Put down that doughnut right now

Sugar is bad for you and we (I'm talking about Americans--I don't care about the rest of you people) have a sugar addiction. I'm not telling you anything you haven't already heard. The airwaves have been flooded with Washington Post articles, New York Times articles, L.A. Times, Fox News reports, CNN, MSNBC clips, no sugar diaries (or here's the shorter version), John Oliver clips, Jamie Oliver (no relation) TED Talks, other TED Talks, more TED talks, Lengthy University of California lectures, 60 Minutes segments, BBC News clips, American Journal of Clinical Nutrition studies, and other scientific studies about the dangers of sugar. That last link takes you to PubMed's website where a search for "sugar intake" articles published in the last ten years gives you over 13,000 results. I'm sure some of those are all about how sugar is the miracle drug that will cure cancer, but I'm equally sure the pro-sugar studies were done by scientists who benefited from the sugar industry (I'm talking about you, Dr. Pepper!!!). That reminds me, you really need to watch that John Oliver clip:

John Oliver #ShowUsYourPeanuts

So, sugar is bad and the government doesn't seem to be in a big rush to regulate it. It falls to us to rid ourselves of our sugar addiction. This can be extremely difficult, if not impossible, for some people though. And I'm not talking about those who are genetically predisposed to having a sweet tooth either. I'm talking about tubies. When I first got my feeding tube, my doctor prescribed a regimen of 6-7 Ensure Pluses a day. That's 132-154 grams (nearly a cup) of sugar every day. This is over 4 times the daily amount of sugar the American Heart Association recommends. Understandably, formulas can cause a sugar rush (glycemic spike) and resultant comedown after consumption.

Why do formula companies pack so much sugar into their products? I think there are a lot of different reasons for this. The main reasons, in my opinion, are taste, and because sugar packs a lot of calories and companies still operate under the belief that, "a calorie is a calorie." If a nutritionist mandates that patients consume 2,000 calories a day, and the food has to be liquid and not exceed a certain volume, the easiest (cheapest) way to pack in those calories is by adding corn syrup. Sure, Ensure has a lot of other nutrients ("26 Vitamins and Minerals!"), but from my standpoint, it's like they mixed a can of corn syrup with a Centrum Multi-Vitamin and slapped a label on it.

There are formulas out there for tubies with diabetes. Two of the main examples are Glucerna and Boost Glucose Control. These products have a higher percentage of fats with lower amounts of carbohydrates (only 4-6 grams of sugar in each, compared with 22 grams in Ensure Plus). The carbs have a lower glycemic index, so the sugar is converted more slowly before being released into the bloodstream. Plus, the diabetic formulas have more fiber to further slow the breakdown of carbs.

The drawbacks to diabetic formulas? For one thing, it's still added sugar. I have yet to find a commercial formula out there with no added sugar. This is because, if formula companies want to make any money off their product, they can't just market to tubies specifically, so they have to make a shake that tastes good. Therefore, if you're stuck on formula, but want to go on a sugar-free diet, you're out of luck. Another drawback to diabetic formulas is they're still not real food. Here's the list of ingredients for Boost Glucose Control:

DOES NOT CONTAIN: FOOD

So, specialized diabetic formulas have a higher percentage of fats with lower amounts of carbohydrates. The carbohydrates in diabetic formulas have a lower glycemic index so that the sugars are converted more slowly before they're released into the bloodstream. These formulas also contain more fiber, to slow the breakdown of carbohydrates even more. - See more at: http://oralcancerfoundation.org/nutrition/liquid-tube-nutrition.php#sthash.sWQaFVTq.dpuf

So, specialized diabetic formulas have a higher percentage of fats with lower amounts of carbohydrates. The carbohydrates in diabetic formulas have a lower glycemic index so that the sugars are converted more slowly before they're released into the bloodstream. These formulas also contain more fiber, to slow the breakdown of carbohydrates even more. - See more at: http://oralcancerfoundation.org/nutrition/liquid-tube-nutrition.php#sthash.sWQaFVTq.dpuf

Yep, whole lotta big words in there. Makes you appreciate commercially available blended meals like Real Food Blends even more. Hopefully, tubies are a large enough market that they can turn a profit!! Another drawback to diabetic formulas is that they're just that: diabetic formulas. If you don't have diabetes but would like to control your sugar intake, it can be harder to get insurance to cover the costs of all those cans of Glucerna you need every day.

If you're a tubie--or the caregiver of a tubie--and you're unable to switch from formula to blending your meals for medical reasons, then I am really sorry you have to stay on these commercial products with unrecognizable ingredients and too much sugar. I sincerely hope doctors, nutritionists, and pharmaceutical companies wake up to the fact that sugar is poison and fat isn't nearly as bad as everyone thought it was.

In light of all that we've read about the dangers of sugar, Betsy and I are working really hard to reduce, or even eliminate, sugar from our diet. In my case, going without sugar is simple. I'm completely off formula so the only sugar I get is what I put in my blends. Sometimes I have a gluten-free dessert or a dark chocolate bar, but it's not something I crave. I've already found foods, like nut butters or avocados, that are high in fat and give me the calories I need. If I want to stop added sugar altogether, the only thing I need to cut out is sunflower butter because my grocery store (Earth Fare) adds a teaspoon of sugar to it.

For Betsy and Grace, on the other hand, cutting out sugar--or even reducing it--is more challenging. Betsy and Grace don't eat gluten-free. Both of the main products with gluten--bread and pasta--have added sugar. All cereal at the grocery store has added sugar. Lunch meats have sugar.  Sugar is added to just about everything except unprocessed fresh vegetables and meat. Even more than Grace, Betsy can be a finicky eater. There are certain things she eats in the morning and all that stuff has added sugar. On one hand, she's fortunate she doesn't need to eat through a feeding tube, so she's not forced to drink multiple Ensures every day. I don't know how she'd do drinking one or more Ensures a day; probably better than I would. On the other hand, when I get a craving for a doughnut, there's nothing I can do about it. Putting a doughnut through my tube doesn't do anything for me. But Betsy can run to Dunkin Donuts anytime to satisfy her craving. We've made sugar so easy and cheap to buy that we might all need feeding tubes unless you can exercise a little bit of self-control.

So, put down that doughnut right now!!!

Not you, Homer. You can eat all the doughnuts you want.