Tips to Cut Sugar Out of Your Diet

The average American consumes about 34 teaspoons of sugar a day – more than three times the recommended daily amount! If you’d like to make a healthier lifestyle change, consider cutting down on your sugar intake.

Why We Eat Sugar

We may not be aware of it directly, but when we are tired or feeling sluggish, our body craves carbohydrates for energy. Sugar is – you guessed it – a carbohydrate.

Carbohydrates aren’t the enemy though. It’s the refined added sugars that can be dangerous. There is a long list of “added sugars” include high fructose corn syrup, white sugar, brown sugar, corn syrup, corn syrup solids, raw sugar, malt syrup, maple syrup, fructose sweetener, liquid fructose, honey, molasses, anhydrous dextrose, crystal dextrose. .

Foods containing simple sugars may offer a quick burst of energy, but when the body metabolizes sugar quickly, blood sugar levels may dip suddenly, and cause the body to want(or crave) more carbohydrate to increase the blood sugar.

Sugar Hides Everywhere

It’s hard to believe, but sugar – and its aliases – hides in all food from bread and mustard to yogurt and juice. While it may be difficult to remove all sugar from your diet, it’s easier to focus on the sugars you can control, such as using less table sugar in coffee or tea, drinking fewer sodas, sports drinks, or sugar sweetened juice drinks, and consuming fewer or smaller portions of desserts, ice cream and candy. Also use the “Nutrition Facts” label on food to identify just how much sugar is in a serving of food or beverage. The ingredient list will tell you what type of sugar the product contains.

Cutting Out the Sweet

If you want to cut out the sugar in your diet, first start slowly. Lower the amount you add in your coffee, trade your soda for a glass of water, and switch to a lower-sugar cereal for breakfast. Try adding more protein to your diet to keep up energy levels, and if you must have something sweet, reach for a healthier snack like a banana or apple with peanut butter.

Cutting sugar out of your diet can be challenging because so many of us are used to adding sugar to our diet. But, once you break yourself of your sugar habit, you will probably find you have more energy, and may even see the numbers on your scale go down.

Lose Weight at Penn Medicine

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

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Unhealthy “Health” Food

Rebecca Dilks, RD, LDN, research coordinator at the Center for Weight and Eating Disorders and member of the Penn Metabolic and Bariatric Surgery team, and Casey Siegel provide tips for avoiding misleading health claims and being your own healthy food judge.
 

Just because the package or ad claims that a food is “healthy” does not necessarily mean that it is. More and more, food marketers are using healthy as a marketing technique to promote foods that by most people’s definitions do not actually qualify as healthy.

Don’t fall into the food marketing health trap: Next time you are the grocery store, check the nutrition label and ask yourself the following three questions to make sure the food qualifies as healthy health food.  

1. Does it contain too much sugar?
When food manufacturers reduce the fat content in foods, they often sacrifice flavor too. To compensate, many food manufacturers add sugar.
 
Further complicating matters, the sugar listing on nutrition labels groups all sugar together, which can be deceiving. In general, try to stay away from added sugar as much as possible. The American Heart Association recommends women consume no more than 100 calories (6 teaspoons or 24 grams) of added sugar per day and men consume no more than 150 calories (9 teaspoons or 36 grams).

Fruit juices, fruit cups, granola bars and energy drinks all contain added sugar, significantly increasing the calorie content. Try fresh fruit or flavored seltzer to avoid extra sugar without skimping on flavor.

2. Does it contain too much sodium?
Food can be loaded with sodium even if it does not have that traditional salty taste. That is why you must check the sodium content on the nutrition label. Don’t assume a food’s salt content meets the healthy food requirement. Stick to foods that contain less than 140 milligrams of sodium per serving.

For example, fat-free cottage cheese, which does contain healthy nutrients like calcium, also contains 400 milligrams of sodium per four ounce serving.

3. Does it contain healthy nutrients?
Food manufacturers are onto the growing healthy diet trend and have started making snacks in healthier portion sizes than ever before. But while many of these foods have reduced calories and fat, they also fall short on healthy nutrients like fiber or protein.

Instead of reaching for a pre-packaged, manufactured snack, try opting for all natural low-calorie and low-fat snacks that also offer important nutritional benefits, like fruits and veggies.

