Photo by Steve Snodgrass

It’s no secret that I don’t like sugar. But something funny happens every time I recommend people eat less of it: I get bombarded with questions about whether this or that sugar substitute is a good choice.

Sometimes people ask about more natural or “less processed” sweeteners like honey, agave or molasses. Other folks want to know about calorie-free sweeteners like stevia and sucralose (Splenda). But the gist of the question is always the same: what should I eat if I want to have something sweet?

My answer, to many people’s surprise, is to pick whichever one tastes best with what you’re eating (even if it’s plain old cane sugar) and don’t worry about it.

The thing about sugar is no matter what form it comes in, it’s still sugar and is not good for you. Moreover, foods that require sweetening (e.g. pastries) usually have enough other unhealthy ingredients that swapping out the sugar isn’t going to make a huge difference. Sure maybe molasses has a little more vitamin D, or agave ranks a little lower on the glycemic index (because it has more fructose, similar to high-fructose corn syrup), but that doesn’t change the fact that these are still highly concentrated sources of sweetness and should never be eaten in large quantities.

But that doesn’t mean you shouldn’t eat them at all. There’s room for small amounts of sugar in a healthy diet, and it doesn’t matter much where it comes from. Don’t forget to keep everything you eat in perspective. You could get hit by a bus tomorrow, then how virtuous would you feel for ruining your grandmother’s famous apple pie recipe by swapping out sugar for Splenda? We all know pie isn’t the healthiest thing in the world, but some experiences have more value than nutrition alone. As long as you don’t choose experiences over health every single day, those occasional indulgences are not going to kill you.

Artificial sweeteners have other problems as well. Despite their lack of calories, evidence shows that people who use non-caloric sweeteners do not weigh any less than people who don’t use them, and there is no evidence that they help with weight loss. People tend to think they are being virtuous if they choose lower-calorie foods over higher-calorie foods. But without an obvious benefit, what is the point exactly?

Lack of effectiveness is not my only issue with artificial sweeteners. Some studies have suggested that consuming calorie-free sweeteners enhances a person’s appetite and cravings for sweet foods, and this has been proposed as one of the reasons they are not effective at helping people lose weight.

The safety of several of the most popular sugar substitutes has been questioned as well. Though I’ve never found any of the arguments about the dangers of saccharin (Sweet’N Low) or aspartame (Equal) particularly convincing (the original studies were flawed and currently both are officially considered safe for human consumption), they are relatively recent additions to the human diet and the long-term consequences for you as an individual remain unknown. So if you really want to cut back on sugar enough to suffer through the taste of these of these impostors, keep in mind that you are essentially volunteering yourself for a long-term human health experiment that may or may not work out in your favor.

In my opinion still the strongest reason to avoid artificial sweeteners is taste. To me there is something innately unsatisfying about the taste of no-calorie sweeteners, and bad tasting desserts are a paradox of the worst kind. But the assault on your taste buds doesn’t stop there. Artificial sweeteners keep your palate accustomed to overly sweet foods (most are hundreds of times more sweet than table sugar), making it more difficult to re-acclimate to the taste of real food. So not only do artificial sweeteners ruin your dessert experience, they also ruin your healthy eating experience. Awesome, right?

I make one notable exception with these recommendations. Diabetics have a medical condition that prevents them from eating sweet foods that impact blood sugar. This includes cane sugar, honey, agave, molasses, and most other forms of natural sweeteners. The only exception is the stevia plant, which is a natural calorie-free sweetener that has been used therapeutically for hundreds of years. Stevia has been shown in some cases to reduce hyperglycemia and hypertension in patients with pre-existing conditions, and is probably the best option for those who cannot tolerate any kind of caloric sweetener. Because the benefits do not exist for non-diabetic patients and, like other calorie-free sweeteners, stevia is still hundreds of times sweeter than sucrose, I do not recommend it except in these specific clinical conditions.

What’s your sweetness of choice?

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

I love Marion Nestle calling out the food industry on their ridiculous health claims, the emphasis on food culture in health and the launch of the new and awesome Gilt Taste.

Want to see all my favorite links? Be sure to follow me on on Digg. I also share links at Twitter (@summertomato) and the Summer Tomato Facebook fan page. I’m very active on all these sites and would love to connect with you.

