Sweet Necessity: The Extent and Perils of Sugar Addiction

By Cathy Cassata

Telling a sugar addict to stop eating sugar is like telling an alcoholic to stop drinking.

Yeah. Yeah. Yeah. You’ve heard it before—sugar is bad for you. But, just how bad? According to Action on Sugar, a group of leading medical and nutrition experts, the sweet substance is bad enough that earlier this year, the group called for a 20-30% reduction in sugar added to packaged and processed foods over the next three to five years. Action on Sugar estimates that this change would result in a reduction of about 100 calories each person eats daily, and over time would reverse the obesity epidemic.

“Telling people to stop eating sugar is well-intended and might work for those who are not addicted to it,” says Kathleen DesMaisons, PhD, author of The Sugar Addict’s Total Recovery Program and Potatoes Not Prozac. “But it’s likely that many people who are obese or who have Diabetes Type 2 are sugar addicts. Telling them to stop eating sugar is like telling an alcoholic to stop drinking. There is much more to it than that.”

There is a lot of pain associated with this addiction. It’s real.

Nicole Avena, PhD, research neuroscientist and faculty member at the New York Obesity Research Center, agrees. “We’ve done lots of studies looking at what sugar can do to your brain, and we find that when some people eat too much sugar it can cause the release of the chemicals associated with pleasure and reward. Over time, their brains adapt to that and it down-regulates the receptors for these chemicals, so eventually they feel like they’re not getting enough pleasure out of the food they eat, and so they want to eat more and more of it,” she says.

Just like alcohol?

More and more research is showing the link between a dependence on sugar and addiction to other substances. A study that Avena helped conduct, published in 2007 in the Neuroscience & Biobehavioral Reviews, reported that in some circumstances, intermittent access to sugar can lead to behavior and neurochemical changes that resemble the effects of a substance of abuse. The study showed that rats with intermittent access to food and a sugar solution can show both a constellation of behaviors and parallel brain changes that are characteristic of rats that voluntarily self-administer addictive drugs.

A 2011 study of more than 500 people showed that those who had genetic changes in a hormone called ghrelin, which tells the brain you’re hungry, consumed more sugar (and alcohol) than those that had no gene variation. Researchers think that the genetic components that effects people’s ghrelin release may determine if they use sugar to enhance a neurological reward system.

In a 2012 paper in the journal Nature, researchers suggested that, like warnings on alcohol, limitations and warnings should be placed on products containing sugar. The paper included evidence that fructose and glucose in excess can have a toxic effect on the liver; the metabolism of ethanol - the alcohol contained in alcoholic beverages - had similarities to the metabolic pathways that fructose took. The authors also reported that sugar increased the risk for some of the same chronic conditions as alcohol does. “We need to do more studies to understand the overlap and comorbidity between substance abuse and food addiction. However, there is long-standing literature of becoming overweight after one quits having substance addiction. So people who get clean from drugs, smoking, and alcohol, gain weight. It seems they replace that urge with a food addiction,” says Avena.

DesMaisons says she noticed a clear connection between sugar and alcohol while working in a treatment center during the 1980s. “I worked with many alcoholics, and I’d ask them what they ate. Many said they ate lots of sugar and didn’t eat breakfast or regular meals throughout the day, so when asked to change their eating habits and improve their nutrition, I saw so many improvements,” she says.

After seeing how healthy nutrition helped many addicts, DesMaisons founded Radiant Recovery®, a free online community dedicated to healing unbalanced sugar sensitivity. Her work is based on the premise that some people are predisposed to addiction. “This group of people has a type of brain and body chemistry that makes them more vulnerable to addictive substances and behaviors, and they’ll be very drawn to sugar way before they discover alcohol because sugar creates the same biochemical response that alcohol does in the brain,” she says.

Your body and brain on sugar

Sugar is a simple carbohydrate that is found naturally in fruits, vegetables and dairy products, as well as added to many foods. All carbohydrates are converted into glucose during digestion, and glucose is the form of sugar that is used in the body for energy.

While natural sugars aren’t harmful to eat for healthy people, the World Health Organization recommends that “added sugar” make up no more than 10 percent of our daily intake. “Right now the average American is consuming much more than that - about 22 teaspoons of added sugar a day,” says Avena. “Sugar in and of itself isn’t bad, but we as a society have lost our ability to accurately control how much we’re consuming. Many of the foods we consume that we think are healthy, are actually packed with sugar. Things like pasta sauce, BBQ sauce, and sausage, you don’t necessarily associate with sugar, but often contain added sugar.”

So what’s the real deal with sugar when it enters your body? Cameron Wells, MPH, RD, dietitian at the Physicians Committee for Responsible Medicine, says when you eat sugar it immediately turns into glucose, gets into your blood stream and triggers the release of insulin.

“It’s then pulled into all your muscles and cells so the sugar can be used for energy. When you get too much sugar, you’re going to have that real intense spike in blood sugar level, which is associated with that addictive cycle because you have that sugar high and a lot energy for a while and then you quickly crash once that insulin kicks in and your blood sugar level comes back down. This is when people tend to go back for more so they can get that rush of energy again,” Wells explains.

Your brain is instantly affected too. “When sugar touches your tongue, you trigger the release of opioids in your brain. These opioids are like natural pain killers or endorphins. They trigger the release of dopamine, the chemical that’s responsible for feelings of pleasure,” explains Wells. “Your body typically remembers that experience so when you eat that sugary food again, you have that fond memory and are more apt to go back for more. Alcohol, tobacco, and marijuana all play on the same pleasure center of the brain too.”

