Well Wisconsin Radio

Host: The information in this podcast does not include medical advice, diagnosis, or treatment. It should not be used as a substitute for healthcare from a licensed healthcare professional. Consult with your healthcare provider for individualized treatment or before beginning any new program.

Hello and welcome to Well Wisconsin Radio, a podcast discussing health and wellbeing topics with experts from all around the state of Wisconsin. I’m your host, Renee Fox, and today my guest is Emma Gellar, step a registered dietician at UW Health. Emma works primarily in a preventative cardiology clinic specializing in all things heart health, but she also sees a wide variety of patients with metabolic conditions like diabetes.

Additionally, Emma works in the non-surgical osteoarthritis clinic at the East Madison Hospital. Working with patients on reducing inflammation with the anti-inflammatory diet and supporting patients with weight loss efforts. She’s originally from Iowa and has lived in Wisconsin since 2021 when she moved here to get a master’s degree in clinical nutrition from the University of Wisconsin-Madison. Emma, thanks for joining us today.

Guest: Yeah, of course. Thanks, Renee. Thanks for having me. I’m excited to be here.

Host: Great. Well, let’s get started by talking about sugar. And if you could just tell us what that looks like in the average American diet, like how much sugar are we typically cons ing and what are those main sources?

Guest: Yeah, definitely. So that’s, that’s a great question. I want to start by noting there that there are two different, you know, types of sugars. There are naturally occurring sugars, you know, those things that we find in, in fruit, and then some dairy products like milk that has sugar, in the form of lactose, and then there are those added sugars that come in the form of, you know, our table sugar and syrups that are added to food during the during food processing. And so, a lot of the statistics that we have about consumption of sugars comes from added sugar. And so that’s what I’m going to kind of be sharing mostly about today.

So, the average American cons es about 77 grams or 17 teaspoons of added sugar each day. So this is equal to about 270 extra calories. And so, over the span of a year, this adds up to about 60 pounds of added sugar throughout the course of a year. And so, our main sources of added sugar do come from beverages, such as soft drinks, fruit juices, sports and energy drinks, as well as coffees and teas that have, you know, sugar added in there.

Then the second largest source is going to be desserts and sweet snacks. So, you know, cookies, brownies, ice cream, donuts, pastries, sugary cereals, things like that. So, yeah.

Host: Mm-hmm. Now, if we want to understand how much sugar we are consuming in our diet, how can we identify that and, also are there recommendations of how much sugar we should not exceed?

Guest: Yeah. So, the most recent dietary guidelines for Americans recommends that Americans above the age of two keep their intake of added sugars to less than 10% of their total daily calories. So, what does that look like? So, in a 2000 calorie diet, the 10% would be about 200 calories. And so, if we, you know, there’s, there’s four calories per one gram of sugar, and so that’s about 50 grams of sugar or equal to about 12 teaspoons.  There are varying recommendations. And so, the American Heart Association, which is what I typically go by, by their recommendations in my practice area. They have more specific recommendations based on age and sex and so the American Heart Association typically recommends, no more than 24 grams of added sugar for women and children each day, and then for men no more than 36 grams.

And so, this is a, a little bit less than you know, what we see in the dietary guidelines, and remembering that, you know, the average American is currently consuming about 77 grams per day. So, if we’re thinking about 24 grams, you know, for women and children, that’s about, you know, three times the recommended amount and about two times the recommended amount for men. So, and then, you know, we can determine how much we’re currently eating by reading food labels. That’s going to be the really easy way to spot added sugars because, you know, in foods that we’re eating that don’t come with food labels, you know, those, those fruits and veggies and things like that, they are not going to have sugar added during the food processing.

So, the food label will help us spot those added sugars. And so, this process has actually become a lot easier since rolling out the new nutrition facts labels that came out just a few years ago. And so, previously food and beverage manufacturers were required to list the total amount of sugar per serving on the label, but they did not need to disclose how much of that was from added sugars versus naturally occurring sugars.

And so now nutrition, facts labels lists both total sugars and then our added sugars underneath, and so there’s also the percent daily value, as there is for, you know, all of the other nutrients on the label. And so that percentage is based on that 2000 calorie diet, so the 50 grams a day. And so, you know, when you’re looking at that number, just kind of a quick guide for the percent daily value, 5% or less of added sugars per serving, is going to be considered low.

And then 20% of the daily value or more of added sugar is per serving as considered high. And so to kind of put that again all into perspective, you know, a can of Coca-Cola, regular Coca-Cola has about 39 grams of added sugars. And so for a person consuming about 2000 calories a day, that one soda is 39 of that 50 grams.

