In August 2023, we will be continuing our Let’s Talk series with a “Let’s Talk About Sugar” workshop on 7 August (2.30pm-4pm), to discuss the effects of sugar on our physical and emotional wellbeing. This workshop will be co-delivered by Jack and Phil, our Physical Health Liaison Workers who, as part of their role at MFT, support individuals living with more severe mental health conditions, encouraging them to attend physical health checks and make positive lifestyle changes.
As someone who suffers from hypoglycaemia and insulin resistance himself, Phil shares his personal experience of discovering how sugar can really impact our bodies and mood, and offers ways to reduce sugar intake and its negative effects on our wellbeing.
“I recently discovered that I have what is called ‘insulin resistance’. This means that I am in danger of becoming diabetic. Diabetes is a medical condition in which blood sugar levels are too high, and which is associated with increased risk of heart disease, stroke and numerous other illnesses.
I wish I could say that I represent a small proportion of the population, and that most people will never need to worry about diabetes. Unfortunately I really can’t say this. Because it is estimated that around one in three people are prediabetic. [Source: https://bjgp.org/content/bjgp/68/669/172.full.pdf]
What do I mean by prediabetic? Well people with prediabetes have elevated blood sugar levels, and an increased chance of developing diabetes. And eighty percent of prediabetics are unaware that they have this condition.
It is of no surprise to me that I have insulin resistance, since I have always thought of myself as a “chocoholic”. I remember when I was at school, queuing at the tuck shop every day in order to buy a Mars bar. In fact, I started craving chocolate so much, that I began buying two Mars bars a day, and eating them one straight after the other!
And throughout my life, I’ve never been able to stop myself from eating copious amounts of chocolate, once the first bite has passed my lips. For example: if I began eating an Easter egg, I typically wouldn’t stop eating until I had consumed at least half the egg. And such behaviour, often described as “binge eating”, certainly incurs the potential for developing diabetes.
Why is Sugar Toxic?
When we eat sugar, our body breaks it down into glucose. Now our blood can only comfortably hold a heaped teaspoon of glucose: i.e. 5 grams. A sustained blood glucose level of 7 or 8 grams in our bloodstream, is toxic to our cells. (And in fact such a state would be considered diabetic.)
Returning for a moment to the example of me eating Mars bars: in 1990, two Mars bars contained a whopping 80 grams of sugar! So after consuming them, my body would have had to extract 75 grams of sugar from my bloodstream, pronto! Cue insulin.
When we eat sugar, our body starts releasing insulin: a hormone made in the pancreas. This hormone tells our cells that they must start absorbing glucose, or using it for energy. As our cells begin to soak up glucose, this lowers our blood sugar level, thereby averting the risk of cell poisoning. Such poisoning would occur if our blood-sugar level were sustained above 5 grams.
I mentioned I have insulin resistance. This means that, since I have eaten copious quantities of sugar throughout my life, my cells have been continually bombarded by insulin, as my body has desperately attempted to maintain my blood sugar levels within safe parameters. And, unfortunately, as a result of this continual onslaught, my cells have now developed a resistance to insulin. So my cells are being told (by insulin) to absorb glucose: but they’re ignoring the message.
In response, my body pumps out higher quantities of insulin, in an attempt to trigger my cells into absorbing glucose (in order that they avoid poisoning from prolonged sugar exposure).
However, over time this causes my cells to become even more resistant to insulin. And eventually this can lead to diabetes, whereby my blood sugar levels would be permanently elevated above a safe range.
I’m not very keen on the term ‘binge eating’, because it makes addictive eating behaviour sound like it’s our fault: as though we’re gluttonous over-indulgers with no impulse control. I really don’t see it this way though. Because I think sugar is actually playing tricks on our bodies.
See, refined sugar doesn’t exist in nature. Humankind developed industrial techniques to strip out the fibrous elements from the sugar cane plant, and create what I can only describe as a drug. And in modern society, we are all introduced to sugar when we are children: as though it were an innocuous substance. And so from a very young age, we become addicts. We get hooked.
But the consequences come later in life. And it’s only when we see the consequences (obesity, heart disease, diabetes etc), that we then feel ‘shamed’ about being an addict. But we’re all addicts. Except for the few people who are a little indifferent to sugar. Lucky them!