Links of the week

• Foods With Benefits? Oh please. <<Excellent, must read article about the BS the food industry is trying to pull on you. (Food Politics)
• The Mediterranean Diet: It’s Not Just About Food <<It’s about culture. (Huffington Post)
• Localizing Fruit, Vegetable Consumption Doesn’t Necessarily Solve Environmental, Health Issues, Study Suggests <Once again, if you read this carefully you’ll see it’s a problem with food culture, not a problem with the definition of “local.” (ScienceDaily)
• Fine Food and Fat: Are Chefs to Blame for Obesity? <<BS of the week. People are clearly confused about the causes and effects of obesity. If we have any chance of coming out of this health crisis, we’re going to have to embrace the food movement and reinstate a food culture based on quality over quantity. (Time)
• Sitting is Killing You <<We just talked about sedentary behavior last week, but here it is in visual form. (Obesity Panacea)
• Dairy Consumption Does Not Elevate Heart-Attack Risk, Study Suggests <<Not even with all that “evil” saturated fat. Skeptics: this was funded by the NIH, not the Dairy Council. (ScienceDaily)
• Exploding watermelons put spotlight on Chinese farming practices <<Still need reasons to avoid Chinese food imports? Eek. (Guardian)
• Eat a Protein-Rich Breakfast to Reduce Food Cravings, Prevent Overeating Later, Researcher Finds <<My two favorite scientific fields (nutrition and neuroscience) united at last. (ScienceDaily)
• People with diabetes more likely to get cancer <<In case you didn’t know, there are many reasons to avoid metabolic syndrome. (Medline)
• Skillet Chicken with Green Onions and Ramps <<I’m totally inspired by the new Gilt Taste site, and I’m going to try this recipe ASAP. Check out their anti-mission statement for a dose of inspiration. (Gilt Taste)

What inspired you this week?

Photo by j.reed

I’ve been a student my entire life so have never had to worry about health insurance. (I’m 30. I know.) As you might expect, I consequently don’t know much about how the whole business works.

One thing I do know, however, is that when I finally have to join the real world and find my own coverage I hope to use it as little as possible. According to today’s guest post, it looks like I’m on the right track.

Yamileth Medina is an up-and-coming expert on health and health insurance plans. She lives in Miami, Florida. Follow her on Twitter @YamilethMedina.

How Healthy Eating Saves You Money On Health Insurance

by Yamileth Medina

We all know eating healthy helps us look and feel our best, but there is another great reason to upgrade your healthstyle: a healthy diet can save you a ton of money on health care costs.

Over the past decade, health insurance rates have skyrocketed. In 2009, monthly premiums in the United States were 131% higher than they were in 2000, according to the Kaiser Family Foundation. This is largely due to the high cost of treating diseases related to unhealthy diets.

According to a recent study by the U.S. Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, and RTI International, health conditions related to obesity (including type 2 diabetes and heart disease) cost the American health care system over $147 billion each year.

What is this money spent on?

• Open-heart bypass surgery: up to $20,000
• Prescription medication and supplies for diabetes: $115 to $177 monthly–for life
• CPAP machines (to treat sleep apnea): from $150 to $5,000

An obese person costs 42% more to treat than a person of normal weight, which is an additional $1,429. Health insurance plans must pass these costs onto you through higher premiums. In order to recoup these expenses, obese individuals often find it harder to find individual coverage, due to the increased risk of health problems obesity entails.

Much of this cost is passed onto other consumers, since the majority of Americans have employer-sponsored plans from their jobs. Insurers must recoup the increased costs in order to maintain their margins.

Although the Obama administration’s healthcare reform legislation will eventually forbid health insurance companies from denying you a policy due to your health status, that will not take effect until 2014. Still, unhealthy individuals will not be out of the woods: the law also promotes wellness incentives, which promote healthy lifestyle modifications–such as dietary changes. Under the legislation, insurers and employers will be allowed to refund up to 50 percent of the premiums for those who meet the specified goals. That is a significant amount of money that could end up in your pocket if you maintain a healthy weight.

From my personal experience, healthy eating is close to 80 percent of the equation when it comes to weight loss. I was a faithful exerciser for years, but it wasn’t until I changed my diet–to include more vegetables and whole grains–that I started seeing success.

Even if you are lucky enough to be blessed with an extremely fast metabolism, that doesn’t mean that you can eat nothing but junk all day and not suffer any consequences. The “skinny-fat” phenomenon consists of people who appear healthy, but have the cardiovascular profile of someone in poor health. Unhealthy eating habits promote visceral fat, which is invisible to the naked eye but is even more harmful to your well-being than the visible flabby stuff.

In fact, some studies indicate that even if an obese person does not reach a healthy body mass index (BMI), under a healthy eating plan they would nevertheless be healthier than a person of normal weight that had a relatively high percentage of body fat.