Check out this “buyers beware” list of foods that are commonly marketed as healthy despite questionable nutritional contents:

• Bran muffins: Some may be high in fiber, but many are loaded with calories due to excessively large portion sizes.
• Trail mix and granola: These products tend to come in small portion sizes that are loaded with calories and fat. Get more bang for your buck by snacking on low-calorie, nutrient-rich foods like fresh fruits and vegetables.  
• Tuna salad: Don’t be fooled by the word “salad.” Tuna fish alone is a great choice for lean protein and omega-3 fatty acids, but by adding mayonnaise to make tuna salad you also add lots of calories and fat.  
• Dried fruit: Dried fruit contains healthy nutrients such as fiber, but it also contains large amounts of sugar. Stick with fresh fruit for all the same nutrients but with less sugar. 
• Veggie chips: These chips may have some “veggie” ingredients, but most brands do not contain whole vegetables.  

There are many food claims out there masquerading as healthy despite a lack of nutritional facts to back them up, so you be the judge. Use the nutrition label to determine which foods actually qualify as healthy by your standards, not the food marketers.

Rebecca Dilks RD, LDN
Center for Weight and Eating Disorders
University of Pennsylvania Perelman School of Medicine

Casey Siegel, University Of Pennsylvania, Class of 2012
Biological Basis of Behavior/Nutrition minor

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Maintaining a Healthy Lifestyle during Ramadan

Sabrina Bitar, MS, clinical dietitian and center manager at Diet Watchers^TM in Saudi Arabia, guest blogs about tips for maintaining a healthy lifestyle during Ramadan.

The keys to healthy eating during Ramadan are planning and self-control. After fasting from dawn to dusk, your hunger and delirium make it easy to overeat. That’s why you have to plan ahead of time to get the nutrients your body needs during the non-fasting hours and control your impulse to indulge in unhealthy Ramadan foods that are in high in fat, calories and sugar.

With a focus on empathizing with the poor and needy, Ramadan can even be the perfect time of year to kick-start a new healthy way of eating and living.

Follow these tips to start or maintain a healthy lifestyle during Ramadan.

Drink lots of water
It is important to drink large quantities of water between dusk and dawn to remain hydrated, prevent constipation and headaches and aid in digestion

Consume foods that are high in fiber
High fiber foods are essential because they provide a steady release of energy during the fasting hours. Fiber also helps prevent constipation and makes you feel full for longer periods of time. High-fiber foods include whole grains, vegetables and fruit.

Limit your intake of sugary foods
This includes Ramadan desserts, which can be loaded with sugar.

Avoid spicy and salty foods
Make sure to avoid spicy and salty foods, especially during Sahur, because they make you thirsty for the rest of the day.

Avoid caffeine
Stay away from caffeinated drinks such as cola, coffee or tea. Caffeine is a diuretic, which can lead to dehydration

Avoid frying
Stick to baking and grilling instead of frying your food to keep your calorie and fat intake in check.

Get moving
Incorporate light exercise into your day such as stretching or walking. Exercise is essential for a healthier you.

- Sabrina Bitar, MS

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Lose Weight and Eat Ice Cream? The Real Scoop on the Summertime Staple

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains how to incorporate ice cream into a healthy diet. 


Whether you prefer chocolate, vanilla or a specialty flavor like mint chocolate chip, nothing screams summer like a delicious ice cream cone.

Well, get out your scooper, folks, because ice cream is no longer on the "do not eat" list for people trying to lose weight.

While ice cream can be loaded with calories, saturated fat and sugar, a variety of reduced-fat and light options are now available, which means you can enjoy this summertime treat without sabotaging your diet.

It's easy to go overboard once you start eating ice cream. To prevent overeating, use a small spoon to savor every bite and scoop your ice cream into a bowl instead of eating directly from the container. Another option is to purchase individually packaged treats like ice cream sandwiches or ice cream bars.

