Elevated blood triglycerides, as a part of lipid management, has become a major medical problem. This website is intended to allow you to become an informed patient who can manage your own care, ask the right questions, insist on adequate management and information, and seek an optimal outcome for yourself. Perhaps it will even help the health professionals who are giving care to better understand and, hopefully, incorporate into their practice the nutritional approach to high blood triglycerides.
Please note that this website is not intended for “most people”. It is written for those who want to stand out in self-health care. If you are such a person, we strongly advise that you give serious thought to all of the suggestions about how to improve you blood lipid profile, triglycerides in particular. If you are tempted to think the suggestions are too complicated or too simplistic, or even biased, we assure you they are not.
The WHO's Recommendation: 12 Teaspoons of Free (Added) Sugar Daily
The purpose of this website is to present, to all who want the knowledge, a safe and dependable method through which individuals can lower their elevated blood triglyceride levels. You can achieve astonishing results - if you put your mind to it. By having the whole page printed, you can read it in a nice easy chair, away from that glaring monitor.
Most teenage males consume an average of 34 teaspoons (136 grams) of sugar per day, mostly from the soft drinks, according to the US Department of Agriculture (USDA).
For example, the 1999 figure for added-sugars consumption was 1.5 percent greater than in 1998.
Consumption of “added sugars” includes:
table sugar (refined, processed sugars from cane, beet - sucrose - added to foods by the manufacturer, cook or consumer)
corn sugar (glucose)
corn syrup
high-fructose corn syrup commonly added to fruit juices
sugars naturally present in fruint juices
honey, and
other syrups, like molasses and maple syrup.
The term “added sugars” does not include the sugars naturally present in:
milk (lactose)
fruit (fructose, sucrose), and
vegetables.
A report released in 2006 by the World Health Organization (WHO) urges people to limit their daily consumption of free (added) sugars to less than 10 percent of their total energy intake (Diet Nutrition and the Prevention of Chronic Diseases; TRS916). This recommendation adds up to approximately 12 teaspoons (48 grams) of added (free) sugar a day based on an average 2000-calorie diet.
In North America, however, this report prompted a harsh reaction from the sugar lobby.
The leading American health experts want the FDA to set a maximum recommended daily intake (Daily Value) for added (free) sugars of 10 teaspoons (40 grams) and require labels to disclose the percentage of the Daily Value a food provides. (Daily Values are used on Nutrition Facts labels to indicate the recommended maximum intakes of fat, sodium and other nutrients).
It is so much less than North Americans eat now - on average, more than 20 teaspoons of added sugars per day, that is twice what the U.S. Department of Agriculture recommends.
Although we are eating way too much sugar, consuming less sugar is not that easy as it would seem. Cutting back to 10 - 12 teaspoons a day is going to be tough.
A typical cup of fruit yogurt provides 70 percent of a day's worth of added sugar! No to mention a can of baked beans, listing white beans, water, molasses, sugar, fructose, brown sugar. Lots of sugars!
Of course, you would like to have these beans with a hot dog which lists such ingredients as pork, chicken, beef, water, salt, dextrose. It means more sugar!
The bun contains another half-teaspoon of sugar. And with that hot dog you would like to have a dash of ketchup (a third of ketchup is sugar)…
Another example: a health snack – granola bar has two teaspoons of sugar.
One little Fruit Rollup, Mellon Berry Blast has about 3 teaspoons of sugar, mostly in form of cheap corn syrup.
The WHO report recommending we eat less sugar provoked loud criticism from the sugar lobby in the U.S. and Canada.
The sugar industry and the American government are really upset about it. Randall Kaplan of the Canadian Sugar Institute says that there is no scientific proof sugar is what is making us fat or giving us diabetes (!)
According to USDA data, people who eat diets high in sugar get less calcium, fiber, folate, vitamin A, vitamin C, vitamin E, zinc, magnesium, iron, and other nutrients.