Who’s at risk for sugar addiction?

One theory that exists is that anyone can become dependent on sugar based on the notion that the more sugar you eat, the more you alter the dopamine receptors in the brain, leading to the desire to want more sugar. While this may need further research, DesMaisons says that research has shown that genetically certain people have lower levels of beta endorphin and this makes them more vulnerable to alcoholism. “People with lower levels of beta endorphin get a more intense reaction when they consume sugar and alcohol because they have more receptors opened up, so they get a bigger hit, and a bigger withdrawal when all the extra receptors empty out,” she says.

DesMaisons adds that people who are not predisposed to addiction can resist sugar more easily. "They can eat half a cookie, leave it on the counter, and walk away. But people who are vulnerable to the addictive qualities of sugar will eat the sugar and want more. Plus, they can’t imagine a life without sweet stuff. The difference between a sweet tooth and sugar addict is that the sweet tooth can adjust her sugar intake when faced with health issues.”

While Avena agrees that certain people are more prone to develop addiction, she says that research indicates people who are diagnosed with binge eating disorder have the highest comorbidity of also having food addiction. “Up to 50 percent of people who have binge eating disorder will meet the criteria for having a food addiction as well. But research also shows that food addiction is among people who are obese, who have had bariatric surgery, and of people who are normal weight, so it seems it can be seen across all types of people,” she adds.

Ways to cut sugar out

To curb your sugar cravings, DesMaisons and Wells say first start by eating a nutritious breakfast. “I have many people tell me that they’re miserable with their sugar intake, but they’re having a cappuccino for breakfast. Starting the day off with a sugar-loaded drink isn’t the way to go,” DesMaisons says. “Once you have eating breakfast down, then move on to eating lunch and dinner daily too. Seems simple, but many people with an addictive nature don’t eat regular meals throughout the day. Giving your brain the nutrients it needs to heal itself is the most important step to recovery.”

Fill up on fiber too, suggest Wells and Avena, because it helps to stabilize your blood sugar. Healthy foods that contain fiber include fruits, vegetables, beans, and legumes.

DesMaisons says apples and bananas are great go-to fruits. “When people are in early recovery, I suggest that they have 3 bananas a day because bananas are high in fruit sugar and help your brain calm down yet they don’t give you a huge spike like candy would,” DesMaisons says. She also suggests eating a small potato before bed. “Potatoes raise the level of serotonin in your brain, which makes you sleep better. If you increase serotonin in your brain you’re also less depressed and able to resist temptations. In fact, alcoholics have lower levels of serotonin in their brains, which is why it’s hard for them to say no.”

Sticking to low glycemic index (GI) foods is a great way to keep blood sugar levels under control, notes Wells. “Look up the foods so you can see their values based on the GI number. While there are rules of thumb, foods are broken down differently. What you may think is a low GI food, may be high. For instance, white and wheat breads have similar GIs, but people don’t generally think that since we’ve been ingrained to think that wheat is healthier. In terms of bread, pumpernickel is typically your best choice. Also, white and wheat pasta have similar GI values and they’re both lower than bread,” she says. While fruit is a healthy choice, Wells says pineapple and watermelon are higher on the GI index.

In her book, Why Diets Fail, Avena suggests that people identify why they consume sugary foods and figure out what healthier alternatives they can replace them with. “For instance, if you’re a big soda drinker, ask yourself what is it about the soda you like? If you like drinking something bubbling, maybe switch to seltzer water. If it’s the caffeine, maybe switch to black coffee. And if it is just the sweet taste, eat fruit every time the craving arises,” she notes.

Not a laughing matter

While it may seem far-fetched to compare over-eating sugar to problem drinking or drug use, DesMaisons says we should take note. “People who laugh off sugar addiction do so because they’re not addicted,” she says. “I work with people all over the world who are addicted to sugar and don’t know what to do about it. There is a lot of pain associated with this addiction. It’s real.”

Avena says the more research that’s done, the more history may repeat itself. “If you look back to the 1960s, the same sentiments were thought about tobacco use. People didn’t think tobacco was addictive or bad for you, and there weren’t regulations on its use. Now, we know tobacco is clearly addictive and can cause cancer, and we have regulations related to its use,” she says. “We need to do more research on sugar to truly characterize it and understand it so we can address it as a society. But the research that already exists certainly leans toward limiting sugar as much as possible.”

That’s easy enough to digest.

10 Protein-Packed Plants

by ALISA RUTHERFORD-FORTUNATI

The continuing debate over how much protein the average person needs* has done little to change our hunger for it. And who can blame us? Protein is one of the basic building blocks of life.

When most people think about protein, images of cheese, eggs and a leg of lamb pop into their head. Did you know though that every – yes, every – whole food contains protein? From your morning banana to your evening salad, finding plants packed with protein is easy to do. And not only is it easy to do, it’s easy for your body to use.

Plant-based foods are practically free from cholesterol, tend to be high in fiber, and are often alkalizing to the body. All animal products, on the other hand, are devoid of fiber, and are acidifying to the body, which causes calcium to be leached from your bones, as well as decreasing oxygen levels in the blood, and negatively impacting the digestive/lymphatic system.