So nearly the maximum amount that, you know, we should be consuming for the day. And so, my general rule of thumb, when looking at food labels is usually to look for items with about eight grams or less of added sugar, and that recommendation comes from the American Heart Association as well.

Host: Hmm. Really helpful, Emma. Thank you. Now, what are some of the negative health impacts, you know, that you see when we consume too much sugar?

Guest: Yeah. You know, so, consuming too much added sugar can really put us at risk for a wide variety of conditions. So, you know, heart, liver, and kidney disease, some cognitive problems like dementia and Alzheimer’s have been connected too high sugar intakes. High blood pressure and cholesterol, specifically high triglycerides, and then of course, you know, diabetes because you know, sugar is definitely going to impact our blood sugar. And then there’s also some connection between how much sugar we eat and cancers like colon and pancreatic cancer, and then, you know, as we have all heard before, you know, growing up. Excess amounts of added sugar can cause cavities. You know, our, our dentists are, are always telling us that and in tooth decay, and then, you know, of course extra sugar is going to provide, you know, more calories to our diet. And so, weight gain, you know, obesity and overeating, can come from a result of eating too much added sugar.

Host: Mm-hmm. Yeah. So, let’s say we take some steps to cut back on the added sugar in our diet. What are some of those health benefits that we’ll realize? How soon will those be experienced? And, you know, it could also lead to weight loss, and just other benefits.

Guest: Yeah. Yeah, definitely. So, yeah, it’s interesting you ask, you know, how soon are we going to see some of these benefits?

And of course, it’s really individual. And, you know, one thing that I didn’t mention in your last question is, because I work in our osteoarthritis clinic, I talk a lot about inflammation in the anti-inflammatory diet and sugar, you know, has shown to have a connection between inflammation and joint pain.

And so, you know, uh, that brought up your question on, you know, how soon can we see this? Sometimes I’ll see, you know, patients in my osteoarthritis clinic who really, you know, cut back on sugar and they see a direct improvement in their joint pain. And then, you know, maybe they’ll eat something sweet or, or have a, a sugary beverage and they’ll notice more pain.

And so that’s one, you know, really direct thing that people see, and then of course, yeah, like I said, you know, the other things are really individual.  You know, cutting back on sugar can really help us avoid all those chronic health problems that I named, you know, before. And then again, you know, because sugary beverages are going to provide extra calories, consuming less of them can help manage our weight a little bit better.

Sugar can also, or reducing sugar, can also help reduce our sugar cravings and improve our energy, so this is actually largely due to experiencing fewer highs and lows in our blood sugar. So, when we eat those simple sugars that we get from sodas or, you know, those sweet snack foods, our blood sugar, it spikes up pretty quickly, and that’s because those things are really easy for our body to just digest. So then, we consume them, our body digests them, and we absorb them and they enter our bloodstream and our blood sugar, it will spike up. And then of course, what must, what goes up must come down.

And so when our blood sugar comes back down just as quickly as it went up, we tend to crave more sugar, because our body wants that homeostasis, it wants to go back up again. And then, you know, we really get into this blood sugar rollercoaster, especially if we’re starting our day off with, you know, a big load of simple sugars.

We will tend to be craving them throughout the day because we’re riding along on that rollercoaster.

Host: So are we just craving sugar or can we actually be addicted to sugar? And either way, if we’re just trying to take those steps to cut back, what recommendations would you have?

Guest: Yeah. You know, the answer to, uh, to this one is, is a little bit complicated, and researchers are continuing to debate whether or not sugar or, you know, just food in general is really addictive. In my personal, you know, practice and, and from, you know, the experience I’ve gained, I think people can certainly feel like they are addicted to sugar and people can definitely display addictive behaviors when they’re exposed to it. But there is, you know, little, little evidence to suggest that sugar is addictive in the same way that tobacco, alcohol, and other drugs are. But like I mentioned with that, you know, blood sugar rollercoaster, we definitely can, you know, feel those cravings and they can be really strong, and sugary foods, they, they light up those pleasure centers in our brains. You know, they make us feel good and, the more we have of those foods, the more we tend to want them. And then getting to your question about, you know, how can we, can we work on cutting back? You know, there’s, there’s a wide variety of ways to do it and it kind of depends on what foods or beverages we’re typically having.

And so really the first area is to look at those sugar sweetened beverages and finding ways to, you know, cut back and reduce those beverages because they are that number one source of added sugar.  Also reducing how much we add into things that we eat or drink every day, like coffee or tea or cereals.

Like oatmeal, you know, typically adding a little bit of brown sugar. I know I like to, I encourage patients to try cutting the usual amount of sugar that they add by half, and then just trying to kind of lean down from there. And so a lot of times we tend to just not even measure how much we’re using.