Although presently it cannot be proved "scientifically" that sugar along is to blame, there’s plenty of evidence that it is the key contributing factor.
Onset of diabetes, for instance, is one of the major concerns for excess sugar intake. Since insulin acts as a "carrier" of glucose (blood sugar), too much sugar can overwork the pancreas, eventually leading to a decrease in insulin production.
Because of such potential problems, the Center for Science in the Public Interest (CSPI) has petitioned the FDA to require that food labels declare how much sugar is added to products.
A high-sugar diet can contribute to other health problems, such as osteoporosis, cancer, and heart disease, not to mention tooth decay and obesity.
Unfortuanately, nutritionally worthless junk food is everywhere. No matter what, in every store that you go to there is a little section of chocolate, candy and chips. Sugar is all over the place and it is hard to resist it.
Simple (Free) Sugars Consumption and Sugar Cravings
An intense desire to consume simple sugars is commonly known as carbohydrate or sugar (sucrose) cravings. Ironically, it is believed to occur as a result of rapid rises and subsequent rapid falls in blood sugar which are caused by… high consumption of simple sugars (carbohydrates).
In the typical diet of the USA population, the major contributing factors in sugar cravings include:
Soft drinks – their consumption is responsible for 33 percent of the total content of added (free) simple sugars
Sweetened grains (primarily breakfast cereals) – their consumption is responsible for 19 percent of the total content of added (free) simple sugars
Sweets/candy – their consumption is responsible for 17 percent of the total content of added (free) simple sugars
Fruit drinks – their consumption is responsible for 10 percent of the total content of added (free) simple sugars
Milk products – their consumption is responsible for 9 percent of the total content of added (free) simple sugars
Unfortunately, many people are actually addicted to sugar. In order to free yourself of the physical addiction, complete avoidance of all sugar is necessary. Complete abstinence resolves the biochemical addiction, however, during this transition it is very important to eat every two-three hours to avoid symptoms of hypoglycemia.
If you do not eat every 2-3 hours your blood sugar may "crash" and you'll feel horrible. Usually, this is necessary for several days to several weeks.
However, carbohydrate (sugar) cravings may be also caused by metabolic and nervous system ailments such as:
Hypoglycemia, a "catch-22" disease where insulin over-counteracts high blood sugar/blood glucose levels, leading to low blood sugar/blood glucose, leading to a craving for… more sugar;
Obesity - excessive body fat, a term applied to persons who are more than 20 percent above their recommended body weight as measured by body mass index (BMI);
Bulimia, a type of eating disorder where the afflicted person eats large amounts of food, then self-induces vomiting;
Depression - sadness and unhappiness;
Seasonal Affective Disorder (SAD), a type of depression that usually occurs during autumn or winter as a result of insufficient exposure to the ultra-violet radiation present in sunlight;
Stress, due to worry, injury or disease.
The other possible causes of sugar (carbohydrate) cravings also include:
Pre-Menstrual Syndrome (PMS), a combination of ailments that can appear at any time during the two weeks (most commonly during the last four days) preceding menstruation;
Excessive proliferation of Candida albicans, one of 70 different species of Candida yeast present in the mouth, esophagus, intestines or vagina.
How to Decipher Sugar Content?
Current food labels do not spell out exactly how much of the most common nutrients we’re getting. Carbohydrates do not include totals for fibers and sugars.
So we just have to rely on the list of ingredients to determine how many sugars are in the foods we eat.
In order to estimate the total number of sugars found in foods, experts use a teaspoon of refined sugar as a metaphor to give us a sense of how much sugar we’re consuming. Therefore, a product which contains 16 grams of sugars per serving would translate into approximately 4 teaspoons of sugars per serving.
In every teaspoon/serving size, there are 4 grams of refined sugar, providing on average 15 calories.
In other words, in order to determine how much sugar is in a serving, you need to check the nutrition label for Sugars (listed in grams) and divide the number of grams by four.
For example, if sugars are listed as 12 grams you should divide that amount by four and this will give you three teaspoons of refined sugar per serving - and 45 calories.
