This week Jill talks about sugar substitutes, artificial sweeteners, and why they may help you with your kidney stone prevention.
Jeff Sarris: Welcome back to the Kidney Stone Diet podcast, the show about reducing your kidney stone risk and living your best life. I’m your host and fellow student who’s laughing because Jill’s dancing, Jeff Sarris.
Jill Harris: And I’m Jill Harris, your kidney stone prevention nurse. Oh, Jeff.
Jeff Sarris: You just always gotta have fun with it, you know?
Jill Harris: I do. I like to have a little bit of fun because–and I’ve had patients say why she laughing and stuff, we’re talking about pain and kidney stones–you know what, from somebody has been really sick, too, it’s like, if you don’t have a sense of humor about life and all the crap that goes down, you’ve got to try your best. Because when you’re feeling good, really go with that day. You never know what the next day is going to bring, right, especially with stone formers.
Jeff Sarris: Yeah, for sure. You’ve definitely experienced the rough times, for sure, with cancer and everything. So you know to cherish the best days, always.
Jill Harris: I really do. When my body’s feeling extra good–because there are some side effects from my surgery, so there are days that aren’t so great–but when I’m feeling like all my energy and all that man, I have to say, I appreciate that my feet move, that my hands can grab, that my eyes can see, that my hair curls, that I can move from place a to b, all of that. Before I got sick, I was just always a strong girl, right? I was lifting and moving and walking and running and doing all my things. And I I was grateful, but I don’t really think I appreciated it until I was laid up in a bed for a few years. So, it really taught me like when I was able to go back into the gym after all my chemo and surgeries, and all the things I was through, you know, I started with like 5 pound bicep curls. Now, I can do 25 pound bicep curls and I’m only five foot two, and 120 pounds. So you know, that’s a lot for a little girl.
Jeff Sarris: Yeah, that’s no joke, that is a serious amount!
Jill Harris: Yeah, for a little person like me! I remember when I was just starting back, there were a couple times where I went back to the gym for the first time I really had to make sure I didn’t cry right there on the gym floor, you know, because I was just like, “oh my god, I’m so weak.” I identify with feeling strong. It makes me happy. It makes me feel grounded. It makes me feel just strong, right? So, if you’re going to the gym, and you’re lifting weights, and all that stuff, and you do your walks, and all the things–a nice side effect is is keeping trim–that’s nice, but I really dig on feeling strong.
And then when I got sick and I felt so weak–I’ll tell you right now that nothing makes me happier than feeling strong. So it took me, I don’t know, almost two years in the gym to get–and that’s another thing! People think “Ahh, I’ve been going to the gym for four weeks and what the hell? Nothing’s going on!” You think it takes 4 weeks? Especially when you’re almost 60 years old?! It takes years to build muscles. That’s just a side note from your personal trainer/nurse Jill. Okay, that’s a side note, people. It takes years. What does SELF magazine say? it’s January 1, get these biceps by February 14. What?! That’s going to take years, ok?! And it’s a lot of diet, too. There’s so much to talk about. We’ve got to do some, like, body stuff and talk about nutrition and exercise and all that. We’ll do those podcasts, too.
Jeff Sarris: Absolutely. I think we’re gonna do some videos, too, at some point.
Jill Harris: Yeah, we should do some videos. But I’m just saying, I remember it took so long to build any kind of strength back up. Jeff, what are we talking about?
Jeff Sarris: No, this is what we’re talking about! About being happy, and savoring the moments, really. That’s where this all came from.
Jill Harris: Be grateful, right, that your body moves and that it does feel stronger! All of that! So, like today after we’re done shooting all our podcasts, I am so happy to be going to the gym. Today’s a chest day and that’s what I’m doing. I just love it because I get to do it, people. You get to do it. Look at it that way!
Jeff Sarris: Yeah, so we’re gonna transition into our kidney stone topic today, but we’re not going to do a listener question this week. We are changing it up and we were going to talk about sweeteners because that is a frequently asked question. And, just in general, sugar is a part of the Kidney Stone Diet that we look at.
Jill Harris: Yes, and people are not going to like what I have to say. We batch a lot of these podcasts, you know, we do three or four of them each time we shoot, and so I’m like I really do want to talk about sweeteners. I don’t know what I’m going to talk about, but I do want to talk. I mean I ad lib all the time, but this one I really haven’t got my mind around. I’ve talked about it enough, so that it should be okay–
Jeff Sarris: Yeah, just to remind people who might be new, you’re doing this all day, every day with patients on live calls, on private calls, on group calls, on Facebook. Like, this is what you live and breathe, 24 hours a day. There really isn’t a question you’re not really prepared to answer. You’re ready to go as it is!
