Sugar Confusion

There are three primary forms of sugar:

1. Glucose 
2. Galactose
3. Fructose

These three forms of sugar are not interchangeable. Each is used by the body differently. Some forms of sugar are our life force energy and others are considered by our body to be tantamount to poison. I'm going to try to quickly sum up how each form of sugar works within our body:

1. Glucose
• Glucose is the energy of life. Almost all living plants and creatures run on glucose. Glucose is made through the process of photosynthesis. It is what is found in starch and when it breaks down, it can be burned down as energy by pretty much every cell in our body. Glucose consists of two elements that mirror each other, these elements are called L-Glucose and D-Glucose. Dextrose is another name for D-Glucose. 
2. Galactose
• Galactose is only found in milk sugar. It is almost instantly turned by our liver in to Glucose. 
3. Fructose
• Fructose is rarely converted in to glucose. It is seen by our body as extraneous and is regularly converted in to liver fat. 
• Unless we are an extreme athlete (think an olympian) or if we are literally starving, our fructose remains solely as liver fat. If you are an olympian, extreme athlete, or literally starving, then your body may convert fructose in to glycogen (liver starch) which can be fished out of your liver if your body desperately needs glucose. This rarely happens. "Chronic and excess alcohol or fructose exposure both cause fatty liver disease, which drives the pathologic process of insulin resistance, and causes the same chronic diseases - obesity, heart disease, and diabetes." 

There is much confusion over the idea that Fructose is bad for us. Because many of us grew up being told that "an apple a day will keep the doctor away," we are not willing to think of fructose as potentially negative. We associate fructose specifically with fruit and we associate fruit with health. When we eat fruit, our body consumes not only fructose, but also fiber. The fiber in fruit helps limit the absorption of fructose. When you refine sugar (which pretty much means that you remove the fiber from the sugar), you absorb the sugar (fructose) all immediately. Your liver becomes overloaded with fructose and ends up converting it in to liver fat. This is why consumption of straight fructose without fiber (fruit juice, soda, honey, agave, sucrose - the combination of glucose and fructose, or generally any time that the naturally occurring fibers that were attached to the fructose are gone) causes us to gain liver fat.  

The more fructose we consume, the harder our body has to work. When we eat too much sugar (read - fructose), our immune cells secret an inflammatory messenger called a cytokines. When cytokines are excreted, our bodies become inflamed. As someone with an autoimmune arthritis who is fighting inflammation constantly, I now monitor my sugar consumption for this reason. 

My Anti-inflammatory Eating Journey

I was diagnosed with Psoriatic Arthritis in 2009. Since that time, I've gone through massive flare ups, long periods with an inability to walk in the mornings, days when I could not climb down steps at all and had to slide down on my butt, massive pain, and so much frustration over the fact that I have to live with an autoimmune arthritis. I was so frustrated about it, in fact, that for the first few years after diagnosis I told very few people what I was going through. I went through the pain alone, fought it, pushed through it, and often made it worse in the process.

I didn't take control of my situation. I felt a victim rather than empowered (I'm happy to say that I now feel empowered). I assumed that whatever a doctor was telling me to do, was the best solution. I'd never met anyone else my age with arthritis. I didn't know what I was supposed to do with that information.

In the past few years though, I've finally shared my story. I have taken control of my experience. I have tried acupuncture (it hardly helped). I've bought orthopedic (but stylish) shoes. I've changed the way I eat.

A few years ago I began to look in to how my diet may be affecting my autoimmune arthritis. I met others with autoimmune diseases. I spoke to them about their diets. I made changes. The first change that I made was to remove lactose and dairy from my diet. In addition to just generally making my digestion work better, I realized that I must actually have been lactose intolerant all along. I do not drink milk, eat cheese, or really consume any dairy products anymore (like ice cream, whipped cream, butter, etc). I feel that removing dairy has impacted my arthritis positively and made my life generally better. 

Despite the fact that removing dairy made a noticeable difference in my health, in 2013 I went through an extremely hard 6 months of flare ups and was having a hard time walking or partaking in my main hobby: swing dance. It was frustrating. So, upon suggestions from a few fellow autoimmune arthritis friends, I decided that I would try to remove gluten from my diet. They all said that it had helped them and I had high hopes that it would help me.  I spent six rather unpleasant months gluten-free. It made literally no difference. I continued to have my worst and most long lasting flare up to date. Going gluten-free was not my solution (much to the relief of my friends and family). It worked for others, but not me.