You may have heard the ongoing debate about “complete” or “incomplete” protein and “food combining”, but be wary; these topics are steeped in misinformation and myth. Here’s what I’ve discovered thus far:

The term “complete protein” refers to foods that have all nine essential amino acids present in the correct proportion for our bodies to build protein with. The term “incomplete protein” refers to foods which have all the essential amino acids, but are simply low in one or more of them. This is called the “limiting amino acid”. While it’s true that most whole plant foods have one or more limiting amino acids and are thus “incomplete”, this shouldn’t send you running for a steak. Our bodies are brilliant, and every food that goes into your system must be broken apart and its nutrients absorbed. During the digestion process, amino acid chains from all sources are broken down and made ready for our bodies to use. If you’re eating a good mix of fruits, veggies, grains and legumes, then your body simply collects what it needs from the “amino soup” that your digestion system has absorbed. There are a growing number of vegan bodybuilders, ultra marathon runners and award-winning athletes out there to prove that meeting your protein needs on a plant-based diet is simple and successful.

Since every whole food has protein in it, you have literally millions of great options to choose from when it comes to creating a balanced diet with the right percentage of protein for your body*. I’ve selected ten nutritious plants to get you started, for both their protein content and other health benefits. You may be surprised at some of the veggies, nuts and grains that made it onto my list.

Eggs are the Perfect Natural Whole Food and are Packed with Nutrients.

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Whole foods are foods that are closest to their natural state, including unprocessed fruit, vegetables, whole grains, eggs, whole fish skinless poultry and lean red meat. Research shows that dietary patterns that include more whole foods results in higher nutrient intake and an increased quantity of antioxidants. 

What nutrients are in eggs?

Eggs have the highest nutritional quality protein of all food sources

Protein is a source of energy but its main role in the body is growth and repair. It helps in the formation of muscles, hair, nails, skin and organs, such as the heart, kidneys and liver. The protein found in eggs is considered to be of the highest quality, providing the right amount and balance of amino acids to match human requirements.  

Eggs contain over 11 essential vitamins and minerals including:

Selenium – antioxidant which protects our body and immune system
Folate  – for growth and maintenance of healthy cells
Biotin – helps cell metabolism and the utilisation of fats, proteins and carbohydrates
Calcium – for building and maintain bones and teeth
Cephalin – a phosphorus-containing lipid found in tissues
Lecithin – contains acetylcholine which has been proven to help brain function
Pantothenic acid (Vitamin B5 ) – releases energy from our food for our body to use
Vitamin B12 – for brain and nervous system functions and blood formation
Vitamin A  – for growth and eye health
Iodine – to ensure proper function of our thyroid gland
Vitamin E – antioxidant to protect our bodies against disease
Phosphorous – helps build strong bones and teeth
Iron – to produce haemoglobin which carries oxygen around our bodies
Thiamine – to turn carbohydrates into energy our body can use
Zinc – helps in growth, wound healing, blood formation and maintenance of tissues
Vitamin D – important in bone health

For more information visit the New Zealand Nutrition Foundation

What is the nutrient content of raw New Zealand hen eggs ?

Nutrient	Two medium eggs (98g)	% Recommended Daily Intake
Energy (kJ)	628	6%
Protein (g)	11.8	18%
Fat (g)	11.4	17%
Saturated fat (g)	3.4
Monounsaturated fat (g)	4.4
Polyunsaturated fat (g)	1.2
Cholesterol (mg)	404
Sodium (mg)	166
Iron (mg)	2.8	35%
Selenium (ug)	15.8	23%
Zinc (mg)	1.2	8.5%
Vitamin B12 (ug)	1.6	67%
Folate (ug)	46	11%
Vitamin A (ug) (Retinol)	130	14%

Source: The Concise New Zealand Food Composition Tables. 7th edition. RDI based on male 31-50yr, 1.9m, 80kg, 10,400kJ/day

Why exercise doesn't always help you lose weight

by Nicola Garrett

We all know exercise helps you lose weight. Right? So why do some of us fail to shed centimetres even though we do plenty of exercise?

Jeff and Liz are like many couples in their early 40s – they love good food, drink a little too much wine and don't do enough exercise.

Unfortunately their lifestyle started taking its toll on their waistlines. So last year they decided to do something about it together and embarked on a new regime of healthy eating, drinking less, and exercising regularly.

Three months later Jeff had lost four kilos, whereas Liz's weight was the same. It's an all too familiar story yet it's one we don't really know the answer to.

Why is it that some people can slog their hearts out at the gym several days a week to discover their scales are telling them the same story?

Weight loss through exercise works 'in theory'

Exercise can be an effective way to lose weight, says Dr Nathan Johnson, an exercise physiologist based at the University of Sydney.

This has been illustrated by plenty of scientific studies that placed people on exercise programs and calculated, based on the energy cost of the exercise, how much weight they should lose. More often than not, study participants lost weight as predicted.

"On the whole people do lose weight when they stick to an exercise plan and nothing else changes," says Johnson.

However, in the real world what tends to happen is people who exercise either don't lose weight, or lose a small amount that they then put back on over time.

A study by an US group of researchers is a good illustration of what typically happens with exercise, says Johnson.

Previously sedentary overweight and obese postmenopausal women were put into either a non-exercise control group or one of three exercise groups with an exercise energy expenditure of 4, 8, or 12 kcal/kg/week (KKW).

At the end of the six-month study the researchers observed no difference in actual and predicted weight loss between the 4 and 8 KKW exercise groups. The 12 KKW group, who exercised for 194 minutes a week, produced only about half of the predicted weight loss.

"People tend to go well for a few weeks and lose the amount of weight you'd expect but then things tend to go the wrong way after that…they begin to not lose as much weight as you'd expect in the end," says Johnson.

"The authors speculate that people are behaviourally compensating by either changing their diet or their physical activity."

Cancelling out your hard work

Johnson says many of us are either consciously or subconsciously 'self-sabotaging' in some way.