How to Reduce Your Sugar Intake?
If we were eating just all vegetables and some low-sweet fruits, and getting our sugars just from there, we would be way better off.
First of all, check nutrition and ingredient labels for sugar and its equivalents, including sucrose, high-fructose corn syrup, corn syrup, dextrose, glucose, fructose, maltose, honey and molasses.
At present, the USDA recommends limiting added sugars, from packaged foods and the sugar bowl, to:
24 grams a day (6 teaspoons) if you eat 1,600 calories
40 grams (10 teaspoons) for a 2,000-calorie diet
56 grams (14 teaspoons) for a 2,400-calorie diet, and
72 grams (18 teaspoons) for a 2,800-calorie diet.
As you can see, this is even less than 12 teaspoons (48 grams) of a sugar a day recommended by the recent WHO's report for an average 2,000-calorie diet.
What you should do then? First of all, cut back on:
soft drinks (40 grams of sugar per 12 ounces) - nutritionally empty "liquid candy" - by far the biggest source of sugar in the average American's diet
fruit "drinks," "beverages," "ades," and "cocktails" as they are essentially non-carbonated soda pop; Sunny Delight, Fruitopia, and other fruit juices have only 5-10 percent juice and are loaded with calories and can be as fattening as pop
candy, cookies, cakes, pies, doughnuts, granola bars, pastries, and other sweet baked goods
fat-free cakes, cookies, and ice cream as they may have as much added sugar as their fatty counterparts and they're often high in calories ("fat-free" on the package doesn't mean fat-free on your waist or thighs).
Instead drink purified, filtered water, eat more vegetables and have few low-sweet fruits.
Look for breakfast cereals that have no more than eight grams (about 2 teaspoons) of sugar per serving.
Watch out for sweets - ice cream, shakes, and pastries - served in restaurants. Their huge servings can provide a day's worth of added sugar. For example, a large McDonald's Vanilla Shake and a Cinnabon each have 12 teaspoons (about 48 grams) of added (free) sugar.
Getting That Sugar Monkey Off Your Back: More Tips
Don’t avoid sugar like the plague. Demystify it. Sugar is neither evil nor your friend. Nutritionally speaking, when you eat sugar, you get only empty calories. There are no virtues associated with sugar.
Eat regular meals. Having small meals every two-three hours will keep your blood glucose levels stable.
Don’t overeat. Just eat appropriate foods at appropriate times. You are less likely to go overboard when you have a full meal in your stomach.
Wait five minutes and see if the craving passes. If it doesn't, have a single serving of what you want, instead of a "healthy substitute." Substitutions do not always work. If you really want ice cream, you're better off having a little ice cream than three pounds of carrot sticks.
Don't use sweet treats as a distraction. When you find yourself reaching for the jelly beans, ask yourself what's going on. If you're hungry, have the kind of snack that will last longer than a sugar rush -- some almonds, for instance. If you're stressed, take a walk. If you're sad, call a friend. If you're bored, get out of the house.
Don’t full yourself into thinking you can eat more of other foods because you have downed a diet soft drink or put artificial sweetener in your coffee.
Get rid of the candy dish on your desk and the stash of Ring-Dings in your kitchen. If junk food isn't around, you can't eat it. When you want a sugary snack, go out and buy – one only.
Get more pleasure out of a piece of higher quality chocolate rather than out of a bag of Hershey's kisses every other day. If you can get into the habit of having a little of your favorite sweet thing every day, you may be less likely to "lose control" and work your way through the candy counter.
What About Fructose?
Fructose is incorporated into triglycerides more readily than glucose (blood sugar); therefore, it has a greater propensity to increase serum triglycerides.
Fructose, also known as fruit sugar (levulose) is a simple sugar twice as sweet as sucrose (table sugar). But because it is mainly metabolized in the liver, fructose has a lower glycemic index.