Can multivitamins make up for a poor diet? Don’t count on it. When it comes to health, nutrients are not the same as food. There seems to be something special about how all of the nutrients work together in the context of whole foods. In that respect, nature can’t be improved upon.

For several years, insurance companies will still be able to judge your health status and decide on your rates accordingly. Maintaining a healthy weight means you will be free of expensive co-payments for cholesterol and heart disease medication, and benefit from any financial incentives that may come about in the future.

Upgrading your healthstyle also assists you in sticking to a budget; cooking for yourself is far less expensive than eating out one or more times a day. In a nation slowly crawling out of a severe recession, this is especially important.

Above all, your immune system will become stronger–helping you stay healthy and reducing the chance of expensive hospitalizations in the future.

Fortunately the solution for better health is relatively simple. Visiting a farmers market once a week and buying a cookbook or two can save you a substantial amount of money on your health insurance plan in the long run.

Is your diet affecting your health insurance costs?

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

Exceptional reading this week. Whatever you do, don’t miss Michael Ruhlman’s calling BS on the food industry deceiving us into believing we’re too busy to cook. There’s also new data suggesting your genes may determine what diet suits you best (healthstyle anyone?) and important news for diabetics taking vitamin B supplements.

I read many more wonderful articles than I post here each week. If you’d like to see more or just don’t want to wait until Friday, be sure to follow me on Twitter (@summertomato) or the Summer Tomato Facebook fan page. For complete reading lists join me on the social bookmarking sites StumbleUpon and Delicious. I’m very active on all these sites and would love to connect with you there. (Note: If you want a follow back on Twitter introduce yourself with an @ message).

Links of the week

• Message to Food Editors: What 30-Minute Meals Really Mean <<Please read this, it isn’t long and it is important. Michael Ruhlman does a fantastic job of explaining how absurd it is that Americans have stopped making food (i.e. health, family, culture) a priority as essential as showering, sleeping and spending time with family. You do have time to cook and eat well–it doesn’t take much. (Huffington Post)
• Fructose: poison or nutrient (or both)? <<People love to make a huge fuss over specific nutrients, but we would be much better off (and less stressed) keeping things in perspective. This is a great example of why. (Nutrition Data)
• 10 Tasty and Healthy Store-Bought Snacks <<BS of the week. Chips, pretzels and ice cream are “healthy”? Seriously SELF editor-in-chief? (Yahoo! Health)
• Individual Response to Weight-Loss Diet May Depend on Genes <<Though we still do not completely understand the interactions between diet and genetics, I can’t imagine how this wouldn’t be true. We have different eye, hair and skin colors. Why would we all metabolize foods exactly the same? Especially since we already know metabolism changes with muscle/fat mass. This is why it is so important to 1) not be dogmatic about diets and 2) find your own healthstyle. (Diabetic Mediterranean Diet Blog)
• Want college students to eat better? Try appealing to their sense of the greater good <<When food is a priority people make healthier choices. Turns out this is much more effective than teaching people about nutrition. Knowing facts is good, but caring is better. (Los Angeles Times)
• Kids Buy More Salad If You Put It Under Their Noses. This Is News? <<Not surprisingly, kids are a bit easier to manipulate than college students. Put healthy food in front of them and they’re 300% more likely to eat it. (Tree Hugger)
• Your chance to tell the FDA what you think of food-package labels <<My vote: tell them to ban them. Front of package food labels only serve to trick consumers into believing processed foods have nutritional value. They say these are “smarter food choices” but the smartest choices are in the produce aisle (or out of the store completely) and don’t have labels. (Los Angeles Times)
• Diabetics should not take high doses of vitamin B, researchers say <<”Rather than reducing the risk of heart attack and stroke, the vitamins appear to actually increase it, the researchers said.” Oops. (Los Angeles Times)
• Whole Grains Reduce Heart Attacks and Strokes <<Not particularly surprising, though I know some of you still don’t believe this. The study is a review of the science and is pretty reliable, though most of the experiments don’t even account for differences between intact grains and whole grains. (Diabetic Mediterranean Diet Blog)
• How to pick, store and cook peas <<Peas are such a springtime treat. Here’s some useful tips to make the most of them, with a recipe. (SFGate)
• Cabbage and lime salad with roasted peanuts <<This recipe looks so fresh, delicious and seasonal. Yum. (smitten kitchen)

What inspired you to eat well this week?

Photo by Robyn's Nest

Artificial sweeteners and sugar substitutes can be very appealing to people looking to cut their calories or control blood sugar, and I get a lot of questions about them. Generally I don’t recommend processed or sweetened foods and encourage people to break free from regular sugar consumption, but I recently discovered coconut palm sugar and decided to look into it.

