stress – Nicole Holovach | Dietitian Nutritionist

Sugar still seems to be everyone’s favorite boogeyman, so I thought with January and “diet season” coming up, I’d put together a quick post with my thoughts on the topic.

But first, fans of the movie The Princess Bride should get a kick out of my favorite meme of all time:

There is a lot of confusion and misinformation out there about sugar. When you say the word sugar to just about anyone, they envision the white granulated stuff. I see even other registered dietitians, who are arguably well-educated in food science, posting blog recipes that contain honey as being “sugar free.”

It makes me want to pull my hair out!

Let’s go over some basic food science, shall we?

Carbohydrates ALL contain sugar and can be divided into three categories:

The first two are molecularly “smaller”, and commonly referred to as “sugars” or “simple carbohydrates”:

1. MONOSACCHARIDES (single sugars): glucose (aka blood-sugar), fructose, and galactose.

2. DISACCHARIDES (contain two sugars bonded): sucrose (glucose + fructose) and lactose (glucose + galactose) are examples.

The third category are carbohydrates that are larger, and commonly referred to as “complex carbohydrates”:

3. POLYSACCHARIDES (contain many glucose molecules bonded): starch and cellulose (an insoluble fiber) are examples.

Disaccharides and polysaccharides cannot be directly used by the body and must be broken down into monosaccharides. The body helps out with the breakdown of disaccharides by producing enzymes like sucrase and lactase, and produces amylase to help breakdown starch. Unlike cows and other ruminants, humans do not produce cellulase, so we are incapable of breaking down cellulose.

That means pretty much any carb you eat that is not cellulose, is broken down into SIMPLE SUGAR.

^^^^Re-read this several times and drill it into your head so you can giggle when celebrities and bloggers go on “sugar free” diets.

So what exactly IS the much-maligned white granulated stuff? It’s merely sucrose, a disaccharide containing both glucose and fructose. Sucrose, the white granulated stuff, is also found in ripe fruit, root vegetables, and honey.

When sugar cane or sugar beets are refined by humans into the white granulated stuff, all that is left is the pure sucrose, without any of the nutrients from the plant. I’ll be referring to this product as white table sugar from here on out. It’s not a great food – it has absolutely no nutritive value other than carbohydrates – but it’s NOT THE BOOGEYMAN. It can be used wisely in the context of a nutrient-dense diet.

How did we get into this mess where people are afraid to eat fruit and where white table sugar is being compared to cocaine?

When sugar fear-mongers criticize white table sugar, you’ll see the products they’re criticizing often contain far more than just white table sugar.

Donuts: Enriched white flour, industrial oils, and sugar.
Cookies: Enriched white flour, industrial oils, and sugar.
Cake: Enriched white flour, industrial oils, and sugar.
Processed foods in general: Enriched white flour, industrial oils, and sugar.

Is sugar really the problem here?

When you read about people going “sugar free” and seeing such miraculous changes in their health, here’s what’s happening:

A.) They’re eating better. They’ve cut out all those processed foods that contain sugar, but that also contain industrial oils that can be inflammatory, and enriched white flour (starch), which can also be inflammatory. If they’re eating more whole foods, they’re likely getting a ton more micronutrients (vitamins and minerals) as well.

AND/OR

B.) They’ve gone too low carb and their body has responded by increasing stress hormones like adrenaline and cortisol. The human body is super smart. Cells need sugar (glucose) so badly, that the body has mechanisms to get it when times are tough, or when humans try something silly like purposefully going low carb. It’s called gluconeogenesis – your body will break down your own tissues (muscles, glands, skin, etc.) to produce sugar. This is a stressful, inefficient way of getting sugar into your cells to create energy.

But you know what? It feels good! Stress hormones like adrenaline and cortisol are meant to be used in emergencies. They pull blood sugar up, create instant energy, clear airways, and are anti-inflammatory. Think about Epi-pens, cortisone shots and cream, and prednisone. They’re all in the same class of hormones as adrenaline and cortisol (glucocorticoids). They make you feel better. But, even your doctor will tell you, you’re not supposed to stay on glucocorticoids long-term because of the adverse side effects.