However, consumption of high amounts of fructose can lower metabolic rate and cause de-novo lipogenesis (the conversion of sugar into fat) since the liver can only metabolize limited amounts of fructose. For this and many other reasons, and contrary to previous claims for its superiority over glucose (blood sugar), fructose does not play essential part in human nutrition.
Although naturally present in fruits, fructose is also available in the form of crystals as a table sugar substitute. It is also sold commercially as high-fructose corn syrup which can contain up to 55 percent sucrose.
However, fructose can have some toxic effects on our health, especially on cardiovascular and digestive systems, as well as on our metabolism.
Fructose, especially its excessive consumption, may increase:
the risk of abnormal blood clotting ailments and hypertension (high blood pressure)
the risk of type 2 diabetes
total blood cholesterol levels (it serves in part as the raw material for the synthesis of cholesterol within the body)
LDL-“bad” cholesterol levels, and
blood triglyceride levels, especially in diabetics (fructose has a greater propensity to increase serum triglycerides than glucose).
Excessive consumption of fructose may also cause:
fatigue, especially in persons who are fructose intolerant
insulin resistance, and
obesity (due to de-novo lipogenesis - the conversion of sugar into fat).
It is estimated that up to 33 percent of persons are unable to completely absorb fructose due to fructose intolerance (also known as dietary fructose intolerance (DFI) which may cause
flatulence (gas)
intestinal cramps (abdominal pain)
bloating, and
altered bowel habits (diarrhea).
Fructose may cause the symptoms of irritable bowel syndrome (IBS) and may be an underlying cause of some cases of IBS due to fructose malabsorption.
Fruit Sources of Fructose
FRUIT LIST
Fructose per 100 grams
1. Dates
32 grams/32%
2. Raisins
29.7 grams/27.9%
3. Figs
22.9 grams/22.9%
4. Prunes
12.5 grams/12.5%
5. Grapes
8.13 grams/8.13%
6. Pears
6.23 grams/6.23%
7. Cherries
6 grams/6%
8. Apples
5.9 grams/5.9%
9. Persimmon
5.56 grams/5.56%
10. Blueberry
4.97 grams/4.97%
11. Bananas
4.85 grams/4.85%
12. Kiwi Fruit
4.350 grams/4.35%
13. Watermelon
3.36 grams/3.36%
14. Plums
3.07 grams/3.07%
16. Honeydew Melon
2.96 grams/2.96%
17. Grapefruit
2.5 grams/2.5%
18. Strawberry
2.5 grams/2.5%
19. Blackberry
2.4 grams/2.4%
20. Raspberry
2.35 grams/2.35%
21. Orange
2.25 grams/2.25%
22. Pineapple
2.05 grams/2.05%
23. Cantaloupe
1.87 grams/1.87%
24. Peach
1.53 grams/1.53%
25. Nectarine
1.37 grams/1.37%
26. Apricot
0.94 gram/0.94%
As you can see, among the twenty-six popular fruits the lowest fructose content show, respectively:
apricots
nectarines
peaches
and
cantaloupes.
Therefore, the above fruits should be your first choice of fruit in triglycerides-lowering diet, provided you have not been diagnosed with fructose intolerance.
Logical, isn't it? But not quite true.
Fruit Sources of Sucrose
FRUIT LIST
Sucrose per 100 grams
1. Papaya
30 grams/30%
2. Dates
20 grams/20%
3. Apricot
5.87 grams/5.87%
4. Pineapple
5.47 grams/5.47%
5. Nectarine
4.87 grams/4.87%
6. Peach
4.76 grams/4.76%
7. Cantaloupe
4.35 grams/4.35%
8. Orange
4.28 grams/4.38%
9. Honeydew Melon
2.48 grams/2.48%
10. Bananas
2.39 grams/2.39%
11. Apples
2.07 grams/2.07%
12. Plums
1.57 grams/1.57%
13. Persimmon
1.54 grams/1.54%
14. Watermelon
1.21 grams/1.21%
As you can see, among the fourteen popular fruits the lowest sucrose (sugar) content show, respectively:
watermelons
persimmons (juicy smooth-skinned orange-red tropical fruits that are sweet only when fully ripe) and
plums.