Sugar consumption and mood
I currently eat extremely low levels of sugar, because I have hypoglycaemia. This means that when I eat sugar, my body pumps out so much insulin that my blood-sugar level drops below normal levels.
So I generally avoid sugar. But occasionally, I will consume something containing a little more sugar than I am used to. Very quickly after I have eaten sugar, I begin to feel quite overwhelmed with what I can only describe as a low-level depression.
I generally have a strong sense of physical wellbeing and alertness. So when I experience this post-sugar low, it has a significant impact on me, and I really hate it. It’s like a depressive fog descends after I eat sugar. And I find it really frustrating that it just suddenly happens, and I have no control over it.
But here’s the crazy thing: when I ate sugar all the time, I felt like this after every meal and after every time I ate a sugar snack. And now when I eat sugar, I recognise that same horrible lethargic, depressive feeling that I used to feel all the time (and the more so after meals). But you can’t really tell this is happening when you feel like this for the majority of the day. I came to accept it as “just the way I always feel”.
It’s unusual for someone who is not diabetic to experience hypoglycaemia. But in my case, it appears to be linked to insulin resistance. Of course, I’m not alone in experiencing insulin resistance. At the very least, a third of people have this condition (all those who are prediabetic), due to lifelong overexposure to sugar.
And insulin resistance has special relevance for those of us who suffer from mental health conditions. For example, it has long been known to be associated with an increased risk of major depression. A recent study found that individuals with insulin resistance were twice as likely to experience this condition. [Source: https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2021.20101479]
Why is insulin resistance linked to major depression? Current research suggests that insulin helps to promote an important hormone called dopamine, which generates feelings of excitement and pleasure. As cells in our brain become resistant to insulin, dopamine production is decreased, with resulting reduction in our sense of pleasure.[Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260070]
How to reduce sugar to benefit our physical and mental health
With all this in mind, we will do well to take measures to reduce our sugar consumption, in order to stave off the serious health and wellbeing consequences that are associated with it.
One thing we need to be aware of, is just how much sugar we eat without realising it: even when we think we’re being healthy! Let’s take a look at which foods contain the most sugar.
1) This refers to sugar that is added to food and drinks: for example, sugar added to biscuits, chocolate, flavoured yoghurts, breakfast cereals and fizzy drinks.
2) It also refers to sugars found in honey, syrups, unsweetened fruit juices, vegetable juices and smoothies.
The UK government recommends that we shouldn’t eat more than around 7 teaspoons (30g) of ‘free sugars’ per day.
With this in mind, it’s certainly worth checking the sugar content of food or drinks before we eat or drink them, in order to obtain some idea of how much sugar we will be consuming. You might be surprised by the amount of sugar that various items contain. For example, a can of Coca-Cola contains 9 teaspoons of sugar! So after drinking just one can, you will have already consumed more than the recommended daily limit!
The NHS makes the following recommendations.
1) Obviously sweets, cakes, biscuits, chocolate (and some fizzy drinks and juice drinks) contain a lot of sugar. So a starting point is certainly to cut down on consumption of these.
2) Instead of drinking sugary drinks (like, for example, orange squash), drink water (a particularly low sugar option), milk or low sugar drinks (i.e. sugar-free, diet or ‘no added sugar’ drinks).
3) Even unsweetened fruit juices and smoothies are sugary: so limit the amount of these you drink.
4) If you want a fizzy drink, you could try mixing a diluted ‘no-added sugar’ squash with sparkling water.
5) If you add sugar to anything (for example tea or cereal), gradually reduce the amount of sugar, or alternatively use a sweetener.
For more information on “free sugars” I’d recommend watching Jamie Oliver’s “Sugar Rush” documentary (also available at the bottom of this blog)
Added “free sugar” is quickly converted into glucose in our bloodstream. So reducing our intake of added sugars will help reduce our blood sugar levels. Is that the end of the story? If only life were that simple! Other foods are also broken down into glucose. However, it can be very confusing working out how much glucose will be generated from specific foods.
Other foods that raise our blood glucose levels
The Public Health Collaboration has provided a very useful resource to help with this on their website which includes some very accessible infographics, highlighting the impact of various foods on our blood glucose levels.
As examples, I’ve included a couple of comparisons from the website:
- Consuming a small slice of white bread has a similar effect to consuming 3.7 teaspoons of sugar.