For instance, you may be less physically active overall throughout your day because you are exercising. This means you're unwittingly cancelling out the benefits of the exercise you've been doing.

"If I start a regular exercise program I may find myself sitting down more or taking the less active option [in other activities]," says Johnson.

"The other thing is people may change their dietary behaviour whether that means eating more, or eating more energy dense foods."

Most of us can identify with this feeling of having 'earned' a treat after a big work out session.

"The actual medicine itself, if we think of exercise as a medicine actually works, …but it's the implementation of it that tends to fall short," he says.

Diet damage is hard to undo

The other issue is that people can do a lot of harm through their diet that is almost impossible to make up through exercise, says Johnson.

"Making a bad eating decision can require a lot of exercise to expend the equivalent amount of energy," he says.

For example, you need to do about 45 to 60 minutes of exercise to offset the kilojoules contained in a burger from a popular fast food joint.

"When you combine the typical choices people make throughout the day, like a snack in the morning, a burger for lunch, we often find that we just can't undo the bad work that's been done."

And the truth is, most of us are largely unaware of how much energy is in the food that we're putting into our bodies, particularly when it comes to sugary or fatty foods.

Putting calories into context

Researchers from Texas found that when they gave people menus that illustrated how much exercise was needed to burn off the calories for each item of food, they opted for healthier choices.

The study of 300 men and women aged 30 and under were divided into three groups. One group received a regular menu, the second group received the same menu with the calorie content for each item, and the third group had a menu that listed calories as well as how many minutes of brisk walking it would take to burn those calories.

The third group ordered and consumed fewer calories compared to the other groups.

The findings showed that putting calories into context might go some way to changing the eating habits of adults, the study authors said.

Right type of exercise

Sometimes there's also a big difference between what people think is exercise, and what exercise actually is, says Johnson.

"People misunderstand what we talk about as exercise and think that just getting up from their chair or having a stroll is adequate."

"There's a perception that they've done some exercise so that offsets all ills."

He says many of us will take the easy route when it comes to exercise.

"Adults inherently tend to select the lazier option of things and this tends to come as self-supporting advice."

"If you stick to that then you're suddenly not doing the recommended regular amount of exercise to keep that energy input energy output balance in check."

Fat burning exercise

When we move our bodies we need energy to be used up at a higher rate to burn fat. The key is to expend as much energy as you can, says Johnson.

He recommends aerobic type activity involving the use of large muscles if you want to lose weight. This is because the more muscles you use, the more energy you need to use to support the activity.

This can include activities like brisk walking, running, cycling, kayaking, swimming as well as many team sports.

It's best to try and accumulate activity for prolonged periods of at least 30 minutes but the more the better, advises Johnson.

Some people respond better

It's also true that some people respond to exercise better than others, but it depends on what outcome you are measuring, says Johnson. For instance, if we're talking about fitness, measured as aerobic capacity, part of that is genetically determined.

"We don't quite have a handle on which genes cause it, but there is definitely evidence that some people get more benefit in terms of fitness from exercise programmes than others".

However, when it comes to weight loss from exercise, having a genetically higher chance of being overweight or obese doesn't mean that you won't respond to exercise as well as anyone else does.

"While there is some evidence of a genetic component to being overweight or obese, the important thing is that there's absolutely no evidence that it changes how people respond to an exercise program."

Don't worry about the scales

According to Johnson, it's actually not weight per se that's the problem, it's fat and in particular, where it is stored.

Most rugby league or union players are overweight in terms of body mass index because they have a lot of muscle. Pear-shaped women typically store excess fat around their hips and bottoms. This is known not to be detrimental to their health, explains Johnson.

Instead it's the fat stored around the abdomen and organs that we should be worried about.

For example, fat stored in the liver, even in small amounts, can have significant consequences on health and the risk of disease, says Johnson.

But the great news is that exercise can reduce these fats, whether it's visceral fat that wraps around organs or whether it's fat in the organ itself – for instance fat in the liver, heart or pancreas.

"It appears these fats can actually be reduced or even got rid of in some of these organs even without losing weight and that's a really important message," he says.

"Don't worry about what's on the scales, worry about doing exercise because we know, aside from all of its benefits, it helps reduce fat from these areas".

Benefits beyond weight loss

It's also important to remember there are a host of benefits to exercise beyond weight loss, says Johnson.

Most people looking to lose weight are at high risk of diseases like heart disease and type 2 diabetes. Research shows that exercise can reduce these risks.

"People at risk of diabetes can halve their chances of the disease by doing moderate amounts of exercise," says Johnson.

Exercise has also been shown to help improve heart function and blood pressure.

The right type of exercise can also reduce depression and anxiety, improve bone health, and reduce risk of falls in old people, he adds.

"The message should move beyond weight loss and be more about actually doing sustainable exercise and doing it regularly for all these types of benefits."

"Otherwise people just end up in perpetual failure… of trying new diets and new fad exercise regimes."

"What we're really about is trying to encourage people to adopt healthy eating and physical activity as part of every day life."

13 Foods That Are Saltier Than You Realize

Just because you can't taste it doesn't mean belly-bloating sodium isn't there. Here's how to spot the salt that's hiding in your diet.

by Jessica Girdwain

Surprisingly salty foods

You already know snack foods like chips, crackers, and pretzels pack a lot of salt. But even if you don't eat those, you may be on a high-sodium diet without realizing it. Many foods you wouldn't expect are swimming in salt, including bagels, cereals, and even cottage cheese, says LeeAnn Smith Weintraub, MPH, RD, a nutrition consultant in Culver City, Calif. Most people should stick to less than 2,300 mg of sodium per day (those with high blood pressure should limit it 1,500 mg). Read on for 13 sneaky sources of salt to watch for.