Jill Harris: And I’ve been doing it for 22 years now, so yeah, you know.
Jeff Sarris: It’s just like the muscles! This is your muscle in this space, as a nurse, that you’ve built up over decades.
Pay Attention to Your Added Sugar Intake
Jill Harris: Totally! All right, so sweeteners. Part of the Kidney Stone Diet is to pay attention to how much added sugar you’re allowed each day. Added sugar; think candy bars, not apples. Okay, now men get 37.5 but I give them the extra half and just say 38. Nobody likes decimals. And women get 25 grams of added sugar. Okay, so the reason we want–well, forget about kidney stone people. Heart people, diabetes, everybody: we shouldn’t be eating all the added sugar we’re eating, okay? We should not. Our kids should not. It’s one of the leading causes of obesity is all this added sugar. Added sugar just means you’re eating a lot of junk, okay?
There’s a reason we want you to pay attention to your added sugar allotment. It’s because added sugar does two things and we do have a video already on this, but I want to–in case this is the first time you’ve ever been to the podcast–I want to remind you that too much added sugar over those goals can take calcium out of your bone and dump it into your urine. So sugar will cause hypercalciuria. “Hyper” meaning too much, “cal” calcium, “urea” urine. Too much calcium in your urine. Sugar can do that. Too much added sugar can lead to, well, kidney stones and bone loss, okay? So that’s the problem.
Also, many people don’t know that too much added sugar can also decrease your urine output. We know that with salt. We have too much salt and we get all puffy. You feel bloated, your rings don’t fit, your dungarees don’t fit. Yeah, I said dungarees. I’m that old. And so sugar does the same thing. We also blow up with sugar. So, it will decrease urine output and also increase your weight most of the time. I know there’s a few skinny minis out there where it doesn’t bother you. God bless, but it does bother most people, okay? And it increases your risk for heart disease and diabetes and everything.
You Don’t Have to Give Up Sweeteners
So I’m a big advocate, as you can imagine, to lower your added sugar. This does not mean we want you to eat 15 pieces of fruit all day. Because people will say “she said no added sugar, or watch our added sugar, but honey, get me a bushel of apples! I’m gonna eat it right now!” Don’t do that either. Eat three to four pieces of fruit a day. If you’re diabetic, you may want lower. Listen to what your doctor says. So here’s what you might not like what I have to say: sweeteners. There’s no great research that says you’re gonna die from eating sweeteners, there’s just not. Now, does that mean I want you taking stevia or swerve and just eating bushels of it?
I know it don’t come in bushels, but I said apple bushels. I’m going with sweetener bushels. Whatever! I just mean in big amounts! That doesn’t mean I want you to put 10 pink packets of Sweet ‘N Low into your coffee. Most of you will say, “I know, Jill. Duh!” But people tend to extrapolate over what I say, you know. They’ll make up their own thing, so I always like to be extra clear. People are going to say, “Are you kidding me? She’s advocating sweetener!” I’m not advocating it. I’m not advocating it, but I am saying listen to my side of this.
If you’re coming to me–because a lot of people come to me just for weight loss and guess what I tell them to do: the Kidney Stone Diet. Again, it’s lowering sugar. It’s lowering salt. It’s getting fluids. It’s getting enough calcium to feed your skeleton and lower your oxalate and eat normal amounts of meat protein if you eat meat, okay? It’s a healthy diet. One everyone should follow. Sweeteners, though. If I have somebody come to me and they’re 350 pounds, and I tell them, “Today is what, Sally? Tuesday? Okay, tomorrow, Wednesday, you have to go down to 25 grams of added sugar, and that’s what you have to do.” Sally’s gonna hang up the phone. Well, first Sally’s gonna say, “I’d like a refund.” That’s what Sally’s gonna say first, and then she’s gonna hang up the phone, she’s like, “There’s no way on god’s green earth that I can be compliant with that. I eat five candy bars a day. Now I’m supposed to go to zero? That’s never going to happen.”
I think my way of doing things sometimes is a little bit different because I’m thinking about a person, not just their disease, not just their weight. I’m thinking about the emotional aspect of what’s going on with them. You can’t ask people to make a lifestyle change overnight. You can’t tell somebody that’s telling you, “I’m a sugar addict” no, too bad, so sad. Because my job is to be a nurse and to help somebody feel better. And for me, personally, that’s also emotionally. So, we have to learn how to motivate patients so they can get to their goal. We can’t just throw goals at them without help.
