Episode 1: The real effects of sugar on kids, with Prof. Michael Goran
Audio Podcast
In this episode we talk to Michael Goran, Professor of Paediatrics at The Children’s Hospital of Los Angeles and the University of Southern California. Michael is the co-author of Sugarproof, a book that educates on the damages sugar does to your child’s health and what you can do about it.
Prof. Michael Goran shares with us scientific insights on how sugar can affect our health and especially the health of our children. He also talks about the effects sugar can have on learning and how artificial sweeteners actually cause you to end up consuming more sweet foods and beverages.
Show Notes
Sugarproof the book: https://www.sugarproofkids.com
Transcript
Michael Goran: ...the body is accumulating the excess fat, it can be obvious Under the Skin that's the subcutaneous fat or it could be around the organs or even in the organs, such as in the liver and then fat builds up around or even within the organs that's when it becomes more damaging so...
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today I've got the great pleasure to speak to Professor Michael gorin Michael is a professor of pediatrics at the Children's Hospital of Los Angeles and the University of Southern California Dr goren also serves as a co-director of the University of Southern California diabetes and obesity Research Institute and Dr goren is a native to Glasgow in Scotland and he received his PhD from the University of Manchester in the UK prior to post doctoral training in the U.S his research has been continuously funded by the National Institutes of Health in the U.S and other foundations for the past 35 years Dr goren's latest book sugarproof kids which was co-authored by Emily Ventura an expert in nutrition education and recipe development was published in 2020 the book aims to help raise healthy kids in today's high sugar food environment to teach them to self-regulate sugar intake and enjoy good food and good health for years to come. So Michael, let me start with a very simple question that many of our listeners probably also might have why is eating whole fruits healthier than drinking fruit juice or a smoothie if it's made from 100 fruit yeah it's a great place to start thank you so much Sarah for having me on for that introduction and you know this is one of the probably one of the trickier points because it gets a little confusing and complicated and um it's all to do with not just the amount of sugar but the rate at which it's absorbed and the types of sugars so for example when when we eat a piece of fruit they're certainly the fruit sugars in there but they are slowly released because they're wrapped up inside the cell wall amongst all the fiber and there's all the other phytonutrients that you get along with the Apple so have you would let's say to eat an apple you might be getting let's say five to ten grams of sugar but it's slowly released whereas a glass of apple juice even if it's 100 percent fresh squeezed juice the sugars are released there's no fiber there's no phytonutrients so you've thrown away all of the the healthy benefits of the of the apple and it's it's rapidly absorbed also in a glass of apple juice you have the sugars from about probably three apples uh so nobody's really eating three apples all at once but you can easily Liberate the juice from three apples and drink it all at once and so it's three times as much sugar and it's rapidly absorbed and that rapid absorption turns out to be very important because when you have that rapid absorption uh there is uh most of the sugars and it's mostly the fructose which is the most abundant sugar in the fruit it's con it's taken up by the liver where it's converted to fat and can cause inflammatory reactions whereas if we Now flip back to the Apple scenario it's not only less sugar but more more slowly released and under those conditions the what the body is the gut is able to convert some of that fructose into glucose and use it for energy but that doesn't get that process gets easily overwhelmed when the sugars are rapidly absorbed and in that case we're not using the fructose for energy directly we're converting it to fat and that process really triggers a lot of negative outcomes and um that's fundamentally the difference between eating an apple and drinking the juice from an Apple the other part of your question was the smoothie and the Smoothie somewhat in in between and smoothies are probably a lot more beneficial because you get the whole fruit which is Blended so you don't toss away the fiber or the other phytonutrients you still get the fiber with with the fruit coming in so it slows down that release some people might argue that the shredding of a smoothie might shred those fibers into smaller more readily easily digested carbohydrates but the evidence for that is less clear and clearly it's very different from the juice where you literally like throw the fiber away it's very interesting because I I do nearly all my home baking with dried fruit or banana or apple and obviously I in some of the recipes I just chop the fruit and in some of them I actually blend it so I'm actually quite interested to hear you know you just said that there's not a lot of research that says that shred it or Blended fruit might release the sugar faster so am I actually still getting a benefit by using although it's Blended fruit or could I also use sugar because I'm kind of destroying the cell wall and I'm destroying the fiber that helps releasing the sugar slower to the body well if you can use the whole food that's definitely more beneficial