Sauces

It's no surprise that marinades and salad dressings contain salt, since they taste salty. But it may shock you just how much they have. A two-tablespoon serving of salad dressing or barbecue sauce may pack 300 mg of sodium (10 to 15% of your day's quota)—and you often use two servings or more on your food. Same with marinades, which can pack nearly a fifth of your limit in just one tablespoon, which isn't even enough to cover one chicken breast. Control sodium by making these marinade recipes and salad dressing recipes at home.

Cottage cheese

Cottage cheese is a good source of calcium and protein. Low-fat cottage cheese packs a whopping 28 grams of protein for only 160 calories. The catch: a one-cup serving can contain almost 1,000 mg of sodium—about 40% of what you're supposed to have in an entire day. Look for no-salt-added cottage cheese. Greek yogurt, which contains just 60 mg of sodium per serving, is a worthy high-protein substitute.

Cereal

Cereal can be healthy way to start your day—or a salty one. Many cereals have 180 to 300 mg of sodium per serving—up to 12% of what you should consume in a whole day—and that's if you only pour one serving in your bowl. Better bet: stick with plain oatmeal topped with fruit, or one of these 20 super-healthy breakfast foods.

Bagels

Bread is a major source of salt in the American diet, according to the CDC. And bagels are just like supersized servings of bread, which is why one bagel can contain 460 mg of sodium, or 19% of what you should get daily. That's for a plain bagel—flavors like asiago cheese or everything add even more, and so does adding a smear of cream cheese (100 mg for two tablespoons). When struck with a bagel craving, opt for a bagel thin to cut sodium by 50%.

Baked goods

You know that packaged cakes and doughnuts are packed with sugar and carbs, but they're also salty. One Entenmann's crumb doughnut, for example, supplies you with over 200 mg of sodium (about 10% of your day's limit). Packaged baked goods rely on sodium as a preservative in addition to any salt used during baking. These treats already have a lot of negative things going for them (lots of calories, fat, and sometimes trans fat), so try one of these healthier cookie recipes at home.

Soup

A bowl of hot soup makes a filling, healthy lunch. What's shocking is just how much salt most soups contain, especially the canned soups on supermarket shelves. Though a bowl might be less than 300 calories, a serving can contain half of your sodium limit for the day.

When it comes to canned soup, buy low-salt versions whenever possible. After years of eating super-salty soup, you may think it tastes bland, warns Weintraub. Dress it up with freshly cracked pepper, fresh herbs, or a sprinkle of Parmesan cheese. You can also add a few shakes of salt yourself—you'll never add more than food companies would. Or you can cook up one of these healthy soup recipes.

"Reduced-sodium" foods

When you see "reduced sodium" on a food label, you may think you're being served up a lot less salt. However, this FDA-regulated term means that a food has only 25% less sodium than the original product. So for a frozen meal that contains 1,000 mg of sodium, the reduced-sodium version would have 750 mg—still high. Reduced-sodium options can be a smart choice if you're slowly trying to cut back on salt, but if you're watching your sodium closely, better labels to look for are "low sodium" (with 140 mg of sodium or less per serving) and "very low sodium" (35 mg of sodium or less).

Veggie burgers
Some soy and veggie burgers are made with a long list of highly processed ingredients and use salt to enhance the flavor. Patties can pack 400 to 500 mg, and that's before the bun, condiments, and cheese.

Hot chocolate

The warming drink is a great way to get your chocolate fix for few calories—there are just 80 to 100 in a packet of mix. But one serving can also contain 7% of your recommended daily intake of sodium. If you're on a reduced-sodium diet for any reason, then one packet will be over 10% of your quota. Try this lower-sodium recipe for Mexican Hot Chocolate.

Pancakes

You want a sweet brunch, so what's 2,000 mg of sodium doing in your stack of chocolate chip pancakes? Making pancakes at home is a better option than ordering them at a diner, but ready-made mixes (with 400 mg of sodium per serving) and pourable mixes (700 mg for three pancakes) can still serve up a lot of salt.

Frozen veggies in sauce

Per cup, pre-sauced frozen vegetable mixes can add nearly 500 mg of sodium to your meal, particularly if you choose cheesy sauces. Skip these and go for plain frozen vegetables, like bags of peas, onions, corn, and spinach. Frozen veggies are just as healthy as fresh, and often more so. Freezing produce shortly after harvest preserves nutrients, whereas fresh produce often loses some nutrients during shipping and storage.

Sandwiches

After counting sodium in bread, deli meat, cheese, and pickles, an innocent-sounding turkey sub sandwich adds up to about 900 mg of sodium. Make a sammie at home to save salt, suggests Weintraub. Use lower-sodium options like pita bread, whole grain mustard instead of pickles, fresh veggies, Swiss cheese (it contains a fraction of the sodium of provolone), and low-sodium deli turkey or—better yet—pieces of freshly carved turkey.

Chicken breasts

Raw chicken breasts harbor a secret: they're often injected with a high-sodium flavoring solution to perk up the taste. To avoid it, buy chicken with the words "non-enhanced" on the label, avoid brands that list salt on the ingredients label, or go for an organic variety. Weintraub likes a brand called Smart Chicken.