In the past year, I began to look in to what foods generally cause flare ups and inflammation. I stumbled upon nightshades and a number of other foods to avoid. The prime suspect was sugar. Cutting out sugar seemed hard, though. I love sugar. Like many others, I began to realize that I was pretty darn addicted to sugar. So, I began to look in to what it does to the body. I was shocked. Fructose was pretty much a poison. I'd always been told that an apple a day kept the doctor away and I'd always been told that fruit was fructose. How could it be bad for you? The more and more I read, the more I realized that I needed to cut it out of my life as much as possible. So, last spring I began a challenge where I ate no added sugar OR even things that converted quickly in to sugar. The impact was almost instantaneous. I felt so much better. Unfortunately I was unable to sustain my sugar-free (read fructose-free) lifestyle. In an effort to feel better and generally take control over my body and my health, I've begun the process of really cutting down my sugar intake in a sustainable and manageable way. I'm hoping to get to the point where I only consume a maximum of 5 days of sugar in a month (equaling 60 days of sugar consumption in a year).

I know that sugar reduction isn't the only solution though. I know that I need to avoid other inflammatory foods. I know that I need to take control of my experience with my doctors. I know that I need to continue to try my hardest to make the best of my situation. I am not my arthritis. 

Despite the months and weeks and days of pain that I've gone through since 2009, I am thankful for my arthritis. You read that correctly: I'm thankful for my arthritis. I've had to re-frame my experience. I know that it doesn't make sense, but my arthritis has actually made me a better person.

Reasons I'm thankful for my autoimmune arthritis:

1. It has forced me to really appreciate when my body is working well and the ways that it moves even when I'm having a rough patch.
2. It has helped me to become more cognizant of others and both their sufferings and their joys.
3. It makes me appreciate the people in my life and the adaptations they make to make my life easier.
4. It causes me to reflect on how my stress and emotions can cause damaging physical effects.
5. It makes me appreciate dancing and swimming so much more and motivates me to find a solution for my inflammation so that I can continue to feel joy in movement.  

These are only a few of the reasons that I am grateful for my Psoriatic Arthritis. I have built a better sense of empathy from the experience. I have grown so much. I am taking control of my health, my life, and my larger impact on the world. It would be so easy to feel downtrodden by my Psoriatic Arthritis. It would be understandable to be sad. I am not sad, though. I consistently aim to live positively and find the best ways to make my life deliciously joyful despite autoimmune arthritis. 

Dessert-less December: 1/3 Check In!

We are 1/3 of the way through December, the hardest month to go sugar-free! Just like I recommended to all of you, I chose 6 days that I knew I'd be tempted to consume sugar and left one extra sugar day for any spontaneous celebrations that might come up. For every other day, I've remained diligently sugar-free. On my Sugar-Free Advent Calendar, the strips of purple paper are slipped in to each date that I have gone without sugar. The green slips are placed on any days I'm planning ahead to celebrate and consume sugar.

To keep myself on track, here are some tricks I used:

1. I allowed for my exception sugar (85% or higher dark chocolate). Though I didn't eat much of it, a small square every day or two, really helped me feel like I wasn't missing out. 
2. I reminded myself any time that I saw store bought cookies, cakes, pies, or treats (which, unfortunately are around quite often at the office during the holiday season) that homemade holiday treats were so much more worth it! This worked in my favor when, four days in, I was really craving sugar. I was able to look ahead to my pre-planned celebration day on the 5th when I knew that I'd have homemade treats that were much better than any store bought sugary treats I might get to satisfy my mid-afternoon sugar cravings. Waiting until my celebration day was really worth it as I was more able to appreciate the sugar I consumed because I knew everything that went in to it. 
3. I brought to work my own tea bags, almond milk, and even a larger mug. Often times in the winter months, I'm tempted to go out and buy myself a nice warm cup of almond milk hot cocoa from the cafe across the street from where I work. Instead of doing that (in an effort to both avoid sugar AND save money), I made my own large cups of tea to drink daily.
4. I brought my own lunch daily as well as small healthy snacks to tide me over in the late afternoons when I often crave sugar.
5. I did use a celebration day and did not make myself feel guilty for doing so. Because I'd planned ahead for the day, I did not feel like I was going off track. 