So that act of just getting out a measure can, can help us cut back. Other things, you know, using flavors like vanilla and cinnamon can really help bring out our food’s natural sweetness, and can help kind of satisfy that sweet craving. And then as I mentioned before, you know, really reading those food labels is going to be important to just get a sense of how much we’re actually getting right now.

And then kind of setting a goal from there, when it comes to making changes and cutting back, what I really like to do is encourage patients to start small and really focus on one or two small changes at a time, and set goals that actually feel attainable for them, because once we are successful at making one change, you know, our body gets that reward and we’re more likely to continue to make additional changes and improvements.

Host: Great recommendations. Mm-hmm. So for some of our listeners that maybe don’t have a sweet tooth, but maybe they crave starchy foods like white breads, pastas, things that are breaking down into simple sugars. So, what are your thoughts on these sources of sugars and how do they impact our health?

Guest: Yeah, that’s another really great question, uh, because you’re right, these foods may not contain the added sugars, but they are broken down and absorbed as glucose in our body, and they’re still going to affect our blood sugar. However, it’s important to think about the type of carbohydrate.

So there’s, you know, complex carbohydrates and then there are those simple carbohydrates. And so, complex carbs, you know, those fruits, you know, sweet potatoes, potatoes, more of those starches, whole grain foods like oats with high fiber, you know, breads and pasta and things like that.

Because they’re higher in fiber, they actually digest more slowly. So, like I was talking about earlier with those added simple sugars, you know, our body can digest them really quickly and that’s why they spike our blood sugar up. And so, the fiber, you know, they, they digest a lot more slowly, which actually helps make them feel more filling.

And we won’t have that big up spike and down spike in our blood sugar, and so it does help manage our blood sugar spikes a little bit. And, you know, that’s a really good point for why we should choose those whole grain versions of products like breads and pastas because they contain more of that fiber. And so, you know, in a world where, you know, carbohydrates like, like breads and pastas are kind of getting a little bit of a bad rap lately, you know, I like to remind patients that these foods and all foods, they can be a part of a healthy diet if we’re eating them in the proper portion sizes and balancing them out with other nutrients like protein and healthy fat.

And so, you know, really thinking about that plate method or that MyPlate model, you know, there’s a reason why, you know, that was created because we want to balance out our meals and make sure we’re not getting too much of one thing. So that’s definitely a resource that I can share for people who are listening.

Host: Wonderful. And our listeners can check out that resource for MyPlate in our episode show notes as well as the resources you mentioned earlier about recommendations of sugar amounts not to exceed, so you can find out more details about that in the show notes. So for people who are wanting to follow your recommended tip on, you know, cutting that sugar amounts, those added sugars in half, is it possible that, you know, we can actually retrain our taste buds when we start making those type of changes?

Guest: So yeah, there, there have been some studies done on this and shown that participants,  you know, in these research studies who cut back sugar and followed a lower sugar diet, actually perceived foods to be noticeably sweeter than they did after they had gone on this low sugar diet for a period of time.

And so, yeah, we definitely can, you know, our taste buds can kind of be retrained, like you said. And I see this all the time in my practice when working with patients who are trying to reduce salt and sodium. And so, as people take away that salt shaker and start to cut back on some salty foods, they often come to me and say how surprised they are at how, you know, foods that they used to really enjoy have become too salty.

And, I can’t say, you know, specifically from my practice, I’ve seen much on sugar, but definitely, you know, I have seen patients say this within just a couple weeks of reducing their sodium and their salt use.

Host: So wonderful. Mm-hmm hmm. So for someone who is wanting to make a change and cut back on the added sugars in their diet, do you have some recommendations for healthier alternatives that they could try?

Guest: Maybe something with naturally occurring sugar or any other just tips that you have found helpful? Yeah, definitely. So, you know, one quick tip, I’m sure many people have heard before, but snacking on fresher, frozen fruit can be a really great way to satisfy a sweet craving. If you’re baking, you know, trying to use those fruits to naturally sweeten your recipe instead of sugars and syrups.

So, you know, mashed banana is a really good one. Applesauce is a great alternative. Dates, you know, give that really sweet kind of caramel taste. So those are a good addition to baked goods. And then like I mentioned again earlier, you know, certain warm spices can bring out the natural sweet flavor of food.

So, uh, nutmeg, ginger, vanilla, cinnamon, clove, more of those fall spices can really do that, you know, again, adding, you know, banana and berries to some of our maybe less sweet foods if we’re switching from a sugary cereal to more of a whole grain unsweetened cereal, using those fruits to help sweeten that can, can be really helpful.