Why do you think I’m a nurse working and making my own business here with Jeff? Why do you think that is? Because I can spend as much time as I want helping. You can’t do that in a normal hospital setting. Ask any nurse or doctor. I have a lot of friends in the healthcare field and it’s hard for them. When I worked in that setting, there’s no time to actually help people. What I care about when I’m helping–and people are like, “oh, here she goes being dramatic”–I’m telling you, this is why I get up every day. I’m thinking about the person I’m working with. If they’re telling me they’re a sugar addict, and they say, “I can’t not have soda all day.” I’m gonna say, “okay, well, you can lower your added sugar by just drinking, instead of ten, 7. Let’s start there.” “Oh, I can do that. My doctor told me to go to zero. I’m not going to be able to do that.”
So I’m going to say, “well, let’s wean yourself off.” All right, so she comes back to me three months later, she’s lost 47 pounds, she feels great. She’s down now to 2 sodas a day on her own. She’s done this with my help in the beginning, but she’s worked her tush-a-lush off, literally. And now she’s like, “Okay, so my doctor wants me to get off all sugar. Added, too.” I’m like, “Well, as a nurse, I don’t override a doctor’s orders, but I’d like you to go back to your doctor and say, ‘Listen, I’m wondering, can I go to Diet Coke now, instead of just going cold turkey, because I cannot be compliant with that long term. And I’m so afraid, dear doctor, that if I can’t be compliant with it, I’m going to go back to my old habits.”
So, what I always tell patients is, you give me something, and I’m going to give you something, and in this case, it’s sweeteners. I’ve dealt with this my whole career: how can you be telling people it’s okay to have sweeteners? Because there’s absolutely no long-term proof. The sugar people made up a lot of those studies. Tell them sweeteners will cause cancer because we don’t want people to stop eating sugar. I’m putting that in my own words, but you get what I’m saying. A lot of the sugar funding goes to those sweetener research things now. Now, they’re chemicals. I’m not a proponent of putting chemicals into your body.
And also sweeteners can cause a lot of gastric intestinal issues: diarrhea, a lot of gas, stomach aches. Many of you won’t be able to tolerate them, okay? So I’m not saying you need to do them. I’m saying if you do want to do them, you can. They’re not going to increase your stone risk. Here’s some of the things that I think about, though. Sweeteners tend to be very sweet; up to 600 times sweeter than regular sugar. So, it will always be difficult to get rid of your cravings. What I would do is ask people to strive for always lowering it; getting it to the least amount you need to stay happy, but you got to stay happy in order to stay compliant. If I looked at a bunch of food on my plate every day, and I was like, “This is disgusting. I wouldn’t feed Luke this.”
I’m not going to do that for the rest of my life. If somebody’s telling me, “Look, Jill. I can keep this 207 pounds off. I can do it, but I need 2 Diet Cokes a day.” By golly, they’re getting their two Diet Cokes. They’re getting it. So I will give them something if they give me something, and what they gave me was no more 10 Cokes every day. No more 17 Diet Cokes every day. They’re having 2 Diet Cokes every day. Have it! Guess what? It counts towards your total water intake; your total fluid intake, too, because you’re not overdoing it. It’s only two. So, I guess, people, what I’m saying before you write me the unhappy comments about it, listen to what I’m saying.
Listen to how I look at this. I’m looking at the bigger picture for each specific person I talk to. If someone came to me and needed to lose weight and said they didn’t want to use sweeteners, we would do it that way. I’ve got to work with what I’m getting to get the compliance that I want. I’ve got to work with a person and do it in a way that they can be compliant long-term, and that they can make these changes day-by-day without overwhelming them into “I quit this” land. So, that’s what we’re doing here. I’m not saying sweeteners are healthy for you, but I’m also saying they’re not going to kill you.
I’m also saying I would like you to get them down to a doable amount every day for you. The less, the better, of course, but let me tell you what. I start my day with added sugar with my creamer. I use a coconut milk vanilla creamer. It makes me so happy that I am willing to give up any other added sugar for the rest of my day in order to have that. So, sometimes, too, you may be like, “Look, I’m giving up a lot, but this really makes me happy every day” like my vanilla creamer does. I’m keeping it. I’m well within my 25 grams of added sugar. You could have it! So, if you want to have something that has added sugar and it’s less than 25 grams every day, have it! You don’t have to eat like a nun. You don’t have to never have added sugar again. And you don’t have to give up sweeteners, so I hope that was helpful.
Jeff Sarris: Yeah, definitely! I think that is just a big question in general because when you look at sweeteners, they feel different. it just feels like a question mark. It feels like something that needs to be addressed because they are different substances. We look at them differently, like a Diet Coke versus regular Coke, for example.