Therefore, the above fruits should be your first choice of fruit in triglycerides-lowering diet, provided you have not been diagnosed with fructose intolerance.
Logical, isn't it? But not necessarily true.
Lowering High Triglycerides: Your Choice of Fruit
Whole fruits are both a source of fructose and - sucrose, in other words, sugar. Also known as beet or cane (table) sugar, chemically it consists glucose and - fructose.
Glucose is the only carbohydrate that actually circulates within the bloodstream (as blood sugar). It provides energy to most of the body's cells and is the preferred fuel for most cells, including the neurons of the brain (the brain utilizes 25 percent of glucose for its own “fuel” requirements).
Sugar then is a sort of "good" and "bad" guy at the same time with fruits as a perfect example. Some of them are high in fructose but at the same time low in sucrose, and vice versa.
Watermelon, for instance, is low in sucrose (1.21%) but at the same time much higher in fructose (3.36%). Apricots on the other hand are low in fructose (0.94%) but very high in sucrose (5.87%). The same applies to other low-high, fructose-sucrose fruits like persimmons, plums, nectarines, peaches and cantaloupes.
So as far as fruit consumption is concerned, the only practical solution is their limited consumption. Because fruits are a considerable source of sugar in our today's diet (already full of sugar!), their daily intake should be carefully monitored by all people, not only those whose health condition could be adversely affected by the sugar, diabetics and pre-diabetics in particular.
Like with many other things in our life, moderation is the key here, the only win-win situation. And this "rule" should be followed by everyone who is seriously concerned about his or her health.
Table of Fruits and Sugars
Tomatoes, avocadoes, lemons and limes are very low in total sugar and do not have to be restricted.
Although eating fresh fruits as your appetite dictates still holds for many people, if you are overweight, insulin resistant, or have elevated blood triglycerides, you should limit your intake of high-sugar fruits, such as grapes, bananas, mangos, sweet cherries, apples, pineapples, pears and kiwi fruit.
This recommendation also applies to dried fruits which contain excessive sugar. As a matter of fact, they more resemble commercial candy than their fresh counterparts.
Try to include more vegetables instead. However, some fruits, like tomatoes, avocadoes, lemons, and limes, are very low in total sugar and do not have to be restricted.
Fructose consumption is particularly problematic for people who are insulin resistant - a condition associated with metabolic syndrome X and/or type 2 diabetes. Because sucrose (table sugar) is split in the gut into its two component parts (fructose and glucose) before it enters the bloodstream, sucrose's contribution to the total dietary fructose load must be considered.
For this reason the total metabolic fructose for items below has been tabulated (in grams of sugar per 100 grams). The term "total metabolic fructose" (Tot. met. fructose) means fructose and sucrose combined.