Coconut palm sugar has garnered attention as being a low-carb sugar substitute that is both more nutritious and sustainable than typical granulated sugar. Because of its complex flavor it is also gaining a reputation in foodie communities, with establishments like the popular Samovar Tea Lounge in San Francisco switching 100% of its sweeteners over to coconut palm sugar.

Pure coconut palm sugar is a natural product made from the nectar of the coconut palm tree. There are several different varieties of palm (Palmyra, date, etc.), and “coconut palm” specifically refers to the coco nucifera plant.

Most of the “palm sugar” commonly sold in Asian markets is not pure coconut palm sugar but is blended with other fillers such as white cane sugar. Pure certified organic coconut palm sugar is sold under the brand name Sweet Tree in the US, and can be found at some natural food stores. It is also available online at Samovar.

The information in this article applies only to 100% pure coconut palm sugar. Check your labels carefully.

Pure coconut palm sugar reportedly has a naturally low glycemic index (GI)–a measure of how food impacts blood sugar–which has led some people to claim that it is a valuable sugar substitute for people with diabetes or those looking to control blood sugar (the low-carb camp). Indeed, a lower GI may be a good indication that a food is safer for diabetics, though it is not a guarantee.

When I first saw that coconut palm sugar has a low GI I figured it would be composed largely of fructose, similar to the popular sweetener agave nectar (and high-fructose corn syrup). Fructose does not impact blood sugar because it is transported directly to the liver and converted to fat. For an explanation of this mechanism, check out Dr. Lustig’s video on the dangers of fructose.

I was surprised to find, however, that coconut palm sugar is reportedly very low in fructose, and its main sugar component is sucrose (aka table sugar). What confuses me is that the GI of coconut palm sugar is supposed to be 35, while the GI of sucrose is 64.

I feel obligated to qualify the numbers on coconut palm sugar, however, since I could only find a summary of how GI was measured and not the published study itself. Also, this information was only available on the website of a company that sells coconut palm sugar. This doesn’t mean the number is inaccurate, it just means I’d like to see the study repeated by another credible source or two before taking it as fact.

(UPDATE: It seems newer tests have indeed found discrepancies with the reported GI of Sweet Tree products)

The number of calories in coconut palm sugar is almost identical to the number in regular table sugar and its closer relative, brown sugar. But coconut palm sugar is notably higher in various micronutrients, probably because it is less processed than industrial sugars.

But does anyone really eat sugar for health benefits?

There are a number of good reasons to consider using coconut palm sugar as a substitute for white or brown sugar in your kitchen. For me the most obvious benefit is that it tastes amazing, similar to brown sugar but with a rich complexity I’ve never tasted in industrial sugars.

Coconut palm sugar is also supposed to be substantially better for the environment, having been called the most sustainable sweetener by the Food and Agriculture Organization (FAO) of the United Nations (couldn’t find the original FAO report though).

Overall coconut palm sugar is a tastier and possibly healthier and more sustainable substitute for granulated or brown sugar. I wouldn’t go so far as to call it a health food, or even low-carb just yet. However it is a nice pantry addition for foodies concerned with sustainable products.

Substitute coconut palm sugar for traditional sugar at a 1:1 ratio in normal cooking and baking.

Have you tried coconut palm sugar? What do you think?

For The Love of Food

I had to take a little break from reading articles this week since I have a big project I’m working on in lab right now. Instead of the usual awesome links, today I want to share with you a video lecture by UCSF professor, Robert Lustig.

It is long, but absolutely worth watching.

And it is particularly important if someone you know is suffering from type 2 diabetes or other chronic disease.

Dr. Lustig argues that sugars, and specifically fructose, are a direct cause of the current obesity epidemic and more similar to alcohol (poison) than to food. His discussion of the effects of fructose on children is heartbreaking and makes his arguments particularly poignant.

It also helps answer the question I often get about why cultures that depend largely on pasta and white rice (Italian and Asian societies) aren’t as unhealthy as Americans even though we all eat “processed carbs.” The answer is that it is both the processing and the additives that cause the problem, and Dr. Lustig explains in detail the science behind it all.

I should warn you that about half way through he starts going into some serious biochemistry, but don’t let it scare you. That section is short and you don’t need to understand the details to get the take home message. Those of you with some undergrad chemistry under your belt will enjoy it, but that is by no means required. Scrub ahead if you must.

My favorite quote:

“Fructose is ethanol without the buzz.”

In other words fructose is much, much worse.

Watch this and share it with your loved ones.