because you are getting the benefit of the whole fruit all of the the nutrients are still there the fiber is still there maybe shredded a little bit but also obviously it's less processed you also get the flavor of the whole fruit which is which is nice and all the recipes that we use in Sugar proof that we developed use that exact same strategy of using uh whole fruits even if this is a dried fruit using that as a sweetener some people may say well there's still sugars in in the banana or the date and that's true but there's also all the other great things in the banana or the fruit and all the recipes that we develop and I'm sure your recipes too are probably at the end of the day got less sugar in them than an equivalent that would be made with with the uh with just sugar I'm also very interested in the effects you said you know the the body makes basically fat out of the sugar but not all effects of eating a lot of sugar are visible to the eyes so you can have a child that is very active and looks very healthy from the outside it's not looking bigger than it should be for the age that it is but it still has a diet high in sugar so what does the inside of a child look like that on the outside it looks healthy and you know you couldn't tell whether it's raised on a non-sugar diet or on a sugar diet but what does the child look like from the inside do they look different from the inside the children well sometimes it can happen there's this concept called the the there's a different there's different subtypes more of of increased body weight one is called the toffee it's an acronym t-o-f-i which means thin on the outside and fat on the inside and it really all depends on and everybody's different it depends on where the body is accumulating the excess fat it can be obvious Under the Skin that's the subcutaneous fat or it could be around the organs or even in the organs such as in the liver and then fat builds up around or even within the organs that's when it becomes more damaging so the analogy I like to use is the car you could have a great looking car but it might not be running very well you have to to really know if you're great looking car is running well you have to look under the hood or on in the you know in the engine as you say in the UK uh so I mean the object could be true too you could have a you know a rundown looking car that looks terrible on the outside but it runs very well so it all depends on what's Happening inside the body metabolically where fat is being stored what the metabolic profile is we have to look Beyond weight unfortunately our we have these very heavy cultural social norms around focused on weight but a lot of the metabolic issues are not directly correlated with weight necessarily often they are unless but sometimes they're not and how would that show in a child or in a person.
well that would show that would show with you know things like blood screens you know when when we when when I want to get a checkup I go get my blood tested looking for high cholesterol levels or blood sugar levels um liver enzyme levels those types of typical clinical panel tests that that we do the same is happening in kids it might not be as elevated as we would see in adults but you can still get a read on metabolically what's Happening those aren't as comments are obviously not as feasible in younger children there's not always easy to do so that's why it doesn't it's it's not something that seems Seems obvious or natural and you mentioned in your book that Sugar can have multiple effects on a growing body from the obvious weight gain that we just said poor health poor oral health and the risk of chronic disease especially in the long run later on in life and then you also mentioned behavior and how well a child might do at school so I just wondered if there have been any large-scale studies especially on the last two points on health mental health and how well children are doing at school in relation to the diet that they eat yeah the literature is actually pretty pretty thin on this topic we we reviewed as much much of it as we could find in the book which wasn't a lot uh but one of the one of the biggest studies was a study in Australia uh from several years ago that looked at several thousand kids and looked at relationships between their habitual diet and their academic test scores and and showed a negative relationship so kids who were consuming more sugar sugars had lower test scores I mean that doesn't you know these types of studies are hard to interpret they don't it doesn't show cause and effect it's just it's just it's just a correlation or an association so it's really hard to tease it out and the same is true for um mental health issues like ADHD for example there's no dirt there's actually very few there's well I don't think there's any studies that show a clear mechanistic link between sugar and mental health conditions in childhood but there are many studies that show that reducing sugars can improve symptoms as as part of the treatment scenario so I can't tell you the difference definitively that there's a cause and effect relationship for mental health but certainly there is a lot of evidence pointing in that direction back in the day sugar was not so much of an issue as it is today I think people focused more on fat rather than sugar not so long ago and I assume that is because we just didn't consume so much sugar or it was more of a you know a special occasion thing and is it also because the sugars that I use today are just different to what was used um let's say 30 40 years ago in the condiments that we ate I think all