When it comes to beverages, you know, trying to choose water, all those seltzer flavored waters that are out there today. Herbal teas can be helpful, and then adding some flavor, so adding an orange or a lemon or, you know, a lime, or maybe some cucumber for that subtle flavor.

Another thing that I came across recently that I’ve been loving is a product called True Lime or True Lemon, and they’re just small packets of basically crystallized pure lime and lemon, so there’s no sugar or artificial sweeteners added. It looks like a little sugar packet, but it’s just lime or lemon flavor. And then, you know, if, if we’re choosing to enjoy, uh, maybe a treat or, or something that’s a little bit higher in sugar, you know, try practicing, maybe just eating a smaller portion of it and being more mindful as we eat. So, enjoying it fully by chewing slowly and taking the time to check in and savor it and, you know, how does it taste? How does it smell? You know, when we take a little bit of time to savor it, you know, we are more likely to feel more satisfied.

Host: Hmm, great tips. So what are your thoughts on artificial sweeteners, and do you think they help you cut back on sugar or even crave more sugar?

Guest: Yeah, that’s a really great question. And there, there is kind of two sides to this answer. So, you know, there is some research to show that artificial sweeteners can cause our bodies to crave more sugar later. You know, these compounds, they have a sweet taste, and they kind of cause our brain to expect a rush of sugar.

And, and when that doesn’t happen, you know, the body may end up having an even stronger craving for something sweet later on.  You know, in my opinion, I think that artificial sweeteners can have their place, they can be really helpful, you know, for people with diabetes or, you know, just the general population who would otherwise drink really high amounts of high calorie, sugary beverages or, you know, sugary foods. But again, you know, they’re also linked to that increased appetite, you know, or cravings for sweet things. So it kind of goes back to that, you know, we can try to retrain our taste buds, use less and less of the real thing, rather than swapping each teaspoon of sugar directly for an artificial sweetener is kind of where I like to land.

And so, like I said, artificial sweeteners can be a short-term way to help people lessen their use of sugar and manage their weight, and in general, these sugar substitutes are safe for healthy adults, but however, we can have too much of anything. So it’s safest to consume these products in moderation and best to use them either for a short time or just every once in a while.

With all these new products out here nowadays, I have been recommending a wide variety of products that still have flavor but don’t have the artificial sweeteners added. So, there’s the hint waters, there’s flavored smart waters. There’s lots of stuff out there for, you know, alternatives to sugary beverages.

Host: Hmmm Great. So for our listeners out there who, maybe their goal is not necessarily to cut back on sugar, but just to make healthier food choices in general. Maybe they have some weight loss goals. I know you’ve touched on some of these things with your recommendations you’ve shared already, but what additional advice do you have for our listeners?

Guest: Yeah, that’s a great question. And since, you know, we’re talking to such a large, large audience here today, you know, I’m going to sound probably a little bit general, but just starting small. You know, a lot of times we feel like we need to completely overhaul our diet and change everything all at once, and when we do this, we often become overwhelmed, you know, by the amount of time and energy that we think the changes will take. Or if we do make some changes, you know, sometimes we’re only able to keep them up for a short time before we exhaust ourselves and then tend to fall back into some old comfortable habits.

And so, I’d encourage listeners today to just pick one thing that they would like to work on and set a goal that is specific and achievable. A goal that’s going to work, you know, within their daily life. And so, you know, focus on that for a period of time and then, you know, start moving on to the next thing. Just one or two small things at a time, they’re really going to add up, and that’s what’s going to be sustainable and attainable for people to do so.

Host: Great. So for our parents and grandparents out there who are listening, what recommendations would you have for them in terms of role modeling and encouraging healthy food choices? Particularly on the topic of cutting back on sugar, and we know that a lot of foods that are high in those added sugars are marketed to children, and are definitely things that children are often craving. So what, what recommendations would you have?

Guest: Yeah, definitely. Yeah. Those sweet foods can tend to be marketed, you know, towards children and, and that’s a great point to make. And you know, they’re going to obviously see, you know, other people eating maybe sugary foods or high foods that are a little bit higher in sugar. You know, my big thing is really just to use neutral language around these foods and trying not to name them as good or bad or you know, put them into some certain light.

You know, just call them by their name and, you know, name them as they are.  This kind of doesn’t make it so special, you know? And, you know, another thing serving sweets, sweet foods with a meal can be really helpful. That helps to balance, you know their blood sugar out a little bit.