P.S. Thanks to those of you who downloaded How To Get Started Eating Healthy. If you thought you should have received a copy but didn’t, you are probably signed up for the blog post emails but not the newsletter. The difference is explained here. Fill out the newsletter form to get a link to the free guide.

For The Love of Food

Welcome to Friday’s For The Love of Food, Summer Tomato’s weekly link roundup.

Lots of great food and health science this week in my top 10, along with the death of the evil Smart Choices food labeling campaign (woohoo!). Also be sure to check out the wonderful Anti-Fast Food article from Zen Habits. And what week would be complete without a lame celebrity gaffe endorsed by the always misguided Diets In Review? Oh right, any week.

Happy reading

I’m still collecting votes for the People’s HealthBlogger Award by Wellsphere and would greatly appreciate your support. Wellsphere is a fantastic resource for anyone interested in healthy living. To vote for me you have to create an account with them, but you can delete it when you’re done (I have yet to get any spam from them). I’m really terrible at asking people for things, but hope you can find a minute to show your support. Much thanks to those who have already voted.

for Darya http://summertomato.com/

I read many more wonderful articles than I post here each week. If you’d like to see more or just don’t want to wait until Friday, be sure to follow me on Twitter (@summertomato) or the Summer Tomato Facebook fan page. For complete reading lists join me on the social bookmarking sites StumbleUpon and Delicious. I’m very active on all these sites and would love to connect with you there. (Note: If you want a follow back on Twitter introduce yourself with an @ message).

For The Love of Food

• Scientists claim junk food is as addictive as heroin <<This study adds a lot of validity to David Kessler‘s argument about the role of the brain‘s reward and addiction circuits in overeating. Apparently sugar and salt make you crazy. Be careful this weekend. (Grist)
• Smart Choices suspended! May it rest in peace. <<Nuf said. (Food Politics)
• Moderate amounts of protein, rather than a lot, might be best for muscle <<Low-carb acolytes seem to treat high-protein as the new low-fat–something we’re all free to eat in unlimited quantities so long as there is no evil carbohydrate around. Probably the story is a little more complex than that. (Los Angeles Times)
• Gwyneth Paltrow’s Controversial Fitness Comment <<B.S. of the week Rumor has it that wannabe fitness guru Gwyneth Paltrow was overheard saying, “When you’re 35, you either starve yourself, or you do serious cardio.” GP herself gets some B.S points because neither starving yourself nor “serious cardio” will help keep you slim (they’re pretty much the same). And double B.S. points go to Diets In Review (worst online diet info ever) for friggin’ agreeing with her! *slaps forehead in disbelief*
• The Anti-Fast Food Diet <<Superb article on the benefits of Slow Food over at Zen Habits. One of the most simple and beautiful descriptions I’ve read on quality eating. (Seriously great job, Leo).
• Why You Don’t Have to Soak Your Nuts ~ Plus: Chai Almonds! <<Funny and brilliant article about nuts by a blogger I just discovered. Holly does a great job of debunking diet lore with amusing prose and a fabulous recipe to boot! (Sustainable Suppers)
• The Life Span of a Rodent May Aid Human Health <<Think cancer is random and inevitable? Wrong. There is abundant evidence in nature that specific, regulated biological processes are responsible for cancer. Isn’t science cool? (New York Times)
• Statin drugs might slightly boost diabetes risk <<There is a downside to every drug, even statins. Do you know what actually prevents diabetes? You guessed it, diet and exercise. (Medline)
• Knowing about calories causes people to eat more <<I love this. Although it is still not clear what this data means, it does suggest that knowledge of calories (all dietary numbers?) doesn’t help much. I prefer to focus on eating good, healthy food. (Weighty Matters)
• Jerusalem Artichoke Soup with Bacon <<This recipe for sunchoke soup not only looks delicious, there are also some tips to prevent the less-than-desirable aspects of eating this delicious root. (Chocolate and Zucchini)

You read anything awesome this week?

Their unique taste and texture make sunchokes a fantastic addition to many foods, however they are particularly useful as a potato substitute for diabetics. Unlike most tubers, sunchokes store their carbohydrates in the form of inulin instead of starch. Our digestive enzymes do not breakdown inulin, so it has a minimal impact on blood sugar and does not raise triglycerides.

The down side of inulin is that since it is not easily digested it can produce gas and bloating in sensitive people. Cooking sunchokes well can minimize this effect. It is also a good idea to eat a small amount the first time you try them and build up your tolerance.

Sunchokes are a good source of potassium, thiamin and phosphorus, and a fantastic source of iron and soluble fiber.

They make a delicious soup, but can also be roasted, sauteed or eaten raw.

What is your favorite way to eat and prepare sunchokes?