Food labels..Solving the mystery with "sugar free"

The food industry is a billion dollar business. We all buy food because everyone needs to eat.  Our decisions are based in part by the packaging. Knowing this companies try to stretch and twist the truth as much as they can so their product appears superior to the consumer.
The food label was put into place to regulate how companies represent the food products. You know to keep it honest. Generally, the food label is on the back of a food product. Some items  have the label on the bag rather than separate pieces like with fruit snacks or fun size candy.
Lets discuss the food label components. Knowing the food label is your ticket to understand what the food product contains. 
  All food labels are titled "Nutrition Facts"immediately below this you will find the serving size. Pay close attention to this as many times the entire package is several servings instead of one.  When you are reading the label you always use the "grams". The percentages on the right hand side is useless information except for "fat". When the fat percentage is 5% or less it is a heart healthy item. So using the fat percentage is a quick way to determine if an item is good for your heart. 
The next item is fat. It will always be labeled "Total Fat". There are two types of fat out there. Saturated fat and Unsaturated fat. Saturated fat is the "bad" kind that causes clogging in the blood vessels and less desirable for this purpose. Unsaturated fat is referred to as the "good fat" that helps prevent clogging. Many people are looking to eat this kind instead of saturated fat to prevent heart disease.  All fats fall into one of these two categories.
Next is "Cholesterol". I don't pay close attention to this because saturated fat causes a larger increase in ones cholesterol blood count than eating cholesterol.  "Sodium" should be watched if you are trying to follow a low sodium diet.
"Total carbohydrate" is the most important thing to watch if you have diabetes. Total carbohydrate is the whole story for carbohydrate. It is made up from dietary fiber, sugars, sugar alcohol, and other carbohydrates.  Carbohydrate is what causes a rise in the blood sugar. So this needs to be watched closely and counted accurately. "Fiber" can generally be subtracted from total carbohydrate. This is because it cannot be broken down. It passes right through the body. "Sugars" comes next. This must be counted every time. Sugar alcohol is generally found in sugar free foods. Half of the sugar alcohol is handled by the liver. The body looks at alcohol as a toxin. The other half contributes to blood sugar. Half of the sugar alcohol can be subtracted. So the carbohydrate you count is the Total carbohydrate less the dietary fiber and half of the sugar alcohol.
Some labels have claims that can be confusing. I think this is done purposely. Some you may have seen is sugar-free, net carbs, or effective carbohydrate.  Sugar -free refers to an item that has less than 5 grams of sugar per serving. This doesn't mean carbohydrate. Also, net carbs or effective carbohydrate. I have seen these used often. Let me explain. Both net carbohydrate and effective carbohydrate are "made-up terms. The food label on the back is your most accurate source of information. It is regulated by law so it can't be "made-up".
When an item is labeled sugar free it isn't always carbohydrate free.

  Examples:

***Cookies that are labeled "sugar free". If they are made with flour it is impossible for them to be carbohydrate free. They are sugar free because they are sweetened with sugar alcohol.

***Sugar free pudding actually has carbohydrate in the powder and then milk is added to make the pudding. By adding milk you add more carbohydrate.

***Sugar-free gelatin can be sugar free. There is no flour in that and milk is not used.

***Sugar free candy such as chocolate bunnies often have more carbohydrate when compared to the regular. Taste is generally not as desirable. Cost is generally much higher as well.

Try, Try and Try again: The stages of change

      Have you ever made a goal with all the best intentions but didn't succeed?  Or maybe you make the same new years resolutions over and over each year hoping this will be the time you finally achieve it. If this sounds familiar you are not alone. Millions of people fail at making the changes they hope to. And we tend to fail over and over. Just think about it. Do you know anyone who has quit smoking several times only to start up again later or the person who has lost 20 pounds 3 times.

 What makes us fall short when we have the best intentions?  Maybe its luck, stress, etc. The reasons can be endless. 

Let us consider the stages of change model developed in the late 1970s and early 1980s by James Prochaska and Carlo DiClemete at the University of Rhode Island

The stages of change describe what the mind/body goes through as one considers changing a behavior.

 Stage 1: Pre-contemplation: This stage describes a person who doesn't consider themselves to have a problem. They defend their bad habits, defensively if needed.  

Stage 2:  Contemplation:  This stage involves acknowledging that there is a problem.  But not yet ready to weigh the pros and cons. Not really sure if you want to make the change.

Stage 3: Preparation/ Determination: This stage involves getting ready to change. Generally, a commitment to change has been made. Often times gathering information and possibly making small changes are included as well.

Stage 4: Action/Will power: Changing behavior. This stage includes the actual change. The person believes they have the ability to change. Sometimes it is the shortest of all the stages. The most progress is made here.

Stage 5: Maintenance:  Maintaining the behavior change. A person successfully avoids temptations to return to the bad habit. They are able to anticipate situations where a relapse could occur and plan accordingly.

Stage 6: Relapse: Returning to old behaviors and abandoning the new changes. Many times this stage is filled with feelings of failure.

Did you see yourself in there somewhere?  The truth is most people actually go through the cycle several times before achieving a stable life style change. The case and point. Don't give up. If you fail at changing a behavior...Sit down with a pencil and paper. Make a list of what you did wrong and what you can do different next time to be successful. 

For example, lets say a person is trying to lose weight but cannot seem to stop snacking on chocolate treats between meals.  The first thing I discuss with patients is what can we substitute for a snack? 

A short list may include: sugar free gum, vegetables with fat free dip, light butter popcorn, dill pickles, sugar free beverage.

Next we consider what can be done instead of eating. Activities may include: reading, walking, getting a drink of ice water, painting, word search, calling a friend. It needs to be something you enjoy. It needs to get your attention.

These are some tips patients have found useful when trying to make a change. Whether you are trying to lose weight, quit smoking or just exercise more regularly, we all go through the same stages. Knowing the stages helps us better identify obstacles keeping us from our goal.  Good Luck!