Total Sugars
Glucose
Galactose
Fructose
Sucrose
Lactose
Maltose
Tot. Met. Fructose
Fresh Fruit
Apples
13.3
2.3
7.6
3.3
9.3
Apricots
9.3
1.6
0.7
5.2
3.1
3.3
Avocado, California
0.9
0.5
0.2
0.1
0.3
Avocado, Florida
0.9
0.5
0.2
0.1
0.3
Banana
15.6
4.2
2.7
6.5
6.0
Blackberries
8.1
3.1
4.1
0.4
4.3
Blueberries
7.3
3.5
3.6
0.2
3.7
Cantaloupe
8.7
1.2
1.8
5.4
4.5
Casaba melon
4.7
0.3
0.0
Cherries, sweet
14.6
8.1
6.2
0.2
1.3
6.3
Cherries, sour
8.1
4.2
3.3
0.5
3.6
Elderberries
7.0
Figs
6.9
3.7
2.8
0.4
3.0
Grapefruit, pink
6.2
1.3
1.2
3.4
2.9
Grapefruit, white
6.2
1.3
1.2
3.4
2.9
Grapes
18.1
6.5
0.4
7.6
0.1
7.6
Guava
6.0
1.2
1.9
1.0
0.7
2.4
Guava, strawberry
6.0
1.2
1.9
1.0
2.4
Honeydew melon
8.2
Jackfruit
8.4
1.4
1.4
5.4
4.1
Kiwi fruit
10.5
5.0
4.3
1.1
4.9
Lemon
2.5
1.0
0.8
0.6
1.1
Lime
0.4
0.2
0.2
0.2
Mamey Apple
6.5
1.1
3.7
1.6
4.5
Mango
14.8
0.7
2.9
9.9
7.9
Nectarine
8.5
1.2
6.2
3.1
Orange
9.2
2.2
2.5
4.2
4.6
Papaya
5.9
1.4
2.7
1.8
0.4
3.6
Peach
8.7
1.2
1.3
5.6
4.1
Pear
10.5
1.9
6.4
1.8
7.3
Pear, Bosc
10.5
1.9
6.4
1.8
7.3
Pear, D'Anjou
10.5
1.9
6.4
1.8
7.3
Pineapple
11.9
2.9
2.1
3.1
3.7
Plum
7.5
2.7
1.8
3
3.3
Pomegranate
10.1
5.0
4.7
0.4
4.9
Purple Passion Fruit or Granadilla
11.2
4.0
3.1
3.3
4.8
Raspberries
9.5
3.5
3.2
2.8
1.0
4.6
Starfruit
7.1
3.1
3.2
0.8
0.1
3.6
Strawberries
5.8
2.2
2.5
1.0
3.0
Tangerine
7.7
Tomato
2.8
1.1
1.4
1.4
Watermelon
9.0
1.6
3.3
3.6
5.1
Dried Fruit
Dates
64.2
44.6
22.3
Dried apricots
38.9
20.3
12.2
6.4
15.4
Dried figs
62.3
26.9
3.9
24.4
6.1
27.5
Dried mango
73.0
Dried papaya
53.5
Dried peaches
44.6
15.8
15.6
13.2
22.2
Dried pears
49.0
Dried prunes
44.0
28.7
14.8
0.5
15.1
Raisins
65.0
31.2
33.8
33.8
Raisins, Golden
70.6
32.7
37.1
0.8
37.5
Zante currants
70.6
32.7
37.1
0.8
37.5
Pure sugars
Sucrose (table sugar)
97.0
97.0
48.5
Maple sugar
85.2
4.3
4.3
75.0
41.8
Honey
81.9
33.8
42.4
1.5
4.2
43.2
High fructose corn syrup (42%)
71.0
36.9
29.8
2.1
29.8
High fructose corn syrup (55%)
77.0
30.8
42.4
2.3
42.4
High fructose corn syrup (90%)
80.0
7.2
72
72.0
Molasses
60.0
11.2
12.9
34.7
30.3
Sorghum syrup
65.7
33.5
Brown sugar
89.7
5.2
84.1
42.1
Candy
M & M chocolate candy
64.7
54.9
7.6
27.5
Lifesavers
66.5
66.5
33.3
Hard candy
62.3
66.7
33.4
Bit O Honey
42.4
5.0
0.5
27.0
2.5
5.0
14.0
Almond Joy
44.9
Baby Ruth
42.0
Butterfinger
48.8
Caramello Candy Bar
54.2
Nestles Crunch Candy Bar
52.4
0.2
45.1
6.8
22.8
Nestles 100 Grand Candy Bar
63.5
Nestles Raisinets
62.5
Reeses Pieces
50.0
Skittles
76.4
Nestles Plain Milk Chocolate Candy Bar
51.0
Hershey's Kisses
50.0
Sugar babies
72.9
Milk Duds
50.0
Junior Mints
82.2
Source: Fruit and Sugar Content: The Paleo Diet by Dr. Loren Cordain, Ph.D.