When it comes to sugar, Fargo man 'knew enough was enough'

FARGO -- Josh Grover's sweet tooth had become a problem. But his body craved sugar and he complied with his soft drink of choice, Mountain Dew.

His daily dose averaged three 20-ounce bottles, loaded with sugar in the form of corn sweetener.

The high school choral director would pick one up on his way to work, have another during the day, and yet another as he was wrapping up his work day.

He estimates the liquid sugar he routinely drank was adding 750 to 950 calories a day, much of it ending up around his waistline.

Grover knew it wasn't good to be consuming so much extra sugar -- he was aware of the warnings about the role of sugary drinks in the obesity and diabetes epidemics.

Health advocates have noted that the nation's obesity epidemic has coincided with the shift to high-fructose corn syrup to sweeten soft drinks and later sports drinks -- which together account for more than a third, 36 percent, of the sugar in the American diet.

"I knew enough was enough," Grover said.

So, in early August, he decided to eliminate the added sugar that had become such a big part of his diet.

"I dropped soda pop. That was my first thing," he said. "Then the candy bars disappeared. I went cold turkey."

He noticed a difference right away. Without the jolts delivered by his sugar water, he felt drowsy. At times he even felt nauseous or dizzy.

"I was getting the sweats," he said. "I went through two weeks of not feeling well. It was really hard for me to break the habit."

To varying degrees, lots of Americans have been lightening their sugar consumption, which by some measures peaked in 2009.

Still, the average American is getting plenty of sugar -- 23 teaspoons a day, which adds up to 88 pounds a year. When other caloric sweeteners are added, the annual per-capita total balloons to 131 pounds.

Sugar is an additive in many foods, so it's not always obvious when a person is eating or drinking sugar.

Of course, sugar is a simple carbohydrate that occurs naturally in fruits, vegetables and dairy products. But it's added as a flavor booster, preservative or for color and texture in a wide variety of foods.

After cutting back drastically on sugar consumption, Grover gradually felt better. He quickly began to lose weight, aided by regular exercise, shedding 37 pounds in less than two months.

Grover's waistline shrank from 41 or 42 inches to 38 inches. Now he has to go shopping for new pants.

Added sugars

Mainstream health and medical experts have issued a string of advisories and recommendations about sugar consumption in recent years.

The focus is mainly on what are called added sugars -- sugars and caloric sweeteners added to foods and drinks in processing.

The American Heart Association recommend that people restrict added sugar intake to no more than 100 calories a day for women and no more than 150 calories for men. That translates into about six teaspoons of sugar for women and nine for men.

The American Medical Association, the influential voice of physicians, has a similar recommendation.

The U.S. Department of Agriculture's dietary guidelines recommend that no more than 5 percent to 15 percent of daily calories come from added sugar and solid fats.

Along with tooth decay, health concerns about sugar include poor nutrition -- many call sugar a source of "empty calories," with no real nutritive value that can displace nutritional calories.

Another problem is weight gain. Foods and beverages that are heavily laden with sugar are calorie dense; one teaspoon contains 16 calories.

Also, an excessive amount of sugar can increase triglyceride levels, which may increase the risk of heart disease, according to the Mayo Clinic.

In a disputed finding, some experts even claim that the way the body metabolizes sugar is harmful.

Most famously, in a YouTube video that went viral in 2009, a specialist in pediatric hormone disorders gave a lecture laced with references to sugar, including corn sweetener, as a "toxin" or "poison."

Sugar is mostly metabolized in the liver, so eating more sugar means more effort for the liver than from the same number of calories of starch.

Especially in liquid form, soda or fruit juices, the sugar reaches the liver faster than eating, for instance, an apple. In animal studies, at least, the liver is more likely to convert much of the sugar to fat.

That can cause a condition called insulin resistance, a major problem in obesity and an underlying factor in heart disease and type 2 diabetes.

For those reasons, sugary drinks have come under increasing scrutiny from health advocates.

In a nearby example, Essentia Health, in its downtown Duluth, Minn., and Superior, Wis., locations, stopped making soft drinks available in its cafeterias and vending machines. It has not done so in Fargo.

Last year, the Minnesota Medical Association adopted a resolution encouraging physicians to use guidance including zero sugary beverages and healthy weight.

The Minnesota chapter of the American College of Pediatrics issued a hospital challenge saying that such guidance would be easier when providers model healthy choices.

Dr. Timothy Zager, a pediatrician and president of the Essentia Duluth Clinic, said the focus on sugary drinks should be seen as part of a broader spectrum of health choices, not as a "smoking gun."

Yet the rise in childhood and adolescent obesity is striking. Although not all of the blame can be placed on sugar, Zager noted that research suggests liquid calories are a major culprit.

The doctor advocates what he calls "knowledgeable moderation." People must be aware of their dietary choices.

For example, according to a California study, a 12-ounce serving of fresh orange juice contains the same amount of sugar as a soft drink.

Therefore, Zager said, eating an orange is probably a better choice than drinking a lot of orange juice.

"I do enjoy my orange juice occasionally at breakfast," he added, noting it is a good source of vitamin C.

Andrea Haugen, a nutritionist at Sanford Health in Fargo, also advocates moderation. Too much sugar can be a problem, but so can too much sodium or fat, she said.

"It certainly can add a lot of extra calories and cause weight gain," she said of added sugar in the diet. People often aren't aware, she said, of how many calories are packed into sweetened soft drinks, sport drinks and smoothies.

But, she added, "I don't ever tell people you can't have your favorite coffee drink or not have a cookie now and then."

Rory Beil, director of the Cass Clay Healthy People Initiative, calls sugar consumption, including sugary drinks, "a huge issue."

High-caloric sports drinks and soft drinks have become socially accepted, widely consumed with little thought.

On the other hand, there is a growing movement in area schools to restrict access to sugary drinks, or at least make it easier to make healthier snack choices, Beil said.

A few decades ago, the norm was to buy a 6-ounce soft drink, he said. Now 20-ounce soft drinks are the norm, and larger sizes are readily available.

"Our culture has changed so drastically to accept sugary drinks," Beil said.

No going back

Josh Grover, who has three young kids, is continuing with his self-imposed ban on sugary drinks and candy bars.

One strong motivation, said his wife, Kris, is that he wants to be able to see their children grow up.

Standing 6 feet, 5 inches tall and weighing 279 pounds, he wants to keep slimming.

"I don't think I'll ever go back to the way I was with sugar. There's no way," he said. "I have much more energy now."