Always remember to check out the nutrition label before you dig into your ice cream treat. Even some ice cream varieties with the label "light" can be deceiving, which underscores the importance of reading the nutrition facts. Stick to nutrition labels that follow these guidelines:

• 120 calories or less
• 4 grams of total fat or less
• 3 grams of saturated fat or less
• 15 grams of sugar or less (equal to approximately 3 teaspoons of table sugar)

These are examples of healthy ice cream choices:

• Breyers^® Double Churned light ice cream
• Edy's^® fat free frozen yogurt or Slow Churned light ice cream
• Turkey Hill^® fat free frozen yogurt
• Whole Fruit^® no sugar added sorbet
• Skinny Cow^® low fat fudge bars or ice cream sandwiches
• Healthy Choice^® fudge bars
• Rice Dream^® frozen yogurt

- Cara Stewart, RD, LDN

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Tips to Skip Sugar

Many prepared foods contain added sugar, including yogurts, cereals, granola bars, jams, canned fruit, and sweetened beverages. Natural sugar occurs in healthy and unprocessed foods, including milk, fruit and vegetables. Added sugar is introduced into food in the processing or preparation stage and lacks nutritional value. High intake of added sugar is linked to increased risk for obesity, high blood pressure, high triglycerides, heart disease and stroke.

After bariatric surgery, it is essential to limit intake of added sugars for continued and maintained weight loss. The best option is to avoid food and beverages that are high in added sugar, or consume only small portions.

In addition, for people who had gastric bypass surgery, consuming too much added sugar can also lead to dumping syndrome.

Added sugar is often disguised under a variety of names. It is important to carefully review the nutrition facts of food and beverage products before consuming them. If any of the following ingredients appears near the beginning of the nutrition facts, the food or beverage may be high in added sugar:

• Beet sugar
• Brown sugar
• Brown rice syrup
• Cane sugar
• Cane juice or evaporated cane juice
• Confectioner's sugar
• Corn syrup or high fructose corn syrup
• Corn syrup solids
• Crystallized cane juice
• Fruit juice concentrate
• Honey
• Ingredients ending in "ose" including dextrose, glucose, maltose and sucrose
• Invert sugar
• Maltodextrin or dextrin
• Maple syrup
• Molasses
• Palm sugar
• Raw sugar
• Turbinado

To find the added sugar content in many common foods, visit the U.S. Department of Agriculture’s Database for the Added Sugars Content of Selected Foods.

Get more information about weight-loss surgery at Penn

Learn if bariatric surgery is right for you and attend a free information session about the Penn Metabolic and Bariatric Surgery Program.

At this free session, you will learn more about weight-loss surgery at Penn, and meet physicians and team members from the Penn Metabolic & Bariatric Surgery Program

Register for this free event here.

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Shape Up Your Plate in Honor of National Nutrition Month

Karen Buzby, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, discusses a new government-sponsored program to encourage better food choices and provide tips for eating healthy.
March is National Nutrition Month and the Academy of Nutrition and Dietetics is providing you the information you need to achieve a healthier lifestyle. But even after you make the commitment to eating healthy, figuring out how to achieve that on a meal-to-meal basis can be tough and confusing. The U.S. Department of Agriculture has developed a program to help.

MyPlate is an online resource that provides dietary advice based on the 2010 Dietary Guidelines for Americans. Unlike other diet guides, MyPlate uses an actual place setting to visually illustrate a healthy meal made up of all the major food groups. That means no more confusion about how to translate dietary advice to an actual meal and no more guessing about portion size.

Follow these tips to get your plate in shape*:

Balance calories
If you’re unsure how many calories you need to manage your weight, there’s no need to guess! Go to www.ChooseMyPlate.gov to find out your daily caloric needs. MyPlate provides the recommended number of daily servings from each food group to help you make smart and healthy dietary choices.

Enjoy your food, but eat less
Take your time to eat and pay attention to feelings of fullness.

Avoid oversized portions
Use smaller plates to encourage smaller portions. When eating out, opt to share a meal or take home part of the serving.

Fill up on nutrient-rich foods
Make vegetables, fruit, whole grains and low-fat dairy products staples in your diet. They’re high in nutrients and vitamins and low in fat, making them ideal food choices for good health. In fact, experts recommend covering half your plate with fruits and vegetables and ensuring that half your grains are whole grains.