Medical Exemption Certificates - UK only reader

by Vince

If you have diabetes that is treated by drugs or insulin and you are a citizen of the UK you are entitled to free prescriptions on the NHS. But you must apply for a Medical Exemption Certificate or be 60 years old and older. These certificates are issued by the NHS Business Service Authority (NHS BSA).

If you already have a certificate it has an expiry date, it is valid for 5 years. The NHS BSA allegedly sends out reminders close to when the 5 years expiry comes to an end. (This is so that you can renew in time. The certificate is back dated by 28 days so if you have collected a prescription there won't be any net charge.) The reminder is reportedly sent by second class post so is not guaranteed to reach you.

This is important because it is to catch you out so that you pay for your prescriptions. This is an under hand tactic to extort money from patients that are not careful with keeping records.

Your pharmacy and GP will not remind you. They will not have a copy of your exemption either. It actually doesn't matter to them who pays for the prescription - whether the funds are government or your own. So it is not their business to let you know.

In a 5 year span with no reminders you are likely to forget about the exemption certificate and can be paying for months without noticing.

The NHS BSA does not keep long enough records so that there is no way to recover your costs if you have paid for them. Even if you have had diabetes for a long time the NHS BSA will just say you did not have a medical exemption certificate at the time. This is a real problem and will catch a lot of people out.

The NHS BSA can not connect your Exemption to a NHS number (for trust issues where an employee might look up your personal details), it is not linked to address (or it might be linked to some and not others) and it is not linked to where you got your prescription from. So you are at a loss which ever way you turn. But if you collect any sort of government benefit it might be possible to connect that to your exemption.

(In most cases people with diabetes do not get any better and GPs recommend more drugs to control the symptoms of diabetes. So treatment tends to get more expensive as the diabetes gets worse. Treatment for diabetes is not free it costs the government. Who say treatment is free to the patient. BUT ONLY IF YOU HAVE A MEDICAL EXEMPTION CERTIFICATE. Otherwise you will be billed. Now if you was not diabetic during the time where you forgot about your certificate that would be a blessing.)

23 Superfruits You Need Now!

by Benjamin Plackett

You've heard of Superfoods, but…Superfruits? Not every fruit qualifies. Those deemed "super" by nutrition scientists are packed with antioxidants, fiber, vitamins and minerals, and other nutrients that can help you live longer, look better, and even prevent disease.

Best of all, most are widely available, even at your local grocery store, promises Keri Glassman, R.D., founder of NutritiousLifeMeals.com and author of Slim Calm Sexy Diet. One caveat: Superfruits are best consumed whole, not processed. So if possible, try to buy and eat these fruits fresh. Experts estimate that you should be eating five to nine portions of fruit or vegetables a day, and most of them should be Superfruits.


Açaí Berries
Açaí actually deserves some of the hype it gets, thanks to weapons grade antioxidant levels that clobber other Superfruit rivals like blackberries, strawberries, and blueberries. However, because this tiny berry hails from Brazil, it's not easy to find fresh. "I recommend powdered açaí berry, which can be added into a smoothie," says Glassman. "Not only is this an easy way to get super fruits into your diet, but it also helps mask the tart, sometimes bitter taste."

Apples
Surprise! America's favorite fruit is a secret Superfruit, thanks in part to its red or green color. Apples are a great fiber source, but the skin contains quercetin, an antioxidant that packs antihistamine and anti-inflammatory power, and therefore may help protect you from heart disease and possibly allergic reactions. A study from St. George's Hospital Medical School in London found that people who eat five or more apples a week have better lung function than those who don't. So slip an apple into your lunch bag today.

Bananas
Ever grab a snack but then feel hungry again 20 minutes later? Next time, reach for a banana. This Superfruit is loaded with potassium, which can lower your blood pressure, and is one of the best sources of Resistant Starch, a healthy carb that fills you up and helps to boost your metabolism.

Grapefruit
Remember The Grapefruit Diet? Grapefruit is a Superfruit, but more for your heart than your weight. A grapefruit a day—particularly the ruby variety—can help keep heart disease at bay by lowering cholesterol, according to several studies. The redder your fruit the better; they contain higher levels of antioxidants.

Blueberries
Your go-to Superfruit for brain function and memory. Several studies link high flavonoid levels in blueberries with a better memory, and regular consumption may help keep your brain functioning well as you age, new research suggests. One study found that women with the highest intake of berries appeared to have a delay in cognitive aging by a whopping 2.5 years. Blueberries are also rich in manganese, which plays an important role in your metabolism, which can help keep you slim and energized.

Cantaloupe
Consider cantaloupe your secret weapon for smooth, younger-looking skin. It gets its Superfruit status thanks to Vitamin A and its derivatives, which boosts cell reproduction, making it a natural exfoliator, according to Glassman. 

Cherries
Cherries are one of Glassman's unsung heroes of the Superfruit world. They owe their deep red color to an antioxidant called anthocyanin, which can reduce inflammation and lower triglyceride and cholesterol levels. In a recent study, University of Michigan researchers found that giving cherries to lab rats reduced two common markers of blood vessel inflammation by up to 50%. The cherry eaters also gained less weight and experienced big drops in cholesterol.

Citrus fruits
All citrus, from limes to tangerines, are chock-full of vitamin C, fiber, and small amounts of other nutrients and disease-fighting chemicals. It's the C that makes citrus a Superfruit, says Glassman, because this vitamin counters the effects of sun damage, regulates oils glands, and can even prevent age.