So you go off sugar/carbs and your joints feel better, achiness goes away, allergies and rashes go away – but at what cost?

Your immune system tanks, you lose muscle and cartilage (increasing your risk of injury), and your skin starts to look like you’ve aged 10 years.

What’s the alternative? Go back to feeling like crap?

No. Teach your body how to properly deal with sugar and other carbohydrates.

I work with clients to improve their sugar (glucose) metabolism. Specifically, how to improve their liver’s ability to store glucose and improve their cellular uptake of glucose.

Want some quick, free advice? Eat more potassium-rich carbohydrates and eat at least 80g protein and a day. And DO NOT think of sugar free and low carb diets as a solution, because they’re not. They’re just a Band-Aid covering up a problem.

Want to learn more more about what I do? Schedule a free call HERE.

Did you hear? The latest version of the U.S. Dietary Guidelines, released earlier this year, has removed the recommended limit on cholesterol in the diet. Cholesterol is no longer a nutrient of concern. While most of us in the nutrition world have known for a long time that cholesterol in the diet does not affect risk for heart disease, we also know that it sometimes takes a while for policy to catch up with science.

So if cholesterol in food doesn’t cause high cholesterol, what does? While some might blame saturated fat and fructose (the latest fad), I’m going to dive in and explain to you a more in-depth, big picture view of cholesterol labs and your health.

The most important thing to know is that is that cholesterol isn’t this bad-for-you-you substance that it’s made out to be. Most people think, the lower your cholesterol, the better. If you could just get it down to zero you’d be in great shape! However, cholesterol is absolutely vital to the proper function of the human body. Your body makes cholesterol, regardless of your dietary intake, for good reason. If you had no cholesterol in your body, you would be dead! It plays an important role in digestion, Vitamin D status, hormone production and balance, and many other human body processes.

You also need to know that high cholesterol isn’t a diagnosis. It’s a symptom. Just because you have high cholesterol, doesn’t mean anything bad will happen! The words ‘high cholesterol’ inspire a feeling of dread as something akin to a death sentence. The mainstream narrative on cholesterol is that arteries are like pipes and cholesterol is like gunk. The pipes get clogged up with cholesterol, and then you have a heart attack. This is a powerful image, but it’s not accurate at all. First of all, at least half of all people who suffer a heart attack have normal cholesterol levels (1, 2). Second of all, after age 65, high cholesterol is associated with health and longevity (3). Third, plaques that “clog” arteries are actually made up of calcium and oxidized LDL particles (think rancid – more on that later), and they form under the artery wall (4). So get that vision of “clogged arteries” out of your head, and if you are a health professional, quit using those test tubes full of fat to scare people at health fairs!

Instead of looking at your high cholesterol labs with a sense of doom, let’s look at how cholesterol levels in the blood rise and when it becomes a problem.

One of the basic functions of cholesterol is to stabilize the mitochondria (the energy powerhouse of the cell), preventing their destruction by stress. Anytime you’re under a stressful situation, cholesterol rises as a protective response to the stressor. Yes, you read that right: cholesterol is a protective substance! Stress also lowers intracellular magnesium, which also causes cholesterol production to increase, since magnesium regulates the enzyme that makes cholesterol (5). Stress can be anything from psychological stress like that from jobs, family, money, etc., to physiological stress like skipping meals, not getting enough sleep, and eating poorly.

In youth and those with high metabolisms (good thyroid output AND uptake of thyroid hormone by cells), cholesterol is converted inside cells into pregnenolone, DHEA, testosterone, progesterone, and other important protective hormones. You cannot make these hormones without cholesterol!