Always choose low- or non-fat milk
By choosing fat-free or 1 percent low-fat milk, you cut calories and fat without losing the flavor or important nutrients like calcium and vitamin D.

Curtail your sweet tooth
There’s no doubt that sweet foods and beverages are both tasty and addicting, but they’re also high in fat, sugar and salt. Eat them only occasionally and in small quantities to satisfy your sweet tooth without compromising your healthy diet. One easy way to do this is by replacing sugar beverages with water and unsweetened drinks. 

Pay attention to sodium
You might be surprised by the sodium content in everyday foods. Before making a food selection, read the nutrition facts label and stick to foods that are low in sodium to help promote cardiovascular health.

For more information, visit the MyPlate website. 

- Karen Buzby, RD, LDN

*USDA, Center for Nutrition Policy and Promotion, DG Tip Sheet No. 1, June 2011.

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Healthy Bites for People on the Go: Meal and Snack Bars

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, explains the nutritional value of meal and snack bars and provides a guide for making healthy selections. 

It can be hard to fit healthy eating into a busy lifestyle. Between work, family, social obligations and more, sometimes it feels like there’s not enough time to prepare or sit down for a healthy, balanced or home-cooked meal.

But a shortage of time does not mean you have to sacrifice your commitment to healthy eating!

In fact, snack and meal replacement bars are perfect items to stock up on for those moments when you’re strapped for time and need a healthy bite to eat. They are easy, convenient, portable and if you make smart choices, they can be healthy, too.

From breakfast bars to granola bars to energy bars and protein bars, it’s hard to know which variety is the best, most healthful choice. The wide variety of bars on the market can make selection overwhelming and it doesn’t help that many bars masquerade as healthy despite being packed with sugar and fat.

Use this guide to find a healthy snack or meal replacement bar for the next time your stomach is grumbling but you’re on the way out the door.

Meal Replacement Bars
These bars are ideal when you’re in a rush and otherwise would skip a meal. Look for the following nutritional requirements per serving when making a selection:

• 200 to 300 calories
• At least 15 grams of protein
• At least 5 grams of fiber
• Less than 20 grams of sugar (Less than 10 grams of sugar for people who had gastric bypass surgery)
• Less than 10 grams of total fat
• Less than 2.5 grams of saturated fat

Snack Bars
Snack bars are great for quenching hunger between meals or as fuel before a workout. Make sure that your snack bar contains the following nutritional requirements per serving:

• 150 to 200 calories
• At least 5 grams of protein
• At least 3 grams of fiber
• Less than 15 grams of sugar
• Less than 7 grams of total fat
• Less than 2 grams of saturated fat

These general considerations are helpful to keep in mind when deciding which meal or snack bars to purchase:

• Bars that are low in carbohydrates are generally low in fiber or high in fat, especially saturated fat. Be careful that you’re not trading one unhealthy nutrient for another.
• Some bars, especially those that are low in sugar and carbohydrates, contain sugar alcohols, which can cause bloating, gas and diarrhea.  
• Bars that contain fruit naturally have more sugar. With fruit bars, you can be more flexible with the sugar content per serving.
• Pay attention to flavor and consistency. Make sure that you actually enjoy the taste of the bar!

Snack and meal bars made specifically for people who have had bariatric surgery are available on the following websites:

• BariatricAdvantage.com
• BariatricChoice.com
• BariatricEating.com
• DoctorsBestWeightLoss.com

- Cara Stewart, RD, LDN

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Tips for Healthy Holiday Eating After Weight Loss Surgery

Karen Buzby, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, provides tips for managing your post-surgical diet during the holidays.

There is no getting around it. Food is a central part of the holiday season. Whether you’re enjoying holiday food with friends and family or inundated with unhealthy treats at the office, it is hard to maintain your healthy eating goals over the holiday season, but it is possible.

These tips can help you stay on track with your post-surgical diet and lifestyle changes while still allowing you to enjoy the holiday festivities.

Don’t skip meals
Always make time for breakfast, lunch and dinner. Going long stretches without eating can lead to eating too much or too quickly and cause nausea or vomiting in people who have had weight loss surgery. It can also result in unhealthy food choices due to overwhelming hunger.