They’re not gonna have that quick spike and then, you know, come asking for more. So actually serving dessert with the meal can be really helpful. And, kids are less likely to want a large portion if they’ve just, you know, filled up on what they’re having. Enjoying sweets with our children can be helpful cause this, you know, we can teach our kids how to fully enjoy the treat, you know, savor it. Enjoy it. You know, talk about how delicious it is. This makes it more satisfying for them as well as for us, like I talked about earlier. And, then trying not to use sweets, you know, or sugary foods as rewards or gifts—that puts a lot of emphasis on them. And so, you know, trying not to do that.

Host: Yeah, I’ve, I’ve heard other people talk about looking for different ideas, trying to get out of that habit. If they have started using things like cake or ice cream as rewards, you know, for people trying to encourage that healthy behavior, reward their kids for a job well done. What are some alternatives to sweets that we can use for that recognition?

Guest: Yeah. Yeah, that’s a great question. Yeah, sweet foods, sugary foods, they often get used as rewards and we grow up with that. And, you know, it can be something that we get really used to and, and we don’t even notice that we do it. So, for kids, some good non-food rewards is what I like to call them. Stickers are good, new art supplies like coloring books and new crayons or markers, you know, going to the playground using that as kind of their reward or allowing them to choose a game to play or maybe a movie to watch.

Or, I found this idea recently, calling or FaceTime with a loved one. Using that as kind of reward and, you know, they’re also getting that connection, that social connection there. Which I really love, and then, like I said, you know, oftentimes this gets engrained in us from childhood, and we tend to bring this into our, our adult life.

And so for adults, giving ourselves acts of self-care, like having an at-home spa, a or maybe getting a massage or getting our nails done or our hair done, can be a nice way to, to treat ourselves without food. And, you know, if we want to recognize someone that we love or show appreciation to coworkers or colleagues, a lot of times, you know, sweets get brought into the office.

You know, we bring them as gifts for people. Some non-food gifts, you know, flowers are a great one. A handwritten letter or a card or, or maybe a piece of artwork. You know, plants that are easy to care for, those little succulents that you can give now, all of those kinds of things can be good ways to give some recognition and appreciation, you know, without food.

Host: Oh, I love all of those ideas. Thank you so much, Emma. I really appreciate your time today and all the great resources and tips and recommendations that you shared. Thank you so much for joining us.

Guest: Of course. Thank you so much for having me.

Host: Do you have a goal to cut back on sugar, improve your eating habits, or lose weight? When it comes to making changes, we can all use some help. A WebMD Health Coach can be the beneficial guide you need to get the real results you’re looking for. Hear how coaching impacted a fellow well, Wisconsin participant’s life.

Coaching Participant: Hi, I liked the Web MD coaching calls. I’ve had trouble with my weight my entire life, and by checking in with my coach every month or two, it helps keep me accountable in reviewing what I’ve done and how I can do it better. And I find it quite useful to talk to someone about it. It’s helped me keep on track to achieve my goal. Uh, but anyway, I find it quite helpful. Thank you WebMD.

Host: Coaches are trained health professionals ready to support you, whatever your goal. Get started today by calling 1-800-821-6591 or send a confidential message on the Well Wisconsin portal.

Host: With the Balance Your Diet Daily Habits Plan, you’ll learn how to make nutrition work for your lifestyle and enjoy the many benefits of healthy eating. During this daily habits plan, you’ll create a weekly healthy eating plan and add nutritious foods to your plate. Along the way, we’ll let you know how you’re doing. Get started on this Daily Habits plan by visiting www.webmdhealth.com/wellwisconsin.

Thanks for listening today. I hope you enjoyed this show. Well, Wisconsin Program participants, to earn credit for listening to this podcast for your wellbeing activity, visit www.webmdhealth.com/wellwisconsin and complete the steps to self-report this activity. You can also find our survey, transcripts and previous episodes at www.webmdhealthservices.com/WellWisconsinRadio. If you’re listening to this podcast on your platform of choice, be sure to subscribe so you will never miss an episode.

Looking for advice and tips to cut back on sugar? Join us for a conversation with Registered Dietitian, Emma Gellerstedt, where she talks about how much sugar we shouldn’t exceed in our diet and the health benefits experienced when we cut back. She shares creative ideas for taming a sweet tooth and eating balanced meals. Whether you have a goal to lose weight, make healthier food choices, or role model healthy eating for young ones in your life, this episode is for you.Click the links below for more information on sources referenced in this interview.

Added Sugar Recommendations:

• Dietary Guidelines for Americans
• American Heart Association

Resources for Healthy Eating:

• Plate Method
• Using the Nutrition Facts Label

The information in this podcast does not provide medical advice, diagnosis or treatment. It should not be used as a substitute for health care from a licensed healthcare professional. Consult with your healthcare provider for individualized treatment or before beginning any new program.