- However, a small slice of wholemeal bread has a similar impact to consuming 2.6 teaspoons of sugar.
- Consuming a 120g banana has a similar effect to consuming 6 teaspoons of sugar.
- Whereas consuming 120g of strawberries only has the impact of 1.4 teaspoons of sugar!
These infographics are extremely useful, since they can help us to become more aware of the blood glucose impact of individual foods. This can help us in steering toward foods that don’t generate such a big sugar spike after we eat.
Eating sugar between meals
It’s also good to know that there is a key way in which we can reduce the impact of sugar in the food we eat. The above calculations concerning the blood sugar impact of various foods were obtained when these foods were eaten in isolation. However, if we consume sugar as part of a meal (in which we also eat non-sugary items), this will serve to reduce the speed with which our body breaks down the sugars. So if we do decide to consume a sugary snack, it is far better to eat this as part of a balanced meal, than it is to eat it on its own in between meals.
One can’t understate how difficult it can be for many of us to reduce our sugar intake. But we tend to do a lot better with this kind of health commitment, when we get support from others. The Public Health Collaboration resources page provides numerous links for help with sugar addiction. I would also recommend the “Sugarbomb In Your Brain” Facebook group, with 10k members (who are also seeking to fight sugar addiction) which offers many free resources, podcasts and weekly online live support groups.
What Difference Sugar Reduction Can Make
I have shared in this blog how extreme changes in my blood sugar levels were wreaking havoc with my emotions. I used to spend most of my day in an emotional rut, as a result of extremely unstable blood sugar levels after eating. But whilst most people do not experience the effects of my kind of extreme hypoglycaemia, sugar affects all of us both physically and emotionally in a myriad of ways. For probably at least half of us, eating too much sugar (and foods that raise our blood sugar levels) poses significantly increased risk of serious negative health and wellbeing outcomes, such as heart diseases, stroke, diabetes, depression and anxiety to name only a few.
While I was growing up, I ignored all the health warnings regarding sugar. But after I found out that I was experiencing insulin resistance, I cut sugar (and other substances that raise my blood sugar levels) almost entirely from my diet. And this has resulted in significant improvements in my physical health and my ongoing sense of emotional wellbeing.
I warmly encourage each of us to think carefully about the potential health consequences of high sugar intake. And if we are currently consuming too much sugar, to consider taking measures to reduce our sugar consumption sooner rather than later.
Our “Let’s Talk About Sugar” workshop
Phil and Jack, our Physical Health Liaison Workers, and Nicole Walker from Public Health Collaboration will be running a workshop on how sugar can affect our mood and what we can do about it as part of our “Let’s Talk” programme, directed primarily at new clients (but also open to more long-term clients).
It will take place online on Monday 7 August, 2.30pm-4pm on Zoom. To book your place, you need to register as a client of MFT first, then contact our office at email@example.com or on 01372 375400 or SMS 07929 024722 to get the Zoom link. Download poster.
Diabetes UK Resources
We really recommend the Diabetes UK’s Sugar Craving guide explaining the psychologic side of sugar cravings and sharing lots of helpful tips on how to fight a sweet tooth.
You can also use their Food and Mood Diary to monitor what you are eating and how it makes you feel before and after. It will help you understand why you reach for certain foods and give you an insight of how it affects your mood too.
Weekly Online Lifestyle Support Course
Run by volunteers from Public Health Collaboration, this online weekly lifestyle support group is hosted every Monday at 6pm through video meetings. You can register to attend the support group on their website as well as watch their free real food lifestyle video course.
We also encourage you to visit the Public Health Collaboration Resources page.
“Sugar Rush” Mini Documentary
This mini documentary by Jamie Oliver investigates how much sugar we really eat every day without realising, with all the “free sugar” added to our food. It is a 25-minute documentary but if you don’t have the time to watch it all, fast-forward to 6’10min.
Surrey Downs Diabetes Group
Nicole Walker from Public Health Collaboration runs regular walks, alongside Diabetes UK, to support people susceptible to diabetes. All are welcome to attend. They meet on the first and third Monday of the month in Leatherhead and on the second and fourth Monday of the month at Denbies in Dorking.
To find out more, please visit the Mole Valley District Council website.