Be selective about food choice
Resist the temptation to try foods that are high in sugar and fat. After gastric bypass surgery, fatty and sugary foods can cause “dumping syndrome,” resulting in severe abdominal pain and cramping, diarrhea, nausea and vomiting. Instead, choose low-calorie party foods such as raw vegetables, fruit with yogurt dip or boiled shrimp with lemon or cocktail sauce.

Stay well hydrated
Stay hydrated by drinking water and low-calorie beverages. Avoid alcoholic beverages and try to separate eating and drinking by 30 minutes.

Keep a food diary
Research* shows that recording what you eat helps you stay on track during the holidays. It also helps you meet your protein and fluid goals. Take a minute each night to record your food and fluid intake for the day.

Click here for more healthy eating tips for you and your family.

- Karen Buzby, RD, LDN


*Cornett R, Akers J, Salva J, Zoellner J, Davy B. Daily self-monitoring during the winter holiday period: a feasible strategy for holiday weight maintenance. SCAN’s PULSE. Fall 2011, Vol 5, No 4: 1 – 6.

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Eat Right When Eating Out

Karen Buzby, RD, LDN, and Cara Stewart, RD, LDN, members of the Penn Metabolic and Bariatric Surgery team, offer these tips for eating healthy when dining out.

Dining out can be a challenge for anyone trying to follow a healthy eating plan, but it is especially difficult if you have had weight loss surgery. Restaurant portions are notoriously large and the meals are often packed with sodium and hidden calories from fats, sugars and sauces. Before weight loss surgery, larger portions may have tempted you to eat more than you wanted or needed. After weight loss surgery, the food may go to waste or cause discomfort. 

The following tips can help you enjoy your meal out while sticking to your diet plan.

Limit calories:

• Be conservative with food selection, especially during the first few months after surgery. Stick with simple prepared foods.
• Before ordering, ask yourself: “Is this food pouch worthy?” Make sure you order foods that are a good source of protein and fiber.
• Look for heart-healthy, low-fat or light options. U.S. Food and Drug Administration (FDA) regulations require restaurants to back up their health claims. Feel free to ask for nutrition information if it is not already provided.
• Stay away from the bread and chip baskets as well as dessert and alcohol menus. Ask the server not bring out the dessert cart. If you choose to eat bread, opt for a small, plain yeast roll and avoid items with added fat like garlic bread, cornbread, croissants and muffins.  
• Salad dressings are often high in calories and fat. Always order dressing on the side and ask for low-fat dressing, a lemon wedge or flavored vinegar instead of the full fat and calorie version. 
• Don’t drink your calories. Quench your thirst with calorie-free drinks like water or unsweetened iced tea. Limit or avoid alcoholic beverages.
• If your job requires socializing or doing business over meals, call ahead or go online to learn about your options in advance. Inform the restaurant manager of your dietary restrictions and make special requests ahead of time if necessary.
• Savor each bite of food, enjoy the company and take your time. Allow at least 20 to 30 minutes for each meal. Remember, conversation is calorie-free!

Control portion sizes:

• Watch your portion size. People who have had bariatric surgery receive a “restaurant card” to request smaller portions when dining out. Use it to make sure your meals are an appropriate size.
• Share a meal or order a smaller portion. This reduces portion size and the expense as well.  
• Order from the lunch menu if it is available. Often the lunch menu offers smaller and less expensive entrees.
• Order from the children’s menu if there are healthy selections available.
• Order an appetizer as a main entrée. The portions of appetizers are usually two to four ounces, which is the ideal meal size after weight loss surgery. 
• Ask the waiter to split the main dish and box half before serving it. You can also request a “doggie bag” as soon as you feel satisfied to avoid the temptation of overeating. 
• Try a tapas restaurant, which serves snack-sized appetizers and entrées.  

Manage leftovers:

• When you take home leftovers, remember to refrigerate the food promptly to avoid food-borne illness. Food left out for more than two hours may not be safe to eat.
• Write the date of purchase or preparation on leftovers and remember to discard the food after three to five days. Always follow the mantra: “When in doubt, throw it out.” Plus, you don’t want your refrigerator to turn into a jungle of leftover containers. 
• Reheat food thoroughly.

- Karen Buzby, RD, LDN and Cara Stewart, RD, LDN

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