of the above are part are true I think you've heard on a couple of important points there so number one yeah we are consuming more sugar that's true um but it's also different types of sugar it's it used to be that most sugar was just ordinary table sugar which is sucrose now there's over 200 different names for sugar uh that that can exist in different different types which have different effects on on the body and really yeah you mean you're right the pendulum has swung uh between fat and sugar and you know historically when we were all kind of brainwashed into thinking low fat food was the way uh forward the food industry actually at the time was and there's pretty good concrete evidence to show this that there was suppression of evidence blinking high sugar to um to these kind of metabolic and mental health problems which the fudency was trying to cover up because they were promoting low-fat diets and when that shift happened when you take fat out of foods you have to add some flavor back and that usually was in the form of some type of sweetener some type of sugar so 70 percent of processed foods have some type of added sugar but the food industry was suppressing the evidence to see that adding the sugar back would be problematic and now we've Unearthed that evidence as well as a whole range of new studies that have shown pretty strong relationships between sugar in the diet and all of these problems whether it's physical health or mental health so there's a lot of things happening all the ones that have made it very complicated with the net sum being that more sugars in More Foods different types of sugar and it's affecting different parts of the body let me take a quick break and tell you about our great up Phoebe that gives you all the inspiration for cooking healthy food for your family Phoebe is currently free to use so make sure you get it today the link is in the show notes and if you find this episode helpful please give us a five star review on Apple podcast to help more parents Discover it now let's get back to our episode what types of sugar can manufacturers hide on the label and do different countries have different rules for those yeah I think the rules are a little different in different countries for sure and even in terms of what how sugars are named and referred to uh certainly food labeling is different and in the U.S for example we do have a new rule that says that food companies have to list added sugars so here we're getting into differentiation between let's say you have a pot of yogurt for example there's going to be some sugar in there from the from the milk from the dairy that's that's not added sugar that's the natural sugar in the dairy and then there will be added sugar a sweetener added of any type of variety so those added sugars have to be differentiated but also now we have to repeat a little bit of a foot detective and look at the ingredient list as well it's not just about the food label and in the U.S the ingredient list has to be listed in the order of most abundant ingredient in that particular item and so it used to be you would just look for sugar as the number one or number two high temperature now with the food industry is doing with these 200 different names they can use multiple types of sugars and use use multiple sugars in a food so that they can put them in a lower down in the ingredient list so that you might not see them at first pass and and they can also use other names like organic brown rice syrup or mango juice puree or evaporated grape juice things like sound fairly uh healthy and have a very healthy ring about them but they're really just they're really just not very not that different from sugar yeah that's very interesting I mean now that we're talking about different kinds of sugar I know many people they use agarf syrup or they use maple syrup um coconut sugars all of these kind of new healthier ways of sweetening recipes what's the research on that I mean are we really doing ourselves a favor by using these or are they just as bad as just ordinary sugar they're all a little different um so Agave is a you know it is fairly popular it's very sweet the reason it's very sweet is it's it's 90 percent fructose and fructose going back let me rewind a little bit so sucrose is the most common form of sugar is a fructose molecule connected to a glucose molecule that's called a disaccharide the glucose is used for energy the fructose is the one that can go to the liver and be converted to fat so and it's much sweeter so fructose is twice as sweet as glucose so the syrup from the agave plant most of it most Agave is 90 fructose and so that can be an issue with um with agari syrup maple syrup and coconut sugar they would come under the you know under the definition of a more preferred added sugar so I certainly have those in my own pantry and would use them in cooking partly because they are both less processed and coconut sugar for example has a little bit of fiber in there that can slow down the glycemic response and it's a more sustainable crop than than sugar cane raw honey would be another one less processed other you know some beneficial nutrients in the fiber and in real maple syrup not the thick syrups that you can get in the grocery store so there's definitely a hierarchy and and then the other thing I'll just say is that this is not to say that I would never use sugar I just try to use less of it so and and for the most part if her recipe calls for a cup of sugar for example you could easily reduce that to three quarters of a cup or even half a cup and still get the the same type of baking consistency