All About Sugar

By Shirley A. D’Souza

As a former hard core sugar addict who has to work hard to keep my sweet tooth under control, today’s topic is incredibly close to my heart.  In fact, one of the biggest reasons people struggle to get and stay in ketosis, lose weight, and achieve whole body health is because of sugar.  Chilli's molten cake had my name written on it for years!! lol.  

You can cut carbs super low, load up on healthy fats, get the right amount of protein, but if you’re still eating sugar, you will always struggle with body fat and lack of energy.

Sugar has caused a rise in Metabolic Syndrome (a cluster of conditions — increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels — that occur together, increasing your risk of heart disease, stroke and diabetes) in both adults and kids.  Sugar is added to just about EVERY processed food item these days, and smart food manufacturers mask the name to make it sound healthier.

Sugar is sugar, and no matter how “healthy” the sweetener is, it will always impair your weight loss and potentially kick you out of ketosis. 

Fresh Fruit Juices: Although fresh fruit juices should be avoided on very low-carb diets, you can still consume certain berries as long as they fit your daily carb limit.  Not all berries are the same.  While blackberries, raspberries and strawberries have the least amount of net carbs (6-8 g per cup), blueberries contain more than twice the amount of net carbs (stick to ¼ cup or less at a time).  Bananas need to be avoided all together – they’ve got like 29 grams of sugar each!

The quality of your carbohydrates matter, and so does the quality of your sweetener!  Yesterday I explained that sugar is included in the Total Carbohydrates on food labels.  Sugar Alcohols will also be listed separately on food labels.  There truly aren’t many good sugars, but there are some great sweeteners and some really awful ones.

Sugar alcohols (mostly with names ending in "tol," such as sorbitol, maltitol, and erythritol) are sweet substances that have a highly variable impact on blood glucose.  Sugar alcohols must be included in "total carbohydrates" on the nutrition label, and if used in sugar-free foods, also have their own line on the label so you can see how much of the total carb count is from sugar alcohols.
When you look at the label of most sweeteners containing sugar alcohols, they claim to be "sugar-free" or "carb-free".  These products often contain sorbitol, maltitol and/or Splenda.  They use a simple rule:

Net Carbs (including sugar alcohols, polyols) = Total carbs - Fiber
This is not exactly true, as sugar alcohols may affect blood sugar and contain calories, too.  Sugar Alcohols (polyols) are carbohydrates that the human body does not completely absorb.  The keyword here is "not completely".

Maltitol MAY affect blood sugar & cause GI issues – in fact in MOST people, it does, so if you are looking at your label and you see total carbs at 10 grams, and you look at Sugar Alcohols, and that says 10 grams, THEN you look at the ingredients and it’s MALTITOL, instead of subtracting the full amount of maltitol, you can only subtract half.   In this case, the total carbs would be 5g net per serving.  This is because of maltitol’s effect on blood sugar levels (many keto-lovers report maltitol for kicking them out of ketosis).  

Once you determine which - if any - sugar alcohols spike your blood glucose levels, when you look at an ingredient label, only subtract HALF of the sugar alcohols from the total carb count (IF you choose to consume them at all).  For those that do NOT spike your levels, you can subtract the FULL amount.  Listen to your body and be HONEST with your body.  Refer back to your Program Guide for how to calculate net carbs when a food contains sugar alcohols – specifically how to calculate if it contains sorbitol, maltitol, or Splenda.
Erythritol is naturally found in fruits, vegetables, and fermented foods.  It is a sugar alcohol that does not affect blood glucose and has zero calories.  Erythritol has a GI of 0 and 0.2 calories per gram.  It does not affect blood sugar and is suitable for ketogenic recipes.  Its sweetness is about a 1:1 ratio with sugar so you’d use the same amounts of it as sugar in a recipe.  If you are looking at your label and you see total carbs at 10 grams, and you look at Sugar Alcohols, and that says 10 grams, THEN you look at the ingredients and it’s erythritol, you may subtract the full amount of sugar alcohols from the total carbs.  In this case, the total carbs would be 0g net per serving. 

Monk fruit extract comes from monk fruit, or luo han guo, a melon-like fruit that grows on a vine and is native to parts of China and Thailand. “The sweetener is made by juicing the fruit and processing it into crystal form,” explains Frances Largeman-Roth, RDN, New York City–based nutrition expert and author of Eating in Color. (Monk fruit extract is also made into a liquid.)

With zero calories, the FDA extract doesn’t raise blood sugar levels like standard table sugar does. That makes it a great alternative for diabetics, according to Largeman-Roth.

Monk fruit extract may be considered "natural," but that doesn’t mean it’s unprocessed or 100% pure. “Monk fruit is often combined with other sweeteners, or with sugar and molasses,” notes Largeman-Roth. The problem? If it’s combined with sugar, it’s no longer calorie-free. 

Yet combining monk fruit extract with another non-nutritive (in other words, zero-calorie) sweetener, like the popular sugar alcohol erythritol, isn’t ideal either.

“Erythritol can cause gastrointestinal issues like gas and diarrhea, especially among people with IBS,” says Largeman-Roth.

Like other sweeteners, monk fruit extract can be added to foods or drinks to enhance sweetness without excess calories. Be sure to use it sparingly. “You can add monk fruit extract to beverages, baked goods, and other things that you’d like to taste sweeter,” says Largeman-Roth. “Just remember that you only need to use a tiny amount because it tastes so much sweeter than sugar.”

The best sweetener by far is stevia.  It’s just a plant with no other calories, vitamins, or nutrients, but personally I cannot stand the taste and prefer next best option of monkfruit sugar.  If you can, get the liquid stevia/drops, not powdered stevia products.  Beware of sweeteners, especially powdered stevia products, that may additionally contain artificial sweeteners, dextrose, maltodextrin (e.g. Stevia in the Raw) or even sugar.  Sweeteners with dextrose and maltodextrin are known to raise blood sugar.  These may be the hidden carbs you are eating which may be the reason you can't get into ketosis. 

Also, Dextrose is usually made from GMO corn, while Maltodextrin is made from rice and may contain monosodium glutamate (MSG) which is not required by law to be labeled.  MSG can spike insulin for days, and in the presence of insulin, fat-burning is blocked (SOURCE: Dr. Eric Berg).

Is your head spinning a bit trying to figure out which sweeteners are good and which ones to avoid?  Simplify!  Stick to whole, unprocessed ketogenic foods.  When you want a “sweet” bite, how about a tablespoon of almond butter or coconut butter?

Do you know which sweeteners you can and cannot tolerate? 

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