Cranberries
These tart little berries are Superfruits, but especially for women. They may prevent urinary-tract infections, and might help fight a far scarier disease: ovarian cancer. According to a new Rutgers University study, cranberries can boost the effectiveness of chemotherapy drugs used to fight ovarian cancer (at least in laboratory culture dishes) and may slow the growth of some cancer cells. Another study found that people who drink a glass of unsweetened cranberry juice each day raise their HDL, or good cholesterol, by 10%.

Dragon fruit
The name and vibrant color of this fruit's skin tell you that it's something special, even though the taste is actually quite mild. Four years ago, researchers from Malaysia's Universiti Putra analyzed the seeds and found there to be a bounty of essential fatty acids, which we need but can't be made by our body. In fact, 50% of the seeds were made up of an essential fatty acid, oleic acid, which helps lower bad cholesterol and raise good cholesterol. While this Superfruit is grown mainly in Asia, you might be able to find one at your local Chinatown or farmer's market.

Grapes
What makes grapes a Superfruit? A powerful antioxidant called resveratrol, which promotes a healthy heart. Researchers have also found that compounds found in grape seed extract seem to help slow Alzheimer's disease (at least in mice) and can clobber head and neck cancer cells grown in the laboratory. Oh, and forget bleaching your teeth. "The malic acid in grapes naturally breaks down stains and discolorations on teeth," says Elisa Mello, DDS, assistant clinical professor at New York University. Snack on grapes that are just ripe, because the acid declines as the fruit ripens.

Blackberries
These tart and tasty gems rank in the top 10 for antioxidant power, according to the USDA, and they are specifically rich in polyphenols, the same family of antioxidants found in green tea, which may help prevent cardiovascular disease, cancers, and osteoporosis. Blackberries are also number one for fiber: One cup delivers one-third of your daily target of 25 to 35 grams a day.

Kiwi
If you've got digestive gripes, then kiwi is your Superfuit. In one study, 41 people who had irritable bowel syndrome (IBS) consumed two kiwis a day for six weeks and reported a reduction of symptoms compared to those who didn't. One theory: Kiwi, especially the skin, is high in fiber and pre-biotic complex carbohydrates.

Oranges
If you manage to eat just one medium orange, then you'll already have your reached recommended daily intake of vitamin C, which keeps your immune system humming. This familiar sweet fruit is also a great source of fiber, potassium, calcium, folate, and other B vitamins, so take one with your everywhere you go.

Plums
Plums are yum—and they may help keep anxiety at bay. Plums contain an antioxidant called chlorogenic acid, which, according to French researchers, is linked to decrease in anxiety-related behaviors in mice.

Pomegranate
Pomegranates deserve their Superfruit status. The juice from this gorgeous fruit beat red wine to win first place in a list of beverages ranked by antioxidant levels in a University of California, Los Angeles study. However, if you are set on fresh pomegranate over juice, wait for winter; the fruit is at its best between September and February.

Strawberries
Strawberries are bursting with vitamin C; just a cup full and you've already reached your recommended daily intake. They are also an excellent source of folic acid, which can help protect your heart. Easiest of all, they whiten your teeth naturally! Crush a strawberry to a pulp, then mix with baking soda until blended. Spread the mixture onto your teeth and leave on for 5 minutes. Reapply once a week.

Avocados
Yup, these are a Superfruit (remember, fruits have seeds, vegetables don't). Packed with monounsaturated fat and fatty acids, avocados can help lower LDL (bad cholesterol) levels while raising the amount of good cholesterol in your body. The healthy fats in avocados also promote the absorption of other carotenoids—especially beta-carotene and lycopene—which are essential for heart health.

Tomatoes
The tomato pretty much tops our list of Superfruits (even though some people still think it's a vegetable). Tomatoes pack a sought-after antioxidant called lycopene, which is rarely found in other Superfruits, and they're high in vitamin C, potassium, and fiber, and super-low in calories.

Papayas
Summer colds are the worst, so have some papaya! This tropical fruit is bursting with vitamin C – just one cup gives you more than you need each day. On top of this, papaya is also a good source of vitamins A and E, two powerful antioxidants that may help protect against heart disease and colon cancer.

Raspberries
Fiber is not something that these berries are lacking; just half a cup would give you 4 grams. You'd also get 25% of your recommended intake for vitamin C and manganese too!

Pumpkin & pumpkin seeds
Yes pumpkin is actually a fruit! This squash is overflowing with beta-carotene, which combined with potassium may help to prevent high blood pressure. If making homemade pumpkin pie is too much trouble, try tossing the seeds into salads, soups, etc.

Watermelon
Watermelon is packed with lycopene; in fact just one cup of the stuff has more than twice as much compared to fresh tomato. At just 40 calories per cup, it's also a source of vitamins A and C. You needn't limit yourself to eating watermelon alone; grill and then toss with feta and fresh mint.

Pineapple
Not only does pineapple add juicy sweetness to your meals but it also contains bromelain, a digestive enzyme that helps break down food to reduce bloating.

Fruit & Veg Portions

By Dietitian, Juliette Kellow BSc RD

Q: I know I’m supposed to eat five servings of fruit and veg each day, but what exactly counts as a portion?

A This is a good question and one that confuses a lot of people. All fruit and vegetables, including fresh, frozen, canned, dried and pure juices, count. The only exception is potatoes, which are a starchy food and so aren’t included in the recommended 5 A DAY. Meanwhile, no matter how much you drink, a glass of pure juice only counts as one portion because it’s not a good source of fibre and the juicing process squeezes out all the natural sugars that are normally found between the cells of the fruit or veg, with the result they’re less healthy for teeth. Pulses such as kidney beans, lentils and chick peas also only count as one portion, regardless of how much you eat. This is because they don’t contain the same vitamins and minerals as other fruit and veg.