See some of the hand decorated holiday cookies my friends and I decorated during my holiday party on my celebration day (I don't generally follow the traditional holiday colors or holiday shapes):

My key takeaways from the first 1/3 of my Dessert-less December are:

1. My skin is slowly beginning to become more clear. I've found that the more sugar I consume, the less clear my skin becomes. This is partially in reference to general acne, but also in reference to my psoriasis. 
2. Though the first few days were hard, I've generally become pretty okay with removing sugar. Reading more about Fructose and the effects it has on our body has made me feel more and more like I'm making the right decision in reducing my intake of sugar.
3. Post-celebration day I was certainly feeling the difference. In past months, I'd cut out sugar and had a similar reaction the days after I'd eat sugar again. This time I felt a strong sense of fatigue and a dull ache in many of my joints that had been less apparent during the sugar-free days leading up to the celebration. Though I generally do have sore joints (due to my psoriatic arthritis), I hadn't had a flare up in a few weeks. 

All in all, I think that the endeavor to minimize my sugar intake has really proven to be the right decision and I hope that I can keep it up for the upcoming 2/3 of the month and ideally in to future months! Over the coming week, I have 3 pre-scheduled celebration days, though I'd like to minimize how many I actually use because three in one week seems a bit much. Ideally, I would cut out one or two of them so that sugar-free days are more spread out. However, I will not let myself feel guilty if I do use them to celebrate, as I've already planned ahead for the celebrations. I hope that you're doing just as well on your Dessert-less December! Let me know if I can help you more in your process of cutting out fructose!

10 Steps To Begin Your Sugar-Free (-ish) December!

If you, too, are planning on joining me in my Sugar-Free (-ish) Advent Calendar this December, but don't really know how to move forward, here are a few tips as well as a few great reads on the subject:

1. First, enjoy this song about being Sugar Free by a K-Pop band called T-ara.
2. Then gain a little more insight in to Why We Focus on Fructose (Even Though It Is Not In Our Name) by I Quit Sugar
3. Now, start to begin the process of defining your sugar parameters by reading these 4 Tips To Become Sugar-Free.
4. Now, look over your monthly calendar. What 1-5 days this month have celebrations and situations during which you think it would be hard to avoid sugar? Place a marker (whatever color you've chosen to represent your celebration days) in each of your advent pockets that align with the date of the celebration. Make sure to leave at least one-to-two marker(s) for any spontaneous celebrations that may come up.
5. Then, create a clean eating grocery list. This list should include many vegetables, proteins, and supplies to make sugar free sauces or dressings. I highly recommend prioritizing how you're going to make sugar-free breakfasts as this is often the hardest meal to make, sugar-free. Over the coming weeks, I'll be suggesting various sugar-free breakfast ideas that you can try! 
6. If you know that it will be hard to avoid sugars that are already in your house, place them all in a box to put in your pantry. Then label the box "CELEBRATIONS." This way, if you get the urge to pull them out or use them, you're making the intentional decision to consider this one of your 7 celebration days.
7. Know that you WILL crave sugar. It will happen. During these times, either acknowledge the feeling and then let the feeling pass or allow yourself a small serving of your exception food. Often times when we are craving sugar, it is actually our body in want of protein. Try feeding yourself your protein of choice. If you're a dairy eater, this could be cheese. If you're an egg eater this could be a hard boiled or fried egg. If you're a vegetarian or vegan this could be a combination of a legume and a grain. Or if you're a meat eater, this may be a slice of (non-processed) meat.
8. Then if you're feeling like you JUST HAVE TO HAVE SOMETHING WARM AND SWEET TO DRINK WHILE SITTING BY THE FIRE/ READING A BOOK ON YOUR SOFA WHILE IT GENTLY RAINS, go out and buy some fructose-free Rice Malt Syrup and make this amazing Anti-Inflammatory Hot Chocolate. 
9. Make sure to assess how you feel each week. Do you notice that your skin is clearer? Are your joints feeling less inflamed? Has your Psoriasis cleared up? What small victories are you accomplishing by minimizing your sugar intake? Note these victories and write them down so that you may look at them again when you're feeling frustrated about minimizing your sugar intake (and about the fact that sugar seems to be in literally everything).
10. If you are just having a hard time with removing sugar, message me. Lets be accountability buddies!