Jill Harris: A hundred percent, but here’s how I look at it. So, yes, that little point is a big point you’re making, Jeff. It’s chemicals, there’s no doubt about that, but my bigger picture is is this person going to kill herself from the cardiovascular disease, the one kidney, and she’s a diabetic, and she’s 502 pounds? Or am I going to worry about a little stevia? Am I going to worry about a little whatever she’s using? No, I’m not going to worry about that artificial sweetener, so maybe I said it better. Does that make better sense?
Jeff Sarris: Yeah, that makes perfect sense!
Jill Harris: Yeah? Okay, it’s a weird topic because people will be like, “How can she be promoting it?” I’m not promoting it. I’m saying it’s okay for kidney stone formation, first of all. Is it something I want everyone to use? No, but in my meal plan service I actually will use– sugar can be tough for me because of my bowel issues, because of my, you know, very little colon, no rectum from my cancer, so too much sugar really wreaks havoc on me–but, for some reason, I can handle a little bit of sweetener. So, some of my meal plans, to lower the added sugar, I will use like sugar-free maple syrup. A bit, a bit, a bit, okay?
But, people, even in the meal plan will say, “Can I use regular sugar?” And with each recipe in the meal plan service, I always put Kidney Stone Diet-safe tips. And I’ll say, “It’s your kitchen. It’s your rules. If you want to add a little real maple syrup here, and it fits in your 25 grams of added sugar, absolutely have it! So, I’m using the maple syrup, the sugar-free, because that makes me happy, and a bip of it. But if you want to use real and it fits in your goals, God bless! Of course you can use it, right? Absolutely!
Jeff Sarris: Yeah, absolutely! And the meal plans–again, we mentioned it last episode–but every day Jill is giving you inspiration for what you can eat and she’s developed some amazing recipes. You can find everything kidneystonediet.com. I have it on the the screen right now, like sort of from the dashboard what you’ll see. But yeah, these are inspiration for you to just figure out how to approach this diet in a way that works for you, and to show you that along with the Kidney Stone Diet-safe tips that Jill mentioned, how versatile it can be. Because it’s not as rigid and regimented as you might expect when you’re thrown all these lists, these oxalate lists–don’t eat this, don’t eat this, don’t eat this. There is a lot you can still eat and should be eating.
Jill Harris: Absolutely! My meal plan will have black beans–”Really, Jill? Oh my god, I’m never buying that meal plan! What are you talking about, black beans? Sweet potatoes…sweet potatoes! Jill’s just lost her mind! She’s drinking again!” Listen, it just comes down to this: I’m known for this, a portion not perfection. You can’t eat five cups of beans no more. You can have a a cup of beans in the whole recipe, though, because you’re only getting a little bip of it. So, again, it’s when people eat the same foods over and over and over again that are super high in oxalate in large quantities with absolutely no calcium.
That’s when they run into a problem. When they get their portions in check–all of our portions, even healthy foods, people, should be in check and not eat as much. I know a lot of people come to me, “I thought it was healthy. I ate it all day long because I thought that would just give me more health!” Larger amounts of healthy food don’t mean more health, and kidney stone formers know that better than anybody, unfortunately. It’s so annoying, I know, but we should not be eating food in any amount we want. We need to eat normal amounts of food in the right portion sizes. And again, you know, these popular diets say eat as much of this, you don’t ever eat that again, but eat as much as you want of that. You know, because we want to eat a lot. It’s fun. You know, it’s something to do.
Jeff Sarris: And we want that really, really simple cut and dry: “This is it, don’t do that, and do it forever.” But health isn’t that simple. We’re diverse creatures who need that diversity within our diet, within our lifestyle, and experience.
Jill Harris: Oh, and Jeff, I just love that, too, because that’s why Dr. Coe and I made this diet like with goals in it. Because, I mean, you can’t tell millions and millions of people to eat this one diet, right? That says this thing, not this and this. You should be allowed to eat the foods that make you happy as long as you fit into our Kidney Stone Diet goals, then you can eat whatever lifestyle you want. That’s the beauty of this.
Jeff Sarris: Yeah, absolutely! I think that’s a good place to wrap. So, again, if you want to dive a little deeper, learn more about the Kidney Stone Diet, you can head over to kidneystonediet.com. The link, you’ll see right here in the video, I think right over here. But head on over there, you’ll find the Start Page. You can find the Start Page, which is a great spot to direct you to the oxalate list, to the blog, to the email newsletter, to everything that we have out there that’s absolutely free and just here to help you along on your journey. Then, if you want to dive deeper, we have the meal plans, the prevention course, and you also have the kidney stone prevention group on Facebook, which is very active. Jill’s there every single day answering questions, and it’s just a great community of like-minded, like-experienced individuals. So, definitely check that out. That’ll do it for this week. Thanks again for listening and we will see you next time!
Jill Harris: Bye, guys!