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Sugar is everywhere. And who doesn’t enjoy a little sweetness in our lives? But the bitter truth is that sugar is a silent threat that contributes to worse health outcomes as well as to chronic pain. I’m going to reveal the hidden ways sugar affects your body and show you how reducing your sugar intake can significantly improve your overall health.


According to the American Heart Association, adults consume an average of 17 teaspoons of added sugar every day, more than 2-3 times the recommended amount. This adds up to around 60 pounds of added sugar consumed annually per person.


And all of this results in real damage to our overall health. This applies to people of all weight categories, it doesn’t matter if you are normal weight, overweight, or even slim. The reality is that excess sugar is toxic to our health. And the question is why? How could something that tastes so good be so damaging to our body?


Well, consuming too much sugar can lead to insulin resistance. Insulin is a hormone produced by the pancreas that regulates energy through managing blood sugar levels. When cells in our body, specifically muscles, fat, and liver, become less responsive to insulin, our pancreas works harder, producing more insulin to keep our blood sugar levels stable.


Now initially, the pancreas can compensate for the insulin resistance but if this persists, and the blood sugar levels continue to stay high, the pancreas is going to struggle. And when that happens, our blood sugar levels start to rise leading to prediabetes or even full blown diabetes.


Excessive sugar intake also suppresses the immune system. Research shows that after consuming sugar, the efficiency of white blood cells in attacking bacteria is significantly reduced. This leads to a diminished immune response and a weakened immune system. This is why diabetics are at significantly higher risk for respiratory infections like influenza or pneumonia, urinary tract infections, and skin infections.


Diets high in sugar also contribute to the development of atherosclerosis, which is an underlying cause of heart disease and cardiovascular disease. Elevated blood sugar levels result in the formation of advanced glycation end products which ultimately causes plaque build up in our blood vessels. In addition, high sugar levels lead to chronic inflammation as well as damage to endothelial cells in blood vessels. Both of these contribute to heart disease and heart attacks.


Chronic inflammation is also how elevated blood sugar levels affect how we experience pain. High blood sugar levels have been linked to the promotion of proinflammatory cytokines which are involved in both inflammatory pain as well as nerve pain. That’s also why we see other studies such as this one that find that those with high blood sugars are more likely to have musculoskeletal pain, osteoarthritis, osteoporosis, and rheumatoid arthritis.


And this makes sense. Sugar in the body causes low grade inflammation which increases stress on the body and accelerates the degeneration of joints and soft tissue. And the risk is real. This study reports that those with prediabetes and diabetes have a 3 times higher risk of tendon injury when compared to those with normal sugar levels.


What’s worse is that other research shows that not only are people with metabolic problems more likely to have musculoskeletal pain, they also don’t respond as well to usual treatment. They have higher rates of treatment failures and need longer courses of treatments such as physical therapy, pain medications, or injections.


So you can see now how excess sugars can be really damaging to our bodies. But before you cut out all carbohydrates from your diet, you need to know that not all sugars exert the same effects on the body. Almost everything that I just mentioned are a result of added sugars, processed carbohydrates, and simple sugars. Many of these negative health effects do not apply to complex carbohydrates.


In fact, quite the opposite. Switching out processed grains, sugary beverages, and starchy vegetables such as potatoes or corn with equal amounts of whole grains, fruits, or non starchy vegetables such as carrots or green leafy vegetables has been shown to improve weight loss. So let’s take a quick detour and understand the differences between simple and complex carbohydrates.


Simple sugars include glucose, fructose, and sucrose. These sugars are found in refined foods such as bread, pasta, rice, and potatoes. The problem with these sugars are that they are easily digested and absorbed which leads to a quick spike in blood sugar levels. Now, our bodies can deal with a few spikes here or there. The problem is that if we have these spikes throughout the day, they can quickly overwhelm our body’s ability to manage blood sugar, potentially leading to insulin resistance over time.


Complex carbohydrates are much less likely to cause these spikes in blood sugar levels. Complex carbohydrates are found in whole foods such as fruits, vegetables, legumes, and whole grains. These foods contain fiber, which slows down digestion, resulting in a more gradual increase in blood sugar levels. This helps the body to manage energy more efficiently and prevents the inflammatory response associated with sugar spikes. Additionally, these foods are rich in nutrients, phytochemicals, and antioxidants, which help improve our overall health.


So when we talk about reducing sugar intake, we want to keep the complex sugars and try to decrease the intake of simple sugars. The easiest way to do this is to cut back on added sugars. And to do that, look no further than your drinks. Beverages are the biggest offenders of added sugars with 47% of all sugars coming from sugary drinks.


The worst are soft drinks comprising 25% of all added sugars. This is followed by fruit drinks at 11%, coffee and tea at 7%, and sports and energy drinks at 3%. The second biggest category is snacks and sweets comprising 31% of all added sugars. These two categories alone take up almost 80% of all added sugars.


Now a few practical tips on how to reduce your intake of sugary drinks. Start slow. If you're used to drinking sugary drinks regularly, begin by cutting back gradually. Mix them with water, starting with half water and half sugary drink, and then increase the water ratio over time. Eventually make water your go-to drink. If plain water doesn't appeal to you, try adding slices of fruits like lemon, lime, cucumber, or berries for natural flavoring.


And how do we cut back on the sugary snacks and carbohydrates that fill our diets? It's tough to scale back on sugar since it can be quite addictive. Sugar taps into the same brain areas like addictive substances to generate cravings and a temporary sense of well being. This often leads to a cycle of intense cravings and eating to feel good.


But when we're stressed, this cycle intensifies. We eat more sugar to regulate our mood, our appetite, and how we perceive pain. But this fix doesn’t last long. Leaning on sugar to cope with emotions can leave us feeling worse and trapped. So here’s what I recommend to my patients who are stuck.


Read food labels and check the ingredient list for sugars like sucrose or high fructose corn syrup. Opt for natural spices that provide taste such as cinnamon or vanilla. Consider buying keto snacks that are low in carbohydrates and higher in fats and proteins. Examples of these include cheese, nuts, and seeds.


The most important thing that I want to point out is that you do not have to choose an extremely restrictive diet. I counsel my patients to find balance. Aiming for a perfect ‘A+ diet’ will yield quick results but those effects will only last if the diet is maintainable. It’s far more effective to adopt a realistic and manageable dietary plan. An achievable ‘B diet’ that fits your lifestyle and is sustainable is better than an ‘A+ diet’ that’s too restrictive. The goal is to avoid the ‘F diet” that caused all the issues in the first place.

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