Washington Hospital Center in Northwest.

“The advantage of complex carbs is they tend to be filling,” Mrs. Nassar says.

Complex carbohydrates provide a more stabilized source of energy than the quick energy boost that comes from sugar, Mrs. Balis says.

“It’s not sugar that’s bad, but what follows. It’s the cravings sugar might bring,” she says.

Mrs. Balis recommends identifying when cravings occur and the qualities of the cravings, such as sweet and creamy, sweet and chewy, sweet and salty, sweet and crunchy, or sweet and spicy. Once they’ve been identified, find a healthy way to satisfy the craving, such as eating rice pudding as a substitute for ice cream to satisfy cravings for something sweet and creamy, she says.

“I believe that it’s more important to introduce new foods than to deny the old ones,” Mrs. Balis says. “It’s not necessarily taking away sugar, but knowing what’s in your food and eating more simply.”

Sweets are not nutrient-rich foods, and cutting back on those allows for satiation from healthier foods, says Kathy McFalls, a registered and licensed dietitian who is senior nutritionist at the George Washington University weight-management program.

“You don’t want to set yourself up for deprivation, nor do you want sweet foods to replace healthy foods,” Ms. McFalls says. “It’s important to keep a balance.”

Cutting back on sugar requires reading labels for nutrition facts, Ms. Martin says. Foods rich in sugar list sugar, high-fructose corn syrup, syrup, sucrose, dextrose, maltose and honey, among other sugars, in the ingredients, especially in the first three to four items listed, she says.

“If the sugar number is high compared to total carbs, that could indicate added sugars,” Ms. Martin says.

Ms. Martin recommends evaluating sugar in the diet and making gradual changes, such as cutting back from a daily sweet to eating one every other day in a controlled portion. Or, replace a sugary cereal with a whole-grain or high-fiber cereal, she says.

Eating meals regularly every four to five hours also can help reduce sugar cravings that can come from needing a quick boost of energy, Ms. Martin says.

So can cutting back on sodas, including diet sodas, because artificial sweeteners are shown to trigger an insulin release, Dr. Chutkan says

“Your body still responds to it as a sweet,” she says.

For breakfast, Dr. Chutkan recommends eating foods that have fiber to slow down sugar absorption, along with protein to help curb sugar cravings. The fiber content should be higher than the sugar content in the food, as listed on the product’s label, she says.

“Sugar tastes really good. That’s why it’s added to almost everything,” Dr. Chutkan says.

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