Cells need two things to make the conversion: Vitamin A in its active form and thyroid hormone. As humans get older, their ability to convert beta carotene into active Vitamin A decreases, most Americans don’t eat much active Vitamin A in their diet, and metabolism decreases. In fact, up until about 40 years ago, high cholesterol was diagnostic of hypothyroidism, and routinely treated with supplemental thyroid hormones.

So high cholesterol is a problem because you’re not making youthful, protective hormones. But it’s also a problem because cholesterol oxidizes if it hangs around in the blood stream long enough, losing its protective functions. The cholesterol — or more accurately, the lipoproteins like LDL that are carrying cholesterol — get damaged by oxidation, and then the immune system’s response to that oxidative process is what causes the buildup of plaque and then ultimately the rupture of plaque and heart attack.

So the real question everyone should be asking when it comes to atherosclerosis and heart disease is: “what causes LDL to oxidize?”

There are three main ways oxidized cholesterol builds up in your bloodstream (6):

eating commercially fried foods, such as fried chicken and French fries
eating excess polyunsaturated fatty acids, which are found in vegetable oils, packaged food and restaurant food
cigarette smoking

Your doctor, and most dietitians for that matter, will tell you that polyunsaturated fats from refined vegetable oils, margarine, nuts, seeds, and other plant foods lower your cholesterol. And they’re right! But given what you just learned about cholesterol, do you really think lowering your body’s protective production of cholesterol is a good idea?! Within this framework, the effect of polyunsaturated fats is the same as the effect from statins, which come along with nasty side effects. I hope after reading this, you’ll start to understand physiologically why statins have the side effects they do, and why they’re not very helpful for most people (7).

A note about Paleo diets and fructose. Paleo bloggers and gurus have been pretty hard on fructose recently, blaming carbs and sugar for raising cholesterol. “Quit sugar and watch your cholesterol plummet!” Yup, also watch your libido and energy tank from lack of fuel for the liver and brain. Don’t fall for the low-carb trap when trying to lower your cholesterol. Fructose has pretty much been absolved of any wrongdoing in my book (8, 9).

If you have high cholesterol and your doctor is concerned, here is what I would advise:

Ask your doctor for a cholesterol particle size test (LDL-P). Small LDL particles are more likely to oxidize and form plaques under the artery walls (10).
Know your calcium status. One of my favorite things about Mineral Analysis, is the crucial information on tissue calcium it gives me. Coronary calcium scans will also give you good information about your tissue calcium buildup (4).
Have your thyroid status checked. This involves more than a TSH test! Blood lab work, including TSH, will tell you if your thyroid gland is producing enough thyroid hormone, but tells you nothing about your cells’ ability to use it. Broda Barnes was an American physician who was able to reduce heart disease incidence in his almost 2,000 patients by 90 percent. He used basal body temperature first thing in the morning as an indicator for thyroid uptake. Anything less than 97.8 degrees was considered functionally hypothyroid (11).

If you want to lower your cholesterol in a physiologically-sound way, that ensures proper body function for years to come:

Make sure your diet has plenty of sources of active Vitamin A. Eggs, liver, and grass-fed dairy are examples. Hmmm, imagine that….all potent sources of cholesterol! It’s like nature has a plan or something…
Make sure your diet has plenty of Vitamin K2, active Vitamin K. K2 is a calcium director and can remove calcium buildup from the arteries (12). It’s found in, again, eggs, liver, and grass-fed dairy. This is sounding more and more like a French diet. It’s not genes or the wine protecting them from heart disease (13).
Eat plenty of potassium-rich foods, like fruits and vegetables (14). You are likely not eating enough.
Eat more magnesium and supplement if needed. Cooked dark leafy greens and organic dark chocolate are good sources. Magnesium is also absorbed topically through the skin.
Destress!
Focus on all the things that improve thyroid uptake by cells: get enough calories, protein, carbohydrates, potassium and other minerals, good estrogen metabolism, and good liver function – AKA all the things I work on with clients!

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How to Talk Rationally about Sugar

Cholesterol Through a Metabolism Lens

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