or cooking consistency so if this is not an All or Nothing thing this is just to say that there are more there are some sugars that are a bit more healthier a bit more beneficial and you can easily just use less of it and get a big Advantage right there so you don't have to give up all sugars and go keto just to get you know just to get the benefits of sugar reduction and what is your view on low calorie and low sugar products I mean there's so many you know sports drinks um Coca-Cola zero just to name that for example what happens with these drinks or with foods that say they have no added sugar but yet they're sweet so they have artificial sugars how unhealthy are they really because for me just by gut feeling I feel that this is this must be so unhealthy because it's not real if I have sugar I you know I'd rather have proper sugar and know that this is sugar that I'm consuming so what what is happening there well it's interesting that you say this is your gut feeling because a lot of a lot of the issues are in the gut uh with these sweeteners that can affect gut health but just more generally before I get into the more s uh specifics of it so the there are at least in the U.S I'm seeing a lot of products that are sometimes advertised as sugar-free but they have sweeteners in it even natural sweeteners like Stevia or monk fruit it's getting complicated because now there's just dozens of these different types of sweeteners they could be used and they're all they all taste a little different and they all act a little differently in the body but in my view they are all somewhat problematic for multiple different reasons that I'll try and reel off um but before I get into the specifics I would just say that I'm with you I would say why add a sweetener I would just use less sugar to begin with um and try and work with that but the issues are well a lot of them affect the gut the gut microbiome and the reason is because the reason they're sugar-free or calorie free is because they're not absorbed if you eat something and it's calorie free that just means that it's not absorbed by the body and converts it into energy so where does it go it it it it it just it doesn't disappear it gets stuck in the gut um gut microbiome got microbes can chew it up and digest it and produce chemicals into the body and can change the composition of the gut microbiome and that can affect your gut health those types of studies have been shown that's number one uh number two is the there's this um scent there's this issue that they kind of trick the body because they still they may be calorie free in you know on paper but they're they still activate the sweet taste receptor right if you drink a diet soda it still tastes sweet which means it's activated a receptor in your tongue and those those sweet receptors exist not just in your tongue but throughout the body and when the body senses that sweet taste one of the things it does it sends a message to the rest of the body to see that sugar is coming in those receptors don't know the difference between ordinary sugar and an alternative sweetener like Splenda or Monk food doesn't matter it's people say well Stevia is natural it must be okay it doesn't matter where it came from it's still activating the same receptor that says sugar is coming in and when the body gets that message that Sugar's coming in what's it going to do it's going to withdraw sugar from from the blood because it thinks there's a surplus coming in and when it draws it out what's going to happen is your blood sugar will go down and when your blood sugar goes down you'll know it because you feel cranky and hungry and you start wanting to eat food and the Studies have shown this they verify this that children or adults who habitually consume sweeteners hand up consuming more calories throughout the day it's a reverse effect so it's not what you wanted it to do but it's actually making you consume more food in the end of the day yeah yeah and I either that's because you're lulled into this false sense of security like if you had a box of sugar-free cookies maybe you would eat two or three or four whereas if it was an or regular cookie that you made
maybe you just eat one and be satisfied so plus if you make it yourself it's probably going to taste better
so it's a little bit so taste is important too and and that's that's the that's the other issue with the sweeteners is they all taste different they all and and for most people not everybody some people don't mind the taste but most people find it find that they taste have an unpleasant taste so to me it seems that it's all about reading and understanding food labels I'm just you know quite an idealistic person so I'm thinking could you know the answer to the to the food industry kind of disaster that's going on at the moment that we're being fed so much sugar without without actually understanding this could an educational system or initiative be the answer for this that we teach children and teach the population how to read labels and to under really understand what is sugar what you know what's listed on there on the ingredient list and also how do you think you can spread your message apart from this amazing book that you wrote how can we really infiltrate um the whole world to make people understand that sugar is bad if you consume it too much yeah it's a great question yeah so I you know that's what we're trying to do with the book and with with these interviews and all the other things that we're doing to promote the message to help consumers understand and I think we've been lulled into kind of accepting uh whatever the food industry does as being okay for us but we have to really think about what we're ingesting what the different chemicals are how they're affecting the body short and long term usually these things aren't a one-off thing so there's cumulative effects over time in the same way that we're affected by air pollution or other chemical exposures these are chemicals that are put in our food so you know we wouldn't just blindly start ingesting chemicals without knowing what they were doing to our body but because it's in food there's this natural belief that it must be okay