It’s important to eat five different fruit and veg each day to get a wide range of vitamins and minerals. For example, you could add dried apricots or sultanas to cereal, have an apple with lunch, serve dinner with two veg such as carrots and broccoli, and snack on a nectarine. It’s as easy as that!

On average, a portion of fruit or veg is equivalent to 80g. Below are some examples of what counts as one portion:

• 1 apple, banana, pear, orange or other similar sized fruit
• 2 plums, satsumas, kiwi fruit or other similar sized fruit
• 1⁄2 a grapefruit or avocado
• 1 large slice of melon or fresh pineapple
• 3 heaped tablespoons of vegetables, beans or pulses
• 3 heaped tablespoons of fruit salad or stewed fruit
• 1 heaped tablespoon of raisins or sultanas
• 3 dried apricots
• 1 cupful of grapes, cherries or berries
• 1 dessert bowl of salad
• 1 small glass (150ml) of pure fruit juice

Comments:

Aim for 10 portions of vegetables and fruits or more. The leafy greens are the highest nutrient dense foods. (Even frozen vegetables count. If you are on a budget there is frozen spinach, peas, broccoli, cauliflower, carrots, mushrooms and sweetcorn. Onions are cheap and so are beans.

Increasing Insulin Sensitivity is the Key to Fat Loss

By Tony Schober, CPT

When formulating a diet, one of the most important goals you should have in mind is to improve your insulin sensitivity. What is insulin sensitivity? To fully understand what it is, let’s discuss insulin and its function.

Insulin is a storage hormone. After you eat a meal, your body converts the carbohydrates into glucose. This glucose circulates the bloodstream and is used by all the cells in your body.

Insulin is the hormone that stores the extra glucose that your body doesn’t use. Your body has a limited capacity to store glycogen. A typical male will be able to store around 500 grams of glycogen.

In case you didn’t know, glycogen is what’s formed from glucose. When your body can no longer store anymore glycogen, the excess glucose is taken up by insulin and stored as fat.

Insulin sensitivity has to do with how well your cells respond to insulin. People that are highly insulin sensitive require very little insulin to store carbohydrates. By reason then, people that are insulin resistant (type II diabetics), need larger amounts of insulin to shuttle those carbohydrates around.

What this means is that when you have high insulin sensitivity, you are able to eat carbohydrates without such a large rise in insulin. When insulin is kept low enough, fatty acids can still be released.

However, once insulin gets too high, fat loss comes to a halt. People that have bombarded their bodies with high-glycemic carbohydrates and processed foods over their lifetimes have become somewhat resistant to the effects of insulin. Therefore, when they eat carbohydrates, it causes a larger release of insulin. This inhibits the release of fatty acids.

Higher insulin levels = more fat storage

Reduce Insulin Resistance

When insulin is high, fat can’t be released. For fat loss to occur, it needs an environment of low insulin, and high growth hormone. Growth hormone is a very powerful hormone that is responsible for many positive metabolic functions – one of which is the release of fatty acids.

In order to increase growth hormone levels, you need to have insulin levels low. GH and insulin levels are inversely correlated. When one is high, the other is low. So then, what are the factors that both raise and lower insulin?

Insulin is released in response to a meal that contains carbohydrates (and protein). Insulin is directly correlated to both the amount of carbohydrates (glycemic load) you eat and the GI (glycemic index) of that carb.

The GI, in short, is how quickly a particular carbohydrate is digested by the body. The more sugar you ingest, the more insulin your body releases in order to store that energy. The higher the GI of that carbohydrate, the quicker your blood sugar levels rise, and in response, your body releases more insulin to store that energy. To recap:

• Insulin levels are low when growth hormone levels are high, and vice versa.
• Insulin is a fat storage hormone that stores extra carbohydrates.
• Growth hormone releases fatty acids in an environment of low insulin.
• Insulin sensitivity is how sensitive your cells are to the effects of insulin. The more insulin you need to store those carbohydrates, the harder it’s going to be to lose fat.

We’re going to be needing those carbohydrates for our high-intensity exercise. So then, how do we ingest carbohydrates for fuel, while at the same time keep insulin low enough so that fat can still be released?

Eat Carbohydrates When Insulin Sensitivity is High

The best way to do this is both through nutrient timing, and choosing the right carbohydrates in the first place. Your insulin sensitivity is at its highest first thing in the morning, and after a workout.

This is when your body has its lowest muscle and liver glycogen, and therefore will be more receptive to soak up the carbohydrates you just ate, instead of sending out large amounts of insulin to store that glucose as fat for another time. So when formulating a meal plan with a goal of improved insulin sensitivity, try placing the bulk of your carbohydrates for your first meal and the meals around your workout.

Choosing the right food to eat will always be the easiest and most effective way to increase your insulin sensitivity. Whole foods contain fiber. Fiber helps to slow down the digestion of carbohydrates, and as a result, your body gets a nice steady feed of glucose to use instead of a large influx of sugar that causes insulin to go through the roof!

Whole foods also tend to have a lower GI. Lower GI foods cause a slower release of glucose into the bloodstream. This results in lower amounts of insulin needed to shuttle those carbohydrates around.

So, eat fruit, vegetables, legumes, potatoes, and whole grains. They are high in fiber and nutrients, and will help put your body in the optimal environment to release fat.

Don’t fight against your body. It will beat you every single time! The great news is that you can reverse the effects of insulin resistance by changing your diet and exercising. Eat the right foods, and you’ll be well on your way to regaining that fat loss advantage.