Delicious Arthritis Step #1: Cut Out Added Sugars

Sugar triggers inflammation. The American Journal of Clinical Nutrition warns that process sugars trigger the release of inflammatory messengers called cytokines.  

Let me break it down for you. There are basically two types of sugars:

1. Natural sugars - These are foods that naturally contain sugar, along with vitamins, minerals, and fiber. These are foods like dairy products (which I personally can’t eat), vegetables, and fruits. These are fructose, glucose/dextrose, and galactose. The white table sugar we are all used to is sucrose; a combination of fructose and glucose.
2. Added sugars - These are foods that have sugar added in, on top of their natural sugars. These are included in many processed foods, such as soft drinks and candies. These foods are high in sugar but have very low levels of vitamins, minerals, or fiber. Unfortunately, added sugars seem to be in almost everything.

Though some people worry about ALL sugars, I know that cutting out sugars entirely would be impossible for me, so I’m just trying to minimize how much added sugars I intake.

How I began cutting out added sugar: 

1. I began reading nutrition labels. 
• 4 grams of sugar = 1 teaspoon
• The daily recommended amount of sugar for women = 20 grams (5 teaspoons)
• The daily recommended amount of sugar for men = 36 grams (9 teaspoons)
• The daily recommended amount of sugar for children = 12 grams (3 teaspoons)
2. I cut out any sweetened drinks.
• If I drank one can of soda a day (which contain approximately 44 grams of sugar each) for a whole year, that would equal 83.6 CUPS of added sugar per year.
• Even though natural fruit are okay, I cut out most fruit juices as well.
3. I cut out added “healthy sugars” too. All sugars are sugars, just because one is processes more than another doesn't take way from the fact that you're still adding in extra sugar that was not pre-existing, in to your meal. The added "healthy sugars" that I'm referring to are:
• Agave nectar
• Raw honey
• Raw sugar
• Molasses
• Maple syrup
• Coconut palm sugar
4. Because sugar seems to be added to EVERYTHING I am making most of my foods and sticking with a primarily paleo & clean eating diet. I eat a lot of vegetables, eggs, lean meats, and olive oil. I use loads of spices and I promise you that I do not eat boring food! If I am going to restrict my eating so much, it better as hell taste good!
5. I cut out most desserts. Even though I initially felt like this was a fate worse than death, I have found a way to still have some desserts that are VERY LOW in added sugars and I have some general rules about the desserts I do eat:
• I will not eat chocolate that is below 80% cocoa. In addition to there being less sugar added in the more cocoa there is, I find that I am more satisfied with smaller amounts of chocolate because the small amounts that I get are so intensely chocolatey.
• I am beginning to learn how to make sugar free desserts. (I’ll be sharing some awesome recipes soon!)

Lets not lie to ourselves: we love sugar. For most of us, a treat means a freshly baked batch of cookies, a rarely indulged in candy bar, or even a fancy cocktail drink. This doesn’t have to be the absolute end of those treats, but it does need to be a re-framing of how we think of treating ourselves. The worst part about added sugar is that it seems to be in EVERYTHING. Cutting out added sugar can seem really intimidating. The thing that has gotten me through it though is to know that on the rare occasions that I do have sugar, I can definitely feel the difference. My arthritis flares up and that is certainly not a treat. Treating myself now means doing things that make me feel good, not just in the moment, but in the future as well.

***Confession: Because I'm not perfect and I am still working towards being my best inflammation fighting self, I still allow myself sugar one day a week. I call it Celebration Saturday and on that day I can have some - though still not an excessive amount of - sugar. Full disclosure though, I almost always regret it because the flare ups that follow are never fun.

Additional Resources on SUGAR:

• If you haven't yet watched Fed Up (on Netflix) or That Sugar Film, you definitely should.
• If you're having a hard time finding That Sugar Film then check out this clip about breakfast and this clip about Jamba Juice.
• Take a moment to check out I Quit Sugar by Sarah Wilson.
• You can also check out Jamie Oliver's TED talk which not only talks about teaching children about the food that they eat, but also talks about how much sugar children are consuming in America and Britain.
• Or read this article about 11 Ways Sugar Messes With Your Health.