um I think that's we need to think a bit more about what is actually in the food that we're eating and how it's affecting the body we've for too long been too focused on calories so it's this is not just about calories it's really like how how are things affecting the body what's it doing to us metabolically and I don't know I'm accepting invitations to go on podcasts and Instagram lives and everything I can to help spread this message but it's still you know it's nowhere near enough so we need we need a we need a bigger movement and I'm not exactly sure how to how to do that Beyond continuing to do what I'm doing what what do you think we need to do I'm actually currently speaking to the school that my daughter is going to and I will actually do a workshop after the summer on sugar and on you know on unhealthy eating so that's kind of my little my little quiet Revolution but okay I think it's a good place to start I think the schools are good I mean I would I've been I just asked a few weeks ago to do a similar talk um at a school and maybe maybe we need to develop like a little curriculum for schools or a little package that we could send to schools I'd love to get a copy of the book into the schools or maybe it needs more than just a book I think so I think it needs more than a book and I also think that in order to really make a change with children it can't be a one-off session I think like you say it has to be integrated into the curriculum and children just need to be aware constantly and need to be reminded to read the labels so I think it you know you need to run sessions throughout the year to really make a change I think and children are thirsty to a learner they want to do things right so I think yeah starting with schools um is the way forward I don't know sugar-proof kids for children maybe next Edition well that I mean that's what the book's really all about it's um it's targeting parents and teachers to help transmit the knowledge to the kids yeah yeah it's really interesting to hear from you as well you know that that this seems to be something that we have to start as a revolution people that are passionate about it to talk and educate about sugar that's that's the goal for sure what what's next for you after this book yeah it's a good question um you know I didn't the book came out well it was almost two years ago now September 2020 right you know in the first six to eight months of the pandemic so we've been doing a lot of this promotion in the world of zoom and podcasts and things like that but I didn't realize I mean I'm happy I'm great happy and appreciative to have these opportunities to talk about the book is there going to be another book I don't know I think as we just talked about there's enough to still talk about to really make this um take off and make it make it second instinct to families and schools and children so we're doing that so I'm still continuing that effort as best I can um research-wise I'm always busy we're just uh you know this this is my my second job uh my full-time job as a research scientist so we're still continuing with the studies we have new studies at various stages of initiation about to finish we're just launching a brand new center for Latino health it's one of the things we're very focused on is understanding why certain segments of the population are more vulnerable to some of these effects that we're talking about and Latinos are very vulnerable to poor dietary outcomes higher levels of obesity and diabetes and liver disease so with funding from the government we're launching a brand new center to focus on that well I wish the best of luck with the new center and yeah maybe we can have the opportunity to speak to you in a couple of months time I'd love to check in to you know see how it's going on your end and maybe I can report back to you on how the the workshops are going at the school I'd love to hear about that and we'll you know anytime you wanted do this again Sarah happy to jump on a call it's with that's one big benefit of having these type of opportunities we can do it pretty much you know at the drop of a hat uh just put it on the schedule for half an hour and get it done so thank you for for doing that and helping us get the message out there really appreciate that well thank you so much for being on our podcast thank you so much pleasure my pleasure good luck thank you so much for tuning in today make sure you download our app which provides free recipes and weaning tips for families with young children look for Phoebe on the app store that's p-h-o-e-b-e and if you found this episode helpful please give us a five-star review on Apple podcast to help more parents - that's it for today
*Disclaimer: Please be advised that any information is given as general guidance only. Should you have any concerns over the wellbeing of your child such as intolerances, allergies and weight, or your baby was born prematurely or you are unsure if your baby is ready for solids, it is always best to consult with your Health Visitor or GP.*